Board of Veterans' Appeals: Expedited Claims Adjudication Initiative-Pilot Program, 65726-65735 [E8-26310]
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committed to ensuring that rural areas
will have access to affordable, reliable,
advanced telecommunications services,
comparable to those available
throughout the rest of the United States,
to provide a healthy, safe and
prosperous place to live and work.
While the Agency is proud of the
results it has achieved in Rural America
with the Telecommunications Loan
Program, it believes that the overall
effectiveness of the program can be
improved by modifying the existing
rules. The change to the current
regulation will permit additional
financially sound borrowers, who
clearly meet the intent of the
Telecommunications Loan Program, to
be eligible to participate in the program.
Discussion of Changes
Facilities financed by the Loan
Program are typically constructed over a
five year period (Forecast Period). The
feasibility studies used to demonstrate
that an applicant is eligible for a loan
and can repay it assumes this Forecast
Period. The feasibility study is also used
to forecast the applicant’s Times Interest
Earned Ratio or TIER. The TIER is one
measure of an applicant’s ability to
repay the loan. Currently, the regulation
states that applicants must maintain a
TIER of at least 1.0 during the Forecast
Period. At the end of the Forecast
Period, the applicant shall be required
to maintain, at a minimum, a TIER at
least equal to the projected TIER
determined by the feasibility study
prepared in connection with the loan,
but at least 1.0 and not greater than 1.5.
The requirement that an applicant
maintain a TIER of at least 1.0 during
the Forecast Period, arbitrarily and
unfairly disqualifies some applicants
from the Loan Program. During the
Forecast Period as an applicant
constructs facilities, there is always a
delay from the time that the
construction is initiated to the time that
construction is completed and revenues
increase based upon the new
subscribers connected and new services
offered. During this period, it would not
be unusual for the applicant’s TIER to
be less than 1.0. This occurrence is not
generally an indicator that the applicant
is in financial difficulty, but a direct
result of the time lag associated with
construction of facilities. In addition,
the current provision effectively
disqualifies any start up or new entity
from qualifying for the Loan Program. In
many cases these newer entities, and the
rural residents they serve, are the ones
that stand to benefit the greatest from
the program.
This change would not constitute a
loan security risk as an applicant’s
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financial performance is continuously
monitored and the advance of loan
funds can be suspended should the
situation warrant such action. In
addition, the applicant would still be
required to maintain the projected TIER
at the end of the Forecast Period.
List of Subjects in 7 CFR 1735
Loan programs—communications,
Rural Areas, Telecommunications and
Telephone.
■ For reasons set forth in the preamble,
the Agency amends Chapter XVII of title
7 of the Code of Federal Regulations by
revising part 1735 as follows:
PART 1735—GENERAL POLICIES,
TYPES OF LOANS, LOAN
REQUIREMENTS—
TELECOMMUNICATIONS PROGRAM
1. The authority citation for part 1735
continues to read as follows:
■
Authority: 7 U.S.C. 901 et seq., 1921 et
seq., and 6941 et seq.
2. In § 1735.22, paragraph (g) is
revised to read as follows:
■
§ 1735.22
Loan Security.
Subpart B—Loan Purposes
*
*
*
*
*
(g) For Loans approved after
December 22, 2008, the borrower shall
be required to maintain a TIER, at the
end of the Forecast Period, at least equal
to the projected TIER determined by the
feasibility study prepared in connection
with the loan, which shall be at least 1.0
and not greater than 1.5.
*
*
*
*
*
Dated: September 8, 2008.
James M. Andrew,
Administrator, Rural Utilities Service.
[FR Doc. E8–26318 Filed 11–4–08; 8:45 am]
BILLING CODE 3410–15–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Parts 3 and 20
RIN 2900–AM77
Board of Veterans’ Appeals: Expedited
Claims Adjudication Initiative—Pilot
Program
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
SUMMARY: The Department of Veterans
Affairs (VA) is launching an initiative
for accelerated claims and appeals
processing at four VA facilities, based
on voluntary participation by eligible
claimants. The purpose of this initiative
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is to determine whether VA can
expedite the processing of claims and
appeals by obtaining claimants’ waivers
of certain statutory and regulatory
response periods, and by utilizing the
Board of Veterans’ Appeals’ (Board or
BVA) statutory authority to pre-screen
cases. VA’s responsibility to fully
develop and decide cases in a fair,
accurate, and non-adversarial manner
remains unchanged under this
initiative. If this initiative is successful
at the four trial sites, the data obtained
may provide a basis for expanding
some, or all, of the program nationwide,
and ultimately help accelerate the
processing of all claims and appeals.
The parameters of the initiative are set
forth in these regulations.
DATES: Effective Date: The final rule is
effective December 5, 2008.
FOR FURTHER INFORMATION CONTACT:
Steven L. Keller, Principal Deputy Vice
Chairman, Board of Veterans’ Appeals
(012), Department of Veterans Affairs,
810 Vermont Avenue, NW.,
Washington, DC 20420, (202) 461–8078.
(This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: In a
document published in the Federal
Register on April 16, 2008 (73 FR
20571), VA proposed to launch an
initiative for accelerated claims and
appeals processing at four VA facilities.
This initiative would establish a 2-year
pilot program known as the Expedited
Claims Adjudication (ECA) Initiative
(Initiative). The goal of the Initiative
would be to determine whether VA can
expedite the claims and appeals process
by obtaining claimants’ waivers of
certain statutory and regulatory
response periods, and by pre-screening
cases at the Board to determine the
adequacy of the record for appellate
review. As proposed, participation in
the Initiative would be strictly
voluntary, and open to claimants
residing in the jurisdiction of one of the
four trial sites. Additionally, claimants
would be required to be represented by
a recognized Veterans Service
Organization (VSO) or an accredited
agent or attorney at the time of electing
to participate in the Initiative. The ECA
Initiative would be predicated on the
claimant agreeing, at the beginning of
the claims process, to waive certain
identified statutory and regulatory time
limits and processing actions, which
would be carefully outlined in an ECA
Initiative Agreement and Waiver of
Rights (ECA Agreement). ECA
participation would be effectuated only
if both the claimant and his or her
representative sign the ECA Agreement,
certifying that the claimant has
consulted with his or her representative
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to determine if participation in the
Initiative is in his or her best interest.
A claimant’s decision to participate in
the ECA would be revocable at any time
in the VA claims or appeals process,
with no penalty. Rather, as outlined in
the notice of proposed rulemaking,
upon express or implied revocation of
ECA participation, the claimant’s case
would continue to be processed, from
that point forward, using ordinary and
established procedures under current
statutes and regulations governing
claims adjudication. In other words, the
claimant’s case would essentially
continue from the same point in the
adjudication process that it was when it
left the ECA.
The public comment period ended on
June 16, 2008. VA received comments
from one individual and from three
organizations. For the most part, the
comments expressed general
disagreement with the basic structure
and purpose of the ECA, and raised
concerns about the impact the ECA
would have on VA’s workload,
particularly accuracy and quality in
decision-making. More specifically, the
commenters expressed the following
concerns: (1) The effect of the Initiative
on decision quality; (2) whether the
Board has authority to decide ECA
claims out of docket order; (3) time
limits under the Initiative; (4)
disagreement with the good cause
exception in the Initiative; (5) VA’s data
collection under the Initiative; (6) a
challenge to the purpose of the ECA;
and, (7) concern over the impact of the
ECA on the workload at one of the trial
sites. We will address each of these
topics in turn. Based on the rationale
described in this document and in the
notice of proposed rulemaking, VA
adopts the proposed rule as revised in
this document.
A. Decision Quality
An underlying theme throughout the
four comments was that the ECA would
degrade decision quality and accuracy.
One commenter stated that the Initiative
‘‘appears to elevate speed of
adjudication above adequate evidence
development and accuracy of decisionmaking.’’ The commenter stated that the
Initiative ‘‘does violence’’ to the
historical non-adversarial and informal
nature of the VA adjudication system.
The commenter stated the belief that the
Initiative would not lead to any
improvement to the adjudication system
as a whole. Rather, the commenter is
‘‘convinced that the changes the
Initiative proposes will cause the
creation of inadequately developed
records in claims, which will result in
inaccurate decisions denying benefits’’
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and ultimately lead to increased
remands in the system to ‘‘undertake
corrective development in covered
claims.’’
Similarly, another commenter
expressed hesitancy to support the ECA
‘‘without a guarantee that the quality of
the decision rendered will be better than
that of a claim adjudicated in the
normal manner or that there would be
a significant improvement in claims
processing time.’’ The commenter noted
the absence of a quality assurance
component for the ECA. The commenter
recommended ‘‘that VA devote its time
to improving the quality of its
adjudications rather than creating ways
to circumvent procedural protections.’’
We agree that all claimants in the VA
adjudication system are entitled to
accurate and legally correct decisions
based on a fully-developed evidentiary
record. We respectfully disagree,
however, with the commenters’
characterization of the Initiative as
promoting speed of adjudication over
adequate evidentiary development and
administrative efficiency over accuracy.
We also disagree with the suggestion
that the Initiative would do ‘‘violence’’
to the current system. Rather, we believe
that this Initiative is a constructive
attempt to improve efficiency and
timeliness in the VA claims
adjudication system.
As discussed in the notice of
proposed rulemaking, the essential
premise on which the Initiative is based
is that there are many procedural rights
built into the current VA claims
adjudication and appeals process that
unnecessarily lengthen the amount of
time it takes to process an initial claim
or appeal while cases sit without any
action occurring while waiting for a
statutory or regulatory response period
to end. By greatly reducing the amount
of time that a case sits without any
action occurring while waiting for one
of these response periods to run, it is the
goal of this 2-year Initiative to provide
a model to streamline the claims
adjudication and appeals process
system wide. Contrarily, it is not the
goal of the Initiative to avoid VA’s
responsibilities to fully and adequately
develop and decide cases in a fair and
accurate manner, or to change in any
other manner the non-adversarial and
informal nature of the VA adjudication
system.
With respect to evidentiary
development, we emphasize that the
Initiative leaves intact VA’s duty to
notify claimants of the information and
evidence necessary to substantiate their
claims under 38 U.S.C. 5103(a) and 38
CFR 3.159(b)(1), as well as VA’s duty to
assist claimants in obtaining evidence
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necessary to substantiate their claims
under 38 U.S.C. 5103A and 38 CFR
3.159(c). ECA participants will continue
to be provided a notice letter that
informs them of the information and
evidence needed to substantiate their
claim(s) and outlines the claimant’s and
VA’s responsibilities for obtaining such
evidence. See 38 U.S.C. 5103(a) and 38
CFR 3.159(b)(1). The Initiative also
leaves unaltered VA’s duty to make
reasonable efforts to obtain relevant
evidence identified by a claimant, and
leaves unchanged VA’s duty to provide
claimants with a medical examination
or obtain a medical opinion when
necessary to decide a claim. See, e.g., 38
CFR 3.159(c)(4), 3.326, 3.327. These
notice and development requirements
are implicitly referenced under
§ 20.1500(c), which states that any
matter not otherwise covered by this
subpart will be governed by existing
rules.
As the Initiative leaves intact VA’s
duties to notify and assist, we cannot
agree with the commenters’ suggestion
that the Initiative contains no provision
that would ensure that VA adjudicators
have a complete and fully developed
evidentiary record in covered claims. To
the contrary, VA’s obligation to
adequately develop claims under the
Veterans Claims Assistance Act of 2000
(VCAA), see 38 U.S.C. 5103 and 5103A,
applies to both ECA participants and
non-ECA participants alike. Under the
ECA Initiative, VA’s responsibilities
with respect to both obtaining and
analyzing identified evidence remain
unchanged. Thus, ECA participants run
no additional risk of inadequate
evidentiary development as compared
to other claimants in the VA system.
We also do not agree with the
suggestion that the Initiative sacrifices
accuracy for speed. It remains VA’s goal
to provide all claimants, including ECA
participants, with high-quality, legallycorrect decisions in all claims. No
provision in the ECA Initiative runs
counter to this goal. Although the
Initiative shortens various statutory and
regulatory response times to be observed
by participants, it does not diminish
VA’s duty to fully develop the record as
mandated by the VCAA, and accurately
decide a claim taking into consideration
all relevant facts and applicable law.
While one of the commenters is correct
that quality assurance is not specifically
addressed in the proposed regulations,
it is not necessary to include such
regulations as both the Veterans Benefits
Administration (VBA) and the Board
already have robust and established
quality assurance programs in place that
will be equally applicable to ECA cases.
Therefore, for the above reasons, we
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make no change to the proposed rule
based on the concerns raised regarding
decision quality and record
development.
B. Docket Order
One commenter expressed concern
that the Initiative makes no provision
for the Board to issue expedited
decisions in appeals of covered claims.
The commenter suggested that VA adopt
a regulation authorizing the Board to
‘‘consider and decide covered claims of
participating claimants out of docket
order and as soon as practicable upon
their transfer to the Board.’’ Unless the
Board adopts such a provision, the
commenter stated, the Initiative will not
be successful as claimants will not want
to participate in a program that does not
ensure faster processing time by the
Board. The commenter recognized that,
as we explained in the notice of
proposed rulemaking, the Board is
required by statute to consider appeals
in docket order, subject to certain
enumerated exceptions. See 38 U.S.C.
7107(a) (providing that ‘‘each case
received pursuant to an application for
review on appeal shall be considered
and decided in regular order according
to its place on the docket’’). The
commenter presented two
recommendations for the Board to deal
with this statutory requirement. First,
the commenter proposed that ‘‘VA must
ask Congress to enact legislation to
authorize the Board to issue expedited
decisions in appeals of covered claims.’’
Second, the commenter suggested that
the Board, pursuant to either 38 U.S.C.
7107 or 38 U.S.C. 501(a), may already
have authority to decide ECA appeals
out of docket order.
