Revised June 29, 2015
I.i.1.A.1.aDescription of PL 106-475
Public Law (PL) 106-475 , Veterans Claims Assistance Act of 2000 , was enacted on November 9, 2000, and
- redefined the Department of Veterans Affairs’ (VA’s) duty to assist claimants in obtaining evidence necessary to substantiate a claim
- eliminated the requirement from Morton v. West , 12 Vet.App. 477 (1999), that a claimant must submit a well-grounded claim before VA can assist in developing the claim, and
- mandated specific notice requirements regarding information that is necessary to substantiate a claim.
The impact on VA’s duty to notify and duty to assist claimants is discussed in this chapter. References : For more information on VA's
- duty to notify under 38 U.S.C. 5103, see M21-1, Part III, Subpart i, 2.B
- duty to assist with obtaining records, see M21-1, Part III, Subpart i, 2.C, and
- duty to assist with providing a medical examination or opinion, see M21-1, Part IV, Subpart i, 1.A and B, and
- regulation on the duty to notify and duty to assist, see 38 CFR 3.159.
I.i.1.A.1.bAmendment to 38 U.S.C. 5102
PL 106-475 amended 38 U.S.C. 5102 to require VA, upon a receipt of an incomplete application for benefits or an intent to claim or apply for a benefit, to
- notify the claimant of the information necessary to complete the application, and
- to defer assistance until the claimant submits the information.
Note: This includes furnishing the applicant any instructions and forms necessary to apply for that benefit. References: For more information on
- screening applications for substantial completeness, see M21-1, Part II, Subpart iii, 1.C.1
- notification requirements for an incomplete application, see M21-1, Part II, Subpart iii, 1.C.2.b and c
- notification requirements for a request for application or an intent to file a claim, see M21-1, Part II, Subpart iii, 1.C.2.e, and
- prescribed forms to furnish claimants, see M21-1, Part II, Subpart iii, 1.A.1.a.
I.i.1.A.1.cAmendment to 38 U.S.C. 5103
PL 106-475 amended 38 U.S.C. 5103 to require VA to notify the claimant of any information not previously provided that is necessary to substantiate the claim. The PL provided that such information shall be received by VA within one year from the date of the notification. Note: VA has traditionally referred to the required notice in 38 U.S.C. 5103 as a VCAA Notice. However, because of amendments to the law since the Veterans Claims Assistance Act (VCAA) of 2000, the term Section 5103 notice has now replaced VCAA Notice and such term will be used throughout the manual. Reference: For more information on VA's duty to notify under 38 U.S.C. 5103, see
I.i.1.A.1.dAmendment to 38 U.S.C. 5103A
PL 106-475 amended 38 U.S.C. 5103A to require VA to make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate a claim. This assistance includes obtaining relevant Federal records, relevant private records adequately identified by the claimant, and a medical examination, if necessary to decide the claim. Reference: For more information on VA's duty to assist claimants in obtaining evidence, see
2PL 112-154, Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012, and its Impact on 38 U.S.C. 5103 and 5103A
This topic contains information about PL 112-154 and its impact on 38 U.S.C. 5103 and 5103A, including
- PL 112-154, Section 504 , authorization of use of electronic communication to provide notice to claimants for benefits, and
- PL 112-154, Section 505 , duty to assist claimants in obtaining private records.
Revised June 29, 2015
I.i.1.A.2.aPL 112-154, Section 504, Authorization of Use of Electronic Communication to Provide Notice to Claimants for Benefits
PL 112-154, Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012, Section 504 , amended 38 U.S.C. 5103 to streamline VA’s duty to notify responsibilities. These statutory changes, among other things, permit VA to
- provide Section 5103 notices by the most effective means available, including electronic communications
- provide Section 5103 notices before , rather than after , the submission of a claim such as attaching the notice to an application
- eliminate the need to provide additional Section 5103 notices on subsequent claims if the same type of Section 5103 notice has already been provided on a current pending claim within the previous year, and
- utilize e-mails as a way to transmit Section 5103 notices; however, this is currently not a viable option due to privacy and security concerns.
Important: Although PL 112-154 indicates that VA’s duty to notify responsibilities no longer apply when VA can award the maximum benefit based on the evidence of record, VA will refrain from implementing procedures in the manual on this issue until a substantive rule-making is implemented through VA regulation in 38 CFR 3.159.Reference:** For specific guidance on VA’s duty to notify, see
I.i.1.A.2.bPL 112-154, Section 505, Duty to Assist Claimants in Obtaining Private Records
PL 112-154 ,Section 505 , amended 38 U.S.C. 5103A to streamline VA’s duty to assist responsibilities. These statutory changes, among other things, permit VA to
- make no less than two requests to a custodian of a private record (which was consistent with VA procedures prior to enactment of PL 112-154), and
- encourage claimants under VA regulations to submit relevant private medical records if such submission does not burden the claimant.
