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Updated Nov 28, 2023

In This Section

  
This section contains the following topics:
 
Topic
Topic Name
1
2
 

 1.  Screening Applications for Substantial Completeness

Introduction

  

Change Date

  
 January 31, 2022

II.iii.1.C.1.a.  Required Notice of Information Needed to Complete an Application

  
Under 38 U.S.C. 5102, if an application for a benefit is incomplete, the Department of Veterans Affairs (VA) is required to notify the claimant and the claimant’s representative, if applicable, of the information necessary to complete the application.
 
Reference:  For more information on sending notice of an incomplete application, see

II.iii.1.C.1.b.  Determining if a Claim Is Complete or Incomplete

  
An application is considered incomplete if it is not substantially complete.  A substantially complete application is defined in M21-1, Part I, Subpart i, 1.A.4.f.
 
Notes: 
  • Beginning March 24, 2015, unless specifically excluded under M21-1, Part II, Subpart iii, 1.A.1.b, all claims governed by VA’s adjudication regulations must be filed on standard forms prescribed by the Secretary, regardless of the type of claim or posture in which the claim arises.  Statements received without a prescribed form on or after March 24, 2015, will be considered a request for application.
  • A claim for an increased evaluation of a service-connected disability based on a statement from the claimant that the disability has worsened constitutes a substantially complete application, if received prior to March 24, 2015.
References:  For more information on

II.iii.1.C.1.c.  Considerations When a Statement of Income Is Required

  
A statement of income is required for all pension claims.  To satisfy this requirement, at least one entry in the income section of the form is required.
 
If no statement of income is provided, contact the claimant by telephone, documenting the call on a VA Form 27-0820, Report of General Information, to obtain a statement of income.  If no statement is obtained, return the application as incomplete in accordance with M21-1, Part II, Subpart iii, 1.C.2.b.
 
If a statement of income is provided and the claim is at least substantially complete, the claim is accepted and processed.  At this point, the claim may be
Exceptions:
References:  For more information on development for

II.iii.1.C.1.d.  Determining the Action to Take When a Claim Is Substantially Complete or Incomplete

  
After determining whether an application is substantially complete or incomplete, refer to the table below to determine the appropriate action(s) to take.
 
If a claim is …
Then …
at least substantially complete
determine whether Section 5103 notice has been provided or whether a Section 5103 notice letter must be sent under the guidance in M21-1, Part III, Subpart i, 2.B.
incomplete

notify the claimant and claimant’s representative, if applicable, of the information necessary to complete the prescribed application form as described in M21-1, Part II, Subpart iii, 1.C.2.b.

Important:  Do not send a Section 5103 notice.
 

2.  Notification Requirements Based on Screening

Introduction

  

Change Date

  
November 28, 2023

II.iii.1.C.2.a.  Notification Requirements for a Complete Application
 
If an application is complete, the claims processor must check whether the claimant has already received 38 U.S.C. 5103 notification regarding the information and evidence that is necessary to substantiate the claim, when the notice is required.
 
Reference:  For more information on VA’s notification requirements, see

II.iii.1.C.2.b.  Notification Requirements for an Incomplete Application
 
When an incomplete application is received, notify the claimant that a complete application is necessary.  Follow the steps in the table below to notify the claimant of the information necessary to complete the claim.
 
Step
Action
1
Whenever possible, contact the claimant or power of attorney first by telephone to obtain the information needed to complete the application.
 
Reference:  For more information on documenting information received by telephone, see M21-1, Part III, Subpart i, 2.D.1.e.
2
If the information necessary to complete the application cannot be obtained by telephone
  • establish an end product (EP) 400 to control the correspondence, or
  • change the erroneously established EP to an EP 400
    • with an Incomplete Application claim label, and
    • use the date the application was received as the control date.
Note:  An EP 030 or EP 040 should not be cleared or changed to another EP.  In these cases, cancel the erroneously established EP and separately establish the EP 400 per the instructions above.
3
Cancel any other erroneously established EP associated with the incomplete claim.
4
Notate the incomplete application in the claims folder by changing the document’s subject to Incomplete Application.
5
  • Prepare and send the Incomplete Application letter.  The notice must include
    • the application form that is being returned as incomplete as an enclosure to the letter
    • the information VA needs to consider the application complete, including the specific section(s) and question number(s) that require completion
    • a statement that failure to submit a substantially complete application within the required time period will result in no benefit being paid or furnished by reason of that application, and
    • notice that the claimant has
      • 60 days from the date of the notice to submit a substantially complete supplemental claim or request for higher-level review (HLR), or
      • one year from the date the incomplete application was received to submit a substantially complete claim for other types of claims.
  • Add the letter to the claims folder.
6
Clear the EP 400.
 
