FIGURE 3:  INSTRUCTIONS FOR VERIFYING AND REPORTING SERVICE AND MEDICAL DATA
 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA specifically requests: and if: clerk will:
1

 

 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

 all items to be checked are verified correct check center box in the response/endorsement portion of the form. (See figures 4 and 5.)
See also fig. 18 if the VA submits a separation document for verification of service data.
2 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

 Any of the items to be checked are incorrect or are not shown check box on right in the response/endorsement portion of the form and show number(s) of incorrect or missing item(s), followed by correct information. An example of this appears in figures 6 and 7.
See also fig. 18 if the VA submits a separation document for verification of service data.
  "NOTE CONCERNING ITEM", or 12, DATE OF DEATH: When this item is completed by the VA, verify ONLY if occurred in service. If death occurred after separation from active duty, do not verify.
3 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

 requests involves an Army veteran whose active service started before 11/1/12 and he was still serving on that date, and if the records covering the period before 11/1/12 are not at NPRC enter on VA 3101: "serving on Nov. 1, 1912."
4 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

 Veteran had more than one period of active service and records contain copy of statement of service furnish a copy of the SOS or send a duplicate microfiche. Place an asterisk in "Other record" in the enclosure block and another asterisk and the words "Statement of Service" elsewhere in the response block. Do not verify items of service.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA specifically requests: and if: clerk will:
5 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

 records show veteran had prior service in another branch and VA specifically asks that question furnish branch of service, service number, and dates of prior service only if shown in records at hand -- do not look elsewhere. If service is not shown in records at hand, ask VA.. to submit a separate request for verification of service in another branch.
6 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

 veteran had continuous periods of honorable active service verify or furnish only the date of FIRST entry on active duty and the LAST date of separation from active duty unless instructed to do otherwise in specific cases.
7 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA. Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA. Form 3101 requests)

*See note on 1st page
of this table.

 veteran enlisted for 3 or 6 months active duty training under the Reserve Forces Act of 1955 or Reserve Enlistment Program of 1963 verify or furnish ACDUTRA dates and enter in the response block: "RFA-55 (3 or 6) months ACDUTRA," or "REP-63 (3 or 6) months ACDUTRA." as applicable. NOTE: Do not verify short periods of ACDUTRA for which a separation document was not prepared unless specifically asked to do s) by VA.. If separation document was prepared for ACDUTRA, verify but let VA. know service was ACDUTRA.
8 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA. Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA. Form 3101 requests)

 veteran entered active WWI service (Federal) from a state National Guard as was:

a. discharged within 3 months of date of entry

 furnish statement as to whether he was physically examined and accepted for Federal service.
8

 

 Continued

 

 b. physically disqualified for Federal service state that he is considered by the Army to have performed active Federal service during the period of Mexican Border service, if any, and include the dates of WWI service.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
9  Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA. Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA. Form 3101 requests)

 veteran was discharged from draft

(WWI) because of;

a. rejection
 

--------------------------------------------------

b. cancellation of draft

 enter one of the following statements, as appropriate, in the response block:

"Inducted (date); rejected at camp and was discharged from the draft (date), by reason of 
(giving reason for rejection)."

------------------------------------------------------------------

"Inducted (date) by (local board, city, and state). He was discharged from the draft (dated). by reason of cancellation of the draft."

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
10 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14 and/or 15. (manually-generated VA Form 3101 requests)

*See note on 1st page
of this table

 veteran was separated from active service under conditions other than honorable (Undesirable, Bad Conduct, Dishonorable, etc.) and:

a. service record contains documents that describe the steps that led up to the discharge and/or that provide other derogatory or complimentary information about the veteran. Such documents would include, but not necessarily be limited to;

(1) MC, CG, and Navy

(2) Air Force and Army

- a letter from the immediate commander stating reasons why the person should be discharged

- statement(s) of supervisor(s)

- summaries or copies of any Article 15's (non-judicial punishment)

- reports of investigation, such as criminal investigation

- all records of military criminal charges preferred (charge sheet) and records of conviction by court martial (court martial orders)

- Board of Officer Proceedings

- Physical Evaluation Board

- Field Board Hearing (Navy)*

 furnish copies of any documents that will help the VA to make a fair determination of the veteran's eligibility for benefits. There will more likely not be a packet, and the documents will have to be located among the other papers in the record.

furnish originals (but see exceptions below) of any documents that will help the VA to make a fair determination of the veteran's eligibility for benefits. There may be a packet of such papers referred to as the (Facts and Circumstances." 

