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M21-1, Part III, Subpart iii, Chapter 1, Section B – Evidence Requested From the Claimant

Overview


In This Section

This section contains the following topics:

1.  Requesting Evidence From the Claimant


Introduction

This topic contains information on requesting evidence from a claimant, including

Change Date

March 15, 2019

III.iii.1.B.1.a.Written Requests for Evidence

When sending written requests for evidence to a claimant, use available automated tools to generate letter text.
Note:  The Department of Veterans Affairs (VA) also encourages claims development by e-mail, fax, and telephone.
References:  For more information about

III.iii.1.B.1.b.Notice of Time Limits to Submit Evidence

Specify a time limit of 30 days for the claimant to submit evidence.
Further advise the claimant
  • if evidence is not submitted within 30 days, VA may decide the claim based on the information and evidence of record, and
  • he/she has one year from the date of VA’s request to submit evidence or information to substantiate his/her claim.
References:  For information on establishing

III.iii.1.B.1.cClarifying Issues and Claims

Whenever the disability claimed is not clearly identified, ask the claimant and authorized representative to clarify the issues to ensure appropriate development and accurate decision-making.
Example:  Veteran files a claim for compensation for a knee disability, but does not specify whether it is the right or the left knee.
When reviewing unclear claims, follow the steps in the table below.
Step
Action
1
Is the claim substantially complete per M21-1, Part I, 1.A.4.f?
2
Contact the claimant and the authorized representative to clarify.  When contacting the
3
Place a copy of the correspondence in the claims folder and continue processing the claim.
Note:  Notification letters or response periods are not provided when requesting clarification.

III.iii.1.B.1.d.  Claims Development by E-Mail, Fax, and Telephone

VA strongly encourages claims development by e-mail, fax, and telephone, when appropriate.
Appropriate situations include, but are not limited to, requests to the claimant for
  • medical evidence
  • Social Security numbers (SSNs)
  • award/denial letters for certain benefits, such as Social Security disability benefits
  • addresses
  • employment information, and
  • clarification of income-related issues and medical expenses.
Notes:
  • VA considers evidence received by e-mail or fax to be authentic unless there is a specific reason to question the source of the document.
  • The instructions for handling correspondence received through traditional means apply to correspondence received by e-mail or fax.
  • When using electronic media for communication, be sure to adhere to VA’s information security policy in maintaining the privacy of a claimant’s records.
References:  For more information on

III.iii.1.B.1.e.Documenting Information Received by Telephone

Summarize the details of telephone contact with a claimant and/or authorized representative on VA Form 27-0820, Report of General Information.  Document unsuccessful attempts to contact a claimant and/or authorized representative by telephone as a permanent note in
  • the Veterans Service Network, or
  • VBMS.

III.iii.1.B.1.f.Handling Information Received by Telephone That Might Affect Benefits

VA may use information it receives by telephone to adjust a beneficiary’s award as long as the VA employee who took the information
  • identified himself/herself to the caller as an employee who is authorized to receive the information or statement
  • established the identity of the caller as either the beneficiary or his/her fiduciary by asking the caller to provide specific information about the beneficiary that is contained in VA records, such as the
    • beneficiary’s SSN
    • beneficiary’s date of birth
    • Veteran’s branch of service
    • dates of the Veteran’s service, or
    • other information only the beneficiary would know, and
  • informed the caller VA will use the information he/she provides for the purpose of calculating benefits.
Following telephone contact, the employee must document the call by summarizing it on VA Form 27-0820.  The employee must then retain the form in the claims folder and send a copy of it to the beneficiary’s power of attorney, if applicable.
The summary must include the
  • specific information or statement the caller provided
  • date of the call
  • identity of the caller
  • steps taken to verify the caller’s identity as either the beneficiary or his/her fiduciary
  • confirmation the employee informed the caller that VA would use the information or statement he/she provided for the purpose of calculating benefits, and
  • clear identification of the employee executing the VA Form 27-0820, including a signature that meets the requirements described in M21-1, Part III, Subpart ii, 1.C.2.e.
Exceptions:
 Notes:
  • If a VA employee follows the preceding steps for handling information received by telephone, VA may adjust a beneficiary’s award and provide only contemporaneous notice of the action taken.
  • If a VA employee does not follow the preceding steps, and the beneficiary or his/her fiduciary does not provide signed, written notice of the matter affecting his/her benefits, VA must provide the beneficiary advance notice of any adverse action it intends to take.
  • An e-mail or fax from a beneficiary or his/her fiduciary may serve as written notice of a matter affecting benefits, thereby allowing VA to adjust benefits and provide only contemporaneous notice of the action taken.
References:  For more information on

