Overview
In This Section |
This section contains the following topics:
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1. Handling Added Conditions and Re-enrolled IDES Cases
Introduction |
This topic discusses benefit-entitlement issues that arise after a Military Servcies Coordinator (MSC) holds the initial meeting with an IDES participant, including
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Change Date |
February 15, 2017
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III.i.2.F.1.a. Requirement for a Prescribed Form to Add Claimed Conditions |
Integrated Disability Evaluation System (IDES) participants have the opportunity to raise claimed conditions by submitting a VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, during their initial interview with the Military Services Coordinator (MSC). Conditions identified on a VA Form 21-526EZ that is submitted to the MSC during the initial interview must be considered as part of the IDES process.
IDES participants who wish to claim additional conditions after completion of their initial interview with the MSC must submit the claim on a prescribed form as indicated in M21-1, Part III, Subpart ii, 2.B (a VA Form 21-526EZ is preferred). The form must be signed by the claimant or authorized representative to be considered a complete claim for benefits.
Note: Any issue formally claimed after the initial meeting with the MSC must be handled in accordance with M21-1, Part III, Subpart i, 2.F.1.b.
Important: Any request for benefits that is not submitted on a prescribed form must be handled in accordance with M21-1, Part III, Subpart ii, C.2.a and b The Disability Rating Activity Site (DRAS) must ensure that any request for benefits is properly addressed when preparing the final rating notification. However, both MSCs and DRASs are encouraged to make reasonable attempts to obtain a complete prescribed form via telephone development at the earliest opportunity (i.e., once the request for benefits is raised/identified) when doing so is feasible and beneficial to the participant.
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III.i.2.F.1.b. General Information on Claimed Conditions Added After Initial Meeting With the MSC |
When an IDES participant submits a prescribed form with new claimed conditions after the initial meeting with the MSC has been completed, the MSC or DRAS employee who identifies the new conditions must list the contentions under the end product (EP) 689. A new EP should not be established.
If an EP is established erroneously while the EP 689 is pending, the MSC or DRAS employee who identifies the new EP must
References: For more information on
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III.i.2.F.1.c. Examination Requests Addressing Claimed Conditions Added After Initial Meeting With the MSC |
The Department of Veterans Affairs (VA) is not obligated to request additional examinations solely because an IDES participant claims a condition after the initial meeting with the MSC is completed.
Important: Occasionally, situations may arise that warrant examination of the additional disabilities referenced above. When submitting an examination request under these circumstances, MSCs and DRAS employees should not
Exception: The instructions in this block do not apply to additional disabilities
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III.i.2.F.1.f. Handling the Addition of Referred Conditions That Were Not Previously Claimed |
The service department is required to provide a new VA Form 21-0819, VA/DoD Joint Disability Evaluation Board Claim, to VA in order to refer a new and previously unclaimed condition.
References: For more information on
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III.i.2.F.1.g. Handling New Referred Conditions Added Before Completion of the Medical Evaluation Stage |
When an MSC receives a new VA Form 21-0819 from the service department, adding new referred conditions to a pending IDES claim before VA exams have been completed, the MSC must
Important: New referred conditions that are added before examinations are conducted will not require the case to be disenrolled in VTA. Continue processing under the original Case ID.
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III.i.2.F.1.h. Handling New Referred Conditions Added After the Completion of the Medical Evaluation Stage |
If the service department intends to refer a new and previously unclaimed condition(s) after the medical evaluation stage has been completed, the case must be disenrolled from VTA and reenrolled under a new Case ID number.
Upon receipt of a new VA Form 21-0819 from the service department, the reenrolled case will move through the claims development and medical evaluation stages again under the new Case ID. Examinations will be completed for the new referred condition(s).
Exception: The service department will not disenroll the case if the new referred condition(s) can be addressed without any additional VA examinations. These cases will remain at the DRAS for processing. However, the DRAS must receive a new VA Form 21-0819 so that the new issue(s) can be considered as part of the claim for VA benefits.
