Part V, Subpart i, Chapter 1, Section CPre-Rating Review of Claims by the Rating Activity

VA receives a claim on the prescribed form

• the form to ensure it is substantially complete, and
  • the claim to ensure it is not inherently incredible or lacking merit.

References: For more information on

• substantially complete application, see
  • M21-1, Part I, Subpart i, 1.A.4.f
  • M21-1, Part II, Subpart iii, 1.C, and
  • 38 CFR 3.159(a)(3), and
• action required on claims that are inherently incredible or lack merit, see
  • M21-1, Part I, Subpart i, 1.A.4.c, and
  • M21-1, Part II, Subpart iii, 1.C.2.f.

the form is substantially complete

to determine whether Section 5103 notice requirements have been met under the guidance in M21-1, Part III, Subpart i, 2.B.References: For more information on

• notification requirements for a complete application, see M21-1, Part II, Subpart iii, 1.C.2.a
• when the duty to notify has already been provided on the application form or through filing, see M21-1, Part III, Subpart i, 2.B.1.b
• circumstances where a Section 5103 notice may need to be provided after a claim is submitted, see M21-1, Part III, Subpart i, 2.B.1.c, and
• exceptions to the Section 5103 notice requirement, see M21-1, Part III, Subpart i, 2.B.1.d.

VA becomes aware of the existence of relevant records before the claim is decided

the claims folder to ensure that VA has notified the claimant

• of the relevant records
• of the need for a release of records (if applicable), and
• to obtain the records and provide them to VA if the claimant does not provide the necessary release.

evidence requested by VA from a third party does not exist or cannot be obtained

the claims folder to ensure that VA has

• identified the records that could not be obtained
  • explained the efforts VA made to obtain the records
  • described any further action VA will take regarding the claim, including, but not limited to notice that VA will decide the claim based on the evidence of record unless the claimant submits the records VA was unable to obtain, and
  • indicated that the claimant is ultimately responsible for providing the evidence.

Note:_ _For non-Federal records requests, VA may provide the notice at the same time it makes a follow-up attempt to obtain the relevant records.

a proposed adverse action is referred for final decision

the notice of proposed adverse action to ensure all the elements of due process have been met. References: For more information on

• due process, see M21-1, Part I, Subpart i, 1.B, and
• the notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.A.

needed in support of a benefit-specific or special-issue claim type (for example, individual unemployability or service connection for hepatitis)

notified the claimant

• of any additional forms or special-issue evidence needed to support the claim
  • how the forms/evidence can be obtained/presented, and
  • when the forms/evidence must be received.

Reference : For more information on notification requirements for special issues, see M21-1, Part III, Subpart i, 2.B.1.f.

requested from Federal agencies

• received complete records, or
  • if the records were not obtained, determined that they do not exist or additional efforts would be futile.

Reference: For more information on duty to assist with Federal records, see

• M21-1, Part III, Subpart ii, 1.A.1.a, and
• 38 CFR 3.159(c)(2).

requested from the claimant and/or private providers

• received complete records, or
  • if the records are not received, made reasonable efforts to obtain them.

References: For more information on

• reasonable efforts to obtain non-Federal records, see
  • M21-1, Part III, Subpart i, 2.C.2, and
  • 38 CFR 3.159(c)(1), and
• claimants' cooperation with the duty to assist in obtaining non-Federal records, see
  • M21-1, Part III, Subpart i, 2.C.2.c, and
  • 38 CFR 3.159(c)(1)(i).

VA medical records

• obtained all VA medical records pertinent to the issues, and
  • associated them with the electronic claims folder.

Note: Vet Center records require the Veteran’s authorization to release records and are not stored in the Compensation and Pension Record Interchange (CAPRI). References: For more information on

• obtaining VA medical records, see M21-1, Part III, Subpart ii, 1.A.2
• storing records from CAPRI, see the CAPRI User Manual, and
• obtaining records from a Vet Center, see M21-1, Part III, Subpart ii, 1.A.1.e.

an examination request

• requested all examinations and medical opinions, when required, and
  • included the correct information to the examiner in the request(s).

Reference: For more information on VA’s duty to provide medical examinations or medical opinions, see

• M21-1, Part IV, Subpart i, 1.A, and
• 38 CFR 3.159(c)(4).

an examination report

• received a complete examination report that is sufficient for rating purposes, or
• received notice that the claimant failed to report.