[Congressional Record Volume 146, Number 130 (Tuesday, October 17, 2000)]
[House]
[Pages H9912-H9918]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VETERANS CLAIMS ASSISTANCE ACT OF 2000
Mr. STUMP. Madam Speaker, I move to suspend the rules and concur in
the Senate amendment to the bill (H.R. 4864) to amend title 38, United
States Code, to reaffirm and clarify the duty of the Secretary of
Veterans Affairs to assist claimants for benefits under laws
administered by the Secretary, and for other purposes.
The Clerk read as follows:
Senate amendment:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veterans Claims Assistance
Act of 2000''.
SEC. 2. CLARIFICATION OF DEFINITION OF ``CLAIMANT'' FOR
PURPOSES OF VETERANS CLAIMS.
Chapter 51 of title 38, United States Code, is amended by
inserting before section 5101 the following new section:
``Sec. 5100. Definition of `claimant'
``For purposes of this chapter, the term `claimant' means
any individual applying for, or submitting a claim for, any
benefit under the laws administered by the Secretary.''.
SEC. 3. ASSISTANCE TO CLAIMANTS.
(a) Reaffirmation and Clarification of Duty To Assist.--
Chapter 51 of title 38, United States Code, is further
amended by striking sections 5102 and 5103 and inserting the
following:
``Sec. 5102. Application forms furnished upon request; notice
to claimants of incomplete applications
``(a) Furnishing Forms.--Upon request made by any person
claiming or applying for, or expressing an intent to claim or
apply for, a benefit under the laws administered by the
Secretary, the Secretary shall furnish such person, free of
all expense, all instructions and forms necessary to apply
for that benefit.
``(b) Incomplete Applications.--If a claimant's application
for a benefit under the laws administered by the Secretary is
incomplete, the Secretary shall notify the claimant and the
claimant's representative, if any, of the information
necessary to complete the application.
``Sec. 5103. Notice to claimants of required information and
evidence
``(a) Required Information and Evidence.--Upon receipt of a
complete or substantially complete application, the Secretary
shall notify the claimant and the claimant's representative,
if any, of any information, and any medical or lay evidence,
not previously provided to the Secretary that is necessary to
substantiate the claim. As part of that notice, the Secretary
shall indicate which portion of that information and
evidence, if any, is to be provided by the claimant and which
portion, if any, the Secretary, in accordance with section
5103A of this title and any other applicable provisions of
law, will attempt to obtain on behalf of the claimant.
``(b) Time Limitation.--(1) In the case of information or
evidence that the claimant is notified under subsection (a)
is to be provided by the claimant, if such information or
evidence is not received by the Secretary within one year
from the date of such notification, no benefit may be paid or
furnished by reason of the claimant's application.
``(2) This subsection shall not apply to any application or
claim for Government life insurance benefits.
``Sec. 5103A. Duty to assist claimants
``(a) Duty To Assist.--(1) The Secretary shall make
reasonable efforts to assist a claimant in obtaining evidence
necessary to substantiate the claimant's claim for a benefit
under a law administered by the Secretary.
``(2) The Secretary is not required to provide assistance
to a claimant under this section if no reasonable possibility
exists that such assistance would aid in substantiating the
claim.
``(3) The Secretary may defer providing assistance under
this section pending the submission by the claimant of
essential information missing from the claimant's
application.
``(b) Assistance in Obtaining Records.--(1) As part of the
assistance provided under subsection (a), the Secretary shall
make reasonable efforts to obtain relevant records (including
private records) that the claimant adequately identifies to
the Secretary and authorizes the Secretary to obtain.
``(2) Whenever the Secretary, after making such reasonable
efforts, is unable to obtain all of the relevant records
sought, the Secretary shall notify the claimant that the
Secretary is unable to obtain records with respect to the
claim. Such a notification shall--
``(A) identify the records the Secretary is unable to
obtain;
``(B) briefly explain the efforts that the Secretary made
to obtain those records; and
``(C) describe any further action to be taken by the
Secretary with respect to the claim.
``(3) Whenever the Secretary attempts to obtain records
from a Federal department or agency under this subsection or
subsection (c), the efforts to obtain those records shall
continue until the records are obtained unless it is
reasonably certain that such records do not exist or that
further efforts to obtain those records would be futile.
``(c) Obtaining Records for Compensation Claims.--In the
case of a claim for disability compensation, the assistance
provided by the Secretary under subsection (b) shall include
obtaining the following records if relevant to the claim:
``(1) The claimant's service medical records and, if the
claimant has furnished the Secretary information sufficient
to locate such records, other relevant records pertaining to
the claimant's active military, naval, or air service that
are held or maintained by a governmental entity.
``(2) Records of relevant medical treatment or examination
of the claimant at Department health-care facilities or at
the expense of the Department, if the claimant furnishes
information sufficient to locate those records.
``(3) Any other relevant records held by any Federal
department or agency that the claimant adequately identifies
and authorizes the Secretary to obtain.
``(d) Medical Examinations for Compensation Claims.--(1) In
the case of a claim for disability compensation, the
assistance provided by the Secretary under subsection (a)
shall include providing a medical examination or obtaining a
medical opinion when such an examination or opinion is
necessary to make a decision on the claim.
``(2) The Secretary shall treat an examination or opinion
as being necessary to make a decision on a claim for purposes
of paragraph (1) if the evidence of record before the
Secretary, taking into consideration all information and lay
or medical evidence (including statements of the claimant)--
``(A) contains competent evidence that the claimant has a
current disability, or persistent or recurrent symptoms of
disability; and
``(B) indicates that the disability or symptoms may be
associated with the claimant's active military, naval, or air
service; but
``(C) does not contain sufficient medical evidence for the
Secretary to make a decision on the claim.
``(e) Regulations.--The Secretary shall prescribe
regulations to carry out this section.
``(f) Rule With Respect to Disallowed Claims.--Nothing in
this section shall be construed to require the Secretary to
reopen a claim that has been disallowed except when new and
material evidence is presented or secured, as described in
section 5108 of this title.
[[Page H9913]]
``(g) Other Assistance Not Precluded.--Nothing in this
section shall be construed as precluding the Secretary from
providing such other assistance under subsection (a) to a
claimant in substantiating a claim as the Secretary considers
appropriate.''.