NOTE: Send copies, not originals, if documents pertain to Army or Air Force Board of Officer Proceedings and PL 95-126 is involved. If the veteran was discharged solely as a result of a court martial, furnish a copy of the court martial order that originally imposed the sentence. Also send a copy of the court martial order which affirmed the sentence. Ensure that a copy of each order remains in the record.

NOTE: The kinds of documents available, and the number of them, will vary not only among the different branches of service, but also depending on the exact nature of the discharge and the era in which it occurred. Also, if documents are on microfiche and a duplicator is available, send duplicate(s).

*When sending Field Board Hearing, be sure that the commanding officer's transmittal letter also is included, along with all enclosures and the Pers F3 letter authorizing discharge.
 
10 Continued b. requests specifies court-
martial proceedings		 furnish copy of court-martial orders from the service record.
10
 
 
 
 
 
 
 
 
 
 
 

 

 Continued
 
 
 
 
 
 
 
 
 
 
 

 

 c. Court Martial proceedings are 
not in the service record
 
 
 
 
 
 
 
 
 
 

 

 seek copy of proceedings from Organizational Records Section, using NA Form 13015, NPRC Search Request and Reply. On the form, clerk will include veteran's organization at the time of the CM, plus location and date. NOTE: If the request indicates, or the service record shows, that the veteran received a Bad Conduct Discharge as the result of a Special or General Court Martial, the proceedings would not be in the OR Section. Rather, see NPRC 1865.69, Fig. 28, (NOTE: Cancelled Memo) and forward request to the correct location, using NA Form 13051. Notify VA of the referral #.
10
 
 
 
 
 
 
 
 
 
 

 

 Continued
 
 
 
 
 
 
 
 
 
 

 

 d. request specifically asks for 
Physical Evaluation Board papers or a report of investigation, but there is none in the service record
 

(1) MC, CG, and Navy
 
 

(2) Air Force and Army
 

 
 
 
 

refer request to Director (232), VARPC, P. O. Box 5020, St. Louis, MO 63115, using NA Form 13051 and notifying VA of the referral #.

reply in remarks section, either "No Physical Evaluation Board papers found in file," or "No report of investigation found in file."
10

 

 Continued

 

 e. papers available to answer the inquiry, as described in item a, above, are stamped "FOR OFFICIAL USE ONLY" furnish available documents without making copies, except sends duplicate microfiche when file copy is on fiche.
10
 

 

 Continued
 

 

 f. papers available to answer the inquiry, as described in item a, above, are stamped "CONFIDENTIAL" send service record and the VA request to the appropriate service department for possible downgrading action. Route through branch chief for authorization to dispatch. Notify VA of referral #1.
10
 

 

 Continued
 

 

 g. Navy enlisted person was given an administrative discharge by reason of undesirable discharge and records contain no substantiating evidence send case and records to C6 Navy correspondence clerk for determination of character of discharge. NOTE: This situation normally is found in cases in which discharges occurred before 1924.
10 Continued h. Navy officer was discharged under other than honorable conditions Refer request to NMPC-312, using NA Form 13051, and notify VA of referral #1.
10
 

 

 Continued
 

 

 i. record is fire-related and no papers are available relevant to the circumstances surrounding discharge furnish reason for discharge, if available, and use fire stamp which states: "All records, if any, in our custody regarding this subject were lost in the fire in July 1973."

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
11 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14, and/or 15. (manually-generated VA Form 3101 requests)
 
 

*See note on 1st page
of this table.

 discharge is being reviewed by the Review or Correction Board for:

a. Army personnel
 
 

NOTE: For Special Review
Projects separate procedures are issued as required
 
 
 
 

b. All other branches
 
 

refer the inquiry to ARPERCEN Special Actions Branch, Room 4565, using NA Form 13051, Transmittal. If the record was charged out for a discharge review, the clerk specifies PAS-AD on the transmittal; it if was charged out for the Correction Board, the code to be used is PAS-AA. Notify the VA office of the referral #.
 
