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Updated Sep 27, 2024

In This Section

This section contains the following topics:
Topic
Topic Name
1
2
3
4
5
6
7
8
9
10 Proposed Ratings for Participants Who Decline to Submit a VA Claim

1.  Handling Added Conditions and Reenrolled IDES Cases

Introduction
This topic discusses benefit-entitlement issues that arise after a Military Services Coordinator (MSC) holds the initial meeting with an IDES participant, including

Change Date
February 16, 2024

X.i.6.K.1.a.  Requirement for a Prescribed Form to Add Claimed Conditions
Integrated Disability Evaluation System (IDES) participants have the opportunity to raise claimed conditions by submitting a VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, during their initial interview with the Military Services Coordinator (MSC).  Conditions identified on a VA Form 21-526EZ that is submitted to the MSC during the initial interview must be considered as part of the IDES process.
IDES participants who wish to claim additional conditions after completion of their initial interview with the MSC must submit the claim on a prescribed form as indicated in M21-1, Part II, Subpart iii, 1.A (a VA Form 21-526EZ is preferred). The form must be signed by the claimant or authorized representative to be considered a complete claim for benefits.
Note:  Any issue formally claimed after the initial meeting with the MSC must be handled in accordance with M21-1, Part X, Subpart i, 6.K.1.b.
Important:  Any request for benefits that is not submitted on a prescribed form must be handled in accordance with M21-1, Part II, Subpart iii, 2.G (or M21-1, Part II, Subpart iii, 2.H for claims received prior to March 24, 2015).  The disability rating activity site (DRAS) must ensure that any request for benefits is properly addressed when preparing the final rating notification.  However, both MSCs and DRASs are encouraged to make reasonable attempts to obtain a complete prescribed form via telephone development at the earliest opportunity (once the request for benefits is raised/identified) when doing so is feasible and beneficial to the participant.

X.i.6.K.1.b.  General Information on Claimed Conditions Added After the Initial Meeting With the MSC
When an IDES participant submits a prescribed form with new claimed conditions after the initial meeting with the MSC has been completed, the claims processor who identifies the new conditions must list the contentions under the end product (EP) 689.  A new EP should not be established.
If an EP is established erroneously while the EP 689 is pending, the claims processor who identifies the new EP must
  • ensure that any new conditions on the new application are added as contentions under the EP 689, and
  • cancel the new EP established in connection with the new application.
References:  For more information on

X.i.6.K.1.c.  Examination Requests Addressing Claimed Conditions Added After the Initial Meeting With the MSC
The Department of Veterans Affairs (VA) is not obligated to request additional examinations solely because an IDES participant claims a condition after the initial meeting with the MSC is completed.
Important:  Occasionally, situations may arise that warrant examination of the additional disabilities referenced above.  When submitting an examination request under these circumstances, MSCs and DRAS employees should not
Exception:  The instructions in this block do not apply to additional disabilities
  • a participant’s service department refers to VA, or
  • examiners identify during IDES-related examinations that are related to disabilities a participant’s service department referred to VA.

X.i.6.K.1.d.  Rating Decisions Addressing Claimed Conditions Added After the Initial Meeting With the MSC
Unless the evidence of record is sufficient to make a decision regarding the additional conditions, DRASs should defer a decision on the additional conditions in the final rating decision.
Exceptions:  Instructions in this block do not apply to additional disabilities
  • a participant’s service department refers to VA, or
  • examiners identify during IDES-related examinations that are related to disabilities a participant’s service department referred to VA.
Reference:  For more information on deferring issues raised during the IDES process, see

X.i.6.K.1.e.  Handling the Addition of Referred Conditions That Were Previously Claimed
If the service department adds new referred conditions that were previously claimed by the participant during the initial meeting with the MSC, the MSC or DRAS must
  • ensure the communication from the service department is documented in the electronic claims folder (eFolder), and
  • continue routine IDES processing.
These conditions will be examined and evaluated by DRAS according to standard IDES procedures.  No additional action or prescribed form is required.

X.i.6.K.1.f.  Handling the Addition of Referred Conditions That Were Not Previously Claimed
The service department is required to provide a new VA Form 21-0819, DOD Referral to Integrated Disability Evaluation System (IDES), to VA in order to refer a new and previously unclaimed condition.
References:  For more information on

X.i.6.K.1.g.  Handling New Referred Conditions Added Before Completion of the Medical Evaluation Stage
When an MSC receives a new VA Form 21-0819 from the service department, adding new referred conditions to a pending IDES claim before VA examinations have been completed, the MSC must
  • request examinations to address the new conditions as needed
  • provide examination results to the Physical Evaluation Board Liaison Officer (PEBLO) for all conditions, including the newly referred conditions, prior to closing out the medical evaluation stage in VTA, and
  • handle the new VA Form 21-0819 in accordance with the instructions in M21-1, Part X, Subpart i, 6.F.1.
Important:  New referred conditions that are added before examinations are conducted will not require disenrollment of the case in VTA.  Continue processing under the original case identification (ID) number.

