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Updated Mar 13, 2025

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

1.  General Information on Administrative Decisions

Introduction
This topic contains general information on administrative decisions, including

Change Date
March 13, 2025

X.v.1.C.1.a.  Issues Requiring an Administrative Decision

The table below lists
  • the types of issues that require a formal administrative decision, and
  • references to additional information about the issues.
Unless otherwise specified, complete an administrative decision regardless of whether the decision is favorable or unfavorable.
Important:
  • The information in this table may not be all-inclusive.
  • Instructions for handling specific issues found elsewhere in the M21-1 may vary from the general guidelines in this section.  Those specific instructions override the general instructions provided here.
Issue
Reference
Character of Discharge (COD)
  • Line of Duty
  • Willful Misconduct
Lack of Qualifying Service
Exception:  There is no requirement to complete an administrative decision to deny a claim for Veterans and/or Survivors Pension for lack of qualifying service under the circumstances described in last row of the table in M21-1, Part III, Subpart i, 1.A.1.f.
Former Prisoner of War Status
Common Law Marriage
Deemed Valid Marriage
(unfavorable decisions only)
Note:  For administrative decisions of this type processed by the pension management center (PMC), second-level approval is required from a senior Veterans Service Representative (VSR) or higher.  They do not require approval by a Pension Management Center Manager (PMCM).
Continuous Cohabitation (unfavorable decisions only)
Cessation of Marital Relationship Due to a Finding of Death
Parental Relationship (unfavorable decisions only, unless contested)
Note:  Administrative decisions of this type do not require approval by a Veterans Service Center Manager (VSCM)/PMCM designee.
Child by Adoption (unfavorable decisions only)
Note:  Administrative decisions of this type do not require approval by a VSCM/PMCM designee.
Stepchild Relationship (unfavorable decisions only)
Note:  Administrative decisions of this type do not require approval by a VSCM/PMCM designee.
Child Income Hardship Exclusion
Note:  Administrative decisions of this type do not require approval by a VSCM/PMCM designee.
Presumed Death
Findings of Fact and Date of Death
Homicide
Forfeiture of Benefits Based on Fraud or Treasonable Acts
Insanity
Note:  The rating activity makes insanity determinations which may be used in making an administrative decision regarding eligibility for benefits.
Administrative Error
Apportionments
Note:  Administrative decisions of this type do not require approval by a VSCM/PMCM designee.
Contested Claims (other than apportionments)

X.v.1.C.1.b.  Organizational Responsibility for Making Administrative Decisions

 The development activity is generally responsible for making and documenting administrative decisions except where the guidance relating to a particular type of administrative decision assigns that responsibility to another activity. Important:  The wording above, assigning general responsibility for administrative decisions to the development activity, is not intended to imply that a specific adjudicative office or division is required to make administrative determinations.  The determinations can be assigned to another activity, staff, office, or center subject to capacity and the availability of claims processors who are appropriately qualified as provided in M21-1, Part X, Subpart v, 1.C.2.h. References:  For more information on

X.v.1.C.1.c.  Finality of Administrative Decisions

 Administrative decisions, made in accordance with existing guidance and by application of the same criteria and based on the same facts are binding when issued under 38 CFR 3.104(b).  Those include administrative decisions on
  • line of duty
  • COD
  • relationship
  • dependency
  • domestic relations questions
  • homicide
  • findings of fact of death, and
  • presumptions of death.
A binding administrative determination can be appealed.  It can also be changed when there is/was clear and unmistakable error (CUE), a change in law, or new and relevant evidence. References:  For more information on

2. Making, Documenting, and Issuing Administrative Decisions

Introduction

 This topic contains information on making, documenting, and issuing administrative decisions, including

Change Date

 October 18, 2024

X.v.1.C.2.a.  General Guidelines for Making Administrative Decisions

 When making administrative decisions, refer to the guidance pertaining to the specific determination required (for example COD) and the guidance on evaluating evidence in M21-1, Part V, Subpart ii, 1. It is also important for decision makers to consider the particular standard of proof that applies.  Some administrative decisions, such as a person’s relationship to a Veteran, require “a preponderance of the evidence” favoring a matter in order for it to be established or proven.  Where a standard of proof is not stated, the default standard of proof is relative equipoise.  When there is an approximate balance of evidence for and against a matter, the reasonable doubt rule is applied, the benefit of the doubt is given, and the matter is established. References:  For more information on

X.v.1.C.2.b.  General Guidelines for Documenting Administrative Decisions

 Due to the importance of administrative decisions and the fact they are subject to review by beneficiaries and their representatives, all formal decisions, including special apportionment decisions, must be documented according to the instructions in M21-1, Part X, Subpart v, 1.C.2.c. When issuing a decision notice regarding an administrative decision, claims processors must attach a copy of the administrative decision to the decision notice for the claimant’s review unless superseded by instructions specific to the particular type of administrative decision. Always ensure when discussing the underlying issue that the tone of the administrative decision is
  • audience-appropriate, and
  • non-adversarial.
Exception:  PMCs are not required to attach administrative decisions to decision notices. Reference:  For more information about electronically signing an administrative decision in the Veterans Benefits Management System (VBMS), see M21-1, Part X, Subpart v, 1.C.2.i.

