What this means
m21-1:XIII.i.3.C explains service connection (sc) for mental conditions for treatment purposes under 38 u.s.c. 1702. In plain terms, the official guidance says claims for medical or psychological treatment are normally determined by the Veterans Health Administration (VHA) without referral to the Veterans Benefits Administration (VBA). However, a medical facility may require information or a determination from VBA It also addresses 38 U.S.C. 1702 provides that SC is presumed for VA treatment purposes for a Veteran of
How this may help with a claim
Use m21-1:XIII.i.3.C when organizing evidence or checking VA's handling of service connection (sc) for mental conditions for treatment purposes under 38 u.s.c. 1702. Compare your application, supporting records, and notice with this source-specific point: Claims for medical or psychological treatment are normally determined by the Veterans Health Administration (VHA) without referral to the Veterans Benefits Administration (VBA). 38 U.S.C. 1702 provides that SC is presumed for VA treatment purposes for a Veteran of Save proof of submission and identify the exact condition, exception, or missing development step before requesting correction or choosing a review option.
What to review in your file
- Check the file against this official condition: when the Veterans Benefits Administration (VBA) must decide the issue of SC under 38 U.S.C. 1702
- Confirm that the record or notice addresses this source point: XIII.i.3.C.1.b. When VBA Must Decide the Issue of SC Under 38 U.S.C. 1702
- Document how this stated step or exception applies: VBA must decide the issue of SC for a psychosis or other mental condition under 38 U.S.C. 1702 when
Important limits
m21-1:XIII.i.3.C explains VA guidance for service connection (sc) for mental conditions for treatment purposes under 38 u.s.c. 1702; it does not guarantee an award or replace the statutes, regulations, binding decisions, and review instructions that control an individual claim. Conditions and exceptions still matter, including this source point: Claims for medical or psychological treatment are normally determined by the Veterans Health Administration (VHA) without referral to the Veterans Benefits Administration (VBA). Use the table below when issuing a rating decision in response to a request by VHA for a 38 U.S.C. 1702 determination.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Service Connection (SC) for Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702
- m21-1:XIII.i.3.C
- Service Connection Mental
- Conditions Treatment Purposes
- Service Connection Mental Conditions
- mental conditions treatment purposes
- when Benefits Administration must
- U.S.C. 1702 criteria mental
Original VA guidance
The official VA text of this section
Overview
In This Section
This section contains the topic, “ SC of Mental Conditions Under 38 U.S.C. 1702."
1. Service Connection (SC) of Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702
Introduction
This section contains information on the evaluation of mental conditions for SC under 38 U.S.C. 1702, including
- SC of mental conditions for treatment purposes under 38 U.S.C. 1702
- when the Veterans Benefits Administration (VBA) must decide the issue of SC under 38 U.S.C. 1702
- 38 U.S.C. 1702 criteria for SC of mental conditions for treatment purposes
- Veterans Health Administration (VHA) requests for 38 U.S.C. 1702 determinations
- addressing a VHA-requested 38 U.S.C. 1702 determination in the rating decision, and
- addressing the subordinate issue of 38 U.S.C. 1702 in the rating decision.
Change Date
Feburary 13, 2020
XIII.i.3.C.1.a. SC for Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702
38 U.S.C. 1702 creates a presumption of service connection (SC) for the purpose of eligibility for VA treatment for
- psychoses based on wartime service, or
- any mental condition based on Persian Gulf War service.
Claims for medical or psychological treatment are normally determined by the Veterans Health Administration (VHA) without referral to the Veterans Benefits Administration (VBA). However, a medical facility may require information or a determination from VBA
References: For more information on
- determining eligibility for medical care see M21-1, Part XIII, Subpart i, 3.A, and
- the definition of Persian Gulf War service, see 38 CFR 3.2(i).
XIII.i.3.C.1.b. When VBA Must Decide the Issue of SC Under 38 U.S.C. 1702
VBA must decide the issue of SC for a psychosis or other mental condition under 38 U.S.C. 1702 when
- requested by VHA, or
- when a decision maker finds the facts support the 38 U.S.C. 1702 criteria in the course of denying SC for compensation purposes for
- a psychosis based on wartime service, or
- any mental disorder based on Persian Gulf War service.
References: For more information on
- the 38 U.S.C. 1702 criteria, see M21-1 Part XIII, Subpart i, 3.C.1.c
- VHA-requested determinations, see M21-1, Part XIII, Subpart i, 3.C.1.d
- rating decision requirements, see M21-1, Part XIII, Subpart i, 3.C.1.e, and
- considering issues within scope of a claim, see M21-1, Part V, Subpart ii, 3.A.2.
