Department of Veterans Affairs M21-1, Part III, Subpart i Veterans Benefits Administration January 20, 2016 Washington, DC 20420 Key Changes Changes Included in This Revision The table below describes the changes included in this revision of Veterans Benefits Manual M21-1, Part III, “General Claims Process,” Subpart i, “Overview of Claims Processing and Structure of the Veterans Service Center (VSC).” Notes: The term “regional office” (RO) also includes pension management center (PMC), where appropriate. Unless otherwise the term “claims folder” refers to the official, numbered, Department of Veterans Affairs (VA) repository – whether paper or electronic – for all documentation relating to claims that a Veteran and/or his/her survivors file with VA. Replaced references to “informal” fully developed claims (FDCs) with the correct term, “incomplete” FDCs. Minor editorial changes have also been made to improve clarity and readability update incorrect or obsolete references update obsolete terminology, where appropriate, and bring the document into conformance with M21-1 standards. Reason(s) for the Change Citation To clarify the Fully Developed Claim (FDC) Program benefits, to include the retroactive effective date established under PL 112-154 as a potential benefit of the FDC Program. To add additional relevant references. To clarify what constitutes an incomplete FDC. To add a note that the informal claim requirements under historical 38 CFR 3.155 did not apply to incomplete FDCs. To add a reference. Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service
Distribution LOCAL REPRODUCTION AUTHORIZED Section A. General Information About the Fully Developed Claim (FDC) Program Overview In This Section This section contains the following topics: Name 1 Overview of the FDC Program 2 Forms Claimants Must Use When Submitting an FDC 3 Regional Office (RO) Responsibilities 1. Overview of the FDC Program Introduction This topic contains an overview of the FDC Program, including purpose of the FDC Program, and benefits of and criteria for participation in the FDC Program. Change Date January 20, 2016 a. Purpose of the FDC Program The Department of Veterans Affairs (VA) designed the Fully Developed Claim (FDC) Program for the purpose of reducing its backlog of pending claims, and improving claims-processing timeliness. b. Benefits of and Criteria for Participation in the FDC Program In order to streamline the claims process, t
b. Timeliness Targets for Processing FDCs The table below shows the timeliness targets for the various activities involved in processing an FDC. If the activity is ... Then the timeliness target will be ... intake processing, as described in M21-1, Part III, Subpart i, 3.B.1 within one day of claim receipt. development, as described in M21-1, Part III, Subpart i, 3.B.3.a within 10 days of receipt of a that requires scanning (conversion to an electronic format), or within three days of receipt of a paperless claim that requires no scanning. rating within 10 days of designation as Ready for Decision. award promulgation/authorization within five days of generation of the rating decision. c. Designation of Drop-Off Points The VSCM at each RO and PMCM at each PMC are responsible for designating drop-off points for FDCs that are awaiting action in the next of the claims process. This will ensure speedy identification and retrieval by personnel responsible for handling claims in that next phase. The table below identifies the drop-off points the VSCM and PMCM must designate, and explains how RO personnel must use the drop-off points. As soon as … RO personnel must deliver the corresponding claims folder to a point for FDCs that are awaiting … intake processing is complete the development described in M21-1, Part III, Subpart i, 3.B.3.a. the claim is ready for a decision a rating decision. the rating decision is complete award promulgation/authorization. Note: Before processing FDCs in a paperless environment, and PMCMs must establish electronic work queues that correspond to the physical drop-off points referenced above, and to which users may assign cases that are awaiting action in the next phase of the claims process.