(b) Reenactment of Rule for Claimant's Lacking a Mailing
Address.--Chapter 51 of such title is further amended by
adding at the end the following new section:
``Sec. 5126. Benefits not to be denied based on lack of
mailing address
``Benefits under laws administered by the Secretary may not
be denied a claimant on the basis that the claimant does not
have a mailing address.''.
SEC. 4. DECISION ON CLAIM.
Section 5107 of title 38, United States Code, is amended to
read as follows:
``Sec. 5107. Claimant responsibility; benefit of the doubt
``(a) Claimant Responsibility.--Except as otherwise
provided by law, a claimant has the responsibility to present
and support a claim for benefits under laws administered by
the Secretary.
``(b) Benefit of the Doubt.--The Secretary shall consider
all information and lay and medical evidence of record in a
case before the Secretary with respect to benefits under laws
administered by the Secretary. When there is an approximate
balance of positive and negative evidence regarding any issue
material to the determination of a matter, the Secretary
shall give the benefit of the doubt to the claimant.''.
SEC. 5. PROHIBITION OF CHARGES FOR RECORDS FURNISHED BY OTHER
FEDERAL DEPARTMENTS AND AGENCIES.
Section 5106 of title 38, United States Code, is amended by
adding at the end the following new sentence: ``The cost of
providing information to the Secretary under this section
shall be borne by the department or agency providing the
information.''.
SEC. 6. CLERICAL AMENDMENTS.
The table of sections at the beginning of chapter 51 of
title 38, United States Code, is amended--
(1) by inserting before the item relating to section 5101
the following new item:
``5100. Definition of `claimant'.'';
(2) by striking the items relating to sections 5102 and
5103 and inserting the following:
``5102. Application forms furnished upon request; notice to claimants
of incomplete applications.
``5103. Notice to claimants of required information and evidence.
``5103A. Duty to assist claimants.'';
(3) by striking the item relating to section 5107 and
inserting the following:
``5107. Claimant responsibility; benefit of the doubt.'';
and
(4) by adding at the end the following new item:
``5126. Benefits not to be denied based on lack of mailing address.''.
SEC. 7. EFFECTIVE DATE.
(a) In General.--Except as specifically provided otherwise,
the provisions of section 5107 of title 38, United States
Code, as amended by section 4 of this Act, apply to any
claim--
(1) filed on or after the date of the enactment of this
Act; or
(2) filed before the date of the enactment of this Act and
not final as of that date.
(b) Rule for Claims the Denial of Which Became Final After
the Court of Appeals for Veterans Claims Decision in the
Morton Case.--(1) In the case of a claim for benefits denied
or dismissed as described in paragraph (2), the Secretary of
Veterans Affairs shall, upon the request of the claimant or
on the Secretary's own motion, order the claim readjudicated
under chapter 51 of such title, as amended by this Act, as if
the denial or dismissal had not been made.
(2) A denial or dismissal described in this paragraph is a
denial or dismissal of a claim for a benefit under the laws
administered by the Secretary of Veterans Affairs that--
(A) became final during the period beginning on July 14,
1999, and ending on the date of the enactment of this Act;
and
(B) was issued by the Secretary of Veterans Affairs or a
court because the claim was not well grounded (as that term
was used in section 5107(a) of title 38, United States Code,
as in effect during that period).
(3) A claim may not be readjudicated under this subsection
unless a request for readjudication is filed by the claimant,
or a motion is made by the Secretary, not later than two
years after the date of the enactment of this Act.
(4) In the absence of a timely request of a claimant under
paragraph (3), nothing in this Act shall be construed as
establishing a duty on the part of the Secretary of Veterans
Affairs to locate and readjudicate a claim described in this
subsection.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Arizona (Mr. Stump) and the gentleman from Illinois (Mr. Evans) each
will control 20 minutes.
The Chair recognizes the gentleman from Arizona (Mr. Stump).
General Leave
Mr. STUMP. Madam Speaker, I ask unanimous consent that all Members
may have 5 legislative days within which to revise and extend their
remarks and include extraneous material on H.R. 4864.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Arizona?
There was no objection.
Mr. STUMP. Madam Speaker, I yield myself such time as I may consume.
(Mr. STUMP asked and was given permission to revise and extend his
remarks.)
Mr. STUMP. Madam Speaker, H.R. 4864 is the Veterans Claims Assistance
Act of 2000. The bill addresses the Morton versus West court decision
and corrects difficulties veterans have experienced with VA's claims
processing. This bill clarifies VA's duty to assist veterans with their
claims.
Over the last few months, the Committee on Veterans' Affairs has
worked closely with the Veterans Administration, the Senate Committee
on Veterans' Affairs, and the veterans service organizations on this
bill.
Passage of this bill today will restore the balance in the VA claims
system. Although this legislation will require some claims to be
redone, it is the right thing to do.
I urge my colleagues to support H.R. 4864.
Madam Speaker, I include an explanatory statement on H.R. 4864, as
amended, as follows:
Explanatory Statement on H.R. 4864, As Amended
H.R. 4864, as amended, reflects a compromise agreement that
the House and Senate Committees on Veterans Affairs have
reached on H.R. 4864 and section 101 of S. 1810. H.R. 4864,
the Veterans Claims Assistance Act of 2000, passed the House
on July 25, 2000 (hereinafter referred to in context as the
``House Bill''). On September 21, 2000, the Senate passed S.
1810, the Veterans Programs Enhancement Act of 2000
(hereinafter referred to in context as the ``Senate Bill'').
The House and Senate Committees on Veterans Affairs have
prepared the following explanation of H.R. 4864, as amended
(hereinafter referred to as the ``Compromise Agreement'').
Differences between the provisions contained in the
Compromise Agreement and the related provisions of H.R. 4864
and section 101 of S. 1810 are noted in this document, except
for clerical corrections, conforming changes made necessary
by the Compromise Agreement and minor drafting, technical and
clarifying changes.
background
The Department of Veterans Affairs' (VA) system for
deciding benefits claims ``is unlike any other adjudicative
process. It is specifically designed to be claimant friendly.
It is non-adversarial; therefore, the VA must provide a
substantial amount of assistance to a veteran seeking
benefits.'' H. Rept. No. 105-52, at 2 (1997). Chapter 51 of
title 38, United States Code, provides the general
administrative provisions relating to processing of claims
for veterans benefits. In particular, section 5107 of title
38, United States Code, states that it is a veteran's
responsibility to submit evidence of a ``well-grounded''
claim, and the Secretary shall assist a veteran in developing
the facts pertinent to the claim. Such assistance
historically has included requesting service records, medical
records and other documents identified by the veterans.
