General Evidence Requirements, Effective Dates, Revision of Decisions, and Protection of Existing Ratings, 28770-28793 [E7-9542]
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Federal Register / Vol. 72, No. 98 / Tuesday, May 22, 2007 / Proposed Rules
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 5
RIN 2900–AM01
General Evidence Requirements,
Effective Dates, Revision of Decisions,
and Protection of Existing Ratings
Department of Veterans Affairs.
Proposed rule.
AGENCY:
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ACTION:
SUMMARY: The Department of Veterans
Affairs (VA) proposes to reorganize and
rewrite in plain language general
provisions applicable to its
compensation and pension regulations,
including general evidence
requirements, general effective dates for
new awards, revision of decisions, and
protection of existing ratings. These
revisions are proposed as part of VA’s
rewrite and reorganization of all of its
compensation and pension rules in a
logical, claimant-focused, and userfriendly format. The intended effect of
the proposed revisions is to assist
claimants and VA personnel in locating
and understanding these general
provisions.
DATES: Comments must be received by
VA on or before July 23, 2007.
ADDRESSES: Written comments may be
submitted through
www.Regulations.gov; by mail or handdelivery to the Director, Regulations
Management (00REG), Department of
Veterans Affairs, 810 Vermont Ave.,
NW., Room 1068, Washington, DC
20420; or by fax to (202) 273–9026.
Comments should indicate that they are
submitted in response to ‘‘RIN 2900–
AM01—General Evidence
Requirements, Effective Dates, Revision
of Decisions, and Protection of Existing
Ratings.’’ Copies of comments received
will be available for public inspection in
the Office of Regulation Policy and
Management, Room 1063B, between the
hours of 8 a.m. and 4:30 p.m. Monday
through Friday (except holidays). Please
call (202) 273–9515 for an appointment.
(This is not a toll-free number.) In
addition, during the comment period,
comments may be viewed online
through the Federal Docket Management
System (FDMS).
FOR FURTHER INFORMATION CONTACT:
William F. Russo, Director, Regulations
Management (00REG), Department of
Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420, (202) 273–
9515. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: The
Secretary of Veterans Affairs has
established an Office of Regulation
Policy and Management (ORPM) to
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provide centralized management and
coordination of VA’s rulemaking
process. One of the major functions of
this office is to oversee a Regulation
Rewrite Project (the Project) to improve
the clarity and consistency of existing
VA regulations. The Project responds to
a recommendation made in the October
2001 ‘‘VA Claims Processing Task
Force: Report to the Secretary of
Veterans Affairs.’’ The Task Force
recommended that the compensation
and pension regulations be rewritten
and reorganized in order to improve
VA’s claims adjudication process.
Therefore, the Project began its efforts
by reviewing, reorganizing, and
redrafting the content of the regulations
in 38 CFR part 3 governing the
compensation and pension program of
the Veterans Benefits Administration.
These regulations are among the most
difficult VA regulations for readers to
understand and apply.
Once rewritten, the proposed
regulations will be published in several
portions for public review and
comment. This is one such portion. It
includes proposed rules regarding
general evidence requirements, general
effective dates for awards, revision of
decisions, and protection of VA ratings.
After review and consideration of public
comments, final versions of these
proposed regulations will ultimately be
published in a new part 5 in 38 CFR.
Outline
Overview of New Part 5 Organization
Overview of This Notice of Proposed
Rulemaking
Table Comparing Current Part 3 Rules with
Proposed Part 5 Rules
Content of Proposed Regulations
General Evidence Requirements
5.130 Submission of statements,
evidence, or information affecting
entitlement to benefits.
5.13 Applications, claims, and exchange
of evidence with Social Security
Administration (SSA)—death benefits.
5.132 Claims, statements, evidence, or
information filed abroad; authentication
of documents from foreign countries.
5.133 Information VA may request from
financial institutions.
5.134 Will VA accept a signature by mark
or thumbprint?
5.135 Statements certified or under oath
or affirmation.
Evidence Requirements for Former
Prisoners of War (POWs)
5.140 Determining former prisoner of war
status.
5.141 Medical evidence for former
prisoners’ of war compensation claims.
General Effective Dates for Awards
5.150 General effective dates for awards
or increased benefits.
5.151 Date of receipt.
5.152 Effective dates based on change of
law or VA issue.
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5.153 Effective date of awards based on
receipt of evidence prior to end of appeal
period.
General Rules on Revision of Decisions
5.160 Binding effect of VA decisions.
5.161 Review of benefit claims decisions.
5.162 Revision of decisions based on
clear and unmistakable error (CUE).
5.163 Revision of decisions based on
difference of opinion.
5.164 Effective dates for revision of
decisions based on difference of opinion.
5.165 Effective dates for reduction or
discontinuance of awards based on error.
5.166 New and material evidence based
on service department records.
General Rules on Protection or Reduction
of Existing Ratings
5.170 Calculation of 5-year, 10-year, and
20-year protection periods.
5.171 Protection of 5-year stabilized
ratings.
5.172 Protection of continuous 20-year
ratings.
5.173 Protection against reduction of
disability ratings when revisions are
made to the Schedule for Rating
Disabilities.
5.174 Protection of entitlement to benefits
established before 1959.
5.175 Protection or severance of service
connection.
5.176 Due process procedures for
severing service connection or reducing
or discontinuing compensation benefits.
5.177 Effective dates for severing service
connection or discontinuing or reducing
benefit payments.
Endnote Regarding Amendatory Language
Paperwork Reduction Act
Regulatory Flexibility Act
Executive Order 12866
Unfunded Mandates
Catalog of Federal Domestic Assistance
Numbers and Titles
List of Subjects in 38 CFR Part 5
Overview of New Part 5 Organization
We plan to organize the part 5
regulations so that most of the
provisions governing a specific benefit
are located in the same subpart, with
general provisions pertaining to all
compensation and pension benefits also
grouped together. We believe this
organization will enable claimants,
beneficiaries, and their representatives,
as well as VA personnel, to find
information relating to a specific benefit
more quickly than the organization
provided in current part 3.
The first major subdivision would be
‘‘Subpart A—General Provisions.’’ It
would include information regarding
the scope of the regulations in new part
5, general definitions, and general
policy provisions for this part. This
subpart was published as proposed on
March 31, 2006. See 71 FR 16464.
‘‘Subpart B—Service Requirements for
Veterans’’ would include information
regarding a veteran’s military service,
including the minimum service
requirement, types of service, periods of
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Federal Register / Vol. 72, No. 98 / Tuesday, May 22, 2007 / Proposed Rules
war, and service evidence requirements.
This subpart was published as proposed
on January 30, 2004. See 69 FR 4820.
‘‘Subpart C—Adjudicative Process,
General’’ would inform readers about
types of claims and filing procedures,
VA’s duties, rights and responsibilities
of claimants and beneficiaries, general
evidence requirements, and effective
dates for new awards, as well as
revision of decisions and protection of
VA ratings. This subpart will be
published as three separate Notices of
Proposed Rulemaking (NPRMs) due to
its size. The first, concerning the duties
of VA and the rights and responsibilities
of claimants and beneficiaries, was
published as proposed on May 10, 2005.
See 70 FR 24680. The portion of this
subpart covering general evidence
requirements, effective dates for awards,
revision of decisions, and protection of
VA ratings is the subject of this
document.
‘‘Subpart D—Dependents and
Survivors’’ would inform readers how
VA determines whether an individual is
a dependent or a survivor of a veteran.
It would also provide the evidence
requirements for these determinations.
This subpart was published as proposed
on September 20, 2006. See 71 FR
55052.
‘‘Subpart E—Claims for Service
Connection and Disability
Compensation’’ would define serviceconnected compensation, including
direct and secondary service
connection. This subpart would inform
readers how VA determines entitlement
to service connection. The subpart
would also contain those provisions
governing presumptions related to
service connection, rating principles,
and effective dates, as well as several
special ratings. This subpart will be
published as three separate NPRMs due
to its size. The first, concerning
presumptions related to service
connection, was published as proposed
on July 27, 2004. See 69 FR 44614.
‘‘Subpart F—Nonservice-Connected
Disability Pensions and Death
Pensions’’ would include information
regarding the three types of nonserviceconnected pension: Improved pension,
Old-Law pension, and Section 306
pension. This subpart would also
include those provisions that state how
to establish entitlement to Improved
pension, and the effective dates
governing each pension. This subpart
would be published in two separate
NPRMs due to its size. The portion
concerning Old-Law pension, Section
306 pension, and elections of Improved
pension was published as proposed on
December 27, 2004. See 69 FR 77578.
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‘‘Subpart G—Dependency and
Indemnity Compensation, Death
Compensation, Accrued Benefits, and
Special Rules Applicable Upon Death of
a Beneficiary,’’ would contain
regulations governing claims for
dependency and indemnity
compensation (DIC); death
compensation; accrued benefits; benefits
awarded, but unpaid at death; and
various special rules that apply to the
disposition of VA benefits, or proceeds
of VA benefits, when a beneficiary dies.
This subpart would also include related
definitions, effective-date rules, and
rate-of-payment rules. This subpart was
published as two separate NPRMs due
to its size. The portion concerning
accrued benefits, death compensation,
special rules applicable upon the death
of a beneficiary, and several effectivedate rules, was published as proposed
on October 1, 2004. See 69 FR 59072.
The portion concerning DIC benefits
and general provisions relating to proof
of death and service-connected cause of
death was published as proposed on
October 21, 2005. See 70 FR 61326.
‘‘Subpart H—Special and Ancillary
Benefits for Veterans, Dependents, and
Survivors’’ would pertain to special and
ancillary benefits available, including
benefits for children with various birth
defects. This subpart was published as
proposed on March 9, 2007. See 72 FR
10860.
‘‘Subpart I—Benefits for Certain
Filipino Veterans and Survivors’’ would
pertain to the various benefits available
to Filipino veterans and their survivors.
This subpart was published as proposed
on June 30, 2006. See 71 FR 37790.
‘‘Subpart J—Burial Benefits’’ would
pertain to burial allowances.
‘‘Subpart K—Matters Affecting the
Receipt of Benefits’’ would contain
provisions regarding bars to benefits,
forfeiture of benefits, and renouncement
of benefits. This subpart was published
as proposed on May 31, 2006. See 71 FR
31056.
‘‘Subpart L—Payments and
Adjustments to Payments’’ would
include general rate-setting rules,
several adjustment and resumption
regulations, and election-of-benefit
rules. Because of its size, subpart L will
be published in two separate NPRMs.
The final subpart, ‘‘Subpart M—
Apportionments to Dependents and
Payments to Fiduciaries and
Incarcerated Beneficiaries,’’ would
include regulations governing
apportionments, benefits for
incarcerated beneficiaries, and
guardianship.
Some of the regulations in this NPRM
cross-reference other compensation and
pension regulations. If those regulations
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have been published in this or earlier
NPRMs for the Project, we cite the
proposed part 5 section. We also
include, in the relevant portion of the
Supplementary Information, the Federal
Register page where a proposed part 5
section published in an earlier NPRM
may be found. However, where a
regulation proposed in this NPRM
would cross-reference a proposed part 5
regulation that has not yet been
published, we cite to the current part 3
regulation that deals with the same
subject matter. The current part 3
section we cite may differ from its
eventual part 5 counterpart in some
respects, but we believe this method
will assist readers in understanding
these proposed regulations where no
part 5 counterpart has yet been
published. If there is no part 3
counterpart to a proposed part 5
regulation that has not yet been
published, we have inserted
‘‘[regulation that will be published in a
future Notice of Proposed Rulemaking]’’
where the part 5 regulation citation
would be placed.
Because of its large size, proposed
part 5 will be published in a number of
NPRMs, such as this one. VA will not
adopt any portion of part 5 as final until
all of the NPRMs have been published
for public comment.
In connection with this rulemaking,
VA will accept comments relating to a
prior rulemaking issued as a part of the
Project, if the matter being commented
on relates to both rulemakings.
Overview of This Notice of Proposed
Rulemaking
This NPRM pertains to those
regulations governing the following for
purposes of compensation and pension
benefits: (1) General evidence
requirements; (2) general effective dates
for awards; (3) revision of decisions; and
(4) protection of existing ratings. These
regulations would be contained in
proposed Subpart C of new 38 CFR part
5. Although these regulations have been
substantially restructured and rewritten
for greater clarity and ease of use, most
of the basic concepts contained in these
proposed regulations are the same as in
their existing counterparts in 38 CFR
part 3. However, a few substantive
differences are proposed, along with
some rules that do not have
counterparts in 38 CFR part 3.
Table Comparing Current Part 3 Rules
With Proposed Part 5 Rules
The following table shows the
relationship between the current
regulations in part 3 and those proposed
regulations contained in this NPRM:
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Federal Register / Vol. 72, No. 98 / Tuesday, May 22, 2007 / Proposed Rules
Proposed part 5
section or
paragraph
Based in whole or in
part on 38 CFR part 3
section or paragraph
(or ‘‘New’’)
Proposed part 5
section or
paragraph
Based in whole or in
part on 38 CFR part 3
section or paragraph
(or ‘‘New’’)
5.130(a) .....................
3.217(a) and Note to
3.217(a).
3.217(b).
3.217(b)(1)(i).
3.217(b)(1)(ii).
3.217(b)(1)(iii).
3.217(b)(2).
New.
3.153.
3.201(a).
3.201(b).
3.108.
3.202(a).
3.202(b)(1).
3.202(b)(2).
3.202(b)(3).
3.202(b)(6).
3.202(b)(4).
3.202(a) [first sentence] and
3.202(a)(2).
3.202(a)(1).
3.202(c).
3.115(a).
New.
New.
New.
3.115(b).
3.115(b).
3.2130.
3.200.
3.1(y)(1), (y)(3).
3.1(y)(2)(i).
3.1(y)(2)(ii).
3.1(y)(4).
3.304(c).
New.
3.304(e).
3.304(e) [first sentence].
3.304(e) [last two
sentences].
3.326(b).
3.400 [intro] and (a),
3.400(h)(1), and
3.400(q)(1)(ii).
New.
3.1(r).
3.114.
3.156(b) and
3.400(q)(1)(i).
3.104(a).
3.104(b).
3.2600.
3.105(a) first two sentences].
3.105 [intro—first
sentence] and
3.105(a) [third and
fourth sentences].
3.105(b).
3.400(h)(1).
3.500(b).
3.500(b)(1).
3.500(b)(2).
3.156(c).
3.344, 3.951, and
3.957.
3.951(b) and 3.957.
New.
New.
5.170(e) .....................
5.171(a) .....................
5.171(b) .....................
5.171(c)(1) .................
5.171(c)(2) .................
5.171(d) .....................
5.171(e) .....................
5.172(a) .....................
New.
3.344(a).
3.344(c).
3.344(c).
3.344(a).
3.344(a).
3.344(b).
3.951(b) [first sentence].
3.951(b) [second sentence].
New
3.951(a) and 3.952.
3.952.
3.952.
3.952.
3.953(a).
3.953(c).
3.957 [first sentence].
3.957 [last sentence].
3.105(d) [first two
sentences].
3.105(d) [third and
fourth sentences].
3.105(d) [fifth and
sixth sentences]
and 3.105(e) [first
two sentences].
3.105(d) [last two
sentences] and
3.105(e) [last two
sentences].
3.105 [intro—last sentence].
3.105 [intro—second
sentence].
3.105 [intro—first
sentence] and
3.500(b).
3.105(d).
3.105(c).
3.105(e).
3.105(f).
3.105(g).
3.105(h).
5.130(b) .....................
5.130(c)(1)(i) .............
5.130(c)(1)(ii) .............
5.130(c)(1)(iii) ............
5.130(c)(2) .................
5.130(d) .....................
5.131(a) .....................
5.131(b) .....................
5.131(c) .....................
5.132(a) .....................
5.132(b) .....................
5.132(c)(1) .................
5.132(c)(2) .................
5.132(c)(3) .................
5.132(c)(4) .................
5.132(c)(5) .................
5.132(d)(1) ................
5.132(d)(2) ................
5.132(e) .....................
5.133(a) .....................
5.133(b) .....................
5.133(b)(1) ................
5.133(b)(2) ................
5.133(c)(1) .................
5.133(c)(2) .................
5.134 .........................
5.135 .........................
5.140(a) .....................
5.140(b) .....................
5.140(c) .....................
5.140(d) .....................
5.141(a) .....................
5.141(b) .....................
5.141(c) .....................
5.141(d) .....................
5.141(e) .....................
5.141(f) ......................
5.150(a) .....................
5.150(b) .....................
5.151 .........................
5.152 .........................
5.153 .........................
5.160(a) .....................
5.160(b) .....................
5.161 .........................
5.162(a) .....................
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5.162(b) .....................
5.163 .........................
5.164 .........................
5.165(a) .....................
5.165(b) .....................
5.165(c) .....................
5.166 .........................
5.170(a) .....................
5.170(b) .....................
5.170(c) .....................
5.170(d) .....................
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5.172(b) .....................
5.172(c) .....................
5.173(a) .....................
5.173(b)(1) ................
5.173(b)(2) ................
5.173(b)(3) ................
5.174(a) .....................
5.174(b) .....................
5.175(a)(1) ................
5.175(a)(2) ................
5.175(b)(1) ................
5.175(b)(2) ................
5.176(a) and (b) ........
5.176(c) .....................
5.177(a) .....................
5.177(b) .....................
5.177(c) .....................
5.177(d) .....................
5.177(e) .....................
5.177(f) ......................
5.177(g) .....................
5.177(h) .....................
5.177(i) ......................
Readers who use this table to compare
existing regulatory provisions with the
proposed provisions, and who observe a
substantive difference between them,
should consult the text that appears
later in this document for an
explanation of significant changes in
each regulation. Not every paragraph of
every current part 3 section regarding
the subject matter of this rulemaking is
accounted for in the table. In some
instances, other portions of the part 3
sections that are contained in these
proposed regulations will appear in
subparts of part 5 that are being
published separately for public
comment. For example, a reader might
find a reference to paragraph (a) of a
part 3 section in the table, but no
reference to paragraph (b) of that section
because paragraph (b) will be addressed
in a separate NPRM. The table also does
not include provisions from part 3
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regulations that will not be carried
forward to part 5. Such provisions are
discussed specifically under the
appropriate part 5 heading in this
preamble. Readers are invited to
comment on the proposed part 5
provisions and also on our proposals to
omit those part 3 provisions from part
5.
Content of Proposed Regulations
General Evidence Requirements
Section 5.130 Submission of
Statements, Evidence, or Information
Affecting Entitlement to Benefits
Proposed § 5.130 is derived from
current § 3.217, VA’s regulation
governing the submission of statements
or information affecting entitlement to
benefits. We propose explicitly to make
this regulation applicable to ‘‘evidence’’
as well as statements and information.
The current regulation does not
explicitly apply to the submission of
written evidence; however, in practice
the principles therein do apply to the
submission of written evidence, and
there is no reason not to make the part
5 regulation explicit in this regard.
Proposed paragraph (a) addresses the
methods by which beneficiaries may
submit statements, evidence, or
information affecting their entitlement
to benefits. Acknowledging that certain
VA regulations require that particular
types of evidence or information be
submitted in writing—e.g., Marriage
(§ 5.192), Divorce (§ 5.194), and Birth
(§ 5.229)—we propose to state that it is
VA’s policy to accept electronic
submissions unless another regulation,
form, or directive expressly requires a
different method of submission.
Proposed paragraph (a) would state that
this policy does not apply to the filing
of a claim, Notice of Disagreement,
Substantive Appeal, or any other
submissions or filing requirements
covered in parts 19 and 20 of this title.
We propose not to include the
introductory phrase, ‘‘For purposes of
this part, unless specifically provided
otherwise,’’ which is used in paragraph
(b) of current § 3.217. Because proposed
§ 5.0 specifically states that ‘‘[e]xcept as
otherwise provided, this part applies
only to benefits governed by this part,’’
it is no longer necessary to state that any
rule in part 5 applies only for purposes
of this part. 71 FR 16464, 16473.
Therefore, in paragraph (b) of § 5.130,
we propose to state, ‘‘Except as
otherwise provided.’’ By so doing, we
achieve our goal of greater readability
without loss of clarity or substance.
In § 5.130(c)(1), we propose to include
a reference to the beneficiary’s
authorized representative that is not
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contained in current § 3.217(b)(1).
Including the representative merely
clarifies the established legal principle
that the actions of an authorized
representative are considered to be
actions by the client beneficiary.
Current § 3.217(b)(1)(iii) states that,
when a beneficiary or fiduciary orally
provides information or a statement that
VA may use to adjust benefits, VA must
inform him or her that ‘‘the information
or statement will be used for the
purpose of calculating benefit
amounts.’’ In proposed § 5.130(c)(1)(iii),
we use the word ‘‘may’’ instead of
‘‘will.’’ This wording is more accurate
because VA may determine that the
information or statement needs to be
verified through other means. It also
makes this paragraph consistent with
the first sentence in proposed paragraph
(b), which states that, ‘‘VA may take
action* * *’’ Similarly, we also propose
to use the phrase ‘‘may be used’’ in
§ 5.130(c)(2)(v) instead of ‘‘would be
used’’ as stated in current § 3.217(b)(2).
Finally, in proposed paragraph (d) we
articulate the exceptions to the rule that
VA cannot act on an oral statement
unless VA has complied with
paragraphs (c)(1) and (2). These
exceptions, which apply to statements
made at a hearing or to a physician,
reflect current practice. Persons who
appear at a hearing or who provide
information to a physician, especially in
connection with a VA medical
examination, should expect that such
information will be considered as part
of their claim. Neither current § 3.217
nor the proposed part 5 version of that
rule preclude VA from relying on
medical statements or statements made
at a hearing. Moreover, there is no doubt
as to the identity of the person making
the statement in these two discrete
situations. Finally, §§ 5.81, 5.82, and
20.700 adequately regulate statements
made at a hearing. 70 FR 24680, 24686–
87.
Section 5.131 Applications, Claims,
and Exchange of Evidence With Social
Security Administration (SSA)—Death
Benefits
Proposed § 5.131(a) is derived from
the first sentence of current § 3.153,
which states that an application for
death benefits filed with SSA on or after
January 1, 1957, on a form jointly
prescribed by VA and SSA, will be
considered a claim for VA death
benefits, and will be considered as
received by VA as of the date SSA
received it.
Note that although current § 3.1(p)
uses the terms ‘‘claim’’ and
‘‘application’’ interchangeably, we
propose to only use the term ‘‘claim’’ in
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part 5, for the sake of consistency, when
referring to a formal or informal
communication in writing requesting a
determination of entitlement or
evidencing a believe in entitlement to a
benefit, as the term ‘‘claim’’ is defined
in part 3. (A future NPRM will fully
address the definition of ‘‘claim’’ for the
purposes of part 5.) Thus, the term
‘‘claim’’ would have the same meaning
in Part 5 as it currently does in Part 3;
no substantive change is intended. We
propose to use the term ‘‘application’’
when referring to a certain form that a
claimant must file to apply for benefits.
This definition will be contained in
§ 5.1 General Definitions.
Current § 3.153 implements the
statutory provision 38 U.S.C. 5105 that
governs joint applications for SSA and
dependency and indemnity
compensation (DIC). The statute is
applicable only to claims for chapter 13
benefits, which means that it applies to
claims for DIC. Current § 3.153 states
that a claim on a joint form is to be
treated as a claim for ‘‘death benefits.’’
However, under 38 U.S.C. 5101(b)(1), a
claim for DIC must also be considered
a claim for death pension and accrued
benefits. Consequently, proposed
§ 5.131(a) would parenthetically
describe ‘‘VA death benefits’’ as ‘‘[DIC],
death pension and accrued benefits.’’
We also propose to update the statutory
authority citation by including a
reference to 38 U.S.C. 5101(b)(1), as the
authority for considering a joint
application to be a claim for ‘‘death
benefits’’ is not derived from 38 U.S.C.
5105 alone. For the reasons set forth
above, the inclusion of death pension
and accrued benefits in the proposed
regulation would not create a new basis
of entitlement or result in a substantive
right that does not exist within the
current framework of the pertinent law
or regulations.
The second sentence of current
§ 3.153 states that VA is not precluded
by reason of having received a joint
application from requesting necessary
evidence. This language is unnecessary
because nothing in any statute or
regulation, including proposed § 5.131,
precludes VA from requesting necessary
evidence after we have received a claim
for benefits. In addition, the sentence
merely reiterates the last sentence of 38
U.S.C. 5105(b), and there is no need to
maintain a regulatory provision that
merely recites a statutory provision.
Proposed § 5.131(b) is derived in part
from the second sentence of current
§ 3.201(a), which pertains to the
exchange of evidence between VA and
SSA. The cited authority for this
regulation includes 38 U.S.C. 5105,
discussed above. Proposed § 5.131(b)
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does not incorporate the first sentence
of current § 3.201(a), as it is unnecessary
and redundant of proposed § 5.81,
which explicitly states that ‘‘VA will
include in the record of proceedings any
information, evidence (whether
documentary, testimonial, or in other
form), and any argument that a claimant
offers in support of a claim.’’ 70 FR
24680, 24686. In addition, VA’s ‘‘duty to
assist’’ regulation, 38 CFR 3.159(c)(2),
requires VA to obtain relevant records
from a federal department or agency,
including records in custody of SSA.
Moreover, SSA is required, pursuant to
38 U.S.C. 5105(b), to forward to VA all
information and supporting documents
that it receives in conjunction with a
joint application for DIC/SSA benefits.