References: For more information on
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III.i.2.F.1.i. Handling Additional Disabilities Noted During Examination |
If an IDES participant’s examination report reveals the existence of a condition that was neither part of a complete claim on a prescribed form nor referred by the service department, then the DRAS should address the condition only when the condition is reasonably within the scope of the issues enumerated in the complete claim in accordance with 38 CFR 3.155(d)(2).
DRASs must follow the instructions in the table below if an IDES participant’s examination report reveals the existence of a disability that neither the participant claimed nor his/her service department referred to VA.
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III.i.2.F.1.j. Handling IDES Cases Disenrolled Due to Additional Referred Conditions |
Use the table below to determine how to process IDES cases that are disenrolled due to the addition of new referred conditions.
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Introduction |
This topic contain instructions that are unique to IDES cases involving members of the Reserve or National Guard that are not on active duty, including
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Change Date |
February 15, 2017
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III.i.2.F.2.b. Requests for Examination of Members of the Reserve or National Guard That Are Not on Active Duty |
The MSC that requests examination of a member of the Reserve or National Guard who is not on active duty must ask the examining facility to notify the following of the date and time of all examinations at least one week prior to the date they are scheduled to occur
Rationale: Following this practice ensures the member’s unit has ample time to prepare orders allowing the member to attend the examinations.
Reference: For information on routing examination requests, see M21-1, Part III, Subpart iv, 3.A.2.b.
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III.i.2.F.2.c.Handling Notice That a Member Meets Retention Standards, Is Fit for Duty, or Has Been Disenrolled |
The MSC or DRAS having current jurisdiction over the IDES case of a member of the Reserve or National Guard who is not on active duty must take the actions described in the table below when the member’s
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III.i.2.F.2.d.Requests From PEBs for a Rating Decision Involving Member Who Is Not on Active Duty |
Upon receipt of a request from a PEB for a rating decision involving a member of the Reserve or National Guard who is not on active duty, DRASs must follow the steps in the table below.
References: For more information on
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III.i.2.F.2.e. Requests for Reconsideration From Members That Are Not on Active Duty |
The rating decision that DRASs provide PEBs for members of the Reserves or National Guard that are not on active duty serves as both a proposed rating decision and a final rating decision. As a result, these members may
DRASs must carefully review requests for reconsideration under these circumstances to determine whether they also constitute a notice of disagreement (NOD) according to M21-1, Part I, 5.B.3.
Reference: For more information about handling requests for reconsideration, seeM21-1, Part III, Subpart i, 2.E.3.q-s.
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3. Handling Cases Involving Pregnant IDES Participants
Introduction |
This topic contains instructions unique to cases involving pregnant IDES participants, including
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Change Date |
September 14, 2016
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III.i.2.F.3.c. Handling Examination Reports Involving Pregnant Participants |
Once all examination reports that MSCs request for a pregnant IDES participant are available, MSCs must take the following actions, even if some or all of the reports indicate the participant could not be examined because of her pregnancy:
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4. Handling Notice or Evidence That an IDES Participant May Be Incompetent for VA Purposes
Change Date |
February 15, 2017 |
III.i.2.F.4.a. Handling Evidence That an IDES Participant May Be Incompetent for VA Purposes |
The table below provides an overview of the process that must followed after a DRAS RVSR determines the evidence of record indicates an IDES participant may be incompetent per 38 CFR 3.353(a).
Important: The information in this block does not apply if a court has appointed a fiduciary to a participant or determined a participant is incompetent. Instructions for handling these types of cases is found in M21-1, Part III, Subpart v, 9.B.2.e-g.
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5. Handling Notice or Evidence That an IDES Participant Has Died on Active Duty
Change Date |
September 14, 2016 |
III.i.2.F.5.a. Handling Notice That an IDES Participant Has Died |
MSCs and/or DRAS personnel must follow the steps in the table below upon receipt of notification or evidence indicating that an IDES participant has died during the IDES process.
Important: If the participant was referred into IDES as a member of the National Guard or Reserves and was not on active duty, the potential for accrued benefits may exist. The MSC or DRAS with jurisdiction of the claim is responsible for completing the actions outlined in M21-1, Part VIII, 3.1.c.
