[Congressional Record Volume 156, Number 94 (Tuesday, June 22, 2010)]
[Senate]
[Pages S5270-S5275]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA:
  S. 3517. A bill to amend title 38, United States Code, to improve the 
processing of claims for disability compensation filed with the 
Department of Veterans Affairs, and for other purposes; to the 
Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, as Chairman of the Senate Committee on 
Veterans' Affairs, I introduce the proposed Claims Processing 
Improvement Act of 2010, to focus on enhancements that can be made to 
adjudicate veterans' disability compensation claims in a more timely 
and accurate manner.
  VA has seen a dramatic rise in the number of claims, driven by a 
number of factors, including the aging of the general veteran 
population and our prolonged involvement in two overseas conflicts. 
Further complicating matters, many claims are increasing in complexity, 
as veterans seek service-connection for multiple disabilities and for 
disabilities that are difficult to diagnose, such as traumatic brain 
injury and post traumatic stress disorder.
  Claims adjudication is an intricate process that has seen many 
piecemeal changes in recent years. Unfortunately, these changes have 
yet to produce the results that veterans deserve. My goal, a goal that 
I am sure is widely shared, is to ensure that veterans are provided 
accurate and timely resolution to their claims.
  This legislation I am introducing today would make several 
improvements in the claims adjudication process. Provisions in title I 
of the bill would establish a pilot program that would utilize ICD 
codes to identify disabilities of the musculoskeletal system. Over 
fifty percent of Operations Iraqi and Enduring Freedom veterans that 
the Department of Veterans Affairs has had some health care contact 
with have a possible musculoskeletal diagnosis. ICD codes are standard 
medical condition identification codes used in electronic records that 
have been adapted by the Secretary of Health and Human Services for 
electronic transmission of medical data.
  This proposed pilot program would take place in six to ten regional 
offices and require VA to develop a new method of rating claims, which 
would consider the frequency, severity, and duration of symptoms of the 
disability in rating the claim, rather than the current rating schedule 
published in the Code of Federal Regulations. The current rating 
schedule adds to the complexity of claims adjudication, because many 
disabilities claimed are not exactly as described in the regulation and 
several rating codes may need to be considered. The new rating schedule 
would focus on the impact of the disability, for example, an inability 
to walk normally, rather than a particular VA rating code 
classification. All limitations resulting from all disabilities of the 
musculoskeletal system would be combined to provide one rating, rather 
than separate ratings for each individual disability. This information 
would be placed into an organized and searchable electronic record. A 
veteran could elect to not participate in the pilot program. I believe 
that such an approach will result in fairer, comprehensive ratings for 
the entire musculoskeletal system.
  Title II of the bill includes a number of provisions that are 
intended to yield some near-term changes to the claims processing 
system and should help reduce the overall time a claim is under 
consideration by VA. During the last several years, the Committee has 
held oversight hearings on the claims processing system. Many of the 
provisions in this legislation were first suggested by veterans service 
organizations and other interested parties in connection with those 
hearings. Others have been recommended by the administration. The 
legislation I am introducing today serves as a starting point to move 
forward in our effort to improve VA's claims adjudication process.
  Provisions in title II would allow for VA to issue partial ratings of 
claims that include multiple issues for those issues that can 
adjudicated expeditiously; give equal deference to private medical 
opinions during the rating process; and clarify that the Secretary is 
required to provide notice to claimants of additional information and 
evidence required only when additional evidence is actually required. 
It would also modify filing periods for notices of disagreement from 
one year to 180 days and require a claimant to file a substantive 
appeal within 60 days of the Department issuing a post-Notice of 
Disagreement decision both of these modifications would contain good 
cause exceptions to the filing deadlines.
  Other provisions in title II would automatically waive the review of 
new evidence by the agency of original jurisdiction, usually a Regional 
Office, so that any evidence submitted after the initial decision would 
be subject to initial review at the Board of Veterans' Appeals unless 
the claimant or the claimant's representative requests in writing that 
the agency of original jurisdiction initially review such evidence. 
This legislation would also replace the Secretary's obligation to 
provide a Statement of the Case with an obligation to provide a post-
Notice of Disagreement decision. The post-Notice of Disagreement 
decision would be in plain language and contain a description of the 
specific facts in the case that support the decision including, if 
applicable, an assessment as to the credibility of any lay evidence 
pertinent to the issue or issues with which disagreement has been 
expressed; a citation to pertinent laws and regulations that support 
the decision; the decision on each issue and a summary of the reasons 
why the evidence relied upon supports such decision under the specific 
laws and regulations applied; and the date by which a substantive 
appeal must be filed in order to obtain further review of the decision. 
The Secretary would also be required to send, with a rating decision, a 
form that if completed and returned, would suffice as a notice of 
disagreement.
  This is not a comprehensive recitation of all of the provisions 
within this important veterans' legislation but does, I hope, provide 
an overview of the changes encompassed in this bill.
  Everyone involved realizes that there is no quick fix to solving the 
myriad issues associated with disability claims processing, but the 
Committee intends to do everything within its power to improve this 
situation. To bring optimal change to a system this complicated and 
critical, we must be deliberative, focused, and open to input from all 
who are involved in this process.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3517

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Claims 
     Processing Improvement Act of 2010''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.

       TITLE I--RATING OF SERVICE-CONNECTED DISABILITIES MATTERS

Sec. 101. Pilot program on evaluation and rating of service-connected 
              disabilities of the musculoskeletal system.

               TITLE II--ADJUDICATION AND APPEAL MATTERS

Sec. 201. Partial adjudication of claims for disability compensation 
              consisting of multiple issues one or more of which can be 
              quickly adjudicated.

