In This Section |
This section contains the following topics:
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1. COD Determinations and Health Care Eligibility
Introduction |
This topic contains information on the effect that COD determinations have on health care eligibility, including
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Change Date |
February 2, 2023 |
X.iv.1.B.1.a. Health Care Benefits for Former Service Members With Certain OTH Discharges |
Effective October 8, 1977, Public Law (PL) 95-126, amended the law to extend eligibility for health care benefits for any disability incurred or aggravated in the line of duty during active service to former service members with other-than-honorable (OTH) discharges.
The Department of Veterans Affairs (VA) incorporated the principles of PL 95-126 on eligibility to health care when character of discharge (COD) would otherwise be a bar to basic eligibility to VA benefits in 38 CFR 3.360.
Under the regulation, health care benefits can be paid to former service members when there is an OTH discharge except when
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X.iv.1.B.1.b. When to Make a Determination Under 38 CFR 3.360 |
When making a COD determination in response to a claim, and the primary decision reached is that the discharge for the period of service is found to be dishonorable for VA purposes (such that there is no Veteran status and no eligibility to VA benefits requiring Veteran status), a secondary decision must be made on whether the former service member meets basic eligibility for health care under 38 CFR 3.360. A former service member’s contentions on the claim form are deemed to include service connection (SC) for treatment purposes. Therefore, when basic eligibility to benefits requiring Veteran status is precluded under 38 CFR 3.12, there is still an issue of whether basic eligibility to health care can be established under 38 CFR 3.360. |
X.iv.1.B.1.c. When Not to Make a Determination Under 38 CFR 3.360 |
38 CFR 3.360 was promulgated to provide an avenue for basic eligibility for health care for former service members with OTH discharges whose conduct fell under a 38 CFR 3.12(d) bar such that COD would otherwise be a bar to all VA benefits. It must be read together with 38 CFR 3.12 (as well as 38 CFR 3.13 and 38 CFR 3.354, if applicable). It must not be used to deny health care under where basic eligibility to benefits based on Veteran status has been established.
It is incorrect to find that
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X.iv.1.B.1.d. Making the Correct 38 CFR 3.360 Decision |
The table below contains instructions for addressing the issue of basic eligibility to health care under 38 CFR 3.360 in the administrative decision.
Important: As noted directly above in M21-1, Part X, Subpart iv, 1.B.1.c, do not make a decision on basic eligibility to health care pursuant to 38 CFR 3.360 if basic eligibility to all VA benefits is appropriately established under other regulations applicable to discharges. This block only applies when making a primary COD decision that there is a statutory or regulatory bar to benefits under 38 CFR 3.12, which puts the issue of basic eligibility to health care under 38 CFR 3.360 at issue.
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X.iv.1.B.1.e. Health Care Purposes Processing After an Administrative Determination That Service Was Dishonorable |
If eligibility to health care is established based on a determination under 38 CFR 3.360, a rating decision on SC for treatment purposes for each contention is required after the administrative decision is issued.
When a COD determination issued in connection with a claim for benefits concludes that there is a 38 CFR 3.12(d) bar to benefits, and that service is dishonorable for VA purposes, but that basic eligibility to health care exists, after completing all steps of the procedure in M21-1, Part X, Subpart iv, 1.A.1.h, the development activity will
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2. Conditional Discharges and Deemed Discharge Under Other Than Dishonorable Conditions
Introduction |
This topic contains information on conditional discharges and deemed discharge under other than dishonorable conditions, including
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Change Date |
February 2, 2023 |
X.iv.1.B.2.a. Provisions of 38 U.S.C. 101(18) for Reenlistment Prior to Discharge |
38 U.S.C. 101(18) provides that an individual who enlisted or reenlisted before completion of a period of active service may establish eligibility for VA benefits if he/she satisfactorily completed the period of active service for which he/she was obligated at the time of entry.
VA incorporated the statutory concept and principles in 38 CFR 3.13.
Under the regulation, specified changes of status (reenlistment, acceptance of an appointment as a commissioned or warrant officer, and change from a Reserve or Regular commission to accept a commission in the other component) are considered a conditional discharge. After a conditional discharge, the former service member is considered unconditionally discharged or released from the prior period of obligated service when they
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X.iv.1.B.2.c. Determining Whether a Conditional Discharge Determination Is Necessary |
Use the table below to determine whether a conditional discharge determination is necessary.
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X.iv.1.B.2.e. Scenario for Determining Dates of Service for a Conditional Discharge |
Scenario:
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X.iv.1.B.2.f. Example: Method for Determining Dates of Service for a Conditional Discharge |
The table below shows how dates of service would be determined for the scenario described in M21-1, Part X, Subpart iv, 1.B.2.e.
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X.iv.1.B.2.g. Example: Alternative View of the Method for Determining Dates of Service for a Conditional Discharge |
The table below shows an another way of looking at the same calculation method described in M21-1, Part X, Subpart iv, 1.B.2.d applied to the scenario described in M21-1, Part X, Subpart iv, 1.B.2.e, using only the dates of entry, periods of obligation, and RAD dates (for VA purposes).
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X.iv.1.B.2.h. Sample Language for a Conditional Discharge Determination |
When a conditional discharge analysis affects the determination, and results in service not covered by a bar to benefits, the Decision must
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X.iv.1.B.2.i. Assigning Effective Dates for Claims Based on a Conditional Discharge |
Use the table below to determine the effective dates for claims based on a conditional discharge.