Note: If the participant was on active duty at the time of death, the service department will provide VA with a DD Form 1300, Report of Casualty, which will be routed to the Casualty Assistance Officer (CAO) at the SOJ. The CAO will contact the survivor to provide the necessary information and facilitate the application process for appropriate VA benefits.
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6. Handling Notice or Evidence That an IDES Participant Has Been Discharged Under Conditions Other Than Honorable
Change Date |
September 14, 2016 |
III.i.2.F.6.a. Handling Notice of a Participant’s Discharge Under Conditions Other Than Honorable |
MSCs and/or DRAS personnel must follow the steps in the table below upon receipt of notification or evidence that an IDES participant has been (or will be) discharged with an administrative discharge under conditions other than honorable.
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7. Ancilary Benefits for IDES Participants
Introduction |
This topic contains information on the processing of Vocational Rehabilitation and Employment (VR&E) and Loan Guaranty claims for IDES participants, including
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Change Date |
September 14, 2016
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III.i.2.F.7.a. Handling VR&E Claims Received From IDES Participants |
Intake sites may receive claims from IDES participants for Vocational Rehabilitation and Employment (VR&E) benefits under 38 U.S.C. Chapter 31 that they may use while on active duty or after separation.
When a MSC at an intake site receives a VA Form 28-1900, Disabled Veterans Application for Vocational Rehabilitation, while an IDES claim is pending, he/she must take the following actions within 24 hours of receipt.
Exception: If a pending IDES claim does not exist or a proposed rating is not of record, MSCs must broker the VR&E claim to the SOJ, based on his/her current address, to prepare the memorandum rating decision and forward any evidence received to the scanning vendor.
Reference: For more information about forwarding rating decisions to VR&E, seeM21-1, Part IX, Subpart i, 1.B.3.d.
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III.i.2.F.7.b. Actions DRAS Must Take Upon Receipt of VR&E Claim |
If the PEB of a service member who is participating in IDES determines the service member is unfit for duty, the proposed rating decision that the DRAS prepares is acceptable for use in determining whether a service member is eligible for VR&E benefits.
Upon completion of the proposed rating, DRASs must send an encrypted e-mail to the VR&E mailbox of the local RO with the claimant’s
Note: The encrypted e-mail will alert VR&E personnel to retrieve the documents from the eFolder.
Reference: For more information about forwarding rating decisions to VR&E, seeM21-1, Part IX, Subpart i, 1.B.3.d.
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III.i.2.F.7.d. Handling VA Form 26-1880 Received From IDES Participants |
Upon receipt of VA Form 26-1880, Request for a Certificate of Eligibility, MSCs must
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III.i.2.F.7.e. RLC Action Upon Receipt of VA Form 26-8937 From a Service Member |
Upon receipt of VA Form 26-8937, Verification of VA Benefits, from a service member, RLCs request an eligibility determination from the DRAS of jurisdiction by sending an e-mail to a designated point of contact at the appropriate site.
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III.i.2.F.7.f. DRAS Responsibility for Preparing Memorandum Rating Decisions |
Upon receipt of a request for an eligibility determination from an RLC, DRASs must prepare a memorandum rating decision for inclusion in the service member’s claims folder if the
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8. Post-Separation Revisions of IDES-Related Rating Decisions
Introduction |
This topic contains instructions for handling post-separation revisions of IDES-related rating decisions, including
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Change Date |
September 29, 2016 |
III.i.2.F.8.a. Identifying Cases in Which Post-Separation Revisions of IDES-Related Rating Decisions Are Applicable |
VA must take the actions described in M21-1, Part III, Subpart i, 2.F.8.c if
Rationale: Rating decisions VA makes as a result of a Veteran’s participation in IDES directly impact the benefits the Veteran receives from his/her service department.
Notes:
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III.i.2.F.8.b. Situations That Require the Application of Post-Separation Revisions of IDES-Related Rating Decisions |
Examples of situations that would require application of the instructions in M21-1, Part III, Subpart i, 2.F.8.c are described below.