X.i.6.K.1.h.  Handling New Referred Conditions Added After Completion of the Medical Evaluation Stage
If the service department intends to refer a new and previously unclaimed condition(s) after the medical evaluation stage has been completed, the case must be disenrolled from VTA and reenrolled under a new case ID number.
Upon receipt of a new VA Form 21-0819 from the service department, the reenrolled case will move through the claims development and medical evaluation stages again under the new case ID number.  Examinations will be completed for the new referred condition(s).
Exception:  The service department will not disenroll the case if the new referred condition(s) can be addressed without any additional VA examinations. These cases will remain at the DRAS for processing.  However, the DRAS must solicit an application for the new condition on a prescribed form so that the new issue(s) can be considered as part of the claim for VA benefits.
References:  For more information on
  • the service department’s responsibility when adding new referred conditions, see the VTA User Guide, Section 3.4, and
  • handling cases that are disenrolled due to additional referred conditions, see M21-1, Part X, Subpart i, 6.K.1.j.

X.i.6.K.1.i.  Handling Additional Disabilities Noted During Examination
If an IDES participant’s examination report reveals the existence of a condition that was neither part of a complete claim on a prescribed form nor referred by the service department, then the DRAS should address the condition only when the condition is reasonably within the scope of the issues enumerated in the complete claim in accordance with 38 CFR 3.155(d)(2).
DRASs must follow the instructions in the table below if an IDES participant’s examination report reveals the existence of a disability that neither the participant claimed nor the service department referred to VA.
If the disability is …
Then the DRAS of jurisdiction must …
related to any disability the participant’s service department referred to VA
Example:
  • A participant’s service department refers to VA a disability identified as “gunshot wound.”
  • Scarring, as a residual of the gunshot wound, is noted in an IDES-related examination report.
address the disability in the proposed rating decision.
Important:
  • If the evidence of record is insufficient to make a decision regarding the disability, the DRAS must request another examination.
  • It is appropriate to treat the examination report that revealed the existence of the disability as insufficient because it contained insufficient information about the disability for rating purposes.
  • within the scope of any disability the participant claimed, and
  • the record includes sufficient evidence to decide the issue
address the disability in the proposed rating decision.
  • within the scope of any disability the participant claimed, and
  • additional evidence is required to decide the issue
  • add the new issue to the list of contentions, and
  • defer the issue on the proposed rating decision.
Important:  If the issue cannot be decided before completion of the final IDES rating decision, it must be handled in accordance with M21-1, Part X, Subpart i, 6.J.1.e.
  • not within the scope of any claimed or referred disability, but
  • the evidence suggests the potential for entitlement exists
invite a claim from the participant as indicated in M21-1, Part II, Subpart iii, 2.G.2.e.

X.i.6.K.1.j.  Handling IDES Cases Disenrolled Due to Additional Referred Conditions
Use the table below to determine how to process IDES cases that are disenrolled due to the addition of new referred conditions.
If the service department …
Then …
reenrolls the participant in VTA within 30 days of the disenrollment
  • the service department is required to provide the MSC with a new VA Form 21-0819 that indicates the new referred condition(s)
  • VA will treat as referred conditions all conditions listed on both the original and the new VA Form 21-0819
  • referred conditions added by the service department must be addressed for VA purposes (provided the participant signed and submitted VA Form 21-526EZ as part of the initial interview), and
  • it is not necessary to send the IDES disenrollment letter or clear the pending EP 689, as the IDES claim will continue to be controlled under the EP 689 that was established in response to the original VA Form 21-0819.
Important:  If the reenrolled record in VTA reflects a PREPARE CLAIM START DATE, but a new VA Form 21-0819 has not been provided by the service department, the MSC must handle the case as an improper referral in accordance with M21-1, Part X, Subpart i, 6.E.3.g.
does not reenroll the participant in VTA within 30 days of the disenrollment
the MSC will process the disenrollment in accordance with M21-1, Part X, Subpart i, 6.I.2.a.
Important:  If the participant is on active duty, VA will take no further action on the claim.  If the participant is not on active duty, VA must process the claim in accordance with M21-1, Part X, Subpart i, 6.K.2.c.
reenrolls the participant in VTA more than 30 days after the disenrollment
  • the MSC will handle the case as a new IDES referral, and
  • VA will treat as referred conditions only the conditions listed on the current VA Form 21-0819.