[[Page S5271]]

Sec. 202. Clarification that requirement of Secretary of Veterans 
              Affairs to provide notice to claimants of additional 
              information and evidence required only applies when 
              additional information or evidence is actually required.
Sec. 203. Equal deference to private medical opinions in assessing 
              claims for disability compensation.
Sec. 204. Improvements to disability compensation claim review process.
Sec. 205. Provision by Secretary of Veterans Affairs of notice of 
              disagreement forms to initiate appellate review with 
              notices of decisions of Department of Veterans Affairs.
Sec. 206. Modification of filing period for notice of disagreement to 
              initiate appellate review of decisions of Department of 
              Veterans Affairs.
Sec. 207. Modification of substantive appeal process.
Sec. 208. Provision of post-notice of disagreement decisions to 
              claimants who file notice of disagreements.
Sec. 209. Automatic waiver of agency of original jurisdiction review of 
              new evidence.
Sec. 210. Authority for Board of Veterans' Appeals to determine 
              location and manner of appearance for hearings.
Sec. 211. Decision by Court of Appeals for Veterans Claims on all 
              issues raised by appellants.
Sec. 212. Good cause extension of period for filing notice of appeal 
              with United States Court of Appeals for Veterans Claims.
Sec. 213. Pilot program on participation of local and tribal 
              governments in improving quality of claims for disability 
              compensation submitted to Department of Veterans Affairs.

       TITLE I--RATING OF SERVICE-CONNECTED DISABILITIES MATTERS

     SEC. 101. PILOT PROGRAM ON EVALUATION AND RATING OF SERVICE-
                   CONNECTED DISABILITIES OF THE MUSCULOSKELETAL 
                   SYSTEM.

       (a) Pilot Program Required.--The Secretary of Veterans 
     Affairs shall carry out a pilot program to assess the 
     feasibility and advisability of applying an alternative 
     schedule for rating service-connected disabilities of the 
     musculoskeletal system.
       (b) Schedule for Rating Service-connected Disabilities.--
       (1) In general.--Not later than 240 days after the date of 
     the enactment of this Act, the Secretary shall establish an 
     alternative schedule for rating service-connected 
     disabilities of the musculoskeletal system.
       (2) Publication in federal register.--Not later than 270 
     days after the date of the enactment of this Act, the 
     Secretary shall publish the alternative schedule established 
     under paragraph (1) in the Federal Register.
       (3) Collaboration.--The Secretary shall establish the 
     alternative schedule required by paragraph (1) 
     collaboratively through the Under Secretary for Benefits, the 
     Under Secretary for Health, and the General Counsel.
       (4) Elements.--The alternative schedule for rating 
     disabilities under paragraph (1) shall include the following:
       (A) The use of the International Classification of 
     Diseases, as adopted by the Secretary of Health and Human 
     Services under section 1173(c) of the Social Security Act (42 
     U.S.C. 1320d-2(c)) and any successor revisions to such 
     classification so adopted, for purposes of identifying 
     disabilities of the musculoskeletal system.
       (B) A residual functional capacity assessment instrument to 
     describe the functional musculoskeletal loss resulting from 
     any disability of the musculoskeletal system.
       (C) Mechanisms for the assignment of one residual 
     functional capacity rating for all musculoskeletal 
     disabilities determined to be service-connected, which 
     mechanisms shall take into account the following:
       (i) Frequency of symptoms affecting residual functional 
     capacity of the musculoskeletal system, set forth as a range 
     of--

       (I) infrequent (once a year or less);
       (II) several (two to six) times a year;
       (III) occasional (seven to twelve times a year);
       (IV) weekly; and
       (V) daily or continuous.

       (ii) Severity of symptoms affecting residual functional 
     capacity of the musculoskeletal system resulting in loss of 
     functional capacity of the musculoskeletal system, set forth 
     as a range of--

       (I) minimal (symptoms present but requiring no treatment);
       (II) slight (such as requiring minor alteration of activity 
     or treatment with over-the-counter medication);
       (III) mild (such as requiring rest of relevant body part 
     and use of over-the-counter medication, prescription 
     medication, or therapy, such as ice or heat to an affected 
     part);
       (IV) moderate (such as requiring medical evaluation and 
     treatment or prescription medication for pain or symptom 
     control with side effects which can be expected to interfere 
     with full performance of work-related activities); and
       (V) moderately severe to severe (such as requiring the need 
     to use assistive devices for ambulation, use of opioid or 
     similar prescription medication to control pain which 
     precludes driving or being around machinery, in-patient 
     hospitalization or rehabilitation or frequent out-patient 
     treatment physical therapy, or loss or loss of use of 
     functional capacity in both arms or feet, or one arm and one 
     foot, or requiring a wheelchair for mobility).

       (iii) Duration of symptoms affecting residual functional 
     capacity of the musculoskeletal system resulting in reduced 
     functional capacity of the musculoskeletal system, set forth 
     as a range of--

       (I) one day or less to one week;
       (II) more than one week but less than four weeks;
       (III) four weeks or more but less than six months;
       (IV) six months or more but less than one year; and
       (V) one year or more.

