Section C. Decision Review Officer (DRO) Review Process Overview In This Section This section contains the following topics: Topic Topic Name 1 Overview of the DRO Review Process 2 DRO Duties and Responsibilities 3 DRO Jurisdiction and Authority 4 De Novo Review 5 Informal Conferences 6 Making the Decision 7 Exhibit 1: Informal Conference Report 8 Exhibit 2: Appeals Satisfaction Notice 1. Overview of the DRO Review Process Change Date June 5, 2015 a. DRO Review Process The table below describes the stages of the Decision Review Officer (DRO) review process. Stage Description 1 The appellant elects the DRO review process. 2 The DRO conducts a de novo review of the prior decision. Reference: For more information on de novo review, see M21-1, Part I, 5.C.4. 3 Based on a review of the evidence of record, is there enough evidence to make a new decision? If yes, the DRO makes a new decision. If no, the DRO pursues additional evidence considered necessary to resolve the claim, and/or conducts an informal conference to obtain additional evidence from the appellant and his/her representative.
him/herself. Important: The DRO must review the record to ensure that any issues that are inextricably intertwined with the issue(s) on appeal are addressed. Reference: For more information on the definition of inextricably intertwined, see M21-1, Part I, 5.A.1.g. b. DRO Jurisdiction Over Downstream Issues When a DRO issues a favorable decision on an appealed issue, the DRO assumes jurisdiction over and decides any downstream issues, including disability evaluation effective date, and any inferred or ancillary issues that are encompassed by that favorable decision. Important: The de novo review of a downstream issue must be conducted by a DRO who did not render the initial decision on the downstream issue. References: For more information on the definition of downstream issues, see M21-1, Part I, 5.A.1.f when a decision on a downstream issue confers new appeal rights, see Part I, 5.C.3.c considering subordinate or ancillary issues, see M21-1, Part III, Subpart iv, 6.B.2 ancillary benefits, see M21-1, Part IX, Subpart i handling new issues raised on a substantive appeal, see M21-1, Part I, 5.E.3, and review of benefit claims decisions, see . c. When a Decision on a Downstream Issue Confers New Appeal Rights Use the table below to determine whether a decision made on a downstream issue confers new appeal rights. If the appeal is for… And… Then service connection (SC) for a disability the DRO renders a full grant Note: When the underlying appeal action is contesting SC, there are no partial grants. the grant of SC satisfies the underlying appeal action, and the evaluation and effective date are separately appealable issues. Note: A new, timely
a. Who May Receive a De Novo Review An appellant has a right to de novo review of his/her claim if he/she files a timely NOD with the decision on a benefit claim, and either requests de novo review at the time of submission of NOD, or requests de novo review within 60 days of the date VA sends the notice of the right to de novo review. Notes: The 60-day time limit cannot be extended. An appellant cannot have more than one de novo review of the issue on appeal. References: For more information on de novo review, see , and M21-1, Part I, 5.A.1.i definition of appellant, see M21-1, Part I, 5.A.1.a DRO jurisdiction and authority, see M21-1, Part I, 5.C.3, and downstream issues, see M21-1, Part I, 5.A.1.f, and M21-1, Part I, 5.C.3. b. Who Conducts a De Novo Review At VA discretion, the de novo review is conducted by the VSCM PMCM, or DRO. Note: Only an individual who did not participate in the original decision being appealed may conduct the de novo review. References: For more information on who conducts a de novo review, see DRO jurisdiction and authority, see M21-1, Part I, 5.C.3 acting DROs, see M21-1, Part I, 5.C.2.e, and visiting DROs, see M21-1, Part I, 5.C.3.e. c. What May Be Reviewed During a De Novo Review Review only those decisions that have not become final by appellate decision, or failure to timely appeal. The review will encompass only the decision with which the appellant has expressed disagreement in the NOD.
