Dro

[carlie]

Here's a training letter I had stored in my favorites.

Best to all,

carlie

January 21, 2003

Director (00/21)

All VBA Regional Offices and Centers Training Letter 03-01

SUBJ: Duties and Responsibilities of the Decision Review Officer (DRO)

Purpose of This Letter

The DRO program was first pilot tested in 1997, with permanent implementation in 2000. From 1997 until the present time, a number of things have changed with the DRO position, notably the introduction of the post-decision review process, as codified in 38 CFR 3.2600, and the creation of the Claims Process Improvement (CPI) structure. This letter clarifies the:

• Role of the DRO in the appeal process;

• De novo review expectations;

• Functions of the DRO.

Who is The Decision Review Officer

The DRO is a valuable VA resource. An individual in this position should possess expert knowledge and well-developed skills and abilities regarding all Compensation and Pension program operations. The DRO should also have strong interpersonal and oral communication skills, and use these skills in working with veterans and their representatives. The position itself describes an individual, not necessarily the actual job duties which are involved. While DROs are typically synonymous with appeals, the DRO may also work in other environments, namely a Rating Team, where they fulfill second signature review, training, mentoring and other needs of the Service Center.

The Appeal Process

There is only one function in the appeal process requiring involvement of the DRO:

If an appellant elects a post decision review, the DRO must provide a de novo review and new decision.

All other functions of the appeals process can be accomplished by any knowledgeable, experienced RVSR (Rating Veterans Service Representative), or in the case of authorization issues, a SVSR (Senior Veterans Service Representative - Super Senior GS-12), Sr. VCE (Senior Veterans Claims Examiner GS-11) or VSR. What sets the DRO apart is the special review authority and his or her expert job knowledge.

Nothing precludes the DRO from working any other component of the appeal process, however such utilization is determined by Service Center Management based on the needs of the Regional Office (RO).

Post Decision Review Process and the De Novo Review

The post decision review process is designed to be an optional appeal route, which kicks in at the beginning of the appeal at the notice of disagreement (NOD) stage. If elected by the appellant, the DRO is required to take a fresh look at the same evidence and provide a new decision. The “review” in de novo review ultimately requires an actual new decision. It does not mean that a complete file review is required, but rather a complete review of the pertinent evidence and information used in the decision in disagreement, accompanied by a new decision.

The new decision can be in many forms, depending upon the outcome of the DROs assessment. The result may be a new rating granting the benefit sought, a Statement of the Case (SOC) giving the reasons for the continued denial of benefits, or a combination of decisions or documents somewhere in between. In all cases, however, the decision must be “new.”

The special review authority allows for a de novo review only when a timely NOD has been submitted and the claimant has timely elected the post decision review process. This fresh look at the same evidence can be used only once.

While the DRO also has the option to develop for additional evidence, any decision based on new evidence requested as part of the de novo review fulfills the requirement for a new decision. The DRO also conducts formal hearings, as requested.

Functions of the DRO

The primary function of a DRO working on an Appeal Team is appeal resolution. The DRO is tasked with getting involved early in the disagreement, contacting the appellant and/or their representative, preferably in person or by phone, to clarify any issues, engage in frank discussions about possible resolutions while providing an honest and realistic assessment to the veteran.

Extensive development should not be a hallmark of appeals resolution. This would tend to indicate less than complete development in the initial rating which led to the disagreement.

The DRO needs to provide a realistic assessment of the appeal to the veteran. Prolonged development which affords no value to the process or any hope of changing the decision should be avoided. Once the DRO has insured that the necessary claims development is complete and has exhausted all plausible avenues of resolution, the appeal simply needs to be moved forward to the next stage and ultimately to the Board of Veterans Appeals (BVA) to ensure that the veteran is afforded timely appellate review.

Other duties which are tasked to the DRO include providing feedback to RVSRs on appeal cases, providing feedback to local management about trends, training needs and overall quality, and training and mentoring other employees. It is anticipated that a number of these duties will be handled by DROs working in a Rating Team.

Other Appeal Issues

There are no provisions in the regulations or the manual which require the DRO to keep jurisdiction of an appeal after they have conducted the de novo review and made a decision. Some ROs may find it helpful to limit DRO jurisdiction after an initial appeal decision has been made, such as a new decision granting a benefit or an SOC, and subsequently hand this work over to RVSRs assigned to the Appeals Team. The DRO would then focus their efforts on continued upfront resolutions, where their skills provide the most value in the appellate process.

Additionally, while the DRO is a designated authorizing official for certification of cases to the Board of Veterans Appeals, the DRO is not the only employee who can certify cases. The Service Center Manager has broad discretionary authority to designate other employees well versed in the appellate process, such as senior RVSRs and Appeals Team Coaches, to these duties.

Alternate Resolution

A DRO is empowered to call clear and unmistakable error, with single signature authority, on any case under appeal, subject to the provisions of 38 CFR 3.105(a). An election of the post-decision review process is not required.

Direct communication and conferencing with the veteran and their representative is not an exclusive feature of the post decision review process. The DRO, RVSR, SVSR, Sr. VCE or VSR can and should contact an appellant when there is reason to believe that some measure of appeal resolution can be achieved.

Informal Conferences

As defined by M21-1 Part IV, Chapter 35, an informal conference can be any form of communication directly between the DRO and the appellant and or his representative, provided it is documented properly. One of the features of this process is to make these discussions more informal and start a dialogue about the appeal, addressing the specific contentions and attempting to focus the appeal, providing explanatory information and determining if other evidence exists which would support the issue on appeal. DROs are expected to make judicious use of informal conferences to resolve appeals, or minimally, to achieve efficient, expedient appellate review.

The key difference between an informal conference as a procedural tool, and other forms of direct communication is that an informal conference requires a course of agreed upon action. While the actual course of action is not prescribed and contingent on the nature of the discussions, other forms of direct communication are open ended, dependent wholly on the facts of the case and any new information developed or conveyed in the course of discussions.

Decisions and Work Credit

All decisions made pursuant to a claimant’s election of the post-decision review process require a statement, in the decision, that the decision is based on a de novo review.

The “new” decision must be prepared by the DRO, and for SOCs, cannot simply be a copy of the prior rating which led to the disagreement.

A one time EP 174 is PCLR’d at the time a de novo review decision is finalized. This includes SOCs when the de novo review does not lead to any change in the prior decision. The EP 174 will not be taken concurrently with any EP 172 or 070 for the same issues.

Whom To Contact With Questions About this Letter

If you have questions concerning this letter, please e-mail VAVBAWAS/CO/21Q&A.

/S/

Ronald J. Henke, Director

Compensation and Pension Service