 
 
 

Information requesting VA office that records have been lent to the service department for review or correction of the discharge and suggest that the request be resubmitted in 90 days if the information is still needed.
 

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
12 Verification of any or all of items 1, 2, 6*, 7, 8, and/or 9 and 10. (computer-generated VA Form 3101 requests)

Verification of any or all of items 8, 9, 12*, 13, 14, and/or 15. (manually-generated VA Form 3101 requests)

*See note on 1st page
of this table.

 discharge was changed by Review or Correction Board (including Special Programs)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

See also fig. 18 if the VA
submits a separation document for verification of service data. This rule applies to fig. 18 if
discharge was changed by
Review or Correction Board.

 enter in the response/endorsement block of VA 3101:

(1) The board, special program/project, or authority for changing the character of discharge. INDICATE THE TYPE OF DISCHARGE GRANTED.

Examples: "Upgrade under DoD Discharge Review

Review Program (Special) to _________

Discharge."

"Upgrade under Presidential Proclamation

4313 to ____________ discharge."

(2) Date applied for upgrade (shown on application).

(3) Date discharge was upgraded.

(4) Character of discharge BEFORE upgrade.

NOTE: Upgraded discharges granted under either the Ford Presidential Proclamation 4313 (January 19, 1977) or Carter Program (April 4, 1977) SHOULD include the above items (1 thru 4) on November 1, 1972, edition of DD Form 214 in the record. A copy of that DD 214 attached to VA 3101 is sufficient. Records not containing an amended DD 214 are IBR'd to C5 for thorough record examination to determine items 1 thru 4. If sufficient information is not in record, refer the request and record to the service branch for determination, using NA Form 13051. Notify the VA of the referral #.

information is not in record, refer the request and record to the service branch for determination, using NA Form 13051. Notify the VA of the referral #.
#NOTE: In rules 10, 11, and 12, referrals, and notifications of referrals, may be made on any of the forms that would be consistent with existing instructions on referral notices, such as VA Form 3101; NA Form 13053, National Personnel Records Center Acknowledgement/Referral; or NA Form 13051, Transmittal.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
13 Character, conduct, and/or efficiency ratings   Forward request with records to the VA Liaison Officer for disposition. Do NOT furnish any information from or copies of these records.
14 Eligibility for complete separation veteran not eligible for complete separation enter in the response block the following:

"Veteran was not eligible for complete separation when discharged on (date)." (See figures 9 and 10.) NOTE: See NPRC 1865.107 fig 2-7 for instructions on processing fire related inquiries.
Cases involving PL 95-126 (veteran received dishonorable or 'other than honorable' discharge).

If the VA asks:

"Was the veteran eligible for complete separation prior to (date of dishonorable or other than honorable discharge)? If not, please state date(s) on which this individual completed the period(s) of active service for which he/she was obligated at the time(s) of induction of reenlistment(s)."

And the veteran was not eligible for complete separation, enter in the response block:

(1) "Veteran was not eligible for complete separation prior to (date)."

(2) Include the date of original enlistment/induction, term of active duty, and show date active duty obligation would terminate.

(3) Include the reason or authority for separation, if separated before date of dishonorable or OTH discharge (e.g., for purpose of reenlistment).

(4) If the obligation was extended, include an explanation of the extension; such as, number of days and dates of 'time lost,' or extended by Executive Order # for specified period.

EXAMPLES:

(1) Veteran was not eligible for complete separation prior to (date of Dishonorable Discharge). Enlisted 1-2-72 for 4 years which would terminate 1-1-76. Reenlisted 12-1-75 for 3 years. Separation 11-30-75 for sole purpose of reenlistment. (In this example, date of Dishonorable Discharge was 6-6-76 and record shows no time lost.)

(2) Veteran was not eligible for complete separation prior to (date of OTH). Minority enlistment 3-1-62 to 2-7-66. Extended 33 days 'time lost'--AWOL 2-7-66. (In this example "date of OTH" is 3-12-66.)