       (D) Mechanisms for the assignment of ratings of disability 
     in certain cases as follows:
       (i) If the veteran has an active musculoskeletal cancer or 
     other active musculoskeletal disability likely to result in 
     death, a rating of 100 percent.
       (ii) If the veteran would qualify for a temporary 
     disability rating under section 1156 of title 38, United 
     States Code, the rating provided under that section.
       (iii) If the veteran would qualify for a temporary 
     disability rating under any regulations prescribed by the 
     Secretary not provided for under this section, the rating 
     assigned under such regulations.
       (E) Such other mechanisms as the Secretary considers 
     appropriate for the pilot program.
       (5) Forms for recording residual functional capacity 
     assessments.--
       (A) In general.--The Secretary shall establish one or more 
     functional capacity assessment forms to be used in performing 
     assessments with the instrument required by paragraph (4)(B).
       (B) Availability.--The Secretary shall make the forms 
     established under subparagraph (A) available to the public in 
     an electronic format for use by any physician or other 
     medical provider in assessing the residual functional 
     capacity related to disabilities of the musculoskeletal 
     system.
       (6) Exemption from apa.--The establishment of the 
     alternative schedule required by paragraph (1) shall not be 
     subject to the requirements of subchapter II of chapter 5, 
     and chapter 7, of title 5, United States Code (commonly known 
     as the ``Administrative Procedure Act'').
       (c) Application of Alternative Schedule.--
       (1) In general.--In carrying out the pilot program, the 
     Secretary shall apply the alternative schedule for rating 
     disabilities established under subsection (b) to veterans 
     described in paragraph (3) who have a condition of the 
     musculoskeletal system that has been determined to be a 
     disability incurred or aggravated during military service to 
     determine the rating to be assigned for such disability.
       (2) Application through regional offices.--
       (A) In general.--The Secretary shall apply the alternative 
     schedule for rating service-connected disabilities under this 
     subsection through not fewer than six and not more than ten 
     regional offices of the Department of Veterans Affairs 
     selected by the Secretary for purposes of the pilot program.
       (B) Diversity of selection.--In selecting regional offices 
     under subparagraph (A), the Secretary shall select--
       (i) at least one regional office considered by the 
     Secretary to be a small office;
       (ii) at least one regional office considered by the 
     Secretary to be a large office; and
       (iii) regional offices representing a variety of geographic 
     settings.
       (3) Covered veterans.--Veterans described in this paragraph 
     are veterans who--
       (A) submit to the Secretary more than one year after their 
     date of discharge or release from the active military, naval, 
     or air service an original claim for benefits under the laws 
     administered by the Secretary;
       (B) allege in the claim described in subparagraph (A) the 
     existence of a condition of the musculoskeletal system that 
     was incurred or aggravated in such military, naval, or air 
     service;
       (C) file such claim with a regional office of the 
     Department with original jurisdiction of the claim that is 
     participating in the pilot program; and
       (D) have not expressly declined participation in the pilot 
     program.
       (4) Relation to combined ratings table.--A rating assigned 
     for a musculoskeletal service-connected disability under the 
     pilot program shall be determined without regard to the 
     Combined Ratings Table in title 38, Code of Federal 
     Regulations, except that in determining the final rating of 
     all service-connected disabilities, the rating for 
     musculoskeletal disabilities as determined under the pilot 
     program shall be combined with any other disabilities using 
     such table.
       (5) Treatment of disability ratings for loss of bodily 
     integrity.--Compensation under laws administered by the 
     Secretary for a disability receiving a disability rating 
     under the schedule established under subsection (b)(1) shall 
     be, as applicable, in addition to or consistent with any 
     compensation otherwise provided under subsections (k) through 
     (s) of section 1114 of title 38, United States Code.
       (d) Limitations on Denial of Service Connection.--During 
     the pilot program, the Secretary may not determine a 
     musculoskeletal

[[Page S5272]]

