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M21-1, Part III, Subpart i, Chapter 2, Section B – Division of Responsibilities for Processing Benefits Delivery at Discharge (BDD) and BDD-Excluded Claims

Overview


In This Section

This section contains the following topics:

1.   ROJ and Intake Site Responsibilities


Introduction

This topic contains information about the responsibilities of intake sites and ROs in handling pre-discharge claims, including

Change Date

October 24, 2018

III.i.2.B.1.a. Definition:  Intake Site

An intake site is any location where the Department of Veterans Affairs (VA) accepts claims.  This includes
  • all regional offices (ROs)
  • demobilization sites with a VA presence
  • military installations with a VA presence, and
  • VA health care facilities.
A Benefits Delivery at Discharge (BDD) intake site is responsible for conducting outreach efforts, accepting claims, initiating development as appropriate, identifying points of contact for VA examinations, handling Vocational Rehabilitation and Employment issues, and serving as a general liaison.
Note:  Not all intake sites have the staffing or capability to perform the actions described in this topic.  Under such circumstances, the parent RO of these sites bears the responsibility for taking these actions.

III.i.2.B.1.b.  Responsibilities of BDD Coordinators

Each RO must assign a BDD coordinator to monitor the BDD claims it receives, including BDD claims routed to it from the National Work Queue (NWQ), and ensure that tasks, including the following, are performed in a timely and proactive manner:
  • soliciting and accepting claims from service members prior to their release from active duty (RAD)
  • conducting development actions, including requesting all required examinations (including specialty examinations) at the same time
  • following up on development actions
  • scanning claims locally or transferring claims to designated scanning sites
  • determining whether BDD claims with completed examinations are ready for a decision
  • completing BDD ratings prior to discharge, and
  • authorizing awards as soon as possible after discharge.
Reference:  For more information on selecting the general medical examination vs. the Separation Health Assessment (SHA) for pre-discharge claims, see M21-1, Part III, Subpart iv, 3.F.4.c.

III.i.2.B.1.c.  Paper Document Handling Procedures Specific to Pre-Discharge Claims

Intake sites must follow the paper document handling procedures in this block.
Incoming documents
  • Screen and place all incoming mail under Veterans Benefits Management System (VBMS) control within five calendar days of receipt.
  • Date stamp on the front page of all documents received in connection with a BDD claim within 24 hours of receipt.
  • When an out-based employee accepts a paper pre-discharge claim it must be marked using a special stamp.  The stamp must
    • be in red ink
    • contain the RO name, number, and date received (mm/dd/yyyy), and
    • identify the out-based office where the mail was received.
Exception:  If a date stamp meeting the above requirements is not available the claims processor may annotate the application with
  • his/her initials
  • his/her title
  • the date of receipt, and
  • the location where the claim was received.
Important:  Annotation of paper claims received at an out-based facility is intended to be used only as a temporary, emergency measure until the RO requests and receives a stamp meeting the requirements specified above.
Storage and outgoing documents
  • All paper documents received in out-based environments must be secured in an approved, lockable container for transporting, then hand-delivered or mailed by secure carrier to the service center with a copy of the register within 72 hours.
  • Each piece of physical, paper mail that leaves the intake site should bear an annotation that shows
    • the pending end product (EP), and
    • a description of any action the employee took, including
      • the date of the action
      • initials of the employee that took the action, and
      • routing instructions.
Reference:  For more information on mail handling and related procedures, see

III.i.2.B.1.d. Initial Actions Upon Receipt of a BDD Claim

Upon receipt of a BDD claim, intake sites are responsible for taking the initial actions described in the table below.
Step
Action
1
Review the application to ensure it is complete.
2
Date-stamp the application with the date of receipt.
3

Confirm the service member’s

Important:  BDD claimants must be available for examination as provided in M21-1, Part III, Subpart i, 2.A.1.d.

4
Ensure a VA Form 21-686c, Declaration of Status of Dependents, is of record if dependents are indicated on the application.
5
Obtain the service member’s service treatment records (STRs) (including DD Form 2807-1, Report of Medical History) for the current period of service.
The following are acceptable formats for the STRs:
  • photocopies
  • compact disk – read only memory (CD-ROM), and
  • digital media files transferred by a secure method.
If the service member hand delivers his/her original STRs, the best practice to minimize the risk of loss of original documents is to copy and return the records to the service member during the office visit.
Exception:  If original STRs cannot be returned during the service member’s office visit, return them to the Department of Defense (DoD) military treatment facility (MTF), or one of the addresses below.
Branch of Service
Address to Return STRs
Navy
Bureau of Medicine and Surgery
7700 Arlington Blvd, Suite 5126
Falls Church, VA 22042-5126
Army
AMEDD Record Processing Center
3370 Nacogdoches Road, Suite 116
San Antonio, TX 78217
Air Force
Air Force Record Processing Center
3370 Nacogdoches Road, Suite 116
San Antonio, TX 78217
Coast Guard
Commanding Officer
HSWL Service Center
ATTN: Central Cell
300 E Main St, Suite 1000
Norfolk, VA 23510-9109
References:  For more information on

III.i.2.B.1.e.   Initial Development Actions in Pre-Discharge Claims

After ensuring a complete pre-discharge claim has been received, use the table below to determine the initial development actions to complete.
If the claim …
Then follow the guidance in …
meets the requirements for processing through the BDD program
does not meet the requirements for processing through the BDD program
Reference:  For more information on the requirements for participating in the BDD program, see M21-1, Part III, Subpart i, 2.A.1.d.

