Updated Nov 04, 2024
In This Section |
This section contains the following topics:
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1.Applications for Benefits
Introduction |
This topic contains information on applications for benefits, including
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Change Date |
November 4, 2024
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II.iii.1.A.1.a. Requirements for a Complete Claim Received on or After March 24, 2015 |
Effective March 24, 2015, the Department of Veterans Affairs (VA) only recognizes compensation, pension, survivors, and related claims if they are submitted on the required standard forms.
Use the table below to determine the correct VA form to use based on the type of benefit sought by the claimant.
References: For more information on
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II.iii.1.A.1.b. Situations Not Requiring a Prescribed Form |
A prescribed claim form is not required for
References: For more information on
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2. Principles for Application Review
Introduction |
This topic contains information on reviewing applications to determine the benefit sought, including
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Change Date |
November 4, 2024
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II.iii.1.A.2.a. Using a Claimant’s Entries on VA Form 21-526 to Determine Which Benefit the Claimant Is Seeking |
VA Form 21-526, Veteran’s Application for Compensation and/or Pension, was discontinued effective February 19, 2019. Use the table below to determine whether a claimant’s entries on VA Form 21-526 constitute a claim for disability compensation, Veterans Pension, or both, for forms accepted prior to February 19, 2019.
Note: If any doubt exists as to which benefit a claimant is seeking, ask the claimant for clarification.
Reference: For more information on handling discontinued forms, see M21-1, Part II, Subpart i, 2.B.4.
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II.iii.1.A.2.b. Discretionary Application of 38 CFR 3.151(a) |
38 CFR 3.151(a) instructs that a claim for compensation may be accepted as a claim for Veterans Pension and vice versa. Application of this provision of 38 CFR 3.151(a) is discretionary. Not all claims for Veterans Pension are necessarily claims for compensation and vice versa.
Consider the following three criteria when deciding whether VA will make the discretionary decision to apply 38 CFR 3.151(a) in the context of the Standard Claims and Appeals Forms rule.
Important: If all of the above criteria are not met, then the discretionary application of 38 CFR 3.151(a) is not warranted. In situations where the
Note: For DIC and Survivors Pension, the claims provisions are not discretionary.
References: For more information on
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II.iii.1.A.2.c. Processing Additional Correspondence Received With a Prescribed Form |
A claimant may submit additional correspondence, including but not limited to, statements and other prescribed forms, in conjunction with a prescribed form that identifies additional claimed issues. VA may accept the additional issues as part of the claim when
Follow the procedures in M21-1, Part II, Subpart iii, 2.G, when the additional correspondence requests a benefit without the appropriate prescribed form required for the benefit requested.
Important:
Note: When the source of additional correspondence received with a prescribed form cannot be ascertained, presume it is from the same source as the prescribed form unless there is evidence to the contrary.
References: For more information on
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II.iii.1.A.2.d. Examples: Situations Involving Additional Correspondence Received With a Prescribed Form |
Example 1: A Veteran submits a claim for increase for SC right elbow condition on a VA Form 21-526EZ, also listing the previously denied SC issue of migraines, explaining migraines resulted from an in-service injury. At the same time the Veteran submits a supplemental claim for a previously denied SC right hip condition on a VA Form 20-0995, also listing SC for depression (not previously claimed) due to their SC back condition, and includes private treatment records.
Analysis: Migraines can be accepted as a supplemental claim because the VA Form 20-0995 is the prescribed form for supplemental claims, potentially new evidence was received, and the VA Form 21-526EZ was submitted at the same time as the prescribed VA Form 20-0995. Depression can be accepted as an initial claim for SC because the VA Form 21-526EZ is the prescribed form for initial SC, and the VA Form 20-0995 was submitted at the same time as the prescribed VA Form 21-526EZ.
Example 2: Same scenario as Example 1, except the Veteran also submits a VA Form 21- 10210, Lay/Witness Statement, at the same time, claiming SC for right wrist condition (not previously denied). The Veteran also states VA previously denied SC for a left knee condition on a direct basis and requests it be considered secondary to the SC back condition.
Analysis: The right wrist condition can be accepted as a claim for SC because the VA Form 21-526EZ is the prescribed form for initial SC and the VA Form 21-10210 was received at the same time as the VA Form 21-526EZ. Left knee condition can be accepted as a supplemental claim because the VA Form 20-0995 is the prescribed form for supplemental claims, potentially new evidence was received, and the VA Form 21-10210 was received at the same time as the VA Form 20-0995.
