M21-1 Adjudication Procedures Manual

Part 01 (Part I) – Claimants Rights and Claims Processing Centers and Programs

Subpart i – Claimants’ Rights and Responsibilities

Chapter 01 – Legal Authority

Section A – Description and General Information on Duty to Notify and Duty to Assist

Section B – General Information on Due Process

Chapter 02 – Power of Attorney

Section A – General Information on Power of Attorney (POA)

Section B – A Representative’s Right to Notification and Review of Records

Section C – System Updates for Power of Attorney (POA) Appointments

Chapter 03 – Other Information Disclosures

Subpart ii – Claims Processing Centers and Programs

Part 02 (Part II) – Intake, Claims Establishment, Jurisdiction, and File Maintenance

Subpart i – Receiving and Screening Mail

Chapter 01 – Receiving Mail via Centralized Mail (CM)

Section A – Centralized Mail (CM) Intake

Section B – Veterans Claims Intake Program (VCIP) Shipping

Chapter 02 – Screening Mail

Section A – Process Overview for Screening Mail

Section B – Recording the Date of Receipt and Handling Signatures and Outdated Forms

Section C – System Updates for Power of Attorney (POA) Appointments

Section D – Handling Specific Types of Mail

Subpart ii – Claims Folder Establishment, Maintenance, Jurisdiction, and Transfer

Chapter 01 – Claims Folder Establishment

Section A – Establishing New and Converting Old Claims Folders

Section B – Lost Paper Claims Folders and Reconciliation of Duplicate Records

Chapter 02 – Claims Folder Maintenance

Section A – Folder Maintenance

Section B – Restricted Records Storage and Control

Section C – Locked Files Folder Maintenance

Chapter 03 – Claims Jurisdiction and Transfer

Subpart iii – Application Review and Claims Establishment

Chapter 01 – Screening Applications for Benefits

Section A – Applications for Benefits

Section B – Screening Applications for Benefit Eligibility

Section C – Screening Applications for Substantial Completeness and Notification Requirements

Chapter 02 – Types of Claims and Claims Actions

Section A – Intent to File (ITF)

Section B – Supplemental Claims

Section C – Claims for Increase

Section D – Claims Based on Reports of Examination or Hospitalization

Section E – Incorrectly Established Claims

Section F – Withdrawal of Initial Claims

Section G – Requests for Application and Claims Solicitation

Section H – Historical Guidance on Formal Applications and Informal Claims Received Prior to March 24, 2015

Chapter 03 – Claims Establishment and Other System Updates Made at Intake

Section A – Claims Establishment

Section B – System Updates at Intake

Chapter 04 – Claims Screening and Establishment From Claims Submission Service Websites

Section A – The Veterans Online Application (VONAPP) Direct Connect (VDC) Program and Department of Veterans Affairs (VA) Claims Submission Service Websites

Section B – Stakeholder Enterprise Portal (SEP) Claims

Part 03 (Part III) – The Development Process

Subpart i – Verification of Service and Claims Development

Chapter 01 – Establishing Veteran Status and Verifying Service

Section A – Establishing Veteran Status

Section B – Service Requirements and Verification of Eligibility

Section C – Civilian Groups Approved for Veteran Status

Chapter 02 – Claims Development

Section A – Development Duties and Responsibilities

Section B – Duty to Notify Under 38 U.S.C. 5103

Section C – Duty to Assist With Obtaining Records

Section D – Evidence Requested From the Claimant

Section E – Relevance Determinations

Section F – Record Maintenance During the Development Process

Subpart ii – Requesting Records

Chapter 01 – Federal Records

Section A – Requesting Evidence From Federal Record Custodians

Section B – Department of Veterans Affairs (VA) Requests for Information From the Social Security Administration (SSA)

Section C – Information Requests to Other Federal Agencies

Chapter 02 – Service Records

Section A – General Information on Service Records

Section B – Procedures for Obtaining Service Treatment Records (STRs)

Section C – Clinical Records and Personnel Records

Section D – Control and Follow-Up of Requests for Service Records

Section E – Service Record Address Codes and Addresses for Military Records Centers and Other Agencies

Section F – Fire-Related Records, Supplementary or Substitute Records, and Records for Unique Situations

Section G – Record Exchanges Between the Department of Veterans Affairs (VA) and the Service Departments

Section H – Service Department Organizational Structures and Service Number Assignments

Chapter 03 – Private Health Provider (PHP) Records

Chapter 3 – Requesting Evidence From Private Health Providers (PHPs)

Part 04 (Part IV) – Examinations

Subpart i – Examination Requests in Support of Claims

Chapter 01 – Satisfying the Duty to Assist with Examination and Opinion Requests

Section A – Duty to Assist With Providing a Medical Examination or Opinion

Section B – Evidentiary Standards for Finding an Examination or Opinion Necessary