2.  IDES Participants in the Reserve or National Guard Who Are Not on Active Duty

Introduction
This topic contains instructions that are unique to cases involving IDES participants in the Reserve or National Guard but not on active duty, including

Change Date
June 9, 2022

X.i.6.K.2.a.  References to Participants in the Reserve or National Guard Who Are Not on Active Duty
Any reference in this section to participants in the Reserve or National Guard who are not on active duty includes individuals returned to active duty for the sole purpose of participating in IDES.

X.i.6.K.2.b.  Requests for Examination of Participants in the Reserve or National Guard Who Are Not on Active Duty
The MSC that requests examination of a participants who are in the Reserve or National Guard but not on active duty must ask the examining facility to notify the following of the date and time of all examinations at least one week prior to the date they are scheduled to occur
  • member
  • MSC, and
  • member’s
    • PEBLO, and
    • unit (if the PEBLO provided contact information to the MSC, and the MSC included the information in the examination request).
Rationale:  Following this practice ensures the member’s unit has ample time to prepare orders allowing the member to attend the examinations.
Reference:  For information on routing examination requests, see M21-1, Part IV, Subpart i, 2.A.1.b.

X.i.6.K.2.c.  Handling Notice That a  Veteran Will Not Be Medically Separated via IDES
When a member of the National Guard or Reserve who is not serving on active duty (a “Veteran,” for the purpose of this block) submits a claim for VA benefits as an IDES participant, VA must fully resolve the Veteran’s claim regardless of the outcome of the IDES process.
Follow the steps in the table below if a service department removes a Veteran from the IDES program and disenrolls them from VTA because the service department decided not to medically separate the Veteran (this includes Veterans that a service department determined meet retention standards or are fit for duty).
Step
Action
1
Complete the actions described in Steps 1 through 5 of the procedure outlined in M21-1, Part X, Subpart i, 6.I.2.a.
2
Has a DRAS fully resolved all contentions the Veteran raised in the claim?
  • If yes, no further action is required.
  • If no, go to the next step.
3
Is EP 110, 010, or 020 already pending?
  • If yes, go to Step 5.
  • If no, go to the next step.
4
Establish the appropriate rating EP (110, 010, or 020), using
the
  • date shown in the FINAL DISPOSITION DATE field in VTA as the date of claim (DOC), and
  • applicable standard (non-IDES) claim label.
Notes:
  • If the Veteran’s service department disenrolled them from VTA without entering a date in the FINAL DISPOSTION DATE field, use as the DOC the date the service department disenrolled the Veteran from VTA.
  • Do not select an IDES claim label when establishing the EP (to ensure proper National Work Queue (NWQ) routing).
References:  For more information on
5
Under the rating EP, list any unresolved contentions that originated from the member’s involvement in IDES.
Notes:
  • NWQ will route the claim to a Veterans Service Center (VSC) for standard processing.
  • The VSC is responsible for taking any required actions on the Veteran’s claim in accordance with standard claims-processing procedures.
  • If the VSC grants entitlement to benefits, it must use the date stamped on VA Form 21-0819 (the date VA received the form from the PEBLO) as the effective date of entitlement.

X.i.6.K.2.d.  Preparing Rating Decisions in Cases Involving Participants Who Are Not on Active Duty