On July 14, 1999, the U.S. Court of Appeals for Veterans
Claims ruled in Morton v. West, 12 Vet. App. 477, remanded on
other grounds _F.3d_, 2000 U.S. App. LEXIS 22464 (Fed. Cir.,
August 17, 2000), that VA has no authority to develop claims
that are not ``well-grounded,'' and invalidated VA manual
provisions which directed regional offices to undertake full
development of all claims. This and previous court decisions
construing the meaning of section 5107 of title 38, United
States Code, have constructed a significant barrier to
veterans who need assistance in obtaining information and
evidence in order to receive benefits from the VA.
Definition of ``Claimant'' for Purposes of Veterans Claims
Current Law
Chapter 51 of title 38, United States Code, refers to an
applicant for veterans benefits as a ``claimant,'' but does
not provide a definition of the term.
House Bill
Section 2 of H.R. 4864 would amend chapter 51 of title 38,
United States Code, by adding a new section at the beginning
of the chapter. The new section would define the term
``claimant'' to mean ``any individual applying for, or
submitting a claim for, any benefit under the laws
administered by the Secretary.''
Senate Bill
Section 101(a) of S. 1810 would add a new section 5101 to
title 38, United States Code, to define the term ``claimant''
as ``any individual who submits a claim for benefits under
the laws administered by the Secretary.''
Compromise Agreement
Section 2 of the compromise agreement follows the House
language.
Assistance to Claimants
application forms; notices to claimants of incomplete applications
Current law
Section 5102 of title 38, United States Code, provides that
the Secretary shall furnish,
[[Page H9914]]
upon request made in person or in writing by any person
claiming or applying for benefits, all printed instructions
and forms necessary to establish a claim for veterans
benefits at no cost to the claimant.
Section 5103 of title 38, United States Code, provides that
if a claimant's application for benefits is incomplete, the
Secretary shall notify the claimant of the evidence necessary
to complete the application. It further provides that in the
event that the additional evidence is not received within one
year from the date of notification, no benefits may be paid
by reason of the incomplete application. Section 5103 does
not apply to any application or claim for Government life
insurance benefits. Section 5103 also provides that benefits
may be not be denied on the basis that the claimant does not
have a mailing address.
The Secretary of Veterans Affairs' duty to assist claimants
is codified at section 5107(a) of title 38, United States
Code. The courts have held that the Secretary's duty to
assist claimants does not arise until a claimant has first
submitted a ``well-grounded'' claim.
House Bill
Section 3 of H.R. 4864 substantially revises current
sections 5102, 5103, and 5107 of title 38, United States
Code. The ``duty to assist'' provision would be transferred
from section 5107 of title 38 to section 5103. As revised,
section 5102 would contain almost all of existing sections
5102 and 5103. Subsection (a) of the proposed section 5102 is
identical to existing section 5102. Subsections (c) and (d)
of proposed section 5102 are identical to subsections (a) and
(b) of existing subsection 5103. Proposed section 5102(b)
contains the provisions of subsection (a) of existing section
5103. Proposed subsection 5102(b) clarifies the Secretary's
obligation to send notices to the claimant and the claimant's
representative, and to advise the claimant and the claimant's
representative as to information the claimant must submit to
complete the application. It also would require the Secretary
to notify the claimant (and the claimant's representative) of
any additional information and medical and lay evidence
necessary to substantiate the claim, and which portion of
such evidence is to be provided by the claimant and which
portion, if any, the Secretary will attempt to obtain.
Senate Bill
Section 101(b) of S. 1810 would amend existing section
5103(a) by striking ``evidence'' both places it appears and
inserting ``information,'' in order to clarify that claimants
will not be obligated to present any evidence upon initial
application for benefits.
Subsection (c) of proposed section 5103A (as added by
section 101(c)) would require VA to notify the claimant and
the claimant's representative of the information and medical
or lay evidence needed in order to aid in the establishment
of eligibility for benefits, and inform the claimant and his
or her representative what information under subsection
(c)(1) the Secretary was unable to obtain.
Compromise Agreement
Proposed section 5102(a) would require the Secretary to
furnish all instructions and forms necessary when a request
is made, or an intent is expressed, by any person applying
for veterans benefits. It is the Committees' intent that such
a request might be made by using various modes of
communication--electronic, telephonic, written, or personal.
The removal of the ``in person or in writing'' requirement
from current section 5102 of title 38, United States Code, is
not intended to change current VA regulations with respect to
the definition of a claim or the requirements concerning what
communication is sufficient to treat the communication as an
informal claim. By removing the restriction on requests ``in
person or in writing,'' the Committees intend to permit
veterans and VA to use current and future modes of
communication. The Committees expect VA to appropriately
document its communications with veterans regardless of the
form of communication used.
The compromise version of revised section 5103 of title 38,
United States Code, substantially maintains the current
provisions of section 5103. However, it renames the title of
the section as ``Notice to claimants of required information
and evidence'' to more accurately reflect the section's
purpose. The compromise agreement enhances the notice that
the Secretary is now required to provide to a claimant and
the claimant's representative regarding information that is
necessary to complete the application. The notice would
inform the claimant what information (e.g., Social Security
number, address, etc.), and what medical evidence, (e.g.,
medical diagnoses and opinions on causes or onset of the
condition, etc.) and lay evidence (e.g., statements by the
veteran, witnesses, family members, etc.) is necessary to
substantiate the claim. The notice would also specify which
portion of this information and evidence is to be provided by
the Secretary or by the claimant.
The compromise agreement also maintains the language in
current section 5103 relating to time limits, but expands
that language to include ``information or evidence.'' It is
not the Committees' purpose to modify the historical
application of this provision, nor do the Committees intend
that this section be interpreted as a hypertechnical bar to
benefits. For example, if the Secretary notices a claimant to
submit three pieces of information or evidence, and the
claimant submits only two of the specified items, which are
sufficient evidence for VA to grant the claim, then VA must
act at that point. The failure to submit the additional
information would not be grounds for barring payment of
benefits of an otherwise established claim.
