Fast Letter 06-20-06

[Wings]

x

x

x

 

 

 

DEPARTMENT OF VETERANS AFFAIRS

Veterans Benefits Administration

Washington, D.C. 20420

 

October 16, 2006

 

Director (00/21) In Reply Refer To: 211B

All VA Regional Offices and Centers Fast Letter 06-20

 

 

SUBJ: Centralization of Radiation Claims Processing

 

It has been determined that the accuracy and timeliness of radiation claims processing could be improved by centralizing jurisdiction of these claims. This letter gives instructions for implementing the new policy.

 

 

Background

 

Radiation claims under 38 CFR 3.309(d) and 3.311 represent a small segment of pending claims, yet they comprise some of the oldest pending claims in VA’s inventory. VA requires dose estimates by the Defense Threat Reduction Agency (DTRA) to adjudicate claims for radiation-related disabilities under § 3.311.

 

The National Research Council (NRC) reviewed the accuracy of radiation dose reconstruction by DTRA in their report dated May 8, 2003. The report found that the upper bound (highest) radiation dose estimates provided by DTRA for atmospheric nuclear weapons tests and Hiroshima and Nagasaki occupation forces were inaccurate. Many cases needed re-adjudication, which required a revised radiation dose estimate from DTRA using procedures modified as a result of the NRC report. This significantly increased the claims processing timeline from six to ten months, as required prior to the NRC report, to the current two years or more. Since regional offices infrequently process radiation claims, unfamiliarity with special adjudication procedures sometimes created additional processing delays.

 

 

Claims Subject to Centralization

 

In order to provide more efficient service to veterans and survivors, processing of all claims for service connection based on radiation exposure will be centralized at the Jackson Regional Office (RO). All folders with pending radiation claims will be transferred to the Jackson RO. All appeals will remain under the jurisdiction of the current regional office or the Appeals Management Center. The Jackson RO will

have jurisdiction of all non radiation-related claims while the radiation issue is pending, and will resolve all such claims. Following resolution of all pending issues, the file will be transferred back to the office of original jurisdiction (OOJ).

 

 

Permanent Transfer of Claims Folders

 

Permanent transfer of claims folders with pending radiation claims will be initiated and completed according to the schedule in this fast letter. All ROs except Jackson will run a list of pending radiation claims identified by the third digit modifier "2." The end products normally associated with radiation claims are 012, 022, 112, and 142. Other end products ending with the third digit modifier "2" may not represent radiation-related claims for service connection. All folders with claims alleging disability or disease related to radiation exposure will be transferred to the Jackson RO.

 

The enclosed FLASH notice (see Appendix A for a copy of the FLASH) will be reverse-filed in the center section of all claims folders identified as requiring centralization. The OOJ is responsible for indicating the status of the radiation claim by circling one of the following choices:

 

·        No development accomplished

·        Partial/complete development - Request not sent to DTRA

·        Development completed - Request sent to DTRA

·        Pending opinion from C&P Service

 

Claims folders will be shipped to the Jackson RO using Federal Express Ground. Folders will be pulled and shipped according to the following schedule:

Area

Begin Shipping on:

East

October 16, 2006

Central

October 23, 2006

West

October 30, 2006

South

November 6, 2006

 

 

 

 

 

 

 

 

Each OOJ will create an inventory sheet containing the name, claim number, and box number in which the file was shipped. A copy of the inventory will be placed inside each box, and a copy will be maintained by the sending office. COVERS will be updated to reflect permanent transfer to the Jackson RO. The COVERS transfer sheet

will show all pending end products and will note the reason for transfer as Fast Letter 06-20.

 

A list of end products 012, 022, 112, and 142 pending as of September 13, 2006, was created. This list was given to Hines to transfer the end products to the Jackson RO. Any of these end products established by an OOJ on or after September 14, 2006, will need to be cancelled and reestablished by the Jackson RO after receipt of the claims folder. The COVERS sheet should be annotated if the EP has been cancelled.

 

The Jackson RO will assume responsibility for processing all claims pending at the time of transfer or received following transfer. All issues will be resolved before the claims folder is returned to the OOJ. Any new material received at the OOJ for the claims folder will be routed to the Jackson RO: 323/21 - Radiation (FL 06-XX). As regional offices receive subsequent radiation claims, these instructions must be used to transfer the folders to the Jackson RO as quickly as possible so development can be initiated immediately.

 

The Jackson RO will annotate the date of receipt of the folder on the FLASH notice reverse-filed in the center section of the claims folder. The Jackson RO will expedite its action on the radiation claim so that the folder can be permanently transferred back to the OOJ as soon as possible. The claims folder will not be transferred until all pending issues have been finalized.

 

As noted above, the OOJ retains jurisdiction on any appeals, including decisions by Jackson. If an appeal is pending when the claims file is shipped to Jackson, the OOJ must take all action possible on the appeal before permanently transferring the claims folder to Jackson. The COVERS transfer slip must be annotated with a suspense date for return of the folder to complete action on the appeal. Jackson will develop the pending radiation claim and temporarily transfer the folder through COVERS back to the OOJ for completion of the appeal. If a claims folder is at the OOJ for appeals processing when the radiation claim can be adjudicated, Jackson will request return of the folder so proper rating and award action can be taken.

 

Each RO will designate a point of contact for coordination of future claims and appeals to minimize shipment of files.

 

 

Notification of Transfer

 

The OOJ will notify the claimant that his or her folder has been transferred to the Jackson RO for processing of the radiation claim and all other pending issues and that it will be returned to the OOJ as soon as the claim has been finalized. (See Appendix B.) The claimant will be directed to address any new correspondence, to include claims for new disabilities, to the Jackson RO.