 In cases involving IDES participants in the Reserve or National Guard who are not on active duty, when VA examinations are complete, DRASs must prepare a rating decision following the steps in the table below. Exception:  Do not complete the actions in the table below if the participant declined to file a VA claim.  In these instances, DRAS must complete the actions outlined in M21-1, Part X, Subpart i, 6.K.10.a.
Step Action
1 Clear the pending EP 689.
2 Is EP 110, 010, or 020 already pending?
  • If yes, go to Step 4.
  • If no, go to the next step.
3 Establish the appropriate rating EP (110, 010, or 020), and enter contentions in the Veterans Benefits Management System (VBMS) in accordance with M21-1, Part II, Subpart iii, 3.A.  When establishing the rating EP, use
  • the same DOC as for the EP 689 (which was cleared in Step 1 above), and
  • the applicable IDES claim label, specifically
    • IDES Non-AD Initial Live Comp <8 Issues
    • IDES Non-AD Compensation 8+, or
    • IDES Non-AD Non-Original.
Note:  The DOC of the EP 689 and the date of the rating EP must both reflect the date that the participant’s IDES case was initially referred to VA.
4 Prepare a final rating decision and notification letter that
  • addresses all claimed and referred conditions as required by M21-1, Part X, Subpart i, 6.H.1.c, and
  • formalize VA decisions (and award VA benefits, if applicable).
Notes:
  • The final rating decision and notification letter will be provided to the PEB in lieu of a proposed rating and benefits estimate letter (BEL).
  • If issues are deferred on the final rating, they must be handled in accordance with M21-1, Part X, Subpart i, 6.J.1.e.
  • If the claim requires assignment of an evaluation for PEB purposes only, take the action outlined in M21-1, Part X, Subpart i, 6.K.2.e.
Important:  If benefits are granted for issues that were raised as part of the IDES process (those referred by the service department and those formally claimed during the initial interview with the MSC), the date VA first received notification from the Department of Defense (DoD) of the participant’s referral into IDES will generally serve as the effective date of entitlement. Reference:  For more information on evaluations for PEB purposes only, see M21-1, Part X, Subpart i, 6.H.2.d
5 Update the following fields in VTA
  • PROPOSED RATING COMPLETED ON DATE
  • PROPOSED RATING COMPLETED BY, and
  • DEFERRED ISSUES?.
Important:  Although the above field names in VTA refer to proposed ratings they must be completed in all IDES cases, including those where a final rating is completed in lieu of proposed ratings.  In these instances, the fields above should be updated with consideration of the final rating document.
6 Complete the actions outlined in the table shown in M21-1, Part X, Subpart i, 6.J.1.f .
7 Update BENEFIT ESTIMATE LETTER COMPLETED ON DATE field in VTA. Important:  It is critical that this field is updated in all IDES cases.  When a standard notification letter is completed in lieu of a BEL, this field must reflect the day the standard notification letter was completed and available in the eFolder.
  References:  For more information on

X.i.6.K.2.e.  Providing Evaluations for PEB Purposes Only When Participants Are Not on Active Duty

 Never use final VA rating decisions to indicate proposed evaluations assigned for PEB purposes only.  If an IDES claim involving a participant who is not on active duty requires an evaluation for PEB purposes only, the DRAS must prepare a separate proposed rating document for the PEB (in addition to the final rating). Alternatively, DRAS management may elect to communicate these evaluations to the PEB via a supplemental memorandum, provided to the PEB along with the final rating.  The proposed rating or memorandum for PEB must include a clear indication that the evaluation assigned is for PEB purposes only. Reference:  For more information on addressing conditions for PEB purposes only, see M21-1, Part X, Subpart i, 6.H.2.d.

X.i.6.K.2.f.  Requests for Reconsideration From Members That Are Not on Active Duty

 The rating decision that DRASs provide PEBs for participants in the Reserve or National Guard who are not on active duty serves as both a proposed rating decision and a final rating decision.  As a result, these members may
  • request a one-time reconsideration of evaluations assigned to referred conditions, and/or
  • appeal or request a higher-level review (HLR) of the rating decision.
Notes:
  • DRASs are responsible for addressing the requests for reconsideration referenced in the preceding paragraph that PEBs refer to them as part of the IDES process.
  • As stated in M21-1, Part X, Subpart i, 6.J.1.g, appeals and requests for an HLR of a final IDES rating decision are not addressed as part of the IDES process, and DRASs have no responsibility with regard to them.
Reference:  For more information on handling the requests for reconsideration referenced in this block, see M21-1, Part X, Subpart i, 6.H.4.

3.  Handling Cases Involving Pregnant IDES Participants

Introduction
This topic contains instructions unique to cases involving pregnant IDES participants, including

Change Date
August 11, 2020

X.i.6.K.3.a.  Information MSCs Must Provide to Pregnant Participants During Their Initial Meeting
When holding the initial meeting with a pregnant IDES participant, MSCs must advise the participant of the following:
  • medical professionals that examine participants in connection with IDES may, at their discretion, defer some or all examinations because the participant is pregnant
  • without the medical evidence an examination provides, VA may have to defer a decision on some or all of the participant’s disabilities when preparing its proposed and final rating decisions
  • deferral of a decision will not adversely affect the ultimate outcome of the participant’s claim
  • the participant must notify VA of any address or telephone number changes, which will ensure VA can follow up with the participant on any deferred decisions after the anticipated delivery date, and
  • the participant should contact VA if VA defers any decisions then fails to follow up within 90 days after the delivery date.