The Committees have agreed to use the phrase ``information
. . . and evidence . . . that is necessary to substantial the
claim'' [emphasis added] in appropriate places in revised
sections 5103 and 5103A. This wording is used in lieu of
phrases such as ``establishment of the eligibility of the
claimant'' (S. 1810) or ``establishment of eligibility for
the benefits sought'' (H.R. 4864). Although all three phrases
convey a similar if not identical purpose, the Committees
believe that they have chosen a less ambigioius and more
objective test for the types of evidence that could be useful
to the Secretary in deciding the claim. If information or
evidence has some probative value, there must be an effort
made to obtain it or to explain to the claimant how he or she
might obtain it.
It is the Committees' intent that the verb ``to
substantiate,'' as used in this subsection and throughout the
compromise bill (cf., proposed 5103A(a), 5103A(2), 5103A(g))
be construed to mean ``tending to prove'' or ``to support.''
Information or evidence necessary to substantiate a claim
need not necessarily prove a claim--although it eventually
may do so when a decision on a claim is made--but it needs to
support a claim or give form and substance to a claim.
SECRETARY'S DUTY TO ASSIST CLAIMANTS: GENERAL DUTY TO ASSIST
House Bill
Proposed subsection (a) of new section 5103 is a revision
of language currently found in section 5107(a), which
requires the Secretary to assist claimants who have filed a
``well-grounded'' claim. As revised, the Secretary would be
obligated to assist a claimant in obtaining evidence that is
necessary to establish eligibility for the benefit sought.
The well-grounded claim requirement would be eliminated.
However, the Secretary would be able to decide a claim
without providing assistance under this subsection when no
reasonable possibility exists that such assistance would aid
in the establishment of eligibility for the benefit sought.
Senate Bill
Subsection (a) of proposed section 5103A would require the
Secretary to make reasonable efforts to assist in the
development of information and medical and lay evidence
necessary to establish the eligibility of a claimant for
benefits. It eliminates the well-grounded claim requirement.
Subsection (b) provides that the Secretary is not required
to provide assistance to a claimant under subsection (a) if
no reasonable possibility exists that such assistance would
aid in the establishment of the eligibility of the claimant
for benefits.
Compromise Agreement
Section 3 of the compromise agreement would require the
Secretary to make reasonable efforts to assist a claimant in
obtaining evidence necessary to substantiate the claimant's
claim for the benefit sought. The exact type of assistance,
such as obtaining documentary evidence or medical
examinations or opinions, is not specified in this section
since the type of assistance needed for each claim will vary
depending upon the benefit sought. This lack of specificity
is not intended to limit the type of assistance required or
rendered. However, the Secretary is not required to assist a
claimant if no reasonable possibility exists that such
assistance would aid in substantiating the claim. Under this
section, the Secretary may defer providing assistance pending
the submission by the claimant of essential information
missing from the claimant's application.
assistance in obtaining records
House Bill
Proposed subsection (b) of the new section 5103 clarifies
the Secretary's obligation to assist a claimant in obtaining
evidence that is relevant to a particular claim. Under the
House bill, the Secretary would be required to make
reasonable efforts to obtain relevant records that the
claimant adequately identifies and authorizes the Secretary
to obtain. Subsection (b) would also require that the
Secretary provide notice to the claimant if the effort to
obtain records is unsuccessful and briefly explain the
Secretary's efforts to obtain such records, describe any
further actions to be taken by the Secretary, and allow the
claimant a reasonable opportunity to obtain the records
before the claim is decided and notify the Secretary of such
actions.
Senate Bill
The Senate bill does not specifically provide for general
assistance to secure records, but considers that obligation
as part of VA's duty to assist claimants in the development
of information and evidence necessary to establish
entitlement to benefits.
Compromise Agreement
Under section 3, the Secretary would be required to make
reasonable efforts to obtain relevant records, including
private records, that the claimant adequately identifies and
authorizes the Secretary to obtain. In an effort to keep the
claimant informed about the status of the development of his
or her claim, the Secretary would be required to notify the
claimant when the Department is unable to obtain records. The
notice would identify the records the Secretary is unable to
obtain, provide a brief explanation of the
[[Page H9915]]
efforts that the Secretary has made to obtain those records,
and describe any further action to be taken by the Secretary
with respect to the claim. The Secretary would be required to
continue attempts to obtain the records from a Federal
department or agency until it is reasonably certain that the
records do not exist or that further efforts to obtain them
would be futile.
obtaining records for compensation claims
House Bill
Proposed subsection (c) of section 5103 would provide for
special rules for obtaining evidence in disability
compensation claims. For this type of claim, the Secretary
would always be obligated to obtain (1) existing service
medical records, and other relevant service records if the
claimant has provided sufficient locator information, (2)
records of treatment or examination at Department health care
facilities, if the claimant has provided information
sufficient to locate such records, and (3) records in the
possession of other Federal agencies if such records are
relevant to the veteran's claim.
Senate Bill
Subsection (d) of the proposed 5103A would specify the
assistance to be provided by the Secretary to a claimant
applying for disability compensation. The Secretary would be
obligated to obtain (1) relevant service and medical records
maintained by applicable governmental entities that pertain
to the veteran for the period or periods of the veteran's
service in the active military, naval, or air service, (2)
existing records of relevant medical treatment or
examinations provided at Department health care facilities or
at the expense of the Department but only if the claimant has
furnished information sufficient to locate such records, (3)
relevant records from adequately identified governmental
entities authorized by the claimant to be released, and (4)
relevant records from adequately identified private person or
entities authorized by the claimant to be released. Efforts
to obtain governmental records would be required to continue
until it is reasonably certain, as determined in accordance
with the regulations prescribed under subsection (f) that
such records do not exist.
Compromise Agreement
Recognizing that VA has a higher burden in securing records
maintained by VA and other governmental agencies, section 3
of the compromise agreement requires the Secretary to obtain
the claimant's service medical records and other relevant
records pertaining to the claimant's active military, naval,
or air service that are maintained by a governmental entity
if the claimant provides sufficient information to locate
them. By use of the term ``governmental entity,'' it is the
Committees' intention that VA also secure relevant records
maintained by state national guard and reserve units, as they
may provide important information relating to the veteran's
service history.
medical examinations for compensation claims
House Bill
In the case of a claim for disability compensation,
subsection (d) of proposed section 5103 would require the
Secretary to provide a medical examination or obtain a
medical opinion when the Secretary has established that (1)
the claimant has (a) a current disability, (b) current
symptoms of a disease that may not be characterized by
symptoms for extended periods of time, or (c) persistent or
recurrent symptoms of disability following discharge from
service, and (2) there was an in-service event, injury, or
disease (or combination of events, injuries, or diseases)
during the claimant's active military, naval, or air service
which could have caused or aggravated the current disability
or symptoms, but (3) the evidence ``on hand'' is insufficient
to establish service connection.