III.i.2.B.1.f. Circumstances Requiring Additional/ Alternative Intake Site Action(s)

Under certain circumstances, intake sites must take additional and/or alternative action(s) upon receipt of a pre-discharge claim.  Use the table below to determine these circumstances and the corresponding action(s) to take.
If a(n) …
Then the …
service member claims entitlement to pension
intake site must provide the Section 5103 notice that is unique to claims for pension unless the claim was submitted on a VA Form 21P-527EZ, Application for Pension.
service member files a claim more than 180 days prior to discharge
intake site must follow the instructions inM21-1, Part III, Subpart i, 2.B.1.g.
service member files a claim with no known date of discharge
intake site must follow the instructions inM21-1, Part III, Subpart i, 2.B.1.h.
intake site
  • receives a claim, that is excluded from VBMS, 10 or fewer days before a service member’s discharge date, or
  • does not have the capability to place claims under EP control
intake site must follow the instructions inM21-1, Part III, Subpart i, 2.B.3.g.
service member submitting a pre-discharge claim will be unable to attend examinations within 45 days of filing the claim
intake site must
intake site receives a BDD claim without a complete copy of STRs for the current period of service
intake site must follow the instructions inM21-1, Part III, Subpart i, 2.B.1.j.
intake site receives a claim that is excluded from the BDD program underM21-1, Part III, Subpart i, 2.A
intake site must
  • enter a note in VBMS that explains why the claim cannot be processed as a BDD claim, and
  • change the EP and claim label to the proper non-BDD rating EP (110, 010, 020, etc.).
service member’s initial examinations for the pre-discharge claim are being requested after discharge General Medical Disability Benefits Questionnaire (DBQ) should always be requested.

Reference:  For more information on selecting the general medical examination vs. the SHA for pre-discharge claims, see M21-1, Part III, Subpart iv, 3.F.4.c.


III.i.2.B.1.g.  Actions to Take for Claims Filed More Than 180 Days Prior to Discharge

If a service member files a claim more than 180 days before discharge, the intake site is responsible for
  • establishing a non-BDD EP 400 and processing the claim outside of the BDD program
  • denying the service member’s claim using the On Active Duty selection from the drop-down menu in VBMS – Awards (VBMS-A)
  • notifying the service member of the reason for the denial, and
  • clearing the EP.
Exception:  Do not deny the claim if, by the time it is discovered that a claim was filed more than 180 days before discharge, the service member now has 180 or fewer days remaining on active duty.  Continue processing the claim.
Reference:  For more information on non-BDD EPs and claim attributes, see

III.i.2.B.1.h. Actions to Take for Claims Filed With No Known Date of Discharge

If a service member files a claim with no known date of discharge, the intake site must
  • disregard the instructions in M21-1, Part III, Subpart i, 2.B.1.d and e
  • explain to the service member that VA cannot pay compensation or pension to a person who is still on active duty, and
  • encourage the service member to re-file the claim within 180 days of discharge.
Exception:  If the service member is not present when the intake site discovers he/she has no known discharge date, the intake site must
Notes:
  • If the intake site contacts the service member by letter, it may clear an EP 400.
  • By failing to provide his/her date of discharge, the service member did not submit a “substantially complete application” under 38 CFR 3.159(a)(3).  For this reason, the intake site would not
    • establish EP control, or
    • provide appeal rights with any letter sent to the service member.

III.i.2.B.1.i.  Intake Site Responsibilities to Update VBMS

Upon receipt of a BDD claim and throughout the time an intake site has custody of it, the intake site is responsible for updating VBMS to show
  • all claimed contentions
  • all claimed dependents, and
  • any development actions taken, to include the
    • location(s) where the service member will be examined, and
    • date the intake site
      • requested the examination(s), and
      • received a corresponding examination report.
Note:  Tracked items must be created for all development actions.  VBMS notes are important and necessary but they are not sufficient to track development.
Reference:  For more information on record maintenance during the development process, including utilizing contentions and tracked items, see M21-1, Part III, Subpart iii, 1.F.

III.i.2.B.1.j. Actions to Take for BDD Claims Without STRs

Upon receipt of a BDD claim without STRs for the current period of service, the claims processor must
  • establish an EP 336 with the Pre-Discharge Excluded claim label
  • enter a note in VBMS indicating that the claim does not meet BDD requirements because it was received without STRs, and
  • take the actions described in the table below.
If …
Then the intake site/RO must …
  • the service member is able to attend examinations prior to discharge, and
  • STRs for the current period of service are not required for the examination
  • request the examination(s)
  • follow up with the service member for his/her STRs, and
  • forward the claim for immediate Veterans Claims Intake Program (VCIP) scanning.
  • the service member is unableto attend examinations prior to discharge, or
  • STRs for the current periodare required for the examination
  • forward the claim for immediate VCIP scanning, and
  • follow up with the service member by phone and letter for his/her STRs.
  • the intake site/RO later obtains STRs through follow-up with the service member
  • at least 90 days remain before his/her date of discharge, and
  • the service member is still able to attend examinations
  • change the claim label to the appropriate BDD claim label, and
  • process the claim as a BDD claim.
the intake site/RO later obtains STRs through follow-up with the service member, but
  • less than 90 days remain before his/her discharge date, or
  • the service member no longer meets the BDD program requirements
  • change the EP and claim label it initially established to the appropriate non-BDD diary rating EP/claim label, and
  • process the claim under the Fully Developed Claim (FDC) Program.
Note:  The claim may be handled under the standard VA claims process or another qualifying program if the service member marks the VA Form 21-526EZ to indicate the claim should not be considered under the FDC Program.
the intake site/RO does not receive the service member’s STRs before his/her discharge date
  • change the pending EP 336 to a non-BDD EP/claim label, and
  • the claim will receive standard, non-BDD processing.
Notes:
  • Development for current period of service STRs for service members who have not yet been discharged requires:
    • contacting the service member by telephone, e-mail, or letter (if telephone and e-mail development is not successful), and
    • assisting the service member in obtaining copies of STRs from the MTF whenever possible.
  • A contact list of Military Services Coordinators who can assist in obtaining records from the local MTF can be found on the pre-discharge website.
  • Defer examinations that require the service member’s STRs if the STRs are unavailable.
References:  For more information on