X.i.6.K.3.b.  Requesting Examinations for Pregnant Participants
MSCs must include the following remarks in any examination request for a pregnant IDES participant:
Please be advised that this individual has indicated that she is currently pregnant.  If the examining physician determines that this examination (or any part of this examination) is medically contraindicated, please clearly indicate which parts of the examination were not completed due to the pregnancy.
  
Further, the examiner should indicate the earliest point (in days following delivery) that the examination may be safely completed.

X.i.6.K.3.c.  Handling Examination Reports Involving Pregnant Participants
Once all examination reports that MSCs request for a pregnant IDES participant are available, MSCs must take the following actions, even if some or all of the reports indicate the participant could not be examined because of pregnancy:
  • provide the examination reports to the participant’s PEBLO, and
  • update the MEDICAL EVALUATION END DATE field on the MSC tab in VTA to reflect the date they provided the examination reports to the PEBLO.

X.i.6.K.3.d.  PEBLO or MEB Requests for Examination After Pregnancy Ends
MSCs will make a second request for examination of an IDES participant after pregnancy ends if the
  • participant’s PEBLO or medical evaluation board (MEB) requests the examination, and
  • time period has passed during which previous examiners indicated examination was contraindicated due to pregnancy.
Important:  Under the circumstances described above, MSCs should
  • not update any of the following fields in VTA unless a participant was disenrolled from IDES due to pregnancy and reenrolled with a new case ID number:
    • MEDICAL EVALUATION START DATE
    • EXAM END DATE, or
    • MEDICAL EVALUATION END DATE, and
  • record as a note in VTA the date the MSC
    • made the second request for examination, and
    • provided the corresponding examination report(s) to the participant’s PEBLO.

X.i.6.K.3.e.  DRAS Deferral of a Decision in a Pregnant IDES Participant’s Case
DRASs may defer a decision on any issue in a pregnant IDES participant’s case if the evidence of record is insufficient to decide that issue because the participant was unable to undergo some or all examinations due to pregnancy.
If a DRAS defers a decision on one or more issues in a final rating decision, it must process the deferral according to the instructions in M21-1, Part X, Subpart i, 6.J.1.e .
Exception:  If a DRAS is unable to prepare a final rating decision because it must defer a decision on all issues in a pregnant participant’s case, the DRAS must establish EP 930 (instead of a rating EP), with a suspense date that is 90 days after the participant’s anticipated delivery date.

4.  Handling Notice or Evidence That an IDES Participant May Be Incompetent for VA Purposes

Change Date

 August 11, 2020

X.i.6.K.4.a.  Handling Evidence That an IDES Participant May Be Incompetent for VA Purposes
The table below provides an overview of the process DRASs must follow when the evidence of record indicates an IDES participant may be incompetent per 38 CFR 3.353(a).
Important:  The information in this block does not apply if a court has appointed a fiduciary to a participant or determined a participant is incompetent.  Instructions for handling these types of cases is found in M21-1, Part X, Subpart ii, 6.D.2.e-g.
Stage
Description
1
The DRAS of jurisdiction prepares a rating decision under EP 689 that proposes a finding of incompetency.
Important:  The DRAS prepares the decision separate from the proposed rating decision discussed elsewhere in this section.
2
The DRAS
  • notifies the participant’s MSC of the proposed rating decision by e-mail
  • provides a copy of the decision and corresponding notice of proposed adverse action directly to the participant, and
  • establishes an EP 600 using the DRAS Incompetency Determination claim label (to run concurrently with the pending EP 689), with a suspense date that is 65 days in the future.
Important:  The DRAS does not provide a copy of the decision to the participant’s PEB.
Reference:  For more detailed information on due process requirements for incompetency determinations, see M21-1, Part X, Subpart ii, 6.D.3.
3
The DRAS clears the EP 600 when either of the following occur:
  • the participant returns to duty, or
  • the suspense date referenced in Stage 2 of this process passes.
Note:  If a participant returns to duty at this point, the process stops at this stage; the DRAS of jurisdiction takes no further action on the proposed rating of incompetency.
4
The DRAS makes a decision regarding the participant’s competency and incorporates it into the participant’s final rating decision.
Note:  If the DRAS determines a participant is competent at this point, the process stops at this stage.
5
The DRAS promulgates the final rating decision according to the instructions in M21-1, Part X, Subpart i, 6.J.
6 The DRAS establishes an EP 290 with the Fiduciary Adjustment claim label.
7
The DRAS must follow the steps in the table in M21-1, Part X, Subpart ii, 6.C.1.c for preparing VA Form 21-592, Request for Appointment of Fiduciary, Custodian or Guardian, for the fiduciary hub.
8
  • authorizes the award
  • clears the EP 290, and
  • releases retroactive payments, if applicable, according to the instructions in M21-1, Part X, Subpart ii, 6.E.2.