Example 3: A Veteran submits a claim for an increase for SC right and left knee patellofemoral pain syndrome, and lumbosacral strain on a VA Form 21-526EZ. The Veteran also submits a VA Form 21-10210, at the same time as the VA Form 21-526EZ that describes the worsening of the disabilities as well as a new right hip condition caused by an altered gait related to the knee conditions.
Analysis: The right hip condition can be accepted as a claim because the VA Form 21-526EZ is the prescribed form for initial SC disabilities and the VA Form 21-10210 was submitted at the same time as the prescribed VA Form 21-526EZ.
Example 4: A Veteran submits an initial claim for SC for cervical spine strain on a VA Form 21-526EZ. One day later, the Veteran submits a VA Form 21-10210 for SC for anxiety disorder.
Analysis: VA Form 21-10210 is not the prescribed form for initial claims for SC. Additionally, the VA Form 21-10210 was not received at the same time as the prescribed VA Form 21-526EZ. The VA Form 21-10210 would be processed as a request for application in accordance with M21-1, Part II, Subpart iii, 2.G.
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II.iii.1.A.2.e. Receipt of EZ Form Requesting a Different Benefit Application |
The VA Form 21-526EZ and VA Form 21P-527EZ contain instructions for the claimant to request a different benefit application.
Use the table to determine what action must be taken upon receipt of such notice.
Reference: For more information on requests for applications, see
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II.iii.1.A.2.f. Considering Unclaimed Theories of SC |
Although there may be multiple theories or means of establishing entitlement to a benefit for a disability, if the theories all pertain to the same benefit for the same disability, they constitute the same claim. A claim for SC encompasses all potential theories of SC, whether claimed or unclaimed.
When a claimant has claimed SC for an issue, the evidence of record must be reviewed to determine the scope of that claim. All claims must be liberally read to consider other potential theories of SC.
Although VA is obligated to determine all potential claims raised by the evidence, theories of SC which have no support in the record need not be further developed or specifically addressed in a rating decision. However, a denial of SC is a denial for all potential theories, whether specifically addressed in the rating or not.
To determine whether an unclaimed theory of SC is reasonably raised by the record, consider factors or evidence such as
Example: A Veteran claims SC for multiple myeloma on a direct basis. The evidence of record does not support the direct theory. However, the evidence does show that the Veteran served in Vietnam. As multiple myeloma is defined in 38 CFR 3.309(e) as a condition presumptively associated with exposure to herbicide, the theory of presumptive SC is reasonably raised by the evidence and considered within the scope of the claim.
Exception: The requirement to liberally read claims based on multiple theories does not extend to claims of CUE, as the burden is on the claimant to specifically raise each issue. Each new CUE theory is independent.
References: For more information on considering
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3. Application Guidance for Specific Types of Claims
Introduction |
This topic contains information on handling applications for specific types of claims, including
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Change Date |
November 4, 2024
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II.iii.1.A.3.a. Reviewing VA Form 21-2680 to Identify Claims for SMC or SMP |
VA Form 21-2680, can be used as a standalone form if the claimant and/or the supporting documentation identifies whether the benefit sought is SMP (only when there is a running pension award) or SMC. Revisions to the form (effective September 2018) allow the claimant to identify the benefit sought.
The identification of the benefit sought can be
When VA Form 21-2680 is submitted, the Veteran is identified as the claimant, and the benefit sought is
Note: Although VA Form 21-2680 may be accepted as a prescribed claim form for SMC or SMP, it is not required to grant entitlement to either benefit. Do not undertake routine development for completion of this form when deciding a claim for SMC or SMP. For more information on use of VA Form 21-2680, see M21-1, Part VIII, Subpart iv, 4.A.1.i.
Use the table below to determine the benefits being sought by reviewing the Veteran’s benefit status and VA Form 21-2680.
Reminder: When accepting VA Form 21-2680 as a claim for SMC or SMP, the form is a potential claim for both A&A and housebound benefits.
References: For more information on
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II.iii.1.A.3.b. Reviewing VA Form 21-2680 for Claims for Spousal or Survivors’ A&A or Housebound Benefits |
VA Form 21-2680 can be used as a standalone form to claim spousal or survivors’ A&A or housebound benefits when there is an active claim and/or running DIC or Survivors Pension award and the benefit sought is adequately identified. Revisions to the form (effective September 2018) allow the claimant to identify the benefit sought.