III.i.2.B.1.k.  Handling Paper Pre-Discharge Claims Folders

Intake sites must establish a Control of Veterans Records System record and location for all paper claims folders associated with a pre-discharge claim.
Use the table below to determine the actions intake sites must take if a paper claims folder already exists at another RO or at a records storage facility such as a Federal records center (FRC) for a service member who submits a pre-discharge claim.
If the claim …
Then the intake must …
meets BDD program requirements
  • manually request the claims folder from its current custodian via e-mail to the corporate mailbox or designated point of contact, and
  • the current custodian will send the folder for VCIP scanning.
Note:  All records from the Records Management Center (RMC) (or another RO or records facility) must be received, and all development actions must be completed, before performing the actions in M21-1, Part III, Subpart i, 2.B.2.c.
does not meet BDD program requirements
send a request to the current custodian to send the records for scanning.
Exception:  Do not manually request the claims folder when it is located at RMC.  As noted in M21-1, Part III, Subpart iii, 2.B.3.a, RMC is automatically notified upon establishment of the EP and will forward records in their possession for scanning.  However, if the RMC sends paper records erroneously, send those records to the scanning vendor.
Notes:
  • FRCs are National Archives and Records Administration facilities.  They only send requested claims folders to the requesting station of origination.
  • RMC is a VBA facility and ships claims folders to scanning vendors, as do all other VBA facilities.
Reference:  For more information on paper folders and electronic claims folders (eFolders), see M21-1, Part III, Subpart ii, 3.B.

III.i.2.B.1.l.   Initial Actions Upon Receipt of an Electronic Pre-Discharge Claim

Upon receipt of an electronic claim, pre-discharge claims processors will follow the instructions in the table below.
Step
Action
1
Did the service member submit STRs for the current period of service?
2
Does the service member meet the other requirements of the BDD program?
  • If yes, proceed to the next step.
  • If no,
    • change the EP 336 to the appropriate non-BDD rating EP, and
    • proceed to Step 4.
3
Develop the claim as required by M21-1, Part III, Subpart i, 2.B.2.b.
4
Process the claim under the FDC Program (or the standard VA claims process, or any other qualifying program, if the service member indicated on the VA Form 21-526EZ indicating they do not want their claim considered under the FDC Program).
Notes:
  • Claims received via eBenefits that are automatically established with an EP 337 must be changed to the appropriate non-BDD rating EP as provided in M21-1, Part III, Subpart i, 2.A.2.f.
  • For claim types excluded from the BDD program
  • For guidance on how to consolidate incremental 400 EPs that are established by the Veterans Online Application Direct Connect following initial receipt of the claim, see M21-1, Part III, Subpart i, 4.C.1.e.

References:  For more information on


III.i.2.B.1.m. Handling Late-Flowing Claim Documents

If an intake site receives additional documents after shipping documents to the scanning vendor, the intake site must

  • update VBMS notes with
    • a description of the documents
    • the date of shipment for scanning, and
    • any other information of importance to the RO of jurisdiction (ROJ)
  • enter any newly identified contentions into VBMS
  • annotate pre-discharge on the outside of the box as appropriate, and
  • follow VCIP Shipping Standard Operating Procedure (SOP) and local vendor protocols.

References:  For more information on


2.  Intake Site Responsibilities Unique to BDD Claims

 


Introduction

This topic contains information about intake site responsibilities unique to BDD claims, including

Change Date

October 24, 2018

III.i.2.B.2.a.  NWQ Routing of BDD Claims

BDD claims in a rating EP status are routed by NWQ to all ROs for post intake site actions based on available capacity at each RO.
Exception:  All restricted-access claims (including Warrior Training Advancement Course (WARTAC) claimants) will be routed via NWQ to, and worked by, the restricted access claims center as provided in M21-1, Part III, Subpart ii, 1.C.6.
Reference:  For more information on EP and claim label adjustment from diary EP 336 to a rating EP, see M21-1, Part III, Subpart i, 2.A.2.d.