5.  Handling Notice or Evidence That an IDES Participant Has Died on Active Duty

Change Date

 January 23, 2023

X.i.6.K.5.a.  Handling Notice That an IDES Participant Has Died
MSCs and/or DRAS personnel must follow the steps in the table below upon receipt of notification or evidence indicating that an IDES participant has died during the IDES process.
Step
Action
1
Document the report of the participant’s death by adding a detailed note in VBMS.
2
Has the case been disenrolled in VTA?
  • If yes, go to Step 7.
  • If no, go to the next step.
3
Document the report of the participant’s death by adding a note in VTA.
4
Complete any required VTA fields associated with actions that were completed prior to the participant’s death.
5
If information about the participant’s death is received by a(n) …
Then the claims processor must …
MSC
  • notify the PEBLO and request disenrollment of the case in VTA, and
  • send e-mail notification to the DRAS (if the case has been transferred to a DRAS).
DRAS employee
notify appropriate parties using the Request DoD Research for Possible Disenrollment hyperlink in VTA.
Note:  The Request DoD Research for Possible Disenrollment hyperlink is found on the bottom of the RO/RATING ACTIVITY tab in VTA.  Selecting this hyperlink will generate an e-mail addressed to all appropriate parties.
6
Document all steps taken to notify appropriate parties with notes in VTA and VBMS.
7
Cancel the pending EP 689.
 
Important:  If the participant was referred into IDES as a member of the National Guard or Reserve and was not on active duty, the potential for accrued benefits may exist.  The MSC or DRAS with jurisdiction of the claim is responsible for completing the actions outlined in M21-1, Part XI, Subpart ii, 3.C.1.c.
Note:  If the participant was on active duty at the time of death, the service department will provide VA with a DD Form 1300, Report of Casualty, which will be routed to the Casualty Assistance Coordinator (CAC) at the station of jurisdiction.  The CAC will contact the survivor to provide the necessary information and facilitate the application process for appropriate VA benefits.

6.  Handling Notice or Evidence That an IDES Participant Has Been Discharged Under Conditions Other Than Honorable

Change Date

 September 14, 2016

X.i.6.K.6.a.  Handling Notice of a Participant’s Discharge Under Conditions Other Than Honorable
MSCs and/or DRAS personnel must follow the steps in the table below upon receipt of notification or evidence that an IDES participant has been (or will be) discharged with an administrative discharge under conditions other than honorable.
Step
Action
1
Document the report of the participant’s discharge by adding a detailed note in VBMS.
2
Has the case been disenrolled in VTA?
  • If yes, go to Step 7.
  • If no, go to the next step.
3
Document the report of the participant’s discharge by adding a note in VTA.
4
Complete any required VTA fields associated with actions that were completed prior to the participant’s discharge.
5
If information about the participant’s discharge is received by a(n) …
Then the claims processor must …
MSC
  • notify the PEBLO and request disenrollment of the case in VTA, and
  • send e-mail notification to the DRAS (if the case has been transferred to a DRAS).
DRAS employee
notify appropriate parties using the Request DoD Research for Possible Disenrollment hyperlink in VTA.
Note:  The Request DoD Research for Possible Disenrollment hyperlink is found on the bottom of the RO/RATING ACTIVITY tab in VTA.  Selecting this hyperlink will generate an e-mail addressed to all appropriate parties.
6
Document all steps taken to notify appropriate parties with notes in VTA and VBMS.
7
Process the disenrollment in accordance with M21-1, Part X, Subpart i, 6.I.2.a.

7.  Ancillary Benefits for IDES Participants

Introduction
This topic contains information on the processing of vocational rehabilitation/employment (VR&E) and home loan claims for IDES participants, including

Change Date
August 24, 2023

X.i.6.K.7.a.  Handling VR&E Inquiries From IDES Participants
Active-duty IDES participants are eligible for and automatically entitled to vocational rehabilitation/employment (VR&E) services.  When participants express interest in, or have questions about, VR&E benefits or services, MSCs must direct the participant to an IDES Vocational Rehabilitation Counselor (VRC).
MSCs must maintain current contact information for the IDES VRC(s) that serve their respective installation so it is readily available to share with participants, as appropriate.  To identify the IDES VRC(s) serving their installation, and/or obtain current contact information for the VRC(s)

X.i.6.K.7.b.  Service Members’ Eligibility for the Home Loan Program
A Veteran who has a compensable, service-connected (SC) disability and purchases a home using VA’s home loan program is eligible for a waiver of the VA home loan funding fee.
A service member who is separating from service may be eligible for the funding fee waiver if the evidence of record establishes the individual will be in receipt of VA disability compensation after separation.

