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M21-1, Part III, Subpart iv, Chapter 6, Section A – Partial Rating Decisions and Deferred Issues

Overview


In This Section 

This section contains the topic “General Information on Partial Rating Decisions and Deferred Issues.”

1.  General Information on Partial Rating Decisions and Deferred Issues


Introduction

This topic contains general information about partial rating decisions and deferred issues, including


Change Date

February 19, 2019

III.iv.6.A.1.a.  Definition:  Partial Rating Decision

partial rating decision is a rating decision that provides a decision on some issues of a claim, but defers a decision on at least one other issue, pending the outcome of additional development.

III.iv.6.A.1.b.  When to Make a Partial Rating Decision

Make a partial rating decision when one or more issues require additional development before they can be decided, but the record otherwise contains sufficient evidence to
  • grant any claim at issue, including service connection (SC) at a noncompensable level, and/or
  • propose to (or take final action on a previous proposal to)
    • reduce a benefit
    • sever SC, and/or
    • implement a finding of incompetency for payment purposes.
Important:  The Veterans Benefits Administration’s mission is to serve Veterans and their eligible dependents and survivors in the most timely and accurate manner possible.
  • It is only appropriate to extend suspense or diary dates if it is necessary for a specific adjudicative action.  Suspense dates must always correspond with specific actions and should not be arbitrarily extended under any circumstance.
  • When employees handle a claim, they are expected to take the most full and complete action possible on a claim every time – including development, rating, and promulgation actions – to move a claim forward to accurate completion in the claims process.  Every effort should be made to move the claim to the next processing cycle each time it is handled.
Exception:  When issues cannot be resolved because of a Veteran’s return to active duty, follow the procedures in M21-1, Part IV, Subpart ii, 2.A.4.c.

III.iv.6.A.1.c.  Improper Use of a Partial Rating Decision

Do not use a partial rating decision to
  • deny one or more claimed issues while deferring others for resolution of outstanding development actions unless one of the permissible decisional outcomes discussed in M21-1, Part III, Subpart iv, 6.A.1.b, may be processed simultaneously, or
  • deny SC for cause of death if development is pending or in progress for another condition possibly involved in the cause of death.

III.iv.6.A.1.d.  When to Defer an Issue

Defer an issue when the rating activity receives a claim that is underdeveloped or incomplete and requires additional development.
Note:  Use of electronic deferral functionality in the Veterans Benefits Management System (VBMS) is required when a
  • partial rating decision is prepared, and/or
  • claim must be reverted to a previous processing stage.
Exception:  Do not defer an issue that is deemed underdeveloped during the course of a higher-level review (HLR).  Instead, dispose of the issue via rating decision to reflect its requirement for remediation of a duty-to-assist (DTA) error.
References:  For more information on

III.iv.6.A.1.e.  Deciding Some Issues While Deferring Others

When deferring an issue in a partial rating decision, the decision

  • must
    • award at least one issue, and/or
    • propose to (or take final action on a previous proposal to)
      • reduce a benefit
      • sever SC, and/or
      • implement a finding of incompetency for payment purposes, and
  • may deny one or more issues for which adequate evidence exists to decide the claim.
Important:  Awarding at least one issue includes SC at a noncompensable level, even when
  • the issue of SC for other disabilities must be deferred or denied,  or
  • entitlement to a higher evaluation on another issue must be deferred or denied.

Example 1:  It is proper to prepare a rating decision that

  • grants SC for hypertension at a noncompensable level based on service treatment records and Department of Veterans Affairs (VA) outpatient treatment reports
  • denies SC for asthma and bilateral hearing loss, and
  • defers the issue of an increased evaluation for service-connected (SC) arthritis pending a VA examination.
Example 2:  It is proper to prepare a rating decision that
  • proposes a reduction in the evaluation of SC lung cancer
  • denies SC for major depressive disorder, and
  • defers the issue of entitlement to SC for dermatitis, pending the outcome of request for a medical opinion.

Note:

  • Identify the deferred issues both in the coded conclusion and in the narrative of the decision, and
  • enter the reason(s) for deferral under the REASONS FOR DECISION field on the ANALYSIS tab.

Reference:  For more information on completing rating decisions, see the VBMS – Ratings (VBMS-R) User Guide.


III.iv.6.A.1.f.  Procedure for Deferring Previously Denied Issues

When a decision on a previously denied issue must now be deferred, decision makers should ensure the coded conclusion of the Codesheet lists the
  • previously denied issue as deferred, and
  • date of the prior denial in the ORIGINAL DATE OF DENIAL field.
Example:
Image of deferred issues text on the codesheet.
Follow the steps in the table below when deferring a previously denied issue.
Step
Action
1
Ensure the
  • previously denied issue is reflected on the MASTER RECORD tab in VBMS-R, and
  • appropriate date is listed in the ORIGINAL DATE OF DENIAL field.
Example:
Image of the Disability Descriptions and Evaluations from the Master Record tab in VBMS-R
References:  For more information on
2
On the ISSUE MANAGEMENT tab,
  • select Compensation from the CATEGORY drop-down menu
  • select the previously denied issue from the SUBJECT drop-down menu, and
  • click on the ESTABLISH ISSUE button.
3
Select the relevant issue in the ISSUE LIST field and click on the ENTER DECISION button.
4
From the SELECT EVALUATION BUILDER screen,
  • choose Disability Decision Information – Manual Entry, and
  • click on the OK button.
5
On the DISABILITY DECISION INFORMATION screen, choose Deferred from the DECISION drop-down menu.
6
Complete the other required decision entries.
References:  For more information on

III.iv.6.A.1.g.  Action to Take When SC for Cause of Death Is Deferred for Further Development

If the rating activity returns a case for further development with regard to the issue of SC for cause of death,
  • request the indicated evidence
  • award pension benefits if entitlement is established and an award was not made prior to submission of the case to the rating activity, and
  • establish a 30-day control for submission of the requested evidence.
Once the 30-day evidentiary submission period has elapsed, resubmit the case to the rating activity for issuance of a formal decision on the issue of SC for cause of death.
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