Chapter 02 – Requesting Examinations

Section A – Examination Requests Overview

Section B – Scheduling Examinations

Section C – Control of Examinations

Section D – Medical Examination Coordinators

Section E – Examinations in Special Situations

Section F – Failure to Report and Rescheduling Examinations

Section G – Historical

Chapter 03 – Sufficiency of Examinations

Section A – General Criteria for Sufficiency of Examination Reports

Section B – Examination Sufficiency for Specific Disabilities

Section C – Insufficient Examinations

Part 05 (Part V) – The Rating Process

Subpart i – Preparation of Claims for the Rating Activity

Chapter 01 – Preparation of Claims for the Rating Activity

Section A – General Information on the Rating Activity

Section B – Referrals to the Rating Activity

Section C – Pre-Rating Review of Claims by the Rating Activity

Subpart ii – Decision Making

Chapter 01 – Review of Evidence

Section A – Principles of Reviewing and Weighing Evidence

Section B – Reviewing Testimony and Lay Evidence

Chapter 02 – Determining Service Connection (SC)

Section A – Direct Service Connection (SC) and Service Incurrence of an Injury

Section B – Presumptive Service Connection (SC)

Section C – In-Service Aggravation of a Pre-Service Disability

Section D – Secondary Service Connection (SC) and Aggravation of Non-Service-Connected (NSC) Disabilities

Section E – Service Connection (SC) for Congenital, Developmental, or Hereditary Disorders

Chapter 03 – Decision Making Principles

Section A – Determining the Issues

Section B – Making Partial Rating Decisions

Section C – Reviewing Diagnoses

Section D – Evaluating Disabilities

Chapter 04 – Effective Dates

Section A – Effective Dates

Section B – Historical Guidance on the Assignment of Effective Dates

Subpart iii – Applying the Department of Veterans Affairs (VA) Schedule for Rating Disabilities

Chapter 01 – Musculoskeletal Disabilities and Muscle Injuries

Section A – Painful Motion and Functional Loss

Section B – Musculoskeletal Disabilities of the Extremities and Spine

Section C – Arthritis

Section D – Osteomyelitis

Section E – Muscle Injuries

Section F – Other Musculoskeletal Considerations

Chapter 02 – Organs of Special Sense

Section A – Conditions of the Eyes

Section B – Conditions of the Auditory System

Chapter 03 – Infectious Diseases, Immune Disorders, and Nutritional Deficiencies

Chapter 04 – Respiratory Conditions

Section A – Respiratory Conditions

Section B – Tuberculosis

Chapter 05 – Cardiovascular System Conditions

Chapter 06 – Digestive Conditions

Chapter 6 – Digestive Disabilities

Chapter 07 – Genitourinary Disabilities

Chapter 08 – Disabilities of the Gynecological System and Breast

Section A – Disabilities of the Gynecological System

Section B – Disabilities of the Breast

Chapter 09 – Hematologic and Lymphatic Systems

Chapter 10 – Skin Conditions

Chapter 11 – Endocrine Conditions

Chapter 12 – Neurological Conditions and Convulsive Disorders

Section A – Neurological Conditions and Convulsive Disorders

Section B – Traumatic Brain Injury (TBI)

Section C – Progressive Neurological Disorders

Chapter 13 – Mental Disorders

Chapter 14 – Dental and Oral Conditions

Subpart iv – Completing Rating Decisions

Chapter 01 – Generating the Rating Document

Section A – Completing the Rating Decision Narrative

Section B – Codesheet Section

Section C – Coded Conclusion

Section D – Finalizing the Rating Decision

Section E – Reviewing the Rating Decision

Part 06 (Part VI) – The Authorization Process

Subpart i – General Authorization and Claimant Notification

Chapter 01 – General Authorization and Claimant Notification

Section A – Decision Authorization

Section B – Decision Notices

Chapter 02 – Audits and Correction of Erroneous Payments

Section A – Requests for Financial Audits

Section B – Correcting the Erroneous Payment of Benefits to a Beneficiary

Subpart ii – Adjustment of Benefits Due to Receipt of Other Benefits

Chapter 01 – General Information on Elections

Section A – General Information on Elections

Section B – Miscellaneous Election Issues

Chapter 02 – Separation Pay

Chapter 2 – Recoupment of Separation Benefits

Chapter 03 – Drill Pay and Active Service Pay

Section A – Adjusting Department of Veterans Affairs (VA) Benefits Based on a Veteran’s Receipt of Drill Pay

Section B – Withholding and Restoration of Benefits Associated With Receipt of Drill Pay

Section C – Examples of Award Adjustments Necessitated by a Veteran’s Election of Drill Pay

Chapter 04 – Military Retired Pay (MRP)

Section A – Elections and Waivers in Military Retired Pay (MRP) Cases

Section B – Preparing and Adjusting Awards in Military Retired Pay (MRP) Cases

Section C – Coordinating Military Retired Pay (MRP) Cases With Retired Pay Centers (RPCs) and Service Departments

