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M21-1, Part VI, Chapter 2, Section D – Authorization Issues

Overview

In This Section
This section contains the following topics:
Topic
Topic Name
1
2

 1.  Effective Date for Reductions and Terminations

Introduction
This topic contains information on the effective date for

Change Date
 May 14, 2015

VI.2.D.1.a.  Effective Date for Reduction of Chapter 18 Benefits
Whenever it is necessary to reduce, or discontinue a monthly allowance, generally reduce or discontinue based on the facts found, except as provided in 38 CFR 3.105(g), and 38 CFR 3.114(b).
The table below provides information to determine the correct effective date of a reduction or discontinuation.
If benefits were paid erroneously due to …
Then the effective date of the reduction or discontinuation is the date of …
beneficiary error
the erroneous award.
VA administrative error
last payment.
Reference:  For more information on resumption of discontinued benefits under 38 U.S.C. Chapter 18, see 38 CFR 3.158.

VI.2.D.1.b.  Effective Date for Termination of Chapter 18 Benefits
In the event of death, discontinue Chapter 18 benefits on the last day of the monthbefore the month in which the child died.
Note:  Handle abandoned claims for Chapter 18 benefits in the same manner as for compensation, pension, or Dependency and Indemnity Compensation.
Reference:  For more information on the effective date for termination of benefits, see 38 CFR 3.503(b).

2.  Processing Awards and Denials

Introduction
This topic contains information on processing awards and denials of Chapter 18 monetary allowances, including

Change Date
May 14, 2015

VI.2.D.2.a.  Description of the Final Stage in the Chapter 18 Claims Process
The final stage in the Chapter 18 claims process is to promulgate the rating decision or prepare an administrative denial, and notify the claimant of the decision.

VI.2.D.2.b.  Roles and Responsibilities for Processing Chapter 18 Awards and Denials
The authorization activity is responsible for processing awards and denials.

VI.2.D.2.c.  Award and Denial Process for Chapter 18 Claims
The processing of Chapter 18 awards is presently accomplished using the Benefits Delivery System (BDN).
For denial codes for
Suppress the BDN letter, in favor of a local Personal Computer Generated Letter, for decision notices of either a grant or denial.
Reference:  For information on award and denial processing and notification, see

VI.2.D.2.d.  Denial Codes for Spina Bifida Benefits
Use the table below to determine the correct denial codes to enter into the 453 screen in BDN.
If spina bifida benefits have been denied because …
Then enter code number …
the individual is not a natural child of the Veteran
01.
of spina bifida occulta
02.
no spina bifida condition exists
03.
the individual was conceived before Vietnam service or specific Korean service
04.
the individual failed to furnish requested evidence
05.
the parent(s) was(were) not a Vietnam Veteran(s) or a Veteran(s) with specific Korean service
06.
of other reasons
07.

VI.2.D.2.e.  Denial Codes for Other Covered Birth Defects
Use the table below to determine the correct denial reasons to enter into the 453 screen in BDN.
If other covered birth defects have been denied because …
Then enter code number …
the individual is not a natural child of the Veteran
01.
the individual was conceived before the Veteran first served in Vietnam
04.
the claimant failed to furnish requested evidence
05.
the individual’s biological mother was not a Vietnam Veteran
06.
of other reasons, such as
  • no qualifying covered birth defect exists
  • the Veteran is not female, or
  • the child died prior to December 1, 2001
07.
trans.doc May 18, 2019 18 KB
Change-May-14-2015-Transmittal-Sheet-M21-1VI_2_SecD_TS.docx May 18, 2019 39 KB
in Chapter 2 Spina Bifida and Other Covered Birth Defects, Chapters 2-6 (Rescinded), Part VI Chapter 18 Benefits
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