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BDD and Quickstart claims BDD and Quickstart claims

BDD and Quickstart claims - PowerPoint Presentation

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BDD and Quickstart claims - PPT Presentation

02282017 References M211MR Part III subpart I Chapter 2 predischarge claims M211MR IIIiv3A4 and 5 exams FL 0931 Guard and Reserve attending Demobilization and Pre Discharge claims worked at the RO ID: 696010

claim service discharge claims service claim claims discharge member duty active disability evaluation pre benefits bdd

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Slide1

BDD and Quickstart claims

02/28/2017Slide2

References

M21-1MR Part III, subpart I, Chapter 2 (pre-discharge claims)

M21-1MR III.iv.3.A.4 and 5 (exams)

FL 09-31 (Guard and Reserve attending Demobilization and Pre- Discharge claims worked at the RO)Slide3

EP controls

Original BDD EP’s 011,

111

Original QuickStart EP’s 017,

117

CFI/Reopen/New claim EP’s for BDD

021

CFI/Reopen/New claim EP’s for QuickStart

027

Claims for Reinstatement EP’s are always

290

IDES EP’s are

689

No

DATES of CLAIM are put in system---they are set up as diaries with the date after separation as diary due dateSlide4

What is a Pre-discharge claim?

A pre-discharge claim is a claim accepted from a service member who is still on active duty

.

The

claim may be a(n)

original claim

reopened claim

claim for an increased evaluation, or

claim for resumption of compensation. 

The goal of pre-discharge claims is to begin the payment of the Department of Veterans Affairs (VA) benefits as soon as possible following a Veteran’s discharge from active duty.Slide5

Who can file one?

Any service member on active duty may file a pre-discharge claim.  This includes

reservists serving on active duty in an Active Guard Reserve (AGR) role under

10 U.S.C.

 full-time National Guard members serving in an AGR role under

32 U.S.C.

, and

service members undergoing medical evaluation board (MEB) or physical evaluation board (PEB) proceedings.Slide6

Requirements for filing?

In order to file a pre-discharge claim, a service member must

be within 180 days of discharge

complete one of the following forms:

VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits

 (preferred)

VA Form 21-526c, Pre-Discharge Compensation Claim

, or

VA Form 21-526, Veteran's Application for Compensation and/or Pension

,

and

provide photocopies of the service treatment records (STRs) for the current period of service. Slide7

QuickStart

0-59 days prior to discharge, or

Files claim w/in 180 days of discharge but is unavailable to attend all exams prior to discharge

What is the difference?

BDD

60-180 days prior to discharge

Must be available to attend ALL exams prior to dischargeSlide8

Exclusions from BDD and Quickstart

claims requiring case management for a service member who is

very seriously injured/ill (VSI)

seriously injured/ill (SI), or

a “special category person” (SCP), which is a service member who has suffered loss of a body part

claims involving a terminally ill service member

claims requiring a VA examination that must be completed in a foreign country,

except

when the examination can be completed through VA offices in

Landstuhl

, Germany, or

Yongsan

, Korea

claims involving a service member who is awaiting discharge, while hospitalized in a VA or military treatment facility, or

claims from pregnant service women

.Slide9

Process

Claim received at an Intake Site

RO Coordinator is responsible for:

Collect claims, obtain STRs, schedule exams, conduct other development

Refer completed claim to rating activity once all evidence obtainedSlide10

Rating Activity Sites (RAS)

Unique to BDD claims only—

Salt Lake City

Covers: West Coast, Midwest, and Korea

Winston Salem

Covers: East Coast, South, and GermanySlide11

Claims Processing Sites (CPS)

Unique to QuickStart—

San Diego

Covers: West Coast, Midwest and Korea

Winston Salem

Covers: East Coast, South and Germany

QS claims received from demobilizing National Guard or Reserve units will be forwarded to the CPS with

juris

over the ROJ where the service member resides.

QS claims with contentions related to the contaminated drinking water at Camp Lejeune should be processed at one of the above RAS

locations

QS claims are excluded from RACC. Slide12

Rating

Following the completion of all development actions (including verification of service), and

after

the service member’s discharge from active duty, complete the rating decision, with consideration being given to the guidance below.

Be

sure to take into account whether an examination was conducted in-service or post-service, as this can have an effect on the evidence required for SC.

A diagnosis of a chronic disability on an

in-service

VA examination is a diagnosed disability while on active duty.

A BDD or QS claim is filed by the claimant while still on active duty; therefore, you inherently have

in-service

symptoms/complaints. Slide13

Other claims and ancillary benefits

Intake sites may receive claims from service members for Vocational Rehabilitation and Employment (VR&E) benefits under

38 U.S.C. Chapter 31

that they may use while on active duty or after separation.

A service member who is separating from service may be eligible for the funding fee waiver if the evidence of record establishes he/she will be in receipt of VA disability compensation after separation.

Civil Service Preference Letters (CSPL) can only be created by the VA when there is a prior period of verified, completed, other than dishonorable service of record. Slide14

Integrated Disability Evaluation System(IDES)

The purpose of the Integrated Disability Evaluation System (IDES) is to save time and resources by combining multiple aspects of the disability evaluation process individuals go through when

the service department calls into question the service member's fitness for duty, and

the service

member

 files a claim for Department of Veterans Affairs (VA) benefits. 

IDES participants undergo only one examination (or one set of examinations), the results of which meet the needs of both VA and the Department of Defense (DoD).  If, based on the results of the examination(s), a physical evaluation board (PEB) decides a participant is unfit for duty, VA prepares a rating decision to determine the amount of VA benefits to which he/she is entitled.  DoD uses this same decision to determine the amount of DoD benefits to which the participant is entitled.Slide15

Terms we may hear

1. Military Services Coordinator (MSC)

are VA representatives that work at IDES intake sites

.

2. A

Physical Evaluation Board Liaison Officer (PEBLO) is a DoD

employee

3. Disability

Rating Activity Sites (DRASs) serve as the PEBs’ primary point of contact with

VA---

Seattle RO (SeaTac)—all Army PEBs

Providence RO—all Air Force and Navy PEBs

4. The

Veterans Tracking Application (VTA) is a web-based application PEBLOs, MSCs, DRASs, and PEBs use to track IDES participants as they proceed through the program.