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Blogs » Business » VA Benefits and Process Changes (Effective 02/19/19)

VA Benefits and Process Changes (Effective 02/19/19)

  • VA Benefits and Process Changes (Effective 02/19/19)


    As of Tuesday, 02/19/2019 any conditions or benefits that have previously been adjudicated and denied cannot be reopened, reconsidered or re-adjudicated on a VAF 21-526EZ and must be done on a VAF 20-0995 which is the VA's new "Decision Review Request."

    Any supplemental claim filed within one year of a determination must have "New and Relevant" evidence, this is like "new and Material" however, it has relaxed the standard.

    If the evidence used to support the claim is not deemed "New and Relevant" an admin decision will be made, a letter sent to the veteran stating that the VA received an incomplete claim, and the EP closed for that claim.

    If a veteran responds within 60 days of the notification with the appropriate materials, the EP code will be re-established with the original date of the VA-0995.

    If a veteran wants to file a claim for a previously denied claim, as well as a claim for increase (regardless of timeframe from prior decision," a VAF 21-526EZ must be done for the increase, as well as a VAF 20-0995 for the previously denied claim. These two claims cannot accompany each other!

    Separate submittals will need to be done.

    If both claims are submitted together they will both go to one of the DROC's. They will then be separated and adjudicated individually. This will only cause delay to the process. Intent to file (VAF 21-0966) will have no bearing on supplemental claims, only in new and increased evaluations

    Effective Date Protection

    As long as the veteran continuously pursues a new option within one year of the last decision, they would be able to preserve their earliest effective date, if the facts so warrant. Thus, a claimant who is not fully satisfied with any decision has one year to seek further review while preserving their effective date.

    Supplemental Claim Lane

    VA will re-adjudicate a claim if "new and relevant" evidence is presented or identified with a supplemental claim (open record)

    VA will assist in gathering new and relevant evidence (duty to assist).

    Effective date for benefits protected if claim is submitted within I year of decision.

    Replaces "reopening" claims with "new and material" evidence.

    Any decision to award benefits must be based on new and relevant evidence or a clear and unmistakable error in the prior decision.

    Definition of New and Relevant

    New evidence means evidence not previously submitted to agency adjudicators, and relevant evidence means evidence that tends to prove or disprove a matter in issue in a claim.

    Note: An initial election for supplemental claim will be presumed to have new and relevant evidence warranting a decision on the merits.

    Click here for another summary from Military Times.