Important: Although PL 112-154 indicates that VA’s duty to assist responsibilities no longer apply when VA can award the maximum benefit based on the evidence of record, VA will refrain from implementing procedures in the manual on this issue until a substantive rule-making is implemented through VA regulation in 38 CFR 3.159. Reference: For more information on VA’s duty to assist claimants in obtaining private records, see
3PL 115-55, Veterans Appeals Improvement and Modernization Act of 2017, and its Impact on 38 U.S.C. 5103 and 5103A
This topic contains information about PL 115-55 and its impact on 38 U.S.C. 5103 and 38 U.S.C. 5103A, including
- impact of PL 115-55, and
- PL 115-55 and * duty to notify * applicability of duty to assist * duty to assist errors, and * duty to provide decision notice.
Revised February 19, 2019
I.i.1.A.3.aImpact of PL 115-55
On February 19, 2019, changes went into effect based on PL 115-55, Veterans Appeals Improvement and Modernization Act of 2017. The PL and associated regulatory changes impacted both VA’s duty to assist and duty to notify requirements.
I.i.1.A.3.bPL 115-55 and Duty to Notify
PL 115-55 revised Section 5103 to state that the notice requirement for a substantially complete claim applies to initial and supplemental claims; however, VA is not required to provide that notice with respect to a supplemental claim filed within one year of an agency of original jurisdiction or Board decision on an issue.
I.i.1.A.3.cPL 115-55 and Applicability of Duty to Assist
VA’s duty to assist in the gathering of evidence begins upon receipt of a substantially complete application for an initial or supplemental claim and ends once VA issues a decision on the claim. The definition of a substantially complete application in 38 CFR 3.159 has been amended to add the requirement that a supplemental claim application include or identify potentially new evidence. Important: The duty to assist does not apply to higher-level reviews (HLRs). Reference: For more information on processing HLRs, see M21-5, Chapter 5.
I.i.1.A.3.dPL 115-55 and Duty to Assist Errors
VA’s duty to assist is reinstated when a substantially complete initial claim or supplemental claim is filed or when a claim is returned to correct a “duty to assist” error in a prior decision. Reference: For more information on duty to assist errors, see M21-5, Chapter 5,5.
I.i.1.A.3.ePL 115-55 and Duty to Provide Decision Notice
PL 115-55 required a change to 38 CFR 3.103(f). Effective February 19, 2019, 38 CFR 3.103(f) requires VA’s written notification of decisions to include all of the following elements:
- identification of the issues adjudicated
- a summary of the evidence considered
- a summary of the applicable laws and regulations
- identification of findings favorable to the claimant
- in the case of a denial, identification of elements not satisfied leading to the denial
- an explanation of how to obtain or access evidence used in making the decision
- if applicable, identification of the criteria that must be satisfied to grant service connection (SC) or the next higher level of compensation, and
- a summary of the applicable review options under 38 CFR 3.2500 available for the claimant to seek further review of the decision.
Note: These elements can be satisfied through a combination of the decision notice and its enclosures. References: For more information on
- required notice elements in
- rating decisions, see M21-1, Part V, Subpart iv, 1.A
- notification letters, see M21-1, Part VI, Subpart i, 1.B, and
- administrative decisions, see M21-1, Part X, Subpart v, 1.C, and
- favorable findings, see M21-1, Part V, Subpart iv, 1.A.5.
4Definitions Related to Duty to Notify and Duty to Assist
This topic contains information about definitions related to duty to notify and duty to assist, including
- definition of relevant records
- refraining from or discontinuing assistance
- claims that are inherently incredible or lack merit, and
- definition of
- competent medical evidence
- competent lay evidence
- substantially complete application
- event
- information
- an initial claim
- a supplemental claim, and
- reopened claim.
Revised February 19, 2019
I.i.1.A.4.aDefinition: Relevant Records
For the purpose of VA statutory duty to notify/assist, relevant records must
- relate to the disability or injury, or pension or Dependency and Indemnity Compensation (DIC) claim for which the claimant is seeking benefits, and
- have a reasonable possibility of helping to substantiate the claim.
VA is not required to assist a claimant in obtaining identified records if no reasonable possibility exists that such assistance would aid in substantiating the claim.Reference:** For more information about relevant records, see
- M21-1, Part III, Subpart i, 2.E, and
- Golz v. Shinseki, 590 F.3d 1317, 1320-21 (Fed. Cir. 2010).
I.i.1.A.4.bRefraining From or Discontinuing Assistance
VA will refrain from or discontinue providing assistance in obtaining evidence for a claim if the 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. Circumstances in which VA will 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.
References: For more information on
- circumstances where VA will refrain from or discontinue providing assistance, see 38 CFR 3.159(d)
- determining Veteran status and eligibility for benefits, see M21-1, Part III, i.1, and
- inherently incredible claims, see M21-1, Part I, Subpart i,1.A.4.c.
