Fully Developed VA Claims

As many of you are aware, the Department of Veterans Affairs (VA) is notorious for its delays in processing claims for VA benefits.

The VA has implemented a new process designed to expedite claims for VA benefits having all information required by the agency and all required supporting evidence. The new process, officially titled “Expedited Claims Adjudication Initiative-Pilot Program,” is unofficially called the Fully Developed Claim (FDC) process. Using the FDC process, claims are often processed by the agency within 30-60 days of submission, whereas it often takes the VA as much as 10-18 months to process a claim and issue a decision using the regular process.

The VA is currently requesting that all state departments of veterans affairs and veterans service organizations only use new fully developed claim forms, although the old application forms (bearing numbers 21-526 and 21-534) are still accepted. The new FDC forms bear the following numbers: 21-526EZ, 21-527EZ, and 21-5eNewsletter34EZ.  These new FDC forms give the claimant a chance to choose regular processing by checking an Item Box on the forms. However, whether the applicant checks the Item Box or not, the VA will use regular processing for any claim in which the applicant fails to provide all supporting evidence within 30 days of the date on which the VA sends a notice to the applicant requesting evidence. Further, the time limit for responding to subsequent requests by the VA for additional information or evidence, either by providing such evidence, or notifying VA that no such evidence exists, also is 30 days.

New Time Limits

There are also other time limits related to the VA’s decision on fully developed claims. For example:

  1. The time limit to file a notice of disagreement is 60 days; and,
  2. The time limit to file a substantive appeal is 30 days.

If either deadline is missed, the VA will presume revocation by the claimant.  In that event, the claim will be routed into regular processing where the claimant has one year to respond to the VA’s request for evidence, but which severely delays processing the claim.

Effect on Informal Requests

At present, an applicant for VA benefits who does not have all required evidence but is otherwise eligible can preserve an early entitlement date by filing an Informal Request form. Once an Informal Request is filed, a claimant has one year from the date of its receipt by the VA (which sets the date of entitlement) to submit the application for benefits.  Unfortunately, the FDC process appears to be interfering with the Informal Request process.  It appears that the agency is routing claims into regular processing when a FDC is submitted after an Informal Request has been filed. Obviously, this results in substantially delayed processing of the VA claim.

Applicants must understand the possibility that a claim will not be expedited if an Informal Request is submitted first. The best course may be to defer filing an Informal Request, and instead diligently collect the required evidence and file an FDC as quickly as possible after all evidence is provided even if some months of eligibility are lost.

As accredited VA attorneys, our office regularly assist veterans and widowed spouses in becoming eligible for and applying for VA benefits to assist in paying for long-term care expenses.

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