(3) Veteran was not eligible for complete separation prior to (date of OTH). Inducted 9-2-49 for 2 years active duty which would terminate 9-1-51, but was extended 12 months by Executive Order 10270 (July 6, 1951). (In this example "date of OTH" is 8-6-52).

NOTE: If the term of original active duty obligation and the date when the original commitment would have been completed cannot be determined, refer the record and request to the appropriate service department. Notify the VA of the referral. NCPMR refers Army cases to DARP-PAS-EAV.
 

 
 
A
B
C
R
U
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E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
14 Continued veteran eligible for complete separation show when veteran was eligible for complete separation prior to the separation under conditions other than honorable. See following NOTE.
  NOTE ON DETERMINING ELIGIBLITY FOR COMPLETE SEPARATION: The criteria to be used in determining whether or not a veteran was eligible for complete separation include: (1) The period for which enlisted or inducted, (2) the period(s) for which enlistment was voluntarily or involuntarily extended, and (3) the authority for discharge or release from active duty. Consult the following directives when making a determination.

a. Army. WD Circular 101, February 26, 1919; WD Circular 154, march 29, 1919.

b. Army and Air Force. Disposition Form dated October 1947, from Management Staff Division, AGO, Washington, DC, to Records Administration Center, TAGO, St. Louis, MO, concerning point system and length of service; and Memorandum dated December 9, 1947, from Chief Clerk, MPRC, to elements of MPRC, concerning point system and length of service; and AFPMP-4 Message 78/52 dated April 24, 1942, for Air Force personnel only.

c. Navy. See fig. 9.

d. Marine Corps. MarCor SOP, Par 8002.

e. Coast Guard. Commandant's Circular No. 35-46; USCG Personnel Bulletin No. 94-45; and Personnel Circulars Numbers 47-50, 2-52, and 26-52.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
15
 
 

 

 Verification of service in Russia
 

 

 a. veteran entered service at any time between 11/12/18 and 4/1/20, inclusive, and did not have at least one day or prior service during the WW I period (4/6/17 thru 11/11/18) furnish a statement as to whether or not the veteran served in Russia. Furnish the ACTUAL dates of service in Russia only upon specific request.
15
 
 
 
 
 
 
 
 
 
 
 
 

 

 Continued
 
 
 
 
 
 
 
 
 
 
 
 

 

 b. records of a Navy or Marine Corps veteran do not show service in Russia but records do show he served aboard a vessel while it was moored or operating in Russian waters between 11/12/18 and 4/1/20, inclusive, and he did not have prior service at any time during the WW I period
 
 
 
 
 
 

 

 furnish a statement that he was aboard (name of vessel) which was moored or operating in Russian waters. The following Naval vessel are credited with having operated within the Russian area:

Albany, Eagle No. 1, New Orleans, Yankton, Brooklyn, Eagle No. 2, Sacramento, Des Moines, Eagle No. 3, South Dakota

NOTE: If allegation is made that veteran served aboard a vessel other than those listed above, check the ships listings filed in the Navy Correspondence Section, or contact the National Archives in Washington, DC.
15
 
 
 
 
 

 

 Continued
 
 
 
 
 

 

 c. Record/request indicates Russian Railway Service Corps (10/9/17 thru 4/1/20)
 
 
 

 

 Code case C6. A computer printout list of names and 'A" Registry numbers of veterans of Russian Railway Service is located in Army Search Section (NCPMA-S). Members considered part of U.S. Army during WW I. NOTE: Russian Railway Service become federally recognized as creditable military service on March 30, 1971.
16
 
 
 
 
 
 

 

 Verification of service in Moro Province
 
 
 
 

 

 a. veteran participated as a member of an expedition or landing party in operations against armed opposition in the Moro Province between 7/3/02 and 7/15/03
 

b. records do not substantiate service in Moro Province
 

 furnish a statement that the veteran did or did not participate as a member of an expedition against opposition in the Moro Province.
 
