M21-5 · Section 6.C.4

Restrictions on Review of Paper Claims Folders Subject to Special Handling

M21-5 section 6.C.4. Official source text with a separately reviewed Claim Raven explanation when available.

Claim Raven wrote the explanation that follows. The original VA text appears below it, unchanged.

What this means

m21-5:6.C.4 explains restrictions on review of paper claims folders subject to special handling. In plain terms, the official guidance says when reviewing a claims folder subject to CAVC review, do not change the order of the filed material. It also addresses during the special-handling period, ROs must limit access to paper claims folders that are subject to CAVC review to the fewest number of employees.

How this may help with a claim

Use m21-5:6.C.4 to audit how VA handled restrictions on review of paper claims folders subject to special handling. Start with the decision date, the issue being reviewed, and the evidence VA was allowed to consider, then compare the record with this rule: When reviewing a claims folder subject to CAVC review, do not change the order of the filed material. During the special-handling period, ROs must limit access to paper claims folders that are subject to CAVC review to the fewest number of employees. Cite the exact document and page when raising a factual or procedural error, and use the review rights in the actual notice for any deadline.

What to review in your file

  • Check the file against this official condition: When reviewing a claims folder subject to CAVC review, do not change the order of the filed material.
  • Confirm that the record or notice addresses this source point: The reviewer is required to document the
  • Document how this stated step or exception applies: record reviewed

Important limits

m21-5:6.C.4 explains VA guidance for restrictions on review of paper claims folders subject to special handling; 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: When reviewing a claims folder subject to CAVC review, do not change the order of the filed material. Non-VA personnel who may review a paper claims folder during the special-handling period include

Search terms when useful

Phrases that may help when searching your claim file or this library.

  • Restrictions on Review of Paper Claims Folders Subject to Special Handling
  • m21-5:6.C.4
  • Restrictions Review Paper
  • Claims Folders Subject
  • Reviewing Paper Claims Folders
  • restrictions review paper claims
  • limiting employee access paper
  • non-VA personnel access paper

Original VA guidance

The official VA text of this section

4. Reviewing Paper Claims Folders During the Special-Handling Period

Introduction

This topic contains information about reviewing the paper claims folder during special handling, including

  • restrictions on review of paper claims folders subject to special handling
  • limiting employee access to paper claims folders
  • non-VA personnel who may access paper claims folders during special handling, and
  • how non-VA personnel may access paper claims folders during special handling.

Change Date

March 2, 2020

6.C.4.a. Restrictions on Review of Paper Claims Folders Subject to Special Handling

When reviewing a claims folder subject to CAVC review, do not change the order of the filed material.

The reviewer is required to document the

  • purpose of the review
  • date and time of the review
  • record reviewed
  • reviewer’s name, and
  • certification that nothing has been added to, or deleted from, the material identified by the Board as subject to review by CAVC.

Note: The required certification appears on the file insert that the Board places over the center flap of the paper claims folder.

6.C.4.b. Limiting Employee Access to Paper Claims Folders

During the special-handling period, ROs must limit access to paper claims folders that are subject to CAVC review to the fewest number of employees.

After each review, the VSCM, PMCM, or designee must certify that no material was added to, or deleted from, the record.

6.C.4.c. Non-VA Personnel Who May Access Paper Claims Folders During Special Handling

Non-VA personnel who may review a paper claims folder during the special-handling period include

  • claimants
  • service officers
  • attorneys, and
  • any other non-VA employee authorized by the appellant.

6.C.4.d. How Non-VA Personnel May Access Paper Claims Folders During Special Handling

To protect the integrity of records contained in the paper claims folder, a VA employee must be present when non-VA personnel, such as a claimant, service officer, or attorney, review a claims folder subject to special handling.

The VA employee does not need to be from the VSC or PMC, but must

  • certify over signature that no material was added to, or deleted from, the record that is subject to review by CAVC, and
  • not comment on, or offer explanations of, material contained in the claims folder.