With respect to the commenter’s
suggestion that VA ask Congress to
enact legislation authorizing the Board
to decide ECA appeals out of docket
order, it was our goal in creating the
Initiative to work within the existing
statutory framework. While there may
be a number of suggested legislative
amendments which, if enacted, could
potentially improve the VA claims
adjudication system, such pursuits are
not within the ambit of this rulemaking
action or the ECA Initiative. Therefore,
we make no changes to the proposed
rule based on this suggestion.
We also respectfully disagree with the
commenter’s suggestion that VA already
has the authority to decide ECA cases
out of docket order. The commenter
specifically argues that ECA cases could
be advanced on the Board’s docket
pursuant to 38 U.S.C. 7107(a)(2). That
statutory provision allows the Board to
advance a case on its docket ‘‘if the case
involves interpretation of law of general
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application affecting other claims;’’ ‘‘if
the appellant is seriously ill or is under
severe financial hardship;’’ or ‘‘for other
sufficient cause shown.’’ The
commenter suggests that the need for
expeditious adjudication of ECA
appeals constitutes ‘‘other sufficient
cause’’ for allowing the Board to
advance ECA cases on its docket.
We do not agree with the commenter
that the need for expeditious
adjudication of appeals under the
Initiative constitutes ‘‘other sufficient
cause’’ for advancing ECA cases on the
docket, as that phrase is used in 38
U.S.C. 7107(a)(2)(C). Consistent with the
limited bases for granting a motion to
advance as provided in section
7107(a)(2), the Board has narrowly
construed ‘‘other sufficient cause’’ as
being limited to situations involving
either administrative error on the part of
VA that resulted in significant delay in
docketing the case, or where the
appellant is of advanced age (75 or
older). See 38 CFR 20.900(c).
Any appeal that is advanced on the
Board’s docket ‘‘goes to the head of the
line’’ and necessarily delays the
consideration of all other pending
appeals. For every case advanced on the
Board’s docket, another appellant whose
case has not been advanced must wait
longer for his or her decision than
otherwise would have been necessary.
Decisions to grant motions for
advancement on the docket are carefully
considered on their individual merits.
Although it is important that ECA
appeals are decided as quickly as
possible, we simply do not believe that
the policy concerns inherent in
advancing ECA cases are tantamount to
those involved in cases where
advancement has traditionally been
allowed. The ECA Initiative is a 2-year
pilot program, which, if successful, may
provide a basis for expanding some, or
all, of the program nationwide. If and
when that occurs, it may be appropriate
to reconsider the issue of what would be
required to properly permit the advance
docketing of ECA appeals. In the
meantime, although ECA cases will not
be automatically advanced on the
Board’s docket, nothing in the Initiative
precludes participants from filing
motions for advancement on the docket
where such action is otherwise
warranted under 38 U.S.C. 7107(a)(2)
and 38 CFR 20.900(c), such as where an
appellant is at least 75 years of age or
suffers from serious illness or severe
financial hardship.
Finally, while ECA cases will not be
automatically advanced on the Board’s
docket, it still is anticipated that the
Board’s use of its screening authority
under 38 U.S.C. 7107(f) will result in
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cases being finally decided by the Board
in a faster manner. Once an appeal
reaches its place on the docket, the
Board often discovers that additional
development is required or that
questions remain regarding
representation, hearing requests, or
waivers of Board review of evidence in
the first instance. Substantial delay can
result while the Board resolves such
matters, particularly where the Board
has to remand for additional
development. Such delays can often add
months or years to the appellate
process. By screening ECA cases at the
Board under 38 U.S.C. 7107(f), the
Board is authorized to take action
pursuant to 38 CFR 19.9 including:
soliciting a waiver from the participant
permitting the Board to review new
evidence obtained by VA in the first
instance; seeking clarification on
matters such as representation and
hearing requests; and, where necessary,
remanding for further development. The
Board’s screening efforts in this regard
will help to ensure that such matters are
resolved before an ECA appeal reaches
its place on the docket. Thus, when an
appeal reaches its place on the docket,
the Board should be able to make a final
decision on the merits without
additional delay, such as would be
caused by remanding for further
development at that time.
As to the concern raised that
claimants will not want to participate in
the ECA program unless the Board
adopts a provision for advancing such
cases on its docket, we simply reiterate
that, by pre-screening appeals, cases
should be finally decided by the Board
more expeditiously than without such
early intervention. Moreover, it is noted
that, based on longstanding past
practice, a majority of cases are resolved
before they reach the Board. Most cases
processed under the ECA will likewise
be resolved at the Agency of Original
Jurisdiction (AOJ) level. For those cases
that do reach the Board, an earlier
docket number will be assigned by
virtue of the case having been more
quickly processed by the AOJ. For all of
the reasons outlined above, we make no
change to the proposed rules based on
the comments regarding docket order.
C. Time Limits
1. Time Limits on VA
One commenter expressed concern
that under the Initiative, ‘‘participating
claimants agree to act within certain
time-limits, while the VA, except for
one instance, does not.’’ The commenter
stated that, if one of the goals of the
Initiative is to ‘‘help accelerate the
processing of all claims and appeals,’’
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VA will help to achieve this goal if it
imposes additional time limits on itself
under the Initiative. The commenter
submits that ‘‘VA must impose timelimits on the four selected VA regional
offices and the Board to take necessary
action,’’ and several specific time limits
were suggested. We reject this comment
for the following reasons.
While the Initiative places only one
time limit on VA, see 38 CFR
20.1504(b), this was done to ensure that
VA adjudicators are afforded adequate
time to gather evidence identified by
participants, obtain necessary
examinations and medical opinions,
and conduct hearings when requested
without arbitrary time limits. As the
commenter correctly notes, inadequate
development can lead to inaccurate
decisions, which unfairly deny benefits
to deserving claimants. It is therefore
critical that all claims processed under
the Initiative have fully-developed
records including all relevant evidence
identified by the participant and any
necessary examination reports or
medical opinions. While it is certainly
helpful for claimants to obtain and
submit evidence on their own behalf,
the minimal obligation is for a claimant
to identify the location of pertinent
records and authorize VA to obtain
them. In obtaining records from various
government and private sources, delays
may be experienced in obtaining a
response. Given that VA has no control
over non-VA organizations and
individuals, it is simply not practicable
to establish fixed periods of time within
which VA must act in this regard,
except as otherwise provided in the
ECA regulations. In fact, upon further
reflection, VA has determined that a
limited exception to the time period
imposed upon VA in § 20.1504(b) is
necessary to ensure fairness and full
compliance with the duty to assist. This
exception would cover the circumstance
when, after issuance of the Statement of
the Case (SOC), VA is put on notice of
a change in circumstances, such as a
worsening of the claimant’s condition or
the location of previously unobtained
relevant evidence. In order to ensure
full compliance with the duty to assist
under the VCAA, see 38 U.S.C. 5103A,
VA may have an obligation to order a
new examination for the claimant or to
obtain copies of the relevant records.
However, due to the time required to
schedule and conduct a new
examination or locate and obtain new
records, these actions may make it
challenging, if not impossible, for VA to
comply with the time limit in
§ 20.1504(b), which requires VA to
certify and transfer the appellate record
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to the Board no later than 60 days from
the date of filing the Substantive
Appeal. Consequently, out of fairness to
the claimant, we are amending
§ 20.1504(b) to create an exception to
the 60-day time period for certification
when VA is required under 38 U.S.C.
5103A and 38 CFR 3.159(c) to provide
assistance in obtaining evidence after
issuance of the SOC.
The ECA Initiative does contain
distinct time periods for claimants to
take certain actions, which we believe
are reasonable. Claimants are in the
unique position of knowing the dates
and places where they received medical
treatment relevant to their claims. When
the claimant adequately notifies VA of
relevant evidence and authorizes VA to
obtain the evidence, VA then has a duty
to assist the claimant in obtaining this
evidence. The sooner that the claimant
provides VA with this information and
authorization, the more complete the
record will be at the beginning of the
claims process. This is a significant
feature of the ECA Initiative—to develop
a complete record as early in the process
as possible, so that informed and correct
decisions may be made.
Although we refrain from establishing
any fixed time limits on VA beyond the
one outlined in § 20.1504(b), we want to
make clear this does not mean that VA
intends to unnecessarily delay action on
ECA claims. To the contrary, it is our
stated intention to develop and
adjudicate ECA claims as quickly as
possible by greatly reducing the amount
of time that a case sits without any
action occurring while waiting for a
statutory or regulatory response period
to end. Further, we also reject the
commenter’s suggestion that we impose
additional time limits on VA because
such action is beyond the scope of this
rulemaking and the ECA Initiative. The
purpose of the ECA is to evaluate
whether claims processing can be
expedited by claimants’ voluntary
waiver of certain existing statutory and
regulatory response periods and prescreening of cases by the Board. It is not
the goal of the Initiative to study the
feasibility of imposing rating deadlines
on VA. Accordingly, for the above
reasons, we make no change based on
the comments received, but we make
one change to the time limit in
§ 20.1504(b), as discussed.
2. Time Limits on Claimants
One commenter stated that the
reduced time limits under the Initiative
for claimants are likely to result in
inadequate records and inaccurate
decisions. The commenter noted that
several of the time limits to be observed
by participants under the Initiative are
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65729
unduly strict and ‘‘unreasonable,’’
particularly the period participants have
to respond to a VCAA notice letter and
to subsequent VA requests for
information and evidence. The
commenter stated that claimants and
their representatives often have to wait
‘‘weeks or months’’ to receive requested
treatment records from medical-care
providers, and that such a wait would
likely result in participants missing the
aforementioned deadlines. The
commenter also noted that claimants’
medical conditions often worsen over
time and that treatment records
reflecting such increase in
symptomatology may not be available
until after the VCAA notice response
period expires.
Additionally, the commenter stated
that evidence submitted after the
deadlines in § 20.1504(a)(1) and (2)
would not be able to be considered by
VA, resulting in unfair denials of
worthy claims. Further, the commenter
added that ‘‘there is no provision in the
VA’s proposed regulations that will
permit the claimant to submit * * *
newly obtained evidence or information
to VA since motions for an extension of
time to submit necessary information
must be filed with VA before the
applicable time period runs.’’ Finally,
the commenter stated that given the
difficulties in obtaining medical
evidence, VA should not ‘‘penalize’’
participating claimants for
circumstances outside of their control.
Although in the notice of proposed
rulemaking we stated that ECA
participants agree to waive the 1-year
period provided under 38 U.S.C.
5103(b)(1) and 38 CFR 3.159(b)(1), we
wish to correct that statement. There is
no such waiver under the ECA. Rather,
an ECA participant must, within 30
days, respond to VA’s VCAA notice
concerning the information and
evidence necessary to substantiate a
claim. An ECA participant may respond
to VA’s notice by providing information
or evidence in the claimant’s
possession, identifying necessary
evidence that the claimant requires VA’s
assistance to obtain, or notifying VA
that no additional evidence exists. See
38 CFR 20.1503(d) (Upon executing the
Agreement and Waiver of Rights, the
participant will identify all relevant
evidence in support of his or her
claim(s), including any VA records,
non-VA Federal records, and any
private records, provide the evidence, or
notify VA that such evidence does not
exist, within the time prescribed in
§ 20.1504(a)(1)). If the participant does
not respond to VA’s notice within 30
days, the implied revocation provisions
of § 20.1509(c) apply and the claim will
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be decided using ordinary, non-ECA
procedures. However, if the participant
responds within 30 days to VA’s notice
of the information and evidence
necessary to substantiate the claim, VA
will make reasonable efforts to obtain
the evidence the participant has
authorized the Department to obtain and
adjudicate the claim. 38 U.S.C. 5103A;
38 CFR 3.159(c).
Section 3.159(b)(1) of title 38, Code of
Federal Regulations, does not require a
claimant to respond to VA’s notice
within 30 days, although VA may
decide the claim if the claimant does
not respond. It is our experience that
often a claimant does not respond to the
notice, VA decides the claim, and then
the claimant submits relevant evidence.
The ECA is designed to short-circuit this
time-consuming adjudication process by
requiring a claimant to affirmatively
advise VA of the existence of relevant
evidence, provide VA with such
evidence, or advise VA that no other
relevant evidence exists or is available,
so that, to the fullest extent possible, all
available evidence can be compiled
before a claim is adjudicated. In order
to clarify our intent, we are revising
proposed §§ 20.1503(d) and
20.1504(a)(1) and (2) to explain what
type of response is required from an
ECA participant within the specified
periods.
An ECA participant, nonetheless, has,
as provided in 38 U.S.C. 5103(b)(1) and
38 CFR 3.159(b)(1), 1 year from the date
of the section 5103(a)—notice in which
to submit the information and evidence
that VA has notified the participant that
the participant must provide. See 38
CFR 20.1500(c) (any matter not
otherwise covered by this subpart will
be governed by existing rules in this
title). If evidence is received by VA after
the SOC is issued, the evidence will not
be subject to another AOJ adjudication,
but instead may be considered by the
Board in the first instance. See 38 CFR
20.1508(b).
We are making one additional change
to proposed § 20.1504(a)(1) by making
the response period 30 days rather than
60 days. This revision to proposed
§ 20.1504(a)(1) will make it conform to
the response period already contained
in 38 CFR 3.159(b)(1), as revised by 73
FR 23353, 23356, on April 30, 2008.
In addition, we point out that several
of the Initiative’s provisions specifically
contemplate a participant submitting,
and VA considering, evidence after the
initial 30-day VCAA notice response
period has expired. For example,
§ 20.1508(b)(2) provides that, if new
evidence is submitted by a participant
or representative following the issuance
of an SOC, the participant will be
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deemed to have waived AOJ review of
such evidence so that the evidence may
be considered by the Board in the first
instance. Moreover, § 20.1504(a)(6)(iii)
allows participants 30 days to submit
evidence or argument after their appeals
have been certified and transferred to
the Board. Any evidence submitted
under this provision would necessarily
be filed after the 30-day VCAA response
period has elapsed.