X.v.1.C.2.c.  Format for Administrative Decisions
Use the table below to determine the proper format for documenting an administrative decision, depending upon its subject and content.
If an administrative decision is needed to document a(n) …
Then document the decision using …
apportionment decision
Reference:  For more information on preparing VA Form 21-441, including instructions on when not to attach the form to a decision notice, see M21-1, Part VII, Subpart iii, 1.A.3.g.
net worth determination
COD determination
the approved format for such a determination, as displayed in M21-1, Part X, Subpart iv, 1.A.1.k.
determination regarding any other issue specified in M21-1, Part X, Subpart v, 1.C.1.a
the approved format displayed in M21-1, Part X, Subpart v, 1.C.2.g.

X.v.1.C.2.d.  Required Elements of Administrative Decisions

 Administrative decisions must include the following elements:
  • identification of the issue(s) adjudicated
  • summary of the
    • evidence considered, and
    • laws and regulations applicable to the claim
  • a listing of findings that are favorable to the claimant under 38 CFR 3.104(c), if any, and
  • identification of the element(s) required to grant the claim that were not met.
Exception:  PMCs are not required to list favorable findings in administrative decisions.  Favorable findings are addressed in PMC decision notices.

X.v.1.C.2.e.  Providing Adequate Reasons and Bases for Administrative Decisions

 In a well-written decision, with valid reasons and bases, the conclusion should be obvious to the reader. Follow the instructions that follow the bullets below when citing the reasons and bases for an administrative decision.
  • State the reasons and bases in clear, simple, easy-to-understand terms.  Fully describe the reasoning that led to the decision.
  • Support conclusions by analysis and explanation of the credibility and value of the evidence on which they are based.  The assertion of unsupported conclusions is unnecessary.
  • Acknowledge contentions that argue against the decision, and explain why they did not prevail.
  • Quote directly from relevant laws and regulations, if/as needed, to support the conclusion reached, but do not rely on the citing of regulatory text in its entirety as a substitute for a qualitative discussion.
  • Impartially list all evidence, both favorable and unfavorable.  Generally, identify and paraphrase pertinent information from the available evidence instead of quoting from it at length.
  • Evaluate all the evidence, including sworn oral testimony and certified statements submitted by claimants, and clearly explain why that evidence is found to be persuasive or unpersuasive.
  • Explicitly address each item of evidence and each of the claimant’s contentions.
Important:
  • In all favorable administrative decisions, include the following statement as part of the reasons and bases:  All elements required to decide the issue of [issue] were met, and all findings were favorable to the claimant.
  • In all unfavorable administrative decisions,
    • discuss as part of the reasons and bases all unmet elements that were required to grant the claim
    • clearly label and identify findings that were favorable to the claimant pursuant to 38 CFR 3.103(f), if any exist, under a FAVORABLE FINDINGS heading.
References:  For more information on

X.v.1.C.2.f.  Addressing Favorable Findings

Findings (conclusions on a fact, or application of law to facts made by the adjudicator concerning the issue) that are favorable, are binding on subsequent Department of Veterans Affairs (VA) adjudicators unless rebutted by evidence showing that they are clearly and unmistakably erroneous. In unfavorable administrative decisions, address any favorable findings under the decision sub-heading FAVORABLE FINDINGS. Example (for parental relationship): FAVORABLE FINDINGS:
  • You are service-connected with an evaluation of 30 percent or more.
  • You provided the name of your claimed foster parent.
  • You provided the Social Security number of your claimed foster parent.
In unfavorable administrative decisions where there are no favorable findings the FAVORABLE FINDINGS sub-heading is not required. In fully favorable administrative decisions, the FAVORABLE FINDINGS sub-heading is not required.  The regulatory requirement of a listing of favorable findings is satisfied with a general statement under the REASONS AND BASES sub-heading that all findings were favorable. Exception:  PMCs address favorable findings in the decision notice rather than in the body of the administrative decision. References:  For more information on

X.v.1.C.2.g.  Template for an Administrative Decision
The following exhibit contains a template for documenting an administrative decision:
[Designation of VA Office]                    [File Number]
[Location of VA Office]                    [Veteran’s Name]
 
ADMINISTRATIVE DECISION
  
ISSUE:  [State the question at issue.]
  