Section D – Reconciliation of Department of Veterans Affairs (VA), Department of Defense (DoD), and Department of Transportation (DoT) Records

Section E – Processing Audit Error Worksheets (AEWs)

Chapter 05 – Federal Employees’ Compensation (FEC)

Subpart iii – Reduction or Discontinuation of Benefits in Special Circumstances

Chapter 01 – Incarceration

Section A – Effects of an Individual’s Incarceration on Department of Veterans Affairs (VA) Benefits

Section B – Paying Benefits to the Dependent(s) of an Incarcerated Veteran

Section C – Incarceration of Dependents and Certain Survivors

Chapter 02 – Processing Awards Involving Indebtedness

Section A – Simultaneous Award Adjustments

Section B – The Finance Activity at the Regional Office (RO)

Section C – Debt Disputes and Collection

Chapter 03 – Contested Claims

Section A – General Information on Contested Claims

Section B – Contested Claims Development

Section C – Authorizing and Notifying Claimants of a Decision on a Contested Claim

Chapter 04 – Disappearance and Reappearance of a Veteran

Chapter 05 – Awards to Veterans in the Armed Forces Retirement Home or St. Elizabeth’s Hospital

Part 07 (Part VII) – Dependency

Subpart i – Relationship and Dependency

Chapter 01 – General Information on Relationship, Dependency, and Dependency Claims Processing

Section A – General Information on Relationship and Dependency

Section B – Verification of Marital Status and the Status of Dependents

Section C – Adjusting Awards for Dependents

Section D – Dependency Claims Processed by the Rules-Based Processing System (RBPS)

Chapter 02 – Marriage

Section A – Establishing the Validity of a Marriage for Department of Veterans Affairs (VA) Purposes

Section B – Establishing Common Law Marriages

Section C – Establishing Other Types of Marriages

Section D – Establishing Marital Relationship in Survivors Cases

Section E – Remarriage of a Surviving Spouse

Chapter 03 – Children

Section A – Establishing a Child’s Age and Relationship

Section B – Biological Children, Adopted Children, and Stepchildren

Section C – Marriage of a Child

Section D – Children With Two Veteran-Parents

Chapter 04 – Parental Relationships and Dependency

Section A – Establishing Parental Relationship

Section B – Establishing Parental Dependency

Subpart ii – School Attendance

Chapter 01 – School Attendance

Section A – Benefit Entitlement for School Children

Section B – Awards and Adjustments Based Upon School Attendance

Subpart iii – Apportionment of Benefits

Chapter 01 – Apportionment of Benefits

Section A – Apportionment Process

Section B – Adjusting Apportioned Awards

Section C – Garnishment of Disability Compensation in Lieu of Military Retired Pay (MRP) to Pay Alimony or Child Support

Part 08 (Part VIII) – Special Compensation Issues

Subpart i – Special Issues Associated With Herbicide Exposure and/or Service in the Republic of Vietnam (RVN)

Chapter 01 – Claims Based on Exposure to Herbicides

Section A – Developing Claims for Service Connection (SC) Based on Herbicide Exposure

Section B – Ratings for Disabilities Associated with Herbicide Exposure

Chapter 02 – Entitlement to Benefits Under the Nehmer Court Order

Section A – Developing Claims Under the Nehmer Stipulation

Section B – Determining Eligibility to Retroactive Payment Under the Nehmer Stipulation

Section C – Authorization Under the Nehmer Stipulation

Chapter 03 – Chapter 18 Benefits for Children with Spina Bifida or Covered Birth Defects

Section A – General Chapter 18 Benefits Information

Section B – Process Overview

Section C – Eligibility and Development

Section D – Rating

Section E – Authorization Issues

Subpart ii – Special Issues Associated with Service During the Gulf War (GW)

Chapter 01 – Presumptive Service Connection (SC) for Persian Gulf Veterans and Infectious Diseases

Section A – General Information on Presumptive Service Connection (SC) for Persian Gulf Veterans

Section B – Developing Presumptive Service Connection (SC) Claims from Persian Gulf Veterans

Section C – Rating Presumptive Service Connection (SC) Claims for Persian Gulf Veterans

Section D – Presumptive Service Connection (SC) for Infectious Disease Under 38 CFR 3.317

Chapter 02 – Service Connection (SC) Based on Fine Particulate Matter Exposure

Section A – General Information on Claims Based on Fine Particulate Matter Exposure

Section B – Developing Claims Based On Fine Particulate Matter Exposure

Section C – Rating Claims Based on Fine Particulate Matter Exposure

Subpart iii – Other Exposure-Based Claims

Chapter 01 – Tropical Diseases – 38 CFR 3.309(b)

Chapter 02 – Tuberculosis

Section A – Developing Claims for Service Connection (SC) for Positive Tuberculin Reactions