     condition of a veteran to be not service-connected for 
     purposes of the veteran's participation in the pilot program 
     unless the Secretary--
       (1) obtains, or receives a report of, a medical examination 
     of the veteran which--
       (A) includes a brief history of the veteran's military 
     service relevant to the condition;
       (B) identifies the diagnosed musculoskeletal disabilities 
     in accordance with the classification required by subsection 
     (b)(4)(A); and
       (C) describes the functional limitations of such 
     conditions, and if applicable, any secondary conditions 
     related to such alleged conditions or any non-service 
     connected disability aggravated by the alleged conditions; 
     and
       (2) obtains or receives a medical opinion on--
       (A) the nexus between any diagnosed musculoskeletal 
     condition alleged to be service-connected and the active 
     military, naval, or air service of the veteran; and
       (B) if applicable, the relationship between any service-
     connected disabilities of the veteran and any secondary 
     disabilities related to such disabilities or any non-service 
     connected disability aggravated by the alleged conditions.
       (e) Records.--
       (1) In general.--The Secretary shall maintain for purposes 
     of the pilot program a separate searchable electronic file on 
     each veteran covered by the pilot program.
       (2) Elements.--The electronic file maintained with respect 
     to a veteran under paragraph (1) shall include for the 
     following:
       (A) An index of the documents contained in the electronic 
     file.
       (B) The claim of the veteran for benefits under the laws 
     administered by the Secretary, including any reapplication 
     with respect to such claim.
       (C) The service treatment records of the veteran from 
     medical care received while serving in the active military, 
     naval, or air service and any other medical treatment records 
     of the veteran from service during periods of active or 
     inactive duty for training.
       (D) The personnel records of service of the veteran--
       (i) in the active military, naval, or air service; and
       (ii) in the reserve components of the Armed Forces.
       (E) Such other private or public medical records of the 
     veteran as the Secretary considers appropriate.
       (F) Records of any medical examinations and medical 
     opinions on the residual functional capacity of the 
     musculoskeletal system of the veteran, including any 
     examinations and opinions obtained under subsection (d).
       (G) Records of any medical examinations and medical 
     opinions concerning any non-musculoskeletal disabilities 
     claimed by the veteran as service-connected.
       (H) Any non-medical evidence applicable to the claim.
       (I) Current information and evidence on any dependents of 
     the veteran for purposes of the laws administered by the 
     Secretary.
       (J) Ratings and decisions of the Secretary with respect to 
     the claims of the veteran.
       (K) Information concerning the amount of compensation paid 
     to the veteran under laws administered by the Secretary.
       (L) Any notices or correspondence sent by the Secretary to 
     the veteran or any correspondence submitted by the veteran to 
     the Secretary in connection with the claim that does not 
     contain evidence or information applicable to the claims of 
     the veteran.
       (3) Organization.--Each file required by paragraph (1) 
     shall be stored or displayed with separate sections for each 
     element required under paragraph (2).
       (f) Termination of Application.--The Secretary shall cease 
     the application to veterans under subsection (c) of the 
     alternative schedule for rating service-connected 
     disabilities under subsection (b) for purposes of the pilot 
     program on the date that is 4 years after the date of the 
     enactment of this Act.
       (g) Preservation of Ratings.--
       (1) In general.--Except as provided in paragraph (2), a 
     disability rating assigned under the alternative schedule 
     established under subsection (b) shall not be reduced during 
     or after termination of the pilot program absent evidence of 
     clear and unmistakable error in the original assignment of 
     the rating or evidence of an improvement in the 
     musculoskeletal disability manifested by less frequent, less 
     severe, or shorter duration of symptoms measured over a 
     period of at least six months in the year prior to any re-
     evaluation.
       (2) Exception.--Paragraph (1) shall not apply to ratings 
     assigned for temporary periods as provided in subsection 
     (b)(4)(D).
       (h) Relationship to Other Provisions of Law Administered by 
     the Secretary of Veterans Affairs.--Except as otherwise 
     specifically provided in this section, all applicable 
     provisions of law administered by the Secretary shall apply 
     to decisions of the Secretary made under the pilot program.
       (i) Interim Report.--
       (1) In general.--Not later than 300 days after the date of 
     the enactment of this Act, the Secretary shall submit to the 
     Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives an interim report on the pilot program.
       (2) Elements.--The interim report required by paragraph (1) 
     shall include the following:
       (A) A description of the alternative schedule for rating 
     service-connected disabilities established under subsection 
     (b).
       (B) The rationale for the alternative schedule as described 
     under subparagraph (A).
       (C) A description of the policies and procedures 
     established under the pilot program.
       (j) Report.--
       (1) In general.--Not later than 3 years and 180 days after 
     the date of the enactment of this Act, the Secretary shall 
     submit to the Committee on Veterans' Affairs of the Senate 
     and the Committee on Veterans' Affairs of the House of 
     Representatives a report on the pilot program.
       (2) Elements.--The report required by paragraph (1) shall 
     include the following:
       (A) A copy of the alternative schedule for rating service-
     connected disabilities established under subsection (b) and 
     any changes made to such schedule during the pilot program.
       (B) A description and assessment of the application of the 
     alternative schedule for rating service-connected 
     disabilities of veterans, including--
       (i) the total number of veterans to which the alternative 
     schedule was applied;
       (ii) the total number of veterans determined to have a 
     service-connected disability consisting of a condition of the 
     musculoskeletal system; and
       (iii) the ratings of disability assigned to veterans 
     described in clause (ii), set forth by percentage of 
     disability assigned.
       (C) An assessment of the feasibility and advisability of 
     applying the alternative schedule for rating service-
     connected disabilities to additional claimants.
       (D) A comparison of a representative sample of decisions 
     rendered by different regional offices for similar 
     disabilities participating in the pilot program.
       (E) The number of appeals filed for claims adjudicated 
     under the pilot program.
       (F) An assessment of the effectiveness of the electronic 
     file maintained under subsection (e) in--
       (i) the adjudication of claims under the pilot program; and
       (ii) improving the efficiency of decision making by the 
     Department.
       (G) Such recommendations for legislative or administrative 
     action as the Secretary considers appropriate in light of the 
     pilot program.
       (k) Definitions.--In this section:
       (1) The term ``active military, naval, or air service'' has 
     the meaning given that term in section 101(24) of title 38, 
     United States Code.
       (2) The term ``non-service-connected'', with respect to a 
     disability, has the meaning given that term in section 
     101(17) of title 38, United States Code.
       (3) The term ``service-connected'', with respect to a 
     disability, has the meaning given that term in section 
     101(16) of title 38, United States Code.

               TITLE II--ADJUDICATION AND APPEAL MATTERS

     SEC. 201. PARTIAL ADJUDICATION OF CLAIMS FOR DISABILITY 
                   COMPENSATION CONSISTING OF MULTIPLE ISSUES ONE 
                   OR MORE OF WHICH CAN BE QUICKLY ADJUDICATED.

       (a) In General.--Section 1157 of title 38, United States 
     Code, is amended--
       (1) by striking ``The Secretary'' and inserting the 
     following:
       ``(a) In General.--The Secretary''; and
       (2) by adding at the end the following new subsection:
       ``(b) Assignment of Partial Ratings.--(1) In the case of a 
     veteran who submits to the Secretary a claim for compensation 
     under this chapter for more than one condition and the 
     Secretary determines that a disability rating can be assigned 
     without further development for one or more conditions but 
     not all conditions in the claim, the Secretary shall--
       ``(A) expeditiously assign a disability rating for the 
     condition or conditions that the Secretary determined could 
     be assigned without further development; and
       ``(B) continue development of the remaining conditions.
       ``(2) If the Secretary is able to assign a disability 
     rating for a condition described in paragraph (1)(B) with 
     respect to a claim, the Secretary shall assign such rating 
     and combine such rating with the rating or ratings previously 
     assigned under paragraph (1)(A) with respect to that 
     claim.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall take effect on the date of the enactment of this Act, 
     and shall apply with respect to claims filed on or after the 
     date that is 60 days after the date of the enactment of this 
     Act.

