If the evidence of record indicates there is a legal bar to benefits, such as a dishonorable discharge, deny the claim on that basis, and do not ask the claimant to complete NA Form 13055, or prepare a memorandum of service record unavailability. Reference: For information on legal bars to benefits, see . d. Handling Negative Replies to PIES Requests Submitted Under Request Code M05 Complete a memorandum of service record unavailability and refer the corresponding claim to the rating activity for a decision based on the evidence of record if a claimant returns a completed NA Form 13055 VA uses information from the form to submit a PIES request under request code M05, and NPRC provides a negative response to the request. Reference: For information on memorandums of service record unavailability, see . 27. Evidence That Supplements or Substitutes for Service Treatment Records (STRs) Introduction This topic contains information about evidence that supplements or substitutes for STRs, including reasons VA does not rely exclusively on STRs to decide claims, and types of evidence VA may use to supplement or as a substitute for STRs. Change Date February 6, 2012 a. Reasons VA Does Not Rely Exclusively on STRs to Decide Claims For reasons that include the following, VA does not rely exclusively on STRs when deciding a Veteran’s claim: the loss of many Veterans’ STRs in a fire at the NPRC in 1973, and the absence of documentation in most STRs of treatment by private health care providers during service or shortly after separation. Reference: For information about service records that the fire at NPRC destroyed, see .
b. Types of Evidence VA May Use To Supplement or as a Substitute for STRs The various types of evidence VA may use to supplement or as a substitute for STRs include but are not limited to statements from service medical personnel certified “buddy” statements or affidavits accident and police reports employment-related examination reports medical evidence from civilian/private hospitals, clinics, and physicians that treated the Veteran during service or shortly after separation letters written during service photographs taken during service pharmacy prescription records, and/or insurance-related examination reports. Continued on next page , Continued (continued) Note: Photocopies of STRs are acceptable for rating purposes if examination of the copies confirms they are genuine and free from alteration. References: For more information on certified statements and affidavits, see , and buddy statements, see . 28. Extracts From Army Surgeon General’s Office (SGO) Records
i. Claims Denied Prior to May 18, 1990, for Which Extracts Might Exist ROs must reopen a previously denied claim and request extracts from SGO records in support of it if, during routine review of a claims folder, an RO discovers a claim VA denied prior to May 18, 1990, and determines extracts from SGO records might exist for the Veteran. Example: A claim from a Veteran who served in the Army during the Korean Conflict, and whose claim for service connection for residuals of back surgery VA denied in 1985. If NPRC ultimately furnishes copies of extracts for the Veteran, follow the steps in the table below. If the extracts ... Then ... contain evidence that supports the claim initiate development (if necessary), or take award action (if entitlement exists). do not contain evidence that supports the claim advise the claimant VA has reviewed his/her claim, and confirmed the prior denial, and clear the appropriate end product. Continued on next page , Continued
j. “Not Found” Entries in Extracts A Not Found entry in the Explanation column of an extract means NPRC was unable to interpret numerical data in the extract. Send a PIES request to NPRC under request code M06 if the entry for a diagnosis in an extract is Not Found the diagnosis is critical in determining a claimant’s entitlement, and NPRC last responded to a VA request for medical records prior to April 1992. If an NPRC response to the request referenced above does not include additional, relevant information, decide the claim based on the evidence of record. Note: Although it is possible NPRC may receive additional information in the future that would enable it to update Not Found entries, this rarely occurs. If and when NPRC does receive such information, it will notify VA. Reference: For more information about PIES, see the . 29. Records of Treatment of a Dependent at a Military Facility Introduction This topic contains information on medical records referring to the treatment of a service member’s dependent at a military facility, including primary purpose for obtaining a dependent’s treatment records migration of a dependent’s treatment records requesting a dependent’s treatment records, and information ROs must provide in a PIES request. Change Date February 6, 2012 a. Primary Purpose for Obtaining a Dependent’s Treatment Records Before granting service connection for a claimed disability, VA must determine whether the disability existed prior to service and, if so, was aggravated beyond its normal progression during service. In order to make this determination, VA may request and review relevant medical records dated prior to a Veteran’s service. These might include records associated with treatment the Veteran received at a military facility as
a service member’s dependent. b. Migration of a Dependent’s Treatment Records Medical records referring to the treatment of a service member’s dependent move with the service member and his/her dependent from duty station to duty station. When the dependent has not received treatment at a military facility for a period of three years, the service member’s service department retires the dependent’s treatment records to NPRC. c. Requesting a Dependent’s Treatment Records Submit requests for the treatment records of a service member’s dependent to NPRC through PIES, by using request code C03 for inpatient treatment records, or C04 for outpatient treatment records. Continued on next page , Continued (continued) Note: In most cases, PIES automatically assigns the correct address code to each request it accepts, based on the request code a user enters. Therefore, the address codes shown below for obtaining dependents’ treatment records are primarily provided for informational purposes: Address code 75 – treatment records from Army and Air Force facilities Address code 13 – treatment records from Navy and Marine Corps facilities. References: For more information about PIES, see the , and PIES address codes, see . d. Information ROs Must Provide in a PIES Request The table below shows the information ROs must provide to NPRC when requesting the treatment records of a service member’s dependent through PIES: If the dependent received treatment as an ... Then the RO must provide NPRC with the ... inpatient year(s) of treatment, and full name of the last facility to treat the dependent. outpatient last year of treatment, and