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3. Assessing COD and Related Matters When There Is an Uncharacterized Discharge or Separation
Introduction |
This topic contains information on analyzing COD when there is an uncharacterized discharge, separation or release, including |
Change Date |
February 2, 2023 |
X.iv.1.B.3.a. Categories of Uncharacterized Separations |
For cases in which enlisted personnel are administratively separated from service on the basis of proceedings initiated on or after October 1, 1982, the separation may be classified as one of the following three categories of administrative separation:
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X.iv.1.B.3.b. Instructions for Handling Cases Involving a Former Service Member With an Uncharacterized Separation |
The table below contains instructions for handling cases involving a former service member with an uncharacterized administrative separation.
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4. Clemency and Upgraded Discharges, and DRB Decisions
Introduction |
This topic contains information on clemency and upgraded discharges and DRB decisions, including
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Change Date |
February 2, 2023 |
X.iv.1.B.4.d. Decision Made Through a Board for Correction of Military Records or a DRB |
A decision by a service department acting through a board for correction of military records is final and conclusive on VA. This applies
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X.iv.1.B.4.e. Effect of an Upgraded Discharge by a DRB |
An honorable or general- under honorable conditions (UHC) discharge that a DRB issued on or after the enactment of PL 95-126 on October 8, 1977 (38 CFR 3.12(g)), does not set aside a statutory bar to benefits under 38 CFR 3.12(c). If a DRB granted such an upgrade, the development activity must make a COD determination if/when the issue of entitlement to VA benefits arises. Exception: Only favorable action by a board for correction of military records will overcome a bar under 38 CFR 3.12(c). Note: The policy expressed in this block also applies to those discharges issued prior to October 8, 1977, under the special review program (38 CFR 3.12(h)), even if a later review by a DRB confirms that the upgrade was warranted under the uniform published review criteria. |
X.iv.1.B.4.f. Effect of a Substituted Discharge Under 10 U.S.C. 874(b) |
An upgraded discharge issued pursuant to 10 U.S.C. 874(b) does not remove the statutory bar to benefits under 38 U.S.C. 5303(a) for individuals discharged or dismissed by reason of the sentence of a GCM because
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X.iv.1.B.4.g. Documenting a Change in a Former Service Member’s COD |
In those instances when VA does recognize a change that a service department makes to a former service member’s COD, the action taken depends on the procedural posture. If the service department makes a change in its characterization of service before VA makes its first COD determination regarding the period of service, assess whether a COD determination is required. If a determination is still required, discuss the service department change in making the COD determination. If the service department makes a change in its characterization of service after VA’s COD determination regarding the period of service, follow the guidance in M21-1, Part X, Subpart iv, 1.A.1.q on changing binding administrative determinations based on new and relevant evidence. Note: If a change in COD results in a grant of entitlement to benefits, apply the provisions of 38 CFR 3.400(g) when assigning an effective date. |
X.iv.1.B.3.h. Guidelines of PL 95-126 |
In addition to a requirement that DoD establish a set of uniform procedures and standards for use by DRBs, PL 95-126 also prohibits payment of VA benefits based solely on a discharge upgraded under
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X.iv.1.B.4.i. Cases Exempt From PL 95-126 |
Former service members are exempt from the procedures applicable to special upgraded discharges if they had
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5. Second Reviews of DRB Determinations
Introduction |
This topic contains information about second reviews of DRB determinations, including
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Change Date |
February 2, 2023 |
X.iv.1.B.5.a. Eligibility for a Second Review of a DRB Determination |
A former service member may request that a DRB perform a second review of a service department-issued discharge characterization.
Note: A second review was done automatically for all former service members whose discharges were upgraded under one of the special programs listed in 38 CFR 3.12(h).
To be eligible for a second review, the former service member must have
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X.iv.1.B.5.b. Narrative of a DRB Decision on DD Form 215 |
The table below shows the narrative commonly found on DD Form 215 based on the outcome of a second review of a DRB determination.
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X.iv.1.B.5.c. Favorable DRB Determinations |
If the outcome of a second review of a DRB determination is favorable, carefully review the full service records and determine if the former service member was discharged or released under one of the conditions listed in 38 CFR 3.12(c).
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X.iv.1.B.5.d. Favorable DRB Determinations When 38 CFR 3.12(c) Is a Factor |
VA can still deny eligibility to benefits, even though the outcome of a second review of a DRB determination was favorable, if the former service member was discharged or released under one of the conditions listed under 38 CFR 3.12(c).
If a previous VA administrative COD determination, issued before the favorable DRB determination, held that the COD was OTH, and 38 CFR 3.12(c) is a factor, follow the procedure in M21-1, Part X, Subpart iv, 1.A.1.q. When documenting no change in the prior determination show the date of the
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X.iv.1.B.5.e. Unfavorable DRB Decisions |
If the outcome of a DRB decision is unfavorable, eligibility to VA benefits rests on the merits of the original OTH discharge and corresponding facts and circumstances.
Follow the steps in the table below to process an unfavorable DRB decision, even if the claims folder contains an unfavorable administrative decision made prior to the issuance of the adverse DRB decision.
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X.iv.1.B.5.f. Effective Date for Compensation or Pension Benefits Based on the Favorable Outcome of a Second Review of a DRB Determination |
When the outcome of a second review of a DRB determination allows for a grant of entitlement to compensation or pension, authorize payments from the later of the following dates:
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