     SEC. 202. CLARIFICATION THAT REQUIREMENT OF SECRETARY OF 
                   VETERANS AFFAIRS TO PROVIDE NOTICE TO CLAIMANTS 
                   OF ADDITIONAL INFORMATION AND EVIDENCE REQUIRED 
                   ONLY APPLIES WHEN ADDITIONAL INFORMATION OR 
                   EVIDENCE IS ACTUALLY REQUIRED.

       (a) In General.--Section 5103(a)(1) of title 38, United 
     States Code, is amended by striking the first sentence and 
     inserting the following: ``If the Secretary receives a 
     complete or substantially complete application that does not 
     include information or medical or lay evidence not previously 
     provided to the Secretary that is necessary to substantiate 
     the claim, the Secretary shall, upon receipt of such 
     application, notify the claimant and the claimant's 
     representative, if any, that such information or evidence is 
     necessary to substantiate the claim.''.

[[Page S5273]]

       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on the date of the enactment of this Act, 
     and shall apply with respect to claims filed on or after the 
     date that is 60 days after the date of the enactment of this 
     Act.

     SEC. 203. EQUAL DEFERENCE TO PRIVATE MEDICAL OPINIONS IN 
                   ASSESSING CLAIMS FOR DISABILITY COMPENSATION.

       (a) Provision of Deference.--
       (1) In general.--Subchapter I of chapter 51 of title 38, 
     United States Code, is amended by inserting after section 
     5103A the following new section:

     ``Sec. 5103B. Treatment of private medical opinions

       ``(a) In General.--If a claimant submits a private medical 
     opinion in support of a claim for disability compensation in 
     accordance with standards established by the Secretary, such 
     opinion shall be treated by the Secretary with the same 
     deference as a medical opinion provided by a Department 
     health care provider.
       ``(b) Supplemental Information.--(1) If a private medical 
     opinion submitted as described in subsection (a) is found by 
     the Secretary to be competent, credible, and probative, but 
     otherwise not entirely adequate for purposes of assigning a 
     disability rating and the Secretary determines a medical 
     opinion from a Department health care provider is necessary 
     for such purpose, the Secretary shall obtain from an 
     appropriate Department health care provider (as determined 
     pursuant to the standards described in subsection (a)) a 
     medical opinion that is adequate for such purposes.
       ``(2) If the Secretary obtains a medical opinion from a 
     Department health care provider under paragraph (1), the 
     Secretary shall ensure that the medical opinion is obtained 
     from a health care provider of the Department that has 
     professional qualifications that are at least equal to the 
     qualifications of the provider of the private medical opinion 
     described in such paragraph.
       ``(c) Department Health Care Provider Defined.--In this 
     section, the term `Department health care provider' includes 
     a provider of health care who provides health care under 
     contract with the Department.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 51 of such title is amended by inserting 
     after the item relating to section 5103A the following new 
     item:

``5103B. Treatment of private medical opinions.''.

       (3) Effective date.--Section 5103B of such title, as added 
     by paragraph (1), shall take effect on the date of the 
     enactment of this Act, and shall apply with respect to claims 
     pending or filed on or after the date that is 270 days after 
     the date of the enactment of this Act.
       (b) Notice.--
       (1) In general.--Section 5103(a) of such title is amended 
     by adding at the end the following new paragraph:
       ``(3) A notice provided under this subsection shall inform 
     a claimant, as the Secretary considers appropriate with 
     respect to the claimant's claim--
       ``(A) of the rights of the claimant to assistance under 
     section 5103A of this title; and
       ``(B) if the claimant submits a private medical opinion in 
     support of a claim for disability compensation, how such 
     medical opinion will be treated under section 5103B of this 
     title.''.
       (2) Effective date.--Paragraph (3) of such section 5103(a), 
     as added by paragraph (1), shall take effect on the date that 
     is 270 days after the date of the enactment of this Act.

     SEC. 204. IMPROVEMENTS TO DISABILITY COMPENSATION CLAIM 
                   REVIEW PROCESS.

       (a) Establishment of Fast Track Claim Review Process.--
       (1) In general.--Subchapter I of chapter 51 of title 38, 
     United States Code, is amended by inserting after section 
     5103B, as added by section 203 of this Act, the following new 
     section:

     ``Sec. 5103C. Expedited review of initial claims for 
       disability compensation