Senate Bill
Proposed section 5103A(d) would require VA to provide a
medical examination needed for the purpose of determining the
existence of a current disability if the claimant submits
verifiable evidence, as determined in accordance with the
regulations prescribed under subsection (f), establishing
that the claimant is unable to afford medical treatment.
Proposed subsection (e) provides that, while obtaining or
after obtaining information or lay or medical evidence under
subsection (d) of proposed 5103A, the Secretary determines
that a medical examination or a medical opinion is necessary
to substantiate entitlement to a benefit, the Secretary would
then provide such medical examination or obtain such medical
opinion.
Compromise Agreement
Under section 3 of the compromise agreement, proposed
section 5103A(d) provides that in the case of a claim for
disability compensation, the Secretary shall provide a
medical examination or obtain a medical opinion when such an
examination or opinion is necessary to make a decision on the
claim. Taking into consideration all information and lay or
medical evidence (including statements of the claimant), an
examination would be necessary if the evidence of record (a)
contains competent evidence that the claimant has a current
disability, or persistent or recurrent symptoms of a
disability and, (b) indicates that the disability or symptoms
may be associated with the claimant's active military, naval,
or air service but, (c) does not contain sufficient medical
evidence for the Secretary to make a decision on the claim.
It is the Committees' intent that the term ``disability''
cover both injuries and diseases, including symptoms of
undiagnosed illnesses.
In the revised section 5103A, the Committees have agreed to
use the phrase ``if the evidence of record . . . taking into
consideration all information and lay or medical evidence
(including statements of the claimant) . . . contains
competent evidence . . . that the claimant has a current
disability, or persistent or recurrent symptoms of
disability'' [emphasis added] as the threshold for when VA
must obtain a medical examination or opinion for compensation
claimants. This wording is used to describe evidence that is
``fit for the purpose for which it is offered.'' U.S. v.
DeLucia, 256 F.2d 487, 491 (7th Cir. 1958). Competent
evidence would be evidence that is offered by someone capable
of attesting to it; it need not be evidence that is credible
or sufficient to establish the claim. A veteran (or
layperson) can provide competent evidence that he or she has
a pain in the knee since that evidence is fit for the purpose
for which it is offered. However, VA would not be bound to
accept a veteran's assertion that he has a torn ligament, for
that would require more sophisticated information, such as
the results of a medical examination or special medical
testing. The Committees emphasize that medical examinations
or medical opinions may be needed in order for the Secretary
to fulfill the duty to assist in other situations not
mandated by this section under the general duty to assist
required in section 3.
regulations
House Bill
Proposed subsection 5103(e) would require the Secretary to
prescribe regulations (1) specifying the evidence needed to
establish a claimant's eligibility for a benefit and (2)
defining the records that are relevant to a claim.
Senate Bill
Proposed subsection 5103A(f) of S. 1810 would require the
Secretary to prescribe regulations for purposes of the
administration of new section 5103A.
Compromise Agreement
Section 3 of the compromise agreement would require the
Secretary to prescribe regulations in order to carry out this
section. It is the Committees' intent that these regulations
address the provisions of the language described above under
``House Bill.''
rule with respect to disallowed claims
House Bill
Proposed subsection (f) of section 5103 would specify that
nothing in section 5103 would be construed to require the
Secretary to reopen a claim that had been disallowed except
when new and material evidence is presented or secured, as
described in section 5108 of title 38, United States Code.
Senate Bill
S. 1810 does not contain a similar provision.
Compromise Agreement
Section 3 of the compromise agreement follows the House
language.
other assistance not precluded
House Bill
Proposed subsection (g) of section 5103 would clarify that
nothing in section 5103 would be construed as precluding the
Secretary from providing such other assistance to a claimant
as the Secretary considers appropriate.
Senate Bill
Proposed subsection 5103A(d)(1)(F) would provide that the
Secretary would provide any other appropriate assistance not
specifically listed in section 5103(d).
Compromise Agreement
Section 3 of the compromise agreement follows the House
language.
reenactment of rule for claimants lacking a mailing address
House Bill
Proposed section 3(b) of H.R. 4864 would recodify the
language found at section 5103(c) as a new section 5126 of
title 38, United States Code.
Senate Bill
S. 1810 does not contain a similar provision.
Compromise Agreement
Section 3 of the compromise agreement follows the House
language.
Decision on Claim
Current Law
Under section 5107(a) of title 38, United States Code, a
person who submits a claim for benefits has the burden of
submitting evidence sufficient to justify a belief by a fair
and impartial individual that the claim is ``well-grounded.''
In order to file a ``well-grounded'' disability compensation
claim, the court has ruled that the claimant must present
evidence of 1) a current disability, 2) an in-service
incidence or aggravation of a disease or injury, and 3) a
nexus between the in-service disease or injury and the
current disability. Caluza v. Brown, 7 Vet. App. 498 (1995)
aff'd 78 F.3d 604 (Fed. Cir. 1996 table). Once that burden
had been met, the Secretary must assist the claimant in
developing the facts pertinent to the claim.
Under section 5107(b) of title 38, United States Code, the
Secretary is required to give claimant the benefit of the
doubt in resolving each material issue where there is an
[[Page H9916]]
approximate balance of positive and negative evidence
regarding the merits of the issue. Subsection (b) also
provides that nothing in that subsection shall be construed
as shifting the burden of establishing a well-grounded claim
from the claimant to the Secretary.
House Bill
Section 4 of the House bill would revise section 5107 of
title 38, United States Code, to eliminate the requirement
that a veteran submit a ``well-grounded'' claim. The proposed
revision of section 5103 discussed above sets out the
authority for the Secretary to provide assistance to a
claimant. Thus, the extent to which the Secretary conducted a
separate threshold examination of the evidence provided in
support of a claim are addressed in that section. The revised
section 5107 would restate, without any substantive change,
the requirements in existing law that the claimant has the
burden of proving entitlement to benefits and that the
Secretary must provide the benefit of the doubt to the
claimant when there is an approximate balance of positive and
negative evidence regarding a material issue.
