VA employees access VTA through the Veterans Information Portal (VIP). They must have access to VIP before they can request access to VTA. Requests for access to VTA must go through an employee’s supervisor and/or Information Security Officer (ISO) for approval. Individual “tabs” for MSCs, DRASs, PEBLOs, and PEBs in VTA contain a field where users may leave notes for a variety of reasons. (There is also a field on the PEBLO tab where staff from the Office of Warrior Care Policy (WCP) may leave comments.) In certain situations that are described in this section, users are required to leave a note in VTA. Example: Scenario: An MSC enters into VTA the dates for specific actions he/she took while processing an IDES case. The dates appear to be out of sequence but are, in fact, correct. Result: To avoid confusion, the MSC should add a note in VTA that explains why the dates are out of sequence. Reference: For more information VTA, see the . (Registration is required.) 2. Department of Defense (DoD) Process for Referring Individuals Into the IDES Introduction This contains information about referring individuals into IDES, including DoD process for referring individuals into the IDES, and Service Department Memorandum of Complete and Current STRs. Change Date July 31, 2015 a. DoD Process for Referring Individuals Into the IDES The table below describes DoD’s process for referring individuals into the IDES. Step Action 1 A physician at a military treatment facility (MTF) refers an ill or injured individual to an MEB by
lists additional disabilities on VA Form 21-0819 inform the participant that VA will request an examination for and decide the participant’s entitlement to VA benefits based on the referred and claimed disabilities listed on VA Form 21-0819, and VA must the examination results for referred and claimed disabilities with the participant’s service department. Exception: VA will not examine the types of disabilities listed in M21-1, Part III, Subpart i, 2.D.6.c. lists on VA Form 21-0819, or the participant’s service department refers to VA, a disability for which VA previously granted SC identification of the disability by the participant or his/her service department as a claim for an increased disability rating. expresses concern about VA’s disclosure of information to his/her service department regarding any disability the participant lists on VA Form 21-0819 recommend the participant delay submitting a claim to VA that involves the disability(ies) in question until after the participant exits the IDES. currently has a claim or appeal pending with VA that involves a disability the participant listed on VA Form 21-0819 follow the instructions in M21-1, Part III, Subpart i, 2.D.15. c. Claims for SC for PTSD MSCs must take the actions described in the table below during the initial meeting with an IDES participant if the participant is claiming SC for PTSD, and further development regarding the claimed in-service stressor is required under M21-1, Part IV, Subpart ii, 1.D. If an IDES participant is claiming SC for PTSD on … Then MSCs must provide the participant with, and assist him/her in completing … personal assault during service VA Form 21-0781a, Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault. in-service stressors other than personal assault VA Form 21-0781, Statement in Support of Claim for Service Connection for PTSD. Important: Stressor verification and completion of one of the above forms are not required if the participant was diagnosed with PTSD during service.
5 Undertake development to assist the participant in obtaining any additional evidence that is relevant to his/her case according to the instructions in M21-1, Part III, Subpart iii, Chapters 1 through 4. 6 File down the following documents, unless otherwise noted, in the center section of the claims folder, from bottom to top VA Form 21-0819 (original copy) Section 5103 notice Notice Response (if returned) Service Department Memorandum of Complete and Current STRs STRs any additional medical evidence documents relevant to the establishment of a relationship between the participant and his/her dependent(s), and upload examination request(s) submitted through CAPRI or the Centralized Administrative Accounting Transaction System (CAATS) into the participant’s eFolder. Notes: If an MSC receives an MEB Referral Form in the referral package, the MSC must return the form to the PEBLO that submitted it. The MSC does not make a copy of the form. If VA is processing the participant’s case in VBMS, handle any evidence received during the intial interview according to the instructions in M21-1, Part III, Subpart i, 2.D.3.g. 7 Upload a copy of the participant’s VA Form 21-0819 into his/her eFolder. 8 Provide to the participant’s PEBLO a copy of the completed VA Form 21-0819, and a list of the examinations requested in Step 3 of procedure described in this table. References: For information about Share, see the VBMS, see the requesting examinations for IDES participants, see M21-1, Part III, Subpart i, 2.D.6, and the proper handling of STRs, see M21-1, Part III, Subpart iii, 2.A.3. b. MSC Responsibility to Notify PEBLOs of Claims Involving TBI MSCs must notify an IDES participant’s PEBLO if the participant claimed during the initial meeting with an MSC that he/she suffers from the residuals of traumatic brain injury (TBI), or any mental disorder, and
the eFolder is accessible through Virtual VA or VBMS (whichever applies). MSCs must alter their request for notification, according to the instructions in M21-1, Part III, Subpart i, 2.D.16.b, if the participant is a member of the Reserves or National Guard who is not on active duty. MSCs must select IDES as a priority code when submitting a request for examination to VHA unless one of the following higher-priority codes is applicable Terminal, or FPOW (former prisoner of war). g. Uploading Examination Requests Into the eFolder MSCs must upload examination requests into the IDES participant’s eFolder, as described in the table of instructions below. If ... Then the MSC ... VHA will conduct the examination submits the examination request through CAPRI copy and pastes the examination request in a Word document saves the document as a Portable Document Format (PDF) file, and uploads the PDF into VBMS. a contract examiner will conduct the examination submits the examination request through CAATS clicks File, then Print, from within the exam request selects the Send to OneNote option from printer options clicks Print (this will send the request to OneNote) from OneNote, saves document as a PDF, and uploads the PDF into VBMS. Note: If Adobe Acrobat Pro is available, then print the request as a PDF instead of using Microsoft OneNote. h. Tracking Examination Requests After an MSC requests all the examinations an IDES participant requires, he/she must make updates on the MSC tab in VTA by entering the date the MSC submitted the request(s) for examination in the MEDICAL EVALUATION START DATE field, and selecting the entity (VAMC, MTF, or QTC/Contract Provider) responsible for completing the SHA DBQ in the EXAM PROVIDER field.