       ``(a) Process Required.--The Secretary shall establish a 
     process for the rapid identification of initial claims for 
     disability compensation that should, in the adjudication of 
     such claims, receive priority in the order of review.
       ``(b) Review of Initial Claims.--As part of the process 
     required by subsection (a), the Secretary shall assign 
     employees of the Department who are experienced in the 
     processing of claims for disability compensation to carry out 
     a preliminary review of all initial claims for disability 
     compensation submitted to the Secretary in order to identify 
     whether--
       ``(1) the claims have the potential of being adjudicated 
     quickly;
       ``(2) the claims qualify for priority treatment under 
     paragraph (2) of subsection (c); and
       ``(3) a temporary disability rating could be assigned with 
     respect to the claims under section 1156 of this title.
       ``(c) Priority in Adjudication of Initial Claims.--(1) As 
     part of the process required by subsection (a) and except as 
     provided in paragraph (2), the Secretary shall, in the 
     adjudication of initial claims for disability compensation 
     submitted to the Secretary, give priority in the order of 
     review of such claims to claims identified under subsection 
     (b)(1) as having the potential of being adjudicated quickly.
       ``(2) The Secretary may, under regulations the Secretary 
     shall prescribe, provide priority in the order of review of 
     initial claims for disability compensation for the 
     adjudication of the following:
       ``(A) Initial claims for disability compensation submitted 
     by homeless claimants.
       ``(B) Initial claims for disability compensation submitted 
     by veterans who are terminally ill.
       ``(C) Initial claims for disability compensation submitted 
     by claimants suffering severe financial hardship.
       ``(D) Partially adjudicated claims for disability 
     compensation under section 1157(b) of this title.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 51 of such title is amended by inserting 
     after the item relating to section 5103B, as so added, the 
     following new item:

``5103C. Expedited review of initial claims for disability 
              compensation.''.

       (3) Effective date.--Section 5103C of such title, as added 
     by paragraph (1), shall take effect on the date that is 90 
     days after the date of the enactment of this Act.
       (b) Authority for Claimants to End Development of Claims.--
       (1) In general.--Such subchapter is further amended by 
     inserting after section 5103C, as added by subsection (a), 
     the following new section:

     ``Sec. 5103D. Procedures for fully developed claims

       ``Upon notification received from a claimant that the 
     claimant has no additional information or evidence to submit, 
     the Secretary may determine that the claim is a fully 
     developed claim. The Secretary shall then undertake any 
     development necessary for any Federal records, medical 
     examinations, or opinions relevant to the claim and may 
     decide the claim based on all the evidence of record.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 51 of such title is amended by inserting 
     after the item relating to section 5103C, as added by 
     subsection (a), the following new item:

``5103D. Procedures for fully developed claims.''.

       (3) Effective date.--Section 5103D of such title, as added 
     by paragraph (1), shall take effect on the date of the 
     enactment of this Act.

     SEC. 205. PROVISION BY SECRETARY OF VETERANS AFFAIRS OF 
                   NOTICE OF DISAGREEMENT FORMS TO INITIATE 
                   APPELLATE REVIEW WITH NOTICES OF DECISIONS OF 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Section 5104 of title 38, United States 
     Code, is amended--
       (1) in subsection (a), by striking the second sentence; and
       (2) in subsection (b), by striking ``also include (1) a'' 
     and all that follows and inserting the following: ``include 
     the following:
       ``(1) A statement of the reasons for the decision.
       ``(2) A summary of the evidence relied upon by the 
     Secretary in making the decision.
       ``(3) An explanation of the procedure for obtaining review 
     of the decision.
       ``(4) A form that, once completed, can serve as a notice of 
     disagreement under section 7105(a) of this title.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall take effect on the date that is 180 days after the date 
     of the enactment of this Act.

     SEC. 206. MODIFICATION OF FILING PERIOD FOR NOTICE OF 
                   DISAGREEMENT TO INITIATE APPELLATE REVIEW OF 
                   DECISIONS OF DEPARTMENT OF VETERANS AFFAIRS.

       (a) Filing of Notice of Disagreement by Claimants.--
       (1) In general.--Paragraph (1) of section 7105(b) of title 
     38, United States Code, is amended--
       (A) by striking ``one year'' and inserting ``180 days'' in 
     the first sentence; and
       (B) by striking ``one-year'' and inserting ``180-day'' in 
     the third sentence.
       (2) Electronic filing.--Such paragraph is further amended 
     by inserting ``or transmitted by electronic means'' after 
     ``postmarked''.
       (3) Good cause exception for untimely filing of notices of 
     disagreement.--Such section 7105(b) is amended by adding at 
     the end the following new paragraph:
       ``(3)(A) A notice of disagreement not filed within the time 
     prescribed by paragraph (1) shall be treated by the Secretary 
     as timely filed if--
       ``(i) the Secretary determines that the claimant, legal 
     guardian, or other accredited representative, attorney, or 
     authorized agent filing the notice had good cause for the 
     lack of filing within such time; and
       ``(ii) the notice of disagreement is filed not later than 
     186 days after the period prescribed by paragraph (1).
       ``(B) For purposes of this paragraph, good cause shall 
     include the following:
       ``(i) Circumstances relating to any physical, mental, 
     educational, or linguistic limitation of the claimant, legal 
     guardian, representative, attorney, or authorized agent 
     concerned (including lack of facility with the English 
     language).
       ``(ii) Circumstances relating to significant delay in the 
     delivery of the initial decision or of the notice of 
     disagreement caused by natural disaster or factors relating 
     to geographic location.

[[Page S5274]]

       ``(iii) A change in financial circumstances, including the 
     payment of medical expenses or other changes in income or net 
     worth that are considered in determining eligibility for 
     benefits and services on an annualized basis for purposes of 
     needs-based benefits under chapters 15 and 17 of this 
     title.''.
       (b) Application by Department for Review on Appeal.--
     Section 7106 of such title is amended in the first sentence 
     by striking ``one-year period described in section 7105'' and 
     inserting ``period described in section 7105(b)(1)''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on the date that is 180 days after the date 
     of the enactment of this Act, and shall apply with respect to 
     claims filed on or after the date of the enactment of this 
     Act.

     SEC. 207. MODIFICATION OF SUBSTANTIVE APPEAL PROCESS.

