M21-1, Part III, Subpart iv, Chapter 8, Section B – Proposed Rating Decisions

In This Section

Introduction

• when to prepare a proposed rating
• preparing proposed and final actions
• providing a due process period
• providing notice
• preparing a rating and providing notice under the proper regulations
• new rating decisions based on new evidence
• preparing a new rating decision following receipt of additional evidence, and
• preparing and sending a final rating decision.

Change Date

III.iv.8.B.1.a.  When to Prepare a Proposed Rating Decision

• reductionof evaluation for compensation
• reduction of pension, in certain circumstances
• severance of service connection (SC), or
• determinations of  incompetency for payment purposes.

• revision of decisions, see 38 CFR 3.105
• reducing a benefit, see
  • M21-1, Part III, Subpart iv, 8.D, and
  • M21-1, Part IV, Subpart ii, 3.A.3
• severing SC, see M21-1, Part III, Subpart iv, 8.E.2
• evaluating competency, see M21-1, Part III, Subpart iv, 8.A
• clear and unmistakable errors, see
  • 38 CFR 3.105(a), and
  • M21-1, Part III, Subpart iv, 2.B.4
• failure to report for routine future examinations, see
  • 38 CFR 3.655(c), and
  • M21-1, Part III, Subpart iv, 8.E.1, and
• reducing a benefit without a proposed rating decision, seeVAOPGCPREC 71-1991.

III.iv.8.B.1.b.  Preparing Proposed and Final Actions

• When the proposed decision would result in a reduction in combined disability evaluation if implemented, the rating decision must state the proposed combined evaluation.
• If the facts contained in the proposed rating decision are complete (no additional evidence has been received or requires consideration), they do not need to be repeated in the final rating decision.  However, the final notification must include all required elements as detailed in M21-1, Part III, Subpart v, 2.B.1.b.
• Include the proposed rating decision in the evidence list of the final rating decision and reference it by citing its date.

III.iv.8.B.1.c.  Providing a Due Process Period

III.iv.8.B.1.d.  Providing Notice

• reduction of a disability evaluation, see M21-1, Part IV, Subpart ii, 3.A.3
• required elements of a notice of proposed adverse action, see M21-1, Part I, 2.B.2, and
• required elements of a final decision notice, see M21-1, Part I, 2.C.4.

III.iv.8.B.1.e.  Preparing a Rating and Providing Notice Under the Proper Regulations

• reasons for the proposed decision
• time period to submit evidence
• proposed date of reduction, and
• proposed combined evaluation.

• procedures to follow when corrected notice of proposed adverse action is required, see M21-1, Part I, 2.B.3.e, and
• available letters for use in connection with proposals to reduce, see theVBMS User Guide.

III.iv.8.B.1.f.  New Rating Decisions Based on New Evidence

• the signature requirements for the final rating decision for reductions or discontinuance due to error under 38 CFR 3.105(a) when new evidence has been received after promulgation of the proposed rating decision, seeM21-1, Part IV, Subpart ii, 3.A.2.d, and
• handling submissions from the beneficiary during the proposal period, see M21-1, Part I, 2.C.2.

III.iv.8.B.1.g.  Preparing a New Rating Decision Following Receipt of Additional Evidence

• new, and
• justifies a favorable decision.

• a complete statement of the facts, stressing the new basis upon which the favorable action is predicated, and
• a clear discussion of the basis for the changed decision.

III.iv.8.B.1.h.  Preparing and Sending a Final Rating Decision

• prepare a final rating implementing the proposal and
• notify the beneficiary of the decision.

• required elements of a final decision notice, see M21-1, Part I, 2.C.4
• signature requirements for rating decisions proposing and finalizing reduction or discontinuance of benefits due to error under 38 CFR 3.105(a), see M21-1, Part IV, Subpart ii, 3.A.2.b, and
• process for making competency determinations, see M21-1, Part III, Subpart iv, 8.A.3.a.

Change Date

III.iv.8.B.2.a.  Invalid Disagreements with Proposed Rating Decisions

• notice of proposed adverse action, or
• notice of proposed incompetency.

• legacy NODs, see M21-1, Part I, 5.B, and
• responding to invalid or premature legacy NODs, see M21-1, Part III, Subpart ii, 3.E.1.e.