ࡱ> W[TUV  bjbjVV :<< S"S"S"S"S"g"g"g"8"c#g"`&t+(+++,-4-`,E`E`E`E`E`E`JbdE`S"/,,//E`S"S"++4Z` 8 8 8/jS"+S"+^r 8/` 8 8WW^+M g"0TO\,^p`0`{\hg4hXW^W^hS"k^(-ZK.@ 8.4.---E`E`57---`////h--------- !: Section B. Evidence Requested From the Claimant Overview  PRIVATE INFOTYPE="OTHER"  In this SectionThis section contains the following topics: TopicTopic NameSee Page2Requesting Evidence From the Claimant1-B-23Controls for Responses to VA Requests for Evidence1-B-64Certifying Eligibility and Continued Entitlement1-B-105Acceptable Evidence of Birth, Death, or Relationship1-B-126Determining the Acceptability of Photocopies1-B-147New and Material Evidence Under 38 CFR 3.1561-B-168Certification of Statements Provided in Support of a Claim for Service Connection1-B-199Requirement for Affidavits or Certification1-B-2110Development of Claims Involving Accidental Injuries1-B-2211Issues Regarding a Claimants Address1-B-25 2. Requesting Evidence From the Claimant  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on requesting evidence from a claimant, including written requests for evidence notice of time limits to submit evidence claims development by e-mail, fax, and telephone documenting information received by telephone handling information received by telephone that might affect benefits, and referencing information received by telephone in decision notices. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Written Requests for EvidenceWhen sending written requests for evidence to a claimant, use Modern Awards Processing Development (MAP-D) letters Personal Computer Generated Letters (PCGL), or free-form letters. Note: VA also encourages claims development by e-mail, fax, and telephone. References: For information about MAP-D, see the HYPERLINK "http://vbaw.vba.va.gov/VetsNet/Claims_Docs/webhelp/Claim_Development1.htm"MAP-D Users Guide PCGL, see the  HYPERLINK "http://vbaw.vba.va.gov/bl/21/publicat/Users/Index2.htm" user guides on the PCGL web page claims development by email, fax, and telephone, see  HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.2.c" M21-1MR, Part III, Subpart iii, 1.B.2.c. PRIVATE INFOTYPE="PRINCIPLE"  b. Notice of Time Limits to Submit EvidenceSpecify a time limit of 30 days for the claimant to submit evidence. Further advise the claimant: if evidence is not submitted within 30 days, the Department of Veterans Affairs (VA) may decide the claim based on the information and evidence of record, and he/she has one year from the date of VAs request to submit evidence or information to substantiate his/her claim.Continued on next page  STYLEREF "Map Title" 2. Requesting Evidence From the Claimant, Continued  STYLEREF "Block Label" b. Notice of Time Limits to Submit Evidence (continued)References: For information on establishing time limits for the submission of evidence, see HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.3"M21-1MR, Part III, Subpart iii, 1.B.3, and suspense dates, see the HYPERLINK "http://vbaw.vba.va.gov/bl/21/systems/docs/Share.pdf"Share User Guide, or document titled  HYPERLINK "http://vbaw.vba.va.gov/bl/21/systems/docs/VSF.doc" VETSNET Suspense Functionality. PRIVATE INFOTYPE="PRINCIPLE"  c. Claims Development by E-Mail, Fax, and TelephoneVA strongly encourages claims development by e-mail, fax, and telephone, when appropriate. Appropriate situations include, but are not limited to, requests to the claimant for medical evidence Social Security numbers (SSNs) grant/denial letters for certain benefits, such as Social Security disability benefits addresses employment information, and clarification of income-related issues and medical expenses. Notes: VA considers evidence received by e-mail or fax to be authentic unless there is a specific reason to question the source of the document. Normally, the instructions for handling correspondence received through traditional means apply to correspondence received by e-mail or fax. When using electronic media for communication, be sure to adhere to VAs information security policy in maintaining the privacy of a claimants records. References: For more information on development by e-mail, fax, or telephone, see HYPERLINK "imi-internal:M21-1MRI.1.C.6.e"M21-1MR, Part I, 1.C.6.e, and HYPERLINK "imi-internal:M21-1MRII.5.8"M21-1MR, Part II, 5.8 handling e-mail responses, see  HYPERLINK "imi-internal:M21-1MRII.5.9" M21-1MR, Part II, 5.9, VAs information security policy, see  HYPERLINK "http://vaww1.va.gov/vapubs/search_action.cfm?dType=2" VA Handbook 6500.Continued on next page  STYLEREF "Map Title" 2. Requesting Evidence From the Claimant, Continued  PRIVATE INFOTYPE="PRINCIPLE"  d. Documenting Information Received by TelephoneUse VA Form 21-0820, Report of General Information, to document all information received by telephone. PRIVATE INFOTYPE="PRINCIPLE"  e. Handling Information Received by Telephone That Might Affect BenefitsVA may use information it receives by telephone to adjust a beneficiarys award as long as the VA employee who took the information identified himself/herself to the caller as an employee who is authorized to receive the information or statement established the identity of the caller as either the beneficiary or his/her fiduciary by asking the caller to provide specific information about the beneficiary that is contained in VA records, such as the beneficiarys SSN beneficiarys date of birth Veterans branch of service dates of the Veterans service, or other information only the beneficiary would know, and informed the caller VA will use the information he/she provides for the purpose of calculating benefits. Following telephone contact, the employee must document the call by summarizing it on VA Form 21-0820, Report of General Information. The