Updated Sep 19, 2024
In This Section |
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This section contains the following topics:
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1. Disclosing Evidence and Issuing an Appeal Decision
Introduction |
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This topic includes general guidance for disclosing evidence and issuing appeal decisions, including
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Change Date |
June 28, 2024 |
7.D.1.a. Who May Issue an Appeal Decision |
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The appeals activity responsible for the decision with which disagreement is expressed issues the appeal decision to the appellant.
References: For more information on
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7.D.1.b. Jurisdiction for Issuing an Appeal Decision |
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Use the table below to determine jurisdiction for issuing an appeal decision when the appealable issue results from a determination done for a special purpose.
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7.D.1.d. Required Language for Liberally Construing Evidence and Statements |
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Veterans Benefits Administration policy is to consider all claims sympathetically or liberally by generously construing the evidence and associated claimant statements and resolving any ambiguities in the claimant’s favor, irrespective of whether the claimant is pro se (unrepresented) or represented by a Veterans Service Organization (VSO) or private attorney.
VA must demonstrate in its decisions that it is compliant with this legally binding requirement. Include the following language below in all SOCs and supplemental statements of the case (SSOCs).
VA, in determining all claims for benefits that have been reasonably raised by the filings and evidence, has applied the benefit-of-the-doubt and liberally and sympathetically reviewed all submissions in writing from the (Veteran/claimant) as well as all evidence of record.
Note: As of March 24, 2015, evidence by itself cannot constitute a claim and must be received on a prescribed form.
References: For more information on
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7.D.1.e. Matters Not to Be Disclosed in an Appeal Decision |
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Do not include matters in an appeal decision of a sensitive nature that would be injurious to the physical or mental health of the appellant, including
References: For more information on disclosure of information in an appeal decision, see
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7.D.1.f. Disclosing Appeal Information to the Appellant’s Representative |
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All matters can be disclosed to the appellant’s designated representative unless the appellant limited the representation. Therefore, in some cases, two different versions of the appeal decision may be prepared when it is not permissible to furnish full information to the representative.
Use the table below when disclosing appeal information to the appellant’s representative.
References: For more information, on
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7.D.1.g. Issuing an Appeal Decision in Contested Claims |
When an appeal is filed in response to a contested claim decision, send the appeal decision to all parties involved in the contested claim decision and their authorized representative(s).
Example: An SOC prepared in response to an apportionment NOD must be sent to the Veteran, the apportionment claimant, and both their authorized representative(s).
References: For more information on
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7.D.1.h. Characterizing Appeal Issues |
An appeal issue in any SOC and any subsequent SSOCs, must be characterized in such a way as to provide meaningful notice of the issues on appeal. The proper characterization of an appeal action reduces confusion and assists appellants when they present written and/or oral arguments before the Board of Veterans’ Appeals (Board). Therefore, all SOCs and SSOCs must properly characterize appealed issues related to reductions, which should not be characterized as claims for increase or as a claim to reopen.
Example 1: An RO issues a rating decision and decision notice informing the Veteran that the evaluation of service-connected (SC) asthma is reduced from 30 percent to 10 percent effective June 13, 2018. The Veteran files an NOD disagreeing with the reduction in the evaluation. The DRO issues an SOC and characterizes the issue as Reduction in the rating for asthma from 30 to 10 percent, effective June 13, 2018.
Example 2: An RO issues a decision that results in a combined SC evaluation of 60 percent. The Veteran files an NOD disagreeing with the combined evaluation. The DRO issues an SOC and characterizes the issue as Calculation of the Veteran’s combined disability rating, currently calculated as 60 percent.
References: For more information on
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2. Partial Grants, Full Grants, Statements of the Case (SOCs), and Supplemental Statements of the Case (SSOCs)
Introduction |
This topic contains information on making the decision on an appeal, including
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Change Date |
August 23, 2024
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7.D.2.a. Types of Appeal Decisions |
The format of an appeal decision is dependent on the type of decision being made. When an appeal requires a decision, use the table below to determine the proper format to document the decision.
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7.D.2.b. Decisions to Award Full Benefits |
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If all benefits sought are awarded for the entire period covered by the appeal
Notes:
Reference: For more information on the definition of full grant, see
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7.D.2.c. Decisions to Award Partial Benefits |
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A decision that partially awards the benefit sought still requires an SOC/SSOC unless the appellant states they are satisfied with the partial award.
Follow the steps in the table below when preparing a partial award of the benefit sought on an appeal.