Section B – Awards for Graduated Tuberculosis (TB)

Chapter 03 – Mustard Gas – 38 CFR 3.316

Section A – Developing Claims for Service Connection (SC) for Disabilities Resulting From Exposure to Mustard Gas or Lewisite

Section B – Rating Claims for Disabilities Associated With Mustard Gas or Lewisite Exposure

Chapter 04 – Radiation – 38 CFR 3.309(d) and 38 CFR 3.311

Section A – Developing Claims for Service Connection (SC) for Disabilities Resulting from Ionizing Radiation Exposure Under 38 CFR 3.309

Section B – Developing Claims for Service Connection (SC) for Disabilities Resulting from Ionizing Radiation Exposure Under 38 CFR 3.311

Section C – Rating Claims for Disabilities Associated With Radiation Exposure

Chapter 05 – Chemical Biological Radiological Nuclear and Explosives (CBRNE) Testing

Section A – Developing Claims Based on Participation in Chemical Biological Radiological Nuclear and Explosives (CBRNE) Testing

Section B – Rating Claims Based on Participation in Chemical Biological Radiological Nuclear and Explosives (CBRNE) Testing

Chapter 06 – Project Shipboard Hazard and Defense (SHAD)

Section A – Developing Claims Based on Participation in Project Shipboard Hazard and Defense (SHAD)

Section B – Rating Claims Based on Participation in Project Shipboard Hazard and Defense (SHAD)

Chapter 07 – Asbestos

Section A – General Information on Claims Based on Exposure to Asbestos

Section B – Development and Examination Requests for Claims Based on Exposure to Asbestos

Section C – Evaluating Evidence of Asbestos Exposure

Section D – Rating Claims Based on Exposure to Asbestos

Chapter 08 – Contaminants in the Water Supply at Camp Lejeune – 38 CFR 3.309(f)

Section A – Developing Claims Based on Exposure to Contaminants in the Water Supply at Camp Lejeune

Section B – Rating Claims Based on Exposure to Contaminants in the Water Supply at Camp Lejeune

Chapter 09 – Exposure to Other Specific Environmental or Military Occupational Hazards

Section A – General Information on Exposure to Specific Environmental or Military Occupational Hazards

Section B – Processing Claims Based on Exposure to Specific Environmental or Military Occupational Hazards

Chapter 10 – COVID-19

Chapter 10 – Presumptive Service Connection (SC) for Coronavirus Disease (COVID-19)

Subpart iv – Other Special Compensation Issues

Chapter 01 – Posttraumatic Stress Disorder (PTSD)

Section A – General Information and Development for Posttraumatic Stress Disorder (PTSD) Claims

Section B – Development for Posttraumatic Stress Disorder (PTSD) or Other Claims Related to Personal Trauma

Section C – Examinations and Medical Opinions for Posttraumatic Stress Disorder (PTSD) Claims

Section D – Evidence Evaluation and Decisions for Posttraumatic Stress Disorder (PTSD) Claims

Section E – Evidence Evaluation and Decisions for Posttraumatic Stress Disorder (PTSD) Claims Related to Personal Trauma

Chapter 02 – Former Prisoner of War (FPOW)

Section A – Former Prisoner of War (FPOW) Status

Section B – Former Prisoner of War (FPOW) Service Records

Section C – Development and Examination Request for Claims Based on Former Prisoner of War (FPOW) Status

Section D – Rating Claims Based on Former Prisoner of War (FPOW) Status

Chapter 03 – Individual Unemployability (IU)

Section A – General Information on Individual Unemployability (IU) Claims

Section B – Individual Unemployability (IU) Claims Development

Section C – Individual Unemployability (IU) Rating and Decision Review

Section D – Monitoring Income for Veterans in Receipt of Individual Unemployability (IU)

Chapter 04 – Special Monthly Compensation (SMC)

Section A – Special Monthly Compensation (SMC)

Section B – History of Special Monthly Compensation (SMC)

Chapter 05 – Chronic Diseases

Chapter 5 – Service Connection (SC) for Chronic Diseases

Chapter 06 – Compensation Under 38 U.S.C. 1151

Section A – Developing Claims Filed Under 38 U.S.C. 1151

Section B – Rating Claims Filed Under 38 U.S.C. 1151

Section C – Authorization of Awards Under 38 U.S.C. 1151

Chapter 07 – Paired Organs or Extremities – 38 CFR 3.383

Section A – Compensation for Paired Organs or Extremities Under 38 CFR 3.383

Section B – Awards and Offsets for Paired Organs and Extremities Under 38 CFR 3.383

