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Updated Oct 21, 2024

In This Section

 
This section contains the following topics:
 
Topic
Topic Name
1
2
3
4
 

                         
                                

1.  Purpose of the DROC’s

 
 


Introduction

 
This topic contains general information on

Change Date

 
July 15, 2024

1.A.1.a.  Purpose of the DROCs

 
In October 2018, the Veterans Benefits Administration (VBA) consolidated Appeals Modernization Act (AMA) higher-level review (HLR) processing into two decision review operations centers (DROC), to 
  • centralize processing of all
    • HLRs
    • AMA full grants by the Board of Veterans’ Appeals (Board)
    • AMA Board remands
  • achieve a more effective use of limited human resources, and
  • improve technical accuracy based on skills specialization and Information Technology enhancements.

1.A.1.b.  HLRs at DROCs

 
VA implemented AMA on February 19, 2019, which authorized VA to process requests for HLRs of decisions relating to disability compensation at DROCs.
 
References:  For more information on

 

2.  DROC Location and Jurisdiction

 
 


Introduction

 
This topic contains information on

Change Date

 
October 3, 2022

1.A.2.a.  Location of the DROCs

 
The three DROCs are located in
  • Seattle, Washington
  • St. Petersburg, Florida, and
  • Washington, District of Columbia (remote office).

1.A.2.b.  Jurisdiction of the DROCs

 
The National Work Queue (NWQ) manages decision review workload distribution through assigned routing rules and established local rules based on available employee capacity, which generally distributes the oldest pending claims to be worked first, except for VBA designated priority claims.  Those designated priority claims are included in the daily workload distribution to ensure priority processing. 
 
The distribution of the workload is determined by set capacities for each claim lifecycle based on the station’s Workforce Information Tool (WIT).
 
DROC Managers (DROCM) are responsible for ensuring that workload is distributed efficiently and equitably to maximize the DROCs’ ability to serve Veterans and their dependents.
 
As part of efficient distribution, DROCMs must update and ensure accuracy of their station’s WIT on a weekly basis, to include the proper designation of specialized claims processors as noted in M21-5, Chapter 1, Section A.3.f.
 
Reference:  For more information on updating the WIT, see the WIT Tool User Guide.
 

 

3.  DROC Team Structure and Work Processing

 


Introduction

 
This topic contains information on DROC team structure and work processing, including

Change Date

 
July 15, 2024

1.A.3.a.  IPC at DROCs

 
The Intake Processing Center (IPC) at the DROCs are primarily responsible for putting claims under end product (EP) control. 
 
Each IPC is composed of a Coach and one or more
  • Claims Assistants (CA), and
  • Mail Clerks or Program Support Assistants (only if the DROC is responsible for mailroom operations).
Note:  As a local option, DROC IPC’s may also include one or more
  • Intake Analysts, and
  • Assistant Coaches.
DROC IPCs are primarily responsible for
  • control and processing of mail inventory,
  • EP and claim label assignment,
  • Control and updating of electronic records, and
  • Caseflow establishment/controls
For additional general information on IPCs, please refer to M21-1, Part I, Subpart ii, 1.A.1.b.

1.A.3.b.  Adjudication Teams at DROCs

 
Adjudication team responsibilities include, but are not limited to
  • claim development
  • rating and non-rating decision activities
  • award promulgation
  • award authorization, and
  • decision notification. 
Examples of cases handled by adjudication teams are
  • HLRs
  • Legacy or AMA Board remands, and
  • Legacy or AMA Board grants. 
The composition of an adjudication team is structured and staffed to process claims for benefits in support of the overall mission of VBA.  Adjudication teams may be cross functional or position based.  The team is typically composed of, but not restricted to
  • a Coach, and
  • one or more
    • Veterans Service Representatives (VSR) that have been trained in claim development and award promulgation
    • Senior VSRs (SVSR), (i.e. GS-12 VSRs and/or certified, GS-11 VSRs),
    • Rating VSRs (RVSR),
    • Decision Review Officers (DRO) 
Note:  As a local option, DROCs may add to a team one or more
  • CAs, and/or
  • Assistant Coaches. 

1.A.3.c.  QRT at DROCs

 
DROCs must establish a Quality Review Team (QRT) to
  • perform quality reviews, and/or
  • identify and address error trends. 
Each QRT is composed of
  • a Coach, and
  • one or more:
    • Assistant Coach(es) and 
    • Quality Review Specialists (QRS) 
The QRT is comprised of Rating Quality Review Specialists (RQRS) and Authorization Quality Review Specialists (AQRS) and is responsible for conducting the following:
  • Individual Quality Reviews (IQR) for all CAs, VSRs, RVSRs, DROs, and QRSs
  • In-Process Reviews (IPR)
  • Veteran Benefits Management System (VBMS) Deferral Mitigations
  • Office of Administrative Review (OAR) mandated and/or local reviews, as necessary
  • Error trend indentification and resolution, and
  • Mentoring and training, as workload permits
For additional information on QRTs, see M21-5, Chapter 3 and M21-4, Chapter 6.

