Overview
In This Section |
This section contains the following topics:
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1. Application and Initial Eligibility Verification
Introduction |
This topic contains information on application and initial eligibility verification, including |
Change Date |
December 12, 2018 |
VI.2.B.1.a. Application Requirement for Chapter 18 Benefits |
A claimant seeking benefits associated with spina bifida and other covered birth defects may use VA Form 21-0304, Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korean Service Veterans. Whether another filing satisfies Department of Veterans Affairs (VA) claim criteria is determined by 38 CFR 3.151 and 38 CFR 3.155.
Reference: For more information about Denver Regional Office (RO) jurisdiction in Chapter 18 claims and determinations see M21-1, Part VI, 1.1.
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VI.2.B.1.b. Initial Review of Eligibility Requirements Before Undertaking Development |
Do not develop for additional evidence from the claimant if it can be determined immediately that the claimant cannot meet all the qualifying requirements for
When confirmation cannot be obtained that the above elements of basic eligibility have been met, prepare an administrative denial and notify the claimant.
Important: Refer to the rating activity any claim found to require
References: For more information on
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VI.2.B.1.d. Example 2: When Additional Development Is Not Necessary for a Chapter 18 Claim |
Situation: A child with spina bifida occulta applies for Chapter 18 benefits.
Action: Refer the case to the rating activity for a rating decision denying the claimwithout developing for Vietnam or specific Korean service requirements and relationship evidence.
Rationale: The claimant does not have a qualifying spina bifida disability that meets the requirements for Chapter 18 benefits. A rating decision is required to implement a denial of benefits when the child has spina bifida occulta or no spina bifida condition exists.
Note: In addition to denying the claim for spina bifida benefits, the rating decision must also address entitlement to benefits for other covered birth defects under 38 CFR 3.815.
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2. Development Process Overview
Change Date |
December 12, 2018 |
VI.2.B.2.a. Development Process for Chapter 18 Benefits |
The table below describes the responsibilities of the development activity during the stages of the development process for Chapter 18 benefits.
Important:
Reference: For more information on Denver RO jurisdiction in Chapter 18 claims and determinations, see M21-1, Part VI, 1.1.
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3. Vietnam Service Requirements and Development
Introduction |
This topic contains information on the Vietnam service requirements and development, including |
Change Date |
October 20, 2016 |
VI.2.B.3.a. Vietnam Service Requirement |
A Vietnam Veteran is a person who performed active military, naval, or air service in the Republic of Vietnam (RVN) during the period
Notes:
References: For more information on
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4. Korean Service Requirements and Development
Introduction |
This topic contains information on Korean service requirements and development, including |
Change Date |
October 20, 2016 |
VI.2.B.4.a. Specific Korean Service Requirements |
Effective December 16, 2003, the Veterans Benefits Act of 2003, as codified at 38 U.S.C. 1821(c), provides benefits and services to children born with spina bifida who are the natural children of Veterans with covered service in Korea.
Covered service in Korea requires
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VI.2.B.4.b. Presumption of Herbicide Exposure for Some Veterans with Covered Service in Korea |
Under 38 CFR 3.814(c)(2), effective February 24, 2011, presume exposure to an herbicide agent for Veterans who served
Exception: The presumption of exposure that arises from the showing above will be rebutted where there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. Notes:
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VI.2.B.4.c. Establishing Herbicide Exposure |
Use the table below to establish exposure to herbicides in claims based on Korean service.
Reference: For more information on requesting records from JSRRC in support of a Korean DMZ herbicide claim, see M21-1, Part IV, Subpart ii, 1.H.4.c.
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5. Date of Conception Considerations
Introduction |
This topic contains information on date of conception considerations in claims involving Vietnam or Korean service, including
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Change Date |
October 20, 2016 |
VI.2.B.5.b. Estimating Date of Conception and Taking Next Action |
Follow the steps in the table below to estimate the date of conception and determine the next action to take.
Note: Questions about the child’s date of conception will be resolved by an administrative decision.
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6. Relationship Requirements and Developing for Relationship Evidence
Introduction |
This topic contains information on relationship requirements and developing for relationship evidence, including
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Change Date |
October 20, 2016 |
VI.2.B.6.a. General Relationship Eligibility Requirements of an Individual |
To be eligible for Chapter 18 benefits, the individual must be the natural child of a Veteran with qualifying service.
Important: VA requires more than a written statement to establish parentage. A birth certificate will always be required.
Note: Specific relationship requirements exist, separately, for spina bifida benefits and other covered birth defects benefits.
References: For more information on
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VI.2.B.6.d. Development for Relationship Evidence for Spina Bifida |
Review the parents’ names on the birth certificate in the Veteran’s claims folder. Ensure the birth certificate lists the Veteran(s) as the parent of the claimant.
