Overview
In This Section |
This section contains the following topics:
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1. Requesting Reports/21-Day Certificates for Admissions
Introduction |
This topic contains information on requesting reports and certificates for admissions, including
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Change Date |
August 18, 2017
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III.v.6.D.1.a.Generating and Screening CAPRI Admission Reports |
Generate reports for service-connected (SC) admissions using the Admission Report for SC Veterans option available from the Compensation and Pension Record Interchange (CAPRI) Reports menu in CAPRI.
Example:
![]() Screen each report (and associated clinical documents, if necessary) across Share to determine if the Veteran was admitted for an SC disability.
Reference: For more information on using CAPRI, see the CAPRI User Guide.
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III.v.6.D.1.c. Printing 21-Day Certificates |
Use the 21 Day Certificate Printing option available from the CAPRI Reports menu to generate and print new 21-day certificates from CAPRI. Example:
![]() Reference: For more information on using CAPRI, see the CAPRI User Guide.
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III.v.6.D.1.d.Handling an Initial Grant of SC While the Veteran Is Hospitalized |
If, while hospitalized, service connection (SC) is granted with a schedular evaluation of less than 100 percent for the condition for which the Veteran is hospitalized, take action as indicated in M21-1, Part III, Subpart v, 6.D.1.b.
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2. Adjusting an Initial Compensation Award for Hospitalization
Introduction |
This topic contains information on adjusting initial awards, including
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Change Date |
December 6, 2018
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III.v.6.D.2.a.Preparing an Award Adjustment for Hospitalization |
Follow the steps in the table below to prepare an open-ended Paragraph 29award.
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III.v.6.D.2.b.Maintaining Controls for Future Hospital Award Adjustments |
To prevent overpayments, it is important to maintain tight controls for open-endedParagraph 29 awards. To ensure such control,
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III.v.6.D.2.c.Determining Commencing Date of Award |
Use the table below to determine when to commence payment of an award adjustment when a Veteran is hospitalized for an SC condition in excess of 21 days.
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3. When VA Is Notified of the Discharge, Termination of Treatment, or Authorized Absence of a Veteran From a Hospital
Introduction |
This topic contains information on action to take when VA receives notification of the discharge, termination of treatment, or authorized absence of a Veteran from a hospital, including
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Change Date |
December 6, 2018
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III.v.6.D.3.a.Considering the Need for Convalescence When a Veteran Is Discharged |
Use the table below to determine the appropriate actions to take when
Note: Reduction to the pre-hospitalization rate due to discontinuance of hospitalization does not require due process notification under the provisions of 38 CFR 3.105(e).
Reference: Total disability benefits are authorized for a period of convalescence under 38 CFR 4.30.
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III.v.6.D.3.c.Consideration of Authorized Absences |
An authorized absence of 96 hours or less (14 days or less for a long-term patient) does not interrupt the continuity of hospitalization when the requirements for a 100-percent evaluation under 38 CFR 4.29(a)(1) of the rating schedule are otherwise met.
One full period of authorized absence may not be immediately followed by another. Requirements for absences exceeding these limits normally are met by releasing the patient.
If consecutive 14-day absences have been granted, a third authorized absence of 14 days is the equivalent of a hospital discharge, per 38 CFR 4.29(a)(2), unless convalescence is required.
Use the table below to determine the appropriate award action to take when a Veteran has been released or granted consecutive authorized absences.
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III.v.6.D.3.d.Action Upon Release to Non-Bed Care Status |
A release to non-bed care is equivalent to a regular discharge. Apply the procedures found in M21-1, Part III, Subpart v, 6.D.3.a.
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III.v.6.D.3.g.Actions to Take When Notified of an Unauthorized Absence or Irregular Discharge |
Follow the steps in the table below when notified of an unauthorized absence or irregular discharge in a case in which a total rating is in effect under Paragraph 29of the rating schedule.
Notes:
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III.v.6.D.3.h.Adjustment for Transfer to Nursing Home Care |
When a Veteran is transferred to nursing home care
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4. Taking Action on Receipt of a Final Hospital Summary
Introduction |
This topic contains information on actions to take on receipt of a final hospital summary, including
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Change Date |
December 6, 2018
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III.v.6.D.4.a.Referring Hospital Summaries to the Rating Activity |
Refer all hospital summary reports, upon receipt, to the rating activity to determine whether the prehospital evaluation should be reduced, or restored.
Reference: For more information on convalescent ratings, see M21-1, Part IV, Subpart ii, 2.J.4.
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III.v.6.D.4.b.Determining Actions When Prehospital Evaluation Is Increased or Restored |
Use the table below to determine the actions to take when a prehospital evaluation is increased or restored based on receipt and adjudication of a claim for increase of a SC disability.
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III.v.6.D.4.c.Determining Actions When Prehospital Evaluation Is Reduced |
Use the following table to determine the actions to take when a prehospital evaluation is reduced.
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Historical_M21-1III_v_6_SecD_4-13-15.doc | May 16, 2019 | 131 KB |
8-18-17_Key-Changes_M21-1III_v_6_SecD.docx | May 16, 2019 | 80 KB |
Historical_M21-1III_v_6_SecD_4-13-15-1.doc | May 16, 2019 | 131 KB |
8-18-17_Key-Changes_M21-1III_v_6_SecD-1.docx | May 16, 2019 | 80 KB |
12-6-18_Key-Changes_M21-1III_v_6_SecD.docx | May 16, 2019 | 69 KB |
Change-March-24-2015-Transmittal-Sheet-M21-1MRIII_v_6_SecD_TS-1.docx | May 16, 2019 | 40 KB |
Change-April-13-2015-Transmittal-Sheet-M21-1III_v_6_Sec-D_TS-1.docx | May 16, 2019 | 38 KB |
Change-March-24-2015-Transmittal-Sheet-M21-1MRIII_v_6_SecD_TS.docx | May 16, 2019 | 40 KB |
Change-April-13-2015-Transmittal-Sheet-M21-1III_v_6_Sec-D_TS.docx | May 16, 2019 | 38 KB |
in Chapter 6 Hospitalization at Department of Veterans Affairs (VA) Expense, Part III General Claims Process, Subpart v General Authorization Issues and Claimant Notification
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