Notes:
  • If a complete claim is submitted within the required time period from the date of receipt of an incomplete application,
    • consider the complete application filed as of the date the incomplete application form was received, but
    • use the date of receipt of the complete claim as the date of claim.
  • If review of an incomplete application reveals that additional evidence exists that could be relevant to the corresponding claim, simultaneously ask the claimant to provide both the additional evidence and the information that is missing from the application.
References:  For more information on

II.iii.1.C.2.c.  Notification Requirements for an Incomplete Application Based on Exposure Allegation

  
An allegation of exposure to a potentially hazardous substance during service without an associated claim for service connection (SC) for a specific disability resulting from the exposure is not a substantially complete claim.  In these cases, follow the procedures in M21-1, Part II, Subpart iii, 1.C.2.b.  In the notification letter, also
  • inform the Veteran that exposure, in and of itself, is not a disability, and
  • ask the Veteran to identify the disability(ies) that resulted from exposure during service.
Important:  Do not
  • process the claim as a denial, or
  • establish EP control for the incomplete claim unless there are other complete claims also submitted.
Reference:  For more information on handling claims for disability arising from toxic exposures, see M21-1, Part VIII.

II.iii.1.C.2.d.  Notification Requirements for an Incomplete Application Based on Experiencing MST

  
An allegation of experiencing MST during service without an associated claim for SC for a specific disability resulting from the trauma experience is not a substantially complete claim.  Use the table below to determine what action(s) to take when MST is identified without a disability that resulted from the trauma experience.
 
If …
Then …
MST is the only issue identified with no resulting disability specified
follow the procedures in M21-1, Part II, Subpart iii, 1.C.2.b.  However, do not contact the Veteran by telephone.  In the notification letter, also
  • inform the Veteran that MST in and of itself is not a disability
  • ask the Veteran to identify the disability(ies) that resulted from experiencing MST during service, and
  • include the language from M21-1, Part VIII, Subpart iv, 1.B.2.e.
Important:  Do not
  • contact the Veteran by telephone to clarify the disability(ies) that resulted from experiencing MST (in compliance with trauma informed practices)
  • process the claim as a denial, or
  • establish EP control for the incomplete claim unless there are other complete claims also submitted.
  • an allegation of MST is identified with no resulting disability specified, and
  • a disability(ies) is claimed on or with the prescribed form
 
 
 
  • add the MST special issue to a claimed disability to allow the claim to be routed for review by an MST claims processor, and
  • do not
Example:  The Veteran submitted a VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, claiming SC for left knee injury and also listed MST with no resulting disability.
 
Result:
  • Add left knee injury as a contention
  • affix the MST special issue to the left knee contention, and
  • do not
Note:  For the purpose of routing the claim for review by an MST claims processor in accordance with the procedures in this table, affix the MST special issue to only one contention when multiple disabilities are claimed.
 
Note:  When a claim is routed to an MST claims processor for review, as described in the table above, the MST claims processor will
  • review the claim and all associated evidence to determine which of the specifically claimed disabilities are potentially related to the experience of MST
  • develop the claim accordingly, following standard personal trauma development procedures, and
  • adjust assignment of the MST special issue indicator to the appropriate contention(s), as necessary.
If, at any time during the claims process, it is determined that the Veteran did not intend to claim any of the specifically identified disabilities as related to MST, then the MST claims processor will follow the instructions in the table above to notify the Veteran of the incomplete application and ask for the specific disability(ies) that resulted from MST.
 
References:  For more information on

II.iii.1.C.2.e.  Notification Requirements for a Request for Application or an ITF

  
Effective March 24, 2015, VA requires all claims to be filed on a standard form.  Therefore, VA must provide the prescribed application forms to the claimant when the claimant
Note:  After the ITF has been entered into the corporate data base, a one-time correspondence is automatically generated and sent to the claimant the following day.
 
References:  For more information on

II.iii.1.C.2.f.  Notification Requirements for Claims That Are Inherently Incredible or Lack Merit
 
Upon identification of a compensation claim that is inherently incredible or clearly lacks merit
  • ensure the claimant received a Section 5103 notice, and
  • defer assistance, including scheduling an examination, until that evidence is received.
If the evidence requested is not received within 30 days, decide the claim based upon all available evidence.
 
Note:  No notice is required beyond the Section 5103 notice for claims that are inherently incredible or clearly lack merit.
 
Reference:  For the definition of claims that are inherently incredible or lack merit, see M21-1, Part I, Subpart i, 1.A.4.c.