III.i.2.B.2.b.  Special Claims-Handling Procedures for BDD Claims
In addition to the responsibilities described in the previous topic (M21-1, Part III, Subpart i, 2.B.1), intake sites are responsible for following the steps in the table below when handling a BDD claim.
Step
Action
1
Did the service member file his/her claim on VA Form 21-526EZ?
  • If yes, proceed to the next step.
  • If no,
    • provide the service member with Section 5103 notice if received on any other VA Form 21-526 series, and
    • proceed to the next step.
2
Does a Beneficiary Identification and Records Locator Subsystem (BIRLS) record exist?
  • If yes, proceed to the next step.
  • If no,
    • establish a BIRLS record, and
    • proceed to the next step.
3
Establish the BDD claim in VBMS.
4
Ensure all evidence is secured together, including
  • a dated copy of the Section 5103 notice or a completed and signed VA Form 21-526EZ
  • photocopies of STRs and/or CD-ROM, and
  • any other evidence and information submitted in support of the claim.
5
Ensure that documents are forwarded for VCIP scanning or scan the documents locally.
If forwarding for VCIP scanning the following must be completed within five calendar days of receipt of the claim:
  • Follow VCIP Shipping SOP and local vendor protocols.
  • Add a VBMS custom tracked item, Documents sent for scanning, with a 10-day suspense.
Important:  If the intake site scans claims documents locally, the intake site must scan all claims documents and upload those into the VBMS eFolder within 10 calendar days of receipt of a claim.
Once documents have been successfully uploaded into the VBMS eFolder, return the original paper documents to the service member.  Complete the Return of Documents letter from the Letter Creator tool and upload a copy to the VBMS eFolder.
Notes:
  • It is recommended that the claims processor scan and return the original paper documents the same day as receipt.  The Return of Documentsletter still needs to be generated if the documents are scanned locally, but can be hand-delivered to the service member during the interview.
  • Following expiration of the 10-day suspense, NWQ must route the claim within 48 hours for additional development action.
  • STRs received electronically should be uploaded directly to the eFolder.
  • Electronic signatures are acceptable with an e-signature pad.
References:  For more information on
6
Are the documents available in VBMS within 10 days?
  • If yes, proceed to Step 8.
  • If no,
    • extend the suspense for an additional five days, and
    • proceed to Step 7.
Note:  Following expiration of the 5-day suspense, NWQ must route the claim within 48 hours for additional development action.
7
Are the documents present after the five-day extension?
  • If yes, proceed to Step 8.
  • If no, e-mail the VCIP Mailbox for resolution.
8
Ensure the service member is available for examinations at his/her current or forwarding address within 15 days.
9
Determine whether a contract examination or Veterans Health Administration (VHA) examination is required by utilizing the Examination Request Routing Assistant (ERRA) as noted below.
  • If a contract examination is required, proceed to Step 10.
  • If a VHA examination is required, proceed to Step 11.
Use the ERRA tool unless at the BDD intake site there is an existing agreement specifying the provider(s) responsible for local BDD examinations.
Within the ERRA tool, select Yes following the text BDD/IDES Claim? as shown below:
Image of EERA screen.
Important:
  • An SHA examination should be requested for all BDD claimants still on active duty at the time of the examination request, along with any necessary specialist examinations.
  • Be sure to review the VA Form 21-526EZ for effective dates of any forwarding addresses provided by the service member.  This will ensure your request is routed to the service member’s current location.  This is most critical if the exam request is a re-input of an original request that was rejected via the Examination Management System (EMS) or Compensation and Pension Record Interchange (CAPRI).
References:  For more information on
10
Enter requests for all required contract examinations at the same time using EMS.
Important:
  • A request for an examination including the SHA DBQ and any other necessary specialist examinations must be entered within five calendar days of claim documents being uploaded into VBMS (see Steps 6 and 7).
  • An intake site must have been entered when the claim was established to prevent the EMS examination request from being rejected.
    • If there is not an intake site shown in the corporate record in SHARE
      • change the EP to an EP 400
      • cancel the EP 400, and
      • re-establish the EP in VBMS with the proper intake site.
    • The intake site location should be indicated on the date stamp on the claim form.  If the claims processor is unable to determine an intake site location, the claims processor may enter the RO location nearest to the service member’s address for the intake site.
References:  For more information on
11
Enter all necessary requests for VHA examinations at the same time using CAPRI.
Important:
  • A request for an examination including the SHA DBQ and any other necessary specialist examinations must be entered within five calendar days of claim documents being uploaded into VBMS (see Steps 6 and 7).
  • select the BDD – DOD SHA claim type in CAPRI.
Note:  If service connection (SC) related to undiagnosed illnesses due to Gulf War environmental exposure is being claimed, and the claimant meets the requirements for a Gulf War examination noted in M21-1, Part IV, Subpart ii, 1.E.2.a, do not request the Gulf War general medical examination.  Instead, copy and paste the Notice to Examiners in Southwest Asia Claims and definitions for examiners in southwest Asia claims, found in M21-1, Part IV, Subpart ii, 1.E.2.m and n, into the SHA DBQ request and identify the contention(s) being claimed related to Gulf War environmental exposure.
References:  For more information on
12
When the examination request has been submitted, upload a copy of the examination request into the eFolder.
13
Ensure that all development actions have been performed, including
  • requesting all evidence identified by the service member, and
  • if there is more than one period of service, requesting the other period’s STRs from the service member, RMC, or other necessary location.
If records exist at
  • RMC, do not manually request, as RMC is automatically notified upon the establishment of an EP and will forward records in their possession for scanning, or
  • FRC, manually request the records and they will forward for scanning.
Move to the next step.
14
Notes:
  • The SHA DBQ and associated DBQs are provided to DoD via an electronic exchange process.  If contacted by an MTF requesting examination results, inform the MTF these results are available in
    • Healthcare Artifacts and Image Management Solution (HAIMS) system for examinations requested through EMS, or
    • the Joint Legacy Viewer (JLV) for examinations requested through CAPRI.
  • The station performing post intake site actions (i.e. Ready for Decision (RFD) review or rating action) is responsible for obtaining examination results.
  • Intake sites
    • must ensure VBMS images are available for review by the examining facility under the circumstances described in M21-1, Part III, Subpart iv, 3.A.8.b
    • are entitled to credit for an interview if they conduct one in connection with a pre-discharge claim, and
    • are responsible for creating tracked items to document completed development actions as indicated in M21-1, Part III, Subpart i, 2.B.1.i.
References:  For more information on

III.i.2.B.2.c.  Actions to Take When Required Development Actions Are Complete

 After all development actions are complete, the intake site must

Notes:
  • Following expiration of the 30-day suspense for examinations, NWQ must route the claim within 48 hours for additional action.
  • After the above actions have been completed, NWQ will route the claim to the proper location for further processing during its overnight cycle.
  • It is not necessary to wait for evidence to be uploaded into the VBMS eFolder prior to performing the above actions if

    • examinations do not require an eFolder review, and
    • all development actions have been completed.