I.i.1.A.4.cClaims That Are Inherently Incredible or Lack Merit
VA will not provide assistance in obtaining evidence if a claim is inherently incredible or clearly lacks merit, even when the application itself is substantially complete. The development or rating activity has the authority to determine whether a claim is incredible or without merit. For compensation claims, this may involve an allegation that a particular disability is secondary to one for which SC has already been established.Important: VA employees have broad authority to determine whether or not a claim is inherently incredible or clearly lacks merit. However, before deciding such a claim, VA may request that the claimant submit evidence to render the claim plausible or credible.Examples:
- A claimant alleges her service-connected tinnitus caused her hammertoes, but she furnishes no medical evidence to support this allegation.
- A Veteran claims he developed posttraumatic stress disorder as a result of combat service in the Republic of Vietnam, but military records clearly show he had no foreign or combat service.
References: For more information on
- claims that are inherently incredible or lack merit, see 38 CFR 3.159(d), and
- notification requirements for claims that are inherently incredible or lack merit, see M21-1, Part II, Subpart iii, 1.C.2.f.
I.i.1.A.4.dDefinition: Competent Medical Evidence
Competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also mean statements conveying sound medical principles found in medical treatises. It would also include statements contained in authoritative writings such as medical and scientific articles and research reports or analyses.Reference:** The definition of competent medical evidence for the purpose of this chapter is set forth in 38 CFR 3.159(a)(1).
I.i.1.A.4.eDefinition: Competent Lay Evidence
Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person.Note:** When evaluating lay evidence,
- accept it at face value unless there is reason to question it, and
- when conflicting evidence exists, weigh all the evidence as appropriate.
Reference: The definition of competent lay evidence for the purpose of this chapter is set forth in 38 CFR 3.159(a)(2).
I.i.1.A.4.fDefinition: Substantially Complete Application
Substantially complete application means an application containing
- the claimant's name
- the claimant’s relationship to the Veteran, if applicable
- sufficient service information for VA to verify the claimed service, if applicable
- the benefit sought and any medical condition(s) on which it is based
- the claimant's signature
- a statement of income in claims for Veterans Pension or Survivors Pension and Parents' DIC
- identification or inclusion of potentially new evidence in supplemental claims, and
- for HLRs, identification of the date of the decision for which review is sought.
References: For more information on
- the criteria for substantially complete applications, see
- signature requirements, see M21-1, Part II, Subpart i, 2.B.2.
I.i.1.A.4.gDefinition: Event
Event means one or more incidents associated with places, types, and circumstances of service giving rise to disability.Reference:** The definition of event for the purpose of this chapter is set forth in 38 CFR 3.159(a)(4).
I.i.1.A.4.hDefinition: Information
Information means non-evidentiary facts, such as the claimant's Social Security number or address; the name and military unit of a person who served with the Veteran; or the name and address of a medical care provider who may have evidence pertinent to the claim.Reference:** The definition of information for the purpose of this chapter is set forth in 38 CFR 3.159(a)(5).
I.i.1.A.4.iDefinition: Initial Claim
An initial claim is a substantially complete claim for a benefit, other than a supplemental claim, on an application form prescribed by the Secretary, including:
- the first filing by a claimant (original claim), and
- a subsequent claim filed by a claimant for
- an increase in a disability evaluation
- a new benefit, or
- a new disability.
References: For more information on
- substantially complete claims, see
- 38 CFR 3.159(a)(3), and
- M21-1 Part I, Subpart i, 1.A.4.f
- initial claims, see 38 CFR 3.1(p)(1), and
- claims for increase, see M21-1, Part II, Subpart iii, 2.C.
I.i.1.A.4.jDefinition: Supplemental Claim
A supplemental claim is a substantially complete claim for a VA benefit on an application form prescribed by the Secretary where an initial or supplemental claim for the same or similar benefit on the same or similar basis was previously decided. Note: In order to be considered substantially complete, a claimant must submit or identify potentially new evidence with a supplemental claim. References: For more information on
- substantially complete claims, see
- 38 CFR 3.159(a)(3), and
- M21-1 Part I, Subpart i, 1.A.4.f, and
- supplemental claims, see
I.i.1.A.4.kDefinition: Reopened Claim
The term reopened claim pertains to requests filed prior to February 19, 2019, for a benefit after the disallowance of an earlier claim for that benefit became final. This includes a claim in which SC for the same disability is reclaimed under a different theory of entitlement.Example: A Veteran whose claim for direct SC for hypertension was denied in 2012 submits a February 1, 2019, claim for SC for hypertension on a secondary basis. Consider the claim for secondary SC to be a reopened claim because the same disability, hypertension, was reclaimed under a different theory of entitlement. Notes:**
- Final means the claim is no longer active, and the appeal period has expired.
- Reopened claims do not include claims for increased evaluations or ancillary benefits.
References: For more information on
- revisions based on a supplemental claim, see M21-1, Part X, Subpart ii, 2.A, and
- claims reopened under a different theory of entitlement, see Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir. 2009).
End of Part I, Subpart i, Chapter 1, Section A