Chapter 08 – Temporary Total Evaluations Provided Under 38 CFR Part 4

Section A – Prestabilization Ratings Under 38 CFR 4.28

Section B – Hospitalization Ratings Under 38 CFR 4.29

Section C – Convalescent Ratings Under 38 CFR 4.30

Section D – Other Temporary Total Evaluations

Chapter 09 – Special Issues Associated with Specific Circumstances in Service

Section A – Claims Based on Participation in Special Operations Incidents

Section B – Diving-Related Disabilities

Part 09 (Part IX) – Pension, Survivors’ Pension, and Parents’ Dependency and Indemnity Compensation (DIC)

Subpart i – Eligibility and Development

Chapter 01 – Pension and Parent’s Dependency and Indemnity Compensation (DIC) Eligibility

Chapter 1 – Overview of Requirements and Development for Pension and Parents’ Dependency and Indemnity Compensation (DIC)

Chapter 02 – Original Disability Pension Claims Development

Chapter 03 – Income and Net Worth Development

Section A – General Information on Income and Net Worth Development

Section B – Income and Net Worth Development Forms and Acceptable Statements

Section C – Pension Income Development

Section D – Reduction of Income Due to Unreimbursed Expenses

Subpart ii – Special Monthly Pension (SMP) and Rating

Chapter 01 – Aid and Attendance (A&A) and Housebound Eligibility

Section A – General Information on Requirements for Aid and Attendance (A&A) and Housebound Status Under 38 CFR 3.351

Section B – Aid and Attendance (A&A) Status for Beneficiaries Who Are Patients in a Qualified Nursing Home

Chapter 02 – Pension and Special Monthly Pension (SMP) Rating

Section A – Requirements for Veterans Pension Ratings

Section B – Determining Disability, Unemployability, and Marginal Employment for Pension

Section C – Special Monthly Pension (SMP) Ratings

Subpart iii – Authorization

Chapter 01 – Authorization Issues

Section A – General Information on the Effect Income and Net Worth Have on Pension and Parents’ Dependency and Indemnity Compensation (DIC)

Section B – Social Security Administration (SSA) Benefits Program

Section C – Section 306 Pension and Old-Law Pension

Section D – Parents’ Dependency and Indemnity Compensation (DIC) Authorization

Section E – Pension – Basic Rate Determinations

Section F – Dependents for Current-Law Pension Purposes

Section H – Adjustments Based on Changes in Status

Section I – Counting Specific Types of Income

Section J – Net Worth, Asset Transfers, and Penalty Periods

Section K – Other Deductible Expenses

Chapter 02 – Adjustments and Elections

Section A – Pension Reductions for Medicaid-Covered Nursing Facility Care

Section B – Pension Adjustments in Unusual Situations

Section C – Elections Between Pension Programs

Section D – Rescinded

Part 10 (Part X) – Benefits Administration and Oversight

Subpart i – Priority Processing and Other Special Mission Claims

Chapter 01 – Priority Processing Programs

Chapter 1 – Priority Processing Programs and Special Requirements

Chapter 02 – Fully Developed Claims (FDCs)

Section A – General Information About the Fully Developed Claim (FDC) Program

Section B – Processing Fully Developed Claims (FDCs)

Chapter 03 – Foreign Claims

Section A – Jurisdiction for Special Act and Foreign Residency Claims

Chapter 04 – Philippine Claims

Section A – General Information on Philippine Cases

Section B – Eligibility for Benefits Based on Philippines Service

Section C – Development of Philippine Claims

Section D – Awards and Payments for Benefits Due to Philippine Service

Chapter 05 – Claims Based on Merchant Marine Service

Section A – Establishing Veteran Status Based on Merchant Marine Service

Section B – Obtaining Merchant Marine Service Records

Chapter 06 – Pre-Discharge Claims

Section A – Introduction to Pre-Discharge Claims

Section B – Benefits Delivery at Discharge (BDD) and Initial Processing

Section C – Division of Responsibilities – Benefits Delivery at Discharge (BDD) and BDD-Excluded Claims

Section D – Ancillary Benefits and Other Issues Involving Benefits Delivery at Discharge (BDD) or BDD-Excluded Claims

Section E – Integrated Disability Evaluation System (IDES), Referrals, and Initial Processing

Section F – Integrated Disability Evaluation System (IDES) Development and Examinations

Section G – Integrated Disability Evaluation System (IDES) Pending Claims, Appeals, and Previously Denied Issues

Section H – Integrated Disability Evaluation System (IDES) Proposed Ratings

Section I – Integrated Disability Evaluation System (IDES) Processing Based on Service Department Outcomes

Section J – Integrated Disability Evaluation System (IDES) Final Ratings

Section K – Special Situations Related to Integrated Disability Evaluation System (IDES)

Subpart ii – Changes in Benefit and Competency Status

Chapter 01 – Finality and Protection

Section A – Finality of Decisions

Section B – Protected Ratings

Chapter 02 – Revision Based on New Evidence

Section A – Revision Based on Specific Types of Submissions, Including Supplemental Claims

