--- title: "Part VI, Subpart i, Chapter 1, Section A Decision Authorization" document: "M-21-1" section: "Part VI, Subpart i, Chapter 1, Section A" canonical: "https://veteranai.co/va-regulations/m21-1/vi.i.1.a-decision-authorization" source: "https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000179468/M21-1-Part-VI-Subpart-i-Chapter-1-Section-A-Decision-Authorization" updated: "2026-09-07T14:37:20.433550Z" --- September 29, 2025 ### VI.i.1.A.1.a. Final Stage in Adjudicating a Claim The final stage in adjudicating a claim, after all relevant evidence (to include Federal tax information (FTI)) has been collected and reviewed, and a rating decision prepared (if necessary), is to * award benefits when entitlement exists, and/or * deny benefits when entitlement does not exist. **Reference:** For more information on FTI, see [M21-1, Part XIV, 4.A]()-[D](). ### VI.i.1.A.1.b. Responsibility for Awarding or Denying Benefits A single claim typically involves multiple issues the Department of Veterans Affairs (VA) must resolve. The authorization activity is responsible for ensuring VA makes a decision to award or deny entitlement to benefits for each issue a claimant raises. The authorization activity must * address all issues based on * eligibility criteria, and * any rating decision, and * inform the claimant of the decision on each issue. **Notes:** * Many adjudication actions will be a combination of awarding and denying entitlement. * The end product controlling the claim must remain pending until VA resolves each of the issues the claimant raised in that claim. ### VI.i.1.A.1.c. Requirement to Reduce or Withhold Payments If VA determines a claimant is eligible for monetary benefits, to include disability compensation for one or more service-connected (SC) disability(ies), VA may have to reduce or withhold payments if * the claimant * received separation benefits * is receiving military retired pay (MRP) or Survivor Benefit Plan (SBP), or * is receiving benefits based on another Veteran’s service, or * VA has proposed to rate the claimant incompetent. _**Note**_ : If a beneficiary is receiving benefits based on the beneficiary's own service and separate benefits based on another Veteran’s service, a change in one benefit may affect the other benefit. _**Example**_ : A Veteran is granted disability compensation at the 20-percent rate. The same Veteran is receiving Parents’ Dependency and Indemnity Compensation (DIC). Disability compensation is countable income and will potentially cause a reduction to the Parents’ DIC award.**References:** For more information on * a Veteran’s receipt of * MRP, see [M21-1, Part VI, Subpart ii, 4.A](), and * separation benefits, see [M21-1, Part VI, Subpart ii, 2]() * beneficiaries that are entitled to benefits under more than one claim number, see [M21-1, Part XIV, 6.2.b]() * SBP offsets, see [M21-1, Part XII, Subpart i, 4.C](), and * a determination of incompetency, see [M21-1, Part X, Subpart ii, 6.D](). ### VI.i.1.A.1.d. Requirements for Veteran-Married-to-Veteran Claims In some cases, VA grants or increases compensation benefits to a Veteran that is married to another Veteran. In these situations, claims processors should review the spouse’s record to determine if the compensation benefit affects the spouse’s VA benefits. If the spouse is receiving pension or Parents’ DIC, the claims processor should * establish an EP 150 with claim label _PMC-Income Adjustment_ on the spouse’s award * use the date of authorization of the compensation claim as the date of claim for the EP 150, and * ensure the _Veteran Married to Veteran_ corporate flash is applied to both Veteran’s records. _**Note**_ : In Veteran-married-to-Veteran cases, the _Veteran Married to Veteran_ corporate flash should be applied even if the spouse is not receiving VA benefits. _**References**_ : For more information on * the _Veteran Married to Veteran_ corporate flash, see [M21-4, Appendix E.1.b](), and * making payments in Veteran-married-to-Veteran pension cases, see [M21-1, Part IX, Subpart iii, 2.B.2](). ### VI.i.1.A.1.e. Reviewing a Supplemental Claim For a supplemental claim, the process for requesting information from a claimant and other sources is the same as it is for an initial claim. If basic eligibility criteria (such as Veteran status, or wartime and minimum active duty service requirements for pension claims) are met, the rating activity must review the following types of supplemental claims: * claims for