EVIDENCE:  [List all documents and information reviewed in making the decision by
  • giving specific data about each to distinguish it from other evidence, and
  • following the evidentiary naming conventions prescribed in M21-1, Part V, Subpart iv, 1.A.4.c.]
Example:
  • Maryland Highway Patrol Accident Report of November 9, 2000, received on January 17, 2017.
  • VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, received on January 17, 2017.
PERTINENT LAWS AND REGULATIONS:  [List all laws and regulations applicable to the decided issue.]
Examples:
  • 38 CFR 3.301 (line of duty/misconduct)
  • 38 CFR 3.53 (continuous cohabitation)
[Reproduce only the relevant portion of the regulations necessary to the decision.]
DECISION:  [Clearly and briefly state the decision.]
  
REASONS AND BASES:  [The reasons and bases section must be included on all administrative decisions, including favorable ones.]
FAVORABLE FINDINGS:  [In all unfavorable decisions, list any favorable findings.  This heading is not required in fully favorable decisions or unfavorable decisions where no favorable findings are made.]
 
Note:  If an electronic claims folder (eFolder) exists, the claims processor will use a VA Form 21-0961, Rating Decision/Administrative Decision/Formal Finding/Statement of the Case (SOC)/Supplemental Statement of the Case (SSOC) (Electronic Signatures), to obtain electronic signatures, using the same process described in M21-1, Part X, Subpart v, 1.C.2.i.
References:  For more information on

X.v.1.C.2.h.  Approval Requirements for Administrative Decisions

Most administrative decisions require approval by a person specified by the VSCM or PMCM (the VSCM/PMCM designee). Exception:  Types of administrative decisions where VSCM or PMCM designee approval is not required are listed in the table in M21-1, Part X, Subpart v, 1.C.1.a. Where approval by a VSCM/PMCM designee is required, it does not mean that the VSCM or PMCM must personally review and sign the administrative decision.  The VSCM or PMCM may designate another employee such as a Coach or even a lower graded employee to perform those actions. Administrative decisions affecting permanent entitlement to benefits (notably including decisions on COD or willful misconduct) require the following approval:
  • A Certified VSR at General Schedule (GS) 11 (or higher) who maintains monthly quality, and who has been given single signature authority requires no further approval or concurrence signature for grants (favorable administrative determinations).
  • A Certified GS-11 (or higher) VSR requires concurrence by a second Certified VSR at the same (or a higher) GS level for a denial (unfavorable administrative determination) or for a grant if the VSR did not have single signature authority.
  • When either a favorable or unfavorable administrative determination is prepared by a lower-grade claims processor, the decision requires second-signature by a certified GS 11 (or higher) VSR.
The GS-11 or higher VSR who approves the decision (either as a single signature or a second signature) satisfies the requirement for approval of the determination by a VSCM or PMCM designee.  Do not refer COD or willful misconduct determinations for the additional signature of a supervisory employee such as a coach. Reference:  For more information on delegations of authority, see 38 CFR 3.100(a) and 38 CFR 2.6.