III.iii.1.B.1.g.Referencing Information Received by Telephone in Decision Notices

Decision notices must include references to any evidence VA
  • received by telephone, and
  • used in determining entitlement.
When referencing the information received by telephone in decision notices, include the
  • date of telephone contact, and
  • name of the individual who provided the information.
Reference:  For more information on decision notice requirements, see

III.iii.1.B.1.h.  Managing Damaged Electronic Media

When evidence submitted via portable media (such as a compact disc (CD), digital versatile disc (DVD), or thumb drive) is inaccessible due to corrupted files or damaged media, use the Special Media Return Letter, which is accessible throughLetter Creator, to
  • notify the claimant that attempts to retrieve evidence stored on the portable media were unsuccessful, and
  • ask the claimant to resubmit the evidence.
Follow the instructions in the table below for creating a letter to notify the claimant ifLetter Creator is unavailable.
Step
Action
1
Insert the following text into a subsequent development letter:
Our records show you submitted evidence via portable media format [insert type of evidence – CD, DVD, thumb drive, etc.]on [date evidence was received].  Unfortunately, the data could not be retrieved due to file corruption or damage; therefore, we are returning the portable media to you.  Please send us a copy of these records within 15 days from the date of this letter.  If we do not hear from you within the 15 days, we will proceed with the claim and make a decision based on the evidence of record.  Please show your full name and VA file number on all correspondence or evidence submitted.
Note:  If the development letter is created in
  • MAP-D, insert the text at the top of the letter, or
  • VBMS, insert the text in the IMPORTANT INFORMATION free-text field.
2
Change all referenced response times in the letter to 15 days.
Important:  Regardless of the means used to notify the claimant,
  • update the claim level suspense reason to Develop to Claimant for:damaged media info, and
  • update the suspense dates for the corresponding claim and tracked item to reflect a date that is 15 days from the date on the notice to the claimant.
Reference:  For more information about using Letter Creator, see the Letter Creator User Guide.

2.  Controls for Responses to Requests for Evidence


Introduction

This topic contains information about controls for responses to VA requests for evidence, including

Change Date

February 19, 2019

III.iii.1.B.2.a.Time Limit for Responding to a Request

Unless otherwise required by VA policy or regulation, allow claimants 30 days to respond to a request for evidence.

III.iii.1.B.2.b.Next Steps After Sending a Request for Evidence

When a claimant submits evidence in response to a request, refer the evidence to either authorization or rating activity (whichever has responsibility for deciding the corresponding claim) for a decision.  Take the same action if a claimant does not respond to a request for evidence within 30 days.
If the evidence of record fails to support an award of the benefits the claimant is seeking, the authorization activity is responsible for
  • processing the denial in the appropriate claims-processing system, and
  • preparing and sending a decision notice as described in M21-1, Part III, Subpart v, 2.B.
Important:
  • If VA requested evidence from a private physician or medical facility on behalf of the claimant, do not deny the claim before taking the actions required under Section 5103, as explained in M21-1, Part I, 1.C.2.
  • If VA obtains any medical evidence in connection with the claim, (such as treatment records from a VA medical facility), the rating activity must determine whether it justifies an award of benefits.
Reference:  For information on the action to take when a claimant furnishes some, but not all, of the requested evidence and award action is justified, see M21-1, Part III, Subpart iii, 1.B.2.c.