III.i.2.B.2.d.  Follow-up Requirements for EMS and CAPRI Examinations 

If an examination is rejected or cancelled, NWQ will route the claim to be corrected.  The claims processor must review the clarification request/cancellation reason.
Thereafter
  • request the claim from NWQ if necessary
  • review the ERRA tool to determine where the examination should be re-requested (EMS or CAPRI), and
  • take the steps necessary to correct or re-input the examination request, if necessary.
The table provides advice on how to proceed depending on the reason for the examination cancellation.
If the examination cancellation is due to …
Then …
the service member’s failure to adhere to BDD requirements
Example:  The service member is not available to report for an examination for 45 days following claim submission as specified in M21-1, Part III, Subpart i, 2.A.1.d.
  • change the pending EP to a non-BDD rating EP,
  • enter a note in VBMS indicating why the service member was removed from the BDD program, and
  • continue processing the claim as a BDD-excluded claim.
a reason outside of the control of the service member
Examples:
  • The claims processor failed to timely request the examination and now the service member has relocated to their forwarding address.
  • The claims processor failed to correctly enter the service members address or other contact information and as a result the service member was not notified of the examination.
  • take the necessary steps to submit a new examination request, and
  • continue processing the claim as a BDD claim.
Note:  Make every reasonable effort to contact the service member via telephone and/or e-mail to verify why an examination was cancelled or rejected.
Reference:  For more information on requesting examinations see M21-1, Part III, Subpart i, 2.B.2.b, Step 9.

3.  ROJ Responsibilities Unique to BDD-Excluded Claims


Introduction

This topic contains information about responsibilities that are unique to BDD-excluded claims, including

Change Date

October 24, 2018

III.i.2.B.3.a.  Handling Claims That do Not Meet BDD Requirements

If a claim is excluded from the BDD program as indicated in M21-1, Part III, Subpart i, 2.A.1.e, and notice has not been provided to the claimant
Important:  If an ROJ discovers a claim in its inventory that is excluded from the BDD program under M21-1, Part III, Subpart i, 2.A.1.e, the ROJ is responsible for completing this action.
Notes:
  • Claims processors may verbally inform the service member of the reasons why their claim was excluded from the BDD program.  When doing so, a VBMS note must be entered regarding the verbal notification and reason for exclusion.
  • If the service member is informed verbally of the BDD exclusion reason(s)and a VBMS note is entered, a BDD excluded letter does not have to be generated.
References:  For more information on

III.i.2.B.3.b.  Options for Processing BDD-Excluded Claims

The ROJ is responsible for processing BDD-excluded claims through the standard claims process, the FDC Program, or any other applicable claims process unless otherwise stated.
Review the claim form to determine whether the claimant wants the claim processed as an FDC or is filing the claim under the standard claim process.
References:  For more information on

III.i.2.B.3.c.  Processing Additional Contentions from BDD Claimants

As noted in M21-1, Part III, Subpart i, 2.A.2.i, BDD claimants with less than 90 days remaining on active duty who submit claims for additional contentions will have those additional contentions processed under a separate EP as a BDD-excluded claim.
Important:
  • Concurrently pending BDD and BDD-excluded rating EPs are allowed and should not be combined unless as noted in M21-1, Part III, Subpart i, 2.B.3.d.
  • These claims will be processed in the same manner as other BDD-excluded claims as noted in this section including:
    • affording the service member the same opportunity to participate in the FDC Program or any other eligible program, and
    • ensuring development actions are undertaken while the service member is still on active duty.

III.i.2.B.3.d.  When to Combine BDD and BDD-Excluded Claims

If the claimant has concurrently pending BDD and BDD-excluded EPs, and it is later determined that the BDD claim did not meet BDD program requirements and should have been established as a BDD-excluded claim, follow the guidance below.
Step
Action
1
Ensure both EPs are under the correct station’s jurisdiction.  Request the other EP from NWQ, if necessary.
2
Change the pending BDD-excluded claim to an EP 400.
3
Change the pending BDD claim to a BDD-excluded EP.
Reference:  For additional information on the proper EPs and claim labels for BDD-excluded claims, see M21-1, Part III, Subpart i, 2.A.2.h.
4
Add the contentions from the EP 400 to the newly changed BDD-excluded claim.
5
Add a note in VBMS describing
  • the actions taken to combine the two EPs
  • why the claimant was not eligible for the BDD program, and
  • development actions for the added contentions that were previously completed under the EP 400, if applicable.
6
Cancel the EP 400.
7
Continue developing the BDD-excluded claim as noted in this section.

III.i.2.B.3.e. Importance of Initiating Development Before Separation

To minimize the claimant’s wait for a decision after discharge, it is important to initiate any required development (such as requests for records or a VA examination) while the service member is still on active duty.