Senate Bill
Section 101(e) of S. 1810 would amend section 5107 of title
38, United States Code, to eliminate the requirement that
claimants submit evidence sufficient to justify the belief
that the claim is ``well-grounded'' before VA will execute
its duty to assist. Section 5107(a), as amended, would
specify that the burden of proof to establish entitlement to
VA benefits remains with the claimant. Section 5107(b), as
amended, retains the language in current section 5107(b)
requiring that claimants be given the ``benefit of the
doubt'' when there exists an approximate balance of positive
and negative evidence.
Compromise Agreement
Proposed section 5107(a) of the compromise agreement
provides that a claimant has the responsibility to present
and support a claim for the benefit sought. As under current
law, the Secretary would be required to consider all
information and lay and medical evidence of record, and when
there is an approximate balance of positive and negative
evidence regarding an issue material to the determination of
a matter, the Secretary would be required to give the benefit
of the doubt to the claimant.
Prohibition of Charges for Records Furnished by Other Federal
Departments and Agencies
Current Law
Section 5106 of title 38, United States Code, provides that
in obtaining evidence for the development of a claim for
veterans benefits, Federal departments or agencies shall
provide information that the Secretary requests to determine
eligibility for, or the amount of benefits, or to verify
other information necessary to adjudicate a claim.
House Bill
Section 5 of the House bill adds a new sentence to section
5106 to provide that Federal departments or agencies shall
furnish the Department of Veterans Affairs with records
pertaining to a benefits application without charge.
Senate Bill
Proposed section 5103A(d) provides that the costs of
providing VA with information are to be borne by the
department or agency supplying the information.
Compromise Agreement
Section 5 of the compromise agreement follows the Senate
language.
Effective Date
House Bill
Section 6 of the House bill provides that, in general, the
provisions in the bill would apply to claims filed on or
after the date of enactment and to claims which are not final
as of that date. Subsection (b) of section 6 would establish
a special rule providing retroactive relief on claims which
were not final or which were dismissed was not ``well-
grounded'' beginning on July 14, 1999 (the effective date of
the Morton decision). In such cases, the Secretary would
order the claim to be readjudicated at the request of the
claimant or on the Secretary's own motion. Subsection (b)(2)
would provide that a motion to readjudicate the claim would
have to be made within two years from the date of enactment,
while subsection (b)(3) would relieve the Secretary, in the
absence of a motion to readjudicate, of any obligation to
locate and readjudicate claims which might be affected by the
change in law described in this subsection.
Senate Bill
The Senate provision is virtually identical to the House
bill.
Compromise Agreement
Section 7 of the compromise agreement contains this
provision.
Madam Speaker, I reserve the balance of my time.
Mr. EVANS. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I rise in strong support of the Veterans Claims
Assistance Act of 2000, H.R. 4864, and I thank every individual who
helped perfect this measure, particularly the gentleman from Arizona
(Chairman Stump). This has broad-based bipartisan, bicameral support;
and it is worthy of the support of every Member of this House.
Last fall, after the Department of Veterans Affairs implemented the
Morton versus West decision of the United States Court of Appeals for
veterans claims, I introduced H.R. 3193, the Duty to Assist Act. This
legislation was introduced to correct erroneous interpretations of the
law. Judicial review was intended to continue VA's long-standing
obligation to assist all veterans develop their claims. Under this
decision, the exact opposite has occurred.
On March 23, 2000, the Subcommittee on Benefits held a hearing on my
bill. Following that, a bipartisan compromise, H.R. 4864, was
introduced.
I am especially pleased all critical providings of H.R. 3193 have
been perfected and incorporated into H.R. 4864's amendment. These
include the removal of the well-grounded claim requirement, specific
notice requirements, duty to assist all claimants, additional specific
requirements for service-connected disability claims.
I strongly believe in judicial review. However, the courts can, and
do, make erroneous decisions. When those decisions affect the
fundamental rights of veterans, it is Congress' responsibility to
correct the problem. I believe this measure will do this.
Madam Speaker, I urge my colleagues to support the Veterans Claims
Assistance Act of 2000, H.R. 4864.
Madam Speaker, the Veterans Claims Assistance Act of 2000, H.R. 4864,
is the product of hard work of many people. Members of the Veterans'
Affairs Committees of both bodies, Democratic and Republican committee
staff from both bodies, representatives of veterans service
organizations and the administration have all contributed to this
measure. I thank each individual who has helped perfect this measure
and I particularly thank Chairman Stump for his leadership in crafting
H.R. 4864, which has broad bipartisan, bicameral support.
Last fall, after the Department of Veterans Affairs (VA) implemented
the Morton v. West decision of the United States Court of Appeals for
Veterans Claims, I introduced H.R. 3193, the Duty to Assist Act. This
legislation was introduced to correct erroneous interpretations of law.
Judicial review was intended to continue VA's long standing obligation
to assist all veterans with the development of their claims. Under the
Morton decision, the exact opposite occurred.
On March 23, 2000, the Subcommittee on Benefits held a hearing on my
bill and the problems experienced by veterans under the well-grounded
claim requirement. A number of suggestions were made during this
hearing and in subsequent meetings with representatives of the VA and
veterans service organizations. As a result, a bipartisan compromise
bill H.R. 4864, was introduced. The other body also addressed this
problem in a provision included in S. 1810. The compromise bill we are
considering today, H.R. 4864, as amended by the other body, includes
elements of bills passed by both houses of Congress.
I am especially pleased that all of the critical provisions from H.R.
3193 have been perfected and incorporated into H.R. 4864. These
include:
removal of the well-grounded claim requirement
First and most importantly, the bill eliminates the requirement that
a veteran submit a well-grounded claim before VA is required to offer
any help to a veteran in the development of his or her claim.
Unfortunately for veterans and their survivors, the requirement to
submit a well-grounded claim gradually increased from the concept of a
uniquely low threshold, to a significant barrier, requiring veterans to
purchase medical evaluations and opinion before their claims could be
considered on their merits. Claims of combat-injured veterans were
denied before VA adjudicators even obtained copies of the veterans'
service medical records. Veterans who were being discharged from
military service because of a disability had their claim for service-
connected disability benefits for that disability denied as not well-
grounded. In some of these cases, the veteran later supplied copies of
their military and other medical records and had benefits awarded after
multiple decision concerning the ``well-groundedness'' of various parts
of the claim. In other cases, I fear that deserving veterans have just
gone away, feeling betrayed by the government they have served so
honorably.