k. Failure of an IDES Participant to Report for Examination The below describes the actions MSCs should take when an IDES participant fails to report for an examination without good cause. If the participant failed to report for examination of a ... Then MSCs should ... referred disability work with the participant’s PEBLO to determine whether it is more appropriate to reschedule the examination, or disenroll the participant from the IDES. Note: VA has no authority to disenroll a participant from the IDES. disability other than a referred disability consider the circumstances of each case and use own discretion to decide whether examinations for claimed conditions should be rescheduled. If an examination is rescheduled for a referred disability, then MSCs should reschedule the examination(s) for claimed disabilities as well. Important: MSCs must enter a note in VTA stating a new examination has been requested due to the participant missing the original appointment. Do not change the PREPARE CLAIM START DATE or MEDICAL EVALUATION START DATE in VTA. Exception: If the purpose of the missed examination was to evaluate a mental disorder, MSCs should consider rescheduling the examination, especially if there is any indication the participant may have simply forgotten about it. Reference: For more information regarding failure to report for examination with good cause, see M21-1, Part III, Subpart iv, 8.E. l. Additional Evidence MSCs Receive After Sending the Claims Folder to the Scanning Vendor If additional evidence pertaining to an IDES participant’s case is received after sending the paper claims folder to the scanning vendor, MSCs should handle the evidence in accordance with M21-1, Part III, Subpart i, 2.D.3.g.
Step Action 1 Attempt to contact the participant by telephone or e-mail to obtain a current address. 2 Was the attempt to obtain a current address from the participant successful? If yes, resend the letter to the new address, and proceed no further. If no, proceed to the next step. 3 Attempt to obtain the participant’s current address from his/her next of kin. 4 Was the attempt to obtain a current address from the participant’s next of kin successful? If yes, resend the letter to the new address, and proceed no further. If no, proceed to the next step 5 Resend the letter to the participant’s next of kin. d. Processing Notice That an IDES Participant Has Accepted a PEB Decision That He/She Is Unfit for Duty An IDES participant may appeal a PEB’s decision that he/she is unfit for duty. Once a participant accepts a PEB decision that he/she is unfit for duty, the participant’s PEBLO is responsible for notifying the participant’s MSC. Note: Sometimes, PEBLOs concurrently provide MSCs with a copy of the participant’s PEB decision separation/retirement orders, and/or DD Form 214, Certificate of Release or Discharge from Active Duty. After an MSC receives notification that a participant has accepted a PEB decision, MSCs and DRASs must follow the steps in the table below. Exception: The instructions in the below apply only to participants who were on active duty when their service department referred them into the IDES. Reference: For more information about handling IDES cases involving members of the Reserves or National Guard, see M21-1, Part III, Subpart i, 2.D.16. Step Description 1 The MSC schedules and holds an exit interview with the participant.
BDD/Quick Start Claim Within three business days of receipt of the MSC’s request, the RO must report to the MSC whether it routed the participant’s claim to rating activity for rating action, or transferred the participant’s claims folder to the MSC (or transferred jurisdiction over the eFolder). Important: If an RO decides that rating action is in order, it must complete the rating decision, promulgate it, and transfer the claims folder (or transfer jurisdiction over the eFolder) within ten business days of receipt of a request for the folder from an MSC. MSCs and DRASs are responsible for developing and deciding any issues an RO does not address in its rating decision. Unless an RO is able to decide all of the issues associated with a pending claim, the EP that controls the claim must remain pending. This EP and the EP 689 that MSCs establish in Step 2 of the procedures described in M21-1, Part III, Subpart i, 2.D.5.a may run concurrently. If a participant’s service department subsequently determines the participant is unfit for duty, the DRAS of jurisdiction will clear the EP 689, and prepare and promulgate the participant’s final rating decision under the EP that the RO established, or returns the participant to duty, the participant’s DRAS or MSC (whichever has current jurisdiction over the participant’s case) will clear the EP 689, and the claim back to the RO for processing. e. IDES Participants With a Pending Appeal If an IDES participant has an appeal pending with VA, and the appeal involves a disability the participant’s service department referred to VA or the participant claimed as a consequence of his/her involvement in the IDES, MSCs and must follow the instructions in the table below. If … Then MSCs must … And DRASs must … a participant’s pending appeal involves a disability the participant’s service department referred to VA request examination of the referred disability complete a separate proposed rating for the PEB (even in duty Veteran cases) assign a disability evaluation for PEB purposes only, and include a clear indication that the evaluation is for PEB purposes only, and note that the issue remains on appeal for the purpose of entitlement to VA benefits and that the evaluation of the appeal issue reflected on the proposed rating does not impact the existing appeal.
