(a)(1)(A) Except as provided in subparagraph (B), a specific claim in the form prescribed by the Secretary (or jointly with the Commissioner of Social Security, as prescribed by section 5105 of this title) must be filed in order for benefits to be paid or furnished to any individual under the laws administered by the Secretary.
(B)(i) The Secretary may pay benefits under chapters 13 and 15 and sections 2303, 2307, and 5121 of this title to a survivor of a veteran who has not filed a formal claim if the Secretary determines that the record contains sufficient evidence to establish the entitlement of the survivor to such benefits.
(ii) For purposes of this subparagraph and section 5110 of this title, the earlier of the following dates shall be treated as the date of the receipt of the survivor’s application for benefits described in clause (i):(I) The date on which the survivor of a veteran (or the representative of such a survivor) notifies the Secretary of the death of the veteran through a death certificate or other relevant evidence that establishes entitlement to survivors’ benefits identified in clause (i).
(II) The head of any other department or agency of the Federal Government notifies the Secretary of the death of the veteran.
(iii) In notifying the Secretary of the death of a veteran as described in clause (ii)(I), the survivor (or the representative of such a survivor) may submit to the Secretary additional documents relating to such death without being required to file a formal claim.
(2) If an individual has not attained the age of 18 years, is mentally incompetent, or is physically unable to sign a form, a form filed under paragraph (1) for the individual may be signed by a court-appointed representative, a person who is responsible for the care of the individual, including a spouse or other relative, or an attorney in fact or agent authorized to act on behalf of the individual under a durable power of attorney. If the individual is in the care of an institution, the manager or principal officer of the institution may sign the form.
(b)(1) A claim by a surviving spouse or child for compensation or dependency and indemnity compensation shall also be considered to be a claim for death pension and accrued benefits, and a claim by a surviving spouse or child for death pension shall be considered to be a claim for death compensation (or dependency and indemnity compensation) and accrued benefits.
(2) A claim by a parent for compensation or dependency and indemnity compensation shall also be considered to be a claim for accrued benefits.
(c)(1) Any person who applies for, signs a form on behalf of an individual to apply for, or is in receipt of any compensation or pension benefit under laws administered by the Secretary shall, if requested by the Secretary, furnish the Secretary with the social security number of such person, or TIN in the case that the person is not an individual, and the social security number of any claimant, dependent, or beneficiary on whose behalf, or based upon whom, such person applies for or is in receipt of such benefit. A person is not required to furnish the Secretary with a social security number for any person to whom a social security number has not been assigned.
(2) The Secretary shall deny the application of or terminate the payment of compensation or pension to a person who fails to furnish the Secretary with a social security number or TIN required to be furnished pursuant to paragraph (1) of this subsection. The Secretary may thereafter reconsider the application or reinstate payment of compensation or pension, as the case may be, if such person furnishes the Secretary with such social security number or TIN.
(3) The costs of administering this subsection shall be paid for from amounts available to the Department of Veterans Affairs for the payment of compensation and pension.
(d)(1) The Secretary shall publish in a central location on the internet website of the Department—(A) the disability benefit questionnaire forms of the Department for the submittal of evidence from non-Department medical providers regarding a disability of a claimant, including any form or process that replaces any such disability benefit questionnaire form, including (except as provided in paragraph (4)(A)) all disability benefit questionnaire forms available to personnel of the Veterans Health Administration and covered non-Department providers for the completion of examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary; and
(B) details about the process used by the Department for submittal of evidence described in subparagraph (A).
(2) Subject to section 6103 of this title, if the Secretary updates a form described in paragraph (1)(A), the Secretary shall—(A) accept the previous version of the form filed by a claimant if—(i) the claimant provided to the non-Department medical provider the previous version of the form before the date on which the updated version of the form was made available; and
(ii) the claimant files the previous version of the form during the one-year period following the date the form was completed by the non-Department medical provider;
(B) request from the claimant (or from a non-Department medical provider if the claimant has authorized the provider to share health information with the Secretary) any other information that the updated version of the form requires; and
(C) apply the laws and regulations required to adjudicate the claim as if the claimant filed the updated version of the form.
(3) The Secretary may waive any interagency approval process required to approve a modification to a disability benefit questionnaire form if such requirement only applies by reason of the forms being made public.
(4)(A) The Secretary may exclude from publication under clauses (i) and (ii) of paragraph (1)(A) 11 So in original. Subpar. (A) of par. (1) does not contain clauses. any form described in subparagraph (B) of this paragraph that the Secretary determines could not reasonably be completed to a clinically acceptable standard by someone not an employee or a contractor of the Department.
(B) A form described in this subparagraph is a form that—(i) was available or in use at any time after the date of the enactment of the Veterans Benefits Improvement Act of 2024; and
(ii) has not been published under paragraph (1).
(C) The Secretary shall include on the same internet website as the website on which forms are published under paragraph (1)(A) a list of forms that have been excluded from publication pursuant to subparagraph (A), and for each such form, a justification for the exclusion of the form from publication.
(e) In this section:(1) The term “mentally incompetent” with respect to an individual means that the individual lacks the mental capacity—(A) to provide substantially accurate information needed to complete a form; or
(B) to certify that the statements made on a form are true and complete.
(2) The term “TIN” has the meaning given the term in section 7701(a)(41) of the Internal Revenue Code of 1986.