employee must then retain the form in the claims folder and send a copy of it to the beneficiarys power of attorney, if applicable. The summary must include the specific information or statement the caller provided date of the call identity of the caller steps taken to verify the callers identify as either the beneficiary or his/her fiduciary, and confirmation the employee informed the caller that VA would use the information or statement he/she provided for the purpose of calculating benefits.Continued on next page  STYLEREF "Map Title" 2. Requesting Evidence From the Claimant, Continued  STYLEREF "Block Label" e. Handling Information Received by Telephone That Might Affect Benefits (continued)Notes: If a VA employee follows the preceding steps for handling information received by telephone, VA may adjust a beneficiarys award and provide only contemporaneous notice of the action taken. If a VA employee does not follow the preceding steps, and the beneficiary or his/her fiduciary does not provide signed, written notice of the matter affecting his/her benefits, VA must provide the beneficiary advance notice of any adverse action it intends to take. An e-mail or fax from a beneficiary or his/her fiduciary may serve as written notice of a matter affecting benefits, thereby allowing VA to adjust benefits and provide only contemporaneous notice of the action taken. References: For more information on documenting information received by telephone, see HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_217.DOC"38 CFR 3.217, and advance notice of proposed adverse action, see HYPERLINK "imi-internal:M21-1MRI.2.A"M21-1MR, Part I, 2.A. PRIVATE INFOTYPE="PRINCIPLE"  f. Referencing Information Received by Telephone in Decision NoticesDecision notices must include references to any information VA received by telephone, and used in determining entitlement. When referencing the information in decision notices, include the date of telephone contact, and name of the caller. 3. Controls for Responses to VA Requests for Evidence  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information about controls for responses to VA requests for evidence, including time limit for responding to a request claimants who do not respond within 30 days denying claims for failure to provide all requested evidence incomplete responses that justify award action situations warranting extension of the time limit what an extension of the time limit does not affect situations that do not warrant extension of the time limit. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Time Limit for Responding to a RequestUnless otherwise required by VA policy or regulation, allow claimants 30 days to respond to a request for evidence. PRIVATE INFOTYPE="PRINCIPLE"  b. Claimants Who Do Not Respond Within 30 DaysIf a claimant does not respond to a request for evidence within 30 days, refer the claim to authorization or rating activity for a decision. Authorization activity is responsible for notifying the claimant of any decision on his/her claim. If the evidence of record fails to support a grant of the benefits the claimant is seeking, the decision notice must inform the claimant of the reason for the denial the one-year time limit for submission of evidence, and his/her appellate rights. Note: If VA obtains any medical evidence in connection with the claim, the rating activity must determine whether it justifies a grant of benefits. Example: Treatment records from a VA medical facility. Reference: For information on the action to take when a claimant furnishes some, but not all, of the requested evidence, see HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.3.c"M21-1MR, Part III, Subpart iii, 1.B.3.c and  HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.3.d" dContinued on next page styleref "Map Title"3. Controls for Responses to VA Requests for Evidence, Continued  PRIVATE INFOTYPE="PROCEDURE"  c. Denying Claims for Failure to Provide All Requested EvidenceIf a claimant provides some of the requested evidence within 30 days, but the evidence of record fails to support a grant of the benefits the claimant is seeking, deny the claim advise the claimant of the specific evidence VA did not receive, and one-year time limit for submission of the missing evidence, and furnish appellate rights. Important: If VA requested evidence from a private physician or medical facility on behalf of the claimant, do not deny the claim before making at least one follow-up request to the custodian of the records, and allowing at least 10 days for a response. Reference: For more information on requesting non-Federal records, see  HYPERLINK "imi-internal:M21-1MRI.1.C.6" M21-1MR, Part I, 1.C.6. PRIVATE INFOTYPE="PROCEDURE"  d. Incomplete Responses That Justify Award ActionDo not postpone award action until the end of the 30-day time limit, if the claimant furnishes some of the requested evidence, and evidence of record supports a partial grant of the benefits the claimant is seeking. When award action is taken prior to expiration of the 30-day time limit, leave the current end product (EP) running send decision notice to the claimant, informing him/her of the evidence considered reason(s) for the decision deferral of action on the remaining aspects of his/her claim, pending receipt of the other requested evidence, and furnish appellate rights.Continued on next page  STYLEREF "Map Title" 3. Controls for Responses to VA Requests for Evidence, Continued  STYLEREF "Block Label" d. Incomplete Responses That Justify Award Action (continued)Note: Follow the instructions in  HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.3.c" M21-1MR, Part III, Subpart iii, 1.B.3.c, if the claimant fails to provide