       (a) In General.--Section 7105 of title 38, United States 
     Code, is amended--
       (1) in subsection (d)--
       (A) in paragraph (3), by striking ``The claimant will be 
     afforded'' and all that follows through the end of the 
     paragraph; and
       (B) by striking paragraphs (4) and (5); and
       (2) by adding at the end the following new subsection:
       ``(e)(1) A claimant shall be afforded a period of 60 days 
     from the date the post-notice of disagreement decision is 
     mailed under subsection (d) to file a substantive appeal.
       ``(2)(A) The period under paragraph (1) may be extended for 
     an additional 60 days for good cause shown on a request for 
     such extension submitted in writing within such period.
       ``(B) For purposes of this paragraph, good cause shall 
     include the following:
       ``(i) Circumstances relating to any physical, mental, 
     educational, or linguistic limitation of the claimant, legal 
     guardian, or other accredited representative, attorney, or 
     authorized agent filing the request (including lack of 
     facility with the English language).
       ``(ii) Circumstances relating to significant delay in the 
     delivery of the initial decision or of the notice of 
     disagreement caused by natural disaster or factors relating 
     to geographic location.
       ``(iii) A change in financial circumstances, including the 
     payment of medical expenses or other changes in income or net 
     worth that are considered in determining eligibility for 
     benefits and services on an annualized basis for purposes of 
     needs-based benefits under chapters 15 and 17 of this title.
       ``(3) A substantive appeal under this subsection shall 
     identify the particular determination or determinations being 
     appealed and allege specific errors of fact or law made by 
     the agency of original jurisdiction in each determination 
     being appealed.
       ``(4) A claimant in any case under this subsection may not 
     be presumed to agree with any statement of fact contained in 
     the post-notice of disagreement decision to which the 
     claimant does not specifically express disagreement.
       ``(5) If the claimant does not file a substantive appeal in 
     accordance with the provisions of this chapter within the 
     period afforded under paragraphs (1) and (2), as the case may 
     be, the agency of original jurisdiction shall dismiss the 
     appeal and notify the claimant of the dismissal. The notice 
     shall include an explanation of the procedure for obtaining 
     review of the dismissal by the Board of Veterans' Appeals.
       ``(6) In order to obtain review by the Board of a dismissal 
     of an appeal by the agency of original jurisdiction, a 
     claimant shall file a request for such review with the Board 
     within the 60-day period beginning on the date on which 
     notice of the dismissal is mailed pursuant to paragraph (5).
       ``(7) If a claimant does not file a request for review by 
     the Board in accordance with paragraph (6) within the 
     prescribed period or if such a request is timely filed and 
     the Board affirms the dismissal of the appeal, the 
     determination of the agency of original jurisdiction 
     regarding the claim for benefits under this title shall 
     become final and the claim may not thereafter be reopened or 
     allowed, except as may otherwise be provided by regulations 
     not inconsistent with this title.
       ``(8) If an appeal is not dismissed by the agency of 
     original jurisdiction, the Board may nonetheless dismiss any 
     appeal which is--
       ``(A) untimely; or
       ``(B) fails to allege specific error of fact or law in the 
     determination being appealed.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall take effect on the date of the enactment of this Act, 
     and shall apply with respect to claims filed on or after the 
     date that is 180 days after the date of the enactment of this 
     Act.

     SEC. 208. PROVISION OF POST-NOTICE OF DISAGREEMENT DECISIONS 
                   TO CLAIMANTS WHO FILE NOTICE OF DISAGREEMENTS.

       (a) In General.--Section 7105 of title 38, United States 
     Code, is amended--
       (1) by striking ``statement of the case'' each place it 
     appears and inserting ``post-notice of disagreement 
     decision''; and
       (2) in subsection (d), as amended by section 207 of this 
     Act--
       (A) in paragraph (1), by striking subparagraphs (A) through 
     (C) and inserting the following new subparagraphs:
       ``(A) A description of the specific facts in the case that 
     support the agency's decision, including, if applicable, an 
     assessment as to the credibility of any lay evidence 
     pertinent to the issue or issues with which disagreement has 
     been expressed.
       ``(B) A citation to pertinent laws and regulations that 
     support the agency's decision.
       ``(C) A statement that addresses each issue and provides 
     the reasons why the evidence relied upon supports the 
     conclusions of the agency under the specific laws and 
     regulations applied.
       ``(D) The date by which a substantive appeal must be filed 
     in order to obtain further review of the decision.''; and
       (B) by adding at the end the following new paragraph:
       ``(4) The post-notice of disagreement decision shall be 
     written in plain language.''.
       (b) Conforming Amendment.--Section 7105A of such title is 
     amended by striking ``statement of the case'' each place it 
     appears and inserting ``post-notice of disagreement 
     decision''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on the date that is 180 days after the date 
     of the enactment of this Act, and shall apply with respect to 
     notices of disagreements filed on or after the date that is 
     180 days after the date of the enactment of this Act.

     SEC. 209. AUTOMATIC WAIVER OF AGENCY OF ORIGINAL JURISDICTION 
                   REVIEW OF NEW EVIDENCE.