In light of the foregoing, it is not
necessary to specify in § 5.131(b) that a
claimant may submit evidence
submitted to SSA, or to permit the
claimant to request VA to obtain such
evidence. We have also clarified that the
rule, embodied in proposed § 5.131(b)
and current § 3.201(a), regarding the
deemed date of receipt for evidence
filed at SSA applies only when the
evidence was filed in conjunction with
a claim for both SSA death benefits and
VA death benefits. The clarification is to
avoid a situation in which a final VA
decision is subject to collateral attack
based upon evidence filed with SSA in
support of a claim for only SSA death
benefits that predates a subsequent
separate claim for VA death benefits.
Proposed § 5.131(c) is derived from
current § 3.201(b), which provides that
when SSA requests evidence from VA
that was submitted in support of a DIC
application, VA will furnish it.
However, current § 3.201(b) does not
acknowledge the existence of laws,
including the Health Insurance
Portability and Accountability Act
(HIPAA), that protect the confidentiality
of various kinds of information or
evidence that claimants or beneficiaries
file with VA. For example, 38 U.S.C.
7332 protects the confidentiality of all
records containing the identity,
diagnosis, prognosis, or treatment of any
patient or subject maintained in
connection with any program or activity
carried out by or for VA and connected
with drug abuse, alcoholism or alcohol
abuse, infection with the human
immunodeficiency virus, or sickle cell
anemia. VA can only release such
records when certain prerequisites are
satisfied, and we do not interpret
section 7332 as providing for an
exemption for mandatory disclosures to
SSA under this regulation or under its
authorizing statute, 38 U.S.C. 5105(b).
Also, 5 U.S.C. 552a contains general
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procedures that all agencies must follow
when determining whether to release
records that they maintain on
individuals. Therefore, we propose to
add a sentence in proposed § 5.131(c) to
clarify that any disclosure of evidence to
the SSA under this paragraph must
comply with all requirements of any
applicable privacy or confidentiality
laws, which would include HIPAA.
Section 5.132 Claims, Statements,
Evidence, or Information Filed Abroad;
Authentication of Documents From
Foreign Countries
Proposed § 5.132 is derived from
current § 3.202, VA’s regulation
pertaining to the criteria for the
acceptance of foreign evidence, and
§ 3.108, which relates to occasions when
the State Department functions as an
agent of VA. We believe it is logical to
consolidate into a single regulation the
rule pertaining to filing claims or
evidence in foreign countries with the
rule pertaining to filing evidence from
foreign sources.
In paragraph (a) of § 5.132, we
propose to include the provisions of
current § 3.108, which recognize U.S.
diplomatic and consular officers abroad
as agents for the acceptance of VA
applications or claims, or evidence in
support of a claim pending with VA. We
clarify that the rule applies to
submissions of claims or of statements,
evidence, or information in support of a
claim.
Current § 3.108 provides that
diplomatic and consular officers may
act as agents of VA, ‘‘and, therefore, a
formal or informal claim or evidence
submitted in support of a claim filed in
a foreign country will be considered as
filed in [VA] as of the date of receipt by
the State Department representative.’’
We intend no substantive changes to
this regulation by eliminating the term
‘‘informal claim.’’ The term ‘‘claim’’
necessarily embraces all of the types of
claims listed in the regulations,
including informal and formal claims.
Current § 3.108 uses the terms
‘‘diplomatic and consular officers of the
Department of State’’ and ‘‘the State
Department representative,’’ to describe
the officials who are authorized to
receive claims and evidence. For
purposes of § 5.132, we propose to
simplify the description by substituting
the inclusive term ‘‘Department of State
representative.’’
Paragraph (b) of proposed § 5.132
explains that the term ‘‘authentication’’
means that ‘‘an official listed in
paragraph (d) of this section verifies that
the foreign document, including each
signature, stamp, and seal appearing on
it, is genuine and has not been altered.’’
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Paragraph (b) of proposed § 5.132
explains that for the purposes of
§ 5.132(b) the term ‘‘foreign documents’’
means documents that are signed under
oath or affirmation in the presence of an
official in a foreign country. This
definition is derived from current
§ 3.202(a). Examples of foreign
documents are described in the
proposed regulation in order to aid the
reader.
Paragraph (b) also directs the reader to
a list (in paragraph (c)) of foreign
documents that do not require
authentication.
Paragraph (c) of proposed § 5.132
restates current § 3.202(b). In addition,
proposed § 5.132(c)(3) contains a direct
reference to § 2.3, which pertains to
delegation of authority to employees to
take affidavits, to administer oaths, etc.
This reference is appropriate, as it bears
directly on the subject matter contained
in proposed § 5.132. Current
§ 3.202(b)(4) states that authentication
will not be required, ‘‘[w]hen a copy of
a public or church record from any
foreign country purports to establish
birth, adoption, marriage, annulment,
divorce, or death, provided it bears the
signature and seal of the custodian of
such record and there is no conflicting
evidence in the file which would serve
to create doubt as to the correctness of
the record.’’ Paragraph (b)(5) states that
authentication will not be required,
‘‘[w]hen a copy of the public or church
record from one of the countries
comprising the United Kingdom,
namely: England, Scotland, Wales, or
Northern Ireland, purports to establish
birth, marriage, or death, provided it
bears the signature or seal or stamp of
the custodian of such record and there
is no evidence which would serve to
create doubt as to the correctness of the
records.’’ VA believes that maintaining
a different rule for the United Kingdom
is unnecessary because records
maintenance in the United Kingdom is
not necessarily superior to that of all
other countries. Moreover, we believe
that a single rule will be easier for VA
personnel to correctly apply and for the
public to understand. We therefore
propose not to include an equivalent to
§ 3.202(b)(5) in § 5.132.
Paragraph (d) of proposed § 5.132 is
derived from current § 3.202(a). Current
§ 3.202(a) uses, among others, the terms
‘‘United States Consular Officer,’’ ‘‘the
State Department,’’ and ‘‘the nearest
American consul,’’ to describe the
various Department of State officials
who may authenticate the signatures of
officials of foreign countries in cases
where affidavits or other documents are
required to be executed under oath
before foreign officials. For purposes of
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§ 5.132, we propose to simplify the
description by substituting the inclusive
term ‘‘officer of the Department of State
authorized to authenticate documents.’’
We note that the Department of State
has promulgated 22 CFR 131.1, which
authorizes specially designated
‘‘authentication officers’’ to issue
certificates of authentication under the
seal of the Department of State on behalf
of the Secretary of State. That regulation
also prescribes the proper form of
authentication. A certificate of
authentication therefore constitutes the
State Department’s official
acknowledgment that a document of
foreign origin is genuine.
Section 5.133 Information VA May
Request From Financial Institutions
Proposed § 5.133, derived from
current § 3.115, will provide readers
with clarification of the different types
of information VA may request from a
financial institution, the conditions
under which a request may be made, the
steps for making a request, and VA’s
responsibilities with regard to the
handling of this information once it is
obtained.
The first sentence of current § 3.115(a)
reads: ‘‘The Secretary of Veterans
Affairs may request from a financial
institution the names and addresses of
its customers.’’ As in several other
proposed part 5 rules, this rule will refer
to ‘‘VA’’ rather than ‘‘[t]he Secretary of
Veterans Affairs’’ to shorten the
reference without changing its meaning.
Some readers may not have a clear
understanding of what constitutes a
‘‘financial institution,’’ a term that is
used in the first sentence of current
§ 3.115(a). Accordingly, we propose to
add examples of various types of
financial institutions. Examples include
banks, savings and loan associations,
trust companies, and credit unions.
The current language of § 3.115 and
the statutory provisions of 12 U.S.C.
3413 explicitly authorize VA to obtain
only names and addresses from a
financial institution. However, VA also
possesses statutory authority to
subpoena financial information.
According to the Right to Financial
Privacy Act, ‘‘A government authority
may obtain financial records * * *
pursuant to an administrative subpoena
or summons otherwise authorized by
law if there is reason to believe that the
records sought are relevant to a
legitimate law enforcement inquiry.’’ 12
U.S.C. 3405. ‘‘Government authority’’ is
defined in this Act as ‘‘any agency or
department of the United States, or any
officer, employee, or agent thereof.’’ 12
U.S.C. 3401(3). The Act also defines
‘‘law enforcement inquiry’’ as ‘‘a lawful
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investigation or official proceeding
inquiring into a violation of, or failure
to comply with, any * * * regulation,
rule, or order issued pursuant thereto.’’
12 U.S.C. 3401(8). These provisions give
VA the authority, under certain
circumstances, to obtain financial
information through a subpoena,
provided it is necessary in order to
determine whether an individual has
violated any of the regulations on
veterans’ benefits. Additionally, 38
U.S.C. 5711(a)(2), authorizes the
Secretary and employees to whom the
Secretary has delegated such authority
to ‘‘require the production of books,
papers, documents, and other
evidence.’’
For example, current §§ 3.660(a),
3.256(a), and 3.277(b) require
individuals claiming entitlement to or
receiving income-based benefits from
VA to promptly report changes in their
income. If VA discovers that a current
or former beneficiary may have reported
a lower amount of income to VA than
the financial institution reported to the
Internal Revenue Service as having been
paid to the beneficiary, VA will ask the
individual to verify the amount
received. If the individual refuses or
fails to respond to VA’s request, VA has
authority under 12 U.S.C. 3405 to
subpoena from the financial institution
a statement showing amounts it paid to
the individual.
Before issuing a subpoena to a
financial institution, 12 U.S.C. 3405(2)
requires VA to: (1) Send a copy of the
subpoena to the current or former
beneficiary; (2) inform the current or
former beneficiary of the reason VA is
requesting financial information from
the financial institution; and (3) explain
to the current or former beneficiary the
procedures for challenging VA’s
proposal to issue a subpoena.
VA’s authority to issue subpoenas to
financial institutions in order to verify
the amount of income paid by a
financial institution to a current or
former VA beneficiary, as well as the
circumstances under which they may be
issued, are not addressed in part 3 of
current 38 CFR. However, we believe
this is an issue about which the public
should be informed. For example, if VA
discovers that a current or former
beneficiary, while receiving either
pension or parents’ dependency and
indemnity compensation, may have
underreported or failed to report to VA
the receipt of income from a financial
institution, VA may ask the financial
institution that paid the income to
provide a statement showing the
amount it paid to the individual. We
propose to clarify in § 5.133(b) that
requests of this type must be made
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through a subpoena. To ensure readers
understand the meaning of the word
‘‘subpoena,’’ we propose to define it in
paragraph (b). Our definition, which is
‘‘a legal document commanding an
individual or organization to provide
specified evidence to the issuer of the
subpoena,’’ is derived from the 2001
edition of Merriam-Webster’s Dictionary
of Law.
The content of paragraph (c)(1) of
proposed § 5.133 is derived from current
§ 3.115(b), while the content of
paragraph (c)(2) is derived from 12
U.S.C. 3412(a), which was part of the
Right to Financial Privacy Act of 1978.
Although we have changed the language
taken from these two sources in order to
make the proposed rule easier to
understand, we intend no change in the
substance they convey.
Section 5.134 Will VA accept a
signature by mark or thumbprint?
Proposed § 5.134 is derived from
current § 3.2130. We are not proposing
any changes to the current regulation.
Rather, we will incorporate the language
of current § 3.2130 at proposed § 5.134.
Section 5.135 Statements Certified or
Under Oath or Affirmation
Proposed § 5.135 is based on current
§ 3.200, which states, in pertinent part,
‘‘All written testimony submitted by the
claimant or in his or her behalf for the
purpose of establishing a claim for
service connection will be certified or
under oath or affirmation.’’ Instead of
referring to ‘‘written testimony’’ we
propose to use the phrase, ‘‘[a]ny
documentary evidence or written
assertion of fact’’ which we believe is
easier for readers to understand. We
propose to give VA discretion to
consider such a submission that is not
certified or under oath or affirmation or
to require certification, oath, or
affirmation if considered necessary to
establish the reliability of a material
document. This would give VA
discretion to consider documents which
are considered reliable under the
circumstances of a particular case. It
would also give VA discretion to require
certification, oath, or affirmation when
a submission appears unreliable, which
will help ensure program integrity.
Whereas current § 3.200(b) is limited
to claims for service connection, we
propose to have § 5.135(b) apply to all
claims within the scope of part 5. We
believe that there is nothing unique
about claims for service connection with
respect to the reliability of evidence. We
believe that the principles stated above
should apply equally to all claims for
compensation or pension benefits.
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Evidence Requirements for Former
Prisoners of War (POWs)
Section 5.140 Determining Former
Prisoner of War Status
Proposed § 5.140 contains rules
relating to the evidentiary and
adjudicative considerations in
determining prisoner of war (POW)
status. Proposed § 5.140 is derived from
current § 3.1(y), which sets forth general
principles applicable to establishing
status as a POW, including definitions
and certain evidentiary and adjudicative
considerations. We have addressed the
various definitions contained in current
3.1(y) in a separate NPRM that restated
such definitions in § 5.1 of proposed
part 5. See 71 FR 16464, 16473.
Additional principles establishing
former POW status are found in § 3.41,
which sets forth special rules applicable
to former prisoners of war with
Philippine service. These principles are
also covered in a separate NPRM. See 71
FR 37790, 37794.
Paragraph (a) of proposed § 5.140
restates the current rule that service
department determinations of POW
status are generally binding on VA, and
states the criteria VA will use to decide
POW status in all other cases. It also
restates the requirement in current
§ 3.1(y)(3) that the Director of the
Compensation and Pension Service
must approve all 152 office decisions
based on criteria for determining former
POW status other than service
department findings. In order to
recognize the modern dangers presented
by non-government forces, we propose
to expand the instances in which
service department findings will be
accepted. Whereas current § 3.1(y)(1)
only accepts service department
findings that a person was a POW
during a period of war when detention
or internment was by an enemy
government or its agents, under
paragraph (a) of proposed § 5.140, VA
will also accept a finding by the service
department that a person was a POW
during a period of war when detention
or internment was by a hostile force.
Paragraphs (b), (c), and (d) of
proposed § 5.140 restate the content of
current § 3.1(y)(2)(i), (y)(2)(ii), and
(y)(4), respectively. In paragraph (d), we
propose to cross-reference § 5.660,
pertaining to ‘‘line of duty’’ and derived
from current §§ 3.1(m) and 3.301(a), and
§ 5.661, pertaining to ‘‘willful
misconduct’’ and derived from current
§§ 3.1(n), 3.301(a) through (d), and
3.302. See 71 FR 31056, 31062–63.
At the end of the proposed rule, we
propose to cross-reference proposed
§ 5.611, which restates current § 3.41,
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relating to POW status and Philippine
service. See 71 FR 37790, 37795.
Section 5.141 Medical Evidence for
Former Prisoners’ of War Compensation
Claims
Proposed § 5.141 is based in part on
those portions of current § 3.304,
‘‘Direct service connection; wartime and
peacetime,’’ that pertain to former
POWs. Except as provided below, no
substantive changes are intended to
these provisions. Portions of current
§ 3.304 have already been addressed in
a prior NPRM, published as proposed
on May 10, 2005. See 70 FR 24680.
Other provisions of current § 3.304 will
be addressed in a separate NPRM.
Proposed paragraph (a) provides
information regarding injuries and
conditions claimed by a former POW
that are obviously due to service. The
paragraph states that VA will rate such
injuries and conditions without
awaiting receipt of service records. This
paragraph is derived from the last
sentence of current § 3.304(c) and is
included to clarify how the general rule
in proposed § 5.91, the part 5 version of
current § 3.304(c), applies to conditions
resulting from POW confinement.
Proposed paragraph (b) provides that
where disability compensation is
claimed by a former POW, the
claimant’s statements as to the
incurrence or aggravation of an injury or
disease during or immediately prior to
detention or internment will be viewed
as truthful unless there is clear and
convincing evidence to the contrary.
This is a substantive change based upon
expanding current § 3.304(d). VA’s
practice has been to treat statements by
former POWs in the same manner as
combat veterans for purposes of 38
U.S.C. 1154(b) in order to recognize the
deficiencies or complete absence of
many former POWs’ service medical
records showing evidence of diseases or
injuries suffered during or immediately
before detention or internment. This
substantive change is consistent with
current § 3.304(f)(2), pertaining to posttraumatic stress disorder claimed by a
former prisoner of war. At the end of
paragraph (b), we propose to add a
reference to § 3.304(f)(2) to let the reader
know the location of a similar provision
regarding POWs. We cite to the current
part 3 regulation because the proposed
part 5 regulation that deals with the
same subject matter has not yet been
published. Current § 3.304(f)(2) may
differ from its eventual part 5
counterpart in some respects.
Proposed paragraph (c) notes that
supporting evidence from fellow service
members that an injury or disease was
incurred during confinement will be
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considered. This is not a substantive
change from part 3 and does not provide
a new benefit to former POWs. VA
accepts ‘‘buddy statements’’ in all cases.
We explicitly provide for such evidence
here, and discuss how to evaluate that
evidence, because such evidence is
more frequently encountered in cases
relating to POWs.
Proposed paragraph (c) would require
VA to consider statements from fellow
service members submitted in
connection with a former POW’s claim
for benefits, regarding the former POW’s
physical condition before capture, the
circumstances surrounding the former
POW’s internment, changes in the
former POW’s physical condition
following release from internment, or
the existence of signs or symptoms of
disability following the former POW’s
release from internment.
Paragraph (d) of proposed § 5.141
provides that the lack of medical
findings from clinical records made
upon a former POW’s return to U.S.
control will not be determinative of
whether service connection is awarded
for a particular disability. It is derived
from the first sentence of current
§ 3.304(e).
Proposed paragraph (e) restates the
second and third sentences of current
§ 3.304(e).
Finally, proposed paragraph (f)
includes information from the second
sentence of current § 3.326(b), which
provides that VA will not deny
monetary benefits unless the claimant
has been offered a complete physical
examination at a VA facility. Unlike
current § 3.326(b), which states that the
examination will be ‘‘conducted at a
[VA] hospital or outpatient clinic,’’
proposed paragraph (f) does not specify
the location of the examination to be
provided because an examination may
be provided by VA at one of a variety
of VA medical facilities, or, in some
instances, VA may provide an
examination with a private contractor at
a non-VA facility. ‘‘[M]edical
examination’’ used in proposed
paragraph (f), as opposed to ‘‘physical
examination’’ used in current § 3.326(b),
clarifies that the examination is not
limited to examination for physical
disorders but includes examination for
mental disorders as well.
General Effective Dates for Awards
Section 5.150 General Effective Dates
for Awards or Increased Benefits
Proposed § 5.150 would restate
without substantive change the
introductory text and paragraph (a) of
current § 3.400, which state:
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Except as otherwise provided, the effective
date of an evaluation and award of pension,
compensation or dependency and indemnity
compensation based on an original claim, a
claim reopened after final disallowance, or a
claim for increase will be the date of receipt
of the claim or the date entitlement arose,
whichever is later.
(a) Unless specifically provided. On
basis of facts found.
The exceptions to the general
effective-date rule, which are currently
contained in other provisions of
§§ 3.400 through 3.405, would be
contained in regulations located
proximate to their respective benefit
regulations.
In paragraph (a) of § 5.150, we
propose not to include the phrase ‘‘facts
found’’ in current § 3.400(a). Instead, we
will only use the phrase ‘‘date
entitlement arose,’’ which appears in
the introductory text of § 3.400. Section
5110(a) of title 38, United States Code,
on which the general effective date rule
stated in § 3.400 is based, uses ‘‘facts
found’’ and does not use the phrase
‘‘date entitlement arose.’’ Nevertheless,
the legislative history of 38 U.S.C.
5110(a) and the regulatory history of 38
CFR 3.400 both suggest that ‘‘facts
found’’ and ‘‘date entitlement arose’’
mean the same thing. Both phrases are
derived from Veterans Regulation No.
2(a), promulgated by Exec. Order 6230
(1933), which states that the effective
date of an award of pension ‘‘shall be
fixed in accordance with the facts
found’’ except that no awards would be
effective before the date of separation
from service, date of death, date of the
happening of the contingency upon
which disability or death pension is
allowed, or the date of receipt of the
claim therefor, whichever is the later
date. The various dates listed in the
immediately preceding sentence, except
for the date of receipt of the claim, are
exceptions to the rule to assign the
effective date in accordance with the
facts found, and are themselves dates
upon which entitlement to various
kinds of benefits is predicated. For all
practical purposes, these are the
relevant ‘‘facts’’ upon which entitlement
would be based.
VA has consistently so construed
Veterans Regulation No. 2(a), a fact
made clear by an examination of the
effective-date regulations VA issued
after Veterans’ Regulation No. 2(a).
These are as follows: VA Regulation
(VAR) 1148 (concerning the assignment
of effective dates for ratings made under
VA’s 1945 Schedule for Rating
Disabilities); VAR 1212 (effective date
for awards of disability compensation);
VAR 2574 (effective date of awards of
death compensation or pension), and
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VAR 2945 (effective date of payment of
dependency and indemnity
compensation). VA used the term ‘‘facts
found’’ in only two of these regulations.
VAR 2574 (Jan. 25, 1936) (which cites
Veterans Regulation No. 2(a)), VAR 2945
(Jan. 1, 1958) (which was changed from
different language to mirror the
language of what is now 38 U.S.C.
5110(a)). Instead of using ‘‘facts found,’’
VA used phrases such as ‘‘date the
evidence shows a compensable or
pensionable degree of disability to have
existed’’ and ‘‘date the evidence shows
entitlement.’’ VAR 1148 (Jan. 25, 1936).
In 1950, VAR 2574 was amended to
state that the effective date for an award
of death compensation or pension
would be the date ‘‘of the veteran’s
death, date of the happening of the
contingency upon which death
compensation or pension is allowed, or
the date of receipt of [the] application
therefor,’’ whichever is later. This
general effective-date provision is very
similar to that of Veterans Regulation
No. 2(a) except that it is devoid of the
phrase ‘‘fixed in accordance with the
facts found.’’ Nevertheless, it conveys
the same information.
When Congress first consolidated the
laws and regulations related to
compensation and pension, the present
version of what is now 38 U.S.C. 5110(a)
first appeared in the statute. Public Law
85–56, section 910(a), 71 Stat. 83, 119
(1957). The purpose of this law was to
incorporate existing law into a single
act. According to the committee reports,
Congress did not intend to make any
substantive changes to the effective date
provisions. See H.R. Rep. No. 85–279, at
2, reprinted in 1957 U.S.C.C.A.N. 1214,
1215 (1957); S. Rep. No. 85–332, at 2,
reprinted in 1957 U.S.C.C.A.N. 1214,
1241 (1957). This statute also repealed
Veterans Regulation No. 2(a). Pub. L.
No. 85–56, § 2202(129), 71 Stat. at 167.
The committee reports stated that the
law ‘‘would repeal those provisions of
law * * * which are obsolete, executed,
or restated in substance.’’ H.R. Rep. No.
85–279, at 2, S. Rep. No. 85–322, at 2.
Therefore, Public Law 85–56 was
intended to restate the substance of the
rule in Veterans Regulation No. 2(a),
despite changing the language.
Current § 3.400 uses ‘‘date entitlement
arose’’ in the introductory text and uses
‘‘facts found’’ in paragraph (a). These
two phrases have been used
interchangeably in the past, though
neither has been defined. This also
suggests that ‘‘facts found’’ and ‘‘date
entitlement arose’’ mean the same thing.
We believe that we should only use one
phrase consistently throughout the part
5 to eliminate any confusion over
whether ‘‘facts found’’ means the same
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thing as ‘‘date entitlement arose’’ and to
make the regulations more user-friendly.
Therefore, we will use ‘‘date entitlement
arose’’ in § 5.150. The proposed rule
clarifies that the term ‘‘date entitlement
arose’’ has the same meaning when used
in other effective-date regulations
throughout part 5.
We also propose to define the phrase
‘‘date entitlement arose’’ in paragraph
(a)(2) of § 5.150 to make the rule easier
to understand. As noted above, the
phrase has never been defined in the
statute or in the regulations. Proposed
paragraph (a)(2) defines ‘‘date
entitlement arose’’ as the date shown by
the evidence to be the date that the
claimant first met the requirements for
the benefit awarded. This definition
accurately expresses the intent of the
relevant statutes cited above.
We also propose to add a sentence to
emphasize that VA will assume the
‘‘date entitlement arose’’ was before the
date VA received the claim for benefits
unless the evidence indicates otherwise.
We believe it is important to provide
this guidance because in the majority of
cases, claimants meet the requirements
for a benefit before they apply for it. In
such cases, the general rule mandates
that the effective date be the date of
receipt of the claim for that benefit, and
not some later date.
Proposed § 5.150(b) sets forth a chart
that provides readers with the location
of other effective-date provisions in part
5, which are exceptions to the general
effective date rule of proposed
paragraph (a). The chart is intended
solely for informational purposes. As
proposed, the chart shows both already
published and as yet unpublished Part
5 sections. The unpublished sections are
included as placeholders; many may
change before publication. The Subpart
B provisions were published as
proposed on January 30, 2004. See 69
FR 4820.
Section 5.101(d) of Subpart C was
published as proposed on May 10, 2005.
See 70 FR 24680. Proposed §§ 5.152,
5.153, 5.162(b), 5.164, 5.165, 5.166(c),
(d), and 5.177 of Subpart C are
contained in this document.
The Subpart D provisions were
published as proposed on September 20,
2006. See 71 FR 55052.
Sections 5.463 and 5.477 of Subpart F
were published as proposed on
December 27, 2004. See 69 FR 77578.