XIII.i.3.C.1.c. 38 U.S.C. 1702 Criteria for SC for Mental Conditions for Treatment Purposes
38 U.S.C. 1702 provides that SC is presumed for Department of Veterans Affairs (VA) treatment purposes for a Veteran of
- any war period who develops a psychosis, or
- the Persian Gulf War who develops any mental illness
within
- two years after the date of separation (under other than dishonorable conditions) from such service, and
- two years after the end of the war period.
Important: Both criteria must be met for the presumption to arise. The presumption that the qualifying disability was incurred in service for treatment purposes does not apply if
- a qualifying mental ilness develops more than two years after the end of the war period, even if the condition develops less than, or at, two years after discharge, or
- a qualifying mental illness develops more than two years after service discharge even if that was during wartime or less than, or at, two years thereafter.
Notes:
- It is not necessary for the Veteran to have had 90 days of service to qualify.
- Persian Gulf War Veterans who manifest primary diagnoses of substance abuse disorders within the applicable timeframes described above will be entitled to mental health treatment for those disorders under 38 U.S.C. 1702 even though the laws administered by VA prohibit awards of monetary benefits for conditions of misconduct etiology.
References: For more information on
- the definition of psychosis, see
- 38 CFR 3.384, and
- M21-1, Part V, Subpart iii, 13.1.f, and
- primary disabilities involving willful misconduct, see M21-1, Part X, Subpart iv, 1.D.
XIII.i.3.C.1.d. VHA Requests for 38 U.S.C. 1702 Determinations
The table below describes the process when VHA requests a VBA determination of SC under 38 U.S.C. 1702.
Scroll sideways to see the full table.
| Stage | Description |
|---|---|
| 1 | VHA submits requests for determination of SC accompanied by a copy of a completed VA Form 10-10EZ, Application for Health Benefits, or VA Form 10-10EZR, Health Benefits Update Form, and VA Form 10-10M, Medical Certificate, and any other available professional report submitted with, or developed in conjunction with, the application for hospital or outpatient treatment. |
| 2 | Follow the procedure for processing a request for rating activity action in M21-1, Part XIII, Subpart i, 3.A. |
XIII.i.3.C.1.e. Addressing a VHA-requested 38 U.S.C. 1702 Determination in the Rating Decision
Use the table below when issuing a rating decision in response to a request by VHA for a 38 U.S.C. 1702 determination.
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| If t he criteria for SC under 38 U.S.C. 1702... | Then... |
|---|---|
| are met | the decision should be a separate issue in the rating decision, and the Codesheet will show the text Active Psychosis/GW Mental, SC for Treatment Only. |
| are not met | the decision should be a separate issue in the rating decision and the Codesheet will show the text Active Psychosis/GW Mental, NSC-1702. |
Note: When addressing a VHA request for a 1702 determination, the issue of SC of a mental disorder for treatment purposes under the provisions of 38 U.S.C. 1702 should always be listed as a separate or stand-alone issue.
Reference: For more information on addressing the subordinate or inferred issue of 38 U.S.C. 1702 in the rating decision see M21-1, Part XIII, Subpart i, 3.C.1.f.
XIII.i.3.C.1.f. Addressing the Subordinate Issue of 38 U.S.C. 1702 in the Rating Decision
Use the table below when considering the subordinate issue of SC for treatment purposes under 38 U.S.C. 1702 based on a denial of SC for compensation purposes for
- a psychosis based on wartime service, or
- any mental illness based on Persian Gulf War service.
Scroll sideways to see the full table.
| If the criteria for SC under 38 U.S.C. 1702... | Then... |
|---|---|
| are established | in the rating decision address the subordinate issue as a separate decision from the decision on the mental conditon, and ensure the rating Codesheet, shows “ Active Psychosis/GW Mental--SC for Treatment Only ” or equivalent. Exception: If a previous decision has awarded entitlement, there is no need to address it again. |
| are not established | do not address the matter at all in the rating decision. |
Important: SC for treatment purposes under 38 U.S.C 1702 is not a subordinate issue and should not be decided in cases for which
- 38 U.S.C. 1702 determination has not been requested by VHA
- a bereavement diagnosis is the only diagnosis noted in the mental examination, as this is considered an acute and transitory condition, or
- a claim for SC for compensation purposes of a psychosis based on any wartime service or any mental illness based on Persian Gulf War service is denied, and under the facts of record the 38 U.S.C. 1702 presumption would not arise.