Section B – Revision Based on Receipt of Supplemental Service Records

Chapter 03 – Applicability of Due Process

Section A – Notice of Proposed Adverse Action

Section B – Adverse Action Proposal Period

Section C – Contemporaneous Notice

Section D – Completing Proposed Rating Decisions

Chapter 04 – Improvement

Section A – Rating Decisions for Reduction Due to Improvement

Section B – Authorization for Reductions in Disability Evaluations Under 38 CFR 3.105(e)

Chapter 05 – Clear and Unmistakable Error (CUE) and Severance

Section A – Revision Due to Clear and Unmistakable Error (CUE)

Section B – Severance of Service Connection (SC)

Section C – Due Process and Authorization Issues for Clear and Unmistakable Error (CUE)

Chapter 06 – Competency

Section A – Evaluating and Rating Competency

Section B – A Child’s Permanent Incapacity for Self-Support

Section C – General Information on Incompetency and Fiduciary Cases

Section D – Processing Awards to Incompetent Beneficiaries

Section E – Authorizing Awards for Fiduciary Cases

Section F – Awards Specific to Institutionalized, Incompetent Veterans

Section G – Competency Determinations for the Insurance Center (IC)

Section H – Historical Information on Estate Limitations

Subpart iii – Hospital Adjustments

Chapter 01 – Hospital Adjustments

Section A – Reports of Hospitalization and Other Information Exchanges Between Department of Veterans Affairs (VA) Regional Offices (ROs) and Medical Facilities

Section B – Adjusting Compensation When a Veteran Is Hospitalized in Excess of 21 Days or Receives Care Consistent With 38 CFR

Section C – Adjusting Awards Involving an Aid and Attendance (A&A) Allowance

Section D – Adjusting Pension Under 38 CFR 3.551 and 3.556

Subpart iv – Adverse Circumstances Affecting Benefit Entitlement

Chapter 01 – Character of Discharge (COD), Line of Duty (LOD), Willful Misconduct, and Related Determinations

Section A – Character of Discharge (COD) and Bars to Benefits

Section B – Special Topics Involving Character of Discharge

Section C – Willful Misconduct and Line of Duty (LOD)

Section D – Disability or Death from Use of Alcohol, Drugs, or Tobacco Products

Section E – Processing Cases Involving Common Accidents in Service

Section F – Reversal of Prior Determinations Related to Character of Discharge (COD), Line of Duty (LOD), or Willful Misconduct

Chapter 02 – Determinations Involving Insanity or Homicide

Section A – Insanity Determinations

Section B – Considering Eligibility When Homicide Is Involved

Chapter 03 – Fraud and Forfeiture

Section A – Fraud and Laboratory Analysis of Evidence

Section B – Forfeiture of Benefits

Chapter 04 – Renouncements

Subpart v – Other Administrative Processes

Chapter 01 – Administrative Processes for Evidence Gathering and Decision Making

Section A – Compensation Service and Pension and Fiduciary (P&F) Service Guidance

Section B – Equitable Relief

Section C – Administrative Decisions

Section D – Regional Office (RO) Hearings

Section E – Requests for Field Examinations

Chapter 02 – Administrative Processes for Adjusting Benefits

Section A – Evaluating a Pending Claim When a Veteran Returns to Active Duty

Section B – Award Adjustments Necessitated by a Veteran’s Return to and Discharge From Active Duty

Section C – Cost-of-Living Adjustment (COLA)

Part 11 (Part XI) – Notice of Death, Benefits Payable at Death, and Burial Benefits

Subpart i – First Notice of Death (FNOD) Processing and Cause of Death Determinations

Chapter 01 – First Notice of Death (FNOD) Processing

Section A – General Policies for Veteran First Notice of Death (FNOD) Processing

Section B – System Information for Veteran Notice of Death (NOD) and Month of Death (MOD) Processing

Section C – Errors During Notice of Death (NOD) Processing

Section D – General Procedures for Non-Veteran Beneficiary Notice of Death (NOD) Processing

Chapter 02 – Cause of Death Determinations

Section A – Reports of Casualty

Section B – Finding of Fact and Date of Death

Section C – Presumption of Death

Subpart ii – Benefits Payable at the Time of Death

Chapter 01 – Referral for Consideration of Survivor’s Benefits

Chapter 02 – Month of Death

Chapter 03 – Accrued and Substitution

Section A – Entitlement to Accrued Benefits Under 38 U.S.C. 5121

Section B – Substitution in Case of Death of Claimant

Section C – Development for Accrued and Requests for Substitution

Section D – Rating Accrued Claims

Section E – Accrued Authorization and Notification

Chapter 04 – Death Gratuity

Chapter 4 – Issuing Death Gratuity Certificates to Service Departments

Subpart iii – Burial Benefits

Chapter 01 – Burial Benefits

Section A – General Information on Burial Benefits and Allowances

Section B – Burial Benefits

Section C – Burial Authorization Payment Issues

Section D – Memorialization

Part 12 (Part XII) – Dependency and Indemnity Compensation (DIC) and Other Survivor’s Benefits (Excluding Survivor’s Pension)