(3) The term “covered non-Department provider” means a medical provider who is not an employee of the Department and who provides examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary pursuant to a contract with the Department.
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1225, § 3001; Pub. L. 97–295, § 4(95)(A), Oct. 12, 1982, 96 Stat. 1313; Pub. L. 99–576, title VII, § 701(61), Oct. 28, 1986, 100 Stat. 3296; Pub. L. 101–508, title VIII, § 8053(a), Nov. 5, 1990, 104 Stat. 1388–352; renumbered § 5101 and amended Pub. L. 102–40, title IV, § 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, § 4(a)(1), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 403–405; Pub. L. 108–183, title VII, § 708(c)(2), Dec. 16, 2003, 117 Stat. 2674; Pub. L. 112–154, title V, § 502(a), Aug. 6, 2012, 126 Stat. 1190; Pub. L. 114–315, title I, § 101(a), Dec. 16, 2016, 130 Stat. 1538; Pub. L. 116–315, title II, §§ 2006(a), 2202(b)(1)(E), Jan. 5, 2021, 134 Stat. 4975, 4985; Pub. L. 118–196, § 2, Dec. 23, 2024, 138 Stat. 2671.)
Editorial Notes
References in TextThe date of the enactment of the Veterans Benefits Improvement Act of 2024, referred to in subsec. (d)(4)(B)(i), is the date of enactment of Pub. L. 118–196, which was approved Dec. 23, 2024.
Section 7701(a)(41) of the Internal Revenue Code of 1986, referred to in subsec. (e)(2), is classified to section 7701(a)(41) of Title 26, Internal Revenue Code.
Prior ProvisionsPrior section 5101 was renumbered section 8301 of this title.
Amendments2024—Subsec. (d)(1)(A). Pub. L. 118–196, § 2(1)(A), inserted “, including (except as provided in paragraph (4)(A)) all disability benefit questionnaire forms available to personnel of the Veterans Health Administration and covered non-Department providers for the completion of examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary” after “any such disability benefit questionnaire form”.
Subsec. (d)(4). Pub. L. 118–196, § 2(1)(B), added par. (4).
Subsec. (e)(3). Pub. L. 118–196, § 2(2), added par. (3).
2021—Subsec. (a)(1)(B)(i). Pub. L. 116–315, § 2202(b)(1)(E), substituted “2303” for “2302”.
Subsecs. (d), (e). Pub. L. 116–315, § 2006(a), added subsec. (d) and redesignated former subsec. (d) as (e).
2016—Subsec. (a)(1). Pub. L. 114–315 designated existing provisions as subpar. (A), substituted “Except as provided in subparagraph (B), a specific” for “A specific”, and added subpar. (B).
2012—Subsec. (a). Pub. L. 112–154, § 502(a)(1), designated existing provisions as par. (1) and added par. (2).
Subsec. (c)(1). Pub. L. 112–154, § 502(a)(2)(A), inserted “, signs a form on behalf of an individual to apply for,” after “who applies for” and “, or TIN in the case that the person is not an individual,” after “of such person” and substituted “claimant, dependent,” for “dependent”.
Subsec. (c)(2). Pub. L. 112–154, § 502(a)(2)(B), inserted “or TIN” after “social security number” in two places.
Subsec. (d). Pub. L. 112–154, § 502(a)(3), added subsec. (d).
2003—Subsec. (a). Pub. L. 108–183 substituted “Commissioner of Social Security” for “Secretary of Health and Human Services”.
1991—Pub. L. 102–40, § 402(b)(1), renumbered section 3001 of this title as this section.
Subsec. (a). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” after “prescribed by the”.
Pub. L. 102–83, § 4(a)(1), substituted “administered by the Secretary” for “administered by the Veterans’ Administration”.
Pub. L. 102–40, § 402(d)(1), substituted “5105” for “3005”.
1990—Subsec. (c). Pub. L. 101–508 added subsec. (c).
1986—Subsec. (b)(1). Pub. L. 99–576 substituted “surviving spouse or” for “widow or” in two places.
1982—Subsec. (a). Pub. L. 97–295 substituted “Health and Human Services” for “Health, Education, and Welfare”.
Statutory Notes and Related Subsidiaries
Effective Date of 2021 AmendmentAmendment by section 2202(b)(1)(E) of Pub. L. 116–315 applicable to deaths that occur on or after the date that is two years after Jan. 5, 2021, see section 2202(d) of Pub. L. 116–315, set out as a note under section 113 of this title.
Effective Date of 2016 AmendmentPub. L. 114–315, title I, § 101(c), Dec. 16, 2016, 130 Stat. 1540, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to claims for benefits based on a death occurring on or after the date of the enactment of this Act [Dec. 16, 2016].”
Effective Date of 2012 AmendmentPub. L. 112–154, title V, § 502(b), Aug. 6, 2012, 126 Stat. 1191, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to claims filed on or after the date of the enactment of this Act [Aug. 6, 2012].”
Rule of ConstructionPub. L. 116–315, title II, § 2006(e), Jan. 5, 2021, 134 Stat. 4977, provided that: “Nothing in this section [amending this section and enacting provisions set out as notes below] or section 5101(d) of such title [title 38], as added by subsection (a), may be construed to require the Secretary [of Veterans Affairs] to develop any new information technology system or otherwise require the Secretary to make any significant changes to the internet website of the Department.”
