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Veterans Benefits AdministrationM21-1, Part III - page 10 / 71





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February 25, 2005M21-1, Part III

                                                                                                                                                    Change 131

Code M05.  NA Form 13055,  “Request for Information Needed to Reconstruct Medical Data,”  should be completed by the veteran or claimant prior to initiating the PIES request in order to facilitate searches of auxiliary records.  Occasionally, information required on NA Form 13055 is available in the claims folder.  In this case, do not delay submission of a PIES request in order to have the NA Form 13055 completed.  Enter the appropriate information on the M05 request.

        (1)  If the claimant fails to furnish an NA Form 13055 and the evidence of record does not establish whether or not there is a legal bar, disallow the claim for failure to prosecute and notify the claimant of the reason for the disallowance.  Furnish notice of procedural and appellate rights.

(2)  If the claimant furnishes an obviously incomplete or inadequate NA Form 13055 and there is insufficient information to complete the PIES M05 request, disallow the claim without submitting the PIES request.  Fully advise the claimant of the reason for the disallowance and send the claimant another NA Form 13055.

c.  Alternate Sources–Development.  See paragraph 4.25 for alternate sources of evidence that may be used in these cases.  Where alternative source of evidence is developed, the correspondence must avoid creating the impression that the claimant would have obtained favorable action on the claim had the records in existence at St. Louis not been destroyed by fire.


a.  Pre-Formatted Request Codes.  Pre-formatted request codes have been established for the most common PIES 3101 requests.  These codes are mapped to forward the request to the correct address code and to select the proper record for retrieval at NPRC.  These codes should be utilized whenever possible.  Review Addendum K for the current available request codes.  Where no record code will suffice, use the free text code O99.  Use of this code should be limited as it requires human intervention to process.

b.  Classified Service Records

(1)  If a claimant alleges at any point that disability or death occurred on active duty during classified or covert operations, request the veteran’s personnel records in addition to medical records.

(2)  If the personnel and medical records considered together do not provide a reasonable basis for a grant or denial of service connection, advise the veteran that VA has secured all available service records and invite the veteran to submit any additional evidence in his or her possession that might support the claim.  Suggest possible alternative sources for the veteran to substantiate his or her claim such as statements from members of the unit, contemporaneous letters home, and contemporaneous statements to physicians.  If no additional evidence is forthcoming, adjudicate based on the evidence of record.

(3)  VA does not have access to records that are still classified even if they are relevant to a pending claim for disability or death benefits.

c.  Two Years Honorable Active Service.  If death occurs in service and was not in line of duty or was due to willful misconduct, death pension benefits may be payable, provided the serviceperson completed at least 2 years honorable active service, one day of which was wartime service, prior to death.  See part IV, paragraph 11.04h and 38 CFR 3.1(d).  Send a request for verification of 2 years honorable active service to the service department using


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