Scope Quality lens
Quality reviews the whole completed action QRT is not checking only the final rating paragraph. Rating review includes the adjudicative work that led to completion; non-rating review includes the actions needed to finish that benefit issue.
Use it when Use this as the frame for every pre-release review: intake, development, decision, award, notice, and systems can all matter. Open captured source → Root cause Quality lens
Record the cause, not a chain of duplicate errors A single mistake can create several downstream defects. Quality guidance looks for the root cause and avoids counting the same problem repeatedly as cascading errors.
Use it when When self-review finds several bad outputs, trace them back to the first wrong action and correct the entire chain. Open captured source → VSR 1 Quality lens
Notice and development to the claimant Was the claimant told what was needed, who would get it, and what happened when evidence could not be obtained? Was the notice correct for this lane and sent at the right time?
Use it when Check 5103, incomplete-claim, due-process, inability-to-obtain, and other issue-specific notice before release. Open captured source → VSR 2 Quality lens
Service treatment records Were all pertinent STRs requested, obtained, or properly resolved as unavailable?
Use it when Check every relevant service period and lead; one negative source does not necessarily end Federal-record development. Open captured source → VSR 3 Quality lens
Other Federal records Were relevant VA, SSA, personnel, service-department, or other Federal records pursued under the correct continuing-efforts rule?
Use it when Verify requests, follow-ups, negative replies, formal findings/documentation, and claimant notice when required. Open captured source → VSR 4 Quality lens
Private and non-Federal records Were adequately identified private records developed with the required release, requests, follow-up, and notice?
Use it when Do not mark development complete merely because the initial letter was sent. Open captured source → VSR 5 Quality lens
Examinations and opinions Was every necessary exam/opinion requested correctly—and was every unnecessary request avoided?
Use it when Quality captures an unnecessary exam under this task even when it causes no material delay. Also check DBQ, theory, questions, evidence, specialty, and request language. Open captured source → VSR 6 Quality lens
All issues addressed Every issue that belongs to the action must be developed or decided; no contention should disappear between intake and release.
Use it when Reconcile the application, contentions, evidence, rating/admin decision, codesheet, award, and notice. Open captured source → VSR 7 Quality lens
Award or administrative decision The required award or administrative decision must exist and correctly implement the result.
Use it when Check the decision, award line, payment dates, rates, signatures, and any required administrative determination together. Open captured source → VSR 8 Quality lens
Dependency Dependency decisions and award adjustments must use the correct people, status facts, and dates.
Use it when Reconcile the current award, forms/evidence, additions/removals, effective dates, notice, and any due process. Open captured source → VSR 9 Quality lens
Withholding and reductions Required withholding, offset, reduction, or discontinuance must be calculated and implemented correctly.
Use it when Screen retired pay, drill pay, incarceration, apportionment, debt, attorney fees, and other payment interactions when raised. Open captured source → VSR 10 Quality lens
Claimant notification The notice must accurately explain what VA decided, why, the payment effect, rights, and any required next action.
Use it when Compare the notice to the final decision and award; verify representative handling and address. Open captured source → VSR 11 Quality lens
Systems compliance The electronic record must match the work: EP/DOC, service, addresses, contentions, POA, tracked items, flashes, special issues, routing, and other mandatory fields.
Use it when Treat systems updates as part of the action, not cleanup after the claim is done. Open captured source → VSR 12 Quality lens
Other correctable defects A problem can require correction even when it is not a benefit-entitlement error or one of the named tasks.
Use it when Fix documentation, administrative, notification, and procedural defects before they become repeated local errors. Open captured source → VSR 13 Quality lens
Automation attribution Quality records whether an error came from an automated process or the human action around it.
Use it when Do not assume automation removes the need to review the produced action. Open captured source → RVSR 1 Quality lens
Every claimed issue decided The rating must address each claimed issue within scope.
Use it when Compare the claim, contention list, deferrals, rating, codesheet, and notice issue by issue. Open captured source → RVSR 2 Quality lens
Inferred and ancillary issues The decision must address benefits and issues reasonably raised by the evidence, even when the claimant did not use the exact legal label.