Modernization of Department of Veterans Affairs Disability Benefit QuestionnairesPub. L. 118–210, title III, § 306, Jan. 2, 2025, 138 Stat. 2793, provided that:
“(a) Requirement for Transmission of Certain Information in Machine-readable Format.—“(1) Requirement.—Not later than 180 days after enactment of this Act [Jan. 2, 2025], the Secretary of Veterans Affairs shall require all disability benefit questionnaire data collected in the course of medical disability examinations made by covered non-Department providers to be transmitted to the Department in a machine-readable format.
“(2) Issuance of standards.—Not later than 90 days after the date of the enactment of this Act, the Secretary shall issue standards for the transmission of disability benefit questionnaire data in a machine-readable format as required under paragraph (1).
“(3) Updates.—In making updates to disability benefit questionnaires after the date specified in paragraph (1), the Secretary shall—“(A) ensure that the updates are made in a manner that allows for the data collected under the questionnaires to be in a machine-readable format as of the date on which the update goes into effect; and
“(B) not later than 30 days before an update goes into effect, notify the covered non-Department providers (or the contractor performing a contract under section 504 of the Veterans[’] Benefits Improvement[s] Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note)[set out below]) described in such paragraph of such updates.
“(b) Plan for Information Technology System Modification.—Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a plan to modify the information technology systems and processes of the Department to enable a non-Department health care professional, assigned to or selected by a claimant, to transmit to the Department, in a machine-readable format, disability benefit questionnaire data, including complete disability benefit questionnaires rather than partial questionnaires or elements of medical evidence.
“(c) Public Availability of Information.—The Secretary shall make publicly available on the internet website of the Department referred to in section 5101(d) of title 38, United States Code—“(1) a description of the standards issued under subsection (a)(2); and
“(2) the plan required under subsection (b).
“(d) Definitions.—In this section:“(1) The term ‘claimant’ has the meaning given such term in section 5100 of title 38, United States Code.
“(2) The term ‘covered non-Department provider’ means a health care provider who—“(A) is not an employee of the Department of Veterans Affairs; and
“(B) pursuant to a contract under section 504 of the Veterans[’] Benefits Improvement[s] Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note)[set out below], as amended by sections 304 and 305, examines a claimant for a medical disability.”
Improvement of Provision of Medical Disability Examinations by ContractorsPub. L. 118–196, § 3, Dec. 23, 2024, 138 Stat. 2672, provided that:
“(a) Report on Improving Reimbursement for Travel Relating to Medical Disability Examinations.—Not later than one year after the date of the enactment of this Act [Dec. 23, 2024], the Secretary of Veterans Affairs, after consulting with the Secretary of State and the Commissioner of the Social Security Administration, shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the efforts of the Secretary to reimburse veterans for expenses incurred traveling to a facility of the Department or of a covered non-Department provider incident to an examination with respect to the medical disability of the veteran for purposes of benefits under the laws administered by the Secretary, regardless of whether the facility is located inside or outside the United States.
“(b) Communication by Non-Department Providers Providing Medical Disability Examinations With Individuals and Organizations Designated for Preparation, Presentation, and Prosecution of Claims.—Any contract entered into by the Secretary of Veterans Affairs after the date of the enactment of this Act under which a covered non-Department provider agrees to provide examinations with respect to medical disability for applicants for benefits under the laws administered by the Secretary, shall include a requirement that every communication from the covered non-Department provider to such an applicant regarding the scheduling of a covered medical disability examination be contemporaneously transmitted to any person or organization—“(1) designated by the applicant by a power of attorney filed with the Secretary; and
“(2) recognized under sections 5902, 5903, and 5904 of title 38, United States Code, for the preparation, presentation, and prosecution of claims.
“(c) Department of Veterans Affairs Outreach Regarding Contact Information for Contractors Providing Covered Medical Disability Examinations.—Not later than 120 days after the date of enactment of this Act, the Secretary of Veterans Affairs, in partnership with veterans service organizations and such other stakeholders as the Secretary considers relevant and appropriate, shall implement an outreach program to provide veterans with the following information:“(1) Contact information for covered non-Department providers that provide examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary, including the telephone numbers such providers may use to contact veterans.
“(2) Notice of the requirement for a veteran to provide personally identifiable information to such a provider when contacted in order to verify the identity of the veteran.
“(d) Covered Non-Department Provider.—In this section, the term ‘covered non-Department provider’ means a medical provider who is not an employee of the Department of Veterans Affairs and who provides examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary of Veterans Affairs pursuant to a contract with the Department.”
Temporary Halt on Elimination of Medical Examiner Positions in Department of Veterans AffairsPub. L. 116–315, title II, § 2002(b), Jan. 5, 2021, 134 Stat. 4968, provided that: “The Secretary of Veterans Affairs shall temporarily suspend the efforts of the Secretary in effect on the day before the date of the enactment of this Act [Jan. 5, 2021] to eliminate medical examiner positions in the Department of Veterans Affairs until the number of individuals awaiting a medical examination with respect to medical disability of the individuals for benefits under laws administered by the Secretary that are carried out through the Under Secretary for Benefits is equal to or less than the number of such individuals who were awaiting such a medical examination with respect to such purposes on March 1, 2020.”
