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M21-1, Part III, Subpart iv, Chapter 6, Section D – Codesheet Section

Overview


In This Section

This section contains the following topics:
Topic
Topic Name
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3
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6
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9

1.  System-Generated Data Table Entries and the Jurisdiction of the Codesheet


Introduction

This topic contains information about the system-generated data table entries and the Jurisdiction of the Codesheet, including

Change Date

June 27, 2016

III.iv.6.D.1.a.  System-Generated Data Table Entries Organized by Field

Use the table below to determine when entries are generated by the system in the fields of the data tables on the Codesheet based on user-entered data on the MASTER RECORD tab and/or DISABILITY DECISION INFORMATION screens.
Note:  Each page of the rating decision contains a header with information identifying the claimant and rating.
Reference:  For more information on preparing a rating decision using the Veterans Benefits Management System – Rating (VBMS-R), see the VBMS-R User Guide.
Field
When Entry Is Generated
Reference
Active duty dates, branch, and character of discharge
Entry generated for the initial rating decision.
Note:  The entries remain the same on subsequent rating decisions unless changed.
Additional service code
Entry generated for the initial rating decision, if applicable.
Combat status code
Entry generated for the initial rating decision that addresses service connection (SC).
Note:  There is no need for a later entry unless the combat status has changed.
Special provision codes
Entry generated only if applicable to current or future benefit entitlement.
Future Exam date Entry generated only if applicable to future benefit entitlement See M21-1, Part III, Subpart iv, 3.C.2.b.
Special monthly compensation (SMC) codes
Entry generated only if applicable to current or future benefit entitlement.
Note:  The SMC table is part of the Special Monthly Compensation part of the coded conclusion. The table appears only when SMC is granted at some point in time.

III.iv.6.D.1.b.  Jurisdiction of the Codesheet

The Jurisdiction of the Codesheet
  • appears below the heading section
  • explains why the case is before the rating activity
  • refers to the claim at issue, and
  • cites the pertinent jurisdictional date.

2.  Additional Service Codes


Introduction

This topic contains information about additional service codes, including

Change Date

October 19, 2018

III.iv.6.D.2.a.  Generating Additional Service Codes

The additional service code is automatically generated when, for example, the decision maker selects combat related.

III.iv.6.D.2.b.  Description of the Codes

Use the table below for a description of additional service codes.
Code
Description
1-WT
Indicates additional service, some of which occurred during a wartime period.
2-PTE
Indicates additional service, all occurring during a peacetime period.
3-SCD
Establishes entitlement in a pension rating based on the existence of a service-connected (SC) disability at the time of separation for which discharge or release was or would have been granted, as provided in 38 CFR 3.3(a)(1)(ii) and 38 CFR 3.3(a)(3)(ii).
Note:  This code is used only in pension ratings for Veterans with less than 90 days of service.
WWI-Service in Russia
Indicates whether or not there was service in Russia that qualifies as World War I (WWI) service.
Note:  The narrative must show whether or not there was service in Russia in cases where the Veteran had no active service during the inclusive dates for WWI, April 6, 1917, to November 11,1918, but did serve thereafter, on or before April 1, 1920.

3.  Combat Status Codes


Introduction

This topic contains information about combat codes, including

Change Date

December 13, 2005

III.iv.6.D.3.a.  Definition:  Combat Disability

The term combat disability applies to any injury incurred in action against an enemy of the United States or as a result of an act of such an enemy.  These injuries include
  • wounds by missiles (bullets or shrapnel)
  • psychological trauma or posttraumatic stress disorder experienced in accidents, explosions, or airplane crashes during a period when the Veteran was in combat, and
  • diseases directly attributable to exposure to the elements as a result of action against the enemy or by the enemy, such as exposure following an airplane crash or shipwreck.

Reference For more information on combat-related disabilities, see M21-1, Part IV, Subpart ii, 2.B.3.d.


III.iv.6.D.3.b.  Description of Combat Status Codes

The table below contains descriptions for each of the four combat status codes.
Code
Description
1-None
Indicates no combat disabilities.
2-(Comp.)
One or more combat disabilities, all of which are compensable.
3-(Noncomp.)
One or more combat disabilities, none of which are compensable.
4-(Both)
One or more combat disabilities, not all of which are compensable.