benefits involving (a) specific disability(ies), and/or * claims in which benefits were previously discontinued due to a change in special eligibility, such as no longer being * permanently and totally disabled, or * in need of aid and attendance (A&A). **Important:** The rating activity does _not_ need to review pension claims to make a disability determination when income or net worth bar pension entitlement. **Reference:** For more information on supplemental claims, see * [M21-1, Part II, Subpart iii, 2.B](), and * [M21-1, Part X, Subpart ii, 2.A](). ## 2. General Information on Processing Decisions This topic contains general information on processing decisions, including * responsibility for processing rating decisions * effective date of payment under 38 CFR 3.31 * award-processing responsibilities * awards eligible for self-authorization, and * awards that require Veterans Service Center Manager (VSCM) or Pension Management Center Manager (PMCM) concurrence. June 5, 2026 ### VI.i.1.A.2.a. Responsibility for Processing Rating Decisions After rating decisions are completed they are routed directly to the authorization activity, which is responsible for processing rating decisions. ### VI.i.1.A.2.b. Effective Date of Payment Under 38 CFR 3.31 It is important to understand the difference between the effective date of _payment_ and the effective date of _entitlement_. Under [38 CFR 3.31](), VA may not pay monetary benefits based on an original, supplemental, or increased award of compensation, pension, or DIC for any period prior to the first day of the calendar month following the month in which the beneficiary became entitled to the benefit. **Example:** **Scenario:** The rating activity assigns an increased disability rating to a Veteran’s SC back disorder effective April 21, 2022. (This represents the effective date of _entitlement_.) **Result:** The effective date of the corresponding increase in the Veteran’s compensation is May 1, 2022. (This represents the effective date of _payment_.) **Exception:** Effective October 1, 2011, Section 605 of _Public Law 111-275_ amended [38 U.S.C. 5111]() to allow VA to pay disability compensation from the _date of entitlement_ to said benefit to any Veteran who retires or separates from active duty due to a catastrophic disability. For VA purposes, "catastrophic disability" means a permanent, severely disabling injury, disorder, or disease that compromises the ability of the Veteran to carry out the activities of daily living to such a degree that the Veteran requires * personal or mechanical assistance to leave home or bed, or * constant supervision to avoid physical harm to self or others. ### VI.i.1.A.2.c. Award-Processing Responsibilities The table below describes who is responsible for specific actions during the award process. | **Who Is Responsible**| **Actions** Veterans Service Representative (VSR)| * Conduct a cursory review of the rating decision, to include the code sheet, in an attempt to identify any obvious errors, such as failure to consider entitlement to [Chapter 35]() benefits when a total disability rating is granted and no future examination is required. * Access the RATING screen in the Veterans Benefits Management System – Awards (VBMS-A) to validate data contained in the rating decision and notify the rating activity if any inconsistencies exist. * Enter additional data pertaining to the decision into the claims-processing system, as applicable. * Generate an award. * Ensure, as applicable, that the award document fully reflects _all_ new and/or increased entitlements implemented by the associated rating decision and/or authorization determination(s). * Prepare a decision notice for the claimant. * **For pension and Parents' DIC cases only:** Ensure documentation of calculations made to determine the rate of benefits (such as calculations of medical expenses, net worth, and waived overpayments) are included in the electronic claims folder. * Route the award to a Senior VSR (SVSR). **Notes:** * The only entry or update VSRs may make on the RATING screen is to select one of the override buttons along the bottom of the screen to ensure the appropriate effective date is generated when implementing award actions such as * reducing a disability rating, or * switching a Veteran’s disability rating from a total rating based on individual unemployability to a 100-percent schedular rating (or vice versa). * If the decision notice contains FTI, follow the instructions in [M21-1, Part VI, Subpart i, 1.B.2](). * The successful generation of adjusted payment rates from the earliest implicated effective date – for awards converted from the Benefits Delivery Network – may require the entry of an appropriate control date in the ONLY GENERATE NEW AWARD LINES FROM field on the claims-processing system’s RECORD DECISIONS screen. * The processing of a decision is commonly referred to as an “award” action, regardless of whether the decision * constitutes a grant or denial of benefits, or * results in an adjustment of benefits. **References:** For more information on * decision notices, see * [M21-1, Part VI, Subpart i, 1.B](), and * the _[_Personal Computer Generated Letters User Guide_]()_ , and * processing awards (including those involving converted records) in VBMS-A, see the _VBMS Awards User Guide_. SVSR| * Review the award and decision notice for accuracy. (Return the award and decision notice to the VSR for correction if errors exist.) * Authorize the award. * Date the decision notice with the expected date of mailing (if applicable). * Release the following for mailing to the claimant: * decision notice * copy of the rating decision (if applicable), and * any pertinent enclosures. **Notes:** * If a decision notice contains FTI, see [M21-1, Part VI, Subpart i, 1.B.2](). * M21-1, Part VI, Subpart i, 1.A.2.d, describes circumstances under which a _**VSR**_ may take the actions described in this cell. **Important:** * In the VBMS awards-processing environment, the returning of an award or decision notice to a VSR for correction is known as a deferral. The [_National Work Queue (NWQ) Playbook_]() contains instructions (under the heading _VBMS Deferrals_) that claims processors must follow to properly manage such deferrals. * The Veterans Benefits Administration’s mission is to serve Veterans and eligible dependents and survivors in the most timely and accurate manner possible. * It is only appropriate to extend suspense or diary dates if it is necessary for a specific adjudicative action. Suspense dates must always correspond with specific actions and should not be arbitrarily extended under any circumstance. * When employees handle a claim, employees are expected to take the most full and complete action possible on a claim every time – including development, rating, and promulgation actions – to move a claim forward to accurate completion in the claims process. Every effort should be made to move the claim to the next processing cycle each time it is handled. ### VI.i.1.A.2.d. Awards Eligible for Self-Authorization A VSR may generate _**and**_ authorize the corresponding award action (taking the actions described in _**both**_ rows of the table in M21-1, Part VI, Subpart i, 1.A.2.c) when the award action does _**not**_ result in a change of monetary benefits under the following circumstances: * denying additional compensation for a dependent(s), or * promulgating a rating decision that * constitutes a denial, as defined in M21-1, Part VI, Subpart i, 1.A.3.a, or * does not change the combined evaluation when * granting service connection (SC), and/or * increasing an evaluation(s). **Exceptions:** * VSRs may **_not_** self-authorize the award action if promulgation of the rating or dependency decision will result in an increase, reduction, or discontinuation of benefits. * The policy described in this block does **_not_** apply to award actions * taken by pension management centers, or * involving * the _Nehmer_ stipulation * original claims, and/or * an administrative decision. _**Note**_ : A VSR must have “self-authorization” authority to generate and authorize the same award.**References:** For more information on * self-authorizing an award action in VBMS-A, see the _VBMS Awards User Guide_ * additional compensation for dependents, see [M21-1, Part VII, Subpart i, 1.A]() * the _Nehmer_ stipulation, see [M21-1, Part VIII, Subpart i, 2]() * original claims, see [38 CFR 3.160(b)](), and * administrative decisions, see [M21-1, Part X, Subpart v, 1.C](). ### VI.i.1.A.2.e. Awards That Require VSCM or PMCM Concurrence Some awards require concurrence by a Veterans Service Center Manager (VSCM) or Pension Management Center Manager (PMCM) (_**or**_ a designee of one of these managers) _in addition to_ authorization by an SVSR. These circumstances include * awards having a net effect of a payment of at least $40,000, and * awards that were generated using the GENERATE AWARD OVERRIDE function. **References:** For