Sections 5.567 to 5.572 of Subpart G
were published as proposed on October
1, 2004. See 69 FR 59072. A correction
to proposed § 5.570 was published on
October 21, 2004. See 69 FR 61914.
Sections 5.524(c), 5.573, and 5.574 of
Subpart G were published as proposed
on October 21, 2005. See 70 FR 61326.
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The Subpart H provisions were
published as proposed on March 9,
2007. See 72 FR 10860.
The Subpart I provisions were
published as proposed on June 30, 2006.
See 71 FR 37790.
The Subpart K provisions were
published as proposed on May 31, 2006.
See 71 FR 31056.
Section 5.151 Date of Receipt
Current § 3.1(r) sets forth a definition
of the phrase ‘‘date of receipt.’’ We
propose to address that topic in a
provision designated as § 5.151.
Proposed paragraph (a) would broaden
the concept in current § 3.1(r) to include
‘‘documents’’ in addition to claims,
information, and evidence. Although
the language in the proposed Part 5
counterparts of current §§ 3.108, 3.153,
and 3.201 does not contain the phrase
‘‘date of receipt,’’ proposed paragraph
(a) would nevertheless retain the
exceptions for these provisions that are
contained in current § 3.1(r) because
proposed paragraph (a) will refer to a
concept rather than merely define the
specific term ‘‘date of receipt.’’
Proposed paragraph (b) would
incorporate provisions from current
§ 3.1(r) authorizing VA to establish
exceptions to the general rule when a
natural or man-made disaster or similar
event has caused disruption in the
process through which VA ordinarily
receives correspondence. The intended
effect is to ensure that claimants and
beneficiaries are not deprived of
potential entitlement to benefits because
of unexpected delays or impediments
through no fault of their own. Section
512(a) of 38 U.S.C., listed as statutory
authority for proposed § 5.151, pertains
to the Secretary’s ability to delegate
authority to officials and employees to
administer the laws and make decisions.
The citation to 38 U.S.C. § 512(a) is used
to justify empowering employees and
officials to establish procedures in
emergency circumstances. Although
current § 3.1(r) makes a delegation to the
Under Secretary for Benefits, the cited
statute does not limit delegation to the
Under Secretary for Benefits.
Accordingly, proposed paragraph (b)
does not contain that limitation.
Section 5.152 Effective Dates Based on
Change of Law or VA Issue
We propose to re-state current § 3.114
in § 5.152. The heading for paragraph (b)
of proposed § 5.152, ‘‘Reduction or
discontinuance of benefits’’ differs from
the heading of current § 3.114(b),
‘‘Discontinuance of benefits,’’ in order
to describe more accurately the content
of the paragraph, which addresses both
reductions of benefits and
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discontinuances of benefits. Current
§ 3.114(b) states that a claimant has 60
days from the date of the notice of a
proposed reduction or discontinuance
of benefits in which to submit evidence
showing the proposed action should not
be taken. The last sentence of current
§ 3.114(b) states that
[i]f additional evidence is not received
within that period, the award will be reduced
or discontinued effective the last day of the
month in which the 60-day period expired.
We propose to clarify in § 5.152(b)
that if no evidence is received within 60
days, or if evidence is received that does
not demonstrate that the proposed
action should not be taken, the award
will be reduced or discontinued
effective the last day of the month in
which the 60-day period expired.
Another change has to do with the use
of the term ‘‘facts found’’ used in
current § 3.114 and in 38 U.S.C. 5110(g).
As noted in the discussion of proposed
§ 5.150, VA interprets ‘‘facts found’’ and
another phrase used in effective date
rules, ‘‘date entitlement arose,’’ to have
the same basic meaning. We are
proposing to use only one of these terms
in § 5.152, ‘‘date entitlement arose,’’ to
be consistent.
Section 5.153 Effective Date of Awards
Based on Receipt of Evidence Prior to
End of Appeal Period
We propose to revise current
§§ 3.156(b) and 3.400(q)(1)(i) in order to
establish clearer rules regarding the
effective dates for awards based on the
types of evidence described in current
§ 3.156(b).
Section 3.156(b) reads as follows:
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New and material evidence received prior
to the expiration of the appeal period, or
prior to the appellate decision if a timely
appeal has been filed (including evidence
received prior to an appellate decision and
referred to the agency of original jurisdiction
by the Board of Veterans Appeals without
consideration in that decision in accordance
with the provisions of § 20.1304(b)(1) of this
chapter), will be considered as having been
filed in connection with the claim which was
pending at the beginning of the appeal
period.
Although the words ‘‘effective date’’
do not appear in current § 3.156(b), the
substantive effect of the paragraph is to
establish an appropriate effective date,
in tandem with § 3.400(q)(1)(i).
Section 3.400(q)(1)(i) provides that
the effective date for a claim reopened
based on new and material evidence
‘‘[o]ther than service department
records’’ that are ‘‘[r]eceived within
[the] appeal period or prior to appellate
decision * * * will be as though the
former decision had not been rendered.’’
Under 38 U.S.C. 5110(a), the effective
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date for an award based on an original
claim or a claim reopened after final
adjudication (except as otherwise
provided) ‘‘shall be fixed in accordance
with the facts found, but shall not be
earlier than the date of receipt of
application therefore.’’ Therefore, if the
claim is not ‘‘finally’’ decided when VA
receives additional evidence, that is, if
the evidence is submitted within the
appeal period or before an appellate
decision is rendered, then the effective
date of the award can be as early as the
date VA received the ‘‘open’’ claim.
However, if VA were to treat all
evidence submitted after the appeal
period has begun as ‘‘new and material
evidence,’’ then the effective date could
not be earlier than the date VA received
that evidence (which would be
construed as a claim to reopen). Hence,
38 CFR 3.156(b) and 3.400(q)(1)(i)
provide a claimant-friendly effectivedate rule for awards based on evidence
received while a claim is on appeal or
before the appeal period expires. This
interpretation is consistent with 38
U.S.C. 7105(c), which provides that a
regional office denial is ‘‘final’’ when
the time limit for initiating an appeal to
the Board of Veterans’ Appeals has
expired and no appeal has been filed.
The proposed text is also consistent
with the Federal Circuit’s decision in
Jackson v. Nicholson, 449 F.3d 1204
(Fed. Cir. 2006), which held that current
§ 3.156(b) does not refer to evidence
received by VA after a Board decision
has been issued.
Proposed § 5.153 retains this favorable
interpretation, but does rephrase the
rule. The current regulation can be read
to suggest that new and material
evidence is needed while the claim is
still ‘‘open.’’ However, in such cases
there is no claim to ‘‘reopen’’ because
the claim has not been ‘‘closed’’ (that is,
the claimant could still prevail on that
claim).
General Rules on Revision of Decisions
Section 5.160
Decisions
Binding Effect of VA
Proposed § 5.160 is derived from
current § 3.104, and is intended to
clarify when a decision rendered by a
decision maker in a VA agency of
original jurisdiction is binding on other
VA agencies of original jurisdiction. The
current version provides that decisions
of a VA agency of original jurisdiction,
shall be final and binding on all field offices
of [VA] as to conclusions based on the
evidence on file at the time VA issues written
notification in accordance with 38 U.S.C.
5104. A final and binding agency decision
shall not be subject to revision on the same
factual basis except by duly constituted
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appellate authorities or except as provided in
§ 3.105 and § 3.2600 of this part.
38 CFR 3.104(a) (emphasis added).
We propose to repeat the language of
§ 3.104(a) in proposed § 5.160(a)
without any substantive change.
However, we will not repeat the word
‘‘final’’ in § 3.104(a) in proposed
§ 5.160(a). We believe that use of the
word ‘‘final’’ in this context may cause
confusion because the word ‘‘final’’ is
used elsewhere in VA’s regulations to
refer only to agency of original
jurisdiction decisions that have not been
appealed within the time limits
prescribed by statute and regulation for
their appeal. See, e.g., 38 CFR 20.302(a)
(if Notice of Disagreement not filed
within 1 year of notice of agency of
original jurisdiction decision, that
decision shall become ‘‘final’’). Further,
in 38 CFR 3.160(d), VA defines a
‘‘finally adjudicated claim’’ as one that
‘‘has been allowed or disallowed by the
agency of original jurisdiction, the
action having become final by the
expiration of 1 year after the date of
notice of an award or disallowance, or
by denial on appellate review,
whichever is the earlier.’’ This suggests
that an agency of original jurisdiction
decision might be simultaneously
‘‘final,’’ in the sense implied by
§ 3.104(a), on the date notice of the
decision is given, and ‘‘non-final,’’ in
the sense implied by § 3.160(d), because
the time within which to appeal the
decision has not yet expired.
In Majeed v. Principi, 16 Vet. App.
421, 427–28 (2002), the United States
Court of Appeals for Veterans Claims
(CAVC) rejected the argument that the
phrase ‘‘final and binding’’ in § 3.104(a)
means that a decision is final and
binding as of the date issued because it
could be seen to be at odds with the
availability of an administrative appeal.
VA does not intend that the term ‘‘’final
and binding’’ preclude an
administrative appeal. In fact, other VA
regulations specifically provide for
review of an agency of original
jurisdiction decision that has not
become final for purposes of appeal. For
example, pursuant to 38 CFR 3.2600, a
claimant may seek review of an agency
of original jurisdiction decision by a
Veterans Service Center Manager or
Decision Review Officer after filing a
Notice of Disagreement. Also, pursuant
to 38 CFR 3.105(b), if revision of an
agency of original jurisdiction decision
is warranted as a result of a difference
of opinion, an agency of original
jurisdiction may recommend to VA
Central Office that the decision be
reversed or revised.
VA therefore intends to clarify in this
rulemaking that an agency of original
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jurisdiction decision is ‘‘binding’’ on the
same or another agency of original
jurisdiction on the same factual basis,
barring a change in law, except under
the circumstances enumerated in
current § 3.104(a). Further, we have
changed the cross-references in current
§ 3.104(a) to §§ 3.105 and 3.2600 to
match their part 5 counterparts.
Paragraph (b) of § 3.104 currently
provides that decisions made by an
agency of original jurisdiction and VA
Insurance Service adjudicators, which
are ‘‘made in accordance with existing
instructions,’’ concerning character of
service, character of discharge,
relationship issues, and other matters,
are reciprocally binding when they are
based on the same criteria. VA proposes
not to include the phrase ‘‘made in
accordance with existing instructions’’
from this paragraph because the
instructions to which it refers are
contained in VA procedural manuals
rather than regulations in title 38, Code
of Federal Regulations. The deletion of
this phrase does not imply that VA is
not required to follow the laws and
regulations pertaining to the making of
determinations of the type described in
paragraph (b). It merely reflects a
judgment that references to internal
procedural manuals and other VAgenerated documents that lack the force
and effect of law are not appropriate for
inclusion in the regulations.
Finally, we propose to replace the
terms ‘‘adjudication activity’’ and
‘‘insurance activity’’ contained in
§ 3.104(b) with ‘‘Veterans Service
Center’’ and ‘‘VA Insurance Center,’’
respectively; again, because these are
the more precise modern designations of
the relevant entities. These proposed
changes would simply modify the
terminology to make it easier for the
public to understand.
Section 5.161
Decisions
Review of Benefit Claims
We propose to repeat the language of
§ 3.2600 in proposed § 5.161 without
any substantive change. We have only
changed the cross-references in current
§ 3.2600 to §§ 3.103 and 3.105 to match
their part 5 counterparts.
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Section 5.162 Revision of Decisions
Based on Clear and Unmistakable Error
(CUE)
In § 5.162, we propose to state clearly
that VA adjudicative agency decisions
that are final will be presumed correct
unless there is a showing of clear and
unmistakable error (CUE). In addition,
this section will state the effective date
for awards resulting from the revision or
reversal, based on a finding of clear and
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unmistakable error, of prior final
decisions.
Proposed § 5.162 will not deviate in
scope from the body of law that
precedes it. Consequently, § 5.162
provides that, absent CUE, prior final
decisions are accepted as correct. The
requirement of a showing of CUE
applies only to a ‘‘final decision,’’ as
defined by proposed § 5.2 to mean ‘‘a
decision on a claim for VA benefits with
respect to which VA provided the
claimant with written notice’’ and the
claimant either did not file a timely
Notice of Disagreement or Substantive
Appeal or the Board has issued a final
decision on the claim. See 71 FR 16464,
16473–74 (March 31, 2006). We also
proposed to incorporate 38 U.S.C.
5109A(c) and (d), which state that a
CUE claim may be instituted by VA or
upon request of the claimant and that a
CUE claim may be made at any time
after a final decision is made.
We propose not to include the
examples of determinations contained
in the first sentence of current § 3.105(a)
(‘‘decisions of service connection,
degree of disability, age, marriage,
relationship, service, dependency, line
of duty, and other issues’’). Because the
examples conclude with ‘‘* * * and
other issues,’’ they would include any
determination. Likewise, the proposed
rule applies to any determination. By
eliminating the examples, we intend to
emphasize that the rule applies to any
determination and avoid a
misperception that the examples are a
limitation on the rule.
Section 5.163 Revision of Decisions
Based on Difference of Opinion
Current § 3.105(b) provides that where
an agency of original jurisdiction
believes that revising or amending a
previous decision is warranted, based
on a difference of opinion, a
recommendation will be made to VA
Central Office to authorize a change in
the decision. We have used the term
‘‘Director of the Compensation and
Pension Service’’ instead of ‘‘[VA]
Central Office’’ and used the term
‘‘Veterans Service Center Manager
(VSCM)’’ instead of ‘‘adjudicative
agency’’ to accurately reflect longstanding VA practices. Additionally, we
propose to state that this section
authorizes revisions only when they
would lead to a more favorable decision
on the claim that was the subject of a
prior decision, and that this section
does not apply to a prior decision that
is final or has been the subject of a
Substantive Appeal.
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Section 5.164 Effective Dates for
Revision of Decisions Based on
Difference of Opinion
We propose in § 5.164 to state VA’s
effective-date provision applicable to
revisions of decisions based on
difference of opinion. Proposed § 5.164
provides that the effective date of the
revision would be the date benefits
would have been paid if the previous
decision had been favorable.
Section 5.165 Effective Dates for
Reduction or Discontinuance of Awards
Based on Error
Paragraphs (a), (b), and (c)(1) of
proposed § 5.165 are derived from
current § 3.500(b)(1) and (2), which
govern the effective dates of reductions
or discontinuances of awards of
compensation, DIC, or pension based on
error. In paragraph (a), we propose to
exclude from § 5.165 payment amounts
that are not authorized by a VA rating
decision, such as a payment of an
incorrect amount or a duplicative
payment. Proposed § 5.165 applies only
to reductions or discontinuances of
erroneous awards. If a payment has not
been authorized by a rating decision,
then VA has not made an award of such
an erroneous payment and therefore
recovery of that payment is not a
reduction or discontinuance of an
‘‘erroneous award’’ under 38 U.S.C.
5112(b)(9) or (10). We would add in
paragraph (a) that ‘‘[s]uch amounts are
overpayments, subject to recoupment.’’
We propose to rewrite the current
language of § 3.500(b) to enhance its
readability. We also propose not to
include the word ‘‘payee’’ and insert in
its place the term ‘‘beneficiary.’’ The
term ‘‘beneficiary’’ is consistent with
the phrasing of the authorizing statute,
38 U.S.C. 5112(b)(9).
In paragraph (c)(2), we propose to add
a new definitional section that will
clearly define ‘‘administrative error’’
and ‘‘error in judgment.’’ This definition
will clearly show when these terms are
applicable and will be consistent with
precedential opinions prepared by VA’s
General Counsel. VAOPGCPRECs 2–90
(March 20, 1990) and 6–97 (January 18,
1997) held that an administrative error
includes an error of fact (for example,
VA mistakes or overlooks the facts or
commits a purely clerical error) and that
an error in judgment includes those
instances when VA fails to properly
interpret, understand, or follow
Department instructions, regulations, or
statutes. The proposed definitional
section will assist the users of the
regulation in determining under what
circumstances VA may have committed
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administrative error or an error in
judgment.
Section 5.166 New and Material
Evidence Based on Service Department
Records
Current § 3.156(c) addresses those
situations when a prior final decision is
being reconsidered based on the official
service department records. We repeat
that language in proposed § 5.166.
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General Rules on Protection or
Reduction of Existing Ratings
Currently, the rules that protect
existing VA disability ratings from
either reduction or severance are located
in several different subparts within part
3 of title 38, CFR. For example, most of
the substantive rules on the subject (38
CFR 3.951 et seq.) are located under the
undesignated part 3 subheading,
‘‘Protections;’’ however, substantive
rules relevant to severance of service
connection, as well as unique
procedural provisions, are also located
in current 38 CFR 3.105. Meanwhile,
lesser protections afforded to stable
ratings are located in § 3.344.
We therefore propose to reorganize
these rules under the undesignated
subheading, ‘‘General Rules on
Protection or Reduction of Existing
Ratings,’’ in part 5 of title 38, CFR. This
reorganization will contain the general
rules that relate to the protection of
existing ratings, which are found in
current 38 CFR 3.105. It will also
include those rules pertaining to the
protection of the following ratings:
Those that have stabilized, those in
existence for a 20-year period, those
based on the 1925 Schedule of Rating
Disabilities, those in effect on December
31, 1958, and those in effect for a 10year period. These are derived from
current §§ 3.344, 3.951 through 3.953,
and 3.957, respectively.
This reorganized portion does not
include current § 3.950, the rule relating
to the awards of pension or
compensation to a helpless child,
because this rule does not protect an
existing rating. It also does not include
current § 3.954, the rule relating to
awards of burial benefits, which will be
addressed in another NPRM. The part 5
rule relating to federal employees’
compensation cases, current § 3.958,
will be located with the proposed
regulations regarding concurrent
receipt; the rule relating to tuberculosis
(current § 3.959) will be located with the
regulations regarding tuberculosis; and
the rule relating to Section 306 and OldLaw pension protection (current § 3.960)
is located with the regulations regarding
pension.
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Section 5.170 Calculation of 5-Year,
10-Year, and 20-Year Protection Periods
Current § 3.344 provides that ‘‘ratings
which have continued for long periods
at the same level (5 years or more)’’
cannot be reduced absent a
reexamination ‘‘disclosing
improvement, physical or mental, in
these disabilities.’’ We propose in
§ 5.170 to set forth general provisions
governing how VA determines whether
a rating has been continuously in place
for the 5-year period currently found in
§ 3.344. This rule also sets forth those
provisions that apply to determining
whether a 20-year period has been
continuous, such that a rating is
protected under the part 5 equivalent of
38 CFR 3.951(b). Additionally, proposed
§ 5.170 determines how to calculate
whether service connection has been in
effect for 10 years and is, therefore,
protected under the part 5 equivalent of
38 CFR 3.957. It is preferable to state the
general rules applicable to calculating
these periods in one regulation rather
than repeat the concepts in multiple
regulations.
Proposed paragraph (b) states the
general rule that the described periods
begin on the effective date of the
protected award or rating and end on
the date that service connection would
be severed or the rating reduced. This
provision takes into account any
applicable due process provisions
contained in current § 3.105 and
proposed § 5.176. The method of
measuring the duration of a rating is
explicit in current §§ 3.951 and 3.957;
but it is not explicit in § 3.344.
However, the implicit measurement
method in § 3.344 is consistent with
VA’s current practice and policy, and
with the interpretation of current
§ 3.344(c) set forth in Brown v. Brown,
5 Vet. App. 413 (1993). In that case, the
Court held: ‘‘[T]he duration of a rating
for purposes of § 3.344(c) must be
measured from the effective date
assigned that rating until the effective
date of the actual reduction. * * *
[T]hose results flow from the plain and
unambiguous language of the
regulation.’’ Brown, 5 Vet. App. at 418–
419. We believe that making the
effective-date-measurement rule
explicitly applicable to the 5-year
protection against reduction set forth in
§ 3.344, as it is in current §§ 3.951 and
3.957, will help clarify VA’s practice on
this issue.
The requirement that the 20-year
protection period be continuous is set
forth in 38 U.S.C. 110, which protects
certain ratings that have been
‘‘continuously in force for twenty or
more years.’’ Therefore, proposed
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paragraph (c) states that ‘‘a rating is not
continuous if benefits based on that
rating are discontinued or interrupted
because the veteran reentered active
service.’’ See VAOGCPREC 5–95
(holding that a rating discontinued
based on reentry into service was not
continuous for 20 years for purposes of
section 110).
We believe that the holding of
VAOGCPREC 5–95 logically should
apply to the continuity requirement for
the 5-year protection set forth in current
§ 3.344(c). Explicitly stating this rule in
proposed § 5.170(c) will promote
consistency in decision making by VA
staff.
The rule of 5.170(c) regarding re-entry
into active service does not apply to
break the 10-year period of proposed
§ 5.175 for protection of service
connection. Under current § 3.654(b),
the prior determination ‘‘of service
connection is not disturbed’’ because of
the re-entry into active service. Because
service connection remains in effect, the
period of continuity is not broken.
Proposed paragraph (d) states that a
rating period may be protected without
regard to whether the beneficiary
actually received VA compensation
based on that rating. This is based on
current VA policy. We note that this
rule is intended to apply to all
adjustments, except for reentry of active
service, including a beneficiary whose
payments were adjusted by deduction,
recoupment, apportionment, reduction
in compensation due to incarceration,
and a beneficiary who elected to receive
retirement pay. These common
examples are listed in proposed
paragraph (d).
Proposed paragraph (e) extends the
protections found in current §§ 3.344,
3.951, and 3.957 to retroactive increases
in rating or grants of service connection,
including those awarded based on clear
and unmistakable error (CUE) under
current § 3.105(a)/proposed § 5.162. In
addition, the rule clearly states that it
applies to any protection period even if
it includes a period based on a
retroactive award. The extension to
retroactive awards is not a new VA
practice. First, as to retroactive awards
not based on a finding of CUE, the
practice is well-established, even as to
current § 3.344. See, e.g., Brown v.
Brown, 5 Vet. App. 413, 417 (1993). The
application of the retroactive protection
to the 20-year period in cases based on
findings of CUE is required by 38 U.S.C.
110. See VAOGCPREC 68–91 (citing
H.R. Rep. No. 533, 83rd Cong., 1st Sess.
2 (1953); Pub. L. No. 88–445, 78 Stat.
464 (1964); and VAOGCPREC 16–89).
The legislative intent behind applying a
retroactive award to form the 20-year
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protection should apply as well to the
regulatory 5-year protection because the
purpose of § 3.344 is similar to the
purpose of § 110 in that both protections
support the economic and humane
considerations noted above. Finally, the
proposed regulation provides explicit
protection to veterans, and is in keeping
with our consistent treatment of the
three time periods set forth in current
§§ 3.344, 3.951, and 3.957 in other
respects, as described in the other
paragraphs in this proposed rule.
Section 5.171 Protection of 5-Year
Stabilized Ratings
Proposed § 5.171 is derived from
current § 3.344. Proposed paragraph (a)
restates in plain language the first
sentence of current § 3.344(a). Proposed
paragraph (b) is primarily derived from
the first sentence of current § 3.344(c),
which states: ‘‘The provisions of
paragraphs (a) and (b) of this section
apply to ratings which have continued
for long periods at the same level (5
years or more).’’ Proposed paragraph (b)
rephrases the current rule, as follows:
‘‘For the purposes of this section, if a
disability has been rated at or above a
specific level for 5 years or more, VA
will consider it to be stabilized at that
specific level.’’ No substantive change is
intended.
Proposed paragraph (c) states two
criteria that must be present before we
will reduce a stabilized rating. The first
criterion is stated in proposed paragraph
(c)(1), and requires that there be ‘‘[a]n
examination [that] shows sustainable
material improvement, * * * in the
disability.’’ The requirement of
‘‘material improvement’’ is based on the
third sentence of current § 3.344(c),
which states, ‘‘[r]eexaminations
disclosing improvement, physical or
mental, in these disabilities will warrant
reduction in rating.’’ We propose to
change ‘‘improvement’’ to ‘‘material
improvement.’’ ‘‘Material improvement’’
is what is intended in current § 3.344(c),
as evidenced by the use of the term
‘‘material improvement’’ in paragraph
(a) of the current regulation. Finally,
‘‘material improvement’’ is the standard
used to measure a protected or
stabilized rating in other similar
regulations. See 38 CFR 3.327(b)(2)(ii)
(disability will not be subject to
scheduled reexamination ‘‘[w]hen the
findings and symptoms are shown by
examinations * * * and hospital
reports to have persisted without
material improvement for a period of 5
years or more’’); 38 CFR 3.343(a)
(‘‘[t]otal disability ratings * * * will not
be reduced * * *. without examination
showing material improvement in
physical or mental condition’’).
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Proposed paragraph (c)(2) states the
second criterion that must be present
before VA will reduce a stabilized
rating, which is that ‘‘[t]he evidence
shows that it is reasonably certain that
the material improvement will be
maintained under the ordinary
conditions of life.’’ This requirement is
drawn directly from the seventh
sentence of current § 3.344(a).
We propose not to retain the secondto-last sentence of current § 3.344(c),
which states: ‘‘[The provisions of this
rule] do not apply to disabilities which
have not become stabilized and are
likely to improve.’’ Proposed paragraph
(c) clearly states that this rule applies to
the reduction of stabilized ratings. The
term ‘‘stabilized ratings’’ is clearly
defined in proposed paragraph (b), and
does ‘‘not apply to disabilities which
have not become stabilized.’’ Therefore,
the second-to-last sentence of current
§ 3.344(c) is unnecessary.