all of the requested evidence by the end of the 30-day time limit, and evidence of record fails to support a grant of the remainder of the benefits the claimant is seeking. PRIVATE INFOTYPE="PRINCIPLE"  e. Situations Warranting Extension of the Time LimitExtend the time limit for a response if the response to initial development action raises new issues requiring resolution initial development action did not include a request for essential evidence, and/or the claimant requests an extension, and is making an honest effort to obtain and submit the requested evidence. Note: It is improper to deny a claim while simultaneously developing for evidence to support it. Maintain EP control, with an accurate date of claim, as long as development is pending. PRIVATE INFOTYPE="PRINCIPLE"  f. What an Extension of the Time Limit Does Not AffectAn extension of the time limit for a response does not affect the one year statutory time limit for submission of evidence, or effective date of subsequent award action.Continued on next page  STYLEREF "Map Title" 3. Controls for Responses to VA Requests for Evidence, Continued  PRIVATE INFOTYPE="PRINCIPLE"  g. Situations That Do Not Warrant Extension of the Time LimitDo not extend the time limit for submitting evidence if a request for evidence that is essential to establishing entitlement to the benefit sought was sent to the claimants last known address, and returned as undeliverable. If the mailing address on the request is correct, and a more current address is not available, disallow the pending claim for the reason Whereabouts Unknown (reason code 21), file the returned correspondence in its original envelope on top of all other material in the claims folder, and consider the claim abandoned one-year following the date of request. Reference: For more information on abandoned claims, see HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_158.DOC"38 CFR 3.158(a). 4. Certifying Eligibility and Continued Entitlement  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information about certifying eligibility for and continued entitlement to VA benefits, including requirement to certify eligibility and continued entitlement procedures for certifying eligibility and continued entitlement, and example of a situation requiring certification of eligibility and continued entitlement. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Requirement to Certify Eligibility and Continued EntitlementVA may require beneficiaries to certify that an eligibility factor on which VA based an entitlement determination continues to exist. Reference: For more information on periodic certification of continued eligibility, see HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_652.DOC"38 CFR 3.652. PRIVATE INFOTYPE="PROCEDURE"  b. Procedure for Certifying Eligibility and Continued EntitlementFollow the steps in the table below upon receipt of evidence suggesting an eligibility factor on which VA based an entitlement determination no longer exists. StepAction1Send notice of proposed adverse action to the beneficiary, requesting certification of the eligibility factor advising him/her that VA may terminate benefits if he/she does not provide certification within 60 days. Reference: For more information on notices of proposed adverse action, see HYPERLINK "imi-internal:M21-1MRI.2.B.4"M21-1MR, Part I, 2.B.4.Continued on next page styleref "Map Title"4. Certifying Eligibility and Continued Entitlement, Continued styleref "Block Label"b. Procedure for Certifying Eligibility and Continued Entitlement (continued) StepAction2Did the beneficiary respond within 60 days? If yes continue, adjust, or stop the award based on the beneficiarys response, and send proper decision notice. If no adjust benefits effective the first of the month following the date on which the evidence of record shows the beneficiary last confirmed the existence of the eligibility factor, and send proper decision notice. PRIVATE INFOTYPE="PRINCIPLE"  c. Example of a Situation Requiring Certification of Eligibility and Continued EntitlementThe paragraphs below describe a situation that would require certification of eligibility and continued entitlement, and the appropriate actions to take based on the specific set of facts. Situation: VA receives reliable evidence that indicates a surviving spouse in receipt of pension might have remarried. The surviving spouse has no children. A review of the claims folder shows the most recent documentation confirming the surviving spouses marital status is a VA Form 21-686c, Declaration of Status of Dependents, dated November 12, 2004. On February 11, 2010, VA sends notice of proposed adverse action to the surviving spouse, requesting completion of VA Form 21-686c, and advising him/her that VA may terminate benefits if he/she does not return the completed form within 60 days. Result: If the surviving spouse does not respond within 60 days, stop the award effective December 1, 2004, and send proper decision notice. 5. Acceptable Evidence of Birth, Death, or Relationship  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on acceptable evidence of birth, death, or relationship, including acceptability of written statements information VA requires in written statements, and when VA may require evidence in support of a written statement. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Acceptability of Written StatementsIn most cases, VA accepts written statements from claimants as proof of marriage dissolution of a prior marriage birth of a child, or death of a dependent. Reference: For more information on acceptable evidence of birth, death, or relationship, see  HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_204.DOC" 38 CFR 3.204. PRIVATE INFOTYPE="PRINCIPLE"  b. Information VA Requires in Written StatementsVA requires that written statements include the date (month and year) of the event location of the event dependents full name relationship of the dependent to the claimant the name and address of the person who has custody of the claimants dependent child (if the child does not reside with the claimant), and the SSN of any dependent, the recognition of whom (by VA) would entitle the claimant to benefits or additional benefits.Continued on next page  STYLEREF "Map Title" 5. Acceptable Evidence of Birth, Death, or Relationship, Continued  PRIVATE INFOTYPE="PRINCIPLE"  c. When VA May Require Evidence in Support of a Written StatementVA may require submission of the types of primary and secondary evidence indicated in HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_205.DOC"38 CFR 3.205 through HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_211.DOC"38 CFR 3.211, to confirm the truthfulness of a written statement, when the claimant does not reside within a state the claimants statement raises a question of validity on its face, and/or conflicts with other evidence of record, and/or there is a reasonable indication in the claimants statement or otherwise of fraud or misrepresentation of the relationship in question. 6. Determining the Acceptability of Photocopies  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on the acceptability of photocopies, including photocopies or abstracts of public documents photocopies of documents that confirm military service, and photocopies of service treatment records (STRs). Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Photocopies or Abstracts of Public DocumentsWhen the claimants signed statement is insufficient to a establish a fact, photocopies or abstracts of public documents are acceptable as evidence if examination of the copies or abstracts confirms they are genuine, and free from alteration. Examples: marriage certificates birth certificates, and death certificates Important: VA may request a copy of the document certified over the signature and official seal of the person having custody of such record, if necessary. Reference: For more information on the acceptability of photocopies of public documents, see  HYPERLINK "http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKB/PART3/S3_204.DOC" 38 CFR 3.204.Continued on next page  STYLEREF "Map Title" 6. Determining the Acceptability of Photocopies, Continued  PRIVATE INFOTYPE="PRINCIPLE"  b. Photocopies of Documents That Confirm Military ServiceVA accepts photocopies of original documents that confirm a Veterans military service if the Veterans service department issued the original document and a public custodian of records certifies the photocopy is a true and exact copy of a document in his/her custody, or an accredited agent, attorney, or service organization representative who has successfully completed VA-prescribed training on military records certifies the authenticity of the photocopy by stamping the photocopy with the statement I [name, title, organization] certify that I have completed the VA-prescribed training on certification of evidence for proof of service and that this is a true and exact copy of either an original document or of a copy issued by the service department or public custodian of records, and signing and dating the statement. Reference: For more information on service verification, see HYPERLINK "imi-internal:M21-1MRIII.ii.6.6.a"M21-1MR, Part III, Subpart ii, 6.6.a. PRIVATE INFOTYPE="PRINCIPLE"  c. Photocopies of STRsPhotocopies of service treatment records (STRs) are acceptable for rating purposes if examination of the copies confirms they are genuine, and free from alteration. 7. New and Material Evidence Under 38 CFR 3.156  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on new and material evidence under 38 CFR 3.156, including role of new and material evidence description of new evidence example of new evidence description of material evidence example of material evidence how the concept of new and material evidence applies when character of discharge is at issue when medical opinions are not material effect of new and material evidence on a reopened claim, and claimants right to appeal a decision not to reopen a claim. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Role of New and Material EvidenceA claimant must submit new and material evidence to reopen a claim that has become final because the appeal period has expired, or appellate review is complete. PRIVATE INFOTYPE="PRINCIPLE"  b. Effect of New and Material Evidence on a ClaimA determination by VA that evidence is new and material means the evidence, by itself or when considered with evidence already of record, relates to an unestablished fact that is required to substantiate the claim, and raises a reasonable possibility of substantiating the claim. Note: VA may ultimately continue the previous denial if the evidence of record still fails to establish the facts necessary to substantiate the claim.Continued on next page  STYLEREF "Map Title" 7. New and Material Evidence Under 38 CFR 3.156, Continued  PRIVATE INFOTYPE="CONCEPT"  c. Description of New EvidenceTo qualify as new evidence under HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_156.DOC"38 CFR 3.156, evidence must be submitted to VA for the first time, whether documentary, testimonial, or in some other form. The following does not constitute new evidence: a photocopy or other duplication of information already contained in a VA claims folder (since it was previously considered), or evidence confirming a point already established. Example: A Veteran files a claim for service