III.iii.1.B.2.c.  Incomplete Responses That Justify Award Action

Award action does not need to be postponed until the end of the 30-day time limit, if the
  • claimant furnishes some of the requested evidence, and
  • evidence of record supports a partial award of the benefits the claimant is seeking.
When award action is taken prior to expiration of the 30-day time limit
  • leave the current end product (EP) running
  • send decision notice to the claimant, providing him/her the
    • decision notice elements described in M21-1, Part III, Subpart v, 2.B, and
    • notice that VA is deferring action on the remaining aspects of his/her claim, pending receipt of the other requested evidence.
Note:  Follow the instructions in M21-1, Part III, Subpart iii, 1.B.2.b if the
  • claimant fails to provide all of the requested evidence by the end of the 30-day time limit, and
  • evidence of record fails to support an award of the remainder of the benefits the claimant is seeking.
Reference:  For more information on listing evidence in a decision notice, see

III.iii.1.B.2.d.Situations Warranting Extension of the 30-Day Time Limit

Extend the 30-day time limit for a response if
  • the response to initial development action raises new issues requiring resolution
  • initial development action did not include a request for essential evidence, and/or
  • the claimant
    • requests an extension, and
    • is making an honest effort to obtain and submit the requested evidence.
Note:  It is improper to deny a claim while simultaneously developing for evidence to support it.  Maintain EP control, with an accurate date of claim, as long as development is pending.

III.iii.1.B.2.e.What an Extension of the 30-Day Time Limit Does Not Affect

An extension of the 30-day time limit for a response does not affect the
  • one-year statutory time limit for submission of evidence, or
  • effective date of subsequent award action.

III.iii.1.B.2.f.Situations That Do Not Warrant Extension of the 30-Day Time Limit

Do not extend the 30-day time limit for submitting evidence if a request for evidence that is essential to establishing entitlement to the benefit sought was
  • sent to the claimant’s last known address, and
  • returned as undeliverable.
If the mailing address on the request is correct and a more current address is not available, follow the instruction provided in M21-1, Part III, Subpart ii, 1.B.6.d.

 3.  Affidavits and Certification of Statements Provided in Support of a Claim


Introduction

Change Date
March 15, 2019

III.iii.1.B.3.a.Means of Satisfying VA’s Requirement for an Affidavit or Certification

If VA regulations require an affidavit or certification, an individual may satisfy this requirement by completing the appropriate VA form that contains a certification statement.  Therefore, when requesting evidence to support a claim, enclose the appropriate VA form with the request.
Example:  VA uses VA Form 21-686c to obtain information from a claimant about his/her dependents.  This form contains the following statement above the space provided for the claimant’s signature:  I hereby certify that the information I have given above is true and correct to the best of my knowledge and belief.

III.iii.1.B.3.b.Alternate Means of Certification

In the absence of a form for obtaining a specific type of information or evidence in support of a claim, VA will also accept the following:
Reference:  For more information about what makes a certification statement “appropriate,” see M21-1, Part III, Subpart iii, 1.B.3.c.

III.iii.1.B.3.c.  Determining Certification Requirements for a Claim for SC

To comply with the provisions of 38 CFR 3.200, statements provided by or on behalf of a claimant for the purpose of establishing service connection (SC) must be
  • made under oath or affirmation, or
  • certified.
Use the table below to determine what language an individual should use to certify the authenticity of records or the truthfulness of statements he/she provides in support of a claim for SC.
If the individual is providing …
Then he/she should use the following language:
records
I hereby certify that the following (or attached) is a true transcript of my records pertaining to this case.
a statement
I hereby certify that the information given above is true and correct to the best of my knowledge and belief.

III.iii.1.B.3.d.  Handling Uncertified Statements

Any statement provided for the purpose of establishing SC that is not certified or made under oath must be referred to the rating activity for a determination as to whether or not the statement is required to establish SC.
If the rating activity determines the statement is required, follow the steps in M21-1, Part III, Subpart iii, 1.B.3.f to obtain certification.

III.iii.1.B.3.e.  Waiving the Certification Requirement for a Claim for SC

The rating activity may waive the certification requirement if it can establish SC
  • based on other evidence of record, and
  • without consideration of the uncertified statement.

III.iii.1.B.3.f.  Returning an Uncertified Statement for a Claim for SC

If the rating activity determines certification of an individual’s statement is required to establish SC
  • photocopy the uncertified statement
  • type the appropriate certification language (from M21-1, Part III, Subpart iii, 1.B.3.c) on the photocopy and provide a signature line
  • advise the individual that failure to certify the statement within 30 days may result in a denial of benefits
  • send the photocopy to the individual for certification, and
  • maintain the original document in the claims folder.