Proposed paragraph (d) is derived
from current § 3.344(a). In the current
regulation, paragraph (a) contains ten
sentences, nine of which articulate
specific and distinct adjudicative rules.
Three of these sentences also contain
lists of various disabilities that are
affected by the specific rule articulated
in the sentence. Current paragraph (a)
does not organize those ten sentences
either by associating similar concepts or
by setting the rules out in numbered
paragraphs. We apply both of these
organizational tools in the proposed
rule, in order to improve readability and
help users locate the parts of the
paragraph that apply to their particular
cases.
In essence, § 3.344(a) lists and
describes the evidence required by VA
to justify the reduction of a stabilized
rating. Hence, we propose to title the
paragraph that restates most of the rules
contained in current § 3.344(a), ‘‘How
VA determines whether there has been
material improvement.’’
The proposed rule required
significant reorganization of the current
rule. In order to show clearly what we
have done, we have reproduced below
the current regulation, with numbers
before each of the 10 sentences. Then,
we have indicated how our proposed
rule would dispose of each sentence of
the existing rule.
(a) Examination reports indicating
improvement. [1] Rating agencies will handle
cases affected by change of medical findings
or diagnosis, so as to produce the greatest
degree of stability of disability evaluations
consistent with the laws and Department of
Veterans Affairs regulations governing
disability compensation and pension. [2] It is
essential that the entire record of
examinations and the medical-industrial
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history be reviewed to ascertain whether the
recent examination is full and complete,
including all special examinations indicated
as a result of general examination and the
entire case history. [3] This applies to
treatment of intercurrent diseases and
exacerbations, including hospital reports,
bedside examinations, examinations by
designated physicians, and examinations in
the absence of, or without taking full
advantage of, laboratory facilities and the
cooperation of specialists in related lines. [4]
Examinations less full and complete than
those on which payments were authorized or
continued will not be used as a basis of
reduction. [5] Ratings on account of diseases
subject to temporary or episodic
improvement, e.g., manic depressive or other
psychotic reaction, epilepsy, psychoneurotic
reaction, arteriosclerotic heart disease,
bronchial asthma, gastric or duodenal ulcer,
many skin diseases, etc., will not be reduced
on any one examination, except in those
instances where all the evidence of record
clearly warrants the conclusion that
sustained improvement has been
demonstrated. [6] Ratings on account of
diseases which become comparatively
symptom free (findings absent) after
prolonged rest, e.g. residuals of phlebitis,
arteriosclerotic heart disease, etc., will not be
reduced on examinations reflecting the
results of bed rest. [7] Moreover, though
material improvement in the physical or
mental condition is clearly reflected the
rating agency will consider whether the
evidence makes it reasonably certain that the
improvement will be maintained under the
ordinary conditions of life. [8] When syphilis
of the central nervous system or alcoholic
deterioration is diagnosed following a long
prior history of psychosis, psychoneurosis,
epilepsy, or the like, it is rarely possible to
exclude persistence, in masked form, of the
preceding innocently acquired
manifestations. [9] Rating boards
encountering a change of diagnosis will
exercise caution in the determination as to
whether a change in diagnosis represents no
more than a progression of an earlier
diagnosis, an error in prior diagnosis or
possibly a disease entity independent of the
service-connected disability. [10] When the
new diagnosis reflects mental deficiency or
personality disorder only, the possibility of
only temporary remission of a super-imposed
psychiatric disease will be borne in mind.
At the outset, we note that, as
discussed above, sentence 1 of § 3.344(a)
is reflected in the proposed paragraph
(a) and sentence 7 of § 3.344(a) is
reflected in proposed paragraph (c)(2).
Proposed paragraph (d)(1) is derived
from current § 3.344(a) sentences 2, 3,
and 4, which together emphasize the
requirement that only a complete
examination, including a review of the
full medical record, can serve as a basis
for a reduction under this section. The
items needed for a complete medical
record are in the proposed rule. The list
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includes all of the items in the current
rule.
Proposed paragraph (d)(2) restates in
plain language current § 3.344(a)
sentence 5, which states, ‘‘lists those
diseases that will not be reduced on any
one examination, absent evidence
showing sustained improvement.’’ The
list of diseases contained in the existing
rule is set off as indented ‘‘bullet
points,’’ to improve readability. In
addition, we note that the term ‘‘manic
depressive’’ is no longer an accepted
term in the psychiatric community. It
has been replaced by the term ‘‘Bipolar
Disorders.’’ See American Psychiatric
Association, Diagnostic and Statistical
Manual of Mental Disorders, 382–401
(4th ed. 2000). We therefore propose to
use the term ‘‘Bipolar Disorders’’
instead of using ‘‘manic depressive.’’ In
addition, we note that the term
‘‘psychoneurotic reaction’’ is no longer
an accepted term in the psychiatric
community. It has been replaced by the
term ‘‘Anxiety Disorders.’’ See
American Psychiatric Association,
Diagnostic and Statistical Manual of
Mental Disorders, 429–484 (4th ed.
2000). We therefore propose to use the
term ‘‘Anxiety Disorders’’ instead of
using ‘‘psychoneurotic reaction.’’
The intent behind sentence 5 of
§ 3.344(a) is not that every single piece
of evidence of record clearly warrants
the conclusion that sustained
improvement has been demonstrated.
Such a literal interpretation would lead
to an absurd result because in a case
where a rating has been in effect for 8
years, the evidence from 6–8 years
would not show sustained
improvement; only more recent
evidence would show sustained
improvement. Sentence 5 uses ‘‘all’’ to
refer to the evidentiary record as a
whole. We propose to not include the
word ‘‘all’’ in paragraph (d) to clarify
that VA does not intend that every
single piece of evidence of record must
clearly warrant the conclusion that
sustained improvement has been
demonstrated, but rather that the
evidentiary record as a whole must
clearly warrant such a conclusion.
Proposed paragraph (d)(3) restates in
plain language current § 3.344(a)
sentence 6.
Proposed (d)(4) provides a statement
of VA’s policy as to when it will find
‘‘material improvement’’ to exist, as
follows: ‘‘(4) Material improvement will
be held to exist only where, after full
compliance with the procedure outlined
in this paragraph (d), the medical record
clearly demonstrates that the disability
does not meet the requirements for the
currently assigned disability rating.’’
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Proposed paragraph (d)(5) reflects the
first, ninth, and tenth sentences of
current § 3.344(a), and references a
similar rule, 38 CFR 4.13. Section 4.13
states that in reevaluating a case based
on a change in diagnosis, ‘‘The
repercussion upon a current rating of
service connection when change is
made of a previously assigned diagnosis
or etiology must be kept in mind. The
aim should be the reconciliation and
continuance of the diagnosis or etiology
upon which service connection for the
disability had been granted.’’ Section
4.13 is similar to § 3.344(a) sentence 1,
but the language of § 4.13 more clearly
places emphasis on the protection of the
existing rating. Therefore, we explicitly
require consideration of the part 4 rule
when VA is confronted with evidence of
a change in diagnosis.
Proposed paragraph (d)(6) restates
without alteration current § 3.344(a)
sentence 8.
Proposed paragraph (e) restates, in
plain language, current § 3.344(b). We
note that the current rule requires VA to
cite ‘‘the former diagnosis with the new
diagnosis in parentheses,’’ whereas the
proposed rule would require VA to cite
‘‘the former diagnosis with the new
diagnosis, if any, in parentheses’’
(emphasis added). This change clarifies
that proposed paragraph (e) applies to
any basis for reduction, not just to
reductions based on a changed
diagnosis.
Section 5.172 Protection of Continuous
20-Year Ratings
Proposed § 5.172 is based on current
§ 3.951(b), which protects disability
ratings and ratings of permanent and
total disability for pension purposes that
have been in effect for at least 20 years.
Proposed paragraph (a) restates in
plain language the protection in current
§ 3.951(b) afforded to disabilities rated
for periods in which the beneficiary was
receiving compensation. It would not
include the phrase ‘‘under laws
administered by the Department of
Veterans Affairs’’ because there is no
ambiguity concerning whether this
regulation applies to ratings under VA
regulations.
Proposed paragraph (b) restates in
plain language the current protection
afforded in current § 3.951(b) to a rating
of permanent total disability for pension
purposes.
Proposed paragraph (c) states that the
20-year protection against reduction
applies ‘‘whether or not the veteran
elects to receive disability compensation
or pension during all or any part of the
20-year period.’’ This additional
language reflects the holding of Salgado
v. Brown, 4 Vet. App. 316, 320 (1993)
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(‘‘The Court holds that the protection
afforded by section 110 of title 38 of the
United States Code applies to ratings for
compensation purposes, whether or not
a veteran elects to receive a monetary
award.’’). Because 38 U.S.C. 110 applies
to both pension and compensation, we
propose to include pension in proposed
paragraph (c).
Section 5.173 Protection Against
Reduction of Disability Ratings When
Revisions Are Made to the Schedule for
Rating Disabilities
Proposed § 5.173 is derived from
current §§ 3.951 and 3.952. Section
3.951(a) states that VA will not reduce
any disability rating in effect on the
effective date of a revision of the
applicable Schedule for Rating
Disabilities, based on such revisions,
unless medical evidence establishes that
the rated disability has actually
improved. Current § 3.952 applies that
protection, with some modification, to
ratings assigned under the Schedule of
Disability Ratings, 1925, which were the
basis of compensation on April 1, 1946,
when the current Schedule of Disability
Ratings took effect. Proposed § 5.173
combines the general rule in current
§ 3.951(a) with the specific rule in
current § 3.952, into a single regulation
titled, ‘‘Protection against reduction of
disability ratings when revisions are
made to the Schedule for Rating
Disabilities.’’ At the end of the proposed
regulation, we cross-reference proposed
§ 5.176, the regulation that describes the
process required before reducing a
rating.
Proposed paragraph (a) restates in
plain language the general rule in
current § 3.951(a), as follows: ‘‘VA will
not reduce a disability rating in effect on
the effective date of a revision of the
applicable Schedule for Rating
Disabilities unless medical evidence
establishes that the rated disability has
actually improved, except when the
rating was assigned under the 1925
Schedule of Disability Ratings (as
provided in paragraph (b) of this
section).’’
Proposed paragraph (b) of § 5.173
restates in plain language the
protections afforded under current
§ 3.952. These changes are meant to
make the rules easier to follow; no
substantive changes are intended.
Section 5.174 Protection of
Entitlement to Benefits Established
Before 1959
Proposed § 5.174 is based on current
§ 3.953. We propose not to include
current § 3.953(b), which refers to
emergency officers’ retirement pay
payable to veterans of World War I. We
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believe it is very unlikely that VA will
receive any more claims for this benefit.
However, if such a claim were to be
received, Section 11, Public Law 85–857
would be used to adjudicate the claim.
Section 5.175 Protection or Severance
of Service Connection
Proposed § 5.175 is derived from
current §§ 3.957 and 3.105(d). Proposed
§ 5.175(a) incorporates current § 3.957,
which states that service connection for
disability or death may be protected if
it has been in effect for 10 years or more.
Such a rating may not be severed unless
any of the following are shown: (1) The
original grant was obtained through
fraud; or, (2) military records clearly
show that the person identified as a
veteran did not have the requisite
qualifying service; or, (3) military
records clearly show that the veteran’s
discharge from service was a bar to
service connection. See 38 CFR 3.12. We
would include the current rule in the
provision governing severance of service
connection because the rule advises
claimants of circumstances when a
protected rating may be severed.
Proposed § 5.175(b) provides that
severance of service connection may
also occur when evidence establishes
that it is clearly and unmistakably
erroneous (the burden of proof being
upon VA), subject to §§ 5.152 and 5.176.
This paragraph further provides that a
change in medical diagnosis may be a
basis for severing service connection if
the examining physician or physicians
or other proper medical authority
certifies that, in light of all accumulated
evidence, the diagnosis that was the
basis of the award is clearly erroneous.
That certification must be accompanied
by a summary of the facts, findings, and
reasons supporting the conclusion that
the diagnosis is erroneous.
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Section 5.176 Due Process Procedures
for Severing Service Connection or
Reducing or Discontinuing
Compensation Benefits
Proposed § 5.176 re-states current
§ 3.105(d), (e). Current § 3.105(d) and (e)
state that a claimant has 60 days from
the date of the notice of a proposed
severance of service connection or
reduction or discontinuance of benefits
in which to submit evidence showing
the proposed action should not be
taken. The last sentence of both current
§ 3.105(d) and current § 3.105(e) states
that
[i]f additional evidence is not received
within that period, final rating action will be
taken and the award will be reduced or
discontinued * * * effective the last day of
the month in which a 60-day period from the
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date of notice to the beneficiary of the final
rating action expires.
We propose to clarify in § 5.176(c)
that if no evidence is received within 60
days, or if evidence is received that does
not demonstrate that the proposed
action should not be taken, VA will
notify the beneficiary that VA is
severing service connection or reducing
or discontinuing the benefit.
Section 5.177 Effective Dates for
Severing Service Connection or
Discontinuing or Reducing Benefit
Payments
Proposed § 5.177 contains the
effective date provisions related to
severance of service connection and
reduction or discontinuance of benefits.
It is derived from various provisions of
current § 3.105. We propose in
paragraph (a) to restate the provisions
found in the introductory paragraph of
§ 3.105 regarding effective dates for
reductions or discontinuances of
suspended awards. We propose in
paragraph (c) to list the three exceptions
to § 5.177, which are derived from the
introductory paragraph of § 3.105 and
current § 3.500(b). We propose not to
include the exception for cases where
the award of service connection was
‘‘clearly illegal’’ because such cases
would properly fall within § 3.105 and
proposed § 5.177(d).
We propose in paragraphs (d) through
(i), to state the specific type of benefit
that is the subject of the particular
effective date rule and to explain when
the benefit will be reduced, stopped, or
severed. These effective date provisions
are from paragraphs (c) through (h) of
the current version of § 3.105.
Endnote Regarding Amendatory
Language
We intend to ultimately remove part
3 entirely, but we are not including
amendatory language to accomplish that
at this time. VA will provide public
notice before removing part 3.
Paperwork Reduction Act
This document contains no provisions
constituting a new collection of
information under the Paperwork
Reduction Act (44 U.S.C. 3501–3521).
Regulatory Flexibility Act
The Secretary hereby certifies that
this regulatory amendment will not
have a significant economic impact on
a substantial number of small entities as
they are defined in the Regulatory
Flexibility Act (RFA), 5 U.S.C. 601–612.
This amendment would not
significantly impact any small entities.
Therefore, pursuant to 5 U.S.C. 605(b),
this amendment is exempt from the
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initial and final regulatory flexibility
analysis requirements of sections 603
and 604.
Executive Order 12866
Executive Order 12866 directs
agencies to assess all costs and benefits
of available regulatory alternatives and,
when regulation is necessary, to select
regulatory approaches that maximize
net benefits (including potential
economic, environmental, public health
and safety, and other advantages;
distributive impacts; and equity). The
Executive Order classifies a ‘‘significant
regulatory action,’’ requiring review by
the Office of Management and Budget
(OMB) unless OMB waives such review,
as any regulatory action that is likely to
result in a rule that may: (1) Have an
annual effect on the economy of $100
million or more or adversely affect in a
material way the economy, a sector of
the economy, productivity, competition,
jobs, the environment, public health or
safety, or State, local, or tribal
governments or communities; (2) create
a serious inconsistency or otherwise
interfere with an action taken or
planned by another agency; (3)
materially alter the budgetary impact of
entitlements, grants, user fees, or loan
programs or the rights and obligations of
recipients thereof; or (4) raise novel
legal or policy issues arising out of legal
mandates, the President’s priorities, or
the principles set forth in the Executive
Order.
The economic, interagency,
budgetary, legal, and policy
implications of this proposed rule have
been examined, and it has been
determined to be a significant regulatory
action under the Executive Order
because it is likely to result in a rule that
may raise novel legal or policy issues
arising out of legal mandates, the
President’s priorities, or the principles
set forth in the Executive Order.
Unfunded Mandates
The Unfunded Mandates Reform Act
of 1995 requires, at 2 U.S.C. 1532, that
agencies prepare an assessment of
anticipated costs and benefits before
issuing any rule that may result in an
expenditure by State, local, and tribal
governments, in the aggregate, or by the
private sector of $100 million or more
(adjusted annually for inflation) in any
given year. This proposed rule would
have no such effect on State, local, and
tribal governments, or the private sector.
Catalog of Federal Domestic Assistance
Numbers and Titles
The Catalog of Federal Domestic
Assistance program numbers and titles
for this proposal are 64.100,
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Automobiles and Adaptive Equipment
for Certain Disabled Veterans and
Members of the Armed Forces; 64.101,
Burial Expenses Allowance for
Veterans; 64.102, Compensation for
Service-Connected Deaths for Veterans’
Dependents; 64.104, Pension for NonService Connected Disability for
Veterans; 64.105, Pension to Veterans
Surviving Spouses, and Children;
64.106, Specially Adapted Housing for
Disabled Veterans; 64.109, Veterans
Compensation for Service-Connected
Disability; 64.110, Veterans Dependency
and Indemnity Compensation for
Service-Connected Death; 64.115,
Veterans Information and Assistance;
and 64.127, Monthly Allowance for
Children of Vietnam Veterans Born with
Spina Bifida.
List of Subjects in 38 CFR Part 5
Administrative practice and
procedure, Claims, Disability benefits,
Pensions, Veterans.
Approved: February 8, 2007.
Gordon H. Mansfield,
Deputy Secretary of Veterans Affairs.
For the reasons set out in the
preamble, VA proposes to further
amend 38 CFR part 5, as proposed to be
added at 69 FR 4832, January 30, 2004,
by adding subpart C to read as follows:
PART 5—COMPENSATION, PENSION,
BURIAL, AND RELATED BENEFITS
Subpart C—Adjudicative Process,
General
General Evidence Requirements
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Sec.
5.130 Submission of statements, evidence,
or information affecting entitlement to
benefits.
5.131 Applications, claims, and exchange of
evidence with Social Security
Administration (SSA)—death benefits.
5.132 Claims, statements, evidence, or
information filed abroad; authentication
of documents from foreign countries.
5.133 Information VA may request from
financial institutions.
5.134 Will VA accept a signature by mark
or thumbprint?
5.135 Statements certified or under oath or
affirmation.
5.136–5.139 [Reserved]
Evidence Requirements for Former Prisoners
of War (POWS)
5.140 Determining former prisoner of war
status.
5.141 Medical evidence for former
prisoners’ of war compensation claims.
5.142–5.149 [Reserved]
General Effective Dates for Awards
5.150 General effective dates for awards or
increased benefits.
5.151 Date of receipt.
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5.152 Effective dates based on change of
law or VA issue.
5.153 Effective date of awards based on
receipt of evidence prior to end of appeal
period.
5.154–5.159 [Reserved]
General Rules on Revision of Decisions
5.160 Binding effect of VA decisions.
5.161 Review of benefit claims decisions.
5.162 Revision of decisions based on clear
and unmistakable error (CUE).
5.163 Revision of decisions based on
difference of opinion.
5.164 Effective dates for revision of
decisions based on difference of opinion.
5.165 Effective dates for reduction or
discontinuance of awards based on error.
5.166 New and material evidence based on
service department records.
5.167–5.169 [Reserved]
General Rules on Protection or Reduction of
Existing Ratings
5.170 Calculation of 5-year, 10-year, and
20-year protection periods.
5.171 Protection of 5-year stabilized ratings.
5.172 Protection of continuous 20-year
ratings.
5.173 Protection against reduction of
disability ratings when revisions are
made to the Schedule for Rating
Disabilities.
5.174 Protection of entitlement to benefits
established before 1959.
5.175 Protection or severance of service
connection.
5.176 Due process procedures for severing
service connection or reducing or
discontinuing compensation benefits.
5.177 Effective dates for severing service
connection or discontinuing or reducing
benefit payments.
5.178–5.179 [Reserved]
Authority: 38 U.S.C. 501(a) and as noted in
specific sections.
Subpart C—Adjudicative Process,
General
General Evidence Requirements
§ 5.130 Submission of statements,
evidence, or information affecting
entitlement to benefits.
(a) Statement of VA policy concerning
submission of written statements,
evidence, or information. (1) It is VA’s
general policy to allow submission of
statements, evidence, or information by
e-mail, facsimile (fax) machine, or other
electronic means, unless a VA
regulation, form, or directive expressly
requires a different method of
submission (for example, where a VA
form directs claimants to submit certain
documents by regular mail or hand
delivery). This policy does not apply to
the submission of a claim, Notice of
Disagreement, Substantive Appeal, or
any other submissions or filing
requirements covered in parts 19 and 20
of this chapter.
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(2) Paragraph (a)(1) of this section
merely concerns the method by which
written statements, evidence, or
information is submitted to VA.
Requirements regarding the content of
the submission must still be met.
(b) VA action following submission of
statements, evidence, or information.
Except as otherwise provided, after a
beneficiary or his or her fiduciary or
authorized representative provides VA
with a statement, evidence, or
information that affects entitlement to
benefits, either orally or in writing, VA
may take action affecting the
beneficiary’s entitlement to benefits
based upon the statement, evidence, or
information.
(c) Notice and documentation or oral
statements. Except as provided in
paragraph (d) of this section, VA will
not take action based on oral statements
unless the VA employee receiving the
information meets the following
conditions:
(1) During the conversation in which
the beneficiary, representative, or
fiduciary provides the statement, the VA
employee:
(i) Identifies himself or herself as a
VA employee who is authorized to
receive the statement (this means that
the VA employee must be authorized to
take actions under §§ 2.3 or 3.100 of this
chapter);
(ii) Verifies the identity of the
provider as the beneficiary or his or her
fiduciary or authorized representative
by obtaining specific information about
the beneficiary that is contained in the
beneficiary’s VA records, such as Social
Security number, date of birth, branch
of military service, dates of military
service, or other information; and
(iii) Informs the provider that the
statement may be used to calculate
benefit amounts; and
(2) During or following the
conversation in which the beneficiary,
representative, or fiduciary provides the
statement, the VA employee documents
in the beneficiary’s VA record all of the
following:
(i) The specific statement provided.
(ii) The date such statement was
provided.
(iii) The identity of the provider.
(iv) The steps taken to verify the
identity of the provider as being the
beneficiary or his or her fiduciary or
authorized representative.
(v) The statement of the employee that
the provider was informed that the
statement may be used for the purpose
of calculating benefits amounts.
(d) Exceptions to paragraph (c) notice
and documentation requirements.
Paragraph (c) of this section does not
apply to the following:
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(1) Oral statements made at a VA
hearing; and
(2) Oral statements recorded by VA
personnel in reports of medical
treatment or examination.
(Authority: 38 U.S.C. 501(a))
§ 5.131 Applications, claims, and
exchange of evidence with Social Security
Administration (SSA)—death benefits.
(a) Dual-purpose SSA and VA
application forms. A claim for death
benefits received by SSA on a form
jointly prescribed by VA and SSA
claiming such benefits is considered to
be a claim for VA death benefits
(including dependency and indemnity
compensation (DIC), death pension, and
accrued benefits). The claim will be
deemed to have been received by VA on
the date that it was received by SSA.
(b) Evidence filed with SSA. Evidence
received by SSA in conjunction with a
claim under paragraph (a) of this section
is considered received by VA on the
date that SSA received the evidence.
(c) SSA request of copies or
certifications of evidence filed with VA.
At SSA’s request, VA will furnish
copies or certifications of evidence that
a claimant has filed with VA in support
of a claim for VA death benefits,
provided that the release of this
evidence fully complies with all
requirements in any applicable laws and
regulations that protect the
confidentiality of VA records.
(Authority: 38 U.S.C. 501(a), 5101(b)(1),
5105)
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§ 5.132 Claims, statements, evidence, or
information filed abroad; authentication of
documents from foreign countries.
(a) Claims and evidence filed abroad.
A claim, or statements, information, or
evidence in support of a claim, may be
submitted to a Department of State
representative in a foreign country. Any
claim, statement, information, or
evidence filed in a foreign country will
be considered received by VA on the
date that it was received by the
Department of State representative in
that foreign country.
(b) Authentication of foreign
documents—generally. Foreign
documents listed in paragraph (c) of this
section do not require authentication.
All other foreign documents must be
authenticated as specified in paragraph
(d) of this section. ‘‘Foreign documents’’
means documents that are signed under
oath or affirmation in the presence of an
official in a foreign country. Examples
of foreign documents include affidavits,
marriage certificates, and birth
certificates that have been created,
executed, or validated by a foreign
government. ‘‘Authentication’’ means
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that an official listed in paragraph (d) of
this section verifies that the foreign
document, including each signature,
stamp, and seal appearing on it, is
genuine and has not been altered.
(c) Authentication of certain foreign
documents not required. VA does not
require authentication of the following
types of foreign documents:
(1) Documents approved by the
Deputy Minister of Veterans Affairs for
the Department of Veterans Affairs,
Ottawa, Canada.
(2) Documents bearing the signature
and seal of an officer authorized to
administer oaths for general purposes.
(3) Documents signed before a VA
employee authorized to administer
oaths under § 2.3 of this chapter.
(4) Affidavits prepared in the
Republic of the Philippines that are
certified by a VA representative who is
located there and who has the authority
to administer oaths.
(5) Copies of public or church records
from any foreign country used to
establish birth, adoption, marriage,
annulment, divorce, or death, provided
that the documents have the signature
and seal of the custodian of these
records and there is no contrary
evidence of record that tends to cast
doubt on the correctness of the
documents.
(d) Authentication of foreign
documents required. Foreign documents
not listed in paragraph (c) of this section
must be authenticated by:
(1) An officer of the Department of
State authorized to authenticate
documents; or
(2) The Consul of a friendly
government whose signature and seal is
verified by the Department of State.
