Select Page

M21-1, Part III, Subpart iv, Chapter 7, Section B – Reviewing the Rating Decision

Overview


In This Section

This section contains the following topics:

1.  Rating Decision Review


Change Date

February 19, 2019

III.iv.7.B.1.a.  Review of Rating Decisions

When the rating decision is completed, it may be reviewed prior to promulgation by individuals including
  • a second signer including the Veterans Service Center Manager (VSCM) or Pension Management Center Manager (PMCM)
  • a supervisor
  • local quality review team members
  • Veteran service organization (VSO) representatives, and/or
  • the authorization activity.
Individuals who may review promulgated and issued rating decisions include
  • the Compensation Service staff, to include Quality Assurance
  • a decision maker in connection with a legacy appeal or request for decision review under 38 CFR 3.2500and/or
  • Veterans Service Center (VSC) and Pension Management Center (PMC) management and/or quality review personnel.

References:  For more information on


2.  Handling Dissent and Differences of Opinion in Rating Decisions


Introduction

This topic contains information about handling dissenting opinions on two-signature ratings, including

Change Date

February 19, 2019

III.iv.7.B.2.a.  Dissenting Opinion vs. Difference of Opinion

 

 

 For the purpose of this section:
  • dissenting opinion scenario occurs when multiple decision makers whose signatures are required on a rating decision do not concur on some aspect of an unpromulgated decision, and
  • difference of opinion scenario occurs when a decision maker is of the opinion that revision or amendment is needed (for reasons that do not qualify as clear and unmistakable error (CUE)) of a promulgated rating decision completed by another decision maker.
References:  For more information on

III.iv.7.B.2.b.  Who Is Responsible for Resolving Dissenting Opinions

 

 

The VSCM or PMCM will resolve case of a dissenting opinion by providing the required second signature in place of one of the decision makers.

III.iv.7.B.2.c.  Handling Dissenting Opinions

Dissenting opinions regarding a rating decision should be discussed with the decision maker first, to try and resolve the issue.
The table below describes the process to resolve a dissenting opinion on a two-signature rating.
Stage
Who Is Responsible
Description
1
Non-concurring decision maker
Writes the word “Dissenting” at the end of the rating where his/her signature would normally be affixed as the second signatory for concurrence.
For rating decisions completed in the Veterans Benefits Management System – Rating (VBMS-R)
2
Non-concurring decision maker
  • Prepares and signs a rating decision as if he/she was the original author of the rating decision, and
  • includes the reasons for the dissent in theReasons for Decision section of the rating.
3
VSCM/PMCM
  • Reviews the two decisions
  • provides the second signature for the decision with which he/she agrees, and
  • refers the approved decision for processing.
Note:  Retain copies of both decisions in the claims folder.

3.  Correcting Deficiencies in Rating Decisions


Introduction

This topic contains information about correcting deficiencies in rating decisions whether found prior to promulgation or after promulgation and issuance, including

Change Date

February 19, 2019

III.iv.7.B.3.a.  Correcting Narrative Deficiencies Before or After Authorization

The rating activity must correct all Narrative section deficiencies when those are noted prior to promulgation and/or authorization.
The rating activity must also correct the Narrative section of a rating decision ifafter the claimant has been notified of the decision it is discovered that
  • inaccurate information was provided such as service dates or entitlements, and/or
  • incomplete information was provided to the claimant, such as criteria for the next higher evaluation, or a change of law applicable to the pending claim.
References:  For more information on

III.iv.7.B.3.b.  Correcting the Codesheet Before or After Authorization

It is critical to correct errors on the Codesheet, whether identified before or after promulgation or authorization, that

  • affect payment or eligibility to a benefit, or
  • could affect payment in the future.

Such errors include, but are not limited to

  • determinations on entitlement (service connection (SC), special monthly compensation (SMC), etc.)
  • disability evaluations
  • effective dates
  • combined evaluations
  • diagnostic codes (DCs)
  • SMC codes, and
  • bilateral factors.

Important:  In addition to the above, as provided in M21-1, Part III, Subpart ii, 3.C.7.a, periods of active military service must be updated and verified in the system prior to rating.  Such errors may not affect payment but if the Codesheetdoes not reflect the correct service dates, return the rating decision for correction.


III.iv.7.B.3.c.  Procedure for Correction of Rating Decisions

Use the following table for the procedure to follow when correction to a rating decision must be completed, per M21-1, Part III, Subpart iv, 7.B.3.a or b.
If the rating decision has 
Then refer the rating decision to 
not been issued
the decision maker who made the decision, or to VSC or PMC management for assignment of the rating correction.
been issued
VSC or PMC management for assignment to a decision maker to issue a new decision.
Note:  VSC or PMC management may assign rating corrections to another decision maker if the decision’s original author is not available.
Important:

References:  For more information on


III.iv.7.B.3.d.Revising Erroneous Anatomical Qualifiers

Revise an erroneous qualifying description of one part of the body for another that has been previously compensated.  This situation is usually the result of an unwarranted substitution of left for right, or right for left.
Exception:  If an original award of SC contains an erroneous qualifying description of one part of the body for another, revise the rating decision under the CUE provisions of 38 CFR 3.105(a) and M21-1, Part III, Subpart iv, 2.B.4.
Example:  An original award of SC of gunshot wound to the left thigh, rather than the actual right thigh, is a CUE subject to correction under 38 CFR 3.105(a).
Notes:
  • A notice of proposed adverse action is not required simply due to a change in anatomical site, unless it results in a reduction in compensation.
  • This change will not violate the protection of SC under 38 CFR 3.957, or protection of a service-connected evaluation under 38 CFR 3.951.
  • A CUE decision, under 38 CFR 3.105(a), is for application when previous determinations are binding.
 Reference:  For more information, see
Change-May-19-2015-Transmittal-Sheet-M21-1MRIII_iv_7_SecB_TS.docx May 15, 2019 40 KB
Transmittal-08_03_09.doc May 15, 2019 59 KB
Historical_M21-1III_iv_7_SecB_2-22-17.doc May 15, 2019 113 KB
Historical-M21-1III_iv_7_SecB_5-19-15.docx May 15, 2019 62 KB
2-22-17_Key-Changes_M21-1III_iv_7_SecB.docx May 15, 2019 56 KB
2-19-19_Key-Changes_M21-1III_iv_7_SecB.docx May 15, 2019 46 KB
Did this article answer your question?

Leave a Reply





Pin It on Pinterest

Share This