While participants and their
representatives should be as thorough as
possible in responding to VCAA notice
letters or follow-up information
requests, evidence submitted or
identified after the expiration of the 30day response periods will still be
considered by the AOJ or the Board,
provided such submission is allowed
under other provisions of law. The
remainder of the comments expressing
concern that the ECA will result in
inadequate records and inaccurate
decisions are rejected for the reasons
discussed above.
D. Good Cause Exception
One commenter stated that the ‘‘good
cause’’ exception for each of the
enumerated time limits is unduly strict
and should be liberalized to ensure the
success of the Initiative. The
commenter’s primary concern focused
on the use of the good cause exception
as it relates to the 60-day time period in
proposed § 20.1504(a)(1) (now changed
to 30-days in the final rule) for
responding to a VCAA notice letter
under the Initiative. The comment
appears to be based on the assumption
that VA will not consider evidence
submitted after the VCAA notice
response period has expired. As
explained in section C.2 above, ECA
participants do not waive the 1-year
period prescribed in section 5103(a). An
ECA participant is not required to
submit all evidence relating to their
claim within 30 days of the date of VA’s
section-5103(a) notice. Rather, as
explained above, what we intend is that
an ECA participant will be required to
respond to VA’s notice either by
providing the evidence requested,
identifying evidence relevant to
substantiating the claim and authorizing
VA to obtain the evidence, or notifying
VA that no such evidence exists.
ECA participants are not necessarily
required to submit any evidence at all
within the response period in
§ 20.1504(a)(1) or (2), though they are
free to do so. All a participant has to do
to comply with the notice response
period(s) is to affirmatively respond by
identifying the relevant evidence then
in existence and authorizing VA to
obtain such evidence or notifying VA
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that no such evidence exists. See 38
CFR 20.1503(d). It is then VA’s
responsibility to make reasonable
attempts to obtain relevant evidence
identified by the ECA participant,
including any private evidence that the
claimant adequately identifies and
authorizes VA to obtain. 38 U.S.C.
5103A(b). Therefore, because a
sufficient response to a VA request for
information and evidence only requires
the identification of relevant
information or evidence, if any, within
the allowed response period, along with
providing VA with authorization to
obtain the same, we disagree with the
commenter’s suggestion that the good
cause exception as provided for in
§ 20.1509(e), as it applies to responding
to VA’s section-5103(a) notice, is
inadequate as drafted.
Because participants are not barred
from submitting additional evidence
following the expiration of the response
periods set forth in § 20.1504(a)(1) and
(a)(2), an extension motion is not
required to submit evidence after those
periods have expired. An extension
motion, as described in § 20.1509(e), is
only needed if the participant wishes to
extend a time limit in subpart P, most
of which consist of response times. See
38 CFR 20.1504(a).
Finally, it is noted that the commenter
seems to take an unduly restrictive
interpretation of the situations for
which a motion for extension of time
may be granted pursuant to § 20.1509(e).
While examples are provided of
situations in which good cause may be
found, such as ‘‘illness of the
participant or the representative of such
severity that precludes action during the
period,’’ the proposed regulation
specifically states that the examples of
good cause provided ‘‘include, but are
not limited to,’’ the enumerated
examples. Accordingly, provided that a
participant makes a timely request for
an extension of time with adequate
showing of good cause, the participant
may obtain an extension of time.
Accordingly, for all of these reasons, we
make no change to the proposed rule
based on this comment.
E. Data Collection
One commenter expressed concern
regarding VA’s data collection activities
under the Initiative. The commenter
stated that it is ‘‘essential that good
work load data and other management
data be collected * * * and that this
information be used internally and
made available publicly so that the
Initiative’s new procedures can be
carefully evaluated on an ongoing
basis.’’ The commenter suggested
several pieces of information that
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should be tracked, including ‘‘the
number of claimants that volunteer for
the program, how long each stays in the
program, if they are voluntarily or
involuntarily dismissed from the
program, and what results are reached.’’
The commenter also suggested that data
collected at participating VA regional
offices be compared to that obtained at
a control group of non-participating
offices.
While we wholeheartedly agree with
the commenter that comprehensive data
collection will be critical to accurately
evaluate the success of the Initiative, the
description of such data collection
efforts is not necessary or appropriate
for inclusion in this rulemaking action.
Suffice it to say, we plan to gather a
wide variety of information throughout
the course of the Initiative to ensure that
all aspects of the pilot program are
carefully reviewed and evaluated. As
the commenter suggests, the information
we intend to track includes, among
many other things, the number of
participants, the number of instances of
revocation of participation, processing
times, and the ultimate disposition of
ECA claims. We plan on tracking
customer satisfaction with the ECA to
help assess the strengths and
weaknesses of the Initiative. Moreover,
we intend to compare all data collected
regarding ECA participants with data
from claimants who did not elect ECA
participation. All data collected and
reports generated as part of the Initiative
will be obtainable by the public in the
same manner and means as other VA
data and reports. Accordingly, we make
no change to the proposed rule based on
this comment.
F. The Need for the ECA
One commenter questioned the need
for the ECA, pointing out that there was
no discernable advantage that claimants
would receive from participation in the
ECA, ‘‘other than that which would be
expected to naturally flow from
submitting procedural documents and
evidence as soon as practicable.’’ The
commenter suggested ‘‘that the RO
speed up the certification and transfer
time to the BVA, unilaterally, and
encourage claimants to unilaterally
proceed with their appeal as quickly as
possible, without the necessity of
waiving procedural defects and without
the need for rule changes.’’ For all of the
many reasons already discussed above,
as well as in the notice of proposed
rulemaking, VA respectfully disagrees
with the assertion that claimants will
not benefit from participating in the
ECA. Moreover, because the Initiative is
specifically designed as a 2-year pilot
project at a limited number of VA
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16:01 Nov 04, 2008
Jkt 217001
facilities, the data collected during this
period of time will enable a more fully
informed assessment of the success and
weaknesses of the Initiative to be made,
including whether it should be further
expanded.
In addition, it is noted that
participation in the ECA will be entirely
voluntary. Accordingly, any claimant
who does not feel comfortable
participating in the program, or does not
feel that participation would be
advantageous, is free to proceed under
the existing VA claims adjudication and
appeals process. Further, any ECA
participant will be able to opt out of the
Initiative at anytime without any
negative consequences for doing so.
Instead, the claim or appeal will simply
be returned to the normal claims
adjudication and appeals process at the
point at which the participant withdrew
from the program. Thus, participation
could never be disadvantageous to a
claimant.
Finally, as correctly noted by another
commenter, the ECA Initiative does not
change VA’s basic obligation to assure
that the varying parts of its benefits
programs ‘‘work together to give
prompt, efficient, fair, and accurate
service to disabled veterans and other
claimants for VA benefits.’’ We agree
with this proposition. As discussed at
length above, the Initiative leaves intact
VA’s duties to notify claimants of the
information and evidence needed to
substantiate their claim, and VA’s duty
to assist claimants in obtaining relevant
evidence, including securing a VA
examination when required by existing
law. At every point in the Initiative, the
paternalistic and non-adversarial nature
of the VA claims adjudication system is
preserved. Thus, for all of the above
reasons, we make no changes based on
these comments.
G. The Impact of the ECA on Workload
at Trial Sites
Finally, one commenter expressed
concern that the ECA Initiative would
have an adverse impact on the overall
workload at the Philadelphia regional
office, which is one of the trial sites. He
noted that Philadelphia currently
handles many cases that are ‘‘brokered’’
from the Boston regional office, and
stated that the addition of ECA cases to
Philadelphia’s workload will negatively
impact the processing of the brokered
cases. The commenter also raised some
general concerns with VBA’s case
brokering process that are beyond the
scope of this rulemaking action and will
not be further addressed here.
We respectfully disagree with the
commenter’s concerns. To be eligible to
participate in the Initiative, a claimant
PO 00000
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Sfmt 4700
65731
must reside within the jurisdiction of
one of the four participating VA regional
offices (the jurisdiction of each of the
four participating regional offices is
specifically outlined in § 20.1501(e)). As
a result of this requirement, the
Philadelphia regional office would only
be allowed to handle ECA claims from
participants who already reside within
the jurisdiction of that office. Such
claims would already have been the
responsibility of the Philadelphia
regional office, regardless of a claimant’s
decision to participate in the Initiative.
Because ECA participants are taken
from the same pool of claimants already
being served by the four respective
participating regional offices, the
Initiative simply will not increase the
number of claims handled by each
office, and therefore will not have an
impact on the overall workload of any
of the test sites, including the
Philadelphia regional office. Moreover,
even in the unlikely event that
Philadelphia’s workload did increase,
VBA would be free, at the discretion of
management, to reduce or discontinue
the brokering of cases to that office and
instead broker Boston cases to another
facility. We make no changes to the
proposed rule based on these comments.
H. Technical Amendments; Pilot Site
Change
In addition to the revisions discussed
above, we are making three minor
technical changes to the proposed rule,
and one change regarding the pilot sites.
First, we are changing the language in
§ 20.1500(d) to more clearly set forth the
effective date of the Initiative. Second,
we are making a minor revision to
§ 20.1501(d) to clarify that
representatives of ECA participants
must be accredited by VA. See 38 CFR
14.631. Third, we are adding a crossreference and brief discussion to
§ 20.1508(b)(1) to more clearly indicate
that an implied revocation from the
Initiative will occur if a participant does
not agree to waive initial consideration
by the agency of original jurisdiction of
any new evidence obtained by VA
following the issuance of a Statement of
the Case. See 38 CFR 20.1509(c)(2).
In addition to the foregoing, we are
changing one of the four pilot sites due
to increased workload that has arisen at
the St. Paul regional office since
publication of the NPRM. The St. Paul,
Minnesota regional office will no longer
be involved in the ECA pilot program.
Rather, the regional office in Lincoln,
Nebraska, will be one of the four pilot
sites. The jurisdiction of the Lincoln
regional office extends to the entire
State of Nebraska.
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Paperwork Reduction Act
This document contains no provisions
constituting a collection of information
under the Paperwork Reduction Act (44
U.S.C. 3501–3521).
hsrobinson on PROD1PC76 with RULES
Regulatory Flexibility Act
The Secretary hereby certifies that
this rule would not have a significant
economic impact on a substantial
number of small entities as they are
defined in the Regulatory Flexibility
Act, 5 U.S.C. 601–612. It will not affect
any small organizations or small
governmental jurisdictions, and will not
have a significant economic impact on
these small entities. Therefore, pursuant
to 5 U.S.C. 605(b), this rule is exempt
from the initial and final regulatory
flexibility analysis requirement of 5
U.S.C. 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 rule have been
examined and it has been determined to
be a significant regulatory action under
Executive Order 12866, as it raises novel
legal or policy issues arising out of legal
mandates.
Unfunded Mandates
The Unfunded Mandates Reform Act
of 1995 requires, at 2 U.S.C. 1532, that
agencies prepare an assessment of
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16:01 Nov 04, 2008
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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
1 year. This rule would have no such
effect on State, local, and tribal
governments, or on the private sector.
Catalog of Federal Domestic Assistance
Numbers
The Catalog of Federal Domestic
Assistance program numbers and titles
for this proposal are 64.100,
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; 64.103, Life Insurance for
Veterans; 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; 64.114,
Veterans Housing-Guaranteed and
Insured Loans; 64.115, Veterans
Information and Assistance; 64.116,
Vocational Rehabilitation for Disabled
Veterans; 64.117, Survivors and
Dependents Educational Assistance;
64.118, Veterans Housing-Direct Loans
for Certain Disabled Veterans; 64.119,
Veterans Housing-Manufactured Home
Loans; 64.120, Post-Vietnam Era
Veterans’ Educational Assistance;
64.124, All-Volunteer Force Educational
Assistance; 64.125, Vocational and
Educational Counseling for
Servicemembers and Veterans; 64.126,
Native American Veteran Direct Loan
Program; 64.127, Monthly Allowance
for Children of Vietnam Veterans Born
with Spina Bifida; and 64.128,
Vocational Training and Rehabilitation
for Vietnam Veterans’ Children with
Spina Bifida or Other Covered Birth
Defects.
List of Subjects
Administrative practice and
procedure, Claims, Disability benefits,
Health care, Pensions, Veterans,
Vietnam.
38 CFR Part 20
Administrative practice and
procedure, Claims, Veterans.
Frm 00018
Fmt 4700
For the reasons set forth in the
Preamble, VA amends 38 CFR parts 3
and 20 as follows:
■
PART 3—ADJUDICATION
Subpart A—Pension, Compensation,
and Dependency and Indemnity
Compensation
1. The authority citation for part 3,
Subpart A, continues to read as follows:
■
Authority: 38 U.S.C. 501(a), unless
otherwise noted.
■
2. Add § 3.161 to read as follows:
§ 3.161 Expedited Claims Adjudication
Initiative—Pilot Program.
Rules pertaining to the Expedited
Claims Adjudication Initiative Pilot
Program are set forth in part 20, subpart
P, of this chapter.
(Authority: 38 U.S.C. 501(a))
PART 20—BOARD OF VETERANS’
APPEALS: RULES OF PRACTICE
3. The authority citation for part 20
continues to read as follows:
■
Authority: 38 U.S.C. 501(a), and as noted
in specific sections.
■
4. Add subpart P to read as follows:
Subpart P—Expedited Claims
Adjudication Initiative—Pilot Program
Sec.
20.1500 Rule 1500. Expedited Claims
Adjudication Initiative.
20.1501 Rule 1501. Definitions.
20.1502 Rule 1502. Eligibility.
20.1503 Rule 1503. Election, identification
of evidence, and representation.
20.1504 Rule 1504. Time limits.
20.1505 Rule 1505. Review of initial
benefits claim decision.
20.1506 Rule 1506. Board review of cases.
20.1507 Rule 1507. Hearings.
20.1508 Rule 1508. Waiver.
20.1509 Rule 1509. Compliance and
revocation of participation.
20.1510 Rule 1510. Termination of the
Initiative.
Subpart P—Expedited Claims
Adjudication Initiative—Pilot Program
§ 20.1500 Rule 1500 Expedited Claims
Adjudication Initiative.