Initial FormPub. L. 116–315, title II, § 2006(c), Jan. 5, 2021, 134 Stat. 4976, provided that: “The Secretary of Veterans Affairs shall begin carrying out section 5101(d)(1) of such title [title 38], as added by subsection (a), by publishing, as described in such section, the form described in such section that was in effect on January 1, 2020.”
Alternate ProcessPub. L. 116–315, title II, § 2006(d), Jan. 5, 2021, 134 Stat. 4976, provided that:
“(1) Assessment and report.—“(A) In general.—Subject to paragraph (2), not later than 180 days after the date of the enactment of this act [sic] [Jan. 5, 2021], the Secretary [of Veterans Affairs] shall—“(i) assess the feasibility and advisability of replacing disability benefit questionnaire forms that are used by non-Department medical providers to submit to the Secretary evidence regarding a disability of a claimant for benefits under laws administered by the Secretary, with another consistent process that considers evidence equally, whether provided by a Department or a non-Department medical provider; and
“(ii) submit to Congress—“(I) a report on the findings of the Secretary with respect to the assessment conducted under clause (i); and
“(II) if the report submitted under subclause (I) of this clause includes a finding that replacing the disability benefit questionnaire forms described in clause (i) as described in such clause is feasible and advisable, a plan to replace such forms as described in such clause.
“(B) Collaboration required.—If, in carrying out the assessment required by clause (i) of subparagraph (A), the Secretary determines that replacing the disability benefit questionnaire forms described in such clause as described in such clause is feasible and advisable, the Secretary shall collaborate with, partner with, and consider the advice of veterans service organizations, and such other stakeholders as the Secretary considers appropriate, on the replacement forms and process for submitting such forms.
“(2) Requirements.—The Secretary may only determine under paragraph (1)(A) that replacing the forms described in such paragraph is feasible and advisable if the Secretary certifies that—“(A) it is in the best interest of veterans to do so;
“(B) the replacement process would include all the medical information needed to adjudicate a claim for benefits under laws administered by the Secretary; and
“(C) the new process will ensure that all medical information provided will be considered equally, whether it is provided by a Department medical provider or a non-Department medical provider.
“(3) Implementation.—“(A) In general.—Subject to subparagraph (B), if the Secretary determines under paragraph (1)(A) that replacing the forms as described in such paragraph is feasible and advisable, the Secretary shall, not later than two years after the date on which the Secretary submits the report under paragraph (1)(B)(i)—“(i) replace the forms as described in paragraph (1)(A);
“(ii) publish such replacement pursuant to subparagraph (A) of section 5101(d)(1), as added by subsection (a)(2); and
“(iii) update the details under subparagraph (B) of such section.
“(B) Reports by inspector general of the department of veterans affairs.—If the Secretary replaces the forms under subparagraph (A), the Inspector General of the Department of Veterans Affairs shall, not later than one year after the date that the Secretary replaces such forms and not less frequently than once each year thereafter until the date that is three years after the date on which the Secretary replaces such forms, submit to Congress a report on the process that replaced such forms that ascertains whether the process properly protects veterans.
“(4) Limitation.—The Secretary may not discontinue the use of the disability benefit questionnaire forms described in paragraph (1)(A) until a replacement form or process is implemented.”
Overpayments of Pension to Veterans Receiving Pension From the Department of Veterans AffairsPub. L. 116–315, title VI, § 6003, Jan. 5, 2021, 134 Stat. 5051, provided that:
“(a) Guidance and Training for Claims Processors.—As the Secretary of Veterans Affairs considers necessary, but not less frequently than once every three years until the date that is 10 years after the date of the enactment of this Act [Jan. 5, 2021], the Under Secretary for Benefits of the Department of Veterans Affairs shall update guidance and training curriculum for the processors of claims for pension under chapter 15 of title 38, United States Code, regarding the evaluation of questionable medical expenses on applications for pension, including by updating such guidance with respect to what constitutes a questionable medical expense and by including examples of such expenses.
“(b) Identification and Tracking.—The Under Secretary shall develop a method for identifying and tracking the number of individuals who have received overpayments of pension under chapter 15 of title 38, United States Code.
“(c) Annual Report.—Not later than one year after the date of the enactment of this Act and not later than October 31 of each fiscal year beginning thereafter until the date that is four years after the date of the enactment of this Act, the Under Secretary shall submit to Congress a report that includes, for the period covered by the report, the following:“(1) The number of individuals who received overpayments of pension under chapter 15 of title 38, United States Code.
“(2) The five most common reasons for overpayments described in paragraph (1).
“(3) The number of veterans who had to repay overpayments described in paragraph (1).
“(4) The number of veterans for whom the Secretary waived a requirement to repay an overpayment described in paragraph (1).
“(5) The total dollar amount of overpayments described in paragraph (1).
“(6) The total dollar amount of repayments of veterans for overpayments described in paragraph (1).
“(7) The average dollar amount of repayments described in paragraph (6).”
