6.09 INFORMAL CLAIMS

a. General (38 CFR 3.155). An informal claim is any communication or action which shows an intent to apply for benefits under laws VA administers. If an original claim has not been filed under 38 CFR 3.160, the communication or action must identify the benefit sought.

b. Specific Types of Informal Claims

(1) A Claim for Benefits not Filed on the Proper Form

(a) If a claim is not filed on the proper form (e.g., VA Form 21-526, Veterans Application for Compensation or Pension, or 21-534, Application for Dependency and Indemnity Compensation or Death Pension by a Surviving Spouse or Child), it is an informal claim.

(b) Inform the claimant of the need to return the completed form within 1 year to receive benefits from the date VA received the informal claim.

EXAMPLE: A telephone call or a letter from a claimant indicating the intent to apply for benefits is acceptable as an informal claim for date of claim purposes, but do not control the issue. Send the proper application form to the claimant and tell him or her to return the completed form within 1 year to receive benefits from the date the letter or telephone call was received.

NOTE: The submission of any properly completed and signed but obsolete form such as a superceded version of a 21-526 or 21-534 is a formal claim. If further information is needed, solicit the evidence by asking the claimant to complete any needed VA forms or by furnishing VA Form 21-4138, Statement of Claim, with the necessary evidence. See M21-1, part III, paragraph 2.04.

(2) An Unsigned Application

(a) If an unsigned application is received, make a copy for the file.

(b) Return the original application to the claimant for signature.

(c) Inform the claimant of the need to return the signed form within 1 year to receive benefits from the date VA received the informal claim. Concurrently develop for any other necessary evidence.

(d) Do not establish an end product control until a signed application is received.

(3) Reports of Examination or Hospitalization by VA or Military (38 CFR 3.157(b)

(a) Evidence of examination or hospitalization in a VA or uniformed services health care facility is an informal claim for an increased evaluation of a condition previously service connected. Additional information regarding uniformed services medical facilities may be found in Subchapter III. A notice of hospitalization may not suffice as an informal claim if a veteran service connected for one disability is hospitalized for a different disability for which service connection has not been granted. If the medical evidence shows treatment for the service-connected disability or manifestations of the service-connected disability, the provisions of 38 CFR 3.400(o) pertaining to the 1-year limitation for receipt of a claim do not apply. Accept the date of admission for treatment for a service-connected disability as the date of claim for increased evaluation. Establish and maintain control of the claim.

(b) Accept evidence of examination or hospitalization at a VA or uniformed services health care facility as an informal claim if a claim specifying the benefit sought is received within 1 year of treatment. Liberally interpret reasonable probability of a valid claim. After final adjudication of an original claim, if subsequent communication from a claimant alleges facts that present the reasonable probability of a valid claim, accept the claimant's written allegations as a reopened claim or a claim for increase. The claimant need not specifically state that it is a claim or identify the exact benefit sought. Establish and maintain control of the claim.