Use it when Screen SMC, IU, dependents, complications, secondary issues, scars, and other applicable ancillary matters. Open captured source → RVSR 3 Quality lens
Necessary non-exam development The record must contain the non-examination development needed to decide the issue.
Use it when Before rating, identify missing service facts, records, stressor/exposure verification, releases, or procedural development. Open captured source → RVSR 4 Quality lens
Exam need and adequacy The rater must identify missing necessary exams/opinions and reject or clarify inadequate ones.
Use it when Review factual premise, rationale, scope, theory, DBQ findings, internal consistency, and whether all opinion questions were answered. Open captured source → RVSR 5 Quality lens
Grants A grant must be legally and factually supported and implemented for the correct disability, theory, evaluation, and period.
Use it when Verify elements, favorable findings, diagnostic code, effective date, and downstream award effect. Open captured source → RVSR 6 Quality lens
Denials A denial must apply the correct standard to a complete record and explain the actual missing element.
Use it when Check every raised theory, favorable evidence, benefit of doubt, reasons, favorable findings, and notice language. Open captured source → RVSR 7 Quality lens
Evaluation, SMC, and combined evaluation The assigned percentage, diagnostic code, staged periods, SMC, and combined result must follow the rating criteria and record.
Use it when Compare the evidence dates and findings to the schedule rather than copying the examination conclusion. Open captured source → RVSR 8 Quality lens
Effective dates Each grant, increase, reduction, or ancillary benefit needs the correct date under the applicable claim and exception rules.
Use it when Build the timeline separately: claim/ITF, finality, continuous pursuit, entitlement facts, liberalizing law, and special exceptions. Open captured source → RVSR 9 Quality lens
Decision quality The decision must be internally consistent, understandable, and free of other material defects.
Use it when Read the result, narrative, codesheet, award, and notice as one product; they should tell the same story. Open captured source → RVSR 10 Quality lens
Deferrals A deferral must be necessary, specific, and correctly recorded; it should move the claim toward a decision.
Use it when State exactly what is missing, why it matters, and what action resolves it. Avoid vague or unnecessary deferral cycles. Open captured source → RVSR 11 Quality lens
Rating systems and codesheet The rating, codesheet, EP, POA/service data, special issues, and signature requirements must match the legal decision.
Use it when Check systems fields before release, including any required additional signature or promulgation instruction. Open captured source → RVSR 12–13 Quality lens
Other correctable defects and automation Quality also records correctable rating defects and whether automation created or contributed to the error.
Use it when Correct the action even if the defect does not change entitlement, and review automated outputs before relying on them. Open captured source → CA 1 Quality lens
Correct claimant The work must be attached to and performed for the correct claimant.
Use it when Verify identity/file association before establishing or routing the control. Open captured source → CA 2 Quality lens
Correct EP control The correct EP, modifier, label, date, and control must be established for the work received.
Use it when For broad EPs such as 290, 330, and 400, use the actual issue and system label—not the number alone. Open captured source → CA 3–4 Quality lens
Record updates, tracking, routing, and other CA work Documents, contentions, routing, tracked items, flashes, addresses, and other intake actions must accurately prepare the claim for the next processor.
Use it when A downstream processor should not have to rediscover or repair the intake facts before starting the claim. Open captured source → Overdevelopment Quality lens
More development is not automatically safer Unnecessary exams are quality defects. Other overdevelopment becomes a quality issue when it materially delays the claim.
Use it when Before every request, name the unresolved material fact and the authority that makes the action necessary. Open captured source → 38 CFR § 3.1
Definitions This section supplies basic meanings used throughout Part 3. A familiar word may have a narrower regulatory meaning.
Open it when a rule turns on a defined term such as claim, date of receipt, notice, or veteran. Source 38 CFR § 3.12
Character of discharge This rule addresses when the character and circumstances of discharge affect eligibility for VA benefits.
Use with the current COD M21 procedure; check the rule version that applies to the relevant decision period. Source 38 CFR § 3.103
Procedural due process Claimants have procedural rights: notice of decisions, an opportunity to respond in covered actions, representation, hearings, and fair process.