Plan for Processing Legacy Appeals and Implementing New Appeals SystemPub. L. 115–55, §§ 3–6, Aug. 23, 2017, 131 Stat. 1116–1127, provided that:
Pilot Programs on Expedited Treatment of Fully Developed Claims and Provision of Checklists to Individuals Submitting ClaimsPub. L. 110–389, title II, § 221, Oct. 10, 2008, 122 Stat. 4154, provided that:
“(a) Pilot Program on Expedited Treatment of Fully Developed Claims.—“(1) In general.—The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing expeditious treatment of fully developed compensation or pension claims to ensure that such claims are adjudicated not later than 90 days after the date on which such claim is submitted as fully developed.
“(2) Duration of pilot program.—The pilot program under this subsection shall be carried out during the one-year period beginning on the date that is 60 days after the date of the enactment of this Act [Oct. 10, 2008].
“(3) Program locations.—The pilot program under this subsection shall be carried out at 10 regional offices of the Department of Veterans Affairs selected by the Secretary for purposes of such pilot program.
“(4) Fully developed claim defined.—For purposes of this subsection, the term ‘fully developed claim’ means a claim for a benefit under a law administered by the Secretary—“(A) for which the claimant—“(i) received assistance from a veterans service officer, a State or country [probably should be “county”] veterans service officer, an agent, or an attorney; or
“(ii) submits along with the claim an appropriate indication that the claimant does not intend to submit any additional information or evidence in support of the claim and does not require additional assistance with respect to the claim; and
“(B) for which the claimant—“(i) submits a certification in writing that is signed and dated by the claimant stating that, as of such date, no additional information or evidence is available or needs to be submitted in order for the claim to be adjudicated; and
“(ii) for which the claimant’s representative, if any, submits a certification in writing that is signed and dated by the representative stating that, as of such date, no additional information or evidence is available or needs to be submitted in order for the claim to be adjudicated.
“(b) Pilot Program on Provision of Checklists to Individuals Submitting Claims.—“(1) In general.—The Secretary shall carry out a pilot program to assess the feasibility and advisability of providing to a claimant for whom the Secretary is required under section 5103(a) of title 38, United States Code, to provide notice of required information and evidence to such claimant and such claimant’s representative, if any, a checklist that includes information or evidence required to be submitted by the claimant to substantiate the claim.
“(2) Duration of pilot program.—The pilot program under this subsection shall be carried out—“(A) for original claims filed after the date of the enactment of this Act [Oct. 10, 2008], during the one-year period beginning on the date that is 60 days after the date of the enactment of this Act; and
“(B) for claims to reopen and for claims for increased ratings that were filed after the date of the enactment of this Act, during the three-year period beginning on the date that is 60 days after the date of the enactment of this Act.
“(3) Program locations.—The pilot program under this subsection shall be carried out at four regional offices of the Department selected by the Secretary for purposes of such pilot program.
“(4) Construction.—A checklist provided under the pilot program under this subsection—“(A) shall be construed to be an addendum to a notice provided under section 5103(a) of title 38, United Sates Code; and
“(B) shall not be considered as part of such notice for purposes of reversal or remand of a decision of the Secretary.
“(c) Reports.—“(1) First initial report.—Not later than 335 days after the date of the enactment of this Act [Oct. 10, 2008], the Secretary shall submit to Congress a report on the pilot program under subsection (a) and the pilot program under subsection (b) with respect to claims described in subsection (b)(2)(A).
“(2) Second interim report.—Not later than 1,065 days after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the pilot program under subsection (b) with respect to claims described in subsection (b)(2)(B).
“(3) Elements of interim reports.—The reports required by paragraphs (1) and (2) shall include the following:“(A) Data concerning the number and type of claims covered by the respective pilot program.
“(B) The findings of the Secretary with respect to the respective pilot program.
“(C) The recommendations of the Secretary on the feasibility and advisability of continuing or expanding the respective pilot program and any necessary modifications to such pilot program for continuation or expansion.
“(D) Such other information as the Secretary considers appropriate.
“(4) Final report.—Not later than 180 days after the completion of each pilot program carried out under this section, the Secretary shall submit to Congress a final report on the feasibility and advisability of continuing or expanding the respective pilot program.”
Study of Performance Measures for Claims Adjudications of the Veterans Benefits AdministrationPub. L. 110–389, title II, § 226, Oct. 10, 2008, 122 Stat. 4159, provided that:
“(a) Study of Work Credit System and Work Management System Required.—The Secretary of Veterans Affairs shall conduct a study on the effectiveness of the current employee work credit system and work management system of the Veterans Benefits Administration of the Department of Veterans Affairs, which is used—“(1) to measure and manage the work production of employees of the Veterans Benefits Administration who handle claims for compensation and pension benefits; and
“(2) to evaluate more effective means of improving performance.
“(b) Contents of Study.—In carrying out the study under subsection (a), the Secretary shall consider—“(1) measures to improve the accountability, quality, and accuracy for processing claims for compensation and pension benefits under laws administered by the Secretary that are adjudicated by the Veterans Benefits Administration;
“(2) accountability for claims adjudication outcomes;
“(3) the quality of claims adjudicated;
“(4) a simplified process to adjudicate claims;
“(5) the maximum use of information technology applications;
“(6) rules-based applications and tools for processing and adjudicating claims efficiently and effectively;
“(7) methods of reducing the time required to obtain information from outside sources; and
“(8) the elements needed to implement—“(A) performance standards and accountability measures, intended to ensure that—“(i) claims for benefits under the laws administered by the Secretary are processed in an objective, accurate, consistent, and efficient manner; and
“(ii) final decisions with respect to such claims are consistent and issued within the target identified in the most recent annual Performance and Accountability report submitted by the Secretary to Congress for the most recent fiscal year;
“(B) guidelines and procedures for the identification and prompt processing of such claims that are ready to rate upon submittal;
“(C) guidelines and procedures for the identification and prompt processing of such claims submitted by severely injured and very severely injured veterans, as determined by the Secretary; and
“(D) requirements for assessments of claims processing at each regional office for the purpose of producing lessons learned and best practices.
