Overview
In This Section |
This section contains the following topics:
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1. General Information on FPOW Rating Activities
Introduction |
This topic contains general information on FPOW rating activities, including
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Change Date |
March 20, 2011
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2. Deciding Claims Involving FPOWs
Introduction |
This topic contains information on deciding claims involving FPOWs, including
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Change Date |
May 13, 2015
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IV.ii.2.E.2.a. Considering All Relevant Laws, Regulations, and Directives for FPOW Claims |
All claims filed by FPOWs must be adjudicated in accordance with all sections of the laws, regulations, and directives concerning such claims.
References: For more information on
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IV.ii.2.E.2.b. Liberal Application of Directives Per 38 CFR 3.304(e) in FPOW Claims |
In accordance with 38 CFR 3.304(e), the Department of Veterans Affairs (VA) employs a liberal approach when adjudicating claims for service connection (SC) from FPOWs.
This policy is based on the following two important factors
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IV.ii.2.E.2.d. Considering the Adequacy of Medical Evidence in FPOW Claims |
Medical evidence that is current, accurate, and complete is paramount. Examine medical evidence thoroughly to determine whether it is adequate to evaluate the disabilities under consideration. Request a physical examination to supplement the evidence when necessary.
Ensure that a determination is not made on the basis of medical evidence that is not current or that is incomplete with regard to the disabilities under consideration.
Important: If the Veteran was not previously examined under an FPOW Protocol Disability Benefits Questionnaire, request such an examination.
References: For more information on
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IV.ii.2.E.2.h. Requesting an Advisory Opinion in FPOW Claims |
If it is unclear whether a condition is a residual of the POW experience, submit the claim to the Compensation Service mailbox, VAVBAWAS/CO/21Q&A, for an advisory opinion.
Reference: For more information on Compensation Service guidance and advisory opinions, see M21-1, Part III, Subpart vi, 1.A.
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3. Presumption of SC for FPOWs
Introduction |
This topic contains information on presumptive SC for FPOWs, including
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Change Date |
May 13, 2015
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IV.ii.2.E.3.a. Establishing Presumptive SC Under 38 CFR 3.309(c) |
The diseases specified in 38 CFR 3.309(c)(1) and (2) must be presumed to be SC if they become 10 percent or more disabling at any time after service and the Veteran has qualifying POW service.
References: For more information on
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IV.ii.2.E.3.b. Disabilities Presumed to be SC for FPOWs Under 38 CFR 3.309(c) |
The disabilities presumed to be SC for FPOWs can be found at 38 CFR 3.309(c).
Important:
Notes:
Reference: For more information on diseases and disabilities subject to a presumption of SC, see 38 U.S.C. 1112.
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IV.ii.2.E.3.c. Absence of Evidence in Service Records of Presumptive Disabilities in FPOW Claims |
Since the disabilities listed in 38 CFR 3.309(c) are presumed to be service- connected a record of their treatment or existence during service is not required.
Do not deny SC for one of these conditions predicated solely upon a deficiency in the Veteran’s STRs.
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IV.ii.2.E.3.e. Denying Presumptive SC for an FPOW Claim |
Before denying presumptive SC for an FPOW, at least one of the following two conclusions must be reached based on a thorough review of the evidence of record
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4. Considering SC for Certain Disabilities of FPOWs
Introduction |
This topic contains information on considering SC for certain disabilities of FPOWs, including
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Change Date |
May 13, 2015
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IV.ii.2.E.4.a. Considering SC for Residuals of Frostbite |
Internment as a POW in climatic conditions consistent with the occurrence of frostbite is a prerequisite to establishing SC on a presumptive basis for organic residuals of frostbite.
Notes:
Reference: For more information on rating residuals of cold injury, see M21-1, Part III, Subpart iv, 4.E.2.
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IV.ii.2.E.4.b. Considering SC for Peptic Ulcer Disease |
For rating purposes, a diagnosis of peptic ulcer is not sufficiently specific. To properly evaluate the disability, the diagnosis must be supported by evidence adequately identifying the particular location of the ulcer.
Reference: For more information on rating peptic ulcer disease, see 38 CFR 4.110.
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IV.ii.2.E.4.c. Considering SC for Peripheral Neuropathy |
Peripheral neuropathy is subject to a presumption of SC under 38 CFR 3.309(c),except when the evidence establishes that peripheral neuropathy is directly related to infectious causes which are unrelated to an FPOW’s detainment.