References: For more information on
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7.D.2.d. Examples of Action to Take on Partial Appeal Awards |
Example 1: A Veteran files an NOD with a decision denying an increased evaluation for a knee condition. The appeals team member decides to award a partial rating increase and assigns a 20-percent evaluation. However, the Veteran has specifically indicated that the evaluation should be 40-percent disabling. The appeals team sends the Veteran
Example 2: A Veteran submits VA Form 9, Appeal to Board of Veterans’ Appeals, regarding the decision on an individual unemployability (IU) claim, attaches new evidence, and requests an RO review. The Veteran also files a new NOD on the evaluation of SC asthma. The appeals team member determines the claim for IU can be awarded. In response to a telephone inquiry, the Veteran was advised that the IU was granted, but not yet promulgated. The Veteran submits a written statement that the grant of IU satisfies all appeal issues, including the asthma. The appeals team prepares a rating effectuating the award of IU, dispatches both VACOLS records, and sends the Veteran a decision notice with the Withdrawn Appeal letter language acknowledging the withdrawal of the NOD for asthma.
Reference: For more information on withdrawn appeal procedures, see M21-5, Chapter 7, Section A.3.
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7.D.2.e. Decisions to Uphold the Previous Decisions on NODs |
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If confirming the previous decision on an NOD, send the appellant
References: For more information on preparing and issuing an SOC, see
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7.D.2.f. Decisions to Uphold the Previous Decisions After an SOC |
If confirming the previous decision on an appeal after an SOC has been sent, and when required as specified in M21-5, Chapter 7, Section D.4.a, send the appellant
References: For more information on preparing and issuing an SSOC, see
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7.D.2.g. Jurisdiction Over Downstream Appeal Issues |
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When issuing a favorable decision on an appealed issue, the decision maker assumes jurisdiction over and decides any downstream issues, including
Exception: If character of discharge (COD) is favorably resolved on appeal, control the issue of SC for the claimed issue(s) that led to the COD determination under an end product (EP) 930 and handle through the regular claims process.
Important: De novo review of a downstream issue must be conducted by a DRO who did not render the initial decision on the downstream issue.
References: For more information on
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7.D.2.h. When Decisions on Downstream Issues Confer New Review Rights |
Use the table below to determine whether a decision made on a downstream issue confers new appeal rights.
References: For more information on
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7.D.2.i. Processing Issues Within the Scope of the Appeal |
When completing decisions on appeals, appeal decision makers must address any issue within the scope of the appeal. The issue can be raised by lay statements, medical evidence, or as a logical and legal consequence of other VA decisions, such as increased evaluations. Send the appellant a VA Form 20-0998, Your Right to Seek Review Of Our Decision, with the decision notice on the within scope issue.
Example: The appeal decision maker is reviewing medical evidence in support of the appeal on the Veteran’s SC neurological disability and discovers that it now causes loss of use. The appeal decision must include a decision on any ancillary benefits to which the Veteran is entitled, such as SMC and auto grant.
References: For more information on
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7.D.2.j. Addressing Potential Entitlement that Requires a Prescribed Form |
When completing appeals decisions, appeal decision makers must recognize and solicit for benefits when entitlement is shown and a prescribed form is required to grant such benefits, if the prescribed form is not of record.
Example: Cause of death was previously denied. The subsequent appeal granted cause of death. The Veteran’s dependent was established prior to the Veteran’s death. The now service-connected cause of death and a dependent on a previous award indicates potential entitlement to Dependency and Indemnity Compensation (DIC). Therefore, the appeals decision maker should solicit for a VA Form 21P-534, Application for DIC, Survivors Pension, and/or Accrued Benefits, with the notification letter.
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3. Preparing and Issuing an SOC
Introduction |
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This topic contains information on an SOC, including |
Change Date |
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June 28, 2024 |
7.D.3.a. When to Issue an SOC |
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Issue an SOC when there is an active, valid NOD that cannot be fully granted. Before issuing the SOC
Note: This policy on the preliminary steps to take before issuing an SOC applies to both traditional appellate and DRO reviews.
References: For more information on
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7.D.3.b. Purpose of an SOC |
The purpose of an SOC is to provide the appellant a decision and explanation of the continued denial on the issue(s) listed on an NOD. As stated in 38 CFR 19.29, the SOC must contain enough information to allow the appellant to present written and/or oral arguments before the Board.
The SOC must provide the appellant
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7.D.3.c. SOC Format |
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The table below describes the sections of an SOC and the actions required when completing each section.
References: For more information on
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7.D.3.d. Submission of New and Material Evidence |
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If the evidence is considered both new and material, then the legacy appeal is successfully reopened and must be adjudicated on its merits.
However, if the evidence on the reopened claim does not change the prior decision based on that evidence, the issue in any SOC resulting from that decision is the continued denial of the benefit claimed. The evidence, pertinent laws, and regulations cited in the SOC must support the decision.
In this situation, the SOC includes the
References: For more information on
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7.D.3.e. Evidence Not New and Material |
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If an appellant disagrees with the decision that the evidence submitted to reopen a legacy appeal is not new and material, the SOC should explain why the evidence considered does not meet the new and material standard as defined in 38 CFR 3.156(a).
In this situation
References: For more information on
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7.D.3.f. SOC Printing and Filing Requirements |
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When preparing an SOC
Notes:
Reference: For more information on editing document properties in VBMS, see the VBMS User Guide.