Subpart i – Dependency and Indemnity Compensation (DIC)

Chapter 01 – Dependency and Indemnity Compensation (DIC) Eligibility and Development

Section A – Overview of Dependency and Indemnity Compensation (DIC)

Section B – Common Dependency and Indemnity Compensation (DIC) Processing Issues

Section C – In-Service Death and Former Prisoner of War (FPOW) Dependency and Indemnity Compensation (DIC) Claims

Chapter 02 – Dependency and Indemnity Compensation (DIC) Ratings

Section A – Ratings for Dependency and Indemnity Compensation (DIC)

Section B – Aid and Attendance (A&A) and Housebound Determinations for Survivors

Chapter 03 – Dependency and Indemnity Compensation (DIC) Authorization

Section A – Dependency and Indemnity Compensation (DIC) Initial Authorization Issues

Section B – Dependency and Indemnity Compensation (DIC) Awards Following Death of a Surviving Spouse or Dependent

Section C – Awarding Dependency and Indemnity Compensation (DIC) to Children Based on the Determination of Surviving Spouse Entitlement

Section D – Awards Barred by Receipt of Federal Employees’ Group Life Insurance (FEGLI)

Section E – Allowance, Allotments, or Service Pay Under 38 U.S.C. 5110(j)

Section F – Prohibition Against Duplication of Benefits

Chapter 04 – Special Dependency and Indemnity Compensation (DIC) Issues and Allowances

Section A – Dependency and Indemnity Compensation (DIC) Benefits Based on Social Security Administration (SSA) Application

Section B – Dependency and Indemnity Compensation (DIC) Allowance Under 38 U.S.C. 1311(a)(2) and Other Allowances

Section C – Survivor Benefit Plan (SBP) Offsets

Subpart ii – Other Survivor’s Benefits

Chapter 01 – Death Compensation

Chapter 02 – Special Allowance Under 38 U.S.C. 1312

Section A – Special Allowance Under 38 U.S.C. 1312(a)

Section B – Eligibility Determinations and Claims for the Special Allowance Under 38 U.S.C. 1312(a)

Section C – Development of Claims for the Special Allowance Under 38 U.S.C. 1312(a)

Section D – Authorization and Notification for the Special Allowance Under 38 U.S.C. 1312(a)

Chapter 03 – Restored Entitlement Program for Survivors (REPS)

Section A – Overview of the Restored Entitlement Program for Survivors (REPS)

Section B – Handling Claims for Restored Entitlement Program for Survivors (REPS) Benefits

Section C – St. Louis Regional Office (RO) Actions on Claims for Benefits Under the Restored Entitlement Program for Survivors (REPS)

Part 13 (Part XIII) – Eligibility Determinations and Information Sharing for Other Benefits

Subpart i – Eligibility Determinations for Other Department of Veterans Affairs (VA) Benefits

Chapter 01 – Education Benefits and Permanent and Total (P&T) Disability

Section A – Ratings for Dependents’ Educational Assistance (DEA)

Section B – Notification and Award Actions for Dependents’ Educational Assistance (DEA)

Section C – Ratings to Extend the Delimiting Date for Educational Assistance

Chapter 02 – Auto and Housing Allowance Eligibility Determinations

Section A – Automobile and Adaptive Equipment Allowance Under 38 U.S.C. Chapter 39

Section B – Specially Adapted Housing (SAH) or Special Home Adaptation (SHA) Grants

Chapter 03 – Eligibility for Medical Care and Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Section A – General Information on Eligibility for Medical Services

Section B – Healthcare Eligibility Determinations for Former Service Members Discharged Under Other-Than-Honorable (OTH) Conditions

Section C – Service Connection (SC) for Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702

Section D – Eligibility for Medical Services Associated With Aid and Attendance (A&A) or Housebound Status

Section E – Medical Treatment for Veterans Showing a Positive Tuberculin Reaction

Section F – Medical Treatment for Veterans Treated with Nasopharyngeal Radium Irradiation (NRI)

Section G – Eligibility for Medical Services for Polish and Czechoslovakian Armed Forces

Section H – Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) Eligibility Determinations

Chapter 04 – Eligibility for Dental Treatment

Section A – Overview of Classes of Eligibility for Dental Treatment

Section B – Processing Dental Claims

Section C – Ratings for Dental Treatment Purposes

Chapter 05 – Veteran Readiness and Employment (VR&E) Eligibility Determinations

Section A – Veteran Readiness and Employment (VR&E) Eligibility

Section B – Memorandum Vocational Rehabilitation/Employment (VR&E) Ratings

Chapter 06 – Medal of Honor Pension

Chapter 07 – Home Loan Benefits

Section A – Department of Veterans Affairs (VA) Home Loan Program

Section B – Department of Veterans Affairs (VA) Pension-Related Home Loans

Section B – Memorandum Vocational Rehabilitation/Employment (VR&E) Ratings

Chapter 08 – Eligibility Determinations and Certifications for Other Department of Veterans Affairs (VA) Benefits