38 CFR Part 3
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Approved: August 20, 2008.
James B. Peake,
Secretary of Veterans Affairs.
Sfmt 4700
(a) Purpose. The Expedited Claims
Adjudication Initiative is a pilot
program designed to streamline the
claims adjudication and appeals
process. This subpart establishes
procedures governing this Initiative.
(b) Outline of Initiative. This Initiative
allows eligible claimants to voluntarily
participate in an alternative claims
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adjudication program as set forth in this
subpart, which is predicated on the
claimant’s waiver of certain identified
statutory and regulatory time limits,
procedural rights, and processing issues
that may arise.
(c) Scope. Except as specifically
provided in this subpart, claims
processed under this Initiative will be
adjudicated according to the procedures
outlined in part 3 of this chapter, and
appeals will be processed according to
the Appeals Regulations and Rules of
Practice, as outlined in parts 19 and 20
of this chapter. Any matter not
otherwise covered by this subpart will
be governed by existing rules in this
title.
(d) Duration. The Secretary will
accept an executed Agreement and
Waiver of Rights as provided in
§ 20.1503 of this part for a period not to
exceed 2 years from December 5, 2008.
(Authority: 38 U.S.C. 501(a))
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§ 20.1501
Rule 1501. Definitions.
For purposes of this subpart, the
following definitions apply:
(a) Initiative means the Expedited
Claims Adjudication Initiative as
promulgated by this subpart.
(b) Participant means any eligible
claimant who elects to participate in the
Initiative by executing, with his or her
representative, an Expedited Claims
Adjudication Initiative Agreement and
Waiver of Rights as provided in
§ 20.1503 of this part.
(c) Covered claim or covered claims
means any claim or claims, as described
in § 20.1502(c) of this part, that a
participant elects to have processed
under the rules governing the Initiative,
including any downstream element of
the claim(s), such as assignment of a
disability rating and effective date, and
any claim that is inextricably
intertwined with a covered claim.
(d) Representative means an
accredited representative of a
recognized Veterans Service
Organization or an accredited attorney
or agent, as set forth in part 14 of this
chapter, for whom a claimant has
properly executed and filed a VA Form
21–22, ‘‘Appointment of Veterans
Service Organization as Claimant’s
Representative,’’ or a VA Form 21–22a,
‘‘Appointment of Individual as
Claimant’s Representative,’’ as required
by § 14.631 of this chapter.
(e) Participating VA regional office
means one of the following four VA
regional offices: Nashville, Tennessee;
Lincoln, Nebraska; Seattle, Washington;
and Philadelphia, Pennsylvania. The
jurisdiction of the Nashville, Lincoln,
and Seattle regional offices extends to
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16:01 Nov 04, 2008
Jkt 217001
residents of Tennessee, Nebraska, and
Washington, respectively. The
jurisdiction of the Philadelphia regional
office extends to residents of the 40
easternmost counties of Pennsylvania
and residents of the seven southernmost
counties of New Jersey. For purposes of
this Initiative only, the jurisdiction of
these regional offices extends only to a
covered claim, as described in
§ 20.1502(c) of this part.
(Authority: 38 U.S.C. 501(a))
§ 20.1502
Rule 1502. Eligibility.
To participate in the Initiative, a
claimant must:
(a) At the time the Agreement and
Waiver of Rights is executed, have a
representative, as defined in
§ 20.1501(d) of this part;
(b) Reside within the jurisdiction of a
participating VA regional office, as
defined in § 20.1501(e) of this part; and
(c) File one of the following types of
claims for VA disability compensation
as outlined in parts 3 and 4 of this
chapter at a participating VA regional
office:
(1) Original claim;
(2) Claim for an increased rating;
(3) Claim to reopen a previouslydenied claim based on the submission
of new and material evidence as
provided in § 3.156 of this chapter; or
(4) Requests for revision of a decision
of an agency of original jurisdiction
under § 3.105 of this chapter based on
clear and unmistakable error.
(Authority: 38 U.S.C. 501(a))
§ 20.1503 Rule 1503. Election,
identification of evidence, and
representation.
(a) When and how election made.
Upon the filing of a claim described in
§ 20.1502(c) of this part, VA will
promptly notify the claimant in writing
of the opportunity to participate in the
Initiative and provide the claimant with
an Agreement and Waiver of Rights. A
claimant may elect to participate in the
Initiative by filing an executed
Agreement and Waiver of Rights as
provided in paragraphs (b) and (c) of
this section within 30 days of the date
of the notice of the opportunity to
participate in the Initiative. An election
to participate in the Initiative can be
revoked at any time in accordance with
§ 20.1509 of this part.
(b) Execution of agreement. To
participate in the Initiative, a claimant
and his or her representative must
execute an Agreement and Waiver of
Rights on a form prescribed by the
Secretary. The claimant will specifically
identify in the Agreement and Waiver of
Rights all claims he or she wishes to
have processed under the Initiative.
PO 00000
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Sfmt 4700
65733
(c) Where to file. The executed
Agreement and Waiver of Rights must
be filed with the participating VA
regional office that has jurisdiction over
the claim.
(d) Identification of relevant evidence.
Upon executing the Agreement and
Waiver of Rights, the participant will
respond, within the time period
prescribed in § 20.1504(a)(1), to VA
notice regarding the information and
evidence necessary to substantiate the
claim by identifying all relevant
evidence in support of his or her
claim(s), providing the requested
evidence, or notifying VA that no such
evidence exists. Relevant evidence may
include any VA records, non-VA
Federal records (such as Social Security
disability records), and any private
records (such as treatment records from
a family physician). If the participant
requires assistance from VA in obtaining
any identified records, the participant
will provide VA, upon request, the
appropriate release form so VA may
attempt to promptly obtain the records
on behalf of the participant. VA must
receive the necessary information and
evidence requested from the participant
within 1 year of the date of the notice,
in accordance with § 3.159(b)(1) of this
chapter.
(e) Effect of change in representation
on the election. If a participant changes
or terminates representation after having
made a valid election to participate in
the Initiative, participation in the
Initiative will continue under the terms
of the signed Agreement and Waiver of
Rights, unless the participant indicates,
in writing, pursuant to § 20.1509(b) of
this part, that he or she wishes to revoke
participation.
(Authority: 38 U.S.C. 501(a))
§ 20.1504
Rule 1504. Time limits.
The following time limits will be
applicable to all covered claims:
(a) Time limits to be observed by the
participant. The participant will comply
with the following time limits for all
covered claims:
(1) Response to initial notice letter.
The time limit for responding to the
notification regarding the information
and medical or lay evidence necessary
to substantiate a claim in the manner
required by § 20.1503(d) will be 30 days.
(2) Subsequent requests by VA for
additional information and evidence.
The time limit for responding to any
subsequent request by VA for additional
information or evidence, either by
notifying VA of the existence of such
information or evidence, providing such
evidence, or notifying VA that no such
evidence exists, will be 30 days.
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(3) VA request for waiver. The time
limit for responding to a VA request for
waiver as set forth in § 20.1508 of this
part, will be 30 days.
(4) Notice of Disagreement. The time
limit for filing a Notice of Disagreement
pursuant to § 20.302(a) of this part will
be 60 days.
(5) Substantive Appeal. The time limit
for filing a Substantive Appeal pursuant
to § 20.302(b) of this part will be 30
days.
(6) Following certification of appeal to
the Board. Following the issuance of
notification that the appeal has been
certified and transferred to the Board,
the time limit for taking the following
actions pursuant to § 20.1304 of this
part will be 30 days:
(i) Request a hearing before the Board,
(ii) Request a change in
representation, or
(iii) Submit additional evidence or
argument.
(b) Time limit to be observed by the
participating VA regional office. The
participating VA regional office shall
certify covered claims and transfer the
appellate record to the Board as set forth
in §§ 19.35 and 19.36 of this chapter
within 30 days of the receipt of the
Substantive Appeal, or within 30 days
of receipt of any additional submissions
following the Substantive Appeal, but
no later than 60 days from the receipt
of the Substantive Appeal. However, if,
after issuance of the Statement of the
Case, additional assistance in obtaining
evidence is required in order to comply
with § 3.159(c) of this chapter, the
participating VA regional office shall
certify covered claims and transfer the
appellate record to the Board within 60
days after the requisite action is
completed.
(Authority: 38 U.S.C. 501(a) and 5103A)
§ 20.1505 Rule 1505. Review of initial
benefits claim decision.
If a participant files a Notice of
Disagreement as to a covered claim, the
decision of the participating VA
regional office will be reviewed by a
Decision Review Officer under the
provisions set forth in § 3.2600 of this
chapter.
(Authority: 38 U.S.C. 501(a))
hsrobinson on PROD1PC76 with RULES
§ 20.1506
cases.
Rule 1506. Board review of
(a) The Board will screen cases that
are certified and transferred to the Board
under the Initiative to determine
whether the record is adequate for
decisional purposes. If the Board
determines that the record is
inadequate, the Board will take
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16:01 Nov 04, 2008
Jkt 217001
appropriate action pursuant to § 19.9 of
this chapter.
(b) A case screened by the Board for
purposes of determining the adequacy
of the record will be decided in docket
order and will not be advanced on the
Board’s docket except as provided in
§ 20.900(c) of this part.
(Authority: 38 U.S.C. 7107(a), (f))
§ 20.1507
Rule 1507. Hearings.
(a) Before the participating VA
regional office. Upon request, a
participant is entitled to a hearing by a
Decision Review Officer before the
participating VA regional office as
provided in §§ 3.103(c) and 3.2600(c) of
this chapter, subject to the following
limitations:
(1) No hearing will be conducted prior
to the initial adjudication of the claim
by the participating VA regional office.
(2) Only one hearing on a claim will
be conducted at the participating VA
regional office and the hearing will be
conducted by a Decision Review Officer
in accordance with § 3.2600 of this
chapter.
(b) Before the Board. Upon request, a
participant is entitled to a hearing
before the Board as provided in
§§ 20.700 through 20.717, and 20.1304,
subject to the following limitations:
(1) Only one hearing before the Board
will be conducted.
(2) After consultation with the
participant and his or her
representative, the Board will determine
whether the hearing will be conducted
in person in Washington, DC, at the
participating VA regional office with
jurisdiction over the claim, or by
electronic equipment as set forth in
§ 20.700(e) of this part. The Board’s
determination will be based primarily
on the type and place of hearing which
will allow for scheduling at the earliest
possible date. An in-person hearing will
be conducted in Washington, DC, only
if geographically convenient for the
participant and his or her
representative, or if the participant
agrees to travel to Washington, DC, at
his or her own expense.
(Authority: 38 U.S.C. 501(a))
§ 20.1508
Rule 1508. Waiver.
(a) General. When requested by VA, a
participant will waive, in writing,
identified procedural processing issues
and actions relating to covered claims.
VA will provide the participant with a
clear explanation, in writing, as to what
rights he or she may be waiving. If a
hearing on appeal is conducted, the
waiver may be formally and clearly
entered on the record at the time of
hearing. A response to a written waiver
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Sfmt 4700
request from VA must be filed within
the 30-day period prescribed in
§ 20.1504(a)(3) of this part. Such waiver
is not required for matters that have
already been waived by virtue of
electing participation in the Initiative.
(b) Evidence obtained or submitted
after the Statement of the Case.
(1) Evidence obtained by VA. If new
evidence is obtained by VA following
issuance of a Statement of the Case
under §§ 19.29 and 19.30 of this
chapter, and the claim(s) is not
otherwise granted in full based on this
new evidence, VA will provide a copy
of such evidence to the participant and
representative, and request a waiver of
review by the agency of original
jurisdiction of such evidence and
issuance of a Supplemental Statement of
the Case pursuant to the provisions set
forth in § 20.1304(c) of this part. A
response to a written waiver request
from VA must be filed within the 30-day
period prescribed in § 20.1504(a)(3) of
this part. The failure of the participant
to agree to a waiver of initial
consideration by the agency of original
jurisdiction of any evidence obtained by
VA will constitute an implied
revocation of participation in the
Initiative, as provided by
§ 20.1509(c)(2).
(2) Evidence submitted by participant
or representative. If new evidence is
submitted by the participant or
representative following issuance of a
Statement of the Case under §§ 19.29
and 19.30 of this chapter, the
participant, by virtue of executing a
valid Agreement and Waiver of Rights,
is deemed to have knowingly and
voluntarily waived agency of original
jurisdiction review of such evidence
and issuance of a Supplemental
Statement of the Case, which permits
the Board to review such evidence in
the first instance.
(Authority: 38 U.S.C. 501(a))
§ 20.1509 Rule 1509. Compliance and
revocation of participation.
(a) Unless the participant revokes his
or her participation in the Initiative as
provided in paragraphs (b), (c) or (d) of
this section, all covered claims will
continue to be processed by VA or the
Board in accordance with the provisions
of this subpart until a final decision of
the agency of original jurisdiction or the
Board has been issued.
(b) Express revocation. A participant
may revoke participation in the
Initiative at any time by submitting a
revocation request in writing. The
revocation request must be filed with
the participating VA regional office
unless the case has been certified and
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transferred to the Board, in which case
the revocation request should be filed
with the Board. As of the date of receipt
of the revocation, any covered claims
will be processed in the same manner as
if the participant had not elected to
participate in the Initiative.
(c) Implied revocation. The failure of
a participant to meet the terms of these
rules, as outlined in the executed
Agreement and Waiver of Rights, will
have the same result as if the participant
had expressly revoked his or her
participation in the Initiative. As of the
date of the action constituting such
implied revocation, any covered claims
will be processed in the same manner as
if the participant had not elected to
participate in the Initiative. Grounds for
implied revocation of participation
include, but are not limited to:
(1) The failure of the participant or
representative, as appropriate, to
comply with any of the time limits set
forth in § 20.1504(a) of this part;
(2) The failure to waive initial
consideration by the agency of original
jurisdiction of any evidence obtained by
VA that was not considered in the
Statement of the Case;
(3) A request by a participant or
representative for an extension of any of
the time limits set forth in § 20.1504(a)
of this part, unless a motion for good
cause is granted, as described by
paragraph (e) of this section; and
(4) Any other failure on the part of the
participant to comply with the terms of
the Agreement and Waiver of Rights, as
determined by VA.
