M21-1 Manual  /  Part II, Subpart iii, Chapter 2, Section H

Historical Guidance on Formal Applications and Informal Claims Received Prior to March 24, 2015

M21-1, Part II, Subpart iii, Chapter 2, Section H

Overview

In This Section

 This section contains the following topics:
TopicTopic Name
1 Informal Claims Received Prior to March 24, 2015
2 Formal Claims Received Prior to March 24, 2015

1. Informal Claims Received Prior to March 24, 2015


Introduction

 This topic contains information regarding the identification and processing of informal claims prior to March 24, 2015, including
  • characteristics of an informal claim
  • why informal claims were important
  • required elements of an informal claim
  • original claims not filed on the prescribed form before March 24, 2015, and
  • claims made by telephone before March 24, 2015.

Change Date

 June 1, 2020

II.iii.2.H.1.a. Characteristics of an Informal Claim

 Informal claims were defined by regulations in effect prior to March 24, 2015. After that date, the concept of informal claim was removed from the Department of Veterans Affairs (VA) regulations and replaced by the intent to file (ITF) and request for application regulations included in 38 CFR 3.155. Identify an informal claim received prior to March 24, 2015, by any of the following characteristics:
  • any communication or action that shows an intent to apply for benefits under laws administered by VA, as described at historical 38 CFR 3.155
  • an original claim not filed on the prescribed form
  • an unsigned application (except for those received via the Veterans On-Line Application (VONAPP) or VONAPP Direct Connect (VDC))
  • evidence of examination or hospitalization in a VA or uniformed services health care facility for a service-connected disability under historical 38 CFR 3.157 (b)(1), or
  • any communication regarding the death of the appellant in a legacy appeal
    • submitted to the U.S. Court of Appeals for Veterans Claims (CAVC), and
    • furnished to VA by CAVC.
Important: VA only recognizes informal claims received prior to March 24, 2015. Notes:
  • Claims received prior to March 24, 2015, via VONAPP or VDC that are initiated but not completed are not informal claims. However, the date the application was initiated may be considered when determining the effective date in certain circumstances.
  • CAVC ruled that complaints noted by a Veteran during a VA examination (and included in the corresponding examination report) do not constitute an informal claim unless "the veteran sufficiently manifested an intent to apply for benefits for a particular disease or injury.
References: For more information on

II.iii.2.H.1.b. Why Informal Claims Were Important

 Informal claims were important prior to March 24, 2015, because VA could grant entitlement to benefits from as early as the date of receipt of an informal claim as long as VA received a formal claim within one year of the date VA sent the claimant an application. References: For more information on

II.iii.2.H.1.c. Required Elements of an Informal Claim

 In order for a communication or action received by VA prior to March 24, 2015, to be accepted as an informal claim, the historical version of 38 CFR 3.155 required claimants to identify the benefit(s) they were seeking, such as compensation and/or pension. If a claimant was attempting to reopen a previously denied claim or was seeking an increased disability rating, VA also required the claimant to describe the nature of the disability for which they were seeking benefits. A claimant could accomplish this by identifying the body part or system that was disabled or by describing symptoms of the disability. Note: In Shea v. Wilkie, 926 F. 3d 1362 (Fed.Cir. 2019), the U.S. Court of Appeals for the Federal Circuit held that in certain situations, the reference to and submission of medical records may be sufficient to raise an informal claim for benefits.
  • General, non-specific, or non-concrete references to records would not be sufficient under this standard to raise an informal claim for benefits.
  • The holding in Shea is limited by the factual circumstances underlying its analysis, and the application of the decision should be constrained to cases only with similar factual scenarios.
  • Refer to M21-5, Chapter 7, Section B.1.c for more information on sympathetic review of appeal submissions.
References: For more information on

II.iii.2.H.1.d. Original Claims Not Filed on the Prescribed Form Before March 24, 2015

Consider an original claim not filed on the prescribed form before March 24, 2015, an informal claim. Upon receipt of an original claim not filed on the prescribed form
  • add the form to the claims folder
  • send the claimant the correct form
  • create and send a letter to the claimant to inform them that in order to establish potential entitlement to benefits from the date of receipt of the informal claim, they must complete and return the correct form within one year of the date VA sent it
  • include the correct form as an enclosure in the letter, and
  • do not place the issue under a rating-controlled end product (EP).
Important: The letter to the claimant will be completed under an EP 400. Once the letter is completed and sent to the claimant, the EP 400 will be cleared. Reference: For a list of forms claimants must use to file an original claim for disability compensation or pension prior to March 24, 2015, see M21-1, Part II, Subpart iii, 2.H.2.a.

II.iii.2.H.1.e. Claims Made by Telephone Before March 24, 2015

 Consider an original claim made by telephone before March 24, 2015, an informal claim. Example: A telephone call from a claimant indicating intent to apply for benefits, documented on VA Form 27-0820, Report of General Information,is acceptable as an informal claim for the purpose of establishing a potential date of entitlement to benefits if received prior to March 24, 2015. Follow the steps in the table below to handle a claim made by telephone.
StepAction
1 Verify the identity of the person providing the information by telephone by asking for the claimant’s
  • Social Security number
  • date of birth, or
  • any other information that might help to establish identity.
Notes:
  • If the caller is unable to furnish this information, or if the person’s identity remains questionable, complete development by letter.
  • A parent or guardian may file a claim by telephone on behalf of a claimant who is a minor.
  • Per 38 CFR 3.155, the following persons may also file a claim by telephone on behalf of a claimant
    • any appointed representative, such as an attorney, agent, or Veterans service organization, or
    • a member of Congress.
2 Send the appropriate application to the claimant or fiduciary, and inform the claimant or fiduciary that in order to establish potential entitlement to benefits from the date VA received the telephone call (informal claim), they must return the signed and completed application within one year of the date VA sent it.

2. Formal Claims Received Prior to March 24, 2015

Change Date

 June 24, 2021

II.iii.2.H.2.a. Requirements for a Formal Application Received Prior to March 24, 2015

 Prior to March 24, 2015, the historical 38 CFR 3.151 required claimants to complete and submit a form prescribed by the Secretary of the VA when filing an originalclaim for disability compensation and/or pension. The prescribed forms were As the names of the forms imply, claimants may have used
  • VA Form 21-526 to apply for disability compensation and/or pension
  • VA Form 21-526c or VA Form 21-526EZ to apply for disability compensation only,and
  • VA Form 21P-527EZ to apply for pension only.
References: For more information on

Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part II, Subpart iii, Chapter 2, Section H (U.S. government work, reproduced for reference). Browse all sections →