       (a) In General.--Section 7105 of title 38, United States 
     Code, as amended by section 207 of this Act, is further 
     amended by adding at the end the following new subsection:
       ``(f) If, either at the time or after the agency of 
     original jurisdiction receives a substantive appeal, the 
     claimant or the claimant's representative, if any, submits 
     evidence to either the agency of original jurisdiction or the 
     Board of Veterans' Appeals for consideration in connection 
     with the issue or issues with which disagreement has been 
     expressed, such evidence shall be subject to initial review 
     by the Board unless the claimant or the claimant's 
     representative, as the case may be, requests in writing that 
     the agency of original jurisdiction initially review such 
     evidence. Such request for review shall accompany the 
     submittal of the evidence or be made within 30 days of the 
     submittal.''.
       (b) Effective Date.--Subsection (f) of such section, as 
     added by subsection (a), shall take effect on the date that 
     is 180 days after the date of the enactment of this Act, and 
     shall apply with respect to claims for which a substantive 
     appeal is filed on or after the date that is 180 days after 
     the date of the enactment of this Act.

     SEC. 210. AUTHORITY FOR BOARD OF VETERANS' APPEALS TO 
                   DETERMINE LOCATION AND MANNER OF APPEARANCE FOR 
                   HEARINGS.

       (a) Location.--Subsection (d) of section 7107 of title 38, 
     United States Code, is amended--
       (1) in paragraph (1), by striking ``An appellant'' and all 
     that follows through the end and inserting the following: 
     ``Upon request by an appellant for a hearing before the 
     Board, the Board shall determine whether the hearing will be 
     held at its principal location or at a facility of the 
     Department, or other appropriate Federal facility, located 
     within the area served by a regional office of the Department 
     as the Secretary considers most appropriate to schedule the 
     earliest possible date for the hearing.''; and
       (2) by adding at the end the following new paragraph:
       ``(4) A determination by the Board under paragraph (1) with 
     respect to the location of a hearing shall be final unless 
     the appellant demonstrates, on motion, good cause or special 
     circumstances warranting a different location.''.
       (b) Manner of Appearance.--Subsection (e) of such section 
     is amended--
       (1) in paragraph (2)--
       (A) by striking ``afford the appellant an opportunity'' and 
     inserting ``, as the Chairman determines appropriate, require 
     the appellant''; and
       (B) by striking the last sentence; and
       (2) by adding at the end the following new paragraph:
       ``(3) A determination by the Chairman under paragraph (2) 
     with respect to the participation of an appellant in a 
     hearing shall be final unless the appellant demonstrates, on 
     motion, good cause or special circumstances warranting a 
     different determination.''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on the date that is 180 days after the date 
     of the enactment of this Act, and shall apply with respect to 
     requests for hearings filed on or after the date that is 180 
     days after the date of the enactment of this Act.

     SEC. 211. DECISION BY COURT OF APPEALS FOR VETERANS CLAIMS ON 
                   ALL ISSUES RAISED BY APPELLANTS.

       Section 7261 of title 38, United States Code, is amended--
       (1) in subsection (a), in the matter before paragraph (1), 
     by striking ``, to the extent necessary to its decision and 
     when presented, shall'' and inserting ``shall, when 
     presented'';
       (2) by redesignating subsections (c) and (d) as subsections 
     (d) and (e), respectively; and
       (3) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) In carrying out a review of a decision of the Board 
     of Veterans' Appeals, the Court shall render a decision on 
     every issue raised by an appellant within the extent set 
     forth in this section.''.

     SEC. 212. GOOD CAUSE EXTENSION OF PERIOD FOR FILING NOTICE OF 
                   APPEAL WITH UNITED STATES COURT OF APPEALS FOR 
                   VETERANS CLAIMS.

       (a) In General.--Section 7266 of title 38, United States 
     Code, is amended--

[[Page S5275]]

       (1) by redesignating subsections (b), (c), and (d) as 
     subsections (c), (d), and (e), respectively;
       (2) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b)(1) The Court may extend the initial period for the 
     filing of a notice of appeal set forth in subsection (a) for 
     an additional period not to exceed 120 days from the 
     expiration of such initial period upon a motion--
       ``(A) filed with the Court not later than 120 days after 
     the expiration of such initial period; and
       ``(B) showing good cause for such extension.
       ``(2) If a motion for extension under paragraph (1) is 
     filed after expiration of the initial period for the filing 
     of a notice of appeal set forth in subsection (a), the notice 
     of appeal shall be filed concurrently with, or prior to, the 
     filing of the motion.''; and
       (3) in subsection (e), as redesignated by paragraph (1), by 
     striking ``subsection (c)(2)'' and inserting ``subsection 
     (d)(2)''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall take effect on the date of the enactment of this Act 
     and shall apply with respect to notices of appeal filed on or 
     after the date of the enactment of this Act.

     SEC. 213. PILOT PROGRAM ON PARTICIPATION OF LOCAL AND TRIBAL 
                   GOVERNMENTS IN IMPROVING QUALITY OF CLAIMS FOR 
                   DISABILITY COMPENSATION SUBMITTED TO DEPARTMENT 
                   OF VETERANS AFFAIRS.

       (a) Pilot Program Required.--The Secretary of Veterans 
     Affairs shall carry out a pilot program to assess the 
     feasibility and advisability of entering into memorandums of 
     understanding with local governments and tribal 
     organizations--
       (1) to improve the quality of claims submitted to the 
     Secretary for compensation under chapter 11 of title 38, 
     United States Code; and
       (2) to provide assistance to veterans who may be eligible 
     for such compensation in submitting such claims .
       (b) Minimum Number of Participating Tribal Organizations.--
     In carrying out the pilot program required by subsection (a), 
     the Secretary shall enter into memorandums of understanding 
     with at least two tribal organizations.
       (c) Tribal Organization Defined.--In this section, the term 
     ``tribal organization'' has the meaning given that term in 
     section 3765 of title 38, United States Code.
                                 ______