more information on the * process for obtaining concurrence, see the [_NWQ Playbook_](), and * dollar amount of retroactive awards to beneficiaries _under fiduciary supervision_ that require fiduciary hub referral, see [M21-1, Part X, Subpart ii, 6.E.1.g](). ## 3. General Information on Denials This topic contains general information on denials, including * definition of a denial * authority of the authorization activity to make decisions that affect an individual's entitlement to VA benefits * conditions under which the authorization activity may deny a claim * requirement to receive and review all required evidence before denying a claim, and * incomplete applications and benefit requests that are not filed on a prescribed form. April 16, 2021 ### VI.i.1.A.3.a. Definition: Denial A decision is considered a denial if, after review of a claim or issue and all evidence associated with it, VA makes a formal decision to * ** _not_** award a benefit the claimant is seeking * confirm and continue a prior decision (this includes rating decisions that confirm and continue a disability rating following a routine future examination or hospitalization of a Veteran), or * reduce or discontinue benefits. **Note:** The initial establishment of a noncompensable disability rating for an SC disability is _not_ considered a denial. Although compensation is not payable for the disability (except, potentially, under [38 CFR 3.324]()), the noncompensable rating may entitle the Veteran to other VA benefits, such as medical care under [38 CFR 17.37(b)]() and [17.38](). ### VI.i.1.A.3.b. Authority of the Authorization Activity to Make Decisions That Affect an Individual's Entitlement to VA Benefits The authorization activity has the authority to make basic _eligibility_ determinations. It also has the authority to decide * the effect an individual's income and/or net worth has on the entitlement to income-based benefits * whether entitlement to additional benefits for a dependent or dependents exists, and * whether entitlement to A&A under [38 CFR 3.351(c)(2)]() exists, based on the status of the following individuals as a patient in a nursing home: * Veteran in receipt of Veterans Pension * surviving spouse or parent in receipt of DIC * surviving spouse in receipt of Survivors Pension, or * spouse of a Veteran when the Veteran is in receipt of disability compensation. **Restrictions:** The authorization activity does _not_ have the authority to * determine whether service treatment records support a claim for disability compensation, or * deny without a rating decision a claim for survivors’ benefits that involves the issue of SC for the cause of death. **Note:** If basic eligibility is established and the claim requires consideration of medical evidence of record, refer it to the rating activity for review. Claims of this nature require a formal, coded rating decision. **Exception:** M21-1, Part VI, Subpart i, 1.A.3.c describes conditions under which the authorization activity may deny a claim without a rating decision. **References:** For more information on * rating activity responsibilities regarding claims for survivors’ benefits, see [M21-1, Part XII, Subpart i, 2.A]() and [B]() * award adjustments based on changes in income, see [M21-1, Part IX, Subpart iii, 1.H.1]() * handling claims for additional benefits for dependents and changes in the number or status of dependents, when the beneficiary is receiving * pension, see [M21-1, Part IX, Subpart iii, 1.F]() * parents’ DIC, see [M21-1, Part IX, Subpart iii, 1.D.6](), and * disability compensation, see [M21-1, Part VII, Subpart i, 1.C](), and * A&A entitlement under [38 CFR 3.351(c)(2)](), see * [M21-1, Part IX, Subpart ii, 1.B.2.a](), and * [M21-1, Part VIII, Subpart iv, 4.A.12](). ### VI.i.1.A.3.c. Conditions Under Which the Authorization Activity May Deny a Claim The authorization activity may deny a claim for disability compensation or survivors benefits _without_ a rating decision under any of the following conditions: * a legal bar to entitlement exists * the claimant does not respond within 30 days to a request for evidence needed to determine whether or not there is a legal bar to entitlement, such as in cases involving continuous cohabitation, or * in survivors benefit cases, the claim is one in which * SC for the cause of death was not specifically claimed, and * there is no reasonable probability that the cause or contributory cause of death was related to service (including, but not limited to, death due to accident or natural disaster, homicide, or execution for a crime). **Notes:** * Resolve any issues regarding basic eligibility or bars to benefits _before_ considering SC. In accordance with [38 CFR 3.159(d)](), VA should _not_ continue providing assistance with a claim if there is no reasonable possibility that assistance will substantiate the claim. * If VA concurrently denies SC for the cause of death and awards pension, enter the following as a remark on the corresponding award document:_ SC death benefits denied – M21-1, Part VI, Subpart i, 1.A.3.c._ * When notifying a claimant of a decision that _authorization activity_ made (without referral to the rating activity) to deny entitlement to a claimed benefit, authorization activity must include the following in the decision notice, just as the rating activity does in rating decisions: * reasons and bases for the decision * laws and regulations relevant to the claim * a summary of the evidence authorization activity considered * element(s) necessary to grant the claim that were not met, and * findings that are favorable to the claimant under [38 CFR 3.104(c)](). **References:** For more information on * situations in which claims for survivors benefits should be referred to the rating activity, see [M21-1, Part XI, Subpart ii, 1]() * claims the rating activity must deny by rating decision, see * [M21-1, Part V, Subpart i, 1.A.1.b](), and * [M21-1, Part XI, Subpart ii, 1]() * situations in which a reasonable probability of SC death exists, see [M21-1, Part XII, Subpart i, 2.A.1.a](), and * the authorization activity’s authority to make decisions that affect an individual’s entitlement to VA benefits, see M21-1, Part VI, Subpart i, 1.A.3.b. ### VI.i.1.A.3.d. Requirement to Receive and Review All Required Evidence Before Denying a Claim Unless there is a statutory bar to entitlement to benefits, the authorization activity must _not_ deny any claim until VA has * received and reviewed all evidence required to make a decision, or * exhausted all reasonable means of obtaining the evidence and, for records from Federal sources, determined that either * the record does not exist, or * further efforts to obtain the record would be futile. **Note:** A formal claim requires a formal decision and notification. However, VA’s consideration of subordinate and within-scope issues associated with a claim (as explained in [M21-1, Part V, Subpart ii, 3.A]()) does _not_ necessarily require a formal decision and notification if such consideration would result in a denial.**References:** For more information on * VA’s duty to assist, see [M21-1, Part III, Subpart i, 2](), and * rating activity determinations that consideration of SC for the cause of death is not warranted, see [M21-1, Part XII, Subpart i, 2.A.1.g](). ### VI.i.1.A.3.e. Incomplete Applications and Benefit Requests That Are Not Filed on a Prescribed Form Do _not_ process a denial if a claimant has failed to submit a * claim on one of the prescribed forms identified in [M21-1, Part II, Subpart iii, 1.A.1.a](), or * substantially complete application, as defined in [M21-1, Part I, Subpart i, 1.A.4.f](). **References:** For more information on * situations in which VA does not require the use of a prescribed form, see [M21-1, Part II, Subpart iii, 1.A.1.b]() * handling claims that were established even though the claimant failed to submit a prescribed form, see [M21-1, Part II, Subpart iii, 2.E](), and * handling incomplete applications, see [M21-1, Part II, Subpart iii, 1.C.2.b](). ## 4. Denials Based on a Claimant’s Failure to Furnish Requested Evidence This topic contains information on denials that are based on a claimant’s failure to furnish requested evidence, including handling * a claimant’s failure to * submit evidence VA requested, and * report for a VA examination, and * an abandoned claim. April 24, 2020 ### VI.i.1.A.4.a. Handling a Claimant’s Failure to Submit Evidence VA Requested If a claimant fails to submit evidence within a time period VA specified, * refer the claim to the rating activity (if a rating decision is required) * process a denial (or award benefits, if other evidence of record supports a grant of entitlement to all or some of the benefits the claimant is seeking), and * prepare a decision notice. **Important:** * If VA denies any portion of a claim because the claimant failed to submit evidence VA requested, the decision notice must * state this fact * explain that