(d) Death of participant. If a
participant dies while his or her claim
is being processed, participation in the
Initiative will be deemed revoked.
(e) Extensions. Extensions of any of
the time limits described in this subpart
may only be granted when the
participant demonstrates on motion that
there is good cause for the extension
request. At no time may time periods be
extended beyond those provided by law
to all claimants and appellants.
Examples of good cause include, but are
not limited to, illness of the participant
or the representative of such severity
that precludes action during the period;
death of an individual representative;
illness or incapacity of an individual
representative that renders it
impractical for a participant to continue
with him or her as representative; or
withdrawal of an individual
representative. Motions for extensions
must be filed prior to the expiration of
the time period for which a motion is
being requested. Motions must be in
writing, and filed with the participating
VA regional office that has jurisdiction
over the claim, unless the case has been
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16:01 Nov 04, 2008
Jkt 217001
certified and transferred to the Board, in
which case the motion must be filed
with the Board. Motions must include
the name of the participant, the
applicable Department of Veterans
Affairs file number; and an explanation
as to why the extension request is being
made.
(Authority: 38 U.S.C. 501(a))
§ 20.1510
Initiative.
Rule 1510. Termination of the
VA may terminate the Initiative at any
time. In the event of such termination,
VA will notify participants and their
representatives in writing and inform
them that any covered claims will be
processed from the date of termination
in the same manner as if the participant
had not elected to participate in the
Initiative.
(Authority: 38 U.S.C. 501(a))
[FR Doc. E8–26310 Filed 11–4–08; 8:45 am]
BILLING CODE 8320–01–P
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 131
[EPA–HQ–OW–2008–0495; FRL–8737–9]
Withdrawal of the Federal Water
Quality Standards Use Designations
for Soda Creek and Portions of Canyon
Creek, South Fork Coeur d’Alene
River, and Blackfoot River in Idaho
Environmental Protection
Agency (EPA).
ACTION: Final rule; Withdrawal of direct
final rule.
AGENCY:
SUMMARY: EPA is promulgating the
withdrawal of the Federal water quality
standards designating cold water biota
uses for Soda Creek and portions of
Canyon Creek, South Fork Coeur
d’Alene River, and Blackfoot River in
Idaho. EPA published a direct final rule
with a parallel proposal for this action
on August 19, 2008. EPA is withdrawing
the direct final rule prior to its effective
date because EPA received comments
that could be viewed as adverse. The
Federal water quality standards
designating cold water biota uses are no
longer necessary since EPA approved
Idaho’s adopted uses that result in
protection for cold water biota. EPA is
also promulgating the withdrawal of the
water quality standards variance
provision applicable to these uses,
because this provision is no longer
necessary given the withdrawal of the
Federal water quality standards
designating these uses.
PO 00000
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Fmt 4700
Sfmt 4700
65735
Effective November 5, 2008, EPA
withdraws the direct final rule
published at 73 FR 48300, on August 19,
2008. The effective date of this final rule
is December 5, 2008.
ADDRESSES: EPA has established a
docket for this action under Docket ID
No. EPA–HQ–OW–2008–0495. All
documents in the docket are listed on
the https://www.regulations.gov Web
site. Although listed on the Web site,
some information is not publicly
available, e.g., CBI or other information
whose disclosure is restricted by statute.
Certain other material, such as
copyrighted material, is not placed on
the Internet and will be publicly
available only in hard copy form.
Publicly available docket materials are
available either electronically through
https://www.regulations.gov or in hard
copy at two docket facilities. The OW
Docket Center is open from 8:30 until
4:30 p.m., Monday through Friday,
excluding legal holidays. The OW
Docket Center telephone number is
(202) 566–2426, and the Docket address
is OW Docket, EPA West, Room 3334,
and 1301 Constitution Avenue, NW.,
Washington, DC 20004. The Public
Reading Room is open from 8:30 a.m. to
4:30 p.m., Monday through Friday,
excluding legal holidays. The telephone
number for the Public Reading Room is
(202) 566–1744. Publicly available
docket materials are also available in
hard copy at U.S. EPA, Region 10, and
1200 Sixth Avenue, Suite 900, Seattle,
WA 98101. Docket materials can be
accessed from 9 a.m. until 3 p.m.,
Monday through Friday, excluding legal
holidays. The telephone number is (206)
553–1834.
FOR FURTHER INFORMATION CONTACT:
Danielle Salvaterra, U.S. EPA
Headquarters, Office of Water,
Mailcode: 4305T, 1200 Pennsylvania
Avenue, NW., Washington, DC 20460;
telephone number: 202–564–1631; fax
number: 202–566–0409; e-mail address:
salvaterra.danielle@epa.gov or Lisa
Macchio, U.S. EPA, Region 10,
Mailcode: OWW–131, 1200 Sixth
Avenue, Suite 900, Seattle, Washington
98101; telephone number: 206–553–
1834; fax number: 206–553–0165; e-mail
address: macchio.lisa@epa.gov.
SUPPLEMENTARY INFORMATION: EPA is
promulgating the withdrawal of the
Federal water quality standards
designating cold water biota uses for
Soda Creek and portions of Canyon
Creek, South Fork Coeur d’Alene River,
and Blackfoot River in Idaho. EPA
published the proposal for this final
rulemaking on August 19, 2008. EPA is
taking further action to withdraw a
direct final rule that EPA published on
DATES:
E:\FR\FM\05NOR1.SGM
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Agencies
[Federal Register Volume 73, Number 215 (Wednesday, November 5, 2008)]
[Rules and Regulations]
[Pages 65726-65735]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-26310]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Parts 3 and 20
RIN 2900-AM77
Board of Veterans' Appeals: Expedited Claims Adjudication
Initiative--Pilot Program
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is launching an
initiative for accelerated claims and appeals processing at four VA
facilities, based on voluntary participation by eligible claimants. The
purpose of this initiative is to determine whether VA can expedite the
processing of claims and appeals by obtaining claimants' waivers of
certain statutory and regulatory response periods, and by utilizing the
Board of Veterans' Appeals' (Board or BVA) statutory authority to pre-
screen cases. VA's responsibility to fully develop and decide cases in
a fair, accurate, and non-adversarial manner remains unchanged under
this initiative. If this initiative is successful at the four trial
sites, the data obtained may provide a basis for expanding some, or
all, of the program nationwide, and ultimately help accelerate the
processing of all claims and appeals. The parameters of the initiative
are set forth in these regulations.
DATES: Effective Date: The final rule is effective December 5, 2008.
FOR FURTHER INFORMATION CONTACT: Steven L. Keller, Principal Deputy
Vice Chairman, Board of Veterans' Appeals (012), Department of Veterans
Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461-8078.
(This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: In a document published in the Federal
Register on April 16, 2008 (73 FR 20571), VA proposed to launch an
initiative for accelerated claims and appeals processing at four VA
facilities. This initiative would establish a 2-year pilot program
known as the Expedited Claims Adjudication (ECA) Initiative
(Initiative). The goal of the Initiative would be to determine whether
VA can expedite the claims and appeals process by obtaining claimants'
waivers of certain statutory and regulatory response periods, and by
pre-screening cases at the Board to determine the adequacy of the
record for appellate review. As proposed, participation in the
Initiative would be strictly voluntary, and open to claimants residing
in the jurisdiction of one of the four trial sites. Additionally,
claimants would be required to be represented by a recognized Veterans
Service Organization (VSO) or an accredited agent or attorney at the
time of electing to participate in the Initiative. The ECA Initiative
would be predicated on the claimant agreeing, at the beginning of the
claims process, to waive certain identified statutory and regulatory
time limits and processing actions, which would be carefully outlined
in an ECA Initiative Agreement and Waiver of Rights (ECA Agreement).
ECA participation would be effectuated only if both the claimant and
his or her representative sign the ECA Agreement, certifying that the
claimant has consulted with his or her representative
[[Page 65727]]
to determine if participation in the Initiative is in his or her best
interest.
A claimant's decision to participate in the ECA would be revocable
at any time in the VA claims or appeals process, with no penalty.
Rather, as outlined in the notice of proposed rulemaking, upon express
or implied revocation of ECA participation, the claimant's case would
continue to be processed, from that point forward, using ordinary and
established procedures under current statutes and regulations governing
claims adjudication. In other words, the claimant's case would
essentially continue from the same point in the adjudication process
that it was when it left the ECA.
The public comment period ended on June 16, 2008. VA received
comments from one individual and from three organizations. For the most
part, the comments expressed general disagreement with the basic
structure and purpose of the ECA, and raised concerns about the impact
the ECA would have on VA's workload, particularly accuracy and quality
in decision-making. More specifically, the commenters expressed the
following concerns: (1) The effect of the Initiative on decision
quality; (2) whether the Board has authority to decide ECA claims out
of docket order; (3) time limits under the Initiative; (4) disagreement
with the good cause exception in the Initiative; (5) VA's data
collection under the Initiative; (6) a challenge to the purpose of the
ECA; and, (7) concern over the impact of the ECA on the workload at one
of the trial sites. We will address each of these topics in turn. Based
on the rationale described in this document and in the notice of
proposed rulemaking, VA adopts the proposed rule as revised in this
document.
A. Decision Quality
An underlying theme throughout the four comments was that the ECA
would degrade decision quality and accuracy. One commenter stated that
the Initiative ``appears to elevate speed of adjudication above
adequate evidence development and accuracy of decision-making.'' The
commenter stated that the Initiative ``does violence'' to the
historical non-adversarial and informal nature of the VA adjudication
system. The commenter stated the belief that the Initiative would not
lead to any improvement to the adjudication system as a whole. Rather,
the commenter is ``convinced that the changes the Initiative proposes
will cause the creation of inadequately developed records in claims,
which will result in inaccurate decisions denying benefits'' and
ultimately lead to increased remands in the system to ``undertake
corrective development in covered claims.''
Similarly, another commenter expressed hesitancy to support the ECA
``without a guarantee that the quality of the decision rendered will be
better than that of a claim adjudicated in the normal manner or that
there would be a significant improvement in claims processing time.''
The commenter noted the absence of a quality assurance component for
the ECA. The commenter recommended ``that VA devote its time to
improving the quality of its adjudications rather than creating ways to
circumvent procedural protections.''
We agree that all claimants in the VA adjudication system are
entitled to accurate and legally correct decisions based on a fully-
developed evidentiary record. We respectfully disagree, however, with
the commenters' characterization of the Initiative as promoting speed
of adjudication over adequate evidentiary development and
administrative efficiency over accuracy. We also disagree with the
suggestion that the Initiative would do ``violence'' to the current
system. Rather, we believe that this Initiative is a constructive
attempt to improve efficiency and timeliness in the VA claims
adjudication system.
As discussed in the notice of proposed rulemaking, the essential
premise on which the Initiative is based is that there are many
procedural rights built into the current VA claims adjudication and
appeals process that unnecessarily lengthen the amount of time it takes
to process an initial claim or appeal while cases sit without any
action occurring while waiting for a statutory or regulatory response
period to end. By greatly reducing the amount of time that a case sits
without any action occurring while waiting for one of these response
periods to run, it is the goal of this 2-year Initiative to provide a
model to streamline the claims adjudication and appeals process system
wide. Contrarily, it is not the goal of the Initiative to avoid VA's
responsibilities to fully and adequately develop and decide cases in a
fair and accurate manner, or to change in any other manner the non-
adversarial and informal nature of the VA adjudication system.
With respect to evidentiary development, we emphasize that the
Initiative leaves intact VA's duty to notify claimants of the
information and evidence necessary to substantiate their claims under
38 U.S.C. 5103(a) and 38 CFR 3.159(b)(1), as well as VA's duty to
assist claimants in obtaining evidence necessary to substantiate their
claims under 38 U.S.C. 5103A and 38 CFR 3.159(c). ECA participants will
continue to be provided a notice letter that informs them of the
information and evidence needed to substantiate their claim(s) and
outlines the claimant's and VA's responsibilities for obtaining such
evidence. See 38 U.S.C. 5103(a) and 38 CFR 3.159(b)(1). The Initiative
also leaves unaltered VA's duty to make reasonable efforts to obtain
relevant evidence identified by a claimant, and leaves unchanged VA's
duty to provide claimants with a medical examination or obtain a
medical opinion when necessary to decide a claim. See, e.g., 38 CFR
3.159(c)(4), 3.326, 3.327. These notice and development requirements
are implicitly referenced under Sec. 20.1500(c), which states that any
matter not otherwise covered by this subpart will be governed by
existing rules.
As the Initiative leaves intact VA's duties to notify and assist,
we cannot agree with the commenters' suggestion that the Initiative
contains no provision that would ensure that VA adjudicators have a
complete and fully developed evidentiary record in covered claims. To
the contrary, VA's obligation to adequately develop claims under the
Veterans Claims Assistance Act of 2000 (VCAA), see 38 U.S.C. 5103 and
5103A, applies to both ECA participants and non-ECA participants alike.
Under the ECA Initiative, VA's responsibilities with respect to both
obtaining and analyzing identified evidence remain unchanged. Thus, ECA
participants run no additional risk of inadequate evidentiary
development as compared to other claimants in the VA system.
We also do not agree with the suggestion that the Initiative
sacrifices accuracy for speed. It remains VA's goal to provide all
claimants, including ECA participants, with high-quality, legally-
correct decisions in all claims. No provision in the ECA Initiative
runs counter to this goal. Although the Initiative shortens various
statutory and regulatory response times to be observed by participants,
it does not diminish VA's duty to fully develop the record as mandated
by the VCAA, and accurately decide a claim taking into consideration
all relevant facts and applicable law. While one of the commenters is
correct that quality assurance is not specifically addressed in the
proposed regulations, it is not necessary to include such regulations
as both the Veterans Benefits Administration (VBA) and the Board
already have robust and established quality assurance programs in place
that will be equally applicable to ECA cases. Therefore, for the above
reasons, we
[[Page 65728]]
make no change to the proposed rule based on the concerns raised
regarding decision quality and record development.
