Updated Oct 21, 2024
In This Section |
This section contains the following topics:
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1. Purpose of the DROC’s
Introduction |
This topic contains general information on
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Change Date |
July 15, 2024
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1.A.1.b. HLRs at DROCs |
VA implemented AMA on February 19, 2019, which authorized VA to process requests for HLRs of decisions relating to disability compensation at DROCs.
References: For more information on
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2. DROC Location and Jurisdiction
Introduction |
This topic contains information on
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Change Date |
October 3, 2022
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1.A.2.a. Location of the DROCs |
The three DROCs are located in
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1.A.2.b. Jurisdiction of the DROCs |
The National Work Queue (NWQ) manages decision review workload distribution through assigned routing rules and established local rules based on available employee capacity, which generally distributes the oldest pending claims to be worked first, except for VBA designated priority claims. Those designated priority claims are included in the daily workload distribution to ensure priority processing.
The distribution of the workload is determined by set capacities for each claim lifecycle based on the station’s Workforce Information Tool (WIT).
DROC Managers (DROCM) are responsible for ensuring that workload is distributed efficiently and equitably to maximize the DROCs’ ability to serve Veterans and their dependents.
As part of efficient distribution, DROCMs must update and ensure accuracy of their station’s WIT on a weekly basis, to include the proper designation of specialized claims processors as noted in M21-5, Chapter 1, Section A.3.f.
Reference: For more information on updating the WIT, see the WIT Tool User Guide.
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3. DROC Team Structure and Work Processing
Introduction |
This topic contains information on DROC team structure and work processing, including
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Change Date |
July 15, 2024
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1.A.3.a. IPC at DROCs |
The Intake Processing Center (IPC) at the DROCs are primarily responsible for putting claims under end product (EP) control.
Each IPC is composed of a Coach and one or more
Note: As a local option, DROC IPC’s may also include one or more
DROC IPCs are primarily responsible for
For additional general information on IPCs, please refer to M21-1, Part I, Subpart ii, 1.A.1.b.
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1.A.3.c. QRT at DROCs |
DROCs must establish a Quality Review Team (QRT) to
Each QRT is composed of
The QRT is comprised of Rating Quality Review Specialists (RQRS) and Authorization Quality Review Specialists (AQRS) and is responsible for conducting the following:
For additional information on QRTs, see M21-5, Chapter 3 and M21-4, Chapter 6.
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1.A.3.d. Informal Conference Telephone Line |
DROCs conducting informal conferences are responsible for establishing and managing a dedicated phone number for informal conference scheduling. The dedicated phone line must include a functional voicemail accessible by employees to account for time zone differentials.
DROCs must determine and document a local plan for oversight of the dedicated informal conference phone line in the DROC workload management plan.
The plan must include:
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1.A.3.e. Attorney Fee Coordination |
Agents or attorneys may charge claimants fees for representation after an agency of original jurisdiction (AOJ) has issued notice of an initial decision on a claim.
Each DROC is responsible for adjudicating whether an agent/attorney representative is eligible for direct payment fees.
Reference: For more information on Payment of Attorney or Agent Fees, see M21-5, Chapter 8.
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1.A.3.f. Designated Specialized Claims Processors |
Each DROC is responsible for designating specialized groups of trained personnel to ensure high priority and complex processing of claims related to
Each DROC must designate specialized processors in the WIT according to the following guidance. For workload requiring WIT input in Special Teams or Team fields, please select from the dropdown list available.
Notes:
Important:
Reference: For more information on updating the WIT, see M21-5, Chapter 1, Section A.2.b and the WIT Tool User Guide.
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1.A.3.g. Training and Signature Requirements for MST Development and Decisions |
Only a VSR, AQRS, or RVSR who meets the below requirements is authorized to complete development actions that address MST, and only an RVSR, DRO, or RQRS who meets the below requirements is authorized to complete a decision on MST.
Development actions completed by a VSR require two signatures until the VSR demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases. Reviews of development actions completed by an AQRS require two signatures until the AQRS demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases. Decisions completed by a decisionmaker for MST conditions require two signatures until the adjudicator demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases, including a mix of grants, denials, and evaluations. Reviews of decisions completed by an RQRS for MST conditions require two signatures until the RQRS demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases, including a mix of grants, denials, and evaluations.
Notes:
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1.A.3.h. Training and Signature Requirements for TBI Decisions |
Only an RVSR, DRO, or RQRS who has met the below requirements is authorized to complete a decision on TBI.
Decisions on TBI cases completed by decisionmakers require two signatures until a decisionmaker demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive TBI cases, including a mix of grants, denials, and evaluations.
Notes:
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1.A.3.i. Training and Signature Requirements for ALS Decisions |
Only an RVSR, DRO, or RQRS who has met the below requirements is authorized to complete a decision on a case where the Veteran is either claiming or has been granted service connection for ALS, even if the current issues under decision are not directly related to the service connected ALS.
Decisions on ALS cases completed by decisionmakers require two signatures until a decisionmaker demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive ALS cases, including a mix of grants, denials, and evaluations.
Notes:
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1.A.3.j. Second Signature Log and Memorandum for Specialized Processors |
OAR requires DROCs to maintain a log of claims processors on second signature review for specialized processing to include MST, TBI, and ALS. DROCs must also maintain a memorandum for each claims processor who has completed training and second signature requirements.
The log must contain an entry for each specialty case reviewed and each entry in the log must contain the following information:
For any reviewed cases that are incorrect, the log must also contain columns to indicate additional date(s) reviewed following corrective action, reviewer name(s), and any further corrective action needed.
All special processing cases must be second-signed and reviewed for accuracy until the individual processing that case has achieved at least 90 percent accuracy over no less than 10 reviews. DROCs must provide each claim processor who is designated to have single-signature authority for special processing to include MST, TBI, and ALS with a formal memorandum confirming completion of training and second signature requirements. Refer to the Delegation of Single-Signature Authority Memorandum template.
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4. DROC Roles and Responsibilities
Introduction |
This topic contains information on duties and responsibilities of
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Change Date |
July 15, 2024
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1.A.4.a. Duties of CAs |
CAs are assigned to the DROC IPC. This group of employees has varying degrees of responsibility within the IPC primarily revolving around claims control.
Responsibilities include but are not limited to
Reference: See M21-1, Part II, Subpart i, 1.A.1.a. for information about mail intake procedures
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1.A.4.b. Duties of VSRs (to include SVSRs, GS-12 VSRs and/or certified, GS-11 VSRs) |
VSR responsibilities include but are not limited to
References: For more information about
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1.A.4.c. Duties of RVSRs |
RVSR responsibilities include but are not limited to
References: For more information about
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