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