“(c) Report to Congress.—Not later than October 31, 2009, the Secretary shall submit to Congress a report on—“(1) the study conducted under subsection (a); and
“(2) the components required to implement the updated system for evaluating employees of the Veterans Benefits Administration required under subsection (d).
“(d) Evaluation of Certain Veterans Benefits Administration Employees Responsible for Processing Claims for Compensation and Pension Benefits.—Not later than 210 days after the date on which the Secretary submits to Congress the report required under subsection (c), the Secretary shall establish an updated system for evaluating the performance and accountability of employees of the Veterans Benefits Administration who are responsible for processing claims for compensation or pension benefits. Such system shall be based on the findings of the study conducted by the Secretary under subsection (a).”
Review and Enhancement of Use of Information Technology in Veterans Benefits AdministrationPub. L. 110–389, title II, § 227, Oct. 10, 2008, 122 Stat. 4160, provided that:
“(a) Review and Comprehensive Plan.—Not later than one year after the date of the enactment of this Act [Oct. 10, 2008], the Secretary of Veterans Affairs shall—“(1) conduct a review of the use of information technology in the Veterans Benefits Administration with respect to the processing of claims for compensation and pension benefits; and
“(2) develop a comprehensive plan for the use of such technology in processing such claims so as to reduce subjectivity, avoidable remands, and regional office variances in disability ratings for specific disabilities.
“(b) Information Technology.—The plan developed under subsection (a)(2) shall include the following:“(1) The use of rules-based processing or information technology systems utilizing automated decision support software at all levels of processing such claims.
“(2) The enhancement of the use of information technology for all aspects of the claims process.
“(3) Development of a technological platform that—“(A) allows for the use of information that members of the Armed Forces, veterans, and dependents have submitted electronically, including uploaded military records, medical evidence, and other appropriate documentation; and
“(B) to the extent practicable—“(i) provides the capability to such members, veterans, and dependents to view applications for benefits submitted online; and
“(ii) complies with the provisions of subchapter III of chapter 35 of title 44, United States Code, section 552a of title 5, United States Code, and other relevant security policies and guidelines.
“(4) The use of electronic examination templates in conjunction with the schedule for rating disabilities under section 1155 of title 38, United States Code.
“(5) Such changes as may be required to the electronic health record system of the Department of Veterans Affairs and the Department of Defense to ensure that Veterans Benefits Administration claims examiners can access the available electronic medical information of the Department of Veterans Affairs and the Department of Defense.
“(6) The provision of bi-directional access to medical records and service records between the Department of Veterans Affairs and the Department of Defense.
“(7) The availability, on a secure Internet website of the Department of Veterans Affairs, of a portal that can be used by a claimant to check on the status of any claim submitted by that claimant and that provides information, if applicable, on—“(A) whether a decision has been reached with respect to such a claim and notice of the decision; or
“(B) if no such decision has been reached, notice of—“(i) whether the application submitted by the claimant is complete;
“(ii) whether the Secretary requires additional information or evidence to substantiate the claim;
“(iii) the estimated date on which a decision with respect to the claim is expected to be made; and
“(iv) the stage at which the claim is being processed as of the date on which such status is checked.
“(c) Review of Best Practices and Lessons Learned.—In carrying out this section, the Secretary shall review—“(1) best practices and lessons learned within the Department of Veterans Affairs; and
“(2) the use of the technology known as ‘VistA’ by other Government entities and private sector organizations who employ information technology and automated decision support software.
“(d) Reduction of Claims Processing Time.—In carrying out this section, the Secretary shall ensure that a plan is developed that, not later than three years after implementation, includes information technology to the extent possible to reduce the processing time for each compensation and pension claim processed by the Veterans Benefits Administration. The performance for claims processing under this plan shall be adjusted for changes to the numbers of claims filed in a given period, the complexity of those claims, and any changes to the basic claims processing rules which occur during the assessment period.
“(e) Consultation.—In carrying out this section, the Secretary of Veterans Affairs shall consult with information technology designers at the Veterans Benefits Administration, the Veterans Health Administration, VistA managers, the Secretary of Defense, appropriate officials of other Government agencies, appropriate individuals in the private and public sectors, veterans service organizations, and other relevant service organizations.
“(f) Report to Congress.—Not later than April 1, 2010, the Secretary shall submit to Congress a report on the review and comprehensive plan required under this section.”