connection for a back disorder and submits an examination report from a physician who states she diagnosed the veteran with a back disorder five years after the veteran was discharged from service. VA denies the claim in the absence of evidence of a relationship between service and the disability. Two years later, the veteran attempts to reopen his claim by submitting an examination report from a second physician. If the second examination report only confirms the diagnosis of the first physician, VA would not consider the report new evidence. If the second examination report indicates the back disorder had its onset significantly closer to the veterans discharge date, VA would consider the report new evidence. PRIVATE INFOTYPE="CONCEPT"  d. Example of New EvidenceSituation: A Veteran injured her ankle while on duty and did not realize at the time that it required medical attention. Later that evening, she began experiencing pain and swelling in the ankle, so she sought treatment from a civilian physician. Explanation: VA might initially deny the veterans claim for service connection if STRs are silent with regard to treatment of the ankle. If the veteran subsequently submits proof of treatment by the civilian physician, VA would consider such information new evidence and reopen her claim. PRIVATE INFOTYPE="CONCEPT"  e. Description of Material EvidenceTo qualify as material evidence under HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_156.DOC"38 CFR 3.156, evidence must bear directly and substantially on the specific matter under consideration.Continued on next page  STYLEREF "Map Title" 7. New and Material Evidence Under 38 CFR 3.156, Continued  PRIVATE INFOTYPE="CONCEPT"  f. Example of Material EvidenceSituation: VA previously determined that a currently diagnosed back condition claimed by a World War II Veteran is not service-connected because it is not related to an in-service event or injury or a disease that had its onset during service. Explanation: If VA subsequently receives new evidence showing the claimant received treatment shortly after release from active duty, this evidence is material to the Veterans claim because it might establish the missing link between service and the current condition, or describing only the current severity of the claimed condition, over 50 years after service ended, the evidence is not material to the Veterans claim because it fails to establish the missing link between service and the current condition. PRIVATE INFOTYPE="PRINCIPLE"  g. How the Concept of New and Material Evidence Applies When Character of Discharge is at IssueStatements and affidavits attesting to a claimants good character since his/her release from active duty are not material when the issue is the character of a claimants military service. However, any new information VA receives (after making an unfavorable character-of-discharge determination) that indicates there were mitigating circumstances behind the action(s) that resulted in the other-than-honorable discharge is material, and does warrant reopening the issue of the character of the claimants service. PRIVATE INFOTYPE="PRINCIPLE"  h. When Medical Opinions Are Not MaterialA medical opinion is not material if it relies on historical facts that are inaccurate. PRIVATE INFOTYPE="PRINCIPLE"  i. Claimants Right to Appeal a Decision Not to Reopen a ClaimClaimants may appeal VAs decision not to reopen a claim because the evidence he/she submitted is not new and material. For this reason, VA must provide appellate rights when issuing decision notice to a claimant who was unsuccessful in reopening a previously denied claim. 8. Certification of Statements Provided in Support of a Claim for Service Connection  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on the certification of statements claimants provide in support of a claim for service connection, including determining certification requirements handling uncertified statements waiving the certification requirement, and returning an uncertified statement. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Determining Certification RequirementsTo comply with the provisions of HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_200.DOC"38 CFR 3.200, statements provided by or on behalf of a claimant for the purpose of establishing service connection must be made under oath or affirmation, or certified. Use the table below to determine what language an individual should use to certify the authenticity of records or the truthfulness of statements he/she provides in support of a claim for service connection. If the individual is providing Then he/she should use this language:recordsI hereby certify that the following (or attached) is a true transcript of my records pertaining to this case.a statementI hereby certify that the information given above is true and correct to the best of my knowledge and belief.Continued on next page styleref "Map Title"8. Certification of Statements Provided in Support of a Claim for Service ConnectionProvided in Support of a Claim for Service Connection, Continued  PRIVATE INFOTYPE="PRINCIPLE"  b. Handling Uncertified StatementsAny statement provided for the purpose of establishing service connection that is not certified or made under oath must be referred to the rating activity for a determination as to whether or not the statement is required to establish service connection. If the rating activity determines the statement is required, follow the steps in HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.8.d"M21-1MR, Part III, Subpart iii, 1.B.8.d to obtain certification. PRIVATE INFOTYPE="PRINCIPLE"  c. Waiving the Certification RequirementThe rating activity may waive the certification requirement if it can establish service connection based on other evidence of record, and without consideration of the uncertified statement. PRIVATE INFOTYPE="PRINCIPLE"  d. Returning an Uncertified StatementIf the rating activity determines certification of an individuals statement is required to establish service connection, photocopy the uncertified statement type the appropriate certification language (from  HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.8.a" M21-1MR, Part III, Subpart iii, 1.B.8.a) on the photocopy and provide a signature line advise the individual that failure to certify the statement within 30 days may result in a denial of benefits, and send the photocopy to the individual for certification. 