1.A.3.d.  Informal Conference Telephone Line

 
DROCs conducting informal conferences are responsible for establishing and managing a dedicated phone number for informal conference scheduling.  The dedicated phone line must include a functional voicemail accessible by employees to account for time zone differentials.
 
DROCs must determine and document a local plan for oversight of the dedicated informal conference phone line in the DROC workload management plan.
The plan must include:
  • designated employees/team responsible for managing the informal conference phone line
  • process for maintaining informal conference phone line and routing informal conference to appropriate personnel
  • requirement to document all attempts, to include voicemail, on VA Form 27-0820, Report of General Information
  • process to evaluate compliance.

1.A.3.e.         Attorney Fee Coordination

 
Agents or attorneys may charge claimants fees for representation after an agency of original jurisdiction (AOJ) has issued notice of an initial decision on a claim. 
 
Each DROC is responsible for adjudicating whether an agent/attorney representative is eligible for direct payment fees. 
 
Reference:  For more information on Payment of Attorney or Agent Fees, see M21-5, Chapter 8.

1.A.3.f.         Designated Specialized Claims Processors

 
Each DROC is responsible for designating specialized groups of trained personnel to ensure high priority and complex processing of claims related to
  • military sexual trauma (MST)
  • amyotrophic lateral sclerosis (ALS)
  • traumatic brain injury (TBI)
  • herbicide exposure claims (i.e., Blue Water Navy (BWN), Nehmer, BWN-Nehmer)
  • pension claims
  • non-rating claims
  • Electronic Health Record Modernization (EHRM) impacted claims, and
  • special mission claims which include:
    • Manila – Philippine (excluding Filipino Veterans Equity Compensation)
    • foreign and U.S. Territory
    • Camp Lejeune Contaminated Water (CLCW), and
    • radiation.
Each DROC must designate specialized processors in the WIT according to the  following guidance. For workload requiring WIT input in Special Teams or Team fields, please select from the dropdown list available.
 
Notes:
  • DROCs should only designate employees as specialized processors for MST, TBI or ALS in the WIT once they meet all training requirements, outlined in M21-5, Chapter 1, Section A.3.gM21-5, Chapter 1, Section A.3.h., and M21-5, Chapter 1, Section A.3.i.
  • Once training requirements are met, specialized processors should be added to the WIT while the employees are working toward completion of the single-signature requirements outlined above.
  • AQRSs and RQRSs are authorized to second sign on specialized cases while still on second-signature.
  • For a definition of SVSR, refer to M21-5, Chapter 1, Section A.3.b.
  • OAR Operations has authority to edit the minimum designations outlined in the table below, based on workload demand. 
Position
Workload
Office(s)
Required WIT Input
Designation Requirements
VSR/SVSR
MST
All DROCs
Special Team: (MST) MST

Minimum of 5% of total VSRs

RVSR/DRO
MST
All DROCs
Special Team: (MST) MST
  • Minimum of 5% of total RVSRs
  • Minimum of 5% of total DROs
RVSR/DRO
ALS
All DROCs
Special Team: (ALS) ALS
  • Minimum of 2-4 RVSRs
  • Minimum of 2-4 DROs
RVSR/DRO
TBI
All DROCs
Special Team: (TBI) TBI
  • Minimum of 5% of total RVSRs
  • Minimum of 5% of total DROs
AQRS
MST
All DROCs
Special Team: (MST) MST
All AQRS
RQRS
MST/TBI/ALS
All DROCs
Special Team: (must select all three): (MST) MST, (ALS) ALS, (TBI) TBI
All RQRS
VSR/SVSR
Agent/Attorney Fees
All DROCs
Special Team: (AAFC) ATTORNEY FEE COORD
All VSRs involved in the promulgation and/or authorization of agent/attorney fee cases
AQRS
Agent/Attorney Fees
All DROCs
Special Team: (AAFC) ATTORNEY FEE COORD
All AQRS
VSR/SVSR
Herbicide Exposure
St. Petersburg
DROC Nehmer (DNHM) Special Team
  • Minimum of 5 VSRs
  • Minimum of 5 SVSRs
RVSR/DRO
Herbicide Exposure
St. Petersburg
DROC Nehmer (DNHM) Special Team
  • Minimum of 5 RVSRs
  • Minimum of 5 DROs
RRS (Journey-level VSR)
Herbicide Exposure
DROC DC
Special Team: (DRRS) DROC RRS

