m21-4:7.A: Version history
These are versions captured by Claim Raven. Capture dates are not legal effective dates. Earlier VA revisions may not be included.
- 2026-09-14 — VA source modified 2026-05-29 — matches current text
Captured VA text
Source modified 2026-05-29. Official VA source
Appendix A. NPQR Checklist (Rating) Introduction This appendix contains information on national pension rating quality reviews, including NPQR Checklist (Rating), and instructions and guidelines for rating review. Change Date September 23, 2025 Appendix A.a. NPQR Checklist (Rating) The following is a sample of the NPQR Checklist (Rating). Checklist Name: NPQR Checklist Questions and Errors: Appendix A.b. Instructions and Guidelines for Pension Rating Quality Review These instructions and guidelines have been developed to promote consistency and uniformity in the review of cases for the STAR program. Use these instructions and guidelines in conjunction with the NPQR Checklist (Rating). For the purpose of measuring technical accuracy under the National Quality program, a case is considered either accurate or in error. A case will be considered accurate when Questions 1 through 10 of the NPQR Checklist (Rating) are either answered Yes or N/A. A case will be considered in error if the answer to any question is No, other than questions 11 through 15. For each case reviewed, a NPQR Checklist (Rating) must be completed and all questions answered. A Yes response indicates that the activity associated with the question was completed accurately. A No response indicates that the activity associated with the question was in error. Indicate N/A if the question is not applicable to the case under review, or if a No response was previously recorded for the only issue subject to review. A narrative summary is required with statutory, regulatory, judicial, or manual references for any error or No answer recorded. The general guideline is that an error will be recorded when an action is taken that violates current regulations or established policies. Examples of outcome-related deficiencies include, but are not limited to, errors that result in an overpayment or underpayment to a claimant. Procedural deficiencies are not recorded as BE errors. These deficiencies are recorded as comments. However, if the procedural deficiency is severe in nature, it will be recorded as an error. A judgment or a difference of opinion reflecting a possible better practice or solution will not be recorded as a comment rather than an error. If an error is identified with an issue not related to the EP under review, that error is recorded as a comment under question 15. The table below provides an explanation of the checklist questions. Question Explanation 1. Does the Veteran meet all service requirements? An error would be cited under this element if the Veteran didn’t meet all service requirements. 2. Dependency Issues correct? An error would be cited under this element if there are issues regarding dependency. Establishment of qualifying dependents can affect the benefit rate payable. Two issues must be resolved: relationship and dependency. Dependency may be assumed or may require development. Dependency is secondary to the primary resolution of relationship. 3. Addressed All Issues? An error would be cited under this element if the reviewer failed to consider all issues associated with the claim under review. 4. Proper Development or Procedural Issues? An error would be cited under this element if development or procedural requirements were not properly followed. 38 CFR 3.159 states that upon receipt of a substantially complete application, VA is required to notify the claimant and the claimant's representative, if any, of any information, and any medical or lay evidence, not previously provided that is necessary to substantiate the claim. As part of that notice, VA is required to indicate which portion of that information and evidence, if any, is to be provided by the claimant and which portion, if any, VA will attempt to obtain on behalf of the claimant. The basic rule concerning notice is contained in 38 CFR 3.103. Within that regulation, at 3.103(b)(2), are provisions for due process associated with adverse actions. A medical opinion may be required to reconcile diagnoses, determine the relationship between conditions, determine etiology or nexus to service-incurred disease or injury, or determine whether and to what extent service-connected disability has aggravated a nonservice-connected condition. Before requesting an opinion, review the claim and supporting evidence to ensure that minimum evidentiary requirements have been met. Procedural errors are considered errors with regard to manual direction but not specified by regulations. 5. Was the Rating Decision Correct? An error would be cited under this element if the rating decision is not warranted or has deficiencies in the Narrative and/or code sheet section of the rating decision. The rating decision states the decisions made and provides an explanation supporting each decision. 6. Income Issues correct? An error would be cited under this element if income, net worth and deductions (i.e., unreimbursed medical expenses, last expenses, education expenses) are incorrect or omitted. 7. Burial Issues correct? An error would be cited under this element if there are deficiencies in following burial regulations contained in 38 CFR 3.1700 through 3.1713. 8. Accrued and Substitution Benefits Issues Correct? An error would be cited under this element if there are deficiencies in following accrued and substitution benefit rules contained in 38 CFR 3.1000 through 3.1010. 9. Were Adjustments Correct? (Hospitalization, Incarceration, Active Duty, Medicaid, Elections) An error would be cited under this element if there are deficiencies in following the rules contained in 38 CFR 3.551 through 3.558 for hospitalization and Medicaid adjustments, 3.665 and 3.666 for incarceration, and 3.654 for active duty. 10. Was the Award Generated and Correct? (Payment Rates and Effective Dates) An error would be cited under this element if there are deficiencies on the generated award for failing to follow basic rules contained in 38 CFR 3.31, 3.114, 3.400 - 3.405 and 3.500 - 3.505. 11. Due Process Issues correct? An error would be cited under this element if there are due process deficiencies as defined in 38 CFR 3.103. Additional instructions for implementation are found in M21-1, Part I, Subpart i, 1.B and M21-1, Part X, Subpart ii, 3.A - C. 12. Administrative Decisions correct? An error would be cited under this element if there are deficiencies in the Administrative Decision. 13. Notification correct? An error would be cited under this element if there are notification issues as defined in 38 CFR 3.103. Claimants and their representatives are entitled to timely notice of any decision made by VA. This rule applies to both awards and disallowances. 14. Were all systems accurately updated? An error would be cited under this element if all the systems were not accurately updated. 15. Were all other actions correct? (unrelated EP or EP notification) An error would be cited under this element if there are discrepancies that would have otherwise been considered as errors had the EP in question been under review.