Adverse Decision character of a former service member’s discharge competency of a claimant or beneficiary to manage his/her financial affairs, and reduction or discontinuation of a VA benefit. Follow the guidelines in M21-1, Part I, 2.B.1 and 2.D.1.a, to determine whether VA must issue notice before taking an adverse action, or may issue notice at the same time it takes the adverse action (also known as “contemporaneous notice”). Reference: For more information about due process, see M21-1, Part I, 2.A.1. b. Notifying a Claimant of a Decision to Grant and/or Deny Entitlement to Benefits After making a decision on a claim, VA must notify the claimant of the decision VA made, and the claimant’s appellate rights, and right to procedural due process a hearing, and representation. The table below shows additional information VA must include in its decision notice. If VA ... Then VA must ... grants entitlement to a benefit notify the claimant of the monthly rate of payment the effective dates of entitlement and payment the amount of any benefits VA is withholding and the reason for the withholding, and information about any additional benefits to which the claimant may be entitled. denies entitlement to a benefit provide the claimant with the reason(s) for the decision, and a summary of the evidence it considered in determining entitlement does not exist. Important: As a result of , 21 Vet.App. 130, 133 (2007), if VA decides a claim but fails to notify the claimant of the decision, the claim remains open, legally, regardless of whether or not the regional office (RO) clears the
processed through ADL, PCGL decision notices do not need to include dependency solicitation language when a dependency decision or dependency development is at issue in the decision notice. The ADL dependency development language should never be used with a 130 EP as any required development should happen up front. Note: Dependency solicitation language is not required in decision notices when a dependency decision or dependency development is at issue as part of the decision notice. increased pension based on unreimbursed medical expenses VA Form 21-8416, Medical Expense Report M21-1, Part V, Subpart iii, 1.G.2 Note: ADLs provide the Veteran additional benefits information by notifying the Veteran of any applicable forms, and referring the Veteran to the web site or phone number where they can receive additional information. i. Other Issues to Consider The table below lists issues VSRs commonly face when processing an award or denial of benefits, and preparing a decision notice, and references to additional information about the issues. Issue Reference elections between benefits waivers of VA benefits recoupment of separation pay, and adjustments based on receipt of military retired pay. M21-1, Part III, Subpart v, 4.A.4 apportionments M21-1, Part III, Subpart v, 3.A.1.b awards to incompetent beneficiaries through a fiduciary or guardian M21-1, Part III, Subpart v, 9 adjustments or reductions due to hospitalization M21-1, Part III, Subpart v, 6.B.1.a
error was not in the decision but in the communication of that decision, and claimant did not meet the statutory requirements for this benefit to begin with. m. Restrictions Placed on the Disclosure of Draft Rating Decisions Draft rating decisions and notices are not intended to be final and binding on VA and should not be shared or transmitted by VSOs to their clients (beneficiaries). Important: ROs should exert sufficient diligence to ensure that decisions and notices that have not yet been finalized are not provided to claimants. References: For more information on finality of decisions, see , and VSO review of new rating decisions, see M21-1, Part I, 3.B.3. 2. Special Requirements for Visually Impaired Veterans Change Date June 1, 2015 a. Preparing Decision Notices for Visually Impaired Veterans Use 14-point font when preparing a decision notice for a Veteran with visual impairment that is at least 70 percent disabling. After the notice is mailed, a member of the Public Contact Team must make a minimum of three attempts to contact the Veteran by telephone to explain the substance of the decision. The Public Contact Team must allow sufficient time for the decision notice to reach the Veteran before attempting to contact him/her, and document successful telephone contact on VA Form 27-0820, Report of General Information, or unsuccessful attempts to contact the Veteran as a contact note in Modern Awards Processing - Development (MAP-D) or VBMS. Important: In order to readily identify the claims folder and corporate record of a visually impaired Veteran, ROs must reverse file VA Form 21-0178, Visually Impaired Veteran, in the center section of the Veteran’s paper claims folder, if one exists, and add the Blind Veteran flash to the Veteran’s record in Share. Reference: For information about adding a flash to a Veteran’s record, see the .
c. Paragraphs Explaining the Veteran’s Responsibilities and Information Regarding Direct Deposit The page below contains paragraphs that instruct the Veteran to notify VA if he/she loses or gains a dependent, or there is a change in his/her income or the income of his/her dependent(s) net worth medical expenses, or his/her address or telephone number, and how to set up direct deposit. d. Paragraphs About Additional Benefits, the Appeal Process, and eBenefits The page below contains paragraphs that inform the Veteran about additional benefits how to appeal VA’s decision, and about eBenefits. e. Closing Paragraphs of the Decision Notice The page below represents the last page of the sample decision notice, which informs the Veteran how to contact VA informs the Veteran that VA has no record he/she selected a representative (if applicable), and lists the enclosures that accompany the decision notice. 6. Exhibit 2: Sample Decision Notice – Denial of Entitlement to Veterans Pension Introduction This exhibit contains a sample decision notice regarding a denied claim for Veterans Pension, including paragraphs explaining what VA decided and additional actions the Veteran may take paragraphs explaining eBenefits, and closing paragraphs of the decision notice.