X.i.6.K.7.c.  Handling VA Form 26-1880 Received From IDES Participants
Following receipt of VA Form 26-1880, Request for a Certificate of Eligibility, MSCs must
  • forward the form to the appropriate regional loan center (RLC)
  • ask whether the service member plans to use VA’s home loan program to purchase a home prior to separation, and, if so,
  • advise the service member to ensure the lender knows a pre-discharge claim is pending with VA.

X.i.6.K.7.d.      RLC Action Upon Receipt of VA Form 26-8937 From a Service Member
Following receipt of VA Form 26-8937, Verification of VA Benefits, from a service member, RLCs request an eligibility determination from the DRAS of jurisdiction by sending an e-mail to a designated point of contact at the appropriate site.

X.i.6.K.7.e.  DRAS Responsibility for Preparing Memorandum Rating Decisions
Following receipt of a request for an eligibility determination from an RLC, DRASs must prepare a memorandum rating decision for inclusion in the service member’s eFolder if the
  • service member’s proposed rating has not been completed yet, and
  • evidence of record shows the service member is at least 10–percent disabled due to an SC disability(ies).

X.i.6.K.7.f.  DRAS Responsibility for Responding to a Request for an Eligibility Determination
DRASs must establish EP 290, with the claim label Pre-Discharge LGY Determination – IDES, 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 service-connected 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, SC disability exists
The evidence of record does not show the claimant has a service-connected disability that is compensable.

8.  Post-Separation Revisions of IDES-Related Rating Decisions

Introduction
This topic contains instructions for handling post-separation revisions of IDES-related rating decisions, including

Change Date

 August 11, 2020

X.i.6.K.8.a.  Identifying Cases in Which Post-Separation Revisions of IDES-Related Rating Decisions Are Applicable
VA must take the actions described in M21-1, Part X, Subpart i, 6.K.8.c if
  • VA revises a rating decision it prepared for a Veteran who participated in IDES (these Veterans are identifiable by the presence of the IDES Participant corporate flash)
  • the revision specifically involves a decision that was made as part of a rating used for IDES purposes, and
  • the revision results in a more favorable decision.
Rationale:  Rating decisions VA makes as a result of a Veteran’s participation in IDES directly impact the benefits the Veteran receives from the service department.
Notes:
  • It is not necessary to consider whether the revision impacts a “claimed” or “referred” IDES condition.  A favorable revision of any decision for IDES purposes will require application of the instructions in M21-1, Part X, Subpart i, 6.K.8.c.
  • The instructions in M21-1, Part X, Subpart i, 6.K.8.c are not applicable when a revision results in a less favorable decision.
  • Direct questions related to revisions of ratings in cases associated with previous IDES participants to VAVBAWAS/CO/DES.

X.i.6.K.8.b.  Situations That Require the Application of Post-Separation Revisions of IDES-Related Rating Decisions
Examples of situations that would require application of the instructions in M21-1, Part X, Subpart i, 6.K.8.a and c are described below.
  • VA conducts a special review of previous decisions.  As a result of this review, VA revises a decision issued in a rating decision used for IDES purposes by issuing a more favorable decision.
  • A Veteran appeals a decision issued in a rating decision used for IDES purposes.  VA later resolves the appeal by issuing a more favorable decision.
  • A Veteran had an appeal pending when entering IDES related to an issue that was raised during the IDES process.  VA eventually resolves the appeal by issuing a more favorable decision.
  • A quality review team identifies an error on an IDES final rating decision.  Correction of the error results in a more favorable decision.
  • A quality review team identifies an error on a proposed rating decision.  Correction of the error will result in a more favorable decision.  However, VA is unable to correct the proposed rating decision, because the Veteran has already separated from service.
  • A claims processor identifies a clear and unmistakable error in an IDES final rating decision.  Correction of the error results in a more favorable decision.

X.i.6.K.8.c.  Notifiying Veterans Whose IDES-Related Rating Decision Has Changed
When VA revises an IDES-related rating decision under the circumstances described in M21-1, Part X, Subpart i, 6.K.8.a, VA must
  • include the text below in the corresponding decision notice, and
  • attach to the notice DD Form 149, Application for Correction of Military Record.
This decision represents a change to a rating originally assigned as part of the Integrated Disability Evaluation System. 
  