By removing the well-grounded claim requirement, I expect that the VA
will proceed in a fair and reasonable fair manner to identify and
obtain all of the relevant evidence necessary to make an accurate
decision on the claim when it is first presented. While some claims may
ultimately be denied, by obtaining and reviewing all of the relevant
evidence first, veterans will be assured that their claims have been
fairly and fully considered.
specific notice requirements
I am particularly concerned that the notices sent to veterans often
do not contain clear information that enables the veteran to understand
what actions VA has taken or will take
[[Page H9917]]
and what information or evidence the veteran should provide. If VA is
requesting the veteran to supply information such as employment
information or school records of children, the notice should provide
enough information in clearly understandable language for the veteran
to understand what is being requested. Following the Morton decision
many veterans received virtually indecipherable notices advising them
that their claim was ``not well-grounded''. I encourage the VA to
continue developing communications using plain English which the
majority of beneficiaries can be expected to understand. The compromise
bill expands upon the notice requirements specified in H.R. 3193.
duty to assist all claimants
The compromise bill makes it clear that VA has a duty to make
reasonable efforts to assist all claimants in obtaining evidence needed
to substantiate their claim. What is reasonable will depend upon the
nature of the claim being pursued and the evidence which is needed to
establish that claim. If a medical examination or opinion is needed VA
is required to provide it. If private medical records are needed, VA
should request the records from the treating source with the consent of
the veteran claimant.
additional specific requirements for service-connected disability
claims
The compromise bill contains specific special requirements for the
adjudication of service-connected disability claims. These requirements
recognize that certain actions are always necessary to the proper
development of claims for service-connected compensation benefits and
are therefore mandated.
The Committees have determined that because of special responsibility
of the government for claims for service-connected compensation
benefits that there are certain circumstances when VA may not proceed
to decide a claim without first obtaining a medical examination or
opinion. If the record contains competent evidence that the claimant
has a current disability or symptoms and indicates that the disability
or symptoms may be associated with the claimant's military service, but
the medical evidence is insufficient to make a determination on the
claim, VA must obtain a medical evaluation or opinion. If the evidence
is sufficient to decide the claim, VA may proceed to decide it.
I am particularly concerned with the number of cases reviewed by
Committee staff in which VA has evidence of a current disability and an
indication of a potential in-service incident or series of events which
may have caused or aggravated the disability, but VA has failed to
obtain a medical opinion concerning the relationship between the two.
For example, under this provision, I expect that if a veteran's
military records indicate he served as a paratrooper, making multiple
jumps during service in Vietnam and the veteran now has evidence of
arthritis of the knees he indicates was due to these jumps, VA will be
required to obtain a medical opinion as to whether it is as likely as
not that his current arthritis is related to his military service.
I recognize that some concerns have been raised that because the bill
mandates certain procedures in some circumstances and not in others, VA
will refuse to comply with its general duty to assist contained in the
amended section 5103A(a)(1) of title 38. I do not believe that in
implementing this law, VA will refuse to comply with its general duty
to assist.
The general duty to assist section is intended to provide VA with the
flexibility to make whatever reasonable efforts are needed in order to
properly adjudicate the particular claim. If a pension applicant needs
a medical examination to determine disability, I fully expect VA to
provide a medical examination. If a medical evaluation or opinion is
needed to resolve conflicts in the medical evidence related to a
service-connected claim, I fully expect VA to obtain the requisite
examination or opinion. the special provisions mandated for service-
connected claims in some circumstances is not, and should not be
interpreted by VA, as a license to ignore the general duty to assist
provided in the same bill.
I strongly believe in judicial review. However, courts can--and do--
make erroneous decisions. When those decisions affect the fundamental
rights of veterans, it is Congress' responsibility to correct the
problem. H.R. 4864, as amended, will do this.
Veterans seeking to establish their entitlement to benefits they have
earned as a result of their service to our country deserve to have
their claims decided fairly and fully based upon all relevant and
available evidence. Where it is as likely as not that a disability was
incurred or aggravated during military service, the benefit of the
doubt rule dictates that the disability will be service-connected.
Passage of H.R. 4864 will help to assure that their claims are properly
considered and fairly decided.
Madam Speaker, I reserve the balance of my time.
Mr. STUMP. Madam Speaker, I yield such time as he may consume to the
gentleman from Nevada (Mr. Gibbons), a member of the committee.
Mr. GIBBONS. Madam Speaker, to the gentleman from Arizona (Mr.
Stump), my friend and colleague, the distinguished chairman of the
Committee on Veterans' Affairs, I want to thank him for his leadership,
as well as the gentleman from Illinois (Mr. Evans), the ranking member,
for his contributions and leadership to this very important issue.
Madam Speaker, I am pleased to rise today in support of H.R. 4864, as
amended, the Veterans Claims Assistance Act of 2000. The members of the
Subcommittee on Benefits have worked for the past 7 months on crafting
legislation to address the Morton versus West decision by the Court of
Appeals for veterans claims. H.R. 4864, as amended, meets that
challenge.
This and previous court decisions have construed VA's authority to
develop claims that are not what is legally referred to as well
grounded, and the results have created a significant barrier to
veterans who need assistance in obtaining information and evidence in
order to receive benefits from the VA.
Among other things, H.R. 4864, as amended, requires the Secretary to
furnish all necessary forms and instructions to file a claim when a
request is made and requires the Secretary to make reasonable efforts
to assist in the development of information and medical and lay
evidence necessary to establish eligibility of a claimant for benefits.
{time} 1215
This bill eliminates the ``well grounded'' requirements.
With regard to compensation claims, this bill requires the Secretary
to obtain the claimant's service medical records and other relevant
records pertaining to the claimant's active military service, if the
claimant provides sufficient information to locate them, and requires
the Secretary to provide a medical examination or obtain a medical
opinion when such an exam or opinion is necessary to make a decision on
that claim.