4.  Special Provision Codes


Introduction

This topic contains information on special provision codes, including

Change Date

March 13, 2017

III.iv.6.D.4.a.  Definition:  Special Provision Codes

Special provision codes are used to identify those rating cases that contain an evaluation or combined degree that would not ordinarily be acceptable but for a special provision of the rating schedule or other Department of Veterans Affairs (VA) regulation.

III.iv.6.D.4.b.  Data Capture of Special Provision Codes

VBMS-R captures the required special provision code data for Codesheet entry based on selection(s) made from the OTHER – SPECIAL PROVISION DETERMINATIONS drop-down on the ISSUE MANAGEMENT tab.
Reference:  For further information on selection of special provisions, see theVBMS-R User Guide.

III.iv.6.D.4.c.  Descriptions of Individual Special Provision Codes

The table below contains descriptions for each of the seven special provision codes.
Code
Description
1
Indicates Medal of Honor pension under 38 CFR 3.802.
2
Indicates naval pension allowance under 38 CFR 3.803.
3
Indicates extra-schedular entitlement to individual unemployability or pension under 38 CFR 3.321(b).
Note:  In legacy systems, any extra-schedular evaluation was identified by entry of ES following the specific diagnostic code (DC).
4
Indicates an under-schedular evaluation (by reason of deduction of the pre-service level of disability) to a pre-service disability aggravated by service.
Note:  In legacy systems, any under-schedular evaluation was identified by entry of US following the specific DC.
5
Indicates the Veteran is incarcerated, and pension is being awarded to dependents under 38 CFR 3.666.
6
Indicates
  • computer audit acceptance of any combination of the special provision codes
  • a total evaluation is continued because it is protected under 38 CFR 3.951, or
  • acceptance of a combined evaluation that is not justified by the individual evaluations.
7
Indicates receipt of compensation or Dependency Indemnity Compensation under 38 U.S.C. 1151.

III.iv.6.D.4.d.  Examples of Special Provision Code 6 Indicating Computer Audit Acceptance

The following are examples of the use of special provision code 6 when a combined evaluation is not justified by the individual evaluations in cases:
  • when graduated evaluations are assigned for two or more diagnoses of inactive tuberculosis that may not be combined
  • when an independent respiratory condition is assigned in addition to a graduated evaluation for pulmonary tuberculosis that may not be combined
  • when the combined evaluation exceeds the maximum allowable under the amputation rule in a case, such as two or more independent disabilities affecting one extremity (Use of code 6 provides for computer audit acceptance of valid DCs at any evaluation and a combined degree of less than the normal value of the individual evaluation.)
  • when a 10-percent combined evaluation may be assigned under 38 CFR 3.324, such as two or more separate noncompensable disabilities, including disabilities under 38 U.S.C. 1151, and
  • when two or more conditions are assigned separate evaluations considered as one for the purpose of meeting the 40-percent or 60-percent single disability requirement of 38 CFR 4.16 in the rating schedule.

5.  SMC Codes


Change Date

April 3, 2015

III.iv.6.D.5.a.  SMC Codes

VBMS-R captures the required SMC coding for Codesheet entry based on data entered on the SMC CODES tab.
Reference:  For more information on entering SMC codes, see

6.  Special Notations and Notification Templates


Introduction

This topic contains information on use of the SPECIAL NOTATION field and notification template, including

Change Date

October 19, 2018

III.iv.6.D.6.a.  Purpose of Special Notations and Notification Templates

The primary purposes of notations made in the SPECIAL NOTATION field and the notification template fields on the Codesheet are to
  • record special remarks or approvals applicable to the rating decision, and
  • communicate an instruction or administrative message to the authorization activity.
Note:  All special notations and templates are generated through input in the PROFILE tab of VBMS-R.
Reference:  For more information on the PROFILE tab, see the VBMS-R User Guide.

