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VA Cleveland Regional Office CVSO School 2013

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Presentation on theme: "VA Cleveland Regional Office CVSO School 2013"— Presentation transcript:

1 VA Cleveland Regional Office CVSO School 2013
Fully Developed Claims Catherine Zalar Express 2 Coach VA Cleveland Regional Office

2 Discuss current procedures for the Fully Developed Claim (FDC) Program
Lesson Objectives Discuss current procedures for the Fully Developed Claim (FDC) Program Discuss Veterans Online Application (VONAPP) Direct Connect (VDC) and how it relates to FDC

3 Fast Letter 12-25 The Fully Developed Claim Program
Rescinds Fast Letter 10-22 VA Forms EZ (January 2013) and EZ (August 2011) were revised New VA Form EZ (December 2012) added

4 VA Form EZ Application for Disability Compensation and Related Compensation Benefits (January 2013) The notice section of the new VA Form EZ provides the claimant §5103 notice for the following live compensation claims: Service connection (original, new, secondary, and reopened) Service connection based upon a period of active duty for training or inactive duty training Increased disability compensation Individual unemployability Temporary total disability rating due to hospitalization or due to surgical or other treatment Compensation under 38 U.S.C. 1151 Increased benefits based on the need for aid and attendance or based on an additional disability or housebound status (SMC) Specially adapted housing or special home adaption Automobile allowance or adaptive equipment Benefits based on a Veteran’s helpless/seriously disabled child

5 VA Form 21-527EZ Application for Pension (August 2011)
The notice section of the new VA Form EZ provides the claimant §5103 notice for the following live pension claims: Improved Pension Special Monthly Pension (aid and attendance or housebound benefits) Improved Pension benefits based on a Veteran’s helpless/seriously disabled child

6 VA Form 21-534EZ Application for DIC, Death Pension, And/or Accrued Benefits (Dec 2012)
The notice section of the new VA Form EZ provides the claimant §5103 notice for the following survivor (dependency and indemnity compensation (DIC), death pension, and/or accrued) claims: Accrued benefits DIC based on service-connected cause of death DIC based on 38 U.S.C. §1318 DIC based on active-duty-for-training or inactive-duty-training death Death pension and Parents’ DIC 38 U.S.C §1151 DIC Increased survivor benefits (aid and attendance or housebound) Benefits for a Veteran’s helpless/seriously disabled child

7 Notice Section and Application Section FDC Certification
Notice Section: Explains difference between FDC process and standard claims process The Application Section: FDC Certification is enclosed within the application. In order to submit a FDC, the claimant must certify the : 1. Truthfulness of the information submitted, 2. Authorization for release of information, 3. Receipt of the §5103 (i.e., VCAA) notice originally bound to the application, and 4. Completeness of the FDC claim (e.g., the submission of all the evidence the claimant has to support the claim)

8 Traditional Claim on EZ Form
In addition to FDC claims, claimants may use the EZ forms to submit a traditional claim by checking the box indicating that they plan to submit additional evidence in support of their claim. (Section V, Box 21 on VA Form EZ) However, §5103 notice may not need to be sent since the EZ form includes proper notice

9 Special Circumstances and FDC Criteria
Submit the claim on a signed and completed VA Form EZ Submit WITH the claim all, if any, relevant private medical records (if you submit a Disability Benefits Questionnaire (DBQ), a VA Examination may not be needed) Identify any relevant treatment records available at Federal facility, such as a VA medical center (be sure to include the location and the approximate dates of treatment) Under special circumstances , you MUST also submit the following with the claim: Guard and Reserve Members, any and all Service Treatment and Personnel Records in custody of your Unit(s). If claiming dependents, complete VA Form c and/or VA Form If claiming PTSD, VA Form or VA Form a

10 Special Circumstances and FDC Criteria cont.
Under special circumstances , you MUST also submit the following with the claim: If Claiming Individual Unemployability, complete VA Form AND VA Form If claiming Specially Adapted Housing or Special Home Adaptation, complete VA Form If claiming Auto Allowance, complete VA Form If claiming additional benefits because the Veteran or the spouse require Aid and Attendance, complete VA Form OR VA Form (if claiming based on nursing home attendance) For current active duty Service Members, submit all service treatment records for your current period of service.

11 FDC Exclusions The claimant indicates on form desire to not have the claim processed in the FDC program. The claimant has a claim pending at the time of receipt of the EZ form The claimant has an appeal pending at the time of receipt of the EZ form AND the claims folder is not located at the RO The claim requires a character of discharge determination The claim requires development to Guard/Reserve unit or further evidence from the claimant or an identified private medical provider The claim requires development beyond developing for: Federal Records in the custody of the Federal Government Claimant-identified Federal Treatment records such as VA VA examination/DBQ

12 Subsequent Exclusion Reasons
FDC Exclusions Cont. Subsequent Exclusion Reasons The claimant fails to report for an examination A supplemental claim, additional evidence, or an NOD on any claim is received from the claimant AFTER receipt of the FDC

13 Reopened Claims If a claim is filed involves a disability which has been previously denied service connection and for which the appeal period has expired (reopened claim), we must comply with the notice requirements set forth in Kent v. Nicholson, 20 Vet.App. 1 (2006). We must therefore send the claimant a subsequent notice containing the following paragraph (which is available in MAP-D): “You were previously denied service connection for [contention VA previously denied].  You were notified of the decision on [date of previous denial].  The appeal period for that decision has expired and the decision is now final.  In order for us to reopen your claim, we need new and material evidence.  Your claim was previously denied because [reason(s) for previous denial, e.g., the disability was not shown in service]. Therefore, the evidence you submit must be new and relate to this fact.”

14 February 2010 VA Form 21-526EZ and VA Form 21-527E
The procedures for this Fast Letter pertain to the August 2011 versions and later. VA allowed for a 30-day grace period in which we continued to consider a claim received on the FEB 2010 EZ form as potentially eligible for FDC processing Upon expiration of this grace period, a claim received on a FEB 2010 form was not considered eligible for the FDC program.

15 VDC (Veterans Online Application (VONAPP) Direct Connect )
Fast Letter 12-26 Claimant can file FDC electronically via eBenefits In addition to VA Form EZ, the claimant can upload up to five supporting documents (up to 5 megabytes per document) Claimant must be eBenefits Premium account holders (DS Logon Level 2) This method is NOT limited to FDC

16 Questions


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