(e) Photocopies of foreign documents.
VA will accept photocopies of any of
the foreign documents described in
paragraphs (c) and (d) of this section if
VA determines that the photocopies
satisfy the requirements of § 5.180.
(Authority: 38 U.S.C. 501(a))
§ 5.133 Information VA may request from
financial institutions.
(a) Names and addresses. If VA needs
to verify a person’s correct name or
address, VA may request this
information from a financial institution,
such as a bank, savings and loan
association, trust company, or credit
union. In its request, VA must certify
that the name or address is necessary in
order to administer properly its benefit
programs and cannot be located by a
reasonable search of VA records.
(b) Financial information. VA may ask
a financial institution to provide
financial records of a current or former
claimant or a current or former
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beneficiary if such evidence is necessary
to determine whether such person has
failed to comply with a statute,
regulation, rule, or order. This request,
however, must be made through a
subpoena. (A subpoena is a legal
document commanding an individual or
organization to provide specified
evidence to the issuer of the subpoena.
See § 2.2 of this chapter for information
on VA’s authority to issue subpoenas.)
Before the date VA serves a subpoena on
a financial institution, VA must:
(1) Serve or mail a copy of the
subpoena to the beneficiary; together
with
(2) A written explanation of the
purpose of VA’s request for financial
information and the procedure for
challenging the subpoena. See 12 U.S.C.
3405.
(c) Limitations on use of information.
Unless permitted under the Right to
Financial Privacy Act (codified at 12
U.S.C. 3401, et seq.), VA may not:
(1) Use information obtained from a
financial institution for any purpose
other than the administration of VA
benefits programs; or
(2) Share this information with any
other individual, group, or government
entity.
(Authority: 12 U.S.C. 3401, 3405, 3412, 3413;
38 U.S.C. 501, 5711, 5319)
§ 5.134 Will VA accept a signature by mark
or thumbprint?
VA will accept signatures by mark or
thumbprint if:
(a) They are witnessed by two people
who sign their names and give their
addresses, or
(b) They are witnessed by an
accredited agent, attorney, or service
organization representative, or
(c) They are certified by a notary
public or any other person having the
authority to administer oaths for general
purposes, or
(d) They are certified by a VA
employee who has been delegated
authority by the Secretary under 38 CFR
2.3.
(Authority: 38 U.S.C. 5101)
§ 5.135 Statements certified or under oath
or affirmation.
(a) All oral testimony presented by
claimants and witnesses on their behalf
will be under oath or affirmation (see
§ 5.82(d)(2)).
(b) Any documentary evidence or
written assertion of fact submitted by
the claimant or on his or her behalf for
the purpose of establishing a claim for
service connection should be certified
or under oath or affirmation. VA may
consider such a submission that is not
certified or under oath or affirmation or
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may require certification, oath, or
affirmation if considered necessary to
establish the reliability of a material
document. Documentary evidence
includes records, examination reports,
and transcripts material to the issue
received by VA from State, county, or
municipal governments, recognized
private institutions, or contract
hospitals.
(Authority: 38 U.S.C. 501)
§§ 5.136 through 5.139
[Reserved]
Evidence Requirements for Former
Prisoners of War (POWs)
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§ 5.140 Determining former prisoner of war
status.
(a) Basis for determination. The
definition of ‘‘hostile force’’ set forth in
paragraph (3) of the definition of
‘‘Former prisoner of war (or former
POW)’’ in § 5.1 applies to this section.
VA will accept a finding by the
appropriate service department that a
person was a POW during a period of
war when detention or internment was
by an enemy government or its agents,
or a hostile force, except when a
reasonable basis exists for questioning
that finding. The Director of the
Compensation and Pension Service
must approve all regional office
determinations not based on service
department findings. VA will apply
paragraphs (b), (c), and (d) of this
section and make its own determination
of POW status if:
(1) The detention or internment
occurred during a period other than a
period of war; or
(2) If a service department has not
made a finding; or
(3) A reasonable basis exists for
questioning a service-department
finding.
(b) Circumstances of detention or
internment. To be considered a former
POW, a serviceperson must have been
forcibly detained or interned under
circumstances comparable to those
under which persons generally have
been forcibly detained or interned by
enemy governments during periods of
war. Such circumstances include, but
are not limited to, physical hardships or
abuse, psychological hardships or
abuse, malnutrition, and unsanitary
conditions. In the absence of evidence
to the contrary, VA will consider that
each individual member of a particular
group of detainees or internees
experienced the same circumstances as
those experienced by the group.
(c) Reason for detention or
internment. For the purposes of
determining POW status, VA will not
consider the reason a service member
was detained or interned, except where
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allegations exist that the service member
violated the laws of a foreign
government. A period of detention or
internment by a foreign government for
an alleged violation of its laws cannot
be used to establish POW status, unless
the charges were a sham intended to
make it appear that the detention or
internment was proper.
(d) Line of duty. VA will consider that
a serviceperson was forcibly detained or
interned in line of duty unless the
evidence of record discloses that
forcible detention or internment was the
proximate result of the service member’s
own willful misconduct. See § 5.660
(defining line of duty) and § 5.661
(defining willful misconduct).
Cross-reference: See § 5.611
(concerning POW status and Philippine
service).
(Authority: 38 U.S.C. 101(32))
§ 5.141 Medical evidence for former
prisoners’ of war compensation claims.
(a) Injuries and other conditions of a
former prisoner of war (POW). As soon
as sufficient evidence for a rating is
available, VA will rate injuries or other
conditions of a former POW that
obviously were incurred in service,
without awaiting receipt of the
claimant’s medical and other service
records.
(b) Statements by a former POW. VA
will presume true a statement by a
former POW that an injury or disease
was incurred or aggravated during (or
immediately before) detention or
internment if the statement is consistent
with the circumstances, conditions, or
hardships of detention or internment (or
is consistent with the former POW’s
situation immediately before detention
or internment). The presumption of
truth as to such a statement is rebutted
by clear and convincing evidence to the
contrary. See also § 3.304(f)(2)
(pertaining to post-traumatic stress
disorder claimed by a former POW).
(c) Evidence from fellow service
members. Evidence from fellow service
members may be used to support an
allegation of incurrence or aggravation
of an injury or disease during detention
or internment. In evaluating evidence
from fellow service members that relates
to a claim for disability compensation
by a former POW, VA will take into
account the fellow service member’s
statements, including statements
regarding any of the following:
(1) The former POW’s physical
condition before capture;
(2) The circumstances during the
former POW’s detention or internment;
(3) The changes in the former POW’s
physical condition following release
from detention or internment; or
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(4) The existence of signs and
symptoms consistent with a claimed
disability following the former POW’s
release from detention or internment.
(d) The absence of clinical records. If
disability compensation is claimed by a
former POW, VA will not consider as
determinative the lack of history or
findings in clinical records made upon
the claimant’s return to United States
control.
(e) Disabilities first reported after
discharge. If any disability is first
reported after discharge, especially if
the claimed disability is poorly defined
and not obviously of intercurrent origin,
VA will determine whether the claimed
disability is etiologically related to the
POW experience. VA will consider the
circumstances of the claimant’s
detention or internment, the duration of
detention or internment, and the
pertinent medical principles.
(f) Examination requirement. If
service connection for disabilities
claimed by a former POW cannot be
established otherwise, VA will provide
the claimant a complete medical
examination.
Cross-references: Definition of
prisoner of war. See § 5.1. Presumptive
service connection for diseases specific
to prisoners of war. See § 5.264(c).
(Authority: 38 U.S.C. 1154)
§§ 5.142–5.149
[Reserved]
General Effective Dates for Awards
§ 5.150 General effective dates for awards
or increased benefits.
(a) General rule. Except as otherwise
provided, the effective date of an award
of pension, compensation, dependency
and indemnity compensation, or
monetary allowance under 38 U.S.C.
chapter 18 for an individual who is a
child of a Vietnam veteran, based on an
original claim, a claim reopened after
final disallowance, or a claim for
increase, will be the later of:
(1) The date of receipt of the claim for
the benefit awarded; or
(2) The date entitlement arose. For the
purposes of this part, ‘‘date entitlement
arose’’ means the date shown by the
evidence to be the date that the claimant
first met the requirements for the benefit
awarded. VA will assume that
entitlement arose before the date of
receipt of the claim unless the evidence
shows that entitlement arose after that
date.
(b) Location of other effective-date
provisions in part 5. The following chart
is intended to provide assistance in
locating various other effective-date
provisions in this part. It is provided for
informational use only.
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Effective date provision
Part 5 location
(1) SUBPART B—SERVICE REQUIREMENTS FOR VETERANS
(i) Individuals and groups designated by the Secretary of Defense as having performed active military service ...............
(ii) Effect of discharge upgrades by Armed Forces boards for the correction of military records (10 U.S.C. 1552) on eligibility for VA benefits.
(iii) Effect of discharge upgrades by Armed Forces discharge review boards (10 U.S.C. 1553) on eligibility for VA benefits.
§ 5.27(c).
§ 5.34(d).
§ 5.35(e).
(2) SUBPART C—ADJUDICATIVE PROCESS, GENERAL
(i) Filing a claim for death benefits ........................................................................................................................................
(ii) New and material evidence ..............................................................................................................................................
(iii) Requirement to provide Social Security numbers ...........................................................................................................
(iv) Effective dates based on change of law or VA issue .....................................................................................................
(v) Effective date of awards based on receipt of evidence prior to end of appeal period ....................................................
(vi) Revision of decisions based on clear and unmistakable error (CUE) ............................................................................
(vii) Effective dates for revision of decisions based on difference of opinion under § 5.163 ................................................
(viii) Effective dates for reduction or discontinuance of awards based on error ...................................................................
(ix) New and material evidence based on service department records ................................................................................
(x) Effective dates for severing service connection or discontinuing or reducing benefit payments ....................................
§ 5.53(c)(5).
§ 5.56(b).
§ 5.101(c), (d).
§ 5.152.
§ 5.153.
§ 5.162(b).
§ 5.164.
§ 5.165.
§ 5.166(c), (d).
§ 5.177.
(3) SUBPART D—DEPENDENTS AND SURVIVORS
(i) Evidence of dependency-reduction or discontinuance of VA benefits .............................................................................
(ii) Effective date for additional benefits based on the existence of a dependent ................................................................
(iii) Effective date of reduction or discontinuance of VA benefits due to the death of a beneficiary’s dependent ...............
(iv) Effective date of reduction or discontinuance of improved pension, compensation, or dependency and indemnity
compensation due to marriage or remarriage.
(v) Effective date of reduction or discontinuance of improved pension, compensation, or dependency and indemnity
compensation due to divorce or annulment.
(vi) Effective date of discontinuance of VA benefits to a surviving spouse who holds himself, or herself, out as the
spouse of another person.
(vii) Effective date of resumption of benefits to a surviving spouse due to termination of a remarriage .............................
(viii) Effective date of resumption of benefits to a surviving spouse who stops holding himself, or herself, out as the
spouse of another.
(ix) Effective date of award of pension or dependency and indemnity compensation to, or based on the existence of, a
child born after the veteran’s death.
(x) Effective date of reduction or discontinuance—child reaches age 18 or 23 ...................................................................
(xi) Effective date of reduction or discontinuance—terminated adoptions ............................................................................
(xii) Effective date of reduction or discontinuance—stepchild no longer a member of the veteran’s household .................
(xiii) Effective date of an award, reduction, or discontinuance of benefits based on child status due to permanent incapacity for self support.
(xiv) Effective date of an award of benefits due to termination of a child’s marriage ..........................................................
§ 5.181(c).
§ 5.183.
§ 5.184.
§ 5.197.
§ 5.198.
§ 5.204.
§ 5.205.
§ 5.206.
§ 5.230.
§ 5.231.
§ 5.232.
§ 5.233.
§ 5.234.
§ 5.235.
(4) SUBPART E—CLAIMS FOR SERVICE CONNECTION AND DISABILITY COMPENSATION
(i) Effective dates—award of disability compensation based on direct service connection .................................................
(ii) Effective dates—award of disability compensation based on presumptive service connection ......................................
(iii) Effective dates—increased compensation due to increased disability ...........................................................................
(iv) Effective dates—reduction or severance of service-connected disability compensation ...............................................
(v) Effective dates—discontinuance of total disability rating based on individual unemployability .......................................
(vi) Effective dates—reduction or discontinuance of additional disability compensation based on parental dependency ...
(vii) Effective dates—award of additional disability compensation based on decrease in the net worth of dependent parents.
(viii) Effective dates—Special monthly compensation under §§ 5.331 through 5.332 ..........................................................
(ix) Effective dates—Additional compensation for aid and attendance payable for a veteran’s spouse ..............................
(x) Effective date: Tuberculosis, special compensation for arrested ....................................................................................
(xi) Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospitalization, medical or surgical treatment, examinations, or vocational rehabilitation training.
(xii) Effective dates for disability or death due to hospitalization, medical or surgical treatment, examinations, or vocational rehabilitation training.
§ 5.310.
§ 5.311.
§ 5.312.
§ 5.313.
§ 5.314.
§ 5.315.
§ 5.316.
§ 5.333.
§ 5.334.
§ 5.349.
§ 5.352(a)(2).
§ 5.353.
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(5) SUBPART F—NONSERVICE-CONNECTED DISABILITY PENSIONS AND DEATH PENSIONS
(i) Permanent and total disability ratings for Improved Disability Pension purposes ............................................................
(ii) Effective dates for Improved Disability Pension ...............................................................................................................
(iii) Effective dates for awards of special monthly pension ...................................................................................................
(iv) Automatic adjustment of maximum annual pension rates ..............................................................................................
(v) Effective dates for Improved Pension awards based on a change in net worth .............................................................
(vi) Effective dates for changes to Improved Pension payments due to a change in income .............................................
(vii) Time limits to establish entitlement to Improved Pension or to increase the annual Improved Pension amount
based on income.
(viii) Effective dates for Improved Death Pension .................................................................................................................
(ix) Effective date of discontinuance of Improved Death Pension payments to a beneficiary no longer recognized as the
veteran’s surviving spouse.
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§ 5.381(b)(2).
§ 5.383.
§ 5.392.
§ 5.401(a).
§ 5.415.
§ 5.422.
§ 5.424(b), (c).
§ 5.431.
§ 5.433.
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Effective date provision
Part 5 location
(x) Award, or discontinuance of award, of Improved Death Pension to a surviving spouse where Improved Death Pension payments to a child are involved.
(xi) Effective dates of improved pension elections ................................................................................................................
(xii) Effective dates for section 306 and old-law pension reductions or discontinuances ....................................................
§ 5.434(b), (c).
§ 5.463.
§ 5.477.
(6) SUBPART G—DEPENDENCY AND INDEMNITY COMPENSATION, DEATH COMPENSATION, ACCRUED BENEFITS, AND SPECIAL
RULES APPLICABLE UPON DEATH OF A BENEFICIARY
(i) Awards of dependency and indemnity compensation benefits to children when there is a retroactive award to a
school child.
(ii) Effective dates for DIC or death compensation awards ..................................................................................................
(iii) Effective dates for discontinuance of DIC or death compensation payments to a person no longer recognized as the
veteran’s surviving spouse.
(iv) Effective date for award, or termination of award, of DIC or death compensation to a surviving spouse where DIC
or death compensation payments to children are involved.
(v) Effective date for reduction in DIC—surviving spouses ...................................................................................................
(vi) Effective date for an award or increased rate based on amended income information—parents’ DIC .........................
(vii) Effective date for reduction or discontinuance based on increased income—parents’ DIC ..........................................
(viii) Effective date for dependency and indemnity compensation rate adjustments when an additional dependent files
an application.
(ix) Effective dates of awards and discontinuances of special monthly dependency and indemnity compensation ...........
§ 5.524(c).
§ 5.567.
§ 5.568.
§ 5.569.
§ 5.570.
§ 5.571.
§ 5.572.
§ 5.573.
§ 5.574.
(7) SUBPART H—SPECIAL AND ANCILLARY BENEFITS FOR VETERANS, DEPENDENTS, AND SURVIVORS
(i) Medal of Honor pension ....................................................................................................................................................
(ii) Awards of VA benefits based on special acts or private laws .........................................................................................
(iii) Special allowance payable under section 156 of Pub. L. 97–377 ..................................................................................
(iv) Effective dates of awards for certain disabled children of Vietnam veterans .................................................................
(v) Clothing allowance ...........................................................................................................................................................
§ 5.580(c).
§ 5.581(d).
§ 5.588(f).
§ 5.591.
§ 5.606(e).
(8) SUBPART I—BENEFITS FOR CERTAIN FILIPINO VETERANS AND SURVIVORS
(i) Filipino veterans and their survivors: Effective dates for benefits at the full-dollar rate ...................................................
(ii) Filipino veterans and their survivors: Effective dates of reductions and discontinuances for benefits at the full-dollar
rate.
§ 5.614.
§ 5.618.
(9) SUBPART K—MATTERS AFFECTING THE RECEIPT OF BENEFITS
(i) Remission of forfeiture ......................................................................................................................................................
(ii) Effective dates—forfeiture ................................................................................................................................................
(iii) Presidential pardon for offenses causing forfeiture .........................................................................................................
(iv) Renouncement of benefits ...............................................................................................................................................
§ 5.680(c)(2).
§ 5.681.
§ 5.682(b), (d).
§ 5.683(c), (e)(1)(ii).
(10) SUBPART L—PAYMENTS AND ADJUSTMENTS TO PAYMENTS
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(i) Benefits paid to a child attending an approved educational institution ............................................................................
(ii) General effective dates for reduction or discontinuance of benefits ................................................................................
(iii) Eligibility verification reports ............................................................................................................................................
(iv) Adjustment in benefits due to reduction or discontinuance of a benefit to another payee ............................................
(v) Disappearance of veteran for 90 days or more ...............................................................................................................
(vi) Resumption of payments when a payee’s whereabouts become known .......................................................................
(vii) Restriction on VA benefit payments to an alien located in enemy territory ...................................................................
(viii) Reduction of Improved Pension when a veteran is receiving domiciliary or nursing home care .................................
(ix) Reduction of Section 306 Pension when a veteran is receiving hospital care ...............................................................
(x) Reduction of Old-Law Pension when a veteran is receiving hospital care .....................................................................
(xi) Reduction of Improved Pension when a veteran or surviving spouse is receiving Medicaid-covered nursing home
care.
(xii) Reduction of special monthly compensation involving aid and attendance when a veteran is receiving hospital care
(xiii) Reduction of special monthly pension involving aid and attendance for Improved Pension when a veteran is receiving hospital care.
(xiv) Reduction of special monthly pension involving aid and attendance for Old-Law Pension or Section 306 Pension
when a veteran is receiving hospital care.
(xv) Resumption of Section 306 Pension and special monthly pension involving aid and attendance when a veteran is
discharged or released from hospital care.
(xvi) Resumption of Old-Law Pension and special monthly pension involving aid and attendance when a veteran is discharged or released from hospital care.
(xvii) General effective dates for awarding, reducing, or discontinuing VA benefits because of an election .......................
(xviii) Prohibition against receipt of active military service pay and VA benefits for the same period .................................
(xix) Procedures for elections between VA benefits and FECA compensation ....................................................................
(xx) Effect of election of compensation under the Radiation Exposure Compensation Act of 1990 on payment of certain
VA benefits.
(xxi) Payment of multiple VA benefits to a surviving child based on the service of more than one veteran .......................
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§ 5.695(c)–(g).
§ 5.705.
§ 5.708(f).
§ 5.710(b).
§ 5.711(b)(2), (c)(2),
(d)(1).
§ 5.712.
§ 5.713.
§ 5.720(a)(4), (d).
§ 5.721(a)(4), (d).
§ 5.722(a)(4).
§ 5.723(b).
§ 5.724(b), (e), (f).
§ 5.725(b), (d), (e).
§ 5.726(b), (e).
§ 5.727(b), (e), (f).
§ 5.728(b), (d), (e).
§ 5.743.
§ 5.746(c), (d)(1).
§ 5.752(b).
§ 5.754(d).
§ 5.762(c)(6)(ii).
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Effective date provision
Part 5 location
(xxii) Payment of dependents’ educational assistance (DEA) and VA pension or dependency and indemnity compensation (DIC) for the same period.
§ 5.764(a)(3).
(11) SUBPART M—APPORTIONMENTS TO DEPENDENTS AND PAYMENTS TO FIDUCIARIES AND INCARCERATED BENEFICIARIES
(i) Effective date of apportionment grant or increase ............................................................................................................
(ii) Effective date of apportionment discontinuance or reduction ..........................................................................................
(iii) Determinations of incompetency .....................................................................................................................................
(iv) Effective date after certification or when a beneficiary regains competency ..................................................................
(v) Payments upon reaching age of majority ........................................................................................................................
(vi) Incarcerated beneficiaries—general provisions and definitions ......................................................................................
(vii) Discontinuance of pension during incarceration .............................................................................................................
(viii) Apportionment where a primary beneficiary is incarcerated .........................................................................................
(ix) Resumptions of disability compensation, dependency and indemnity compensation, or death compensation upon a
beneficiary’s release from incarceration.
(x) Resumptions of pension upon a beneficiary’s release from incarceration ......................................................................
(Authority: 38 U.S.C. 501, 5110(a))
§ 5.151
Date of receipt.
(a) General. The date of receipt of a
document, claim, information, or
evidence is the date on which it was
received by VA, except as provided in
paragraph (b) of this section, in specific
provisions for claims or evidence
received in a foreign country by a
Department of State representative
(§ 5.132(a)) or in the Social Security
Administration (§§ 5.131(a) or 5.131(b)),
or in rules of the Department of Defense
relating to initial claims filed at or
before separation.
(b) Exception to date-of-receipt rule.
VA may establish, by notice published
in the Federal Register, exceptions to
paragraph (a), using factors such as
postmark or the date the claimant
signed the correspondence, when VA
determines that a natural or man-made
interference with the normal channels
through which VA ordinarily receives
correspondence has resulted in one or
more VA regional offices experiencing
extended delays in receipt of
documents, claims, information, or
evidence from claimants served by the
affected office or offices to an extent
that, if not addressed, would adversely
affect such claimants through no fault of
their own.
(Authority: 38 U.S.C. 501(a), 512(a), 5110)
jlentini on PROD1PC65 with PROPOSALS2
§ 5.152 Effective dates based on change of
law or VA issue.
(a) Effective date of award. Where
pension, compensation, dependency
and indemnity compensation, or a
monetary allowance under 38 U.S.C.
chapter 18 for an individual who is a
child of a Vietnam veteran is awarded
or increased pursuant to a liberalizing
law, or a liberalizing VA issue approved
by the Secretary or by the Secretary’s
direction, the effective date of such
award or increase shall be fixed in
accordance with the date entitlement
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arose, but shall not be earlier than the
effective date of the act or
administrative issue. Where pension,
compensation, dependency and
indemnity compensation, or a monetary
allowance under 38 U.S.C. chapter 18
for an individual who is a child of a
Vietnam veteran is awarded or
increased pursuant to a liberalizing law
or VA issue which became effective on
or after the date of its enactment or
issuance, in order for a claimant to be
eligible for a retroactive payment under
the provisions of this paragraph the
evidence must show that the claimant
met all eligibility criteria for the
liberalized benefit on the effective date
of the liberalizing law or VA issue and
that such eligibility existed
continuously from that date to the date
of claim or administrative determination
of entitlement. The provisions of this
paragraph are applicable to original and
reopened claims as well as claims for
increase.
(1) If a claim is reviewed on the
initiative of VA within 1 year from the
effective date of the law or VA issue, or
at the request of a claimant received
within 1 year from that date, benefits
may be authorized from the effective
date of the law or VA issue.
(2) If a claim is reviewed on the
initiative of VA more than 1 year after
the effective date of the law or VA issue,
benefits may be authorized for a period
of 1 year prior to the date of
administrative determination of
entitlement.
(3) If a claim is reviewed at the
request of the claimant more than 1 year
after the effective date of the law or VA
issue, benefits may be authorized for a
period of 1 year prior to the date of
receipt of such request.
(Authority: 38 U.S.C. 1822, 5110(g))
(b) Reduction or discontinuance of
benefits. Where the reduction or
discontinuance of an award is in order
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§ 5.783.
§ 5.784.
§ 5.791(d).
§ 5.794.
§ 5.795(b).
§ 5.810(c).
§ 5.813(b)(2).
§ 5.814(e).
§ 5.815(a), (b)(1),
(c)(2).
§ 5.816(b), (c)(1).
because of a change in law or a
Department of Veterans Affairs issue, or
because of a change in interpretation of
a law or Department of Veterans Affairs
issue, the payee will be notified at his
or her latest address of record of the
contemplated action and furnished
detailed reasons therefor, and will be
given 60 days for the presentation of
additional evidence. If VA receives no
additional evidence within the 60-day
period, or the evidence received does
not demonstrate that the proposed
action should not be taken, the award
will be reduced or discontinued
effective the last day of the month in
which the 60-day period expired.
(Authority: 38 U.S.C. 5112(b)(6))
§ 5.153 Effective date of awards based on
receipt of evidence prior to end of appeal
period.
VA will consider information or
evidence received before the expiration
of the period for initiating or perfecting
an appeal to the Board, or before the
Board renders a decision (if a timely
appeal was filed), without regard to
whether the information or evidence is
‘‘new and material.’’ An award of the
benefit sought based on that information
or evidence is effective on the date
prescribed by § 5.150.