III.iv.6.D.6.b.  Special Notation Field

Use the SPECIAL NOTATION field, accessible from VBMS-R’s PROFILE tab, to communicate an instruction or administrative message to the authorization activity.  Clarify if the message is solely administrative (for example, Cancel the erroneously established EP 930) or to be shared with the Veteran (for example, Tell the Veteran that the evaluation of his nephrolithiasis is currently awaiting higher-level review and will be addressed in a future decision).
Note:  The special notation text appears at the bottom of the Codesheet above the signature(s).
Reference:  For more information on the SPECIAL NOTATION field, see theVBMS-R User Guide.

III.iv.6.D.6.c.  Amputation Rule Template

Use the amputation rule template, accessible from VBMS-R’s PROFILE tab, to list the disabilities and evaluations included in the application of the amputation rule.
Show the actual combined evaluation of all disabilities of the affected extremity, as well as the schedular evaluation associated with amputation of the extremity at the elective level.
Note:  The amputation rule text appears at the bottom of the Codesheet above the signature(s).
References:  For more information on

III.iv.6.D.6.d.
38 CFR 3.105(a) CUE Grant Template

Use the 38 CFR 3.105(a) grant template, accessible from VBMS-R’s PROFILE tab, when granting benefits on the basis of clear and unmistakable error (CUE).
Note:  The 38 CFR 3.105(a) template is comprised of both automated text and free text. It appears at the top of the first page of the Codesheet below the data tables.
Reference:  For more information on the CUE template in VBMS-R, see

III.iv.6.D.6.e.Accrued Grant Template

When granting an accrued benefit claim, use the language generated by enabling the accrued grant template accessible from VBMS-R’s PROFILE tab.
Note:  The accrued template is only available for selection if the Veteran is deceased.  When generated, the accrued grant template will appear at the top of the first page of the Codesheet below the data tables.
Reference:  For more information on the accrued grant template, see the VBMS-R User Guide.

7.  Signature


Introduction

This topic contains information on the signature line on rating decisions, including

Change Date

November 8, 2018

III.iv.6.D.7.a.
Definition: Signatures on Rating Decisions

Rating decisions must contain the decision maker’s digital signature on the bottom of the last page of the Codesheet.
A rating decision signature is defined as
Exception:  If a rating decision requires more than one signature, the rating decision Codesheet must display the required additional signature fields, but the digital signatures of the additional reviewers must be documented on VA Form 21-0961, Electronic Signatures.
Important:  The signature of the decision maker(s) certifies that the claims folder was reviewed and all phases of the claims process leading to the decision were correctly handled.
References:  For more information on

III.iv.6.D.7.b.Procedure for Completing a Digital Signature on the Rating Decision Codesheet

The rating decision Codesheet must contain the standardized digital signature of the decision maker as described in M21-1, Part III, Subpart iv, 6.D.7.a. “Wet signatures” are no longer required.
To establish the standardized digital signature, users should navigate to the SIGNATURE/DOCUMENT TITLE tab in VBMS-R’s options configurations, and populate the AUTHOR SIGNATURE LINE field as follows:
eSign: certified by [decision maker’s LAN ID, job title] 
Example:  eSign: certified by VSCJSMIT, RVSR
 
References:  For more information on

III.iv.6.D.7.c.Single-Signature Ratings

Single-signature authority is restricted to decision makers whose ability to produce quality work independently without additional oversight has been demonstrated by review.
Note:  Authority for single signature may
  • vary among different regional offices (ROs) and decision makers depending on local circumstances, and
  • be granted to a decision maker for specific types of ratings as he/she demonstrates the requisite skill and understanding needed to ensure quality.