III.i.2.B.3.f. Special Considerations on Requesting Examinations

When requesting examinations for BDD-excluded claimants the claims processor must
  • verify with the service member that he/she will be available for examinations at his/hercurrent or forwarding address within 15 days,
  • utilize the ERRA tool to determine where the examination should be requested
  • select No for the BDD/IDES Claim? button in the ERRA tool, and
  • complete at least two attempts to contact the service member to verify their current or forwarding address.
Important:
  • If Pre-Discharge claims processors encounter issues with examination providers cancelling examination requests submitted 15 days before the service member is available for examination, send the details of the issue including the claim number to the pre-discharge mailbox at VAVBAWAS/CO/PREDISCHARGE.
  • If the claims processor is unable to contact the service member after at least two attempts, request the examination based on the evidence of record.
  • Review the VA Form 21-526EZ for a forwarding address and the date the service member will be located at that forwarding address to ensure the correct examination location.
  • For all BDD excluded claims, claims processors must select BDD-Excluded from the SPECIAL ISSUE drop-down box for one contention requiring an examination as shown in the image below.  This is important to ensure the examination request is routed correctly in EMS.
Example:
Image of the BDD-Excluded special issue option.
Note:  Claimants who file pre-separation claims that are excluded from the BDD program will receive a general medical examination and should not be examined under the SHA protocol.
Reference:  For more information on examination of BDD excluded claims, see M21-1, Part III, Subpart iv, 3.F.4.c.

III.i.2.B.3.g.  When Not to Request Examinations
There are several instances when requesting examinations for BDD excluded claimants will be delayed due to the service member transitioning from active duty.  For BDD excluded claims, reasonable time should be allotted to the service member to transition to their new location.
Do not request an examination if the service member
  • will be unable to attend a scheduled examination in the next 15 days
  • will not be available long enough for VHA or the VBA contractor to schedule and complete the examination, or
  • does not currently know his/her forwarding address.
If an examination cannot be requested for one of the reasons noted above, enter a VBMS note explaining
  • why an examination was not requested, and
  • actions taken to obtain missing information, if applicable.
Important:  If the service member is not available to report for a scheduled examination within a 15-day period but does know when he/she will be available, perform both of the following actions:
  • create a VBMS note stating the location where the service member is available for examination and the date her/she is available for examination, and
  • create a custom tracked item in VBMS to control for the examination request with a suspense date that expires 15 days before the date the service member is available for examination.  After this suspense expires, request the examination.

III.i.2.B.3.h. BDD-Excluded Claims Received 10 or Fewer Days Before Discharge Date That Cannot be Processed in VBMS

If an intake site receives a BDD-excluded claim 10 or fewer days before the discharge date that cannot be processed in VBMS
  • do not place the claim under EP control
  • ensure an open period of service exists in BIRLS  (If the open period does not exist, perform a BIRLS update in Share.)
  • attach a paper flash to the application materials that reads No EP or Diary Exists-Establish Control Immediately
  • provide an explanation (on the paper flash) for not placing the claim under EP control, and
  • mail to the ROJ.
Important:  Take the same steps if the intake site does not have the capability to place a claim under EP control.

4.  BDD ROJ Responsibilities


Introduction

This topic contains information about BDD ROJ responsibilities, including

Change Date

October 24, 2018

III.i.2.B.4.a. Initial Actions Upon Receipt of a BDD Claim at the ROJ

Upon receipt of a BDD claim at the ROJ, follow the steps in the table below to ensure all development actions are complete and the claim is RFD.

Step

Action

1
Stations processing BDD claims must ensure all required development actions have been completed in accordance with this section and any generally applicable development guidance in the M21-1.
Important:  Any outstanding development actions must be completed by the ROJ.
2
Obtain completed examination reports.
3
Are all examinations sufficient for rating purposes?
  • If yes, proceed to Step 5.
  • If no, proceed to the next step.
4
If the ROJ determines an examination(s) is insufficient, the claims processor must
  • report the examination as insufficient in
    • CAPRI (when VHA conducted the examination), or
    • EMS (when a VBA contractor conducted the examination)
  • request a corrected examination report or new examination, as necessary (the request should be routed to the provider that completed the initial exam)
  • upload the exam request to the eFolder, and
  • add additional tracked items for each type of examination request submitted under the pending EP.
5
Perform the CAPRI enterprise search for VA medical center treatment records as required by M21-1, Part III, Subpart iii, 1.C.2.g.
6
Update the claims status to RFD after all required development is complete.
Note:  Following development, BDD claims must be routed by NWQ for review of readiness for a rating and rating action within 48 hours of expiration of claim level suspense, or closure of all tracked items, whichever is earlier.

III.i.2.B.4.b.       Pre-Discharge Claims for Both Compensation and Pension

If a service member files a claim for both compensation and pension, the ROJ is responsible for determining entitlement to both benefits.

III.i.2.B.4.c.   ROJ Responsibilities in the SHA Exchange With DoD

The SHA DBQ and associated DBQs are provided to DoD via an electronic exchange process.  If contacted by an MTF requesting examination results, inform the MTF these results are available in
  • HAIMS for examinations requested through EMS and
  • JLV for examinations requested through CAPRI.
Reference:  For additional information on the SHA examination, see M21-1, Part III, Subpart iv, 3.F.4.b.

