II.iii.2.E.2.e. Instructions for Addressing Incorrectly Established Contentions on a Valid EP When a Decision Has Been Made | | Follow the steps in the table below to address requests for benefits that were incorrectly added to a valid EP and a decision was made. | Step | Action |
|---|
| 1 | Review the claimant’s record to determine whether an active ITF (for the same general benefit as the incorrectly established claim) was pending prior to the incorrect establishment of the EP.Was an active ITF pending?- If yes,
- ensure that the ITF status is correctly reflected in the claimant corporate record
- submit requests to correct an ITF status to ESD, and
- go to Step 3.
- If no, go to Step 2.
References: For more information on | | 2 | Determine how VA received the request for benefits. If the request for benefits was received through- CM, go to Step 3, or
- telephone or in-person contact with a VA representative,
- establish an ITF effective the date of the contact, and
- go to Step 3.
| | 3 | Has the rating decision that addressed the incorrectly added contention(s) been promulgated and authorized?- If yes, go to Step 4.
- If no,
- return the case to the rating activity, and
- the rating activity will
- pull the rating back into VBMS-R for corrections
- delete the issues that were invalid to ensure the conditions are removed from the master record
- return the rating with update
- follow the instructions in M21-1, Part II, Subpart ii, 2.A.2.b to request deletion of the rating decision Narrative and Codesheet, and
- route the case to the development activity to complete the actions in M21-1, Part II, Subpart iii, 2.E.2.b beginning with Step 3.
| | 4 | Make two attempts in a 24-hour period to contact the claimant and/or authorized representative and provide the information in M21-1, Part II, Subpart iii, 2.E.1.b.Does the claimant have an authorized representative?- If yes, call, e-mail, or if co-located at the RO, meet the authorized representative in person.
- If no, call the claimant.
If attempts to contact are- successful, wait two business days for receipt of the complete claim on a prescribed form, then go to the next step, or
- unsuccessful, go to Step 7.
Important: All successful telephone or in-person contact must be documented on VA Form 27-0820 and included in the claims folder. All e-mail correspondence must be included in the claims folder. | | 5 | Review the claimant’s record to determine if a complete claim on a prescribed form has been received and the valid EP the issues or conditions were erroneously adjudicated under is still pending. | If a complete claim ... | and the valid EP … | Then ... |
|---|
| has been received | is still pending | - add the issues or conditions back onto the EP
- finish development of the complete claim as needed, and
- go to Step 6.
| | has been cleared and the current EP has been established to control the receipt of the complete claim resulting from the actions in Step 4 | - change the EP to the appropriate variant of EP 930 – Correction of National Quality Error, and
- leave a permanent VBMS note explaining why the EP is being changed to EP 930 and associate the note with the EP 930.
| | has not been received | is still pending | go to Step 6. | | has been cleared | - establish the appropriate variant of EP 930 – Correction of National Quality Error, and
- leave a permanent VBMS note explaining why the EP 930 is being established and associate the note with the EP 930.
| Note: For corrections identified at the RO level, use the appropriate variant of EP 930 - Correction of Local Quality Error. Reference: For more information on associating a permanent note to an EP, see M21-1, Part II, Subpart ii, 2.A.1.c. | | 6 | Review the claimant’s record to determine if a complete claim has been received in response to the actions taken in Step 4. | If a complete claim ... | Then ... |
|---|
| has been received for the issues or conditions previously submitted on correspondence other than a prescribed form | - update the EP 930 contention list with the issues/conditions
- edit the DOCUMENT PROPERTIES and change the SUBJECT of the claim document to response to Incorrect Claim Establishment, and
- clear the EP 930. No further action is required for addressing the incorrect claims.
| | has been received for the issues or conditions previously submitted on correspondence other than a prescribed form and includesnew issues or contentions | - update the EP 930 contention list with the issues/conditions
- edit the DOCUMENT PROPERTIES and change the SUBJECT of the claim document to response to Incorrect Claim Establishment with new issues
- process the new issues or conditions under the appropriate EP, establishing one if necessary, and
- clear the EP 930. No further action is required for addressing the incorrect claims.
| | has not been received | go to Step 7. |
| | 7 | Create the Incorrectly Adjudicated Claim letter, and- attach the required form(s)
- send the letter to the claimant, and
- clear the EP 930.
| | 8 | If a claim is - received, follow the procedures in M21-1, Part II, Subpart iii, 2.E.3.a, or
- not received, no further action is required.
Note: When a claimant fails to submit the prescribed form solicited in Step 7, do not take further action to revise any claim or issue that was decided without the proper submission of a prescribed claim form. Specifically, no further action is necessary to sever service connection or otherwise revise the prior decision unless the decision was otherwise erroneous. |
|