other evidence of record does not support the claim, and * inform the claimant the evidence VA requested must be furnished, along with [_VA Form 20-0995, Decision Review Request: Supplemental Claim_](), within one year of the date of the decision notice in order to remain entitled to benefits from the original date of claim, if VA later establishes entitlement. * Prepare a new decision notice if VA previously denied a claim based on a claimant’s failure to submit evidence, then VA subsequently * makes another determination of non-entitlement based on additional evidence the claimant furnished within one year of the date of the previous notice of denial, or * denies the claim solely on legal grounds. **References:** For more information on * time limits for responding to VA requests for evidence, see * [M21-1, Part III, Subpart i, 2.D.2.a](), and * [38 CFR 3.109](), and * preparing a decision notice, see [M21-1, Part VI, Subpart i, 1.B](). ### VI.i.1.A.4.b. Handling a Claimant’s Failure to Report for a VA Examination The table below describes the process for handling cases in which a claimant fails to report for a VA examination without good cause. | **Stage**| **Who Is Responsible**| **Action** 1| development activity| Refers the claim to the rating activity for consideration. 2| rating activity| Decides the claim in accordance with principles set forth in [M21-1, Part IV, Subpart i, 2.F.1.a](). 3| rating activity| Routes the rating decision to the authorization activity. 4| authorization activity| Processes an award and/or denial and issues notification to the claimant. **Important:** If a denial is based on the claimant’s failure to report for an examination, either the rating decision or the decision notice must * inform the claimant that VA cannot favorably decide the claim without an examination, and * advise the claimant to * notify VA when ready to report for an examination, or * submit a properly executed disability benefits questionnaire. **References:** For more information on * good cause for failing to report for an examination, see [M21-1, Part IV, Subpart i, 2.F.1.b](), and * handling a Veteran's failure to report for an examination, see * [M21-1, Part IV, Subpart i, 2.F]() * [M21-1, Part IV, Subpart ii, 2.B]() * [38 CFR 3.655](), and * [_Turk v. Peake_](), 21 Vet.App. 565 (2008). ### VI.i.1.A.4.c. Handling an Abandoned Claim If a claimant fails to provide evidence within one year of VA’s request **__and__** VA has not decided the claim as of the expiration of the one-year period, consider the claim abandoned. **Important:** It is not necessary to advise a claimant of review rights when the claimant has abandoned the claim. **Reference:** For more information on abandoned claims, see * [M21-1, Part II, Subpart i, 2.C.6.i](), and * [38 CFR 3.158](). ## 5. Special Denial Procedures This topic contains information on special denial procedures, including * changing the basis of a previous denial, and * references to other special denial procedures. August 10, 2020 ### VI.i.1.A.5.a. Changing the Basis of a Previous Denial If VA reviews or reconsiders a claim it previously denied and decides to change the basis of the denial, it must * reprocess the denial according to the instructions in M21-1, Part VI, Subpart i, 1.A.2.c, and * if necessary, make appropriate system selections to * add any new favorable findings related to the basis of the new denial, and/or * overturn any and all findings that * were formerly found favorable to the claimant under [38 CFR 3.104(c)](), but * are no longer applicable. **References:** For more information on * favorable findings, in general, see [M21-1, Part V, Subpart iv, 1.A.5.f](), and * the binding nature of favorable findings, see [M21-1, Part X, Subpart ii, 1.A.2.a](). ### VI.i.1.A.5.b. References to Other Special Denial Procedures The table below contains references to other special denial procedures. | **For more information on …**| **See …** notifying a claimant that election of pension is not in the claimant's best interest| [M21-1, Part IX, Subpart iii, 2.C.2.b](). notifying a claimant of a denial that is based on income| [M21-1, Part IX, Subpart iii, 1.A.3](). eligibility determinations regarding the Department of Defense’s death gratuity| [M21-1, Part XI, Subpart ii, 4](). denying a request for release of information or amendment of records| [ _VA Handbook 6300.4, paragraphs 3.d and 3.e_](). denying claims from certain foreign residents| [M21-1, Part X, Subpart i, 3.B.3]().