III.i.2.B.4.d.  Important Items to Consider When Rating BDD Claims

Rating decisions for BDD claimants will be completed while the service member is still on active duty in order to reduce processing time and ensure that service members receive a decision on their claim the day following discharge from active duty.
The following items are important to consider when rating BDD claims:
  • As is emphasized in M21-1, Part III, Subpart ii, 6.B.2.a, and M21-1, Part III, Subpart ii, 6.A.1.e, BDD claims must not be deferred for service verification.  The current period of service for BDD claimants will not be verified until after RAD.
  • A BDD claim is submitted by a service member still on active duty; therefore, all current symptoms being reported during the claim period are in-service symptoms/complaints.
  • Similarly, the examination conducted in service is demonstrating in service complaints, findings, and diagnoses and/or opinions.  A diagnosis of a chronic disability on an in-service VA examination is a diagnosed disability while on active duty.
  • When the rating decision is completed while the service member is still on active duty, the effective date entered into VBMS-Rating (VBMS- R) will be a future effective date.
  • Take any steps necessary to ensure the service member’s reported separation date is accurate in order to reduce the need to rework the claim due to incorrect effective dates.
Notes:
  • The ROJ should decide every issue for which sufficient evidence exists to grant SC, including at a noncompensable level.
  • If an in-service rating decision requires correction, making a different, corrected decision based solely on a difference of opinion or a different interpretation of rating criteria is not permitted.  The decision can be changed only if
    • a clear and unmistakable error exists, and/or
    • VA receives new evidence after completing the rating decision that justifies changing one or more of the decisions set forth in it.
References:  For more information on

III.i.2.B.4.e. Rating Procedures for BDD Claims

When completing rating decisions for BDD claims, follow the guidance in the table below.
Step
Action
1
Ensure the service member’s reported release from active duty date is accurate to prevent incorrect effective dates.
Important:  The reported RAD will come from the evidence of record.  When completing an in-service rating decision, the claim must not be deferred for service verification.
2
Review the evidence of record to determine if all development is complete.
  • If yes, proceed to Step 3.
  • If no, fully defer the claim for any additional evidence needed such as a medical opinion, examination addendum/ clarification, or missing development.
Important:
  • Rating decisions in BDD claims that are completed when the service member is still on active duty cannot have deferred issues.
  • Do not issue a partial rating for decisions issued while the service member is on active duty as benefits cannot be awarded until after discharge from active duty.
  • In rare cases, due to extenuating circumstances outside of the service member’s control, a rating decision may not be completed until after discharge.   In such cases a partial rating decision may be appropriate since the service member is no longer on active duty at the time the rating decision is completed.
3
Replace the language in the introduction paragraph with the text below.
The records reflect that you are a Veteran of the [service era] Era. You served in the [branch of service] from [MM/DD/YYYY] to [MM/DD/YYYY] and for the current period of service beginning on [MM/DD/YYYY].  You filed an original disability claim that was received on [MM/DD/YYYY].  Based on a review of the evidence listed below, we have made the following decision(s) on your claim.
Please Note The determination of entitlement to VA benefits is contingent upon your discharge from service and upon having the requisite character of service.  We will review all evidence of record upon discharge to ensure the information provided in this decision is accurate.  This rating decision will only be corrected, if necessary, based on the final review after your discharge.
4
Rate the claim under generally applicable rating guidance.  However, given to the fact that the rating decision is being completed while the service member is still on active duty a future effective date must be assigned.
Reference:  For more information on rating considerations for BDD ratings, see M21-1, Part III, Subpart i, 2.B.4.e.
5
Finalize the rating decision.
Important:  Following finalization of the rating decision, NWQ will pull the claim back into NWQ (499) and reroute the claim for promulgation the day following discharge from active duty.
6
Add a bookmark to the rating decision in the VBMS eFolder stating, “DRAFT:  Rating document should not be released until after the award is authorized.”
7
If the Veteran selected a Veterans service organization (VSO) as their power of attorney
  • ensure the completed rating decision is available for review by the appropriate VSO for a minimum of two days, and
  • send an e-mail to the VSO notifying them that the rating is in the eFolder for their review.
8
Following discharge, verify the Veteran’s
  • discharge date, and
  • character of discharge (COD) (must be other than dishonorable)
The diary maturity date/EP date of claim is one day following separation (RAD+1).
Reference:  For additional information on requirements for verification of service, see M21-1, Part III, Subpart i, 2.B.4.h.
9
Ensure the automated VBMS STR request has been generated as noted in M21-1, Part III, Subpart i, 2.B.4.f and g.
Important:
  • The decision maker must follow all standard rating guidance unless superseded by an instruction in the table above.
  • The service member will not receive the rating decision while on active duty.  The service member will receive the rating decision after being discharged when service has been verified.
References:  For more information on

III.i.2.B.4.f. Automated VBMS STR Requests

Automatic STR requests are generated to the HAIMS system for Army, Air Force, Navy, and Marine Corps service members separating or retiring on or after January 1, 2014, on RAD+1 for claims established as diaries.  If the service information is not complete in BIRLS as of close of business on RAD+1, the automated STR request will not generate.
Pre-discharge claims processors need to ensure this automated request is generated for BDD and BDD-excluded claims.
Important:  Follow established procedures as outlined in M21-1, Part III, Subpart iii, 2 for Army, Air Force, Navy, and Marine Corps Veterans separated or retired from military service before January 1, 2014.
Note:  Upon establishment of a rating EP (non-diary EP), VBMS submits an automated request to DoD HAIMS system for Army, Air Force, Navy, and Marine Corps service members separating or retiring on or after January 1, 2014.
Reference:  For more information on generating an automated VBMS STR request for BDD claims, see M21-1, Part III, Subpart i, 2.B.4.g.

