M21-1, Part III, Subpart iii, Chapter 1, Section F – Record Maintenance During the Development Process

In This Section

Introduction

• routine review of eFolder documents, and
• corporate flashes.

Change Date

III.iii.1.F.1.a.Routine Review of eFolder Documents

• end product (EP) controls are consistent with the claims document, including use of the correct
  • date of claim
  • EP series, and
  • claim label
• information regarding the Veteran’s service dates and character of discharge in VA systems are consistent with the evidence in the eFolder, including
  • the Veterans Benefits Management System (VBMS)
  • Benefits Identification and Records Locator Subsystem (BIRLS), and
  • Participant Profile
• the claims folder contains proper documentation of claimant representation, including system updates of
  • Share, and
  • VBMS
• any documents identified as duplicate upon review are managed in accordance with M21-1, Part III, Subpart ii, 4.G.2.q
• any documents reviewed are indexed properly in accordance with M21-1, Part III, Subpart ii, 4.G.2.r
• any misfiled document(s) are removed and transferred to the proper claims folder(s) following the procedures outlined in M21-1, Part III, Subpart ii, 4.G.2.c, and
• all pertinent evidence is properly noted, bookmarked, and/or annotated, following the respective guidance found in
  • M21-1, Part III, Subpart ii, 4.G.2.s
  • M21-1, Part III, Subpart ii, 4.G.2.n, and
  • M21-1, Part III, Subpart ii, 4.G.2.o.

• viewing eFolder documents, see the VBMS Core User Guide
• EP series, see M21-4, Appendix B
• date of claim, see M21-4, Appendix B, I.c
• Veteran’s service dates and character of discharge, see M21-1, Part III, Subpart ii, 6.A and B
• updating military service information, see M21-1, Part III, Subpart ii, 3.C.7, and
• power of attorney appointments, see M21-1, Part III, Subpart ii, 3.C.4.

III.iii.1.F.1.b.Corporate Flashes

Introduction

• identifying contentions
• verifying contentions
• contention classification and examination management
• associating claim types to contentions
• entering a claim-specific special issue, and
• properly applying special issues.

Change Date

III.iii.1.F.2.a.Identifying Contentions

• This information will be made available via eBenefits and should be easy to understand and in the claimant’s own words, as appropriate.
• The use of contentions for each claim is mandatory; claims processors must enter them as they identify issues associated with a claim.
• Each issue, including non-rating issues, must be entered as a separate contention.
• Non-rating contentions must relate to the specific benefit being sought.
• Mandatory language and format must be used for dependency claims.  An example of the mandatory language and format is presented below.
• A claim for total disability due to individual unemployability is treated as a claim for increase in the service-connected (SC) disabilities that the Veteran identifies as causing unemployability.  Therefore, the identified SC disabilities must be entered as individual contentions.

• A Veteran submits a claim for ringing in the ears.  The contention should be entered as ringing in the ears.
• A Veteran submits a claim to add a spouse and a child to a running award.  Create separate contentions for the spouse and child as follows:
  • Dependency claim for [name of spouse], and
  • Dependency claim for [name of child].
• VA receives a claim for “increase in diabetes mellitus to include heart, depression, and numbness in hands.”   The contentions should be entered as
  • diabetes mellitus
  • heart condition
  • depression, and
  • numbness in hands.
• A Claims Assistant establishes a claim for “bilateral knees.”  A review of the corporate record indicates the Veteran is SC for right knee patellofemoral pain syndrome and was previously denied service connection (SC) for a left knee strain.  The contentions should be entered as
  • right knee patellofemoral pain syndrome (claimed as bilateral knees), and
  • left knee strain (claimed as bilateral knees).

III.iii.1.F.2.b.Verifying Contentions

III.iii.1.F.2.c.  Contention Classification and Examination Management

• When selecting a classification, use
  • appropriate medical verbiage that corresponds to the claimed medical condition, instead of the claimant’s original language, and
  • the Administrative classification only for non-rating issues, such as dependency.
• Select Yes in the MEDICAL field if the contention may require an examination or medical opinion to make a determination.  Otherwise, select No.

• selecting Unemployability as a classification in order to complete necessary specific development actions in VBMS, and
• selecting Yes in the MEDICAL field.

III.iii.1.F.2.d.Associating Claims Types to Contentions

• A Veteran claims an increase in her SC peripheral neuropathy of the left lower extremity.  SC was previously granted on a secondary basis associated with the Veteran’s SC diabetes mellitus, type II.  Although SC was originally granted on a secondary basis, the current claim is for an increased evaluation.  Therefore, the correct contention claim type isIncrease.
• VA receives a claim for a right knee disability from an altered gait, due to the Veteran’s SC left ankle fracture.  The claim was previously denied on a direct basis because the evidence did not show the disability occurred in service.  Although the claim was originally claimed on a direct basis, the current claim is based on a secondary SC theory of entitlement and should be labeled Secondary.
• A Veteran is SC for migraines.  An examiner indicates the condition is likely to improve.  A diary date for a review examination is set.  When the EP is established for the routine future examination, the contention type for migraines would be RFE.

III.iii.1.F.2.e.  Entering a Claim-Specific Special Issue

III.iii.1.F.2.f.Properly Applying Special Issues

• inputting special issues into
  • VBMS, see the VBMS Core User Guide, and
  • Modern Award Processing-Development (MAP-D), see the MAP-D User Guide, and
• appropriate use of special issues, see M21-4, Appendix C, III.

Introduction

• purpose of tracked items
• creation of tracked items
• tracked item dispositions
• tracked item automation
• accuracy of tracked items, and
• determining that a claim is ready for a decision.

Change Date

III.iii.1.F.3.a.Purpose of Tracked Items

III.iii.1.F.3.b.  Creation of Tracked Items

• available standard tracked items, see M21-4, Appendix D, I.b, and
• creating tracked items in
  • VBMS, see the VBMS Core User Guide, and
  • MAP-D, see the MAP-D User Guide.

III.iii.1.F.3.c.  Tracked Item Dispositions

• managing tracked item dispositions in
  • VBMS, see the VBMS Core User Guide, and
  • MAP-D, see the MAP-D User Guide, and
• processing solicited and unsolicited mail, see M21-1, Part III, Subpart ii, 1.E.5.d.

III.iii.1.F.3.d.  Tracked Item Automation

• Ready for Decision for rating claims, and
• Ready to Work for non-rating claims.

III.iii.1.F.3.e.  Accuracy of Tracked Items

• the necessary tracked items have been generated
• all suspense dates are accurate, and
• the disposition of all tracked items have been accurately managed, to include any automated tracked item actions.

III.iii.1.F.3.f. Determining That a Claim Is Ready for a Decision

Introduction

• claim status, and
• claim-level suspense.

Change Date

III.iii.1.F.4.a.  Claim Status

• VBMS, see the VBMS Core User Guide, and
• MAP-D, see the MAP-D User Guide.

III.iii.1.F.4.b.  Claim-Level Suspense

Change Date

III.iii.1.F.5.a.  Managing Suspense and Diary Dates Through the Claims Process