Overview
In This Section |
This section contains the following topics:
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1. Receipt and Processing of VA Form 10-7131
Introduction |
This topic contains information on procedures for processing VA Form 10-7131 for outpatient dental treatment, including
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Change Date |
July 20, 2016
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III.v.7.C.1.a. Handling Requests for Dental Treatment |
As is discussed in M21-1, Part IX, Subpart ii, 2.3.a, the Veterans Benefits Administration is responsible for developing and deciding claims for service connection (SC) of dental and oral disabilities. If, however, a Veteran submits a benefit application containing a request for dental treatment (with or without claiming a specific disability), do not
Instead, use the Veterans Benefits Management System (VBMS) (or other appropriate claims-processing system) to generate a subsequent development letter, informing the Veteran of the following:
We recently received your request for dental treatment. In order to initiate a determination regarding your eligibility to dental treatment services, you may
Notes:
References: For more information on
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III.v.7.C.1.b. Responsibility of the Treating VHA Facility to Initiate VA Form 10-7131 |
The treating VA facility initiates VA Form 10-7131 if it cannot determine eligibility and the dental treatment claim may involve
Generally, this determination is made promptly upon receipt of an outpatient treatment claim and prior to a VA) examination.
Reference: For a description of dental classes, see M21-1, Part III, Subpart v, 7.B.
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III.v.7.C.1.c. Responsibility of the Treating VHA Facility to Complete Development in Dental Claims |
The treating facility personnel also complete any development required to establish dates and places of treatment. The following documents are provided by the treating facility, except in referrals of Class II(c) or Class IV cases:
Note: Claims for missing teeth should not be referred for adjudication unless exercise of professional judgment alone cannot establish entitlement after VA examination. In such cases, a copy of the VA examination should be submitted with VA Form 10-7131, with the annotation, Claim for missing teeth under 38 CFR 17.161(f), in the Remarks section of Part I, Item 6 of the form.
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III.v.7.C.1.d. Procedures for Processing VA Form 10-7131 for Dental Eligibility |
The basic procedures for processing VA Form 10-7131 for dental outpatient treatment are the same as those provided in M21-1, Part III, Subpart v, 7.A.2.
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III.v.7.C.1.e. Verification of FPOW Status for Dental Eligibility |
When the request involves verification of former prisoner of war (FPOW) status or total service-connected (SC) disabilities, the request appears in the Remarkssection of Part I, Item 6 of VA Form 10-7131 as follows:
Information on verification of the Veteran’s FPOW status or total SC disabilities should appear in the claims folder. Verification of FPOW status should be requested if not available in the claims folder.
References: For more information on
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III.v.7.C.1.f. Determining the Character of Discharge for Dental Eligibility |
When a request involves determining the character of the Veteran’s discharge, follow the procedures in
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III.v.7.C.1.g. Procedures for Review and Development Following Receipt of VA Form 10-7131 |
Follow the steps in the table below when a request for adjudication of a dental claim is received on VA Form 10-7131.
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2. Completing VA Form 10-7131 for Missing Teeth
Introduction |
This topic contains information on completing VA Form 10-7131 for missing teeth, including
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Change Date |
April 12, 2007
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III.v.7.C.2.a. Responsibility of Authorization Personnel in Claims for Missing Teeth |
If service dental records are received in a claim under 38 CFR 17.161 for missing teeth, authorization personnel have the primary responsibility for
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III.v.7.C.2.b. Procedures for Completing VA Form 10-7131 When Reviewing Service Dental Records |
Use the table below to take the appropriate actions when completing VA Form 10-7131 based on the evidence contained in the service dental records.
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3. Referring Dental Disability Claims to the Rating Activity
Introduction |
This topic contains information on referring dental disability claims to the rating activity, including
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Change Date |
May 11, 2015
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III.v.7.C.3.a. Referral of VA Form 10-7131 to the Rating Activity for Dental Treatment Claims |
In addition to the normal referral for rating required when a claim for a compensable dental disability is filed on a prescribed form, rating action is also required for the proper disposition of VA Form 10-7131 on a claim for dental treatment for
Reference: For more information on ratings for dental treatment, see M21-1, Part IX, Subpart ii, 2.2.
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III.v.7.C.3.b. Using Photostatic Copies of Naval Dental Examinations |
If the Veteran served prior to 1953, photostatic copies of Naval dental examinations are generally not usable for rating purposes since red and blue markings were used on the originals. These markings cannot be distinguished from each other on photocopies.
In these cases, do not refer the claims folder to the rating activity until the originals are obtained.
Reference: For more information on Naval dental records, see M21-1, Part IX, Subpart ii, 2.2.o.
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4. Processing VA Form 10-7131 for FPOWs and Totally Disabled SC Veterans
Change Date |
May 11, 2015
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III.v.7.C.4.a. Procedure for Processing VA Form 10-7131 for Dental Eligibility for FPOWs and Totally Disabled SC Veterans |
When processing VA Form 10-7131, follow the procedure in the table below for claims filed under 38 U.S.C. 1712(a)(1)(F) and (G) for FPOWs and totally disabled SC Veterans.
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5. Disposition of VA Form 10-7131 Requests and Handling Legacy NODs and Appeals
Introduction |
This topic contains information on disposition of VA Form 10-7131 requests and handing legacy NODs and appeals, including
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Change Date |
February 25, 2019
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III.v.7.C.5.a. Disposition of VA Form 10-7131 Request After a Dental Rating Decision |
After a dental rating decision has been made, submit a copy of the dental rating with the VA Form 10-7131 request to the originating office.
Important: Do not furnish notice of the decision directly to the Veteran. The Chief Dental Officer notifies the claimant of the final decision.
Note: The rating decision should be prepared in accordance with the VBMS-Rating User Guide. The historic manually prepared rating, VA Form 21-546b, is obsolete and should not be used.
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III.v.7.C.5.b. Handling a Legacy NOD When Dental Eligibility Is at Issue |
If a legacy notice of disagreement (NOD) is received in response to a dental rating decision, the VSC is responsible for preparing a statement of the case if SC is at issue, including discussion of such issues as
Reference: For more information about legacy NODs, see M21-1, Part I, 5.B.
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III.v.7.C.5.c. Certifying a Legacy Appeal to BVA When Dental
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Follow the steps in the table below when certification of a legacy appeal to the Board of Veterans Appeals (BVA) is in order.
Reference: For more information on BVA, see M21-1, Part I, 5.G.
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Change-May-10-2015-Transmittal-Sheet-M21-1III_v_7_SecC_TS.docx | May 16, 2019 | 41 KB |
2-25-19_Key-Changes_M21-1III_v_7_SecC.docx | May 16, 2019 | 48 KB |
7-20-16_Key-Changes_M21-1III_v_7_SecC.docx | May 16, 2019 | 58 KB |
in Chapter 7 Eligibility for Department of Veterans Affairs (VA) Medical and Dental Treatment, Part III General Claims Process, Subpart v General Authorization Issues and Claimant Notification
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