Notes:
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VI.2.B.6.e. Development for Relationship Evidence for Other Covered Birth Defects |
Review the mother’s name on the birth certificate in the Veteran’s claims folder. Ensure that the birth certificate lists the Veteran as the mother of the claimant.
Note: A birth certificate with the mother’s name on it or a photocopy of the birth certificate is considered sufficient evidence to verify the claim.
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7. Disability Requirement for Spina Bifida Benefits
Change Date |
December 12, 2018 |
VI.2.B.7.a. Qualifying Types of Spina Bifida for Eligibility Under Chapter 18 |
Spina bifida benefits are payable for all types of spina bifida except spina bifida occulta.
The term spina bifida refers to a defective closure of the bony encasement of the spinal cord but does not include other neural tube defects, such as encephalocele and anencephaly (VAOPGCPREC 5-1999).
Note: The rating activity is responsible for assessing disability level for spina bifida.
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8. Disability Requirement for Other Covered Birth Defects
Introduction |
This topic contains information on the disability requirement for other covered birth defects, including
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Change Date |
October 20, 2016 |
VI.2.B.8.a. Definition: Birth Defect |
A birth defect is an abnormality of
The abnormality may be
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VI.2.B.8.b. Limitation on Birth Defects and Conditions Covered |
Not all birth defects and conditions qualify an individual for Chapter 18 benefits. VA will only cover birth defects that are potentially linked to a female Veteran’s Vietnam service and have resulted in a permanent mental or physical disability.
Birth defects and conditions that have been excluded fall under one of the categories listed below. The condition
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VI.2.B.8.c. Covered Birth Defects for Benefits Under Chapter 18 |
Covered birth defects include, but are not limited to
Note: If any of the birth defects listed above are determined to be familial in a particular family, they are not covered birth defects. |
VI.2.B.8.d. Birth Defects Not Covered Due to Familial Disorders |
Birth defects that are familial disorders are not covered birth defects. These include, but are not limited to
Note: If any of the birth defects listed above are determined not to be familial in a particular family, then they are covered birth defects. |
VI.2.B.8.e. Birth Defects Not Covered Due to Birth-Related Disorders, Chromosomal Disorders, or Congenital Malignancies |
Conditions identified in the table below are not considered covered birth defects by reason of their respective classifications as
Note: These listings are not necessarily exhaustive.
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VI.2.B.8.f. Birth Defects Not Covered Due to Lack of Permanent Physical or Mental Disability |
Birth defects that are not covered because they lack permanent physical or mental disability include, but are not limited to,
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VI.2.B.8.g. Conditions Not Covered Due To Birth-Related Injury or Fetal/Neonatal Infirmity |
Conditions that are due to a fetal or neonatal infirmity with well-established causes or that are miscellaneous pediatric conditions are not covered birth defects. These include, but are not limited to
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VI.2.B.8.h. Conditions Not Covered Due to Developmental Etiology |
Conditions that are developmental disorders are not covered birth defects. These include, but are not limited to
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9. Developing for Medical and Lay Evidence
Introduction |
This topic contains information on developing for medical and lay evidence, including |
Change Date |
December 12, 2018 |
VI.2.B.9.a. VA Examinations Under 38 CFR 3.814 |
For the purpose of cases seeking monetary allowance under 38 CFR 3.814 for spina bifida, VA will schedule an examination only under limited circumstances.
Important:
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VI.2.B.9.b. VA Examinations Under 38 CFR 3.815 |
For cases of a monetary allowance under 38 CFR 3.815 for other covered birth defects, VA will schedule an examination
Note: VA may accept statements from private physicians or examination reports from government or private institutions in lieu of a VA examination.
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VI.2.B.9.c. Developing for Medical Evidence of Spina Bifida Under 38 CFR 3.814 |
Follow the steps in the table below to develop for medical evidence of spina bifida under 38 CFR 3.814.
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VI.2.B.9.d. Developing for Medical Evidence of a Covered Birth Defect Under 38 CFR 3.815 |
Follow the steps in the table below to develop for evidence of a covered birth defect under 38 CFR 3.815.
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Historical_M21-1VI_2_SecB_4-25-15.doc | May 18, 2019 | 164 KB |
Historical_M21-1VI_2_SecB_10-20-16.doc | May 18, 2019 | 162 KB |
12-12-18_Key-Changes_M21-1VI_2_SecB.docx | May 18, 2019 | 61 KB |
Change-April-25-2015-Transmittal-Sheet-M21-1VI_2_SecB_TS.docx | May 18, 2019 | 42 KB |
09_26_08.doc | May 18, 2019 | 29 KB |
M21-1MRVI_2_B_TS.docx | May 18, 2019 | 31 KB |
in Chapter 2 Spina Bifida and Other Covered Birth Defects, Chapters 2-6 (Rescinded), Part VI Chapter 18 Benefits
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