B. Docket Order
One commenter expressed concern that the Initiative makes no
provision for the Board to issue expedited decisions in appeals of
covered claims. The commenter suggested that VA adopt a regulation
authorizing the Board to ``consider and decide covered claims of
participating claimants out of docket order and as soon as practicable
upon their transfer to the Board.'' Unless the Board adopts such a
provision, the commenter stated, the Initiative will not be successful
as claimants will not want to participate in a program that does not
ensure faster processing time by the Board. The commenter recognized
that, as we explained in the notice of proposed rulemaking, the Board
is required by statute to consider appeals in docket order, subject to
certain enumerated exceptions. See 38 U.S.C. 7107(a) (providing that
``each case received pursuant to an application for review on appeal
shall be considered and decided in regular order according to its place
on the docket''). The commenter presented two recommendations for the
Board to deal with this statutory requirement. First, the commenter
proposed that ``VA must ask Congress to enact legislation to authorize
the Board to issue expedited decisions in appeals of covered claims.''
Second, the commenter suggested that the Board, pursuant to either 38
U.S.C. 7107 or 38 U.S.C. 501(a), may already have authority to decide
ECA appeals out of docket order.
With respect to the commenter's suggestion that VA ask Congress to
enact legislation authorizing the Board to decide ECA appeals out of
docket order, it was our goal in creating the Initiative to work within
the existing statutory framework. While there may be a number of
suggested legislative amendments which, if enacted, could potentially
improve the VA claims adjudication system, such pursuits are not within
the ambit of this rulemaking action or the ECA Initiative. Therefore,
we make no changes to the proposed rule based on this suggestion.
We also respectfully disagree with the commenter's suggestion that
VA already has the authority to decide ECA cases out of docket order.
The commenter specifically argues that ECA cases could be advanced on
the Board's docket pursuant to 38 U.S.C. 7107(a)(2). That statutory
provision allows the Board to advance a case on its docket ``if the
case involves interpretation of law of general application affecting
other claims;'' ``if the appellant is seriously ill or is under severe
financial hardship;'' or ``for other sufficient cause shown.'' The
commenter suggests that the need for expeditious adjudication of ECA
appeals constitutes ``other sufficient cause'' for allowing the Board
to advance ECA cases on its docket.
We do not agree with the commenter that the need for expeditious
adjudication of appeals under the Initiative constitutes ``other
sufficient cause'' for advancing ECA cases on the docket, as that
phrase is used in 38 U.S.C. 7107(a)(2)(C). Consistent with the limited
bases for granting a motion to advance as provided in section
7107(a)(2), the Board has narrowly construed ``other sufficient cause''
as being limited to situations involving either administrative error on
the part of VA that resulted in significant delay in docketing the
case, or where the appellant is of advanced age (75 or older). See 38
CFR 20.900(c).
Any appeal that is advanced on the Board's docket ``goes to the
head of the line'' and necessarily delays the consideration of all
other pending appeals. For every case advanced on the Board's docket,
another appellant whose case has not been advanced must wait longer for
his or her decision than otherwise would have been necessary. Decisions
to grant motions for advancement on the docket are carefully considered
on their individual merits. Although it is important that ECA appeals
are decided as quickly as possible, we simply do not believe that the
policy concerns inherent in advancing ECA cases are tantamount to those
involved in cases where advancement has traditionally been allowed. The
ECA Initiative is a 2-year pilot program, which, if successful, may
provide a basis for expanding some, or all, of the program nationwide.
If and when that occurs, it may be appropriate to reconsider the issue
of what would be required to properly permit the advance docketing of
ECA appeals. In the meantime, although ECA cases will not be
automatically advanced on the Board's docket, nothing in the Initiative
precludes participants from filing motions for advancement on the
docket where such action is otherwise warranted under 38 U.S.C.
7107(a)(2) and 38 CFR 20.900(c), such as where an appellant is at least
75 years of age or suffers from serious illness or severe financial
hardship.
Finally, while ECA cases will not be automatically advanced on the
Board's docket, it still is anticipated that the Board's use of its
screening authority under 38 U.S.C. 7107(f) will result in cases being
finally decided by the Board in a faster manner. Once an appeal reaches
its place on the docket, the Board often discovers that additional
development is required or that questions remain regarding
representation, hearing requests, or waivers of Board review of
evidence in the first instance. Substantial delay can result while the
Board resolves such matters, particularly where the Board has to remand
for additional development. Such delays can often add months or years
to the appellate process. By screening ECA cases at the Board under 38
U.S.C. 7107(f), the Board is authorized to take action pursuant to 38
CFR 19.9 including: soliciting a waiver from the participant permitting
the Board to review new evidence obtained by VA in the first instance;
seeking clarification on matters such as representation and hearing
requests; and, where necessary, remanding for further development. The
Board's screening efforts in this regard will help to ensure that such
matters are resolved before an ECA appeal reaches its place on the
docket. Thus, when an appeal reaches its place on the docket, the Board
should be able to make a final decision on the merits without
additional delay, such as would be caused by remanding for further
development at that time.
As to the concern raised that claimants will not want to
participate in the ECA program unless the Board adopts a provision for
advancing such cases on its docket, we simply reiterate that, by pre-
screening appeals, cases should be finally decided by the Board more
expeditiously than without such early intervention. Moreover, it is
noted that, based on longstanding past practice, a majority of cases
are resolved before they reach the Board. Most cases processed under
the ECA will likewise be resolved at the Agency of Original
Jurisdiction (AOJ) level. For those cases that do reach the Board, an
earlier docket number will be assigned by virtue of the case having
been more quickly processed by the AOJ. For all of the reasons outlined
above, we make no change to the proposed rules based on the comments
regarding docket order.
C. Time Limits
1. Time Limits on VA
One commenter expressed concern that under the Initiative,
``participating claimants agree to act within certain time-limits,
while the VA, except for one instance, does not.'' The commenter stated
that, if one of the goals of the Initiative is to ``help accelerate the
processing of all claims and appeals,''
[[Page 65729]]
VA will help to achieve this goal if it imposes additional time limits
on itself under the Initiative. The commenter submits that ``VA must
impose time-limits on the four selected VA regional offices and the
Board to take necessary action,'' and several specific time limits were
suggested. We reject this comment for the following reasons.
While the Initiative places only one time limit on VA, see 38 CFR
20.1504(b), this was done to ensure that VA adjudicators are afforded
adequate time to gather evidence identified by participants, obtain
necessary examinations and medical opinions, and conduct hearings when
requested without arbitrary time limits. As the commenter correctly
notes, inadequate development can lead to inaccurate decisions, which
unfairly deny benefits to deserving claimants. It is therefore critical
that all claims processed under the Initiative have fully-developed
records including all relevant evidence identified by the participant
and any necessary examination reports or medical opinions. While it is
certainly helpful for claimants to obtain and submit evidence on their
own behalf, the minimal obligation is for a claimant to identify the
location of pertinent records and authorize VA to obtain them. In
obtaining records from various government and private sources, delays
may be experienced in obtaining a response. Given that VA has no
control over non-VA organizations and individuals, it is simply not
practicable to establish fixed periods of time within which VA must act
in this regard, except as otherwise provided in the ECA regulations. In
fact, upon further reflection, VA has determined that a limited
exception to the time period imposed upon VA in Sec. 20.1504(b) is
necessary to ensure fairness and full compliance with the duty to
assist. This exception would cover the circumstance when, after
issuance of the Statement of the Case (SOC), VA is put on notice of a
change in circumstances, such as a worsening of the claimant's
condition or the location of previously unobtained relevant evidence.
In order to ensure full compliance with the duty to assist under the
VCAA, see 38 U.S.C. 5103A, VA may have an obligation to order a new
examination for the claimant or to obtain copies of the relevant
records. However, due to the time required to schedule and conduct a
new examination or locate and obtain new records, these actions may
make it challenging, if not impossible, for VA to comply with the time
limit in Sec. 20.1504(b), which requires VA to certify and transfer
the appellate record to the Board no later than 60 days from the date
of filing the Substantive Appeal. Consequently, out of fairness to the
claimant, we are amending Sec. 20.1504(b) to create an exception to
the 60-day time period for certification when VA is required under 38
U.S.C. 5103A and 38 CFR 3.159(c) to provide assistance in obtaining
evidence after issuance of the SOC.
The ECA Initiative does contain distinct time periods for claimants
to take certain actions, which we believe are reasonable. Claimants are
in the unique position of knowing the dates and places where they
received medical treatment relevant to their claims. When the claimant
adequately notifies VA of relevant evidence and authorizes VA to obtain
the evidence, VA then has a duty to assist the claimant in obtaining
this evidence. The sooner that the claimant provides VA with this
information and authorization, the more complete the record will be at
the beginning of the claims process. This is a significant feature of
the ECA Initiative--to develop a complete record as early in the
process as possible, so that informed and correct decisions may be
made.
Although we refrain from establishing any fixed time limits on VA
beyond the one outlined in Sec. 20.1504(b), we want to make clear this
does not mean that VA intends to unnecessarily delay action on ECA
claims. To the contrary, it is our stated intention to develop and
adjudicate ECA claims as quickly as possible by greatly reducing the
amount of time that a case sits without any action occurring while
waiting for a statutory or regulatory response period to end. Further,
we also reject the commenter's suggestion that we impose additional
time limits on VA because such action is beyond the scope of this
rulemaking and the ECA Initiative. The purpose of the ECA is to
evaluate whether claims processing can be expedited by claimants'
voluntary waiver of certain existing statutory and regulatory response
periods and pre-screening of cases by the Board. It is not the goal of
the Initiative to study the feasibility of imposing rating deadlines on
VA. Accordingly, for the above reasons, we make no change based on the
comments received, but we make one change to the time limit in Sec.
20.1504(b), as discussed.
2. Time Limits on Claimants
One commenter stated that the reduced time limits under the
Initiative for claimants are likely to result in inadequate records and
inaccurate decisions. The commenter noted that several of the time
limits to be observed by participants under the Initiative are unduly
strict and ``unreasonable,'' particularly the period participants have
to respond to a VCAA notice letter and to subsequent VA requests for
information and evidence. The commenter stated that claimants and their
representatives often have to wait ``weeks or months'' to receive
requested treatment records from medical-care providers, and that such
a wait would likely result in participants missing the aforementioned
deadlines. The commenter also noted that claimants' medical conditions
often worsen over time and that treatment records reflecting such
increase in symptomatology may not be available until after the VCAA
notice response period expires.
Additionally, the commenter stated that evidence submitted after
the deadlines in Sec. 20.1504(a)(1) and (2) would not be able to be
considered by VA, resulting in unfair denials of worthy claims.
Further, the commenter added that ``there is no provision in the VA's
proposed regulations that will permit the claimant to submit * * *
newly obtained evidence or information to VA since motions for an
extension of time to submit necessary information must be filed with VA
before the applicable time period runs.'' Finally, the commenter stated
that given the difficulties in obtaining medical evidence, VA should
not ``penalize'' participating claimants for circumstances outside of
their control.
Although in the notice of proposed rulemaking we stated that ECA
participants agree to waive the 1-year period provided under 38 U.S.C.
5103(b)(1) and 38 CFR 3.159(b)(1), we wish to correct that statement.
There is no such waiver under the ECA. Rather, an ECA participant must,
within 30 days, respond to VA's VCAA notice concerning the information
and evidence necessary to substantiate a claim. An ECA participant may
respond to VA's notice by providing information or evidence in the
claimant's possession, identifying necessary evidence that the claimant
requires VA's assistance to obtain, or notifying VA that no additional
evidence exists. See 38 CFR 20.1503(d) (Upon executing the Agreement
and Waiver of Rights, the participant will identify all relevant
evidence in support of his or her claim(s), including any VA records,
non-VA Federal records, and any private records, provide the evidence,
or notify VA that such evidence does not exist, within the time
prescribed in Sec. 20.1504(a)(1)). If the participant does not respond
to VA's notice within 30 days, the implied revocation provisions of
Sec. 20.1509(c) apply and the claim will
[[Page 65730]]
be decided using ordinary, non-ECA procedures. However, if the
participant responds within 30 days to VA's notice of the information
and evidence necessary to substantiate the claim, VA will make
reasonable efforts to obtain the evidence the participant has
authorized the Department to obtain and adjudicate the claim. 38 U.S.C.
5103A; 38 CFR 3.159(c).
Section 3.159(b)(1) of title 38, Code of Federal Regulations, does
not require a claimant to respond to VA's notice within 30 days,
although VA may decide the claim if the claimant does not respond. It
is our experience that often a claimant does not respond to the notice,
VA decides the claim, and then the claimant submits relevant evidence.
The ECA is designed to short-circuit this time-consuming adjudication
process by requiring a claimant to affirmatively advise VA of the
existence of relevant evidence, provide VA with such evidence, or
advise VA that no other relevant evidence exists or is available, so
that, to the fullest extent possible, all available evidence can be
compiled before a claim is adjudicated. In order to clarify our intent,
we are revising proposed Sec. Sec. 20.1503(d) and 20.1504(a)(1) and
(2) to explain what type of response is required from an ECA
participant within the specified periods.
An ECA participant, nonetheless, has, as provided in 38 U.S.C.
5103(b)(1) and 38 CFR 3.159(b)(1), 1 year from the date of the section
5103(a)--notice in which to submit the information and evidence that VA
has notified the participant that the participant must provide. See 38
CFR 20.1500(c) (any matter not otherwise covered by this subpart will
be governed by existing rules in this title). If evidence is received
by VA after the SOC is issued, the evidence will not be subject to
another AOJ adjudication, but instead may be considered by the Board in
the first instance. See 38 CFR 20.1508(b).