4.  Certifying Eligibility and Continued Entitlement to VA Benefits


Introduction

This topic contains information about certifying eligibility for and continued entitlement to VA benefits, including

Change Date

June 26, 2015

III.iii.1.B.4.a.Requirement to Certify Eligibility and Continued Entitlement

VA may require beneficiaries to certify that an eligibility factor on which VA based an entitlement determination continues to exist.
Reference:  For more information on periodic certification of continued eligibility, see 38 CFR 3.652.

III.iii.1.B.4.b.Procedure for Certifying Eligibility and Continued Entitlement

Follow the steps in the table below upon receipt of evidence suggesting an eligibility factor on which VA based an entitlement determination no longer exists.
Step
Action
1
Send notice of proposed adverse action to the beneficiary
  • requesting certification of the eligibility factor, and
  • advising him/her that VA may discontinue benefits if he/she does not provide certification within 60 days.
Control for the beneficiary’s response with an EP 600.
Exception:  Do not use a separate EP 600 for income verification match cases.
Note:  Although the beneficiary is instructed to respond to notice of proposed adverse action within 60 days
  • select a suspense date that is 65 days in the future (to allow for mail handling), and
  • take no action to adjust benefits until after the 65-day period has expired.
References:  For more information on
2
Review the folder and determine if the beneficiary responded within 60 days.
If the beneficiary …
Then …
did respond
  • continue, adjust, or stop the award based on the beneficiary’s response, and
  • send the proper decision notice.
did not respond
  • adjust benefits effective the first of the month following the date on which the evidence of record shows the beneficiary last confirmed the existence of the eligibility factor, and
  • send the proper decision notice.

III.iii.1.B.4.c.Example of a Situation Requiring Certification of Eligibility and Continued Entitlement

The paragraphs below describe
  • a situation that would require certification of eligibility and continued entitlement, and
  • the appropriate actions to take based on the specific set of facts.
Situation:
  • VA receives reliable evidence indicating a surviving spouse in receipt of pension might have remarried.
  • The surviving spouse has no children.
  • A review of the claims folder shows the most recent documentation confirming the surviving spouse’s marital status is a VA Form 21-686cdated November 12, 2004.
  • On February 11, 2010, VA sends notice of proposed adverse action to the surviving spouse
    • requesting completion of VA Form 21-686c, and
    • advising him/her that VA may discontinue benefits effective the first of the month following the date on which the evidence of record shows the beneficiary last confirmed his/her marital status if he/she does not return the completed form within 60 days.
Result:  If the surviving spouse does not respond within 60 days
  • stop the award effective December 1, 2004, and
  • send proper decision notice.

5.  Determining the Acceptability of Photocopies


Introduction

This topic contains information on the acceptability of photocopies, including

Change Date

October 14, 2011

III.iii.1.B.5.a.Photocopies or Abstracts of Public Documents

When the claimant’s signed statement is insufficient to a establish a fact, photocopies or abstracts of public documents are acceptable as evidence if examination of the copies or abstracts confirms they are
  • genuine, and
  • free from alteration.
Examples:
  • marriage certificates
  • birth certificates, and
  • death certificates
Important:  VA may request a copy of the document certified over the signature and official seal of the person having custody of such record, if necessary.
Reference:  For more information on the acceptability of photocopies of public documents to establish birth, death, marriage, or relationship, see 38 CFR 3.204(c).

III.iii.1.B.5.b  Photocopies of Documents That Confirm Military Service

VA accepts photocopies of original documents that confirm a Veteran’s military service if the Veteran’s service department issued the original document and
  • a public custodian of records certifies the photocopy is a true and exact copy of a document in his/her custody, or
  • an accredited agent, attorney, or service organization representative who has successfully completed VA-prescribed training on military records certifies the authenticity of the photocopy by
    • stamping the photocopy with the statement [name, title, organization] certify that I have completed the VA-prescribed training on certification of evidence for proof of service and that this is a true and exact copy of either an original document or of a copy issued by the service department or public custodian of records, and
    • signing and dating the statement.
Reference:  For more information on service verification, see M21-1, Part III, Subpart ii, 6.B.3.

III.iii.1.B.5.c.Photocopies of STRs

Photocopies of service treatment records (STRs) are acceptable for rating purposes if examination of the copies confirms they are
  • genuine, and
  • free from alteration.
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