DROC DC: 3

Research Coordinator (Journey-level VSR)
Record Requests
All DROCs
Special Team: (RC) RESEARCH
1 RC for every 30 development VSRs and 1 alternate RC
QRS
Herbicide Exposure
All DROCs
DROC Nehmer (DNHM) Special Team
All QRS
VSR
Pension
Seattle, DC
Seattle – WIT Team: AMA-Pension
 
DC – Special Team: (DRPN) DROC PENSION
Minimum of 5% of total VSRs
RVSR/DRO
Pension
Seattle, DC
Seattle – WIT Team: AMA-Pension for RVSR or HLR-Pension for DRO
 
DC – Special Team: (DRPN) DROC PENSION
Minimum of 5% of RVSRs & DROs
QRS
Pension
All DROCs
Special Team: (DRPN) DROC PENSION
All QRS
VSR
Non-Rating
All DROCs
Seattle/St. Petersburg – WIT Team: Compensation-Non-Rating
 
DC – Special Team: (DRNR) DROC NON RATING
Minimum of 5% of total VSRs
VSR
EHRM
All DROCs
Special Team: (EHRM) EHRM
Minimum of 2 VSRs
VSR
Special Mission
Seattle
Special Team: (DSPM) DROC SPECIAL MISSION
Minimum of 5% of total VSRs
RVSR/DRO
Special Mission
Seattle
Special Team: (DSPM) DROC SPECIAL MISSION
Minimum of 5% of total RVSRs & DROs
 
Note: Of the 5%, a minimum of 2 RVSRs and 2 DROs must be designated to the “DROC Special Mission” team and the “Nehmer” special WIT team.
QRS
Special Mission
All DROCs
Special Team: (DSPM) DROC SPECIAL MISSION
All QRS

 Important

  • DROCs must  assign relevant specialized training to these designated personnel, per M21-5, Chapter 2.
  • These specially trained employees should be the only individuals processing specialized claims; however, they should receive other types of work as well. When there are no specialized claims to distribute, DROC management must provide these employees a normal distribution of work.
  • Unless otherwise specified, VSR refers to all VSRs GS 7-12.
  • Journey-level VSRs have been in the position for at least 25 months.
 
Reference:  For more information on updating the WIT, see M21-5, Chapter 1, Section A.2.b and the WIT Tool User Guide.  

 

1.A.3.g.  Training and Signature Requirements for MST Development and Decisions

 
Only a VSR, AQRS, or RVSR who meets the below requirements is authorized to complete development actions that address MST, and only an RVSR, DRO, or RQRS who meets the below requirements is authorized to complete a decision on MST. 
  • Designated by the DROC as an MST claims processor
  • Meeting or exceeding performance and quality standards, and
  • Completed MST training requirements, as identified in M21-5, Chapter 2, Section 2.4.h.
 
Development actions completed by a VSR require two signatures until the VSR demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases. Reviews of development actions completed by an AQRS require two signatures until the AQRS demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases. Decisions completed by a decisionmaker for MST conditions require two signatures until the adjudicator demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases, including a mix of grants, denials, and evaluations. Reviews of decisions completed by an RQRS for MST conditions require two signatures until the RQRS demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive MST cases, including a mix of grants, denials, and evaluations.
 
Notes:
  • OAR requires DROCs to keep a memorandum of record confirming completion of the requirements and designation of single-signature authority for all MST claims processors and quality review specialists. See M21-5, Chapter 1, Section A.3.j. for specific requirements the DROC should include in the memorandum.
 

 

1.A.3.h.  Training and Signature Requirements for TBI Decisions 

 
Only an RVSR, DRO, or RQRS who has met the below requirements is authorized to complete a decision on TBI.    
Decisions on TBI cases completed by decisionmakers require two signatures until a decisionmaker demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive TBI cases, including a mix of grants, denials, and evaluations.
 
Notes:
  • OAR requires DROCs to keep a memorandum of record confirming completion of the requirements and designation of single-signature authority for an RVSR, DRO, and RQRS. See M21-5, Chapter 1, Section A.3.j. for specific requirements to include on the memorandum.
 

 

1.A.3.i.  Training and Signature Requirements for ALS Decisions 

 
Only an RVSR, DRO, or RQRS who has met the below requirements is authorized to complete a decision on a case where the Veteran is either claiming or has been granted service connection for ALS, even if the current issues under decision are not directly related to the service connected ALS.  
  • Designated by the DROC as an ALS claims processor, and
  • Completed the training requirements for ALS determinations, as identified in M21-5, Chapter 2, Section 2.4.i.
Decisions on ALS cases completed by decisionmakers require two signatures until a decisionmaker demonstrates an accuracy rate of 90 percent or greater based on a review of 10 consecutive ALS cases, including a mix of grants, denials, and evaluations.
 