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III.i.2.F.8.c. Notifiying Veterans Whose IDES-Related Rating Decision Has Changed |
When VA revises an IDES-related rating decision under the circumstances described in M21-1, Part III, Subpart i, 2.F.8.a, VA must
This decision represents a change to a rating originally assigned as part of the Integrated Disability Evaluation System.
This decision could potentially warrant a change to your military record and/or an adjustment to the disability separation benefits you received from your service department.
Each service department operates an agency or board for correction of records. In light of the change in your VA disability rating, it may be to your benefit to request a review of your discharge to the appropriate board. A DD Form 149, Application for Correction of Military Record, is enclosed for this purpose.
Please see the reverse side of the form for instructions and additional information. The completed form, along with a copy of this letter and enclosed rating decision, should be mailed to the appropriate address indicated on the DD Form 149.
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9. Using SAFE to Securely Send and Receive Sensitive Documents
Introduction |
This topic contains information about SAFE, to include
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Change Date |
September 14, 2016 |
III.i.2.F.9.a. Sending Sensitive Documents Through SAFE |
The table below contains instructions for sending sensitive documents through Safe Access File Exchange (SAFE).
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III.i.2.F.9.b. PEB E-Mail Addresses |
The table below contains the e-mail address for each PEB. DRASs require this information in order to send proposed rating decisions and benefits estimate letters to PEBs through SAFE.
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III.i.2.F.9.c. Receiving Sensitive Documents Through SAFE |
SAFE sends notification via e-mail to the intended recipient of sensitive documents when a sender uploads the documents into SAFE. The e-mail contains a hyperlink and a password for accessing the documents.
Notes: Recipients may not
The table below explains how recipients may retrieve documents from SAFE.
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10. Proposed Ratings for IDES Participants Who Decline to Submit a VA Claim
Introduction |
This topic contains information about processing PEB requests for proposed ratings in cases in which the participant declined to submit a VA claim, including |
Change Date |
February 15, 2017 |
III.i.2.F.10.a. Requirement for Issuance of a Proposed Rating to the PEB |
When an IDES Participant declines to submit a claim, VA must still provide proposed evaluations to the PEB for the referred conditions. In these instances, DRAS must:
Important: In these cases, DRAS will not complete a final rating. The DRAS is not responsible for any further action in these IDES cases, except when the participant requests reconsiderations of the proposed decision as described inM21-1, Part III, Subpart i, 2.E.3.q. |
III.i.2.F.10.b. Required Notification Letter to the IDES Participant |
DRAS must prepare a notification letter to IDES participants who have declined to file a claim for VA benefits during the IDES process. The notification letter must include the following language and be uploaded into the participant’s eFolder:
Thank you for your service to our country.
Your military Service Department requested a disability assessment from VA as part of your participation in the Integrated Disability Evaluation System (IDES). We have provided the attached proposed rating decision to your Service Department.
Our records indicate that you declined to submit a claim for VA benefits as part of the IDES program; therefore, the attached proposed rating decision will be used for Department of Defense purposes only. VA compensation will not be awarded as a result of your participation in IDES.
If you would like to submit a claim for VA Benefits, you can do so at the appropriate time. You can file a Pre-Discharge claim once you are within 180 days of your projected separation or retirement date. You can also file a VA claim at any time after your discharge from service.
References: For more information regarding
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Historical_M21-1III_i_2_SecF_11-8-16.doc | May 8, 2019 | 256 KB |
Historical_M21-1III_i_2_SecF_9-29-16.doc | May 8, 2019 | 258 KB |
2-15-17_Key-Changes_M21-1III_i_2_SecF.docx | May 8, 2019 | 93 KB |
Historical_M21-1III_i_2_SecF_9-14-16.doc | May 8, 2019 | 258 KB |
9-29-16_Key-Changes_M21-1III_i_2_SecF.docx | May 8, 2019 | 85 KB |
11-8-16_Key-Changes_M21-1III_i_2_SecF.docx | May 8, 2019 | 85 KB |
9-14-16_Key-Changes-M21-1III_i_2_SecF.docx | May 8, 2019 | 100 KB |
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