X.v.1.C.2.i.  Process for Electronically Signing Administrative Decisions in VBMS
The table below describes the process for electronically signing an administrative decision in VBMS.
Stage
Who Is Responsible
Description
1
decision maker
Saves the completed administrative decision on a shared drive.
Note:  Regional offices may set up folders on a shared drive for this purpose.
2
decision maker
Adds the special issue titled Administrative Decision Review – Level 1 and the Admin Decision tracked item.
Exception:  Add the ADMINCOD tracked item for COD determinations completed in accordance with M21-1, Part X, Subpart iv, 1.A.
Reference:  For more information about adding special issues and tracked items, see the VBMS Core User Guide.
3
decision maker
Completes the top section of VA Form 21-0961.
4
decision maker
Signs the VA Form 21-0961 by
  • clicking on the First Signature field on the form, and
  • clicking the SIGN button on the SIGN DOCUMENT box that pops up.
5
decision maker
  • Saves the VA Form 21-0961 in the same location as the corresponding decision after the SAVE AS box pops up.
  • Enters their personal identification number or local area network password, as applicable, when the ACTIVECLIENT LOGIN box pops up.
6
decision maker
Reassigns the corresponding work item in VBMS to a reviewer using one of the following two methods:
Method 1:  Select
  • the work item from the work queue in VBMS, and
  • Reassign in the ACTION drop-down list.
Example:
VBMS work queue showing reassign function and first item circled in red
Method 2:  Select the number in the ID column from the VBMS work queue that corresponds to the work item associated with the administrative decision.
Example:
VBMS work queue showing the number ID field circled for the first item in the queue
7
decision maker
Selects the reviewer’s name from the drop-down list in the SELECT A USER FOR REASSIGNMENT field of the REASSIGN WORK ITEM box that pops up.
8
decision maker
Enters the location on the shared drive where the decision and VA Form 21-0961 are saved in the PERMANENT NOTE field.
Note:  The note will be displayed on the CLAIM screen.
9
reviewer
  • Navigates to the CLAIM screen in VBMS.
  • Uses the note the decision maker left in Stage 8 to determine the location on the shared drive where the decision and VA Form 21-0961 were saved.
  • Reviews the decision.
  • Takes the actions described in the table below.
If …
Then the reviewer …
  • the reviewer approves the decision with no changes, and
  • a third signature is not required
  • adds a signature in the Second Signature field on the VA Form 21-0961, as described in Stage 4
  • resaves the form to the shared drive, as described in Stage 5
  • reassigns the work item to the decision maker in VBMS, as described in Stages 6 and 7 (substituting the reviewer’s name with the decision maker’s name)
  • explains the action taken in the PERMANENT NOTE field on the REASSIGN WORK ITEM box
  • enters the current date in the RECEIVED column of the Admin Decision tracked item
  • removes the special issue titled Administrative Decision Review – Level 1, and
  • updates the claim-level suspense to ensure correct routing for continued development or notification of the claimant.
Note:  The process continues at Stage 11.
  • the reviewer approves the decision with no changes, and
  • a third signature is required
  • adds a signature in the Second Signature field on the VA Form 21-0961, as described in Stage 4
  • resaves the form to the shared drive, as described in Stage 5
  • replaces the special issue titled Administrative Decision Review – Level 1 with the special issue titled Administrative Decision Review – Level 2 , and
  • assigns the work item to the next reviewer, as described in Stages 6 and 7.
corrections are needed on the decision
  • returns the decision to the decision maker for corrections, using the follow-up feature associated with the Admin Decision tracked item
  • explains the correction(s) that need(s) to be made to the decision in the PERMANENT NOTE field on the REASSIGN WORK ITEM box, and
  • repeats the actions described in Stage 9 after the decision maker makes the necessary corrections and returns the decision for review.
10
reviewer
  • Navigates to the CLAIM screen in VBMS.
  • Uses the note the decision maker left in Stage 8 to determine the location on the shared drive where the decision and VA Form 21-0961 were saved.
  • Reviews the decision.
  • Takes the actions described in the table below.
If …
Then the reviewer …
the reviewer approves the decision with no changes
  • adds a signature in the Third Signature field on the VA Form 21-0961, as described in Stage 4
  • resaves the form to the shared drive, as described in Stage 5
  • reassigns the work item to the decision maker in VBMS, as described in Stages 6 and 7 (substituting the reviewer’s name with the decision maker’s name)
  • explains the action taken in the PERMANENT NOTE field on the REASSIGN WORK ITEM box
  • enters the current date in the RECEIVED column of the Admin Decision tracked item
  • removes the special issue titled Administrative Decision Review – Level 2, and
  • updates the claim-level suspense to ensure correct routing for continued development or notification of the claimant.
corrections are needed on the decision
  • returns the decision to the decision maker for corrections, using the follow-up feature associated with the Admin Decision tracked item
  • explains the correction(s) that need(s) to be made to the decision in the PERMANENT NOTE field on the REASSIGN WORK ITEM box, and
  • repeats the actions described in Stage 10 after the decision maker makes the necessary corrections and returns the decision for review.
11
decision maker
  • Opens VA Form 21-0961 from its location on the shared drive.
  • Verifies all required signatures are present on the form.
12
decision maker
Uploads the administrative decision and VA Form 21-0961 to the eFolder using the DOCUMENT TYPE entry Determinations: Administrative Decision.
Reference:  For information about uploading documents into an eFolder, see the VBMS Core User Guide.
13
decision maker
Deletes the decision and VA Form 21-0961 from the shared drive.

X.v.1.C.2.j.  Notifying Claimants of an Unfavorable Administrative Decision
When an administrative decision is unfavorable, send notice to the claimant in a letter containing the elements in M21-1, Part VI, Subpart i, 1.B.1.b, including options for decision review.  An unfavorable decision includes a determination that
  • new and relevant evidence was not submitted
  • new and material evidence does not change a prior determination, or
  • CUE did not exist in a prior determination.
Important:  A single decision notice will be prepared and released to the claimant after the administrative decision is completed and the claims processor
  • denies benefits, or
  • denies benefits based on a rating decision.
References:  For more information on