Notes:
  • OAR requires DROCs to keep a memorandum of record confirming completion of the requirements and designation of single-signature authority for an RVSR, DRO, and RQRS. See M21-5, Chapter 1, Section A.3.j. for more information on the memorandum and requirements.
 

 

1.A.3.j.  Second Signature Log and Memorandum for Specialized Processors

 
OAR requires DROCs to maintain a log of claims processors on second signature review for specialized processing to include MST, TBI, and ALS. DROCs must also maintain a memorandum for each claims processor who has completed training and second signature requirements.    
 
The log must contain an entry for each specialty case reviewed and each entry in the log must contain the following information:
  • Employee name,
  • Employee position,
  • Date of case completion,
  • Benefit claim ID,
  • Date of case review,
  • Reviewer name,
  • Case accuracy percent (100 for correct or 0 for incorrect),
  • Corrective action required, if necessary,
  • Date corrective action was taken, if applicable.
For any reviewed cases that are incorrect, the log must also contain columns to indicate additional date(s) reviewed following corrective action, reviewer name(s), and any further corrective action needed.
 
All special processing cases must be second-signed and reviewed for accuracy until the individual processing that case has achieved at least 90 percent accuracy over no less than 10 reviews. DROCs must provide each claim processor who is designated to have single-signature authority for special processing to include MST, TBI, and ALS with a formal memorandum confirming completion of training and second signature requirements. Refer to the Delegation of Single-Signature Authority Memorandum template.
 

 
 

4.  DROC Roles and Responsibilities

 


Introduction

 
This topic contains information on duties and responsibilities of

Change Date

 
July 15, 2024

1.A.4.a.  Duties of CAs

 
CAs are assigned to the DROC IPC.  This group of employees has varying degrees of responsibility within the IPC primarily revolving around claims control. 
 
Responsibilities include but are not limited to
  • controlling and processing of mail inventory,
  • performing EP and claim label assignment,
  • controlling and scheduling of Informal Conferences,
  • controlling and updating of electronic records, and
  • establishment/controls of EPs
Reference:  See M21-1, Part II, Subpart i, 1.A.1.a. for information about mail intake procedures

1.A.4.b.  Duties of VSRs (to include SVSRs, GS-12 VSRs and/or certified, GS-11 VSRs)

 
VSR responsibilities include but are not limited to
  • triaging of electronic files received from the Board, to include remands, grants, and partial grants,
  • performing initial review and all required actions to move a claim to the next claim life cycle, 
  • reviewing new remands and ensuring that development and/or action is initiated within fifteen days of receipt of the file (based on existing Board timeframes),
  • completing any directed development for appeals in the remand stage and other assigned claims,
  • updating all appropriate systems, to include Veterans Appeals Control and Locator System (VACOLS), VBMS, Caseflow, etc.
  • ensuring VBA electronic systems accurately reflect
    • suspense dates and reasons
    • contentions associated with a claim
    • development undertaken in connection with a claim
    • evidence received in connection with a claim, and
    • claim status and claim label
  • contacting Veterans who have requested a call related to their claim,
  • following systems compliance policies/procedures,
  • generating awards,
  • authorizing awards,
  • notifying beneficiaries of proposed adverse actions,
  • deciding issues that do not require a rating decision,
  • issuing decisions on non-rating related HLRs, and
  • notifying claimants of decisions on their decision review requests.
References:  For more information about

1.A.4.c.  Duties of RVSRs

 
RVSR responsibilities include but are not limited to
  • issuing timely, high-quality decisions on
    • AMA full grants by the Board,
    • AMA Board remands,
  • completing rating actions for all favorable Board decisions, 
  • requesting any complex medical opinions in accordance with M21-1, Part IV, Subpart i, 2.A.7.b, and
  • following systems compliance policies/procedures.
References:  For more information about

 

1.A.4.d.  Duties of DROs

 
DRO responsibilities include but are not limited to
  • issuing timely, high-quality decisions on
    • grants by the Board,
    • HLRs,
  • identifying DoO or duty to assist errors and returning impacted HLR issues for corrective action,
  • conducting Informal Conferences and updating controls, 
  • following systems compliance policies/procedures,
  • participating in mentoring and training, and
  • performing appeals processes, to include holding formal hearings, and performing de novo review of appeals.
References:  For more information about the duties of DROs, and the DRO review process, see