Section A - Deciding Claims for Disability Compensation - Updated 9/22/14

Chapter 2 - Rating

Overview


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In this Section
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1.   Issues to Consider When Deciding Claims for Disability Compensation
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Introduction
This topic contains information on issues to consider when deciding claims for disability compensation, including
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 ·      disabilities for which service connection must be considered

 ·      soliciting a claim for chronic, unclaimed disabilities

 ·      initial review of supplemental service treatment records (STRs)

 ·      action taken on supplemental STRs

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      notification of rating decisions based on supplemental STRs

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      references concerning the selection of effective dates. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">September 22, 2014 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Disabilities for Which Service Connection Must Be Considered
<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">When deciding an original claim for compensation, or when supplemental service treatment records (STRs) are received following promulgation of an original rating decision the rating activity must
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<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      determine service connection for all claimed disabilities, based on a sympathetic reading of the claim, and

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      consider soliciting a claim for other chronic, unclaimed disabilities noted in the STRs.

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">Notes:

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Except in claims for an increased rating under 38 CFR 3.157(b), the courts have held that generally the mere existence of medical records does not establish an informal claim as there must be some intent by the claimant to apply for a benefit.

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      A claim mentioning an exposure but not specifying a disability from the exposure is not substantially complete. In such claims follow the specific procedures provided in references below.

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Do not solicit a claim based merely on abnormal lab results discovered in the STRs.

<p class="BulletText2" style="mso-list:l0 level1 lfo2"> -     Abnormal laboratory findings, such as elevated blood sugar, hyperlipidemia, elevated triglycerides or elevated cholesterol, even if diagnosed, are not themselves disabilities for VA purposes. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page <span style="font-size:12.0pt;font-family:"Times New Roman","serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA">
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b.   Soliciting a Claim for Chronic, Unclaimed Disabilities
<p class="MsoBlockText">When soliciting a claim for service connection for a chronic, unclaimed disability
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      send a letter to the Veteran and his/her representative, if applicable, and

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      enclose VA Form 21-4138, Statement in Support of Claim.

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<p class="MsoBlockText">Include the following language in the letter:

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<p class="MsoBlockText">''We received evidence indicating that you may be entitled to service connection for [identify chronic condition]. If you wish to claim service connection for [identify chronic condition], please indicate this on the enclosed VA Form 21-4138, Statement in Support of Claim. Sign, date, and return the form to the address at the top of this letter .      ''

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<p class="MsoBlockText">Notes:   

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="mso-bidi-font-size:12.0pt;font-family:Symbol;mso-fareast-font-family:  Symbol;mso-bidi-font-family:Symbol;color:windowtext;mso-bidi-font-style:italic"> ·      Do not establish EP control or initiate development or duty-to-notify/assist procedures until the Veteran responds affirmatively to the letter.

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      When the Veteran responds affirmatively, the date of claim of the EP is the date the regional office (RO) received the Veteran’s response. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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c.   Initial Review of Supplemental STRs
<p class="MsoBlockText">Upon receipt of the supplemental STRs, a Triage Veterans Service Representative (VSR) conducts an initial review of the documents with the claims folder to determine whether the records are duplicates.
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<p class="MsoBlockText">The table below shows the action taken by the Triage VSR after the initial review of the STRs. <p class="MsoNormal"> <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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d.   Action Taken on Supplemental STRs
<p class="MsoBlockText">The table below shows the action the action taken when an RO receives supplemental STRs from the Records Management Center (RMC).
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<p class="MsoBlockText">Note:   When it is necessary to PCLR an EP 699 that is still pending as a future diary, the VSR will

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      change (PCHG) the EP 699 diary to EP 930

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      PCAN the EP 930, and

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      PCLR a new EP 699 using that day as the date of claim. <p class="MsoNormal"> <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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e.   Notification of Rating Decisions Based on Supplemental STRs
<p class="MsoBlockText">All rating decisions granting service connection, an increased disability evaluation, or death benefits based on unassociated supplemental STRs will contain the following language:
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<p class="MsoBlockText">

<p class="MsoBlockText">''VA has received additional service treatment records that were previously unavailable. The following decision is based on the additional medical evidence.'' <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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f.   References Concerning the Selection of Effective Dates
<p class="MsoBlockText">For information on the selection of appropriate effective dates when deciding claims for disability compensation, see
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<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 5110

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.156(c)(3)

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.157

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.400, and

<p class="BulletText1" style="mso-list:l1 level1 lfo1"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.401. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> <span style="font-size:12.0pt;font-family:"Times New Roman","serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA">
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2.   (Empty – Reserved for Future Use)
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Change Date
<p class="MsoBlockText">September 22, 2014 <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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