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7.D.3.g. Issuing an SOC |
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Use the table below to issue an SOC to the appellant, their representative, or fiduciary at the last address of record.
References: For more information on
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7.D.3.h. SOC Transmittal Letter Requirements |
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The transmittal letter on an SOC must contain
Important: The date on the SOC transmittal letter must be the date the SOC is sent to the appellant.
References: For more information on
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7.D.3.i. Issuing an SOC to Appellants in the Philippines |
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When issuing an SOC to an appellant residing in the Philippines, attach the following statement to the letter of transmittal:
HEARING ON APPEAL
A hearing on appeal should not be requested unless the appellant actually intends to make a personal appearance before a hearing agency at Manila. Any expense involved in connection with a hearing, including expenditures for transportation to and from Manila, lodging, food, etc., may not be borne by the Government. Hearings are not required. All the evidence of record, including any statements or affidavits submitted by the appellant or in his/her behalf, receives the same thorough consideration whether or not a hearing is held.
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7.D.3.j. Updating VACOLS When Issuing an SOC |
When an SOC is issued, VACOLS must be updated to reflect the date the SOC was sent to the appellant.
Follow the steps in the table below to update VACOLS to reflect the date an SOC is issued.
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4. Preparing and Issuing an SSOC
Introduction |
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This topic contains information on an SSOC, including |
Change Date |
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June 28, 2024 |
7.D.4.a. When to Issue an SSOC |
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After an SOC has been issued, and when required, ROs should issue an SSOC to document a continued denial of an appealed issue.
Important: If the RO determines the appealed issue can be fully or partially awarded, follow the guidance in M21-5, Chapter 7, Section D.2 and issue the appropriate appeal decision(s).
See the table below to determine if the issuance of an SSOC is required.
References: For more information on
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7.D.4.b. How to Prepare an SSOC |
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Prepare an SSOC in the same format as an SOC and use the appropriate transmittal letter.
Limit the SSOC to those changes or additions to the SOC needed to give complete information to the appellant. For those issues that have undergone a change, repeat in full the
Important:
References: For more information on
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7.D.4.c. Additions to an SSOC if a Substantive Appeal Is Not Filed |
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If the appellant has not filed a substantive appeal at the time the SSOC is released
Notes:
References: For more information on
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7.D.4.d. Items Not Included in an SSOC |
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Do not
Note: Decision makers must evaluate and weigh all evidence, but should not routinely list evidence that was considered in a prior appeal decision.
Reference: For more information on evaluating evidence, see M21-1, Part V, Subpart ii, Chapter 1.A.
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7.D.4.e. SSOC Transmittal Letter Requirements |
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The transmittal letter on an SSOC must contain
Important: The date on the SSOC transmittal letter must be the date the SSOC is sent to the appellant. References: For more information on
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7.D.4.f. SSOC Printing and Filing Requirements |
When preparing an SSOC
Notes:
Reference: For more information on editing document properties in VBMS, see the VBMS Job Aid – Editing Document Properties.
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7.D.4.g. Updating VACOLS When Issuing an SSOC |
When an SSOC is issued, VACOLS must be updated to reflect the date the SSOC was sent to the appellant.
Follow the steps in the table below to update VACOLS to reflect the date an SSOC is issued.
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5. Choices Under the Appeals Modernization Act (AMA)
Introduction |
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This topic includes general guidance on using appeal decisions, such as SOCs and SSOCs, to solicit elections for reviews and claims under the Veterans Appeals Improvement and Modernization Act of 2017, Public Law 115-55, 131 Stat. 1105 including:
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Change Date |
October 15, 2020 |
7.D.5.a. Choices Under the AMA |
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The AMA maintains the ability of claimants to appeal to the Board of Veterans’ Appeals (Board), albeit with some significant procedural changes. For example, the Board now assumes jurisdiction of all appeals from the initial notice of disagreement, as opposed to the prior moment of certification.
AMA also offers appellants the ability to choose, or opt-in to, two new lanes for review of their benefits decisions:
Essentially, HLRs consider the evidentiary record as it existed at the time of the prior contested decision, while supplemental claims require either the identification or submission of new and relevant evidence.
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7.D.5.b. Using SOCs/SSOCs to Solicit AMA Elections |
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The law allows claimants with legacy appeals to opt-in to the two AMA review lanes for issues that are part of those appeals. A legacy appeal stems from any decision (involving original, new, or reopened claims, and SOCs or SSOCs) VA made before February 19, 2019. An election to participate in the new AMA review programs received within 60 days of the date of the SOC/SSOC, or within one year after the notice of the original contested decision, whichever is later, results in withdrawing the legacy appeal for those issues. However, claimants may still appeal to the Board those same issues after VA issues a decision on the HLR or supplemental claim.
Any issues on the SOC/SSOC that are not listed in an AMA election will remain under legacy appeals procedures.
References: For more information on:
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