We are making one additional change to proposed Sec. 20.1504(a)(1)
by making the response period 30 days rather than 60 days. This
revision to proposed Sec. 20.1504(a)(1) will make it conform to the
response period already contained in 38 CFR 3.159(b)(1), as revised by
73 FR 23353, 23356, on April 30, 2008.
In addition, we point out that several of the Initiative's
provisions specifically contemplate a participant submitting, and VA
considering, evidence after the initial 30-day VCAA notice response
period has expired. For example, Sec. 20.1508(b)(2) provides that, if
new evidence is submitted by a participant or representative following
the issuance of an SOC, the participant will be deemed to have waived
AOJ review of such evidence so that the evidence may be considered by
the Board in the first instance. Moreover, Sec. 20.1504(a)(6)(iii)
allows participants 30 days to submit evidence or argument after their
appeals have been certified and transferred to the Board. Any evidence
submitted under this provision would necessarily be filed after the 30-
day VCAA response period has elapsed.
While participants and their representatives should be as thorough
as possible in responding to VCAA notice letters or follow-up
information requests, evidence submitted or identified after the
expiration of the 30-day response periods will still be considered by
the AOJ or the Board, provided such submission is allowed under other
provisions of law. The remainder of the comments expressing concern
that the ECA will result in inadequate records and inaccurate decisions
are rejected for the reasons discussed above.
D. Good Cause Exception
One commenter stated that the ``good cause'' exception for each of
the enumerated time limits is unduly strict and should be liberalized
to ensure the success of the Initiative. The commenter's primary
concern focused on the use of the good cause exception as it relates to
the 60-day time period in proposed Sec. 20.1504(a)(1) (now changed to
30-days in the final rule) for responding to a VCAA notice letter under
the Initiative. The comment appears to be based on the assumption that
VA will not consider evidence submitted after the VCAA notice response
period has expired. As explained in section C.2 above, ECA participants
do not waive the 1-year period prescribed in section 5103(a). An ECA
participant is not required to submit all evidence relating to their
claim within 30 days of the date of VA's section-5103(a) notice.
Rather, as explained above, what we intend is that an ECA participant
will be required to respond to VA's notice either by providing the
evidence requested, identifying evidence relevant to substantiating the
claim and authorizing VA to obtain the evidence, or notifying VA that
no such evidence exists.
ECA participants are not necessarily required to submit any
evidence at all within the response period in Sec. 20.1504(a)(1) or
(2), though they are free to do so. All a participant has to do to
comply with the notice response period(s) is to affirmatively respond
by identifying the relevant evidence then in existence and authorizing
VA to obtain such evidence or notifying VA that no such evidence
exists. See 38 CFR 20.1503(d). It is then VA's responsibility to make
reasonable attempts to obtain relevant evidence identified by the ECA
participant, including any private evidence that the claimant
adequately identifies and authorizes VA to obtain. 38 U.S.C. 5103A(b).
Therefore, because a sufficient response to a VA request for
information and evidence only requires the identification of relevant
information or evidence, if any, within the allowed response period,
along with providing VA with authorization to obtain the same, we
disagree with the commenter's suggestion that the good cause exception
as provided for in Sec. 20.1509(e), as it applies to responding to
VA's section-5103(a) notice, is inadequate as drafted.
Because participants are not barred from submitting additional
evidence following the expiration of the response periods set forth in
Sec. 20.1504(a)(1) and (a)(2), an extension motion is not required to
submit evidence after those periods have expired. An extension motion,
as described in Sec. 20.1509(e), is only needed if the participant
wishes to extend a time limit in subpart P, most of which consist of
response times. See 38 CFR 20.1504(a).
Finally, it is noted that the commenter seems to take an unduly
restrictive interpretation of the situations for which a motion for
extension of time may be granted pursuant to Sec. 20.1509(e). While
examples are provided of situations in which good cause may be found,
such as ``illness of the participant or the representative of such
severity that precludes action during the period,'' the proposed
regulation specifically states that the examples of good cause provided
``include, but are not limited to,'' the enumerated examples.
Accordingly, provided that a participant makes a timely request for an
extension of time with adequate showing of good cause, the participant
may obtain an extension of time. Accordingly, for all of these reasons,
we make no change to the proposed rule based on this comment.
E. Data Collection
One commenter expressed concern regarding VA's data collection
activities under the Initiative. The commenter stated that it is
``essential that good work load data and other management data be
collected * * * and that this information be used internally and made
available publicly so that the Initiative's new procedures can be
carefully evaluated on an ongoing basis.'' The commenter suggested
several pieces of information that
[[Page 65731]]
should be tracked, including ``the number of claimants that volunteer
for the program, how long each stays in the program, if they are
voluntarily or involuntarily dismissed from the program, and what
results are reached.'' The commenter also suggested that data collected
at participating VA regional offices be compared to that obtained at a
control group of non-participating offices.
While we wholeheartedly agree with the commenter that comprehensive
data collection will be critical to accurately evaluate the success of
the Initiative, the description of such data collection efforts is not
necessary or appropriate for inclusion in this rulemaking action.
Suffice it to say, we plan to gather a wide variety of information
throughout the course of the Initiative to ensure that all aspects of
the pilot program are carefully reviewed and evaluated. As the
commenter suggests, the information we intend to track includes, among
many other things, the number of participants, the number of instances
of revocation of participation, processing times, and the ultimate
disposition of ECA claims. We plan on tracking customer satisfaction
with the ECA to help assess the strengths and weaknesses of the
Initiative. Moreover, we intend to compare all data collected regarding
ECA participants with data from claimants who did not elect ECA
participation. All data collected and reports generated as part of the
Initiative will be obtainable by the public in the same manner and
means as other VA data and reports. Accordingly, we make no change to
the proposed rule based on this comment.
F. The Need for the ECA
One commenter questioned the need for the ECA, pointing out that
there was no discernable advantage that claimants would receive from
participation in the ECA, ``other than that which would be expected to
naturally flow from submitting procedural documents and evidence as
soon as practicable.'' The commenter suggested ``that the RO speed up
the certification and transfer time to the BVA, unilaterally, and
encourage claimants to unilaterally proceed with their appeal as
quickly as possible, without the necessity of waiving procedural
defects and without the need for rule changes.'' For all of the many
reasons already discussed above, as well as in the notice of proposed
rulemaking, VA respectfully disagrees with the assertion that claimants
will not benefit from participating in the ECA. Moreover, because the
Initiative is specifically designed as a 2-year pilot project at a
limited number of VA facilities, the data collected during this period
of time will enable a more fully informed assessment of the success and
weaknesses of the Initiative to be made, including whether it should be
further expanded.
In addition, it is noted that participation in the ECA will be
entirely voluntary. Accordingly, any claimant who does not feel
comfortable participating in the program, or does not feel that
participation would be advantageous, is free to proceed under the
existing VA claims adjudication and appeals process. Further, any ECA
participant will be able to opt out of the Initiative at anytime
without any negative consequences for doing so. Instead, the claim or
appeal will simply be returned to the normal claims adjudication and
appeals process at the point at which the participant withdrew from the
program. Thus, participation could never be disadvantageous to a
claimant.
Finally, as correctly noted by another commenter, the ECA
Initiative does not change VA's basic obligation to assure that the
varying parts of its benefits programs ``work together to give prompt,
efficient, fair, and accurate service to disabled veterans and other
claimants for VA benefits.'' We agree with this proposition. As
discussed at length above, the Initiative leaves intact VA's duties to
notify claimants of the information and evidence needed to substantiate
their claim, and VA's duty to assist claimants in obtaining relevant
evidence, including securing a VA examination when required by existing
law. At every point in the Initiative, the paternalistic and non-
adversarial nature of the VA claims adjudication system is preserved.
Thus, for all of the above reasons, we make no changes based on these
comments.
G. The Impact of the ECA on Workload at Trial Sites
Finally, one commenter expressed concern that the ECA Initiative
would have an adverse impact on the overall workload at the
Philadelphia regional office, which is one of the trial sites. He noted
that Philadelphia currently handles many cases that are ``brokered''
from the Boston regional office, and stated that the addition of ECA
cases to Philadelphia's workload will negatively impact the processing
of the brokered cases. The commenter also raised some general concerns
with VBA's case brokering process that are beyond the scope of this
rulemaking action and will not be further addressed here.
We respectfully disagree with the commenter's concerns. To be
eligible to participate in the Initiative, a claimant must reside
within the jurisdiction of one of the four participating VA regional
offices (the jurisdiction of each of the four participating regional
offices is specifically outlined in Sec. 20.1501(e)). As a result of
this requirement, the Philadelphia regional office would only be
allowed to handle ECA claims from participants who already reside
within the jurisdiction of that office. Such claims would already have
been the responsibility of the Philadelphia regional office, regardless
of a claimant's decision to participate in the Initiative. Because ECA
participants are taken from the same pool of claimants already being
served by the four respective participating regional offices, the
Initiative simply will not increase the number of claims handled by
each office, and therefore will not have an impact on the overall
workload of any of the test sites, including the Philadelphia regional
office. Moreover, even in the unlikely event that Philadelphia's
workload did increase, VBA would be free, at the discretion of
management, to reduce or discontinue the brokering of cases to that
office and instead broker Boston cases to another facility. We make no
changes to the proposed rule based on these comments.
H. Technical Amendments; Pilot Site Change
In addition to the revisions discussed above, we are making three
minor technical changes to the proposed rule, and one change regarding
the pilot sites. First, we are changing the language in Sec.
20.1500(d) to more clearly set forth the effective date of the
Initiative. Second, we are making a minor revision to Sec. 20.1501(d)
to clarify that representatives of ECA participants must be accredited
by VA. See 38 CFR 14.631. Third, we are adding a cross-reference and
brief discussion to Sec. 20.1508(b)(1) to more clearly indicate that
an implied revocation from the Initiative will occur if a participant
does not agree to waive initial consideration by the agency of original
jurisdiction of any new evidence obtained by VA following the issuance
of a Statement of the Case. See 38 CFR 20.1509(c)(2).
In addition to the foregoing, we are changing one of the four pilot
sites due to increased workload that has arisen at the St. Paul
regional office since publication of the NPRM. The St. Paul, Minnesota
regional office will no longer be involved in the ECA pilot program.
Rather, the regional office in Lincoln, Nebraska, will be one of the
four pilot sites. The jurisdiction of the Lincoln regional office
extends to the entire State of Nebraska.
[[Page 65732]]
Paperwork Reduction Act
This document contains no provisions constituting a collection of
information under the Paperwork Reduction Act (44 U.S.C. 3501-3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this rule would not have a
significant economic impact on a substantial number of small entities
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. It will not affect any small organizations or small governmental
jurisdictions, and will not have a significant economic impact on these
small entities. Therefore, pursuant to 5 U.S.C. 605(b), this rule is
exempt from the initial and final regulatory flexibility analysis
requirement of 5 U.S.C. 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 rule have been examined and it has been determined
to be a significant regulatory action under Executive Order 12866, as
it raises novel legal or policy issues arising out of legal mandates.
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 1 year. This rule would have no such effect on State,
local, and tribal governments, or on the private sector.
Catalog of Federal Domestic Assistance Numbers
The Catalog of Federal Domestic Assistance program numbers and
titles for this proposal are 64.100, 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; 64.103, Life
Insurance for Veterans; 64.104, Pension for Non-Service-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; 64.114, Veterans Housing-Guaranteed and Insured Loans; 64.115,
Veterans Information and Assistance; 64.116, Vocational Rehabilitation
for Disabled Veterans; 64.117, Survivors and Dependents Educational
Assistance; 64.118, Veterans Housing-Direct Loans for Certain Disabled
Veterans; 64.119, Veterans Housing-Manufactured Home Loans; 64.120,
Post-Vietnam Era Veterans' Educational Assistance; 64.124, All-
Volunteer Force Educational Assistance; 64.125, Vocational and
Educational Counseling for Servicemembers and Veterans; 64.126, Native
American Veteran Direct Loan Program; 64.127, Monthly Allowance for
Children of Vietnam Veterans Born with Spina Bifida; and 64.128,
Vocational Training and Rehabilitation for Vietnam Veterans' Children
with Spina Bifida or Other Covered Birth Defects.
List of Subjects
38 CFR Part 3
Administrative practice and procedure, Claims, Disability benefits,
Health care, Pensions, Veterans, Vietnam.
38 CFR Part 20
Administrative practice and procedure, Claims, Veterans.
Approved: August 20, 2008.
James B. Peake,
Secretary of Veterans Affairs.
0
For the reasons set forth in the Preamble, VA amends 38 CFR parts 3 and
20 as follows:
PART 3--ADJUDICATION
Subpart A--Pension, Compensation, and Dependency and Indemnity
Compensation
0
1. The authority citation for part 3, Subpart A, continues to read as
follows:
Authority: 38 U.S.C. 501(a), unless otherwise noted.
0
2. Add Sec. 3.161 to read as follows:
Sec. 3.161 Expedited Claims Adjudication Initiative--Pilot Program.
Rules pertaining to the Expedited Claims Adjudication Initiative
Pilot Program are set forth in part 20, subpart P, of this chapter.
(Authority: 38 U.S.C. 501(a))
PART 20--BOARD OF VETERANS' APPEALS: RULES OF PRACTICE
0
3. The authority citation for part 20 continues to read as follows:
Authority: 38 U.S.C. 501(a), and as noted in specific sections.
0
4. Add subpart P to read as follows:
Subpart P--Expedited Claims Adjudication Initiative--Pilot Program
Sec.
20.1500 Rule 1500. Expedited Claims Adjudication Initiative.
20.1501 Rule 1501. Definitions.
20.1502 Rule 1502. Eligibility.
20.1503 Rule 1503. Election, identification of evidence, and
representation.
20.1504 Rule 1504. Time limits.
20.1505 Rule 1505. Review of initial benefits claim decision.
20.1506 Rule 1506. Board review of cases.
20.1507 Rule 1507. Hearings.
20.1508 Rule 1508. Waiver.
20.1509 Rule 1509. Compliance and revocation of participation.
20.1510 Rule 1510. Termination of the Initiative.
Subpart P--Expedited Claims Adjudication Initiative--Pilot Program
Sec. 20.1500 Rule 1500 Expedited Claims Adjudication Initiative.
