Compensation Claims Containing Eight Issues Or More.

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Veterans Benefits Administration M21-4, APPENDIX C

Department of Veterans Affairs Change 72

Washington, DC 20420 October 3, 2006

Veterans Benefits Administration Manual, M21-4, "Manpower Control and Utilization in Veterans Service Centers is changed as follows:

Remove pages App. C-1 through App. C-2: Substitute pages App C-1 through App C-2, attached.

Page C-1 is amended to specify that third-digit modifier 1, when used with EPs 110 and 010, may only be used for original BDD claims and not as a sequential EP to correct a processing error. The term “BDD processing centers” is also changed to BDD intake and rating activity sites.

Rescissions: M21-4, Change 71

By Direction of the Under Secretary for Benefits

Renée Szybala, Director

Compensation and Pension Service

Distribution:

FD:

LOCAL REPRODUCTION AUTHORIZED

October 3, 2006 M21-4

Change 72

APPENDIX C

SECTION I. END PRODUCTS - GENERAL PRINCIPLES

1. The end product system is the primary Service Center workload monitoring and management tool. Correct use of the end product system facilitates proper control of pending workloads, and appropriate work measurement credit. Correct work measurement is essential to substantiate proper staffing requirements and determine productive capacity. Received and completed end products are also used to formulate the annual budget submission to the Secretary, OMB, the President, and Congress.

2. Each claim should be promptly (within 7 days of receipt) placed under end product control. Except for the few exceptions specifically identified in this appendix, that end product should remain pending until all required actions on that claim have been completed. Unless specifically authorized, more than one end product should not be taken for any specific issue. Exceptions to this policy are noted in this appendix, or will be based on specific instructions from the Compensation and Pension Service. For example, when rating, award, and supplemental statement of the case are all required concurrently on an appeal issue, only EP 070 is warranted. However, if an entirely separate issue is raised which was not part of the original issue and which cannot be merged with the original appeal, a separate end product credit is warranted.

3. Third Digit Modifiers.

End products may be modified to identify specific issues, type of claim, or incremental multiple claims of the same end product category. For end products 010, 110, 020, 120, 130, 160, 170, 190, 180, 150, 310, 320, 330, 400, 500, 510, 600, 680, 690, 930, 960, and 140 the following modifiers should be used when applicable:

MODIFIER ISSUE

1 Benefits Delivery at Discharge (BDD) (EP 110, 010)

2 Radiation

3 POW Status

4 Post Traumatic Stress Disorder

5 Agent Orange Exposure

6 Foreign Case (Houston, Pittsburgh, White River Junction )

7 Pension Maintenance Centers & BDD Intake and Rating Activity Sites

8 Sexual Trauma

9 Gulf War

The Gulf War modifier 9 may be used with all end product codes. The Gulf War modifier of 9 has priority over all other third digit modifies and should be used regardless of what other modifier might also be applicable.

The modifier 6 should only be used by VAROs Houston, Pittsburgh, and White River Junction, and modifier 7 by the pension maintenance centers. BDD intake and rating activity sites may use modifier 7 only for EPs 020 and 290.

The modifier 1 for EPs 110 and 010 should be used only for original BDD claims and not as a sequential EP to correct a processing error.

App. C-1

M21-4 October 22, 2004

Change 67

APPENDIX C

SECTION II. END PRODUCTS-COMPENSATION AND PENSION OPERATIONS

End Product Codes Claims or Issues Applicable to End

Product Codes

010 1. General. EP 010 is limited to initial disability compensation

Initial Disability or concurrent initial disability compensation and pension claims

Compensation Claims containing eight issues or more. Each disability claimed or

- Eight Issues or More identified and rated for disability compensation entitlement will

be counted as an issue. A claim for pension entitlement will be counted as a single issue. Consideration of entitlement to Special Monthly Compensation will be considered a single issue. Specific determinations for ancillary benefits such as adaptive housing, Chapter 35 eligibility or automobile allowance will also be considered issues.

2. Unless otherwise noted, the EP will not be cleared until all issues raised by the claim have been resolved.

3. Final Disposition and Control in Total Waiver Case Where Compensation Exceeds Retired Pay. EP 010 will be cleared in the absence of certification of actual amounts of retired pay, but an EP 290 control must be maintained until certification is received and all remaining issues are resolved.

4. Exception

Claims from service members who are patients in VA medical centers awaiting discharge from active duty. (See EP 930)

020 1. General. EP 020 applies to reopened disability compensation or

Reopened Claims service-connected death claims. Unless otherwise noted, the EP will not be

- Compensation cleared until all issues raised by the claim have been resolved.

2. Disability Claims. Reopened claims related to service connection, line of duty or similar basic entitlement factors and claims for increase, are generally the disability claims applicable to EP 020.

3. Reopened DIC claims related to cause of death, and basic eligibility (line of duty, character of discharge or misconduct), subsequent to an initial claim (whether from the same or another claimant) adjudicated under EP 140, are generally the death claims applicable to EP 020.

4. Claims for special monthly dependency and indemnity compensation based on need for aid and attendance or being housebound; and death compensation or spouse's compensation based on need for aid and attendance. (See 38 CFR 3.351)

App. C-2

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http://www.warms.vba.va.gov/admin21/m21_4/chg72.doc