The identification of the benefit sought can be
Use the table below when a Veteran’s spouse, surviving spouse, or parent is identified as the claimant or the individual being examined on VA Form 21-2680.
Reference: For more information on handling claims for spousal A&A when the combined evaluation of the Veteran’s SC conditions is less than 30 percent, see M21-1, Part VII, Subpart i, 1.A.4.c.
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II.iii.1.A.3.c. Issues That Arise From Consideration of VA Forms 21-2680, 21-4502, or 26-4555 |
VA Forms 21-2680, 21-4502, and 26-4555 are not specific claims for increased evaluation of an SC disability. However, the issue of increased evaluation can be considered within the scope of the claim for SMC, auto, or adapted housing benefits and should be addressed in the rating decision when evidence on the form or in
Important: If the medical evidence is insufficient to evaluate the disability, request examination of the condition as a part of the claim for SMC, auto, or adapted housing benefits. Do not routinely request examinations without first assessing the medical evidence for sufficiency. Only address the condition in the rating decision when examination or other medical evidence confirms a change in the disability evaluation of the SC issue is warranted or confirms the presence of the condition that is within the scope of another SC condition.
References: For more information on
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II.iii.1.A.3.d. Handling Requests for P&T Status for Compensation |
Veterans may submit a specific request for P&T status related to receipt of compensation benefits.
Note: Requests for P&T status may be routinely addressed as entitlement to Dependents’ Educational Assistance (DEA) in the rating decision.
References: For more information on
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II.iii.1.A.3.e. Non- Discretionary Application of 38 CFR 3.152(b) |
38 CFR 3.152(b) provides that a survivor’s claim for
VA has no discretion in this matter.
Use the table below to determine which benefits VA must address depending on the form the claimant submits.
Note: When a claimant does not indicate which benefit is sought or only checks accrued on the original application, the proper end product (EP) is 140. When a claimant is clearly only applying for pension the proper EP is 190. Change the EP to 140 if it later becomes clear that
References: For more information on
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4. Reviewing Application Completeness and Handling Variances
Introduction |
This topic contains miscellaneous information on claims for VA benefits, including
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Change Date |
April 14, 2021
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II.iii.1.A.4.a. What Constitutes a Substantially Complete Application |
VA has a duty to assist claimants who file a substantially complete application for benefits. The criteria for a substantially complete application are found in 38 CFR 3.160(a) and M21-1, Part I, Subpart i, 1.A.4.f.
References: For more information on
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II.iii.1.A.4.b.
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Do not establish EP control for an application for benefits unless it is substantially complete.
References: For more information on
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II.iii.1.A.4.c. Determining the Proper DOC for Claims Establishment Purposes |
The date of claim (DOC) for claims establishment purposes is the earliest date any VA facility received the claim.
Important: Pension and burial claims electronically submitted via VA.gov use the actual date of VA receipt of the application and not the Centralized Mail time stamp. Applications submitted via VA.gov will have a submission number and text of Submitted Electronically in the upper left corner of every page.
Example Scenario:
Result: When the RO places the claim under EP control, it must use October 14, 2006, as the DOC.
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II.iii.1.A.4.d. Identifying an Incomplete Application |
Consider an application incomplete if it is signed but the claimant has not provided all the information described in M21-1, Part II, Subpart iii, 1.C.
Reference: For more information on the criteria for a substantially complete application, see 38 CFR 3.160(a) and 38 CFR 3.159(a)(3).
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II.iii.1.A.4.e.
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A lack of signature from the claimant or other legally authorized individual renders an application incomplete for
Upon receipt of an unsigned application for benefits, follow the procedures for handling incomplete applications included at M21-1, Part II, Subpart iii, 1.C.
Exception: No claimant signature is required when
Important: The application must be signed by the claimant or other legally authorized individual somewhere on the application itself. The submission of an unsigned application with other signed forms is not sufficient to satisfy the requirement for a signed application.
References: For more information on
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II.iii.1.A.4.f. Requests for Benefits That Are Not Filed on a Prescribed Form |
Use the table below to determine whether a request for benefits that is not filed on a prescribed form is considered an informal claim or a request for application.
References: For more information on
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II.iii.1.A.4.g. Furnishing Applications to Claimants |
VA has an obligation under 38 CFR 3.150 to provide an application for benefits to anyone who requests one.
Before furnishing an application to a claimant in person, enter the Veteran’s name and file number in the appropriate spaces on the form.
Rationale: When the claimant eventually returns the application to VA, it will be easier and faster to
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