III.i.2.B.4.g.  Generating an Automated VBMS STR Request

Follow the steps in the table below to ensure an automated VBMS STR request is generated for BDD and BDD-excluded claims.
Step
Action
1
  • Verify the status of the automated STR request in VBMS by checking the Obtain STRs section of the Development Plan.
  • Determine whether additional action is required using the table below.
If the service member’s information 
Then 
was updated prior to the end of RAD+1 (the STR status is not erroror warning)
no additional action is required.
was not updated prior to the end of RAD+1 (the STR status is error orwarning)
Note:  For pre-discharge claims the message will read WARNING:  This Veteran is not eligible for an Electronic STR Request.  Eligibility checked on MM/DD/YYYY at HH:mm.  The RAD Date does not meet the eligibility criteria.
proceed to Step 2.
2
Update the Veteran’s military profile to reflect the correct RAD date.
For correct RAD on or after January 1, 2014
  • update the Veteran’s military service
  • return to the OBTAIN STR tab in the Development Plan section
  • resubmit the STR request by clicking on Request STR Again, and
  • the status message will be updated immediately to reflect a new status.
Notes:
  • The only way to avoid an error or warning message is to ensure that the service member’s period of service in BIRLS is complete before the end of the RAD+1 date.
  • Clicking on the Request STR Again button without entering a complete period of service in BIRLS will continue to generate the same error message.
  • Do not delay other development actions awaiting the certified copies of the STRs.

III.i.2.B.4.h.  Requirement for Verification of Service

The day following the service member’s discharge from active duty, NWQ will route the BDD claim for promulgation.  Before the ROJ promulgates the claim, the ROJ must verify the claimant’s
  • character of service, and
  • date of discharge.
DD Form 214, Certificate of Release or Discharge from Active Duty, satisfies the requirement for verification.  If a DD Form 214 is not of record, the ROJ must use all available resources to obtain verification.  These include the
  • Defense Personnel Records Information Retrieval System (DPRIS)
  • Veterans Information Solution (VIS), and
  • Personnel Information Exchange System (PIES).
Notes:
  • If a COD determination is needed, the claim sould be excluded from the BDD program.
  • Service departments normally issue a DD Form 214 to service members at the time of their release from active duty.  Under certain circumstances, however, service departments may issue the form prior to separation.  VA considers such forms valid for the purpose of verifying service information.  Other valid means of verifying service include VIS and DPRIS.
References:  For more information on

III.i.2.B.4.i.  Handling Claims From Service Members Who Remain on Active Duty Beyond Their Anticipated Discharge Date

If service members remain on active duty beyond their anticipated discharge date, the ROJ must
  • attempt to contact the service member to obtain a new discharge date, and
  • follow the instructions in the table below.
Exception:  If a service member remains on active duty because his/her service department referred the service member into the Integrated Disability Evaluation System, follow the instructions in M21-1, Part III, Subpart i, 2.D.8.c.
If the service member …
Then the ROJ must …
  • plans to remain on active dutymore than 180 days from the current date, or
  • the ROJ is unsuccessful after three attempts to contact the service member
  • dispose of any hard-copy, unpromulgated rating decisions under RCS VB-1, Part I, Item number 13-052.200
  • delete unpromulgated rating decisions from VBMS-R
  • retain all other accumulated documentation in the claims folder
  • deny the claim using theRETURN TO ACTIVE DUTYselection from the drop-down menu in VBMS-A, and
  • notify the service member of the reason for denial.
Note:  To remove an unpromulgated rating decision from VBMS-R, select the claims folder number from the work pending queue and select Return to Files Without Update.
provides a discharge date that is 180 days or fewer from the current date
  • enter a note into VBMS indicating the new discharge date, and
  • edit the claim detail in VBMS to the proper future suspense date (RAD+1).

If VBMS will not allow a change to the proper future suspense date to the current EP

  • change the pending EP to an EP 400
  • cancel the EP 400
  • establish a new BDD or BDD-excluded diary EP based on the new discharge date
  • update any tracked items if necessary, and
  • return the claim to the rating activity if an in-service rating decision was previously completed.

III.i.2.B.4.j.  Verifying Changes in RAD or Receipt of Additional Evidence Prior to Promulgation of BDD claims

Before promulgation, verify that there has not been a change in RAD or receipt of additional evidence following completion of the rating decision using the guidance in the table below.
Step
Action
1
Verify service according to M21-1, Part III, Subpart i, 2.B.4.h.
2
Has additional evidence been received?
  • If yes, proceed to Step 5.
  • If no, proceed to Step 3.
3
Has RAD changed?
  • If yes, proceed to the next step.
  • If no, proceed to Step 6.
4
Refer to the guidance in M21-1, Part III, Subpart i, 2.B.4.i.
  • If the service member has not been discharged from active duty, take action as provided in M21-1, Part III, Subpart i, 2.B.4.i.
  • If the service member has been discharged from active duty, proceed to Step 5.
5
Return the rating decision to the decision maker utilizing the VBMS deferral functionality.
If the evidence was received after the in-service rating was completed, select the deferral reason Late flowing documents scanning issues.  If another reason is selected, such as Wrong effective date / DOC, this will result in an avoidable deferral which is not applicable to this type of issue.
Note:  The decision maker will correct the effective date or review the additional evidence received to determine if corrective action is needed.
Important:  Do not promulgate until corrections are complete or the decision maker determines that corrective action is not necessary.
6
Remove the bookmark stating, “DRAFT: Rating document should not be released until after the award is authorized.”
7
Promulgate the rating decision.
8
  • Authorize the corresponding award action, and
  • send the notification letter and the rating decision to the Veteran.
Important:  The goal of the BDD program is to provide a decision to the service member the day following their discharge from active duty.  In order to ensure this goal is reached
  • NWQ must route the claim for promulgation the day following discharge from active duty, and
  • the ROJ must ensure the claim is reassigned to another claims processor for action if the claims processor is unavailable to work the claim.
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