9. Requirement for Affidavits or Certification  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on VAs requirement for affidavits or certification of statements or evidence submitted in support of a claim, including means of satisfying VAs requirement for an affidavit or certification, and alternate means of certification. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Means of Satisfying VAs Requirement for an Affidavit or CertificationIf VA regulations require an affidavit or certification, an individual may satisfy this requirement by completing the appropriate VA form that contains a certification statement. Therefore, when requesting evidence to support a claim, enclose the appropriate VA form with the request. Example: VA uses VA Form 21-686c, Declaration of Status of Dependents, to obtain information from a claimant about his/her dependents. This form contains the following statement above the space provided for the claimants signature: I hereby certify that the information I have given above is true and correct to the best of my knowledge and belief. PRIVATE INFOTYPE="PRINCIPLE"  b. Alternate Means of CertificationIn the absence of a form for obtaining a specific type of information or evidence in support of a claim, VA will also accept the following: a signed statement on VA Form 21-4138, Statement in Support of Claim, or any other written communication that is signed, and includes the appropriate certification statement. Reference: For more information about what makes a certification statement appropriate, see  HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.8.a" M21-1MR, Part III, Subpart iii, 1.B.8.a. 10. Development of Claims Involving Accidental Injuries  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on the development of claims involving accidental injuries, including information on determining whether an administrative decision is necessary obtaining an official police report of an accident additional development for administrative decisions when to request a field examination. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Determining Whether an Administrative Decision is NecessaryUpon receipt of a claim for service connection for residuals of an accidental injury, follow the guidance in HYPERLINK "imi-internal:M21-1MRIII.v.1.D.19.c"M21-1MR, Part III, Subpart v, 1.D.19.c to determine whether an administrative decision is necessary. Rationale: According to  HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_301.DOC" 38 CFR 3.301(a), VA may grant direct service connection . . . only when a disability or cause of death was incurred or aggravated in line of duty, and not the result of the Veterans own willful misconduct. . . . VA uses administrative decisions as the formal means of resolving the issue of whether or not a Veteran incurred or aggravated a disability in the line of duty, or as a result of his/her own willful misconduct. References: For more information on line-of-duty determinations, see HYPERLINK "imi-internal:M21-1MRIII.v.1.D.19"M21-1MR, Part III, Subpart v, 1.D.19. willful misconduct investigations, see HYPERLINK "imi-internal:M21-1MRIII.v.1.D"M21-1MR, Part III, Subpart v, 1.D. PRIVATE INFOTYPE="PRINCIPLE"  b. Obtaining an Official Police Report of an AccidentIf a police report covering an accidental injury is of record, and evidence potentially available in such a report is considered relevant to a decision, send a locally generated letter to obtain a copy.Continued on next page  STYLEREF "Map Title" 10. Development of Claims Involving Accidental Injuries, Continued  PRIVATE INFOTYPE="PROCEDURE"  c. Additional Development for Administrative DecisionsFollow the steps in the table below if the Veterans service personnel and treatment records lack sufficient information about the accidental injury to render an administrative decision. StepAction1Send VA Form 21-4176, Report of Accidental Injury in Support of Claim for Compensation or Pension, to the claimant, using Modern Award Processing-Development (MAP-D), and allow the claimant 30 days to return the form. Reference: For more information on MAP-D, see the HYPERLINK "http://vbaw.vba.va.gov/VetsNet/Claims_Docs/webhelp/Claim_Development1.htm"MAP-D User's Guide.2As soon as contact information for witnesses to the injury is available, determine whether statements from them regarding the incident would be relevant. If so, send VA Form 21-4176 to each witness, requesting completion of Section II, and statements of their account of the accident inform the claimant of the request and ask for his/her assistance in obtaining the witnesses statements, and allow the witnesses 30 days to return the form. Note: Enter the date, place, and type of accident in the appropriate locations on VA Form 21-4176 before sending the form to witnesses.3Once all time limits for returning VA Form 21-4176 have expired, route the claim and all accumulated evidence to an employee responsible for preparing administrative decisions, unless