Description Of The Veterans Claims Assistance Act

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Section A. Description and General Information

Overview

In this Section This section contains the following topics:

Topic Topic Name See Page

1 Description of the Veterans Claims Assistance Act of 2000, PL 106-475 1-A-2

2 Description of the Duty to Assist Criteria 1-A-3

1. Description of the Veterans Claims Assistance Act of 2000, PL 106-475

Introduction This section describes the Veterans Claims Assistance Act of 2000 (VCAA), PL 106-475, and contains information about the responsibilities of the Department of Veterans Affairs (VA) background of PL 106-475, and description of PL 106-475.

Change Date August 1, 2002

a. Responsibilities of VA Decisions on Department of Veterans Affairs (VA) benefit eligibility and entitlement are based on the evidence of record. Evidence consists of documents, records, testimonials and information in other forms provided by, or obtained for, a claimant.

VA has a duty to assist a claimant who files a substantially complete application in obtaining evidence to substantiate his or her claim before making a decision on the claim. We are charged with granting every benefit supported by the law.

b. Background of PL 106-475 On November 9, 2000, PL 106-475 was enacted, superceding the decision of the Court of Appeals for Veterans Claims (CAVC) in Morton vs. West, which held that VA cannot assist in the development of a claim that is not well grounded.

c. Description of PL 106-475 The new law, PL 106-475

eliminates the concept of a well grounded claim redefines VA’s duty to assist, and mandates specific notice requirements.

2. Description of the Duty to Assist Criteria

Introduction This section contains information about duty to assist, including issues pertaining to claimants relevant Federal records, and non-Federal records requests for VA examinations or medical opinions, circumstances where VA will refrain from or discontinue providing assistance, and contact information for questions.

Change Date June 19, 2006

a. Duty to Assist Claimants The Veterans Claims Assistance Act of 2000, PL 106-475, defines the scope of Veterans Benefits Administration’s (VBA’s) duty to assist claimants who file substantially complete applications for VA benefits.

Reference: For more information on what constitutes a substantially complete application, see M21-1MR, Part I, 1.B.3.a and 38 CFR 3.159.

b. Duty to Obtain Relevant Federal Records VA’s duty to assist includes developing for all relevant records in the custody of a Federal department or agency, including VA medical records, service medical records Social Security Administration records, or evidence from other Federal agencies.

Note: Relevancy is determined by what is being claimed. For example, in claims for service connection, relevant documents are those that may substantiate one of the elements of service connection (incurrence, current condition, or links). However, in most cases, it may be impossible to determine relevancy before obtaining the records.

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2. Description of the Duty to Assist Criteria, Continued

c. Duty to Obtain Relevant Non-Federal Records Our duty to assist also includes developing for private medical records, and lay or other non-Federal governmental evidence, such as current or former employer records, or state and local government records.

Important: VA should obtain the veteran’s authorization before including identifying data such as the veteran’s name and claim number in a development letter for lay evidence from a third-party. Authorization may be obtained on VA Form 3288, Request for and Consent to Release of Information from Claimant’s Records. This should not be used to obtain authorization and consent for release of medical evidence which is covered by VA Form 21-4142, Authorization and Consent to Release Information to the Department of Veterans Affairs, or release of employer information, which is covered by VA Form 21-4192, Request for Employment Information in Connection With Claim for Disability Benefits.

Reference: For information on the limitation of use of business reply envelopes for third-party development, see M21-1 MR, Part II, 5.B.5.c (TBD) or M21-1, Part III, 11.05, and

VBA Letter 20-05-42.

d. Duty to Obtain Examination or Medical Opinion If an examination or a medical opinion is necessary to make a decision on a claim for compensation, then our duty to assist includes examining claimants, and/or obtaining a medical opinion from the Veterans Health Administration (VHA) or designated contracted provider.

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2. Description of the Duty to Assist Criteria, Continued

e. Circumstances Where VA Will Refrain From or Discontinue Providing Assistance

VA will not provide assistance in obtaining evidence if a substantially complete application for benefits indicates that there is no reasonable possibility that any assistance VA would provide to the claimant would substantiate the claim.

Discontinue providing assistance if the evidence obtained indicates that there is no reasonable possibility that further assistance would substantiate the claim. Circumstances in which to refrain from or discontinue providing assistance in obtaining evidence include, but are not limited to: the claimant's ineligibility for the benefit sought because of lack of qualifying service, lack of veteran status, or other lack of legal eligibility

claims that are inherently incredible or clearly lack merit, and an application requesting a benefit to which the claimant is not entitled as a matter of law.

Reference: For more information on the criteria for a substantially complete application, see, M21-1MR, Part I, 1.B.3.a, and circumstances where VA will refrain from or discontinue providing assistance, see 38 CFR 3.159(d).

f. Contact Information for Questions Questions regarding duty to assist should be submitted to the Q&A mailbox at VAVBAWAS/CO/21Q&A by the Q&A station coordinator.

SOURCE: http://www.warms.vba.va.gov/admin21/m21_1/...1/ch01_seca.doc