[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.
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