additional development involving the administrative decision is necessary, or a witness has not yet returned VA Form 21-4176. If a witness does not return VA Form 21-4176 before expiration of the 30-day time limit, send a follow-up request to the witness, and allow the witness an additional 30 days to return the form.Continued on next page  STYLEREF "Map Title" 10. Development of Claims Involving Accidental Injuries, Continued  PRIVATE INFOTYPE="PRINCIPLE"  d. When to Request a Field ExaminationUse a field examination to resolve conflicts in evidence, or to remedy defects in the evidence, if all other efforts to secure the information necessary to make an administrative decision have been exhausted. Use VA Form 21-3537a, Field Examination Request, to request a field examination. Reference: For more information on requests for field examinations, see HYPERLINK "imi-internal:M21-1MRIII.vi.8.8"M21-1MR, Part III, Subpart vi, 8.8. 11. Issues Regarding a Claimants Address  PRIVATE INFOTYPE="OTHER"  IntroductionThis topic contains information on issues concerning a claimants address, including effect of undeliverable mail on a pending claim or running award categories of undeliverable mail handling undeliverable, nonessential mail procedure for obtaining a current address for undeliverable, essential mail handling undeliverable, essential mail upon identification of a new address handling undeliverable, essential mail when a current address is unobtainable effect of undeliverable mail on the one-year time limit for submission of evidence claimants who are unable or unwilling to furnish a current address checks or correspondence not collected from Agent Cashiers within 30 days. Change DateOctober 14, 2011 PRIVATE INFOTYPE="PRINCIPLE"  a. Effect of Undeliverable Mail on a Pending Claim or Running AwardA claimants address does not constitute evidence. Do not consider a claim to be abandoned solely because the claimants address is unknown. If an award is stopped because a beneficiarys address is unknown and checks are undeliverable, payments may be resumed effective the day following the date of last payment if entitlement is otherwise established, and the claimant furnishes a valid, current address. References: For more information on resuming payments when an award is stopped because the claimants address is unknown, see HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_158.DOC"38 CFR 3.158(c), and homeless claimants, see  HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKA/PART1/S1_710.DOC" 38 CFR 1.710.Continued on next page  STYLEREF "Map Title" 11. Issues Regarding a Claimants Address, Continued  PRIVATE INFOTYPE="PRINCIPLE"  b. Categories of Undeliverable MailUndeliverable mail generally falls within one of two categories: essential (has evidentiary value), or nonessential (has no evidentiary value). The table below provides common examples of both categories of undeliverable mail: Essential MailNonessential Mailnotices of proposed adverse action decision notification requests for evidence from claimants records centers other agencies, and private, third parties questionnaires, including those VA uses to verify dependency status school attendance, and employment status mail involving matching programs, including the Income Verification Match (IVM) Social Security Verification Match, and Railroad Retirement Verification Project, and mail affecting benefit entitlement, including eligibility verification reports (EVRs), and notices of routine review examinations Letters VA releases as notice of cost-of-living adjustments (COLAs) for outreach purposes in connection with special projects, such as the Economic Recovery Payment (ERP), and to declare a beneficiarys eligibility for civil service preference tax abatement, and commissary privileges. Note: Most centrally generated correspondence, such as COLA notices or outreach letters, are mailed in green envelopes to make the identification of nonessential mail easier.Continued on next page  STYLEREF "Map Title" 11. Issues Regarding a Claimants Address, Continued  PRIVATE INFOTYPE="PRINCIPLE"  c. Handling Undeliverable, Nonessential MailUpon receipt of undeliverable, nonessential mail, check to see if the envelope in which VA originally enclosed the mail has a yellow-colored, United States Postal Service (USPS) sticker that shows a forwarding address. If it does, update the corporate or master record to reflect the new address, and send the mail to the new address. If it does not, destroy the returned mail, and do not establish EP 290. Reference: For more information on updating the corporate record through Share, see the HYPERLINK "http://vbaw.vba.va.gov/bl/21/systems/docs/Share.pdf"Share User's Guide. PRIVATE INFOTYPE="PROCEDURE"  d. Procedure for Obtaining a Current Address for Undeliverable, Essential MailUpon receipt of undeliverable, essential mail, follow the steps in the table below to attempt to identify a correct or more current address. Note: Control development for a current address with the existing EP, or (if no EP is pending) EP 290. StepAction1Review the claims folder to ensure the address used on the undeliverable mail matches the current address of record.2Look for a yellow-colored USPS sticker that shows a forwarding address on the envelope in which VA originally enclosed the mail.3Perform a Share inquiry to determine whether the corporate record, master record, or pending issue has a different or more current address than that shown on the returned mail.4Access Automated Medical Information Exchange/Compensation and Pension Record Interchange (AMIE/CAPRI) to determine whether the Veterans Health Administration (VHA) has a more current address. Note: If the claims folder