Temporary Authority for Performance of Medical Disabilities Examinations by Contract PhysiciansPub. L. 108–183, title VII, § 704, Dec. 16, 2003, 117 Stat. 2672, as amended by Pub. L. 110–389, § 105, Oct. 10, 2008, 122 Stat. 4149; Pub. L. 111–275, title VIII, § 809, Oct. 13, 2010, 124 Stat. 2894; Pub. L. 112–191, title II, § 207, Oct. 5, 2012, 126 Stat. 1440; Pub. L. 113–59, § 14, Dec. 20, 2013, 127 Stat. 663; Pub. L. 113–175, title I, § 106, Sept. 26, 2014, 128 Stat. 1903; Pub. L. 114–58, title IV, § 409, Sept. 30, 2015, 129 Stat. 535; Pub. L. 114–228, title IV, § 412, Sept. 29, 2016, 130 Stat. 941; Pub. L. 114–315, title I, § 109(a)(1), Dec. 16, 2016, 130 Stat. 1544; Pub. L. 115–91, div. A, title V, § 529, Dec. 12, 2017, 131 Stat. 1383, provided that:
“(a) Authority.—Using appropriated funds, other than funds available for compensation and pension, the Secretary of Veterans Affairs may provide for the conduct of examinations with respect to the medical disabilities of applicants for benefits under laws administered by the Secretary by persons other than Department of Veterans Affairs employees. The authority under this section is in addition to the authority provided in section 504(b) of the Veterans’ Benefits Improvement Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note).
“(b) Performance by Contract.—Examinations under the authority provided in subsection (a) shall be conducted pursuant to contracts entered into and administered by the Under Secretary for Benefits.
“(c) Expiration.—The authority in subsection (a) shall expire on December 31, 2018. No examination may be carried out under the authority provided in that subsection after that date.
“(d) Licensure of Contract Physicians.—“(1) In general.—Notwithstanding any law regarding the licensure of physicians, a physician described in paragraph (2) may conduct an examination pursuant to a contract entered into under subsection (b) at any location in any State, the District of Columbia, or a Commonwealth, territory, or possession of the United States, so long as the examination is within the scope of the authorized duties under such contract.
“(2) Physician described.—A physician described in this paragraph is a physician who—“(A) has a current unrestricted license to practice the health care profession of the physician;
“(B) is not barred from practicing such health care profession in any State, the District of Columbia, or a Commonwealth, territory, or possession of the United States; and
“(C) is performing authorized duties for the Department of Veterans Affairs pursuant to a contract entered into under subsection (b).
“(e) Report.—Not later than four years after the date of the enactment of this Act [Dec. 16, 2003], the Secretary shall submit to Congress a report on the use of the authority provided in subsection (a). The Secretary shall include in the report an assessment of the effect of examinations under that authority on the cost, timeliness, and thoroughness of examinations with respect to the medical disabilities of applicants for benefits under laws administered by the Secretary.”
Pilot Program for Use of Contract Health Care Professionals for Disability ExaminationsPub. L. 118–210, title III, § 304(b), (c), Jan. 2, 2025, 138 Stat. 2792, provided that:
“(b) Remedies.—The Secretary of Veterans Affairs shall take such actions as the Secretary considers appropriate to ensure compliance with section 504(c) of the Veterans’ Benefits Improvements Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note), as amended by subsection (a).
“(c) Annual Report.—Not later than one year after the date of the enactment of this Act [Jan. 2, 2025] and not less frequently than once each year thereafter, 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—“(1) the conduct of the pilot program established under section 504 of the Veterans’ Benefits Improvements Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note); and
“(2) the actions of the Secretary under subsection (b).”
Pub. L. 116–315, title II, § 2002(f), Jan. 5, 2021, 134 Stat. 4969, provided that: “The Secretary shall take such actions as may be necessary to hold accountable the providers of medical examinations pursuant to contracts under section 504 of the Veterans’ Benefits Improvements Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note) who are underperforming in the meeting of the needs of veterans through the performance of medical examinations pursuant to such contracts.”
Pub. L. 104–275, title V, § 504, Oct. 9, 1996, 110 Stat. 3341, as amended by Pub. L. 113–235, div. I, title II, § 241, Dec. 16, 2014, 128 Stat. 2568; Pub. L. 114–315, title I, § 109(a)(2), Dec. 16, 2016, 130 Stat. 1544; Pub. L. 115–141, div. J, title II, § 256, Mar. 23, 2018, 132 Stat. 826; Pub. L. 115–407, title VII, § 702(b), Dec. 31, 2018, 132 Stat. 5381; Pub. L. 116–315, title II, § 2002(a)(1), (4), Jan. 5, 2021, 134 Stat. 4967, 4968; Pub. L. 118–19, § 1, Oct. 6, 2023, 137 Stat. 106; Pub. L. 118–210, title III, §§ 304(a), (d), 305(a), Jan. 2, 2025, 138 Stat. 2792, provided that:
“(a) Authority.—The Secretary of Veterans Affairs, acting through the Under Secretary for Benefits, may conduct a pilot program under this section under which examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary that are carried out through the Under Secretary for Benefits may be made by persons other than employees of the Department of Veterans Affairs. Any such examination shall be performed pursuant to contracts entered into by the Under Secretary for Benefits with those persons.
“(b) Limitation.—The Secretary may carry out the pilot program under this section as follows:“(1) In fiscal years before fiscal year 2015, through not more than 10 regional offices of the Department of Veterans Affairs.
“(2) In fiscal year 2015, through not more than 12 regional offices of the Department.
“(3) In fiscal year 2016, through not more than 15 regional offices of the Department.