 

check the ships log or other organization records. If no record is found, furnish a negative report.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
17
 
 
 

 

 Ninety-day statement 

NOTE: for pension benefits war-time creditable service is requested.
 

 a. veteran had 90 days or more creditable active service. See NOTES at end of this rule for definitions of creditable and noncreditable service

 

 furnish or stamp the response block with the following statement: "Veteran had 90 days or more creditable active service (which includes one or more days wartime service), exclusive of furlough time and other noncreditable service." (See figures 6 and 7.)
17
 

 

 Continued
 

 

 b. veteran had 90 days or more non-creditable active service only. See NOTES at end of this rule for definitions of creditable and noncreditable service  furnish the following statement: "Veteran did not have 90 days or more creditable active service."
17
 

 

 Continued
 

 

 c. veteran had less than 90 days noncreditable active service only. See NOTES at the end of this rule for definitions of creditable and non-creditable service furnish the following statement: "Veteran did not have 90 days or more creditable active service."
17

 

 Continued

 

 d. veteran had more than 90 days total active service but less than 90 days creditable service after deducting noncreditable time furnish inclusive dates and type of noncreditable time. See NOTES at end of this rule for definition of noncreditable time.
17 Continued e. veteran had less than 90 days active wartime service, including noncreditable time

(1) if separated by reason of disability
 

(2) if separation was NOT by reason of disability
 

 furnish reason for separation. Do NOT furnish noncreditable time unless specifically requested by VA.

furnish only the reason for separation, the line of duty status, and the disease or injury for which discharged.

furnish only the reason for separation and forward all available medical records. (See figure 4 and figure 5.)
17 Continued f. veteran was dishonorably discharged do not furnish 90 day statement unless specifically requested by VA.
  NOTES CONCERNING CREDITABLE AND NONCREDITABLE SERVICE:

1. Creditable active service. Creditable active service is not necessarily all wartime service. If the veteran served at least one day during wartime, the entire period of active service is to be considered in computing the 90 days creditable service. Two or more war periods may be added to obtain 90 days creditable service. See NPRC 1865.37, par. 5 of definition of wartime service.

a. Computing 90 Days Creditable Service. Having determined that at least one day was spent in wartime service, begin with the first day of active service and count days in service. Use a calendar to determine the number of days in each month. Do Not use an average of 30 days per month in your computations. If the month of February is involved in computation of active service, check the leap year index below (1b), for the possibility of a 29th day of February in that particular year.

b. Leap Year Index. The following are years in which February had or will have 29 days:

1880 1896 1912 1928 1944 1960 1976 1992

1884 * 1916 1932 1948 1964 1980 1996 *1900 was not a leap year; centenary

1888 1904 1920 1936 1952 1968 1984 2000 year is a leap year only every 400

1892 1908 1924 1940 1956 1972 1988 2004 years: 1600, 2000, 2400.

c. Other than honorable separations. If person was separated under other than honorable conditions (undesirable, bad conduct, etc., but NOT including dishonorable), include this period of service in computing the 90 days creditable service.

2. Noncreditable service. The following periods will not be counted as creditable active wartime service:

a. All periods of furlough time (industrial/agricultural/farm, definite or indefinite type furloughs).

b. Time lost on absence without leave (without pay), under arrest (without acquittal), in desertion, and while undergoing sentence of court-martial.

c. Tours of active duty "peace time" only.

d. All periods of Active Duty for Training.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
18 Travel time a. veteran served in the Army forward VA inquiry with records to ARPERCEN (living veterans - PAS-EAV; deceased - PAS-AC, for necessary action and disposition.
18 Continued b. veteran served in branch other than Army (1) determine travel time by:

(a) Computing the number of miles traveled from the place of separation from active duty to the veteran's official home of record. Use AFM 177-135, Official Table of Distances, and a map of the United States to determine the mileage. (NO travel time will be credited to persons who were at their homes on the date of separation.)

(b) computing the number of days travel allowed for the miles traveled. Compute in terms of whole days. Any fraction of a day is counted as a whole day. See figures 4 and 5 for the number of days allowed for the miles traveled. NOTE: Requests for "Travel Outside" is not a request for travel time, but a request for verification of overseas service.