Notes:
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IV.ii.2.E.4.d. Distinguishing Between Post-Traumatic Arthritis and Degenerative Arthritis in an FPOW Claim |
If a Veteran of advanced age with multiple joint arthritis alleges trauma as the cause of arthritis at all or some of the disease sites, the rating activity must take care to distinguish between post-traumatic arthritis and degenerative or age-related arthritis when considering SC.
In such situations, obtain the most complete account possible of the traumatic incident. Information that should be available for consideration includes
Important: A reasonable basis for an award of SC might include
Note: A medical opinion from a physician qualified to conduct POW examinations may be necessary to determine whether a current diagnosis of arthritis is consistent with the traumatic injuries reported by the FPOW.
Reference: For more information on POW examiner qualifications, see VHA Directive 2011-018.
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IV.ii.2.E.4.f. Considering SC for Osteoporosis – PTSD Diagnosed |
Effective October 10, 2008, a presumption of SC was established for osteoporosis under 38 CFR 3.309(c)(1) for FPOWs who
Note: PTSD is the only anxiety disorder recognized under 38 CFR 3.309(c)(1) as being associated with osteoporosis.
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IV.ii.2.E.4.g. Considering SC for Osteoporosis – PTSD Not Diagnosed |
Effective September 28, 2009, a presumption of SC was established for osteoporosis under 38 CFR 3.309(c)(2) for FPOWs who were detained or interned for 30 days or longer.
Note: This presumption is based, at least in part, on the likely nutritional deprivation experienced during longer (30 days or more) periods of captivity.
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IV.ii.2.E.4.h. FPOW Claims With Diagnoses of Both Osteoporosis and Arthritis |
Many FPOWs who claim SC for osteoporosis, evaluated under 38 CFR 4.71(a), diagnostic code (DC) 5013 based on joint manifestations, have already established SC for arthritis, which is also evaluated based on symptoms in skeletal joints.
If a claim involves diagnoses of both osteoporosis and arthritis, obtain a medical opinion as to the etiology of the symptoms affecting a particular joint or joints.
Notes:
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5. Preparing a Rating Decision Involving a Presumption of SC
Introduction |
This topic contains information on preparing a rating decision involving a presumption of SC, including
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Change Date |
May 13, 2015
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IV.ii.2.E.5.a. Information Required in the POW Rating Decision |
Rating decisions must contain a summary of all available information about the Veteran’s confinement as a POW, such as the
Reference: For more information on completing the rating decision narrative, seeM21-1, Part III, Subpart iv, 6.C.
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IV.ii.2.E.5.b. Citing Disabilities in an FPOW Claim |
Use the POW special issue indicator when entering a decision in Veterans Benefits Management System Rating (VBMS-R) for all disabilities alleged to have been incurred or aggravated during the Veteran’s period of confinement as a POW.
Reference: For more information on special issue indicators in VBMS-R, seeVBMS-Rating User Guide.
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IV.ii.2.E.5.d. Coding Specific FPOW Disabilities |
Use the information below to code specific FPOW disabilities.
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6. History of Disabilities Subject to Presumptive SC for FPOWs
Introduction |
This topic contains information on the history of disabilities subject to presumptive SC for FPOWs, including the
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Change Date |
May 13, 2015
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IV.ii.2.E.6.a. History Behind the Length of Confinement Requirement for FPOWs |
Effective December 16, 2003, Public Law (PL) 108-183 eliminated the length of confinement requirement of 30 days or longer for the following disabilities
For claims received from October 1, 1981, through December 15, 2003, an FPOW must have been confined for 30 days or longer to be eligible for a presumption of SC for any of the disabilities listed in 38 CFR 3.309(c).
For claims received before October 1, 1981, confinement of six months or longer was required.
Note: Certain disabilities are established under 38 CFR 3.309(c)(1) without regard to length of POW confinement.
Reference: For more information on length of confinement requirements, see
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IV.ii.2.E.6.b. History of PLs and Federal Register Citations for FPOW Diseases |
The table below contains the history of the PLs and Federal Register citations that have authorized a presumption of SC for the disabilities listed in 38 CFR 3.309(c).
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Transmittal-Sheet-pt04_sp02_TS_10-05-10.docx | May 21, 2019 | 41 KB |
Change-May-13-2015-Transmittal-Sheet-M21-1IV_ii_2_SecE_TS.docx | May 21, 2019 | 43 KB |
in Chapter 2 Rating, Part IV Compensation, DIC, and Death Compensation Benefits, Subpart ii Compensation
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