(Authority: 38 U.S.C. 501)
§§ 5.154–5.159
[Reserved]
General Rules on Revision of Decisions
§ 5.160
Binding effect of VA decisions.
(a) General rule. A decision of a duly
constituted rating agency or other
agency of original jurisdiction shall be
binding on all field offices of the
Department of Veterans Affairs as to
conclusions based on the evidence on
file at the time VA issues written
notification in accordance with 38
U.S.C. 5104. A binding agency decision
shall not be subject to revision on the
same factual basis except by duly
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constituted appellate authorities or
except as provided in §§ 5.161, 5.162,
and 5.163 of this part.
(b) Particular issues. A decision made
by a Veterans Service Center on any one
of the issues listed below is binding on
the VA Insurance Center, and vice versa,
unless the decision was based on clear
and unmistakable error. Absent clear
and unmistakable error, neither a
Veterans Service Center nor the VA
Insurance Center may change a decision
of the other if doing so would involve
applying the same criteria and be based
on the same facts. The issues to which
this paragraph (b) applies are:
(1) Line of duty;
(2) Character of discharge;
(3) Relationship;
(4) Dependency;
(5) Domestic relations issues such as
marriage, divorce, adoption and child
custody and support;
(6) Homicide; and
(7) Findings of fact of death or
presumption of death.
(Authority: 38 U.S.C. 501)
jlentini on PROD1PC65 with PROPOSALS2
§ 5.161
Review of benefit claims decisions.
(a) A claimant who has filed a timely
Notice of Disagreement with a decision
of an agency of original jurisdiction on
a benefit claim has a right to review of
that decision under this section. The
review will be conducted by a Veterans
Service Center Manager or Decision
Review Officer, at VA’s discretion. An
individual who did not participate in
the decision being reviewed will
conduct this review. Only a decision
that has not yet become final (by
appellate decision or failure to timely
appeal) may be reviewed. Review under
this section will encompass only
decisions with which the claimant has
expressed disagreement in the Notice of
Disagreement. The reviewer will
consider all evidence of record and
applicable law, and will give no
deference to the decision being
reviewed.
(b) Unless the claimant has requested
review under this section with his or
her Notice of Disagreement, VA will,
upon receipt of the Notice of
Disagreement, notify the claimant in
writing of his or her right to review
under this section. To obtain such a
review, the claimant must request it not
later than 60 days after the date VA
mails the notice. This 60-day time limit
may not be extended. If the claimant
fails to request review under this section
not later than 60 days after the date VA
mails the notice, VA will proceed with
the traditional appellate process by
issuing a Statement of the Case. A
claimant may not have more than one
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review under this section of the same
decision.
(c) The reviewer may conduct
whatever development he or she
considers necessary to resolve any
disagreements in the Notice of
Disagreement, consistent with
applicable law. This may include an
attempt to obtain additional evidence or
the holding of an informal conference
with the claimant. Upon the request of
the claimant, the reviewer will conduct
a hearing under § 5.82.
(d) The reviewer may grant a benefit
sought in the claim notwithstanding
§ 5.163, but, except as provided in
paragraph (e) of this section, may not
revise the decision in a manner that is
less advantageous to the claimant than
the decision under review. A review
decision made under this section will
include a summary of the evidence, a
citation to pertinent laws, a discussion
of how those laws affect the decision,
and a summary of the reasons for the
decision.
(e) Notwithstanding any other
provisions of this section, the reviewer
may reverse or revise (even if
disadvantageous to the claimant) prior
decisions of an agency of original
jurisdiction (including the decision
being reviewed or any prior decision
that has become final due to failure to
timely appeal) on the grounds of clear
and unmistakable error (see § 5.162).
(f) Review under this section does not
limit the appeal rights of a claimant.
Unless a claimant withdraws his or her
Notice of Disagreement as a result of
this review process, VA will proceed
with the traditional appellate process by
issuing a Statement of the Case.
(g) This section applies to all claims
in which a Notice of Disagreement is
filed on or after June 1, 2001.
(Authority: 38 U.S.C. 5109A, 7105(d))
§ 5.162 Revision of decisions based on
clear and unmistakable error (CUE).
(a) General. In the absence of clear
and unmistakable error (CUE), VA will
accept all final decisions as correct.
Where evidence establishes such CUE, a
prior decision will be reversed or
revised. Review to determine whether
CUE exists in a case may be instituted
by VA on its own motion or upon
request of the claimant. A request for
revision of a VA decision based on CUE
may be made at any time after that
decision is made.
Cross-reference: Explanation of what
constitutes CUE and what does not. See
§ 20.1403 of this chapter.
(b) Effect of revision on benefits. For
the purpose of granting benefits, a new
decision that constitutes a reversal or
revision of a prior decision on the
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grounds of CUE has the same effect as
if the new decision had been made on
the date of the prior decision. For
effective dates for reductions or
discontinuances, based on CUE, VA will
apply § 5.165(c)(1). However, for
reductions or discontinuances based on
CUE resulting from an act of
commission or omission by the
beneficiary or with the beneficiary’s
knowledge, VA will apply § 5.165(b).
(Authority: 38 U.S.C. 5109A)
§ 5.163 Revision of decisions based on
difference of opinion.
If the Veterans Service Center
Manager (VSCM) within an agency of
original jurisdiction (AOJ) believes that
revision of a previous AOJ decision (that
is not final and has not been the subject
of a Substantive Appeal) is warranted,
based on a difference of opinion, and
that revision would lead to a more
favorable decision on the claim that was
the subject of that previous decision, the
VSCM will recommend such revision to
the Director of the Compensation and
Pension Service of the Veterans Benefits
Administration for a binding
determination.
(Authority: 38 U.S.C. 501)
§ 5.164 Effective dates for revision of
decisions based on difference of opinion.
If a decision is revised based on
difference of opinion under § 5.163, the
effective date of the revision is the date
the benefits would have been paid if the
previous decision had been favorable.
(Authority: 38 U.S.C. 501, 5110)
§ 5.165 Effective dates for reduction or
discontinuance of awards based on error.
(a) Scope. The rules in this section
apply when determining the proper
effective date to assign for the reduction
or discontinuance of VA benefits based
on error. This section does not apply to
a payment amount not authorized by a
rating decision, such as a payment of an
incorrect amount or a duplicative
payment. Such amounts are
overpayments, subject to recoupment.
(b) Effective date of reduction or
discontinuance based on beneficiary
error. If an award was based on an act
of commission or omission by the
beneficiary or any act of omission or
commission with the beneficiary’s
knowledge, VA will pay a reduced rate
or discontinue benefits effective the
latest of the following dates:
(1) The effective date of the award;
(2) The date preceding the act of
commission or omission; or
(3) The date entitlement to the benefit
ceased.
(c) VA administrative error. (1)
Effective date. Except as provided in
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§ 5.177 (d) and (f), if an award was
based solely on administrative error or
an error in judgment by VA, VA will
pay a reduced rate or discontinue
benefits effective the first of the month
that follows the month for which VA
last paid benefits.
(2) Administrative error or an error in
judgment. Administrative errors or
errors in judgment include:
(i) Overlooking facts;
(ii) Clerical errors; or
(iii) Failure to follow or properly
apply VA instructions, regulations, or
statutes.
service department must be supported
adequately by medical evidence. Where
such records clearly support the
assignment of a specific rating over a
part or the entire period of time
involved, a retroactive rating will be
assigned accordingly, except as it may
be affected by the filing date of the
original claim.
(Authority: 38 U.S.C. 501(a))
§§ 5.167–5.169
[Reserved]
General Rules on Protection or
Reduction of Existing Ratings
§ 5.166 New and material evidence based
on service department records.
jlentini on PROD1PC65 with PROPOSALS2
(Authority: 38 U.S.C. 5112(b)(9) and (10))
§ 5.170 Calculation of 5-year, 10-year, and
20-year protection periods.
(a) VA will apply the following
principles in determining whether
service connection has been ‘‘in effect’’
for the 10-year period in § 5.175 and
whether a rating has been ‘‘continuous’’
for the 5-year period in § 5.171 or the
20-year period in § 5.172.
(b) A protection period begins on the
effective date of the rating decision and
ends on the date that service connection
would be severed or the rating would be
reduced, after due process has been
provided.
Cross-reference: Due process
provisions for reducing compensation
benefits or severing service connection.
See § 5.176.
(c) For purposes of §§ 5.171 and
5.172, a rating is not continuous if
benefits based on that rating are
discontinued or interrupted because the
veteran reentered active service.
Cross-reference: Rule on
discontinuance of awards based on
reentry into active service. See
§ 3.654(b).
(d) A rating period may be protected
even if the beneficiary did not receive
VA compensation based on that rating.
This includes a beneficiary whose
payments were adjusted by deduction,
recoupment, apportionment, reduction
in compensation due to incarceration, or
because the beneficiary elected to
receive retirement pay.
(e) A retroactive increase or award of
service connection, including one made
under § 5.162 of this part (revision
based on clear and unmistakable error),
which results in a veteran being rated or
awarded service connection for a period
of 5, 10, or 20 years will be protected
under §§ 5.171, 5.175, and 5.172,
respectively, of this part. This paragraph
applies to any protection period, even if
it includes a period based on a
retroactive award.
Cross-reference: Specific procedural
due process in reducing ratings or
severing service connection. See § 5.176.
(a) Notwithstanding any other section
in this part, at any time after VA issues
a decision on a claim, if VA receives or
associates with the claims file relevant
official service department records that
existed and had not been associated
with the claims file when VA first
decided the claim, VA will reconsider
the claim, notwithstanding § 3.156(a).
Such records include, but are not
limited to:
(1) Service records that are related to
a claimed in-service event, injury, or
disease, regardless of whether such
records mention the veteran by name, as
long as the other requirements of this
§ 5.166 are met;
(2) Additional service records
forwarded by the Department of Defense
or the service department to VA any
time after VA’s original request for
service records; and
(3) Declassified records that could not
have been obtained because the records
were classified when VA decided the
claim.
(b) Paragraph (a) of this section does
not apply to records that VA could not
have obtained when it decided the
claim because the records did not exist
when VA decided the claim, or because
the claimant failed to provide sufficient
information for VA to identify and
obtain the records from the respective
service department, the Joint Services
Records Research Center, or from any
other official source.
(c) An award made based all or in part
on the records identified by paragraph
(a) of this section is effective on the date
entitlement arose or the date VA
received the previously decided claim,
whichever is later, or such other date as
may be authorized by the provisions of
this part applicable to the previously
decided claim.
(d) A retroactive rating of disability
resulting from disease or injury
subsequently service connected on the
basis of the new evidence from the
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(Authority: 38 U.S.C. 110, 501, 1159)
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28791
§ 5.171 Protection of 5-year stabilized
ratings.
(a) Purpose. VA will adjudicate cases
affected by change of medical findings
or diagnosis to produce the greatest
degree of stability of disability ratings
consistent with the laws and regulations
governing disability compensation and
pension.
(b) Stabilized rating. For the purposes
of this section, if a disability has been
rated at or above a specific level for 5
years or more, VA will consider it to be
stabilized at that specific level.
(c) Material improvement. VA will not
reduce a stabilized rating unless there is
evidence of material improvement. VA
may reduce a stabilized rating when:
(1) An examination shows sustainable
material improvement, physical or
mental, in the disability, as explained in
paragraph (d) of this section; and
(2) The evidence shows that it is
reasonably certain that the material
improvement will be maintained under
the ordinary conditions of life.
(d) How VA determines whether there
has been material improvement. VA
will consider the following when
determining whether a disability has
undergone material improvement:
(1) In order to reduce a stabilized
rating, there must be evidence of an
examination demonstrating
improvement. Examinations less
complete than those on which payments
were authorized or continued will not
be used as a basis for reduction. A
complete medical record includes all of
the following, when such records exist:
(i) The entire case history;
(ii) Medical-industrial history;
(iii) Records related to treatment of
intercurrent diseases and exacerbations,
including hospital reports, bedside
examinations, examinations by
designated physicians, and
examinations that reflect the results of
tests conducted by laboratory facilities
and the cooperation of specialists in
related lines;
(iv) Private and VA medical
examination records; and
(v) Special examinations indicated as
a result of general examination.
(2) VA will not use only one
examination as the basis for a reduction
of stabilized ratings assigned to diseases
that tend to show temporary or episodic
improvement, unless the evidence of
record clearly demonstrates sustained
improvement. Diseases subject to
temporary or episodic improvement
include but are not limited to:
(i) Arteriosclerotic heart disease;
(ii) Bronchial asthma;
(iii) Epilepsy;
(iv) Gastric or duodenal ulcer;
(v) Bipolar disorders or other
psychotic reaction;
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(vi) Anxiety disorders;
(vii) Many skin diseases.
(3) VA will not reduce a stabilized
rating assigned to a disease that
becomes comparatively symptom free
(findings absent) after bed rest based on
an examination that reflects the results
of bed rest.
(4) Material improvement will be held
to exist only where, after full
compliance with the procedure outlined
in this paragraph (d), the medical record
clearly demonstrates that the disability
does not meet the requirements for the
currently assigned disability rating.
(5) Where there is evidence of a
change in diagnosis, VA will follow 38
CFR 4.13 (‘‘Effect of change of
diagnosis’’), as well as this section. VA
will consider whether evidence of a
change in diagnosis represents a
progression of the previously diagnosed
condition, an error in prior diagnosis, or
a disease entity independent of the
service-connected disability. When a
new diagnosis reflects only a mental
deficiency or personality disorder, VA
will consider the possibility of
temporary remission of a super-imposed
psychiatric disease.
(6) When syphilis of the central
nervous system or alcoholic
deterioration is diagnosed following a
long prior history of psychosis,
psychoneurosis, epilepsy, or the like, it
is rarely possible to exclude persistence,
in masked form, of the preceding
innocently acquired manifestations.
(e) Reexamination. If VA cannot
conclude that a reduction is warranted
after considering the evidence as
described in paragraphs (c) and (d) of
this section, VA will continue the rating
in effect, citing the former diagnosis
with the new diagnosis, if any, in
parentheses, with a notation that the
rating will be continued pending
reexamination to be conducted on a date
to be determined on the basis of the
facts of each individual case.
(Authority: 38 U.S.C. 501)
Cross-reference: For specific
procedural due process in reducing
ratings, see § 5.176.
jlentini on PROD1PC65 with PROPOSALS2
§ 5.172 Protection of continuous 20-year
ratings.
(a) Compensation rating. If a disability
has been rated at or above a specific
level for 20 years, VA may not reduce
the rating below such level unless the
rating was based on fraud.
(b) Pension rating. VA will not reduce
a permanent total disability rating for
pension purposes that has been
continuously in effect for 20 or more
years, unless the rating was based on
fraud.
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(c) Effect of election regarding receipt
of disability compensation. The
provisions of paragraph (a) or (b) of this
section apply whether or not the veteran
elects to receive disability compensation
or pension during all or any part of the
20-year period.
(Authority: 38 U.S.C. 110)
§ 5.173 Protection against reduction of
disability ratings when revisions are made
to the Schedule for Rating Disabilities.
(a) General. VA will not reduce a
disability rating in effect on the effective
date of a revision of the applicable
Schedule for Rating Disabilities unless
medical evidence establishes that the
rated disability has actually improved,
except when the rating was assigned
under the 1925 Schedule of Disability
Ratings (as provided in paragraph (b) of
this section).
(Authority: 38 U.S.C. 1155)
(b) Ratings under 1925 Schedule. (1)
VA will reduce a rating that was
assigned under the 1925 Schedule of
Disability Ratings that was the basis of
compensation on April 1, 1946, when
the rated disability has undergone a
sustained material improvement that
would have required a reduction under
the 1925 Schedule.
(2) Subject to paragraph (b)(3) of this
section, VA will modify a rating that
was assigned under the 1925 Schedule
when an increased rating is appropriate
under the Schedule for Rating
Disabilities in part 4 of this chapter.
After such modification, VA will assign
all future ratings of that disability under
the Schedule for Rating Disabilities in
part 4 of this chapter. The increase in
disability level must not be temporary
(due to hospitalization, surgery, etc.). If
a temporary increased rating is assigned,
VA will restore the prior rating under
the 1925 Schedule after the period of
increase has elapsed unless:
(i) The permanent residuals require
reduction under the 1925 Schedule; or
(ii) An increased rating is appropriate
under the Schedule for Rating
Disabilities in part 4 of this chapter.
(3) VA will not increase a rating
assigned under the 1925 Schedule when
the changed condition represents an
increased degree of disability under
either the 1925 Schedule or the
Schedule for Rating Disabilities in part
4 of this chapter, but the rating provided
by the Schedule for Rating Disabilities
in part 4 of this chapter is less than the
rating in effect under the 1925 Schedule
on April 1, 1946.
Cross-reference: For procedural due
process before reduction of rating under
this section, see § 5.176.
(Authority: 38 U.S.C. 501)
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§ 5.174 Protection of entitlement to
benefits established before 1959.
(a) Persons in receipt of or entitled to
receive benefits on December 31, 1958.
Any person receiving or entitled to
receive benefits under any public law
administered by VA on December 31,
1958, may, except where there was
fraud, clear and unmistakable error of
fact or law, or misrepresentation of
material facts, continue to receive such
benefits as long as the conditions
warranting such payment under those
laws continue. VA will pay the greater
benefit under the previous law or the
corresponding current section of title 38
U.S.C. in the absence of an election to
receive the lesser benefit.
(Authority: Section 10, Pub. L. 85–857)
(b) Service connection established
under prior laws. Awards of service
connection and the rate of disability
compensation paid under prior laws
repealed by Public Law 85–56 are
protected, provided that the conditions
warranting such status and rate
continue and the award was not based
on fraud, misrepresentation of facts, or
clear and unmistakable error. With
respect to such protected awards, VA
may award compensation and special
monthly compensation under current
law if such award would result in
compensation payment at a rate equal to
or higher than that payable on December
31, 1957. Where a changed physical
condition warrants re-rating of serviceconnected disabilities, the amounts of
compensation and special monthly
compensation will be determined under
38 U.S.C. 1114.
(Authority: Pub. L. 85–86; Pub. L. 85–857)
§ 5.175 Protection or severance of service
connection.
(a) Protected service connection. (1)
VA may not sever service connection
that has been in effect for 10 years or
more unless evidence shows that:
(i) The original grant was obtained
through fraud, or;
(ii) It is clear from military records
that the person identified as a veteran
did not have the requisite qualifying
military service or the veteran’s
discharge from service is of a type to
prevent service connection as described
in § 5.30.
(2) The protection afforded in this
section extends to determinations of
service connection that were the basis
for grants of entitlement to dependency
and indemnity compensation or death
compensation.
(b) Severance of service connection.
(1) VA will sever service connection
when evidence establishes that it is
clearly and unmistakably erroneous (the
E:\FR\FM\22MYP2.SGM
22MYP2
Federal Register / Vol. 72, No. 98 / Tuesday, May 22, 2007 / Proposed Rules
burden of proof being upon VA), subject
to §§ 5.152 and 5.176.
(2) A change in diagnosis may be
accepted as a basis for severance of
service connection if the examining
physician or physicians or other proper
medical authority certifies that, in the
light of all accumulated evidence, the
diagnosis that was the basis of the
award of service connection is clearly
erroneous. This certification must be
accompanied by a summary of the facts,
findings, and reasons supporting the
conclusion that the diagnosis is
erroneous.
(Authority: 38 U.S.C. 1159, 5104)
§ 5.176 Due process procedures for
severing service connection or reducing or
discontinuing compensation benefits.
jlentini on PROD1PC65 with PROPOSALS2
Except as provided in § 5.83(c), when
VA is contemplating severing service
connection or reducing or discontinuing
compensation benefit payments
(including those based on individual
unemployability), VA will:
(a) Prepare a rating proposing
severance of service connection or
reduction or discontinuance of
compensation benefit payments and
setting forth all material facts and
reasons;
(b) Consistent with § 5.83, notify the
beneficiary at his or her latest address
of record of the contemplated action and
furnish detailed reasons therefor; and
(c) Allow the beneficiary 60 days from
the date of the notice proposing
severance, reduction, or discontinuance,
to present additional evidence to show
that service connection should be
maintained, the rating should not be
reduced, or the benefits should remain
intact. If VA receives no additional
evidence within the 60-day period, or
the evidence received does not
demonstrate that the proposed action
should not be taken, VA will notify the
beneficiary that VA is severing service
connection or reducing or discontinuing
the benefit.
VerDate Aug<31>2005
19:22 May 21, 2007
Jkt 211001
(Authority: 38 U.S.C. 501, 1159)
28793
described in § 5.176, VA will
discontinue benefits effective the first
§ 5.177 Effective dates for severing service
day of the month after a second 60-day
connection or discontinuing or reducing
period beginning on the day of notice to
benefit payments.
the beneficiary of the final decision.
(a) Suspended awards. If an award has
(f) Disability compensation. This
been suspended and it is determined
paragraph (f) applies when VA reduces
that no additional payments are in
or discontinues disability compensation
order, VA will discontinue the award
because of a change in serviceeffective the first of the month that
connected disability or employability
follows the month for which VA last
status. In such cases, two 60-day periods
paid benefits.
apply. After applying the 60-day notice
(b) Running awards. If an award is
running, VA will discontinue the award period described in § 5.176, VA will pay
a reduced rate or discontinue
effective as appropriate under
compensation effective the first day of
paragraphs (d) through (i) of this
the month after a second 60-day period
section.
beginning on the day of notice to the
(c) Exceptions. This section does not
beneficiary of the final decision.
apply if:
(g) Pension. This paragraph (g) applies
(1) There is a change in law or a VA
when VA reduces or discontinues
administrative issue or a change in
pension payments because of a change
interpretation of law or VA issue; if so,
§ 5.152 applies (effective dates based on in disability or employability status. In
such cases, VA will reduce the rate or
change of law or VA issue);
(2) An award was erroneous due to an discontinue pension effective the first
act of commission or omission by the
day of the month after a second 60-day
beneficiary or with the beneficiary’s
period beginning on the day of notice to
knowledge; if so, § 5.165(b) applies; or
the beneficiary of the final decision.
(3) An award was based solely on
(h) Chapter 18 monetary allowance.
administrative error or an error in
This paragraph (h) applies when VA
judgment by VA; if so, § 5.165(c) applies reduces or discontinues payments of a
in cases other than severance of service
monetary allowance under 38 U.S.C.
connection under paragraph (d) of this
chapter 18 for children with certain
section or reduction of compensation
birth defects. In such cases, VA will pay
under paragraph (f) of this section.
a reduced rate or discontinue the
(d) Severance of service connection.
monetary allowance effective the first
This paragraph (d) applies when VA
day of the month that follows the end
severs service connection. In such cases, of the 60-day notice period concerning
two 60-day periods apply. After
the proposed reduction or
applying the 60-day notice period
discontinuance. The 60-day notice
described in § 5.176, VA will sever
period is the one described in § 5.176.
service connection effective the first day
(i) Other. The effective date for other
of the month after a second 60-day
reductions or discontinuances of benefit
period beginning on the day of notice to payments will be based upon the
the beneficiary of the final decision.
reasons for the change as described in
(e) Character of discharge or line of
§ 3.500 through § 3.503 of this chapter.
duty. This paragraph (e) applies when
(Authority: 38 U.S.C. 1110, 1131, 1117, 5112)
VA discontinues benefits based on a
determination as to character of
§§ 5.178–5.179 [Reserved]
discharge or line of duty. In such cases,
[FR Doc. E7–9542 Filed 5–21–07; 8:45 am]
two 60-day periods apply. After
applying the 60-day notice period
BILLING CODE 8320–01–P
PO 00000
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Sfmt 4702
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Agencies
[Federal Register Volume 72, Number 98 (Tuesday, May 22, 2007)]
[Proposed Rules]
[Pages 28770-28793]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-9542]
[[Page 28769]]
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Part II
Department of Veterans Affairs
-----------------------------------------------------------------------
38 CFR Part 5
General Evidence Requirements, Effective Dates, Revision of Decisions,
and Protection of Existing Ratings; Proposed Rule
Federal Register / Vol. 72, No. 98 / Tuesday, May 22, 2007 / Proposed
Rules
[[Page 28770]]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 5
RIN 2900-AM01
General Evidence Requirements, Effective Dates, Revision of
Decisions, and Protection of Existing Ratings
AGENCY: Department of Veterans Affairs.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) proposes to reorganize
and rewrite in plain language general provisions applicable to its
compensation and pension regulations, including general evidence
requirements, general effective dates for new awards, revision of
decisions, and protection of existing ratings. These revisions are
proposed as part of VA's rewrite and reorganization of all of its
compensation and pension rules in a logical, claimant-focused, and
user-friendly format. The intended effect of the proposed revisions is
to assist claimants and VA personnel in locating and understanding
these general provisions.
DATES: Comments must be received by VA on or before July 23, 2007.
ADDRESSES: Written comments may be submitted through
www.Regulations.gov; by mail or hand-delivery to the Director,
Regulations Management (00REG), Department of Veterans Affairs, 810
Vermont Ave., NW., Room 1068, Washington, DC 20420; or by fax to (202)
273-9026. Comments should indicate that they are submitted in response
to ``RIN 2900-AM01--General Evidence Requirements, Effective Dates,
Revision of Decisions, and Protection of Existing Ratings.'' Copies of
comments received will be available for public inspection in the Office
of Regulation Policy and Management, Room 1063B, between the hours of 8
a.m. and 4:30 p.m. Monday through Friday (except holidays). Please call
(202) 273-9515 for an appointment. (This is not a toll-free number.) In
addition, during the comment period, comments may be viewed online
through the Federal Docket Management System (FDMS).