 

The Compensation and Pension Service will notify the national offices of veterans’ service organizations about the centralization of radiation claims processing to the Jackson RO. Regional offices are responsible for notifying our local representatives. The C&P Service will also notify DTRA that all correspondence concerning radiation claims, to include reconstructed radiation doses, should be forwarded to the Jackson RO for processing.

 

 

Actions by the Jackson RO

 

Following receipt of the claims folders, the Jackson RO will update COVERS to reflect the new permanent location. A review of the case will be undertaken to determine the status of the radiation claim and any other pending claim. Additional information required to adjudicate any pending claim will be requested expeditiously. The transferred end product will remain pending. A 682 end product will be established for control and identification purposes, with the same date of claim as the concurrent rating end product. When adjudication of the radiation claim is completed, both end products will be taken.

 

All procedures set forth in the regulations and M21-1MR will be followed in the handling of any pending claim. Reference material specifically relating to radiation claims is identified in Appendix C of this fast letter. Prior to requesting a radiation dose from DTRA for claims under 38 CFR § 3.311, contact C&P Service (211B). No contact with the C&P Service is required for claims under §3.309(d). Questions about processing radiation claims may be directed to 211B staff members at the following phone numbers:

 

·        (202) 273-7250

·        (202) 273-7222

·        (202) 273-7227

 

The Jackson RO will be provided additional national CAPRI access to allow for appropriate examination input and requests for VAMC medical records. Physical examinations for radiation claims under § 3.311 are not necessary unless the C&P Service has provided an opinion that service connection for the claimed radiation disability may be granted, or DTRA has established that the veteran was a participant in a radiation-risk activity under § 3.309(d) and a qualifying presumptive disability exists.

 

Following receipt of information from DTRA for participation in a radiation-risk activity under § 3.309(d), a rating decision will be prepared by the Jackson RO with notification to the claimant.

 

In claims under § 3.311, the Jackson will deny the claim without referral to the C&P Service when DTRA establishes that the veteran did not participate in a radiation-risk activity or the radiation dose estimate is zero rem. If the radiation dose estimate is more than zero rem and a radiogenic disability is of record, the Jackson RO must forward the claims folder to the C&P Service (211B) for a medical opinion. Following receipt of an opinion from the C&P Service, the Jackson RO will prepare a decision with notice to the claimant.

 

Following completion of all pending issues by the Jackson RO, the 682 and rating end products will be cleared simultaneously, and the claims folder will be permanently transferred back to the OOJ.

 

 

Contact Information

 

Questions about the implementation of these instructions may be addressed to Edmond Davenport (211B) through email or telephone (202) 273-7222.

 

 

 

/S/

Renée L. Szybala

Director

Compensation and Pension Service

 

Enclosures

 

 

 

 

APPENDIX A Fast Letter 06-20

 

 

FLASH

(TO REMAIN ON TOP OF MATERIAL IN CENTER SECTION OF CLAIMS FOLDER)

 

 

RADIATION CLAIM TRANSFERRED TO JACKSON REGIONAL OFFICE UNDER

FAST LETTER 06-20

 

 

RETURN FOLDER TO OFFICE OF ORIGINAL JURISDICTION FOLLOWING COMPLETION OF ADJUDICATION OF RADIATION CLAIM

 

 

1.                No development accomplished

 

2.                Partial/Complete development - Request not sent to DTRA

 

3.                Development completed - Request sent to DTRA

 

4.                Pending Opinion from C&P Service

APPENDIX B Fast Letter 06-20

 

Regional Office Notification Letter to Claimants

Reason for Transfer to Jackson RO

 

In Reply Refer To: XXXXX

Claimant C or XC Number

Address Name (if death case)

 

Dear Mr./Mrs. XXX:

 

The Department of Veterans Affairs (VA) is centralizing the processing of all benefits claims related to a veteran’s exposure to radiation while in military service to the VA Regional Office in Jackson, Mississippi. This is being done in order to provide better service to this special category of claimants.

 

Because you have filed a claim based on radiation exposure, your claims folder has been transferred to the Jackson Regional Office. If you have other claims pending in addition to your radiation claim, the Jackson Regional Office will also handle those claims.

 

How To Contact Us

 

If additional information is needed to decide your claim, the Jackson Regional Office will contact you. If you need to submit additional information, the address is:

 

VA Regional Office

1600 East Woodrow Wilson Ave.

Jackson, MS 39216

 

ATTN: Director (21 - Radiation)

 

If you would like to speak to a Veterans Service Representative about this letter or your claim, please call 1-800-827-1000, and someone will assist you. If you use a Telecommunications Device for the Deaf (TDD), the number is 1-800-829-4833.

On the Internet you may contact VA at https://iris.va.gov.

 

Because of the research required to determine a veteran’s level of exposure to radiation while in service, these types of claims often take many months to process. Please be assured we are doing all we can to resolve your claim as quickly as possible. We appreciate your continued patience.

 

Sincerely yours,

 

XXXXX

Veterans Service Center Manager

 

cc: Service Organization

APPENDIX C Fast Letter 06-20

 

 

 

 

Reference Material for Radiation Claims

 

 

 

Regulations:

 

38 CFR 3.309(d): http://vbaw.vba.va.gov/bl/21/publicat/Regs/Part3/3_309.htm - d

 

38 CFR 3.311: http://vbaw.vba.va.gov/bl/21/publicat/Regs/Part3/3_311.htm

 

 

 

Manual Citations:

 

M21-1MR:

 

Part IV, Subpart ii, Chapter 1, Section B [(§ 3.309(d)]:

 

Claims for Service Connection for Radiogenic Diseases Under 38 U.S.C. 1112

 

 

Part IV, Subpart ii, Chapter 1, Section C [(§ 3.311)]: Section C.

 

Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311