Compensation Service and Pension and Fiduciary (P&F) Service Guidance

In This Section

Introduction

• types of guidance available
• determining the type of guidance to request
• requirements for formal requests for Central Office (CO) guidance
• types of cases eligible for CO guidance
• information that letters requesting guidance from P&F Service must contain
• submitting a request for guidance to
  • P&F Service, and
  • Compensation Service
• format of letter for requesting guidance from Compensation Service, and
• handling an apparent conflict or issue of general interest.

Change Date

X.v.1.A.1.a. Types of Guidance Available

X.v.1.A.1.b. Determining the Type of Guidance to Request

• timing of the request for guidance during the claims process, and
• type of issue requiring resolution.

X.v.1.A.1.c. Requirements for Formal Requests for CO Guidance

X.v.1.A.1.d. Types of Cases Eligible for CO Guidance

• a matter of program policy or procedure
• the applicability of
  • a provision in the regulations
  • the rating schedule, or
  • other CO directives, such advisory opinions and instructions contained in M21-1
• the propriety of establishing service connection, other than a question involving the evaluation of evidence
• when rating schedule provisions are not adequate for evaluation
• a proposed rating or authorization action involving a difference of opinion with a prior rating or other action based on the same set of facts (per 38 CFR 3.105(b)), and
• a rating under 38 CFR 3.105(a) awarding monetary benefits for a retroactive period of more than five years.

• payments equal to or exceeding $250,000, or
• an effective date that is eight or more years in the past.

X.v.1.A.1.e. Information That Letters Requesting Guidance From P&F Service Must Contain

• advisory opinion
• administrative review, or
• administrative determination on a difference of opinion under 38 CFR 3.105(b).

X.v.1.A.1.f. Submitting a Request for Guidance to P&F Service

• upload the completed request letter referenced in M21-1, Part X, Subpart v, 1.A.1.c and e into the appropriate electronic claims folder (eFolder), and
• send an encrypted e-mail containing the following information to VAVBAWAS/CO/Pension & Fiduciary Svc.:
  • the Veteran’s name and claim number, and
  • the type of request.
  Important:
  • The period behind Svc must be included when addressing the e-mail to P&F Service.
  • Before submitting a request for guidance to P&F Service, ensure all documents in the claims folder have been scanned (converted into an electronic format) and uploaded into the appropriate eFolder.
  Reference: For more information on shipping documents for scanning, see M21-1, Part II, Subpart i, 1.B.

X.v.1.A.1.g. Submitting a Request for Guidance to Compensation Service

• advisory opinion
• administrative review, or
• administrative determination on a difference of opinion under 38 CFR 3.105(b).

X.v.1.A.1.h. Format of Letter for Requesting Guidance From Compensation Service

X.v.1.A.1.i. Handling an Apparent Conflict or Issue of General Interest

• forward a copy of the document(s) containing the conflicting information, or information of general interest to other ROs, to the Executive Director of Compensation Service (21C) or the Executive Director of P&F Service (21PF) (whichever service authored the directive), and
• include a cover letter explaining how the information is in conflict or why it would be of general interest to other ROs.

Introduction

• requesting an advisory opinion, and
• considering an advisory opinion when deciding a claim.

Change Date

X.v.1.A.2.a. Requesting an Advisory Opinion

X.v.1.A.2.b. Considering an Advisory Opinion When Deciding a Claim

Introduction

• requesting an administrative review
• who may request an administrative review
• handling non-Department of Veterans Affairs (VA) requests for an administrative review
• rejection of a request for an administrative review, and
• significance of an administrative review decision.

Change Date

X.v.1.A.3.a. Requesting an Administrative Review

• situations involving policy or procedure of more than local importance, or
• questions concerning the adequacy or applicability of regulations and other instructions to the field.

X.v.1.A.3.b. Who May Request an Administrative Review

• service organizations
• recognized attorneys or agents, and
• other accredited representatives.

X.v.1.A.3.c. Handling Non-VA Requests for an Administrative Review

• forward it, with a brief cover letter, to the Executive Director of the service with jurisdiction over the issue for which administrative review is requested, and
• advise the requesting party of the referral.

X.v.1.A.3.d. Rejection of a Request for an Administrative Review

• is inconsistent with the provisions of M21-1, Part X, Subpart v, 1.A.1.c or d, or
• merely affords an additional, intermediate step in the legacy appeal or decision review process.

X.v.1.A.3.e. Significance of an Administrative Review Decision

Introduction

• when to request an administrative determination on a difference of opinion
• overview of supervisory review
• handling a difference of opinion, and
• decision review rights and notification requirements.

Change Date

X.v.1.A.4.a. When to Request an Administrative Determination on a Difference of Opinion

X.v.1.A.4.b. Overview of Supervisory Review

• monitor the quality of RO decisions, and
• ensure that RO personnel clearly understand and uniformly apply laws, regulations, and other directives.

X.v.1.A.4.c. Handling a Difference of Opinion

• requesting an administrative review, see M21-1, Part X, Subpart v, 1.A.3
• handling dissent and differences of opinion in rating decisions, see M21-1, Part V, Subpart iv, 1.E.2
• revising binding decisions, see M21-1, Part X, Subpart ii, 1.A.1.f, and
• DRO authority, see M21-5, Chapter 7, Section C.3.

X.v.1.A.4.d. Decision Review Rights and Notification Requirements