d. De Novo Review of Contested Claims The DRO, VSCM designee, or PMCM designee conducts one hearing or de novo review for each of the different appellants in contested claims. In some cases, the appellant requests a hearing or de novo review but does not live in the same jurisdiction as the station having jurisdiction over the appeal. The table below describes the process for reviewing contested claims when the appellant does not live in the same jurisdiction as the station having jurisdiction over the appeal. Stage Who Is Responsible Description 1 DRO/VSCM/PMCM at RO closest to the appellant’s residence Holds a hearing prepares a transcript uploads the transcript into the appropriate electronic claims folder (eFolder), and provides notification to the DRO/VSCM/PMCM at the station with jurisdiction over the appeal once the transcript is uploaded. Reference: For more information on uploading documents into the eFolder, see the . 2 DRO/VSCM/PMCM with jurisdiction over the appeal Reviews the transcript, and makes a decision. 5. Informal Conferences Introduction This topic contains information on an informal conference, including the purpose of an informal conference when to schedule and conduct an informal conference requesting, canceling, or rescheduling an informal conference where and how to conduct an informal conference who may attend an informal conference presenting evidence during an informal conference the Informal Conference Report, and handling new issues raised during an informal conference.
Introduction This topic contains information on making the decision, including considering the Informal Conference Report the VSCM’s or PMCM’s responsibility for the quality of the DRO’s decision the decision to award full benefits award partial benefits, and uphold the previous decision implementing the decision, and the appellant withdrawing the NOD. Change Date June 5, 2015 a. The Informal Conference Report Consider the information recorded in the Informal Conference Report when making a new decision. Reference: For a sample of the Informal Conference Report, see M21-1, Part I, 5.C.7. b. VSCM’s or PMCM’s Responsibility for the Quality of the DRO’s Decision The VSCM or PMCM is responsible for the quality of decisions in the Veterans Service Center (VSC). This responsibility extends to ensuring that DROs properly apply all laws, regulations, and instructions to decisions rendered. In some cases, where the VSCM or PMCM disagrees with the substantive decision of a DRO, the VSCM or PMCM may request reconsideration in the decision, or seek an advisory opinion, administrative review, or administrative appeal. Important: The VSCM or PMCM may not direct a change in the DRO decision unless a CUE is cited, and the existing DRO decision would reduce an SC evaluation(s), or sever SC for a disability(ies). References: For more information on requesting advisory opinions, see M21-1, Part III, Subpart vi, 1.A.2 requesting administrative reviews, see M21-1, Part III, Subpart vi, 1.A.3 administrative appeals, see M21-1, Part I, 5.J.2, and preparing a CUE decision, see M21-1, Part III, Subpart iv, 2.B.4.
Example 2: A Veteran files NODs with two decisions. The DRO decides to grant one of the claims, but deny the other. The DRO prepares a decision that will implement the award, and an SOC for the claim that was denied. References: For more information on the definition of partial grant, see M21-1, Part I, 5.A.1.i the Appeals Satisfaction Notice, see M21-1, Part I, 5.C.8.a and sending an SOC, see M21-1, Part I, 5.D. e. Decision to Uphold Previous Decision If the DRO confirms the previous decision, he/she sends an SOC confirming the decision on appeal, and explaining the reasons and bases for the VA decision, and VA Form 9, Appeal to Board of Veterans’ Appeals, to the appellant. Reference: For more information on issuing an SOC, see M21-1, Part I, 5.D.3. f. Implementing the Decision The DRO routes the completed decision to the appropriate activity for implementation. Important: A DRO’s decision is final and binding on all ROs and is not subject to revision on the same factual basis, except by BVA or as provided under . g. Appellant Withdrawing the NOD If an appellant contacts the DRO by telephone to indicate satisfaction with the decision and a desire to withdraw his/her NOD, the DRO must explain VA’s need to obtain written confirmation of the withdrawal, and inform the appellant that an SOC/Supplemental Statement of the Case (SSOC) will be sent if written confirmation is not received in 10 business days. If the DRO does not receive written confirmation within 10 business days, he/she issues an SOC. Note: An appellant and/or his/her representative may withdraw an appeal at any time, subject to the restrictions of . Reference: For more information on withdrawing an NOD, see M21-1, Part I, 5.A.3.
7. Exhibit 1: Informal Conference Report Change Date August 4, 2009 a. Informal Conference Report An example of an Informal Conference Report is below. 8. Exhibit 2: Appeals Satisfaction Notice Change Date September 22, 2014 a. Appeals Satisfaction Notice A sample of the Appeals Satisfaction Notice is below.