(2) prepare Worksheet for Travel Time (figure 13). File a copy in a transitory file in the processing unit for 90 days and then destroy.

(3) insert the amount of travel time computed in the response/endorsement block on the VA 3101. If no travel time is credited, state: "Under 38 USC 106, travel time has been determined to be 0 days."

(4) forward completed VA 3101 with records to authorized person for signature, as follows:

(a) Air Force and Coast Guard cases to Section Chief.

(b) Navy and Marine Corps cases to appropriate Liaison Officer.

 
 
A
B
C

R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
19 Medical/dental/
health records		 a. medical records are on file in the personnel or medical records jacket furnish all available medical records, such as health records, clinical records (those filed with the personnel records), medical cards, dental records, and physical examinations. Do NOT check records for duplicates or to determine whether allegation (if any) is covered. If a period of service was with the Army from 1942-1945 or 1950-1954, obtain a FAR or check FAR's attached to request for the existence of a QT H (SGO) record. If positive, prepare NA Form 13105, NPRC Search Request, and route to NCPMR-S for a printout of the SGO record. Send original SGO printout to VA and retain a copy for the file. NOTE: In Navy and MarCor cases, do NOT send the abstract of service. See figure 14 and figure 15 for a completed VA 3101 showing medical/health records being forwarded.
19
 
 
 

 
Continued
 
 
 
 

 

 (1) only the original of DDS Form 221 or WDAGO Form 21 (5-1-46 ed.) is on file
 

 

 detach and furnish pages 3 and 4 of DSS Form or pages 2 and 3 of WDAGO Form 21. Enter veteran's name and service number in right margin of pages 3 and 2 respectively. NOTE: Special care should be taken when medical records partially burned or in poor condition are sent to VA.
19

 

 Continued

 

 (2) only the original of AF Form 356, Proceedings and Findings of USAF Physical Evaluation Board is on file send a machine copy. Do NOT send original.
19 Continued (3) Marine Corps health records are in microfiche format send original microfiche. Annotate 3101 showing fiche record. File a copy of VA Form 3101 in fiche envelope.
19 Continued b. medical record not found

(1) Army fire related

 return VA 3101, give appropriate fire stamp and attach NA 13055, Request for Information Needed to Reconstruct Medical Data.
19
 
 
 
 
 
 
 

 

 Continued
 
 
 
 
 
 
 

 

 (2) Army non fire-related, Air Force, and Coast Guard personnel

(a) no allegations made
 
 
 
 
 

 

 complete VA 3101 and insert "None found" in the appropriate enclosure block. Include the following statement in the response/endorsement block. If the date and treatment facility are furnished, an effort will be made to secure the clinical record." NOTE: For Navy and MarCor cases prepare an extra copy of the VA 3101 and a file folder. File the copy of the VA 3101 together with all search reports in the new folder. Send the folder to be filed in the Navy medical records block.
19
 

 

 Continued
 

 

 (b) allegation made

i. date, place, and type of treatment NOT furnished by VA
 

 complete case as outlined in rule 19b(2)(a) above.
19
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 Continued
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 ii. date, place, and type of treatment furnished
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 send delay notice and forward case and records to NCPMA-O for action. Use NA Form 13098, Routing Slip, for this. If service data have also been requested, verify this and complete signature block ("Service Information") before sending case to NCPMA-O. NCPMA-O takes following action:

If the clinical records have been retired here, send all available clinical records for the person concerned.

If clinical records for the named facility have been retired but records for the service person concerned are not included, enter the following statement: "Clinical records for (year) form (hospital) are on file but do not contain any records for the person concerned. If veteran was treated at another medical facility, please furnish date and treatment facility and a further effort will be made to secure the desired records.'