FOR FURTHER INFORMATION CONTACT: William F. Russo, Director,
Regulations Management (00REG), Department of Veterans Affairs, 810
Vermont Avenue, NW., Washington, DC 20420, (202) 273-9515. (This is not
a toll-free number.)
SUPPLEMENTARY INFORMATION: The Secretary of Veterans Affairs has
established an Office of Regulation Policy and Management (ORPM) to
provide centralized management and coordination of VA's rulemaking
process. One of the major functions of this office is to oversee a
Regulation Rewrite Project (the Project) to improve the clarity and
consistency of existing VA regulations. The Project responds to a
recommendation made in the October 2001 ``VA Claims Processing Task
Force: Report to the Secretary of Veterans Affairs.'' The Task Force
recommended that the compensation and pension regulations be rewritten
and reorganized in order to improve VA's claims adjudication process.
Therefore, the Project began its efforts by reviewing, reorganizing,
and redrafting the content of the regulations in 38 CFR part 3
governing the compensation and pension program of the Veterans Benefits
Administration. These regulations are among the most difficult VA
regulations for readers to understand and apply.
Once rewritten, the proposed regulations will be published in
several portions for public review and comment. This is one such
portion. It includes proposed rules regarding general evidence
requirements, general effective dates for awards, revision of
decisions, and protection of VA ratings. After review and consideration
of public comments, final versions of these proposed regulations will
ultimately be published in a new part 5 in 38 CFR.
Outline
Overview of New Part 5 Organization
Overview of This Notice of Proposed Rulemaking
Table Comparing Current Part 3 Rules with Proposed Part 5 Rules
Content of Proposed Regulations
General Evidence Requirements
5.130 Submission of statements, evidence, or information
affecting entitlement to benefits.
5.13 Applications, claims, and exchange of evidence with Social
Security Administration (SSA)--death benefits.
5.132 Claims, statements, evidence, or information filed abroad;
authentication of documents from foreign countries.
5.133 Information VA may request from financial institutions.
5.134 Will VA accept a signature by mark or thumbprint?
5.135 Statements certified or under oath or affirmation.
Evidence Requirements for Former Prisoners of War (POWs)
5.140 Determining former prisoner of war status.
5.141 Medical evidence for former prisoners' of war compensation
claims.
General Effective Dates for Awards
5.150 General effective dates for awards or increased benefits.
5.151 Date of receipt.
5.152 Effective dates based on change of law or VA issue.
5.153 Effective date of awards based on receipt of evidence
prior to end of appeal period.
General Rules on Revision of Decisions
5.160 Binding effect of VA decisions.
5.161 Review of benefit claims decisions.
5.162 Revision of decisions based on clear and unmistakable
error (CUE).
5.163 Revision of decisions based on difference of opinion.
5.164 Effective dates for revision of decisions based on
difference of opinion.
5.165 Effective dates for reduction or discontinuance of awards
based on error.
5.166 New and material evidence based on service department
records.
General Rules on Protection or Reduction of Existing Ratings
5.170 Calculation of 5-year, 10-year, and 20-year protection
periods.
5.171 Protection of 5-year stabilized ratings.
5.172 Protection of continuous 20-year ratings.
5.173 Protection against reduction of disability ratings when
revisions are made to the Schedule for Rating Disabilities.
5.174 Protection of entitlement to benefits established before
1959.
5.175 Protection or severance of service connection.
5.176 Due process procedures for severing service connection or
reducing or discontinuing compensation benefits.
5.177 Effective dates for severing service connection or
discontinuing or reducing benefit payments.
Endnote Regarding Amendatory Language
Paperwork Reduction Act
Regulatory Flexibility Act
Executive Order 12866
Unfunded Mandates
Catalog of Federal Domestic Assistance Numbers and Titles
List of Subjects in 38 CFR Part 5
Overview of New Part 5 Organization
We plan to organize the part 5 regulations so that most of the
provisions governing a specific benefit are located in the same
subpart, with general provisions pertaining to all compensation and
pension benefits also grouped together. We believe this organization
will enable claimants, beneficiaries, and their representatives, as
well as VA personnel, to find information relating to a specific
benefit more quickly than the organization provided in current part 3.
The first major subdivision would be ``Subpart A--General
Provisions.'' It would include information regarding the scope of the
regulations in new part 5, general definitions, and general policy
provisions for this part. This subpart was published as proposed on
March 31, 2006. See 71 FR 16464.
``Subpart B--Service Requirements for Veterans'' would include
information regarding a veteran's military service, including the
minimum service requirement, types of service, periods of
[[Page 28771]]
war, and service evidence requirements. This subpart was published as
proposed on January 30, 2004. See 69 FR 4820.
``Subpart C--Adjudicative Process, General'' would inform readers
about types of claims and filing procedures, VA's duties, rights and
responsibilities of claimants and beneficiaries, general evidence
requirements, and effective dates for new awards, as well as revision
of decisions and protection of VA ratings. This subpart will be
published as three separate Notices of Proposed Rulemaking (NPRMs) due
to its size. The first, concerning the duties of VA and the rights and
responsibilities of claimants and beneficiaries, was published as
proposed on May 10, 2005. See 70 FR 24680. The portion of this subpart
covering general evidence requirements, effective dates for awards,
revision of decisions, and protection of VA ratings is the subject of
this document.
``Subpart D--Dependents and Survivors'' would inform readers how VA
determines whether an individual is a dependent or a survivor of a
veteran. It would also provide the evidence requirements for these
determinations. This subpart was published as proposed on September 20,
2006. See 71 FR 55052.
``Subpart E--Claims for Service Connection and Disability
Compensation'' would define service-connected compensation, including
direct and secondary service connection. This subpart would inform
readers how VA determines entitlement to service connection. The
subpart would also contain those provisions governing presumptions
related to service connection, rating principles, and effective dates,
as well as several special ratings. This subpart will be published as
three separate NPRMs due to its size. The first, concerning
presumptions related to service connection, was published as proposed
on July 27, 2004. See 69 FR 44614.
``Subpart F--Nonservice-Connected Disability Pensions and Death
Pensions'' would include information regarding the three types of
nonservice-connected pension: Improved pension, Old-Law pension, and
Section 306 pension. This subpart would also include those provisions
that state how to establish entitlement to Improved pension, and the
effective dates governing each pension. This subpart would be published
in two separate NPRMs due to its size. The portion concerning Old-Law
pension, Section 306 pension, and elections of Improved pension was
published as proposed on December 27, 2004. See 69 FR 77578.
``Subpart G--Dependency and Indemnity Compensation, Death
Compensation, Accrued Benefits, and Special Rules Applicable Upon Death
of a Beneficiary,'' would contain regulations governing claims for
dependency and indemnity compensation (DIC); death compensation;
accrued benefits; benefits awarded, but unpaid at death; and various
special rules that apply to the disposition of VA benefits, or proceeds
of VA benefits, when a beneficiary dies. This subpart would also
include related definitions, effective-date rules, and rate-of-payment
rules. This subpart was published as two separate NPRMs due to its
size. The portion concerning accrued benefits, death compensation,
special rules applicable upon the death of a beneficiary, and several
effective-date rules, was published as proposed on October 1, 2004. See
69 FR 59072. The portion concerning DIC benefits and general provisions
relating to proof of death and service-connected cause of death was
published as proposed on October 21, 2005. See 70 FR 61326.
``Subpart H--Special and Ancillary Benefits for Veterans,
Dependents, and Survivors'' would pertain to special and ancillary
benefits available, including benefits for children with various birth
defects. This subpart was published as proposed on March 9, 2007. See
72 FR 10860.
``Subpart I--Benefits for Certain Filipino Veterans and Survivors''
would pertain to the various benefits available to Filipino veterans
and their survivors. This subpart was published as proposed on June 30,
2006. See 71 FR 37790.
``Subpart J--Burial Benefits'' would pertain to burial allowances.
``Subpart K--Matters Affecting the Receipt of Benefits'' would
contain provisions regarding bars to benefits, forfeiture of benefits,
and renouncement of benefits. This subpart was published as proposed on
May 31, 2006. See 71 FR 31056.
``Subpart L--Payments and Adjustments to Payments'' would include
general rate-setting rules, several adjustment and resumption
regulations, and election-of-benefit rules. Because of its size,
subpart L will be published in two separate NPRMs.
The final subpart, ``Subpart M--Apportionments to Dependents and
Payments to Fiduciaries and Incarcerated Beneficiaries,'' would include
regulations governing apportionments, benefits for incarcerated
beneficiaries, and guardianship.
Some of the regulations in this NPRM cross-reference other
compensation and pension regulations. If those regulations have been
published in this or earlier NPRMs for the Project, we cite the
proposed part 5 section. We also include, in the relevant portion of
the Supplementary Information, the Federal Register page where a
proposed part 5 section published in an earlier NPRM may be found.
However, where a regulation proposed in this NPRM would cross-reference
a proposed part 5 regulation that has not yet been published, we cite
to the current part 3 regulation that deals with the same subject
matter. The current part 3 section we cite may differ from its eventual
part 5 counterpart in some respects, but we believe this method will
assist readers in understanding these proposed regulations where no
part 5 counterpart has yet been published. If there is no part 3
counterpart to a proposed part 5 regulation that has not yet been
published, we have inserted ``[regulation that will be published in a
future Notice of Proposed Rulemaking]'' where the part 5 regulation
citation would be placed.
Because of its large size, proposed part 5 will be published in a
number of NPRMs, such as this one. VA will not adopt any portion of
part 5 as final until all of the NPRMs have been published for public
comment.
In connection with this rulemaking, VA will accept comments
relating to a prior rulemaking issued as a part of the Project, if the
matter being commented on relates to both rulemakings.
Overview of This Notice of Proposed Rulemaking
This NPRM pertains to those regulations governing the following for
purposes of compensation and pension benefits: (1) General evidence
requirements; (2) general effective dates for awards; (3) revision of
decisions; and (4) protection of existing ratings. These regulations
would be contained in proposed Subpart C of new 38 CFR part 5. Although
these regulations have been substantially restructured and rewritten
for greater clarity and ease of use, most of the basic concepts
contained in these proposed regulations are the same as in their
existing counterparts in 38 CFR part 3. However, a few substantive
differences are proposed, along with some rules that do not have
counterparts in 38 CFR part 3.
Table Comparing Current Part 3 Rules With Proposed Part 5 Rules
The following table shows the relationship between the current
regulations in part 3 and those proposed regulations contained in this
NPRM:
[[Page 28772]]
------------------------------------------------------------------------
Based in whole or in part on
Proposed part 5 section or paragraph 38 CFR part 3 section or
paragraph (or ``New'')
------------------------------------------------------------------------
5.130(a).................................. 3.217(a) and Note to
3.217(a).
5.130(b).................................. 3.217(b).
5.130(c)(1)(i)............................ 3.217(b)(1)(i).
5.130(c)(1)(ii)........................... 3.217(b)(1)(ii).
5.130(c)(1)(iii).......................... 3.217(b)(1)(iii).
5.130(c)(2)............................... 3.217(b)(2).
5.130(d).................................. New.
5.131(a).................................. 3.153.
5.131(b).................................. 3.201(a).
5.131(c).................................. 3.201(b).
5.132(a).................................. 3.108.
5.132(b).................................. 3.202(a).
5.132(c)(1)............................... 3.202(b)(1).
5.132(c)(2)............................... 3.202(b)(2).
5.132(c)(3)............................... 3.202(b)(3).
5.132(c)(4)............................... 3.202(b)(6).
5.132(c)(5)............................... 3.202(b)(4).
5.132(d)(1)............................... 3.202(a) [first sentence]
and 3.202(a)(2).
5.132(d)(2)............................... 3.202(a)(1).
5.132(e).................................. 3.202(c).
5.133(a).................................. 3.115(a).
5.133(b).................................. New.
5.133(b)(1)............................... New.
5.133(b)(2)............................... New.
5.133(c)(1)............................... 3.115(b).
5.133(c)(2)............................... 3.115(b).
5.134..................................... 3.2130.
5.135..................................... 3.200.
5.140(a).................................. 3.1(y)(1), (y)(3).
5.140(b).................................. 3.1(y)(2)(i).
5.140(c).................................. 3.1(y)(2)(ii).
5.140(d).................................. 3.1(y)(4).
5.141(a).................................. 3.304(c).
5.141(b).................................. New.
5.141(c).................................. 3.304(e).
5.141(d).................................. 3.304(e) [first sentence].
5.141(e).................................. 3.304(e) [last two
sentences].
5.141(f).................................. 3.326(b).
5.150(a).................................. 3.400 [intro] and (a),
3.400(h)(1), and
3.400(q)(1)(ii).
5.150(b).................................. New.
5.151..................................... 3.1(r).
5.152..................................... 3.114.
5.153..................................... 3.156(b) and 3.400(q)(1)(i).
5.160(a).................................. 3.104(a).
5.160(b).................................. 3.104(b).
5.161..................................... 3.2600.
5.162(a).................................. 3.105(a) first two
sentences].
5.162(b).................................. 3.105 [intro--first
sentence] and 3.105(a)
[third and fourth
sentences].
5.163..................................... 3.105(b).
5.164..................................... 3.400(h)(1).
5.165(a).................................. 3.500(b).
5.165(b).................................. 3.500(b)(1).
5.165(c).................................. 3.500(b)(2).
5.166..................................... 3.156(c).
5.170(a).................................. 3.344, 3.951, and 3.957.
5.170(b).................................. 3.951(b) and 3.957.
5.170(c).................................. New.
5.170(d).................................. New.
5.170(e).................................. New.
5.171(a).................................. 3.344(a).
5.171(b).................................. 3.344(c).
5.171(c)(1)............................... 3.344(c).
5.171(c)(2)............................... 3.344(a).
5.171(d).................................. 3.344(a).
5.171(e).................................. 3.344(b).
5.172(a).................................. 3.951(b) [first sentence].
5.172(b).................................. 3.951(b) [second sentence].
5.172(c).................................. New
5.173(a).................................. 3.951(a) and 3.952.
5.173(b)(1)............................... 3.952.
5.173(b)(2)............................... 3.952.
5.173(b)(3)............................... 3.952.
5.174(a).................................. 3.953(a).
5.174(b).................................. 3.953(c).
5.175(a)(1)............................... 3.957 [first sentence].
5.175(a)(2)............................... 3.957 [last sentence].
5.175(b)(1)............................... 3.105(d) [first two
sentences].
5.175(b)(2)............................... 3.105(d) [third and fourth
sentences].
5.176(a) and (b).......................... 3.105(d) [fifth and sixth
sentences] and 3.105(e)
[first two sentences].
5.176(c).................................. 3.105(d) [last two
sentences] and 3.105(e)
[last two sentences].
5.177(a).................................. 3.105 [intro--last
sentence].
5.177(b).................................. 3.105 [intro--second
sentence].
5.177(c).................................. 3.105 [intro--first
sentence] and 3.500(b).
5.177(d).................................. 3.105(d).
5.177(e).................................. 3.105(c).
5.177(f).................................. 3.105(e).
5.177(g).................................. 3.105(f).
5.177(h).................................. 3.105(g).
5.177(i).................................. 3.105(h).
------------------------------------------------------------------------
Readers who use this table to compare existing regulatory
provisions with the proposed provisions, and who observe a substantive
difference between them, should consult the text that appears later in
this document for an explanation of significant changes in each
regulation. Not every paragraph of every current part 3 section
regarding the subject matter of this rulemaking is accounted for in the
table. In some instances, other portions of the part 3 sections that
are contained in these proposed regulations will appear in subparts of
part 5 that are being published separately for public comment. For
example, a reader might find a reference to paragraph (a) of a part 3
section in the table, but no reference to paragraph (b) of that section
because paragraph (b) will be addressed in a separate NPRM. The table
also does not include provisions from part 3 regulations that will not
be carried forward to part 5. Such provisions are discussed
specifically under the appropriate part 5 heading in this preamble.
Readers are invited to comment on the proposed part 5 provisions and
also on our proposals to omit those part 3 provisions from part 5.
Content of Proposed Regulations
General Evidence Requirements
Section 5.130 Submission of Statements, Evidence, or Information
Affecting Entitlement to Benefits
Proposed Sec. 5.130 is derived from current Sec. 3.217, VA's
regulation governing the submission of statements or information
affecting entitlement to benefits. We propose explicitly to make this
regulation applicable to ``evidence'' as well as statements and
information. The current regulation does not explicitly apply to the
submission of written evidence; however, in practice the principles
therein do apply to the submission of written evidence, and there is no
reason not to make the part 5 regulation explicit in this regard.
Proposed paragraph (a) addresses the methods by which beneficiaries
may submit statements, evidence, or information affecting their
entitlement to benefits. Acknowledging that certain VA regulations
require that particular types of evidence or information be submitted
in writing--e.g., Marriage (Sec. 5.192), Divorce (Sec. 5.194), and
Birth (Sec. 5.229)--we propose to state that it is VA's policy to
accept electronic submissions unless another regulation, form, or
directive expressly requires a different method of submission. Proposed
paragraph (a) would state that this policy does not apply to the filing
of a claim, Notice of Disagreement, Substantive Appeal, or any other
submissions or filing requirements covered in parts 19 and 20 of this
title.
We propose not to include the introductory phrase, ``For purposes
of this part, unless specifically provided otherwise,'' which is used
in paragraph (b) of current Sec. 3.217. Because proposed Sec. 5.0
specifically states that ``[e]xcept as otherwise provided, this part
applies only to benefits governed by this part,'' it is no longer
necessary to state that any rule in part 5 applies only for purposes of
this part. 71 FR 16464, 16473. Therefore, in paragraph (b) of Sec.
5.130, we propose to state, ``Except as otherwise provided.'' By so
doing, we achieve our goal of greater readability without loss of
clarity or substance.
In Sec. 5.130(c)(1), we propose to include a reference to the
beneficiary's authorized representative that is not
[[Page 28773]]
contained in current Sec. 3.217(b)(1). Including the representative
merely clarifies the established legal principle that the actions of an
authorized representative are considered to be actions by the client
beneficiary.
Current Sec. 3.217(b)(1)(iii) states that, when a beneficiary or
fiduciary orally provides information or a statement that VA may use to
adjust benefits, VA must inform him or her that ``the information or
statement will be used for the purpose of calculating benefit
amounts.'' In proposed Sec. 5.130(c)(1)(iii), we use the word ``may''
instead of ``will.'' This wording is more accurate because VA may
determine that the information or statement needs to be verified
through other means. It also makes this paragraph consistent with the
first sentence in proposed paragraph (b), which states that, ``VA may
take action* * *'' Similarly, we also propose to use the phrase ``may
be used'' in Sec. 5.130(c)(2)(v) instead of ``would be used'' as
stated in current Sec. 3.217(b)(2).
Finally, in proposed paragraph (d) we articulate the exceptions to
the rule that VA cannot act on an oral statement unless VA has complied
with paragraphs (c)(1) and (2). These exceptions, which apply to
statements made at a hearing or to a physician, reflect current
practice. Persons who appear at a hearing or who provide information to
a physician, especially in connection with a VA medical examination,
should expect that such information will be considered as part of their
claim. Neither current Sec. 3.217 nor the proposed part 5 version of
that rule preclude VA from relying on medical statements or statements
made at a hearing. Moreover, there is no doubt as to the identity of
the person making the statement in these two discrete situations.
Finally, Sec. Sec. 5.81, 5.82, and 20.700 adequately regulate
statements made at a hearing. 70 FR 24680, 24686-87.
Section 5.131 Applications, Claims, and Exchange of Evidence With
Social Security Administration (SSA)--Death Benefits
Proposed Sec. 5.131(a) is derived from the first sentence of
current Sec. 3.153, which states that an application for death
benefits filed with SSA on or after January 1, 1957, on a form jointly
prescribed by VA and SSA, will be considered a claim for VA death
benefits, and will be considered as received by VA as of the date SSA
received it.
Note that although current Sec. 3.1(p) uses the terms ``claim''
and ``application'' interchangeably, we propose to only use the term
``claim'' in part 5, for the sake of consistency, when referring to a
formal or informal communication in writing requesting a determination
of entitlement or evidencing a believe in entitlement to a benefit, as
the term ``claim'' is defined in part 3. (A future NPRM will fully
address the definition of ``claim'' for the purposes of part 5.) Thus,
the term ``claim'' would have the same meaning in Part 5 as it
currently does in Part 3; no substantive change is intended. We propose
to use the term ``application'' when referring to a certain form that a
claimant must file to apply for benefits. This definition will be
contained in Sec. 5.1 General Definitions.
Current Sec. 3.153 implements the statutory provision 38 U.S.C.
5105 that governs joint applications for SSA and dependency and
indemnity compensation (DIC). The statute is applicable only to claims
for chapter 13 benefits, which means that it applies to claims for DIC.
Current Sec. 3.153 states that a claim on a joint form is to be
treated as a claim for ``death benefits.'' However, under 38 U.S.C.
5101(b)(1), a claim for DIC must also be considered a claim for death
pension and accrued benefits. Consequently, proposed Sec. 5.131(a)
would parenthetically describe ``VA death benefits'' as ``[DIC], death
pension and accrued benefits.'' We also propose to update the statutory
authority citation by including a reference to 38 U.S.C. 5101(b)(1), as
the authority for considering a joint application to be a claim for
``death benefits'' is not derived from 38 U.S.C. 5105 alone. For the
reasons set forth above, the inclusion of death pension and accrued
benefits in the proposed regulation would not create a new basis of
entitlement or result in a substantive right that does not exist within
the current framework of the pertinent law or regulations.
The second sentence of current Sec. 3.153 states that VA is not
precluded by reason of having received a joint application from
requesting necessary evidence. This language is unnecessary because
nothing in any statute or regulation, including proposed Sec. 5.131,
precludes VA from requesting necessary evidence after we have received
a claim for benefits. In addition, the sentence merely reiterates the
last sentence of 38 U.S.C. 5105(b), and there is no need to maintain a
regulatory provision that merely recites a statutory provision.
Proposed Sec. 5.131(b) is derived in part from the second sentence
of current Sec. 3.201(a), which pertains to the exchange of evidence
between VA and SSA. The cited authority for this regulation includes 38
U.S.C. 5105, discussed above. Proposed Sec. 5.131(b) does not
incorporate the first sentence of current Sec. 3.201(a), as it is
unnecessary and redundant of proposed Sec. 5.81, which explicitly
states that ``VA will include in the record of proceedings any
information, evidence (whether documentary, testimonial, or in other
form), and any argument that a claimant offers in support of a claim.''
70 FR 24680, 24686. In addition, VA's ``duty to assist'' regulation, 38
CFR 3.159(c)(2), requires VA to obtain relevant records from a federal
department or agency, including records in custody of SSA. Moreover,
SSA is required, pursuant to 38 U.S.C. 5105(b), to forward to VA all
information and supporting documents that it receives in conjunction
with a joint application for DIC/SSA benefits. In light of the
foregoing, it is not necessary to specify in Sec. 5.131(b) that a
claimant may submit evidence submitted to SSA, or to permit the
claimant to request VA to obtain such evidence. We have also clarified
that the rule, embodied in proposed Sec. 5.131(b) and current Sec.
3.201(a), regarding the deemed date of receipt for evidence filed at
SSA applies only when the evidence was filed in conjunction with a
claim for both SSA death benefits and VA death benefits. The
clarification is to avoid a situation in which a final VA decision is
subject to collateral attack based upon evidence filed with SSA in
support of a claim for only SSA death benefits that predates a
subsequent separate claim for VA death benefits.
Proposed Sec. 5.131(c) is derived from current Sec. 3.201(b),
which provides that when SSA requests evidence from VA that was
submitted in support of a DIC application, VA will furnish it. However,
current Sec. 3.201(b) does not acknowledge the existence of laws,
including the Health Insurance Portability and Accountability Act
(HIPAA), that protect the confidentiality of various kinds of
information or evidence that claimants or beneficiaries file with VA.
For example, 38 U.S.C. 7332 protects the confidentiality of all records
containing the identity, diagnosis, prognosis, or treatment of any
patient or subject maintained in connection with any program or
activity carried out by or for VA and connected with drug abuse,
alcoholism or alcohol abuse, infection with the human immunodeficiency
virus, or sickle cell anemia. VA can only release such records when
certain prerequisites are satisfied, and we do not interpret section
7332 as providing for an exemption for mandatory disclosures to SSA
under this regulation or under its authorizing statute, 38 U.S.C.
5105(b). Also, 5 U.S.C. 552a contains general
[[Page 28774]]
procedures that all agencies must follow when determining whether to
release records that they maintain on individuals. Therefore, we
propose to add a sentence in proposed Sec. 5.131(c) to clarify that
any disclosure of evidence to the SSA under this paragraph must comply
with all requirements of any applicable privacy or confidentiality
laws, which would include HIPAA.
Section 5.132 Claims, Statements, Evidence, or Information Filed
Abroad; Authentication of Documents From Foreign Countries
Proposed Sec. 5.132 is derived from current Sec. 3.202, VA's
regulation pertaining to the criteria for the acceptance of foreign
evidence, and Sec. 3.108, which relates to occasions when the State
Department functions as an agent of VA. We believe it is logical to
consolidate into a single regulation the rule pertaining to filing
claims or evidence in foreign countries with the rule pertaining to
filing evidence from foreign sources.
In paragraph (a) of Sec. 5.132, we propose to include the
provisions of current Sec. 3.108, which recognize U.S. diplomatic and
consular officers abroad as agents for the acceptance of VA
applications or claims, or evidence in support of a claim pending with
VA. We clarify that the rule applies to submissions of claims or of
statements, evidence, or information in support of a claim.
