M21-1 Manual / Part II, Subpart iii, Chapter 2, Section G
Requests for Application and Claims Solicitation
M21-1, Part II, Subpart iii, Chapter 2, Section G
Overview
In This Section | | This section contains the following topics: | Topic | Topic Name |
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| 1 | Requests for Application | | 2 | Soliciting Claims |
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1. Requests for Application
II.iii.2.G.1.a. Requests for Benefits Not Filed on the Prescribed Form | | Consider a request for benefits which was not filed on an appropriate prescribed form, a request for application.Claims processors must send the appropriate request for application letter with the correct prescribed claim form for the benefit sought. Establish the appropriate end product (EP) with a date of claim as the date the request for application was received. Use the appropriate EP 400 claim label found in M21-4, Appendix C, to generate a request for application letter either manually or via automation, as the facts of the case support. Note: If the letter requires user entry, specify the contentions for which a prescribed form is required. References: For more information on - prescribed forms, see M21-1, Part II, Subpart iii, 1.A.1.a
- identifying contentions, see M21-1, Part III, Subpart i, 2.F.2.a
- EPs for requests for application, see M21-4, Appendix B, and
- generating a letter, see the Veterans Benefits Management System Core User Guide.
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2. Soliciting Claims
Introduction | | This topic contains information on issues to consider when soliciting claims for disability compensation, including- disabilities for which service connection (SC) must be considered
- mere existence of medical records does not constitute a claim
- claims mentioning exposure but not specifying a disability
- fractures discovered in service treatment records (STRs) without a claim, and
- soliciting a claim for a chronic, unclaimed disability.
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II.iii.2.G.2.a. Disabilities for Which SC Must Be Considered | | 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- consider service connection (SC) for all claimed disabilities, based on a sympathetic reading of the claim, and
- consider soliciting a claim for other chronic, unclaimed disabilities noted in the STRs.
Exception: If a claimant or authorized representative submits supplemental STRs, the rating activity must take the actions described in the preceding bullets only if the STRs are accompanied by the required standard claim form. References: For more information on- clarifying claims that are not substantially complete, see 38 CFR 3.159(a)(3)
- the definition of and criteria for a substantially complete application, see M21-1, Part I, Subpart i, 1.A.4.f
- notification requirements for a complete application, see M21-1, Part II, Subpart iii, 1.C.2.a
- soliciting a claim for unclaimed disabilities, see M21-1, Part II, Subpart iii, 2.G.2.e
- actions to take when supplemental STRs are received, see M21-1, Part X, Subpart ii, 2.B, and
- the types of issues that a compensation claim may involve, see M21-1, Part V, Subpart ii, 3.A.
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II.iii.2.G.2.b. Mere Existence of Medical Records Does Not Constitute a Claim | | The mere existence of medical records does not constitute a claim. There must be some intent by the claimant to apply for a benefit. Notes: - Claims for an increased rating were previously an exception to that rule under the historical provisions of 38 CFR 3.157(b).
- The Standard Claims and Appeals Form regulation eliminated 38 CFR 3.157 and requires submission of claims on prescribed forms effective March 24, 2015.
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II.iii.2.G.2.c. Claims Mentioning Exposure but Not Specifying a Disability | | A claim mentioning an exposure but not specifying a disability from the exposure is not substantially complete. Reference: For more information on claims that do not specify a disability but allege exposure, see M21-1, Part II, Subpart iii, 1.C.2.c. |
II.iii.2.G.2.d. Fractures Discovered in STRs Without a Claim | | Fractures constitute a chronic disability for the purposes of soliciting a claim. If the Veteran has not claimed a fracture and STRs contain an x-ray or other objective evidence of a fracture in service, solicit a claim from the Veteran in accordance with M21-1, Part II, Subpart iii, 2.G.2.e. Reference: For more information on SC for fractures documented in service, see M21-1, Part V, Subpart iii, 1.F.1.a. |
II.iii.2.G.2.e. Soliciting a Claim for a Chronic Unclaimed Disability | | When soliciting a claim for SC for a chronic, unclaimed disabilityInclude the following language in the notification: We have reviewed your records and they suggest you may be entitled to an additional benefit. If you want to file a claim for [insert chronic disability] please submit a completed VA Form 21-526EZ, Application For Disability Compensation And Related Compensation Benefits, to the appropriate address listed on the attached Where to Send Your Written Correspondence chart. You can download the form at http://www.va.gov/vaforms or submit your claim online at www.va.gov. We recommend you return the form as soon as you can in order to ensure the earliest possible payment date if an award is authorized.Notes: - Claims processors may combine the claim solicitation notice with other types of correspondence or decision notices being sent to the Veteran.
- Do not establish EP control or initiate development or duty-to-notify/assist procedures until the Veteran responds affirmatively to the notice.
- When the Veteran responds with a claim, the date of claim of the EP is the date the regional office receives the claim.
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Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part II, Subpart iii, Chapter 2, Section G (U.S. government work, reproduced for reference). Browse all sections →