shows the last record of contact with the claimant predates the last date of medical treatment shown in AMIE/CAPRI, the address in VHAs record may be more accurate.Continued on next page  STYLEREF "Map Title" 11. Issues Regarding a Claimants Address, Continued  STYLEREF "Block Label" d. Procedure for Obtaining a Current Address for Undeliverable, Essential Mail (continued) StepAction5Utilize web-based, address locator services, to include those for which VA pays a fee for access, to search for a current mailing address. Note: VA typically authorizes only one or two employees per regional office to access its fee-based address locator services.6Document actions taken under Step 5 by listing the address locator services used on VA Form 21-0820, and filing down the form in the corresponding claims folder.7Query Social Security Administration records through Share to determine whether they contain a more current address.8If VA is paying benefits by direct deposit, fax or mail a letter to the beneficiarys financial institution that requests the beneficiarys current address, and identifies VAs authority to obtain address information from the financial institution. Reference: For sample language to use in the letter to the financial institution, see HYPERLINK "imi-internal:M21-1MRX.8.5"M21-1MR, Part X, 8.5.9Were attempts to obtain a current address successful? If yes, send the mail to the new address. If no, reverse-file the mail in the claims folder, and resend the mail as soon as VA obtains a current address.Continued on next page  STYLEREF "Map Title" 11. Issues Regarding a Claimants Address, Continued  PRIVATE INFOTYPE="PROCEDURE"  e. Handling Undeliverable, Essential Mail Upon Identification of a New AddressUpon identification of a new address for a claimant with undeliverable, essential mail, update the corporate or master record to reflect the new address document the change of address in the claims folder resend the returned correspondence to the new address, and take the action(s) described in the table below. If ...Then ...a claim for benefits is currently pending that relies on a response to the returned mailextend the suspense date to provide the claimant the appropriate amount of time to respond.no claim for benefits is pending, and no other action is necessarychange the pending EP 290 to EP 400, and clear the EP 400. Reference: For more information on updating the corporate record through Share, see the HYPERLINK "http://vbaw.vba.va.gov/bl/21/systems/docs/Share.pdf"Share User's Guide. PRIVATE INFOTYPE="PROCEDURE"  f. Handling Undeliverable, Essential Mail When a Current Address is UnobtainableTake the actions described in the table below if a current address for a claimant or beneficiary with undeliverable, essential mail is unobtainable If ...Then ...no award is runningdisallow any pending claim for the reason Whereabouts Unknown (reason code 21) clear the pending EP, and file the returned mail in its original envelope on top of all other material in the claims folder.an award is runningclear the pending EP send notice of proposed adverse action (to stop benefits) to the last address of record establish EP 600 with a suspense date that is 60 days from the current date suspend benefits if the beneficiary does not respond within 60 days.Continued on next page  STYLEREF "Map Title" 11. Issues Regarding a Claimants Address, Continued  PRIVATE INFOTYPE="PRINCIPLE"  g. Effect of Undeliverable Mail on the One-Year Time Limit for Submission of EvidenceDo not extend the one-year time limit for submission of evidence in support of a claim if VA sent the request for evidence to the claimants last known address the request was returned as undeliverable, and attempts to obtain a current address were unsuccessful. Reference: For more information on the one-year time limit, see HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_158.DOC"38 CFR 3.158(a). PRIVATE INFOTYPE="PRINCIPLE"  h. Claimants Who Are Unable or Unwilling to Furnish a Current AddressIf a claimant or beneficiary is unable or unwilling to furnish a current mailing address but wishes to continue pursuing a claim and/or receiving benefits, send his/her correspondence and/or benefit checks to the Agent Cashier of the office or center having jurisdiction over the claims folder, or Agent Cashier of any VA facility deemed appropriate. Reference: For more information on the delivery of correspondence or benefit checks to homeless claimants, see  HYPERLINK "http://www.warms.vba.va.gov/regs/38CFR/BOOKA/PART1/S1_710.DOC" 38 CFR 1.710(d). PRIVATE INFOTYPE="PRINCIPLE"  i. Checks or Correspondence Not Collected from Agent Cashiers Within 30 DaysThe table below describes the handling of checks and correspondence that beneficiaries and/or claimants fail to collect from Agent Cashiers within 30 days: If a...Then the...beneficiary fails to collect his/her benefit check from an Agent Cashier within 30 daysAgent Cashier returns the check to the Department of the Treasury. Result: This action suspends the beneficiarys award.claimant fails to collect correspondence from an Agent Cashier within 30 daysAgent Cashier returns the correspondence to the Veterans Service Center (VSC), and VSC follows the procedures in HYPERLINK "imi-internal:M21-1MRIII.iii.1.B.11.c"M21-1MR, Part III, Subpart iii, 1.B.11.c - f for handling undeliverable mail. ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT  ADDIN \* MERGEFORMAT      M21-1MR, Part III, Subpart iii, Chapter 1, Section B M21-1MR, Part III, Subpart iii, Chapter 1, Section B 1-B- PAGE 30 1-B- PAGE 29 11/20/01 M21-1(MR) , Part III, Subpart iii, Chapter 1, Overview Change XX CV Draft 1-1 :;UV1 2 L M   ! 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