VBA Knowledge Check Journey of a Claim

example of claim in Due Process phase:

"Incompetency is proposed" letter is sent when VA is proposing an adverse action, like reducing or terminating benefits.

· if the claimant disagrees with VA's decision on that original claim, the three options (or "lanes") are:

--"supplemental claim" lane --"higher level review" lane --"appeal directly to the Board of Veterans' Appeals (BVA)" lane

EP code for Higher Level Review claims

030

EP code for Supplemental Claims

040

a typical, original, SC claim might be on VA form ____________ typicals EP codes would be ________ or ________ depending on the ______________ ____ _____________

0820 110 or 010 number of issues

Which steps of the claims process fall under the CRM/UDO DEVELOPMENT phase?

1) Claim received 2) Under Review 3) Gathering Evidence 4) Review of Evidence

The eight STEPS of the claims process.

1) Claim received 2) Under Review 3) Gathering Evidence 4) Review of Evidence 5) Preparation of Decision 6) Pending Decision Approval 7) Preparation for Notification 8) Complete

EP codes for Service Connected Compensation

110 & 010

EP codes for Service Connected Pension

180 & 120

Many different kinds of eligibility determinations (like clothing allowance, incarceration adjustments, etc.) use EP code______

290____

Which steps of the claims process fall under the CRM/UDO DECISION phase?

5) Preparation of Decision 6) Pending Decision Approval

Which steps of the claims process fall under the CRM/UDO NOTIFICATION phase?

7) Preparation for Notification 8) Complete

The Veteran asks the PCR to check on the status of his claim. Which of the following should the PCR do?

ALL OF THE FOLLOWING: a) Review system from date of claim forward b) Check which development items have been received vs which are still pending c) Review development letters d) Check notes

Which claims require priority processing?

Any claim from Veteran who is: --homeless --terminally ill, or --financial hardship --more than 85 years old --a survivor of a Former Prisoner of War (FPOW) -- became very seriously ill or injured/seriously ill or injured (VSI/SI) during service and is not already receiving Department of Veterans (VA) disability benefits -- is diagnosed with Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig's Disease --is an FPOW, or --received the Medal of Honor

For a claim for an increased evaluation for a SC condition, which of the following items would NOT commonly be developed for?

DD-214

TRUE or FALSE When a claim is excluded from the FDC program, it is denied on that basis.

FALSE · Claim is NOT denied it's simply processed as a standard claim.

The date of the notification letter determines whether it's an old, pre-AMA claim or a new claim. When did AMA become effective?

February 19, 2019

EP code for "appeal directly to the Board of Veterans' Appeals (BVA)" claims

NONE

_________________________ dates should not be discussed with the customer

Suspense

TRUE or FALSE Even a fully developed claim may require some development.

TRUE · VA exam, VA treatment records, or other evidence may be needed - even for a FDC

VA form for the "appeal directly to the Board of Veterans' Appeals (BVA)" lane

VA form 10182

VA form for the "supplemental claim" lane

VA form 20-0995

VA form for the "higher level review" lane

VA form 20-0996

VERBAL VS IN WRITING Q: "My name is SAM, not SMA." Can you accept this name change verbally or must it be submitted in writing?

Verbal b/c Name change is due to reason other than: Marriage/Divorce Clerical Errors

example of claim in development phase:

We need private treatment records from Dr. Gregory House

example of claim in Notification phase:

Your claim has been granted!

the goal is to process claims in ______ days or less

_ 125

EP ___________ is used for old reopened claims and some claims for increase

_020____

EP _________ is used for dependency issues

_130____

claims are generally worked in _____________ order

_DATE_______

When does the PCR complete VA form 27-0820?

both - a&b a) Asking RO or PMC to take an action b) Documenting info for evidentiary purposes

example of claim in Informational phase:

d) The form you requested is enclosed

if the required action has not happened by the suspense date, ______________________ is needed by the SOJ

follow up

INFERRED

refers to an issue that was not claimed by the claimant, but VA regulations require the RVSR to consider it. Common examples include competency decisions and entitlement to Dependents' Educational Assistance, AKA DEA or chapter 35. ie. Unclaimed issue

DEFERRED

when an issue is something the claimant did claim, but the RVSR can't make a decision until some further action takes place. (for example, a VA exam or some additional evidence is needed) ie --Claimed issue --Needs additional action like VA exam --RVSR granted other issue(s) but can't grant this one (at least not yet

Claimant thinks they're ready to file an original claim for SC compensation. What are some options to discuss?

· Online/hard copy · "regular" 526 · Claimant submits or VSO submits · FDC/526EZ · Claim vs ITF vs RFA