“(4) In fiscal year 2017 and each fiscal year thereafter, through such regional offices of the Department as the Secretary considers appropriate.
“(c) Licensure of Contract Health Care Professionals.—“(1) In general.—Notwithstanding any law regarding the licensure of health care professionals, only a health care professional described in paragraph (2) may conduct an examination pursuant to a contract entered into under subsection (a) at any location in any State, the District of Columbia, or a Commonwealth, territory, or possession of the United States, so long as the examination is within the scope of the authorized duties under such contract.
“(2) Health care professional described.—A health care professional described in this paragraph is a physician, physician assistant, nurse practitioner, audiologist, or psychologist, who—“(A) has a current unrestricted license to practice the health care profession of the physician, physician assistant, nurse practitioner, audiologist, or psychologist, as the case may be;
“(B) is not barred from practicing such health care profession in any State, the District of Columbia, or a Commonwealth, territory, or possession of the United States; and
“(C) is performing authorized duties for the Department of Veterans Affairs pursuant to a contract entered into under subsection (a).
“(d) Source of Funds.—Expenses of carrying out the pilot program under this section, including payments for pilot program examination travel and incidental expenses under the terms and conditions set forth by 38 U.S.C. 111, shall be reimbursed to the accounts available for the general operating expenses of the Veterans Benefits Administration and information technology systems from amounts available to the Secretary of Veterans Affairs for payment of compensation and pensions.
“(e) Report to Congress.—Not later than three years after the date of the enactment of this Act [Oct. 9, 1996], the Secretary shall submit to the Congress a report on the effect of the use of the authority provided by subsection (a) on the cost, timeliness, and thoroughness of medical disability examinations.
“(f) Certain Information Provided to Health Care Professional.—The Secretary shall provide to a health care professional who performs an examination under subsection (a), or a contractor performing a contract under such subsection, the contact information of any agent or attorney recognized by the Secretary under chapter 59 of title 38, United States Code, with regards to a claim for benefits that gives rise to such examination.”
[Pub. L. 118–210, title III, § 305(b), Jan. 2, 2025, 138 Stat. 2792, provided that: “The amendment made by this section [amending section 504 of Pub. L. 104–275, set out above] shall apply to an examination described in subsection (a) of such section that is performed on or after the date of the enactment of this Act [Jan. 2, 2025].”
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[Pub. L. 116–315, title II, § 2002(a)(2), Jan. 5, 2021, 134 Stat. 4967, provided that: “The purpose of the amendment made by paragraph (1) [amending section 504 of Pub. L. 104–275, set out above] is to expand the license portability for physicians assistants, nurse practitioners, audiologists, and psychologists to supplement the capacity of employees of the Department to provide medical examinations described in subsection (b) [set out as a note above].”
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[Pub. L. 116–315, title II, § 2002(a)(3), Jan. 5, 2021, 134 Stat. 4968, provided that: “The amendment made by paragraph (1) [amending section 504 of Pub. L. 104–275, set out above] shall not be construed to affect the license portability for physicians in effect under section 504(c) of such Act [Pub. L. 104–275] as in effect on the day before the date of the enactment of this Act [Jan. 5, 2021].”
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[Pub. L. 116–315, title II, § 2002(a)(4), Jan. 5, 2021, 134 Stat. 4968, as amended by Pub. L. 118–19, § 1, Oct. 6, 2023, 137 Stat. 106; Pub. L. 119–37, div. G, title II, § 7203, Nov. 12, 2025, 139 Stat. 650, provided that: “On the date that is six years after the date of the enactment of this Act [Jan. 5, 2021], subsection (c) of such section [section 504(c) of Pub. L. 104–275, set out above] shall read as it read on the day before the date of the enactment of this Act.”
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Expedited Treatment of Remanded ClaimsPub. L. 103–446, title III, § 302, Nov. 2, 1994, 108 Stat. 4658, as amended by Pub. L. 105–368, title V, § 512(c), Nov. 11, 1998, 112 Stat. 3342, provided that Secretary of Veterans Affairs was to take necessary actions to provide for expeditious treatment, by the Board of Veterans’ Appeals and by regional offices of the Veterans Benefits Administration, of any claim that had been remanded by the Board of Veterans’ Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action, prior to repeal by Pub. L. 108–183, title VII, § 707(c), Dec. 16, 2003, 117 Stat. 2673.
Veterans’ Claims Adjudication CommissionPub. L. 103–446, title IV, Nov. 2, 1994, 108 Stat. 4659, as amended by Pub. L. 104–275, title V, § 503(a), Oct. 9, 1996, 110 Stat. 3341, established Veterans’ Claims Adjudication Commission which was directed to conduct comprehensive evaluation and assessment of Department of Veterans Affairs system for disposition of claims for veterans benefits and of system for delivery of such benefits, together with any related issues determined to be relevant to study, for purpose of determining means of increasing efficiency of system, means of reducing number of claims under system for which final disposition is pending, and means of enhancing ability of Department of Veterans Affairs to achieve final determination regarding claims under system in prompt and appropriate manner, and further provided for membership and powers of Commission, personnel matters, definitions and funding, and for submission of preliminary report to Secretary of Veterans Affairs and Congress not later than one year after Nov. 2, 1994, submission of final report not later than Dec. 31, 1996, and for termination of Commission 90 days after submission of final report.