This decision could potentially warrant a change to your military record and/or an adjustment to the disability separation benefits you received from your service department.
  
Each service department operates an agency or board for correction of records.  In light of the change in your VA disability rating, it may be to your benefit to request a review of your discharge to the appropriate board.  A DD Form 149, Application for Correction of Military Record, is enclosed for this purpose. 
  
Please see the reverse side of the form for instructions and additional information.  The completed form, along with a copy of this letter and enclosed rating decision, should be mailed to the appropriate address indicated on the DD Form 149.

9.  Using DoD SAFE to Securely Send and Receive Files

Introduction
This topic contains information about DoD  SAFE, including

Change Date
June 7, 2021

X.i.6.K.9.a.  Sending Files Through DoD SAFE
The Department of Defense Safe Access File Exchange (DoD SAFE) is a web-based tool that provides users with the capability to securely send and receive large files, including files that are too large to be transmitted via e-mail.
To send files via DoD SAFE
  • access the DoD SAFE website
  • click on the DROP-OFF icon, and
  • follow the system prompts.
Without a DoD-issued Common Access Card (CAC), claims processors may not initiate an unsolicited file transfer via DoD SAFE.  When the need arises for a claims processor that does not possess a DoD-issued CAC to transfer a file via DoD SAFE, they must first obtain a request code from a DoD user.
Important:  DoD SAFE is approved for the transfer of personally identifiable information and protected health information.  When transmitting files containing this type of information, users must ensure they check the box labeled Encrypted.
Reference:  For more information on DoD SAFE, see the

X.i.6.K.9.b.  Receiving Files Through DoD SAFE
After a sender completes the drop-off procedure in DoD SAFE, DoD SAFE sends notification via e-mail to the designated recipient(s).  The e-mail contains a hyperlink and a password for accessing the files.
Notes:  Recipients must
  • retrieve files from DoD SAFE within seven days of the date of the e-mail, and
  • not forward the e-mail, hyperlink, or password to anyone else.

10.  Proposed Ratings for IDES Participants Who Decline to Submit a VA Claim

Introduction
This topic contains information about processing PEB requests for proposed  ratings in cases in which the participant declined to submit a VA claim, including

Change Date

 June 7, 2021

X.i.6.K.10.a.  Requirement for Issuance of a Proposed Rating to the PEB
When an IDES participant declines to submit a claim, VA must still provide proposed evaluations to the PEB for the referred conditions.  In these instances, DRASs must:
  • prepare a proposed rating decision for all referred issues in accordance with the procedures outlined in M21-1, Part X, Subpart i, 6.H.1.c; however, the rating decision must clearly indicate the evaluations are provided for DoD purposes only
  • update the following fields in VTA
    • PROPOSED RATING COMPLETED ON DATE
    • PROPOSED RATING COMPLETED BY, and
    • DEFERRED ISSUES?
  • prepare the notification letter described in M21-1, Part X, Subpart i, 6.K.10.b  (Do not prepare a BEL.)
  • upload the notification letter to the participant’s eFolder
  • update the DECLINED TO FILE LETTER DATE field in VTA
  • clear the pending EP 689, and
  • clear EP 310, in accordance with M21-1, Part X, Subpart i, 6.H.1.h.
Important:  In these cases, DRASs will not complete a final rating.  The DRAS is not responsible for any further action, except when the participant requests reconsideration of the proposed decision as described in M21-1, Part X, Subpart i, 6.H.4.a.

X.i.6.K.10.b.  Required Notification Letter to the IDES Participant
DRASs must prepare a notification letter to IDES participants who have declined to file a claim for VA benefits during the IDES process.  The notification letter must include the following language and be uploaded into the participant’s eFolder:
Thank you for your service to our country.
  
Your military Service Department requested a disability assessment from VA as part of your participation in the Integrated Disability Evaluation System (IDES).  We have provided the attached proposed rating decision to your Service Department.
  
Our records indicate that you declined to submit a claim for VA benefits as part of the IDES program; therefore, the attached proposed rating decision will be used for Department of Defense purposes only. VA compensation will not be awarded as a result of your participation in IDES. 
  
If you would like to submit a claim for VA Benefits, you can do so at the appropriate time.  You can file a Pre-Discharge claim once you are within 180 days of your projected separation or retirement date. You can also file a VA claim at any time after your discharge from service.
 
References:  For more information on