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Updated May 17, 2023

In This Section

1.  IDES Participants With a Pending Claim, Appeal, or Previously Denied Claim

Introduction

 This topic contains instructions for handling cases involving IDES participants with a pending claim, appeal, or previously denied claim, including

Change Date

 June 7, 2021

X.i.6.G.1.a.  Handling IDES Claims or Referrals Involving Previously Denied Issues

 Integrated Disability Evaluation System (IDES) participants who are already Veterans might have previously filed claims for Department of Veterans Affairs (VA) compensation and either
  • have a higher-level review (HLR) or appeal currently pending with respect to a previously denied claim, or
  • simply wish to file another claim for a previously denied condition.
Appeals and HLRs, as well as supplemental claims filed by Veterans who are currently not on active duty, are processed outside of the IDES program. However, claims and referrals involving previously denied issues can be developed and decided in the IDES program when Note:  As specified in M21-1, Part X, Subpart i, 6.H.2.d determinations ultimately made on referrals will be for PEB purposes only when the referral is for an issue currently on appeal or HLR, or when the individual declines to file a claim. References:  For more information on

X.i.6.G.1.b.  Examination of Disabilities That Were the Subject of a Previously Denied Claim

 For previously denied disabilities appropriately processed in IDES (as specified in M21-1, Part X, Subpart 1, 6.G.1.a) examinations are required for the
  • referred previously denied condiitons listed on VA Form 21-0819 (for a Physical Evaluation Board (PEB) purposes determination only), or
  • the previously denied conditions claims on VA Form 20-0995 submitted during the initial meeting with the Military Services Coordinator (MSC) when new and relevant evidence exists.
Note:  For supplemental claims submitted after the initial meeting with the MSC, examinations are ordered only under the conditions specified in M21-1, Part X, Subpart i, 6.E.4.h. MSCs should contact their disability rating activity site (DRAS) for guidance regarding the propriety of examining a disability that was the subject of a previous denial if it is unclear whether new and relevant evidence exists. Reference:  For more information about readjudicating a previously decided claim after February 19, 2019, see M21-1, Part X, Subpart ii, 2.A.3.

X.i.6.G.1.c.  Addressing Previously Denied Issues in IDES Ratings

 An issue previously denied by VA will be rated as for PEB purposes only if
  • referred to IDES by the service department but there is an appeal or HLR on the matter currently pending, or
  • there is a referral without an appeal or HLR but the participant declines to file a supplemental claim.
When the participant is a Veteran on active duty and completes a supplemental claim on VA Form 20-0995 follow the guidance in M21-1, Part X, Subpart i, 6.A.2.d. References:  For more information on

X.i.6.G.1.d.  Handling a Pending BDD or Other Pre-Discharge Claim by an Active Duty IDES Participant
The table below describes the actions that are necessary when a service member who filed a Benefits Delivery at Discharge (BDD) or other pre-discharge claim is referred into IDES before the planned discharge date.
Responsible Party
Description of Necessary Action(s)
IDES/MSC
  • Explain to the participant that because they will not be discharge as planned,
    • the BDD/pre-discharge claim will be closed, and
    • they will have an opportunity to submit a claim via the IDES process.
  • Notify the regional office (RO) with jurisdiction over the BDD/pre-discharge claim that the claimant has been retained on active duty and referred to IDES.
  • Process the IDES claim in accordance with standard IDES procedures.
station of jurisdiction (SOJ)/rating activity site
Process the BDD/pre-discharge end product (EP) in accordance with M21-1, Part X, Subpart i, 6.C.3.i.
Important:  If the participant was discharged from active duty, then subsequently referred into IDES as a member of the National Guard or Reserves, handle the case in accordance with M21-1, Part X, Subpart 1, 6.G.1.e.

X.i.6.G.1.e.  Handling Pending Claims From Veterans in IDES
The table below describes the actions that must be taken if a service department refers a Veteran with a pending claim into IDES.
Important:  The instructions in the table below apply to cases involving BDD or other pre-discharge claims, provided the Veteran was discharged from service before the IDES referral was made.
If the BDD/pre-discharge claimant was referred into IDES prior to the projected discharge date, and remains on active duty at the time of the IDES referral, the claim must be handled in accordance with M21-1, Part X, Subpart i, 6.G.1.d.
Responsible Party
Description of Necessary Actions
MSC
  • Explain to the participant that VA will continue to process the pre-IDES claim separately.
  • Do not request transfer of or broker the pre-IDES EP(s).
  • Establish EP 689 and develop the IDES claim in accordance with standard IDES procedures.
  • Ensure all IDES development actions are clearly documented in the Veterans Benefits Management System (VBMS).
  • Consider development actions taken by the RO working the pre-IDES EP, and avoid duplicative actions and examinations to the extent possible.
  • Ensure examinations are completed for all issues raised in IDES.
  • Take the following actions upon completion of IDES development:
    • broker the EP 689 to the appropriate DRAS, and
    • leave any pending pre-IDES EP to remain under the jurisdiction of the assigned RO.
Reference:  For more information on the acceptability of examinations completed outside of IDES, see M21-1, Part X, Subpart i, 6.F.2.c.
RO with jurisdiction of the pre-IDES EP(s)
  • Identify rating-related cases with a concurrent IDES claim by the presence of a pending EP 689.
  • Consider development actions taken by the IDES MSC, and avoid duplicative actions/examinations to the extent possible.
  • Continue to process the pre-IDES EPs in accordance with standard procedures, making all efforts to resolve the claim and EP as expeditiously as possible.
  • Take no action on EP 689.
Assigned DRAS
  • Prepare the IDES rating under the existing rating EP.
  • Attempt to address all contentions (to include any undecided pre-IDES issues) within the IDES rating.
Notes:
  • If the pre-IDES EP has been resolved prior to DRAS rating action, the DRAS must establish a new rating EP in accordance with M21-1, Part X, Subpart i, 6.K.2.d.
  • The DRAS may defer any issue associated with a pre-IDES EP on the IDES rating if
    • the evidence of record is not sufficient to decide the issue, and
    • the issue was not claimed or referred as part of the IDES claim.

X.i.6.G.1.f.  Notifying the RO or BVA of New Evidence Related to a Pending Appeal or HLR
When new evidence or information related to a pending appeal or HLR is uploaded/scanned into VBMS, the MSC or DRAS must take the action outlined in the table below.
If the appeal is at the …
Then notify …
RO
the SOJ (via the appropriate mailbox) of evidence/information related to the pending HLR (or legacy appeal).
Board of Veterans’ Appeals (BVA)
BVA (via BVAVBMSMail@va.gov) of any evidence/information related to the pending appeal.
Reference:  For more information on determining location of an appeal, see the VACOLS User’s Guide.