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mags1023

5103 Waiver Overdue From 3Rd Party

14 posts in this topic

I checked my ebenefits account yesterday and saw that under my gathering evidence for my claim folder the VA has a note in there saying that a 5103 waiver from a 3rd party is overdue. The due date was Aug 5, 2013. Does anyone know what this might be? Would the 800 people or IRIS be able to tell me who this 3rd party might be?

Thanks, Mags

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The 5103 waiver is explained here by Meg:

If you google VA 5103 waiver some more hadit posts will pop up on this.

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In all fairness to Megh, as I know she is a service officer, and we have talked, it's not quite what she thinks and there is way more involved than people realize. So here goes. If I loose you, I applogize, hopefully we can work through this as this 5103 waiver isnew to the VA, as well as new to the Veterans.

eBenefits pulls it's information from the VBMS (Veteran's Benefits Management system - paperless system) claims processing program. In that program there are what we at VA call suspense reasons.

"suspense reasons" are snippets of explainations of what the VSR or RVSR or Coach or claims assistant,or finance, or authorization, (in other words any one having someting to do with your claim) may have for a reason to "suspend" or is "waiting " for something for som reason or another. For example.....

You file a claim, and you send in a VA FORM 21-4142, Authorizing VA to get medical records from Dr. Smith. We now have a contractor who gets the Veterans private records. So the form goes to the Contractor (DOMA), but the VA puts a "suspense" in the system that says, awaiting 3rd party information. Yor records from your doctor are considered third party. The suspense reason has a space to enter an expected date when the VA should have received the information back from DOMA. Usually the suspense is for 7, 15, 30, 60 or 90 days.

Lately everything has been about 15 days, VA is pushing to get responses within 2 weeks. When that date comes we check the system (through a program called VOR- it's a search spreadsheet system) to see if we got Dr. Smith's records. If VBMS shows we did get the records then we move the case to the next step toward making a decision, if we didn't get the records we do supplemental development, we call the doctor, we email a supervisior who's job it is to kick the contractor (DOMA) in the butt to get the records and we update for another 15 days. This goes on in one form or another for all claims and all issues. Certain claimed issues require different supplemental development. (simply as we request records or inforamtion we put in suspense REASONS and as we receive the information requested we indicate RECEIVED.) We can have many, many different request working at one time depending on the issues claimed and the evidence needed or requested.

I am going to take this one step further. The new 5103 waiver is the name for the old VCAA letter. The newer forms of 21-526 are now 21-526ez forms. and for NSC pension are 21-527EZ form. These forms contain what are called WTEMS. WTEMS is an acronym for "what the evidence must show". These are paragraphs of information that the VA MUST provide to the Veteran to aid the Veteran is his claim. There are WTEMS for direct service, seccondary, increase, N&M, A&A, Pension, IU, SMC, and on and on. WTEMS ARE the duty to assist portion of the %!)# or the OLD VCAA letter attachemnts.

In eBenefits, the phrase " 5103" simply means the application YOU USED for YOUR claim had the standard 3 WTEMS. The standard 3 WTEMS are what the evidence must show for, service connected conpensation, service connection for a secondary, and service connection for an increase. It simply states what type of evidence is needed for each type of claim. The 5103 VA Forms 21-526EZ and 527EZ have the WTEMS built into them in the application, READ THE FINE PRINT in your compensation application about evidence.

This notice in ebenfits that states.... 5103 notice or 5103 waiver simply means you have signed either manually or electronically the 5103 Notice that you have been advised of your rights, per the 5103 waiver when you sign your application.

When the VSR or RVSR looks in the computer and we see 5103, it tells the VSR or RVSR we DO NOT HAVE TO SEND YOU A LETTER ANYMORE to tell you what we are doing on your claim if you file one or more of the BIG THREE types f claims. (remember increase, secondary or direct) as you got the evidence requirements on the applictions and you signed the waiver stating you got the imformatin.

I know this is complicated, but it is important you realize the VA Form 21-526 EZ and 527EZ forms are telling you what is needed in support of your claim.

Please ask any questions you have on this as I know it is new and it's taking VA a bit to adjust to the chage as well.

Edited by harleyman

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Thanks, Harleyman!

I got the same status in eBenefits and know that my VSO forwarded the 5103 waiver form to the RO at the end of July. At the 30 day due date for the 5103 waiver form in the middle of August, eBenefits started showing that this document was overdue. My guess has been that no one in the RO, other than whomever did data entry (twice, once into the old system then once into VBMS a month later), has actually touched my claim since the 5103 waiver was generated somewhere else within the VA hierarchy. And that's the assumption I've made again today seeing the same status and no movement on my 4 1/2 month old claim at all -- because the RO where my claim rests is in the midst of trying to solve some older and more challenging claims with heat from the top to clear those claims a year older or more. The claim was supposed to be submitted either on line via eBenefits or locally through the RO. Am I making a bad assumption?

According to the Fast Letter describing the 5103 waiver process, it seems as if some entity above the local RO makes a decision based on what it sees within VBMS or some other system that my claim, like many others, can be decided quickly if I certify that I have nothing else to submit.

So what you're saying is that the 5103 waiver system looks at the WTEMS, decides off the cuff that based on the claim being an FDC-style claim that all the pieces are there to make the decision, then generates a decision that if the veteran certifies that there is nothing else that could bear on the decision, the VA will move the claim along as expeditiously as possible? Have I got that right?

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Thanks Harleyman!

Let me see if I have this right:

"The new 5103 waiver is the name for the old VCAA letter. "

"as you got the evidence requirements on the applictions and you signed the waiver stating you got the imformatin."

Is this in lieu of the old VCAA response form?

The one we were supposed to sign and mail back to the VA?

I never got one. The BVA said I mitigated the prejudicial damage of the illegal VCAA letter I got (it was all snafued) because I had probative evidence anyhow.

The VARO said I had failed to respond to the response form they did not send me.

I could not get my former reps (to include their director here in NY) to support my contention that my VCAA letter was illegal and prejudicial.

I filed a complaint with the OGC against my reps on that long story with Very good results,

but it appears to me here that TiredCoastie digested all this quite well:

"According to the Fast Letter describing the 5103 waiver process, it seems as if some entity above the local RO makes a decision based on what it sees within VBMS or some other system that my claim, like many others, can be decided quickly if I certify that I have nothing else to submit.

So what you're saying is that the 5103 waiver system looks at the WTEMS, decides off the cuff that based on the claim being an FDC-style claim that all the pieces are there to make the decision, then generates a decision that if the veteran certifies that there is nothing else that could bear on the decision, the VA will move the claim along as expeditiously as possible? Have I got that right?"

And that this is solely regarding FDCs????????????????????

Is that fast letter here at hadit?

Edited by Berta

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Wow, thanks Harleyman for the thorough answer! I really appreciate you, Berta, Carlie, and the many others who provide us with such great insight. I get much more out of this sight than from my lawyer.

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