Use whenever VA proposes or takes an adverse action, handles a hearing/request, or issues decision notice. Source 38 CFR § 3.104
Finality and favorable findings VA decisions become binding under the review system, and favorable findings generally remain binding unless the rule's standard for changing them is met.
Check before re-deciding a fact in a later claim or review lane. Source 38 CFR § 3.105
Revision, reduction, and severance procedures This section contains special processes for correcting certain errors and proposing reductions or severance.
Do not treat a reduction, severance, or CUE action like an ordinary new decision; follow its specific notice and timing rules. Source 38 CFR § 3.151
Claims for benefits Benefits normally require a claim in the form prescribed by the Secretary, subject to the rule's linked provisions.
Start here when deciding whether a communication is a claim and what benefit/application framework applies. Source 38 CFR § 3.155
How a claim or intent to file begins This section addresses intent to file and incomplete/complete application procedures under the modern claims system.
Use when receipt date, prescribed form, incomplete application, or an intent to file could protect a date. Source 38 CFR § 3.159
Evidence, notice, and duty to assist This is the core evidence-development rule: what evidence can prove, what VA and the claimant must provide, when VA pursues records, and when an exam/opinion is required.
Use for Federal/private records, claimant notice, relevance, unavailable evidence, and exam/opinion questions. Source 38 CFR § 3.160
Claim status Defines complete, incomplete, original, supplemental, pending, finally adjudicated, and related claim states.
Use before choosing a lane or deciding whether a submission is ready for adjudication. Source 38 CFR § 3.2500
Review options and continuous pursuit After a decision, the claimant must use an authorized review option; timely consecutive choices can preserve continuous pursuit.
Map the procedural timeline before developing a review request or assigning an effective date. Source 38 CFR § 3.2501
Supplemental claims A supplemental claim uses the prescribed form and requires new and relevant evidence before readjudication on the merits.
Use for the EP 040 threshold, assistance in obtaining identified evidence, and the resulting decision posture. Source 38 CFR § 3.307
How presumptions are applied Sets general requirements for specified presumptive service-connection rules, including qualifying service and rebuttal concepts.
Pair with the particular disease/exposure rule instead of treating it as a stand-alone presumptive list. Source 38 CFR § 3.309
Diseases subject to presumptive service connection Lists disease groups for several presumptions, including certain herbicide-related conditions.
Match the exact condition and applicable service presumption; if it does not match, still consider direct and other raised theories. Source 38 CFR § 3.310
Secondary service connection and aggravation A disability may be service connected when caused or aggravated by an established service-connected condition.
Treat causation and aggravation as separate questions when both are raised; obtain an opinion that answers the actual theory. Source 38 CFR § 3.317
Certain Gulf War disabilities Provides a special framework for qualifying chronic disabilities associated with covered Gulf War service.
Verify service area/dates, disability pattern, chronicity, exclusions, and whether other presumptive/direct routes also apply. Source 38 CFR § 3.400
Effective dates The general rule usually ties the date to the later of claim receipt or when entitlement arose, with many claim-specific exceptions.
Build the timeline first, then apply the exact subsection and any AMA, liberalizing-law, increase, or presumptive exception. Source 38 CFR § 3.500
Effective dates of reductions and discontinuances This section supplies date rules for specified reductions/discontinuances, often tied to the event and due-process posture.
Use with the specific adverse-action authority for dependency, status, entitlement, or payment changes. Source 38 CFR §§ 4.1–4.2
Read the disability in context; interpret the evidence Ratings are based on average impairment, but the disability must be viewed in its history and medical reports interpreted as a whole.
Do not rate from one isolated phrase or copy an examiner's conclusion without reconciling the whole relevant record. Source 38 CFR §§ 4.3 and 4.7
Reasonable doubt and choosing between evaluations Resolve reasonable doubt in the claimant's favor, and assign the higher of two evaluations when the disability picture more nearly approximates its criteria.
Apply after assembling the competent evidence and comparing the full disability picture to the criteria. Source 38 CFR § 4.10
Functional impairment Evaluation includes how the disability affects ordinary activity and functioning, not merely the diagnosis name.
Connect examination findings and competent lay/medical evidence to actual functional effects under the applicable criteria. Source