Section A – Clothing Allowance

Subpart ii – Information Sharing and Eligibility Determinations for Benefits Administered by Other Agencies

Chapter 01 – Social Security Administration (SSA) Requests for Information from the Department of Veterans Affairs (VA)

Section A – Social Security Administration (SSA) Requests for Medical Evidence

Section B – Social Security Administration (SSA) Requests for the Amount of Department of Veterans Affairs (VA) Benefits Received

Section C – Compensation-Based Income Calculations for Social Security Administration (SSA) Purposes

Section D – Pension-Based Income Calculations for Social Security Administration (SSA) Purposes

Section E – Calculating Income for Survivor’s Benefits for Social Security Administration (SSA) Purposes

Chapter 02 – Civil Service and Other Employment Preference Certification

Section A – Civil Service Veterans’ Preference Letter

Section B – Ratings for Veterans’ Civil Service Disability Preference

Section C – State or Municipal Disability Preference Certificate

Section D – Information Sharing With the Office of Personnel Management (OPM)

Chapter 03 – Certifications and Determinations for Public Assistance and Housing

Section A – Certificate of Preference for Public Housing

Section B – Requests from Public Assistance Agencies

Section C – Public Benefit Eligibility for Legal Aliens

Chapter 04 – Certifications for Tax or Financial Purposes

Section A – Certifications of Permanent and Total (P&T) Disability for Internal Revenue Service (IRS) Purposes

Section B – Request for Information Regarding State Bonus or Tax Exemption

Chapter 05 – Other Certifications and Information Sharing

Section A – Certification for Service Academy Appointment

Section B – Certificate of Permanent and Total (P&T) Disability for Discontinuation of Survivor Benefit Plan (SBP) Participation

Section C – Information Requests for Research Purposes

Part 14 (Part XIV) – Matching Programs

Chapter 01 – General Information on Matching Programs

Chapter 02 – Matches With Social Security Administration (SSA) Records

Section A – Social Security Income Match

Section B – Social Security Death Master File (DMF) Match

Section C – Social Security Number (SSN) Verification

Chapter 03 – Routine Review of Running Awards to 100-Year-Old Beneficiaries

Chapter 04 – Federal Tax Information (FTI)

Section A – Federal Tax Information (FTI) Match: General Information

Section B – Federal Tax Information (FTI) Match: Safeguarding

Section C – Federal Tax Information (FTI) Match: Post Award Audit (PAA) for Pension and Parents’ Dependency and Indemnity Compensation (DIC) Beneficiaries

Section D – Federal Tax Information (FTI): Income Verification Match (IVM)

Chapter 05 – Matching Programs That Identify Veterans That Returned to Active Duty

Chapter 06 – Review of Potential Duplicate Payment Cases

Chapter 07 – Data-Matching Programs That Identify Incarcerated Beneficiaries and Dependents

Chapter 08 – Fugitive Felon Match

M21-5 – Appeals and Reviews

Chapter 1 Field Oversight

Section A – Decision Review Operations Center (DROC) Structure

Section C, DROC Strategic Oversight and Analysis Reviews (SOARs)

Chapter 2 National Training Program

Chapter 3 Quality Assurance

Section A – Decision Review Operations Center (DROC) Quality Review Team (QRT)

Section B – National Quality Reviews

Chapter 4 AMA Control & Other Activities

Chapter 5 HLR Procedures

Chapter 6 Controlling Legacy Appeals

Section A – Veterans Appeals Control and Locator System (VACOLS)

Section B – Establishing an Appellate Record

Section C – Situations After Decisions by the Board of Veterans’ Appeals

Section D – Litigation Before the Court of Appeals for Veterans Claims (CAVC)

Chapter 7 Legacy Appeal Procedures

Section A – General Information on Legacy Appeals

Section B – Notice of Disagreement (NOD)

Section C – Decision Review Officer (DRO) Process

Section D – Documenting Appeal Decisions

Section E – Filing a Substantive Appeal

Section F – Docketing, Certification, and Claims Folder Transfer to the Board of Veterans’ Appeals

Section G – Board of Veterans’ Appeals (Board) Decisions and Remands

Section H – Board of Veterans’ Appeals (Board) Travel Board and Video Hearings

Section I – Court of Appeals for Veterans Claims (CAVC)

Section J – Special Appeal Issues and Cases

Chapter 8 Agent and Attorney Fee Processing

Section A – Introduction to Fees

Section B – Processing a Case Seeking Direct Payment of Fees