III.iv.6.D.7.d.Two-Signature Ratings

All rating decisions require the signatures of two decision makers, unless approved as single-signature ratings by the Veterans Service Center Manager (VSCM) or Pension Maintenance Center Manager (PMCM).
Exception:  The VSCM/PMCM does not have authority to grant single-signature authority in all cases.  The table below lists specific types of rating issues that always require a second signature.
If deciding …
And the decision maker is a(n) …
Then the rating decision requires …
  • SMC at a rate greater than SMC (l)
  • traumatic brain injuries (TBI) until a decision maker has demonstrated an accuracy rate of 90 percent or greater on a minimum of 10 TBI cases
  • former prisoners of war issues, and
  • proposals to sever SC
Rating Veterans Service Representative (RVSR) or Decision Review Officer (DRO)
second-signature approval of a designated reviewer.
any issue involving a disability related to military sexual trauma (MST), until a decision maker has demonstrated an accuracy rate of 90 percent or greater on a minimum of 10 MST cases
locally designated, specialized RVSR
second-signature approval of a designated reviewer.
extra-schedular pension under38 CFR 3.321(b)(2)
RVSR or DRO
approval by VSCM or PMCM.
CUE under 38 CFR 3.105(a)
Exception:  CUE rating decisions prepared as the result of a Board of Veterans’ Appeals or Court of Appeals for Veterans Claims decision do not require additional approval.
RVSR
approval by VSCM or PMCM or designee at the coach level or higher.
DRO
approval by VSCM or PMCM or designee at the coach level or higher onlyif the issue is
  • severance of SC, or
  • a reduction in evaluation of an SC disability(ies).
certain extensions of temporary total evaluations under
RVSR or DRO
approval by the VSCM.
Reference:  For more information on VSCM approval of temporary total evaluations, see M21-1, Part IV, Subpart ii, 2.J.
Note:  Follow locally established policies to obtain a third signature, when required.
References:  For more information on

III.iv.6.D.7.e.
Obtaining Additional Signatures for Rating Decisionsin VBMS

The table below describes the steps involved in obtaining second/third signatures for rating decisions in VBMS.
Important:
  • A rating decision should not be finalized until all necessary second and third signatures have been obtained.
  • Although additional signatures are recorded on VA Form 21-0961, the rating decision Codesheet must display the required additional signature field(s).
Step
Action
1
Save the draft rating decision in a location designated by locally established procedures.
Note:  ROs may set up folders on a shared drive for this purpose.
2
Complete, sign, and save VA Form 21-0961.
3
  • Perform the system updates detailed in the National Work Queue (NWQ)  Phase 1 & 2 Playbook under Rating Decisions Requiring Second and Third Signatures to prevent recall by the NWQ, and
  • follow established procedures for referring the case to the second and, if required, third reviewer for their review and signature.
4
After all required signatures are obtained,
  • finalize the rating decision and upload VA Form 21-0961 to the corresponding electronic claims folder (eFolder)
  • delete the previously saved draft rating decision and VA Form 21-0961
  • perform all system updates in accordance with the NWQ  Phase 1 & 2 Playbook, and
  • follow established procedures to refer the claim to the authorization activity.
Reference:  For information about uploading documents into an eFolder, see the VBMS User Guide.

III.iv.6.D.7.f.Exhibit: Rating Decision Codesheet Signature Field

The exhibit below contains a sample rating decision Codesheet with the signature field containing the electronic signature certification statement and the user’s LAN ID.
Image of a sample Codesheet with the signature field containing the electronic signature certification statement and the user’s LAN ID.

8.  Exhibit 1: Sample Draft Codesheet for a CUE Rating Decision


Change Date

March 13, 2017

III.iv.6.D.8.a.Sample Draft Codesheet, CUE Rating Decision

The exhibit below contains a sample draft Codesheet for a CUE rating decision prepared under the authority of 38 CFR 3.105(a).
An image of a sample draft Codesheet for a CUE rating decision prepared under the authority of 38 CFR 3.105(a).

9.  Exhibit 2: Sample Draft Codesheet for Application of the Amputation Rule


Change Date

June 27, 2016

III.iv.6.D.9.a.Sample Draft Codesheet, Amputation Rule

The exhibit below contains a sample draft Codesheet demonstrating proper application of the amputation rule under 38 CFR 4.68.
Sample Draft Codesheet, Amputation Rule, 38 CFR 4.68
6-9-17_Key-Changes_M21-1III_iv_6_SecD.docx May 15, 2019 404 KB
6-5-17_Key-Changes_M21-1III_iv_6_SecD.docx May 15, 2019 411 KB
Change-April-3-2015-Transmittal-Sheet-M21-1III_iv_6_SecD_TS.docx May 15, 2019 37 KB
Transmittal-M21-1MRIII_iv_6_SecD_TS.docx May 15, 2019 38 KB
Transmittal-12_13_05.doc May 15, 2019 52 KB
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