Current Sec. 3.108 provides that diplomatic and consular officers
may act as agents of VA, ``and, therefore, a formal or informal claim
or evidence submitted in support of a claim filed in a foreign country
will be considered as filed in [VA] as of the date of receipt by the
State Department representative.'' We intend no substantive changes to
this regulation by eliminating the term ``informal claim.'' The term
``claim'' necessarily embraces all of the types of claims listed in the
regulations, including informal and formal claims.
Current Sec. 3.108 uses the terms ``diplomatic and consular
officers of the Department of State'' and ``the State Department
representative,'' to describe the officials who are authorized to
receive claims and evidence. For purposes of Sec. 5.132, we propose to
simplify the description by substituting the inclusive term
``Department of State representative.''
Paragraph (b) of proposed Sec. 5.132 explains that the term
``authentication'' means that ``an official listed in paragraph (d) of
this section verifies that the foreign document, including each
signature, stamp, and seal appearing on it, is genuine and has not been
altered.''
Paragraph (b) of proposed Sec. 5.132 explains that for the
purposes of Sec. 5.132(b) the term ``foreign documents'' means
documents that are signed under oath or affirmation in the presence of
an official in a foreign country. This definition is derived from
current Sec. 3.202(a). Examples of foreign documents are described in
the proposed regulation in order to aid the reader.
Paragraph (b) also directs the reader to a list (in paragraph (c))
of foreign documents that do not require authentication.
Paragraph (c) of proposed Sec. 5.132 restates current Sec.
3.202(b). In addition, proposed Sec. 5.132(c)(3) contains a direct
reference to Sec. 2.3, which pertains to delegation of authority to
employees to take affidavits, to administer oaths, etc. This reference
is appropriate, as it bears directly on the subject matter contained in
proposed Sec. 5.132. Current Sec. 3.202(b)(4) states that
authentication will not be required, ``[w]hen a copy of a public or
church record from any foreign country purports to establish birth,
adoption, marriage, annulment, divorce, or death, provided it bears the
signature and seal of the custodian of such record and there is no
conflicting evidence in the file which would serve to create doubt as
to the correctness of the record.'' Paragraph (b)(5) states that
authentication will not be required, ``[w]hen a copy of the public or
church record from one of the countries comprising the United Kingdom,
namely: England, Scotland, Wales, or Northern Ireland, purports to
establish birth, marriage, or death, provided it bears the signature or
seal or stamp of the custodian of such record and there is no evidence
which would serve to create doubt as to the correctness of the
records.'' VA believes that maintaining a different rule for the United
Kingdom is unnecessary because records maintenance in the United
Kingdom is not necessarily superior to that of all other countries.
Moreover, we believe that a single rule will be easier for VA personnel
to correctly apply and for the public to understand. We therefore
propose not to include an equivalent to Sec. 3.202(b)(5) in Sec.
5.132.
Paragraph (d) of proposed Sec. 5.132 is derived from current Sec.
3.202(a). Current Sec. 3.202(a) uses, among others, the terms ``United
States Consular Officer,'' ``the State Department,'' and ``the nearest
American consul,'' to describe the various Department of State
officials who may authenticate the signatures of officials of foreign
countries in cases where affidavits or other documents are required to
be executed under oath before foreign officials. For purposes of Sec.
5.132, we propose to simplify the description by substituting the
inclusive term ``officer of the Department of State authorized to
authenticate documents.'' We note that the Department of State has
promulgated 22 CFR 131.1, which authorizes specially designated
``authentication officers'' to issue certificates of authentication
under the seal of the Department of State on behalf of the Secretary of
State. That regulation also prescribes the proper form of
authentication. A certificate of authentication therefore constitutes
the State Department's official acknowledgment that a document of
foreign origin is genuine.
Section 5.133 Information VA May Request From Financial Institutions
Proposed Sec. 5.133, derived from current Sec. 3.115, will
provide readers with clarification of the different types of
information VA may request from a financial institution, the conditions
under which a request may be made, the steps for making a request, and
VA's responsibilities with regard to the handling of this information
once it is obtained.
The first sentence of current Sec. 3.115(a) reads: ``The Secretary
of Veterans Affairs may request from a financial institution the names
and addresses of its customers.'' As in several other proposed part 5
rules, this rule will refer to ``VA'' rather than ``[t]he Secretary of
Veterans Affairs'' to shorten the reference without changing its
meaning.
Some readers may not have a clear understanding of what constitutes
a ``financial institution,'' a term that is used in the first sentence
of current Sec. 3.115(a). Accordingly, we propose to add examples of
various types of financial institutions. Examples include banks,
savings and loan associations, trust companies, and credit unions.
The current language of Sec. 3.115 and the statutory provisions of
12 U.S.C. 3413 explicitly authorize VA to obtain only names and
addresses from a financial institution. However, VA also possesses
statutory authority to subpoena financial information. According to the
Right to Financial Privacy Act, ``A government authority may obtain
financial records * * * pursuant to an administrative subpoena or
summons otherwise authorized by law if there is reason to believe that
the records sought are relevant to a legitimate law enforcement
inquiry.'' 12 U.S.C. 3405. ``Government authority'' is defined in this
Act as ``any agency or department of the United States, or any officer,
employee, or agent thereof.'' 12 U.S.C. 3401(3). The Act also defines
``law enforcement inquiry'' as ``a lawful
[[Page 28775]]
investigation or official proceeding inquiring into a violation of, or
failure to comply with, any * * * regulation, rule, or order issued
pursuant thereto.'' 12 U.S.C. 3401(8). These provisions give VA the
authority, under certain circumstances, to obtain financial information
through a subpoena, provided it is necessary in order to determine
whether an individual has violated any of the regulations on veterans'
benefits. Additionally, 38 U.S.C. 5711(a)(2), authorizes the Secretary
and employees to whom the Secretary has delegated such authority to
``require the production of books, papers, documents, and other
evidence.''
For example, current Sec. Sec. 3.660(a), 3.256(a), and 3.277(b)
require individuals claiming entitlement to or receiving income-based
benefits from VA to promptly report changes in their income. If VA
discovers that a current or former beneficiary may have reported a
lower amount of income to VA than the financial institution reported to
the Internal Revenue Service as having been paid to the beneficiary, VA
will ask the individual to verify the amount received. If the
individual refuses or fails to respond to VA's request, VA has
authority under 12 U.S.C. 3405 to subpoena from the financial
institution a statement showing amounts it paid to the individual.
Before issuing a subpoena to a financial institution, 12 U.S.C.
3405(2) requires VA to: (1) Send a copy of the subpoena to the current
or former beneficiary; (2) inform the current or former beneficiary of
the reason VA is requesting financial information from the financial
institution; and (3) explain to the current or former beneficiary the
procedures for challenging VA's proposal to issue a subpoena.
VA's authority to issue subpoenas to financial institutions in
order to verify the amount of income paid by a financial institution to
a current or former VA beneficiary, as well as the circumstances under
which they may be issued, are not addressed in part 3 of current 38
CFR. However, we believe this is an issue about which the public should
be informed. For example, if VA discovers that a current or former
beneficiary, while receiving either pension or parents' dependency and
indemnity compensation, may have underreported or failed to report to
VA the receipt of income from a financial institution, VA may ask the
financial institution that paid the income to provide a statement
showing the amount it paid to the individual. We propose to clarify in
Sec. 5.133(b) that requests of this type must be made through a
subpoena. To ensure readers understand the meaning of the word
``subpoena,'' we propose to define it in paragraph (b). Our definition,
which is ``a legal document commanding an individual or organization to
provide specified evidence to the issuer of the subpoena,'' is derived
from the 2001 edition of Merriam-Webster's Dictionary of Law.
The content of paragraph (c)(1) of proposed Sec. 5.133 is derived
from current Sec. 3.115(b), while the content of paragraph (c)(2) is
derived from 12 U.S.C. 3412(a), which was part of the Right to
Financial Privacy Act of 1978. Although we have changed the language
taken from these two sources in order to make the proposed rule easier
to understand, we intend no change in the substance they convey.
Section 5.134 Will VA accept a signature by mark or thumbprint?
Proposed Sec. 5.134 is derived from current Sec. 3.2130. We are
not proposing any changes to the current regulation. Rather, we will
incorporate the language of current Sec. 3.2130 at proposed Sec.
5.134.
Section 5.135 Statements Certified or Under Oath or Affirmation
Proposed Sec. 5.135 is based on current Sec. 3.200, which states,
in pertinent part, ``All written testimony submitted by the claimant or
in his or her behalf for the purpose of establishing a claim for
service connection will be certified or under oath or affirmation.''
Instead of referring to ``written testimony'' we propose to use the
phrase, ``[a]ny documentary evidence or written assertion of fact''
which we believe is easier for readers to understand. We propose to
give VA discretion to consider such a submission that is not certified
or under oath or affirmation or to require certification, oath, or
affirmation if considered necessary to establish the reliability of a
material document. This would give VA discretion to consider documents
which are considered reliable under the circumstances of a particular
case. It would also give VA discretion to require certification, oath,
or affirmation when a submission appears unreliable, which will help
ensure program integrity.
Whereas current Sec. 3.200(b) is limited to claims for service
connection, we propose to have Sec. 5.135(b) apply to all claims
within the scope of part 5. We believe that there is nothing unique
about claims for service connection with respect to the reliability of
evidence. We believe that the principles stated above should apply
equally to all claims for compensation or pension benefits.
Evidence Requirements for Former Prisoners of War (POWs)
Section 5.140 Determining Former Prisoner of War Status
Proposed Sec. 5.140 contains rules relating to the evidentiary and
adjudicative considerations in determining prisoner of war (POW)
status. Proposed Sec. 5.140 is derived from current Sec. 3.1(y),
which sets forth general principles applicable to establishing status
as a POW, including definitions and certain evidentiary and
adjudicative considerations. We have addressed the various definitions
contained in current 3.1(y) in a separate NPRM that restated such
definitions in Sec. 5.1 of proposed part 5. See 71 FR 16464, 16473.
Additional principles establishing former POW status are found in Sec.
3.41, which sets forth special rules applicable to former prisoners of
war with Philippine service. These principles are also covered in a
separate NPRM. See 71 FR 37790, 37794.
Paragraph (a) of proposed Sec. 5.140 restates the current rule
that service department determinations of POW status are generally
binding on VA, and states the criteria VA will use to decide POW status
in all other cases. It also restates the requirement in current Sec.
3.1(y)(3) that the Director of the Compensation and Pension Service
must approve all 152 office decisions based on criteria for determining
former POW status other than service department findings. In order to
recognize the modern dangers presented by non-government forces, we
propose to expand the instances in which service department findings
will be accepted. Whereas current Sec. 3.1(y)(1) only accepts service
department findings that a person was a POW during a period of war when
detention or internment was by an enemy government or its agents, under
paragraph (a) of proposed Sec. 5.140, VA will also accept a finding by
the service department that a person was a POW during a period of war
when detention or internment was by a hostile force.
Paragraphs (b), (c), and (d) of proposed Sec. 5.140 restate the
content of current Sec. 3.1(y)(2)(i), (y)(2)(ii), and (y)(4),
respectively. In paragraph (d), we propose to cross-reference Sec.
5.660, pertaining to ``line of duty'' and derived from current
Sec. Sec. 3.1(m) and 3.301(a), and Sec. 5.661, pertaining to
``willful misconduct'' and derived from current Sec. Sec. 3.1(n),
3.301(a) through (d), and 3.302. See 71 FR 31056, 31062-63.
At the end of the proposed rule, we propose to cross-reference
proposed Sec. 5.611, which restates current Sec. 3.41,
[[Page 28776]]
relating to POW status and Philippine service. See 71 FR 37790, 37795.
Section 5.141 Medical Evidence for Former Prisoners' of War
Compensation Claims
Proposed Sec. 5.141 is based in part on those portions of current
Sec. 3.304, ``Direct service connection; wartime and peacetime,'' that
pertain to former POWs. Except as provided below, no substantive
changes are intended to these provisions. Portions of current Sec.
3.304 have already been addressed in a prior NPRM, published as
proposed on May 10, 2005. See 70 FR 24680. Other provisions of current
Sec. 3.304 will be addressed in a separate NPRM.
Proposed paragraph (a) provides information regarding injuries and
conditions claimed by a former POW that are obviously due to service.
The paragraph states that VA will rate such injuries and conditions
without awaiting receipt of service records. This paragraph is derived
from the last sentence of current Sec. 3.304(c) and is included to
clarify how the general rule in proposed Sec. 5.91, the part 5 version
of current Sec. 3.304(c), applies to conditions resulting from POW
confinement.
Proposed paragraph (b) provides that where disability compensation
is claimed by a former POW, the claimant's statements as to the
incurrence or aggravation of an injury or disease during or immediately
prior to detention or internment will be viewed as truthful unless
there is clear and convincing evidence to the contrary. This is a
substantive change based upon expanding current Sec. 3.304(d). VA's
practice has been to treat statements by former POWs in the same manner
as combat veterans for purposes of 38 U.S.C. 1154(b) in order to
recognize the deficiencies or complete absence of many former POWs'
service medical records showing evidence of diseases or injuries
suffered during or immediately before detention or internment. This
substantive change is consistent with current Sec. 3.304(f)(2),
pertaining to post-traumatic stress disorder claimed by a former
prisoner of war. At the end of paragraph (b), we propose to add a
reference to Sec. 3.304(f)(2) to let the reader know the location of a
similar provision regarding POWs. We cite to the current part 3
regulation because the proposed part 5 regulation that deals with the
same subject matter has not yet been published. Current Sec.
3.304(f)(2) may differ from its eventual part 5 counterpart in some
respects.
Proposed paragraph (c) notes that supporting evidence from fellow
service members that an injury or disease was incurred during
confinement will be considered. This is not a substantive change from
part 3 and does not provide a new benefit to former POWs. VA accepts
``buddy statements'' in all cases. We explicitly provide for such
evidence here, and discuss how to evaluate that evidence, because such
evidence is more frequently encountered in cases relating to POWs.
Proposed paragraph (c) would require VA to consider statements from
fellow service members submitted in connection with a former POW's
claim for benefits, regarding the former POW's physical condition
before capture, the circumstances surrounding the former POW's
internment, changes in the former POW's physical condition following
release from internment, or the existence of signs or symptoms of
disability following the former POW's release from internment.
Paragraph (d) of proposed Sec. 5.141 provides that the lack of
medical findings from clinical records made upon a former POW's return
to U.S. control will not be determinative of whether service connection
is awarded for a particular disability. It is derived from the first
sentence of current Sec. 3.304(e).
Proposed paragraph (e) restates the second and third sentences of
current Sec. 3.304(e).
Finally, proposed paragraph (f) includes information from the
second sentence of current Sec. 3.326(b), which provides that VA will
not deny monetary benefits unless the claimant has been offered a
complete physical examination at a VA facility. Unlike current Sec.
3.326(b), which states that the examination will be ``conducted at a
[VA] hospital or outpatient clinic,'' proposed paragraph (f) does not
specify the location of the examination to be provided because an
examination may be provided by VA at one of a variety of VA medical
facilities, or, in some instances, VA may provide an examination with a
private contractor at a non-VA facility. ``[M]edical examination'' used
in proposed paragraph (f), as opposed to ``physical examination'' used
in current Sec. 3.326(b), clarifies that the examination is not
limited to examination for physical disorders but includes examination
for mental disorders as well.
General Effective Dates for Awards
Section 5.150 General Effective Dates for Awards or Increased Benefits
Proposed Sec. 5.150 would restate without substantive change the
introductory text and paragraph (a) of current Sec. 3.400, which
state:
Except as otherwise provided, the effective date of an
evaluation and award of pension, compensation or dependency and
indemnity compensation based on an original claim, a claim reopened
after final disallowance, or a claim for increase will be the date
of receipt of the claim or the date entitlement arose, whichever is
later.
(a) Unless specifically provided. On basis of facts found.
The exceptions to the general effective-date rule, which are
currently contained in other provisions of Sec. Sec. 3.400 through
3.405, would be contained in regulations located proximate to their
respective benefit regulations.
In paragraph (a) of Sec. 5.150, we propose not to include the
phrase ``facts found'' in current Sec. 3.400(a). Instead, we will only
use the phrase ``date entitlement arose,'' which appears in the
introductory text of Sec. 3.400. Section 5110(a) of title 38, United
States Code, on which the general effective date rule stated in Sec.
3.400 is based, uses ``facts found'' and does not use the phrase ``date
entitlement arose.'' Nevertheless, the legislative history of 38 U.S.C.
5110(a) and the regulatory history of 38 CFR 3.400 both suggest that
``facts found'' and ``date entitlement arose'' mean the same thing.
Both phrases are derived from Veterans Regulation No. 2(a), promulgated
by Exec. Order 6230 (1933), which states that the effective date of an
award of pension ``shall be fixed in accordance with the facts found''
except that no awards would be effective before the date of separation
from service, date of death, date of the happening of the contingency
upon which disability or death pension is allowed, or the date of
receipt of the claim therefor, whichever is the later date. The various
dates listed in the immediately preceding sentence, except for the date
of receipt of the claim, are exceptions to the rule to assign the
effective date in accordance with the facts found, and are themselves
dates upon which entitlement to various kinds of benefits is
predicated. For all practical purposes, these are the relevant
``facts'' upon which entitlement would be based.
VA has consistently so construed Veterans Regulation No. 2(a), a
fact made clear by an examination of the effective-date regulations VA
issued after Veterans' Regulation No. 2(a). These are as follows: VA
Regulation (VAR) 1148 (concerning the assignment of effective dates for
ratings made under VA's 1945 Schedule for Rating Disabilities); VAR
1212 (effective date for awards of disability compensation); VAR 2574
(effective date of awards of death compensation or pension), and
[[Page 28777]]
VAR 2945 (effective date of payment of dependency and indemnity
compensation). VA used the term ``facts found'' in only two of these
regulations. VAR 2574 (Jan. 25, 1936) (which cites Veterans Regulation
No. 2(a)), VAR 2945 (Jan. 1, 1958) (which was changed from different
language to mirror the language of what is now 38 U.S.C. 5110(a)).
Instead of using ``facts found,'' VA used phrases such as ``date the
evidence shows a compensable or pensionable degree of disability to
have existed'' and ``date the evidence shows entitlement.'' VAR 1148
(Jan. 25, 1936). In 1950, VAR 2574 was amended to state that the
effective date for an award of death compensation or pension would be
the date ``of the veteran's death, date of the happening of the
contingency upon which death compensation or pension is allowed, or the
date of receipt of [the] application therefor,'' whichever is later.
This general effective-date provision is very similar to that of
Veterans Regulation No. 2(a) except that it is devoid of the phrase
``fixed in accordance with the facts found.'' Nevertheless, it conveys
the same information.
When Congress first consolidated the laws and regulations related
to compensation and pension, the present version of what is now 38
U.S.C. 5110(a) first appeared in the statute. Public Law 85-56, section
910(a), 71 Stat. 83, 119 (1957). The purpose of this law was to
incorporate existing law into a single act. According to the committee
reports, Congress did not intend to make any substantive changes to the
effective date provisions. See H.R. Rep. No. 85-279, at 2, reprinted in
1957 U.S.C.C.A.N. 1214, 1215 (1957); S. Rep. No. 85-332, at 2,
reprinted in 1957 U.S.C.C.A.N. 1214, 1241 (1957). This statute also
repealed Veterans Regulation No. 2(a). Pub. L. No. 85-56, Sec.
2202(129), 71 Stat. at 167. The committee reports stated that the law
``would repeal those provisions of law * * * which are obsolete,
executed, or restated in substance.'' H.R. Rep. No. 85-279, at 2, S.
Rep. No. 85-322, at 2. Therefore, Public Law 85-56 was intended to
restate the substance of the rule in Veterans Regulation No. 2(a),
despite changing the language.
Current Sec. 3.400 uses ``date entitlement arose'' in the
introductory text and uses ``facts found'' in paragraph (a). These two
phrases have been used interchangeably in the past, though neither has
been defined. This also suggests that ``facts found'' and ``date
entitlement arose'' mean the same thing. We believe that we should only
use one phrase consistently throughout the part 5 to eliminate any
confusion over whether ``facts found'' means the same thing as ``date
entitlement arose'' and to make the regulations more user-friendly.
Therefore, we will use ``date entitlement arose'' in Sec. 5.150. The
proposed rule clarifies that the term ``date entitlement arose'' has
the same meaning when used in other effective-date regulations
throughout part 5.
We also propose to define the phrase ``date entitlement arose'' in
paragraph (a)(2) of Sec. 5.150 to make the rule easier to understand.
As noted above, the phrase has never been defined in the statute or in
the regulations. Proposed paragraph (a)(2) defines ``date entitlement
arose'' as the date shown by the evidence to be the date that the
claimant first met the requirements for the benefit awarded. This
definition accurately expresses the intent of the relevant statutes
cited above.
We also propose to add a sentence to emphasize that VA will assume
the ``date entitlement arose'' was before the date VA received the
claim for benefits unless the evidence indicates otherwise. We believe
it is important to provide this guidance because in the majority of
cases, claimants meet the requirements for a benefit before they apply
for it. In such cases, the general rule mandates that the effective
date be the date of receipt of the claim for that benefit, and not some
later date.
Proposed Sec. 5.150(b) sets forth a chart that provides readers
with the location of other effective-date provisions in part 5, which
are exceptions to the general effective date rule of proposed paragraph
(a). The chart is intended solely for informational purposes. As
proposed, the chart shows both already published and as yet unpublished
Part 5 sections. The unpublished sections are included as placeholders;
many may change before publication. The Subpart B provisions were
published as proposed on January 30, 2004. See 69 FR 4820.
Section 5.101(d) of Subpart C was published as proposed on May 10,
2005. See 70 FR 24680. Proposed Sec. Sec. 5.152, 5.153, 5.162(b),
5.164, 5.165, 5.166(c), (d), and 5.177 of Subpart C are contained in
this document.
The Subpart D provisions were published as proposed on September
20, 2006. See 71 FR 55052.
Sections 5.463 and 5.477 of Subpart F were published as proposed on
December 27, 2004. See 69 FR 77578.
Sections 5.567 to 5.572 of Subpart G were published as proposed on
October 1, 2004. See 69 FR 59072. A correction to proposed Sec. 5.570
was published on October 21, 2004. See 69 FR 61914. Sections 5.524(c),
5.573, and 5.574 of Subpart G were published as proposed on October 21,
2005. See 70 FR 61326.
The Subpart H provisions were published as proposed on March 9,
2007. See 72 FR 10860.
The Subpart I provisions were published as proposed on June 30,
2006. See 71 FR 37790.
The Subpart K provisions were published as proposed on May 31,
2006. See 71 FR 31056.
Section 5.151 Date of Receipt
Current Sec. 3.1(r) sets forth a definition of the phrase ``date
of receipt.'' We propose to address that topic in a provision
designated as Sec. 5.151. Proposed paragraph (a) would broaden the
concept in current Sec. 3.1(r) to include ``documents'' in addition to
claims, information, and evidence. Although the language in the
proposed Part 5 counterparts of current Sec. Sec. 3.108, 3.153, and
3.201 does not contain the phrase ``date of receipt,'' proposed
paragraph (a) would nevertheless retain the exceptions for these
provisions that are contained in current Sec. 3.1(r) because proposed
paragraph (a) will refer to a concept rather than merely define the
specific term ``date of receipt.''
Proposed paragraph (b) would incorporate provisions from current
Sec. 3.1(r) authorizing VA to establish exceptions to the general rule
when a natural or man-made disaster or similar event has caused
disruption in the process through which VA ordinarily receives
correspondence. The intended effect is to ensure that claimants and
beneficiaries are not deprived of potential entitlement to benefits
because of unexpected delays or impediments through no fault of their
own. Section 512(a) of 38 U.S.C., listed as statutory authority for
proposed Sec. 5.151, pertains to the Secretary's ability to delegate
authority to officials and employees to administer the laws and make
decisions. The citation to 38 U.S.C. Sec. 512(a) is used to justify
empowering employees and officials to establish procedures in emergency
circumstances. Although current Sec. 3.1(r) makes a delegation to the
Under Secretary for Benefits, the cited statute does not limit
delegation to the Under Secretary for Benefits. Accordingly, proposed
paragraph (b) does not contain that limitation.
Section 5.152 Effective Dates Based on Change of Law or VA Issue
We propose to re-state current Sec. 3.114 in Sec. 5.152. The
heading for paragraph (b) of proposed Sec. 5.152, ``Reduction or
discontinuance of benefits'' differs from the heading of current Sec.
3.114(b), ``Discontinuance of benefits,'' in order to describe more
accurately the content of the paragraph, which addresses both
reductions of benefits and
[[Page 28778]]
discontinuances of benefits. Current Sec. 3.114(b) states that a
claimant has 60 days from the date of the notice of a proposed
reduction or discontinuance of benefits in which to submit evidence
showing the proposed action should not be taken. The last sentence of
current Sec. 3.114(b) states that
[i]f additional evidence is not received within that period, the
award will be reduced or discontinued effective the last day of the
month in which the 60-day period expired.
We propose to clarify in Sec. 5.152(b) that if no evidence is
received within 60 days, or if evidence is received that does not
demonstrate that the proposed action should not be taken, the award
will be reduced or discontinued effective the last day of the month in
which the 60-day period expired.
Another change has to do with the use of the term ``facts found''
used in current Sec. 3.114 and in 38 U.S.C. 5110(g). As noted in the
discussion of