As the chairman has indicated, we have been working with the VA
officials and members of veterans service organizations to develop a
bill that addresses the concerns of all interested parties, and I
believe we have succeeded in this bill. I want to thank the chairman
and the ranking member once again for their leadership, and I urge my
colleagues to support H.R. 4864 as amended.
Mr. EVANS. Madam Speaker, I have no further requests for time, and I
yield back the balance of my time.
Mr. STUMP. Madam Speaker, I yield myself such time as I may consume
to thank the ranking member of the committee, the gentleman from
Illinois (Mr. Evans), and express my appreciation for his efforts on
behalf of this legislation.
I also want to thank the members of the Subcommittee on Benefits, and
the chairman in particular, for all their hard work on H.R. 4864.
I would also like to tell my colleagues about the hard work performed
by the chairman of the Subcommittee on Benefits, the gentleman from New
York (Mr. Quinn), during the 106th Congress. This Congress has been a
very good one for veterans, due in no small part to the extraordinary
energy of the gentleman from New York. He has done a commendable job
leading a subcommittee that deals with very difficult and sometimes
emotional issues, and I thank him very much for all his hard work.
I would also like to thank the gentleman from Nevada (Mr. Gibbons), a
member of the committee, for his contributions to this bill.
Mr. FILNER. Madam Speaker, I thank the Chairman, Mr. Stump and the
Ranking Member of the Full Committee, Mr. Evans for their hard work in
bringing the Veterans Claims Assistance Act of 2000, H.R. 4864 as
amended, before us today.
Following the U.S. Court of Appeals for Veterans Claims decision in
Morton v. West thousands of veterans throughout this country received
letters from VA telling them that their claims for disability benefits
were ``not well-grounded.'' In many cases, the notices were
incomprehensible to veterans.
Veterans were told that they had to submit evidence of a ``nexus''
between their military service and current disability before VA would
provide them any help at all. Claims of combat injured veterans were
denied before records of military service were obtained.
[[Page H9918]]
In our subcommittee hearing on Mr. Evan's bill we heard eloquent
testimony about the seriousness of the problem.
Veterans with claims for service-connected disabilities which were
noted in their service medical records had those claims rejected as
``not well-grounded.''
Veterans being treated by VA physicians were denied VA medical
opinions concerning the relationship between their disability and their
military service and were thus unable to provide ``nexus'' statements
VA required without purchasing medical opinions at their own expense.
Vietnam veterans with conditions presumed under law to be service-
connected as a result of Agent Orange exposure had claims rejected as
not well-grounded.
Medal of Honor winners and former Prisoners of War had their claims
rejected.
This bill will rectify those errors. In addition, the bill contains
very specific notice requirements. Even as a former college professor,
I have found notices sent to veterans who contact my office, both here
and in San Diego, to be virtually incomprehensible. The compromise bill
passed by the Senate requires VA to inform veterans when additional
information is needed. If VA is unable to obtain records identified by
the claimant, VA is required to notify the claimant that the records
were not obtained, describe the efforts made to obtain the records and
describe the action to be taken by the Secretary. These provisions were
inserted to assure that veterans are able to make informed decisions
concerning their claims. I expect VA to provide this information in
simple, plain, understandable English.
By passing H.R. 4864, this House agreed that veterans and other
claimants have a right to have their claims fully developed and
properly evaluated. The Senate has now agreed.
By passing this bill Congress will send a strong message to the VA
and our Nation's veterans concerning our government's obligation to
care for him who has borne the battle. I urge my colleagues to support
this bill.
Mr. GILMAN. Madam Speaker, I rise today in strong support of H.R.
4864, the Veterans' Claims Assistance Act of 2000. I urge my colleagues
to join in supporting this worthy legislation.
H.R. 4864, authorizes the Secretary of Veterans Affairs to assist a
veteran claimant in obtaining evidence to establish an entitlement to a
benefit. The bill achieves this by requiring the Secretary of Veterans
Affairs to make reasonable efforts to obtain relevant records that the
claimant identifies, unless there is no reasonable possibility that
assistance would aid in substantiating the claim. Also, the measure
eliminates the requirement that a claimant submit a ``well-grounded''
claim before the Secretary can assist in obtaining evidence.
For service-connected disability compensation claims, H.R. 4864
requires the Secretary to obtain existing service medical records and
other relevant records pertaining to the claimant's active military,
naval, or air service that are maintained by the Government if the
claimant provides sufficient information to locate them, and provide a
medical examination or obtain a medical opinion when such an
examination (or opinion) is necessary to make a decision on the claim.
The bill further requires other Federal agencies to furnish relevant
records to the Department at no cost to the claimant.
Under the bill a ``claimant'' is a person who would be eligible to
receive assistance from the Veterans Secretary as any person seeking
veterans benefits. The Secretary would be required to give the benefit
of the doubt to the claimant when there is an approximate balance of
positive and negative evidence regarding an issue material to the
determination of a matter.
Finally, H.R. 4864 permits veterans who had claims denied or
dismissed after the court of appeals for veterans claims decision in
Morton v. West to request review of those claims within a 2-year period
following enactment.
Madam Speaker, the VA claims process was initially intended to be
friendly to the veterans. In recent years, however, the system has been
plagued by unacceptably long delays and far too many bureaucratic
hurdles. Earlier this year, the House addressed the issue of
timeliness. This bill seeks to remove one of the barriers that has
recently arisen to block the successful resolution of many claims.
In July 1999, the court of appeals for veterans claims stated in the
case of Morton v. West that the Veterans Administration (VA) could help
a veteran obtain records relevant to a claim only after the veteran
provided enough evidence to prove that the claim is ``well-grounded.''
This decision, not only prevents the VA from providing assistance to
veterans, it has also led to confusion concerning the meaning and
application of the ``well grounded'' claim requirement. H.R. 4864
clarifies the ``well grounded'' claim requirement and enables the VA to
once again provide as much assistance as possible to veterans.
Accordingly, I urge my colleagues to support this important
legislation.
Mr. STUMP. Madam Speaker, I have no further requests for time, and I
yield back the balance of my time.
The SPEAKER pro tempore (Mrs. Morella). The question is on the motion
offered by the gentleman from Arizona (Mr. Stump) that the House
suspend the rules and concur in the Senate amendment to the bill, H.R.
4864.
The question was taken; and (two-thirds having voted in favor
thereof) the rules were suspended and the Senate amendment was
concurred in.
A motion to reconsider was laid on the table.
____________________