Users should not select an examination type displayed in red, as this is an indicator the selected facility does not conduct this type of examination. Users must consider any text displayed in the ROUTING LOCATION INFORMATION and INFORMATION ABOUT THIS EXAM LIST fields, as it may include information about the capability of the selected facility to conduct certain examinations. 10 If the facility selected in Step 8 is unable to conduct one or more of the examinations the member requires, proceed to the next step. Otherwise, proceed to Step 18. 11 Attempt to request the remaining examination(s) by returning to Step 6 selecting the facility in Step 8 that is next closest to the member’s ZIP Code, and following the remaining in the table. Important: attempting to locate other facilities that are able to conduct the remaining examination(s), a user might identify a single facility that is able to conduct all of the required examinations. When this occurs, the user should request all of the examinations at that single facility for the member’s convenience. 12 Do one or more examinations remain that the facilities in the drop-down list referenced in Step 8 are unable to conduct? If yes, proceed to Step 14. If no, proceed to the next step. 13 Are the facilities that are able to conduct the remaining examination(s) located within 50 miles of the member’s current, physical location? If yes, proceed to Step 18. If no, proceed to the next step. 14 Navigate to the for locating VA facilities by ZIP Code. 15 the member’s ZIP Code in the ADDRESS field. Select Hospitals from the drop-down list in the FACILITY field. Select Within 50 in the WITHIN field. on the GO button. 16 From the search results, determine which VAMC is next closest to the member’s ZIP Code. 17 Return to Step 3. When the dialog box displaying available connections appears, select the VAMC identified in Step 16. Attempt to request the remaining examination(s) by following the remaining steps in the table.
jurisdiction over eFolders) to SOJs for a reasonable amount of time after making a decision. a DRO at the DRAS of jurisdiction determines a change in the rating decision is necessary the DRO must prepare a new rating decision, and the DRAS must forward a copy of the revised decision to the member’s PEB, and promulgate the revised decision according to the instructions in M21-1, Part III, Subpart i, 2.D.11.d. the member submits new evidence with his/her request for reconsideration, and a DRO at the DRAS of jurisdiction determines no change in the rating decision is warranted the DRO must prepare a memorandum stating that no change in the rating decision is warranted, and a new rating decision that confirms and continues the prior decision, and the DRAS must forward the memorandum to the PEB, and promulgate the decision according to the instructions in M21-1, Part III, Subpart i, 2.D.11.d, and M21-1, Part III, Subpart v, 2.A.2. the member does not submit new evidence with his/her request for reconsideration, and a DRO at the DRAS of jurisdiction determines no change in the rating decision is warranted the DRO must prepare a memorandum stating that no change in the rating decision is warranted, and the DRAS must forward the memorandum to the member’s PEB. a DRO at the DRAS of jurisdiction determines the request for reconsideration also constitutes an NOD the DRAS must forward the NOD to the SOJ for processing after it processes the request for reconsideration. Reference: For more information about handling requests for reconsideration, see M21-1, Part III, Subpart i, 2.D.10.o-q. 17. Handling Cases Involving Pregnant IDES Participants Introduction This contains instructions unique to cases involving pregnant IDES participants, including
Memorandum Rating Decisions the service member’s proposed rating has not been completed yet, and the evidence of record shows the service member is at least 10 percent disabled due to (an) SC disability(ies). g. DRAS Responsibility for Responding to a Request for an Eligibility Determination DRASs must establish EP 290 with the claim label, Pre-Discharge – LGY Determination, to control an RLC’s request for an eligibility determination. The table below shows the text that DRASs must use when responding to a request for an eligibility determination from an RLC. If ... Then the DRAS must include the following text in the e-mail response to the RLC ... a proposed rating decision already exists The claimant will receive disability compensation of $[amount] monthly upon discharge from active duty. the DRAS prepared a memorandum rating decision The claimant will be entitled to service-connected disability compensation of at least [$10% rate] upon discharge from active duty. the evidence of record is insufficient for rating purposes The claimant has an IDES claim pending; however, the evidence available is not sufficient to determine whether a compensable service-connected disability exists. the evidence of record is sufficient for rating purposes but does not show that a compensable, disability exists The evidence of record does not show the claimant has a disability that is compensable. 20. Using Safe Access File Exchange (SAFE) to Securely Send and Receive Sensitive Documents Introduction This topic contains information about SAFE, to include sending sensitive documents through SAFE PEB e-mail addresses, and receiving sensitive documents through SAFE.