(a) Purpose. The Expedited Claims Adjudication Initiative is a
pilot program designed to streamline the claims adjudication and
appeals process. This subpart establishes procedures governing this
Initiative.
(b) Outline of Initiative. This Initiative allows eligible
claimants to voluntarily participate in an alternative claims
[[Page 65733]]
adjudication program as set forth in this subpart, which is predicated
on the claimant's waiver of certain identified statutory and regulatory
time limits, procedural rights, and processing issues that may arise.
(c) Scope. Except as specifically provided in this subpart, claims
processed under this Initiative will be adjudicated according to the
procedures outlined in part 3 of this chapter, and appeals will be
processed according to the Appeals Regulations and Rules of Practice,
as outlined in parts 19 and 20 of this chapter. Any matter not
otherwise covered by this subpart will be governed by existing rules in
this title.
(d) Duration. The Secretary will accept an executed Agreement and
Waiver of Rights as provided in Sec. 20.1503 of this part for a period
not to exceed 2 years from December 5, 2008.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1501 Rule 1501. Definitions.
For purposes of this subpart, the following definitions apply:
(a) Initiative means the Expedited Claims Adjudication Initiative
as promulgated by this subpart.
(b) Participant means any eligible claimant who elects to
participate in the Initiative by executing, with his or her
representative, an Expedited Claims Adjudication Initiative Agreement
and Waiver of Rights as provided in Sec. 20.1503 of this part.
(c) Covered claim or covered claims means any claim or claims, as
described in Sec. 20.1502(c) of this part, that a participant elects
to have processed under the rules governing the Initiative, including
any downstream element of the claim(s), such as assignment of a
disability rating and effective date, and any claim that is
inextricably intertwined with a covered claim.
(d) Representative means an accredited representative of a
recognized Veterans Service Organization or an accredited attorney or
agent, as set forth in part 14 of this chapter, for whom a claimant has
properly executed and filed a VA Form 21-22, ``Appointment of Veterans
Service Organization as Claimant's Representative,'' or a VA Form 21-
22a, ``Appointment of Individual as Claimant's Representative,'' as
required by Sec. 14.631 of this chapter.
(e) Participating VA regional office means one of the following
four VA regional offices: Nashville, Tennessee; Lincoln, Nebraska;
Seattle, Washington; and Philadelphia, Pennsylvania. The jurisdiction
of the Nashville, Lincoln, and Seattle regional offices extends to
residents of Tennessee, Nebraska, and Washington, respectively. The
jurisdiction of the Philadelphia regional office extends to residents
of the 40 easternmost counties of Pennsylvania and residents of the
seven southernmost counties of New Jersey. For purposes of this
Initiative only, the jurisdiction of these regional offices extends
only to a covered claim, as described in Sec. 20.1502(c) of this part.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1502 Rule 1502. Eligibility.
To participate in the Initiative, a claimant must:
(a) At the time the Agreement and Waiver of Rights is executed,
have a representative, as defined in Sec. 20.1501(d) of this part;
(b) Reside within the jurisdiction of a participating VA regional
office, as defined in Sec. 20.1501(e) of this part; and
(c) File one of the following types of claims for VA disability
compensation as outlined in parts 3 and 4 of this chapter at a
participating VA regional office:
(1) Original claim;
(2) Claim for an increased rating;
(3) Claim to reopen a previously-denied claim based on the
submission of new and material evidence as provided in Sec. 3.156 of
this chapter; or
(4) Requests for revision of a decision of an agency of original
jurisdiction under Sec. 3.105 of this chapter based on clear and
unmistakable error.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1503 Rule 1503. Election, identification of evidence, and
representation.
(a) When and how election made. Upon the filing of a claim
described in Sec. 20.1502(c) of this part, VA will promptly notify the
claimant in writing of the opportunity to participate in the Initiative
and provide the claimant with an Agreement and Waiver of Rights. A
claimant may elect to participate in the Initiative by filing an
executed Agreement and Waiver of Rights as provided in paragraphs (b)
and (c) of this section within 30 days of the date of the notice of the
opportunity to participate in the Initiative. An election to
participate in the Initiative can be revoked at any time in accordance
with Sec. 20.1509 of this part.
(b) Execution of agreement. To participate in the Initiative, a
claimant and his or her representative must execute an Agreement and
Waiver of Rights on a form prescribed by the Secretary. The claimant
will specifically identify in the Agreement and Waiver of Rights all
claims he or she wishes to have processed under the Initiative.
(c) Where to file. The executed Agreement and Waiver of Rights must
be filed with the participating VA regional office that has
jurisdiction over the claim.
(d) Identification of relevant evidence. Upon executing the
Agreement and Waiver of Rights, the participant will respond, within
the time period prescribed in Sec. 20.1504(a)(1), to VA notice
regarding the information and evidence necessary to substantiate the
claim by identifying all relevant evidence in support of his or her
claim(s), providing the requested evidence, or notifying VA that no
such evidence exists. Relevant evidence may include any VA records,
non-VA Federal records (such as Social Security disability records),
and any private records (such as treatment records from a family
physician). If the participant requires assistance from VA in obtaining
any identified records, the participant will provide VA, upon request,
the appropriate release form so VA may attempt to promptly obtain the
records on behalf of the participant. VA must receive the necessary
information and evidence requested from the participant within 1 year
of the date of the notice, in accordance with Sec. 3.159(b)(1) of this
chapter.
(e) Effect of change in representation on the election. If a
participant changes or terminates representation after having made a
valid election to participate in the Initiative, participation in the
Initiative will continue under the terms of the signed Agreement and
Waiver of Rights, unless the participant indicates, in writing,
pursuant to Sec. 20.1509(b) of this part, that he or she wishes to
revoke participation.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1504 Rule 1504. Time limits.
The following time limits will be applicable to all covered claims:
(a) Time limits to be observed by the participant. The participant
will comply with the following time limits for all covered claims:
(1) Response to initial notice letter. The time limit for
responding to the notification regarding the information and medical or
lay evidence necessary to substantiate a claim in the manner required
by Sec. 20.1503(d) will be 30 days.
(2) Subsequent requests by VA for additional information and
evidence. The time limit for responding to any subsequent request by VA
for additional information or evidence, either by notifying VA of the
existence of such information or evidence, providing such evidence, or
notifying VA that no such evidence exists, will be 30 days.
[[Page 65734]]
(3) VA request for waiver. The time limit for responding to a VA
request for waiver as set forth in Sec. 20.1508 of this part, will be
30 days.
(4) Notice of Disagreement. The time limit for filing a Notice of
Disagreement pursuant to Sec. 20.302(a) of this part will be 60 days.
(5) Substantive Appeal. The time limit for filing a Substantive
Appeal pursuant to Sec. 20.302(b) of this part will be 30 days.
(6) Following certification of appeal to the Board. Following the
issuance of notification that the appeal has been certified and
transferred to the Board, the time limit for taking the following
actions pursuant to Sec. 20.1304 of this part will be 30 days:
(i) Request a hearing before the Board,
(ii) Request a change in representation, or
(iii) Submit additional evidence or argument.
(b) Time limit to be observed by the participating VA regional
office. The participating VA regional office shall certify covered
claims and transfer the appellate record to the Board as set forth in
Sec. Sec. 19.35 and 19.36 of this chapter within 30 days of the
receipt of the Substantive Appeal, or within 30 days of receipt of any
additional submissions following the Substantive Appeal, but no later
than 60 days from the receipt of the Substantive Appeal. However, if,
after issuance of the Statement of the Case, additional assistance in
obtaining evidence is required in order to comply with Sec. 3.159(c)
of this chapter, the participating VA regional office shall certify
covered claims and transfer the appellate record to the Board within 60
days after the requisite action is completed.
(Authority: 38 U.S.C. 501(a) and 5103A)
Sec. 20.1505 Rule 1505. Review of initial benefits claim decision.
If a participant files a Notice of Disagreement as to a covered
claim, the decision of the participating VA regional office will be
reviewed by a Decision Review Officer under the provisions set forth in
Sec. 3.2600 of this chapter.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1506 Rule 1506. Board review of cases.
(a) The Board will screen cases that are certified and transferred
to the Board under the Initiative to determine whether the record is
adequate for decisional purposes. If the Board determines that the
record is inadequate, the Board will take appropriate action pursuant
to Sec. 19.9 of this chapter.
(b) A case screened by the Board for purposes of determining the
adequacy of the record will be decided in docket order and will not be
advanced on the Board's docket except as provided in Sec. 20.900(c) of
this part.
(Authority: 38 U.S.C. 7107(a), (f))
Sec. 20.1507 Rule 1507. Hearings.
(a) Before the participating VA regional office. Upon request, a
participant is entitled to a hearing by a Decision Review Officer
before the participating VA regional office as provided in Sec. Sec.
3.103(c) and 3.2600(c) of this chapter, subject to the following
limitations:
(1) No hearing will be conducted prior to the initial adjudication
of the claim by the participating VA regional office.
(2) Only one hearing on a claim will be conducted at the
participating VA regional office and the hearing will be conducted by a
Decision Review Officer in accordance with Sec. 3.2600 of this
chapter.
(b) Before the Board. Upon request, a participant is entitled to a
hearing before the Board as provided in Sec. Sec. 20.700 through
20.717, and 20.1304, subject to the following limitations:
(1) Only one hearing before the Board will be conducted.
(2) After consultation with the participant and his or her
representative, the Board will determine whether the hearing will be
conducted in person in Washington, DC, at the participating VA regional
office with jurisdiction over the claim, or by electronic equipment as
set forth in Sec. 20.700(e) of this part. The Board's determination
will be based primarily on the type and place of hearing which will
allow for scheduling at the earliest possible date. An in-person
hearing will be conducted in Washington, DC, only if geographically
convenient for the participant and his or her representative, or if the
participant agrees to travel to Washington, DC, at his or her own
expense.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1508 Rule 1508. Waiver.
(a) General. When requested by VA, a participant will waive, in
writing, identified procedural processing issues and actions relating
to covered claims. VA will provide the participant with a clear
explanation, in writing, as to what rights he or she may be waiving. If
a hearing on appeal is conducted, the waiver may be formally and
clearly entered on the record at the time of hearing. A response to a
written waiver request from VA must be filed within the 30-day period
prescribed in Sec. 20.1504(a)(3) of this part. Such waiver is not
required for matters that have already been waived by virtue of
electing participation in the Initiative.
(b) Evidence obtained or submitted after the Statement of the Case.
(1) Evidence obtained by VA. If new evidence is obtained by VA
following issuance of a Statement of the Case under Sec. Sec. 19.29
and 19.30 of this chapter, and the claim(s) is not otherwise granted in
full based on this new evidence, VA will provide a copy of such
evidence to the participant and representative, and request a waiver of
review by the agency of original jurisdiction of such evidence and
issuance of a Supplemental Statement of the Case pursuant to the
provisions set forth in Sec. 20.1304(c) of this part. A response to a
written waiver request from VA must be filed within the 30-day period
prescribed in Sec. 20.1504(a)(3) of this part. The failure of the
participant to agree to a waiver of initial consideration by the agency
of original jurisdiction of any evidence obtained by VA will constitute
an implied revocation of participation in the Initiative, as provided
by Sec. 20.1509(c)(2).
(2) Evidence submitted by participant or representative. If new
evidence is submitted by the participant or representative following
issuance of a Statement of the Case under Sec. Sec. 19.29 and 19.30 of
this chapter, the participant, by virtue of executing a valid Agreement
and Waiver of Rights, is deemed to have knowingly and voluntarily
waived agency of original jurisdiction review of such evidence and
issuance of a Supplemental Statement of the Case, which permits the
Board to review such evidence in the first instance.
(Authority: 38 U.S.C. 501(a))
Sec. 20.1509 Rule 1509. Compliance and revocation of participation.
(a) Unless the participant revokes his or her participation in the
Initiative as provided in paragraphs (b), (c) or (d) of this section,
all covered claims will continue to be processed by VA or the Board in
accordance with the provisions of this subpart until a final decision
of the agency of original jurisdiction or the Board has been issued.
(b) Express revocation. A participant may revoke participation in
the Initiative at any time by submitting a revocation request in
writing. The revocation request must be filed with the participating VA
regional office unless the case has been certified and
[[Page 65735]]
transferred to the Board, in which case the revocation request should
be filed with the Board. As of the date of receipt of the revocation,
any covered claims will be processed in the same manner as if the
participant had not elected to participate in the Initiative.
(c) Implied revocation. The failure of a participant to meet the
terms of these rules, as outlined in the executed Agreement and Waiver
of Rights, will have the same result as if the participant had
expressly revoked his or her participation in the Initiative. As of the
date of the action constituting such implied revocation, any covered
claims will be processed in the same manner as if the participant had
not elected to participate in the Initiative. Grounds for implied
revocation of participation include, but are not limited to:
(1) The failure of the participant or representative, as
appropriate, to comply with any of the time limits set forth in Sec.
20.1504(a) of this part;
(2) The failure to waive initial consideration by the agency of
original jurisdiction of any evidence obtained by VA that was not
considered in the Statement of the Case;
(3) A request by a participant or representative for an extension
of any of the time limits set forth in Sec. 20.1504(a) of this part,
unless a motion for good cause is granted, as described by paragraph
(e) of this section; and
(4) Any other failure on the part of the participant to comply with
the terms of the Agreement and Waiver of Rights, as determined by VA.
(d) Death of participant. If a participant dies while his or her
claim is being processed, participation in the Initiative will be
deemed revoked.
(e) Extensions. Extensions of any of the time limits described in
this subpart may only be granted when the participant demonstrates on
motion that there is good cause for the extension request. At no time
may time periods be extended beyond those provided by law to all
claimants and appellants. Examples of good cause include, but are not
limited to, illness of the participant or the representative of such
severity