If clinical records for the named facility have not been retired, suggest VA contact the facility and give the address. If a second request is received and we have previously advised VA to contact the hospital, prepare and send NA Form 13042-A (figure 16) to the hospital. Send copy of form to VA as an enclosure to VA 3101 and place copy of form in the file
19 Continued (3) Navy and MarCor personnel Route to Navy Medical Liaison Officer. See NPRC 1865.103, ch. 2, par. 2.
19
 
 

 

 Continued
 
 

 

 c. dental records (specifically requested) not found
 

 

 send physical examinations to VA. and inform that office that dental records were not located. If the physical examinations cannot be found, inform VA. of this fact. For special instructions on Navy and Marine Corps, see NPRC 1865.103, ch. 2, par. 2.
19

 

 Continued

 

 d. request is a "supplemental" request and medical records previously furnished VA. do not cover allegation take action as outlined in rule 19b(2)(b)

 

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:

20		 Clinical records a. clinical records are filed with personnel records furnish all available clinical records only if they are part of the personnel or health jacket.
20
 
 
 
 
 

 

 Continued
 
 
 
 
 

 

 b. clinical records are not filed with personnel records and:

(1) VA. does not furnish sufficient information to search hospital clinical records
 

 

 make negative reply and include the following statement: "If date and treatment facility are furnished, an effort will be made to secure the clinical records."
20 Continued (2) date and place of hospitalization furnished by VA. follow rule 19b(2)(b)(ii) above.
20

 

 Continued

 

 (3) veteran treated at a civilian or U.S. Public Health Service Hospital and records are not at NPRC make negative reply and furnish dates and places of treatment, if available. Do not make an effort to secure the medical records.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
21 Unit type (organization records) data one of the following conditions exists:

a. medical/health or clinical records do not cover allegation and VA. specifically requests such data

b. request pertains to Navy or MarCor veteran whose outpatient treatment was prior to 1953

c. information from the unit type records has not previously been furnished the VA. and request is not the first request for the specific records
 

requests search of NCPMA-O or NCPMR-B records. NCPMA-O or NCPMR-B extracts and furnishes pertinent information as shown in the unit type records. Make copies of the records only if practical to do so.
 
 
 
 
 
 

 
22 Entrance and/or separation X-ray films a. request indicates that search was NOT made at CPR
 
 

b. request indicates that search at CPR was negative

 return VA. 3101 to VA. and suggest that they contact NPRC (CPR), 111 Winnebago Street, St. Louis, Missouri 63118, as these films are filed at that Center.

complete VA. 3101 by entering "None Found" in the enclosure block before the work "X-rays."
NOTE: All X-ray films taken at Armed Forces Entrance Stations are retired to NPRC (CPR), 111 Winnebago Street, St. Louis, MO 63118

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
23 Interim X-ray films   reply in remarks section "Interim X-ray films are retained at treatment facility for 5 years after the end of the calendar year in which they were taken and then destroyed."
24 Report of the disabilities and percentages for which severance pay was paid information is in the records
 

information is NOT in the records

 furnish the percentage for which severance pay was paid.

return VA. 3101 to VA. and suggest that they contact the appropriate finance center for the percentage for which severance pay was paid.
25 Occupational exposure to ionizing radiation DD Form 1141 or DD Form 8  in record furnish DD Form 1141, Record of Exposure of Occupational Ionizing Radiation or DD Form 8 if service was prior to 1958.
25
 
 

 

 Continued
 
 

 

 DD Form 1141 or DD Form 8 not found in record

(1) Air Force

 

 refer request to:

OEHL/RZ
Brooks AFB, TX 78235-5501
25
 

 

 Continued
 

 

 (2) Coast Guard refer request to:

Commandant, U.S. Coast Guard (GPIM-2) Attn: Mr. James Veazey
Washington, DC 20593-0001
25 Continued (3) Army fire-related furnish a negative reply and advise that it cannot be reconstructed.
25
 
 

 

 Continued
 
 

 

 (4) Navy and MC refer request to: 

Bureau of Medicine
Naval Dosimetry Center
Code 0406
Bethesda, MD 20889-5000
25
 
 
 
 
 
 

 

 Continued
 
 
 
 
 
 

 

 (5) Army non-fire-related

 

 for exposure occurring during 1963 and later refer request to: 

Chief, U.S. Army Ionizing Radiation
Army Dosimetry Center
Attn: AMXTM-CE-DCR
Lexington, Ky 40511-5102

furnish a negative reply if exposure was before 1963.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
26 Pay grade data veteran held the highest grade/rating at separation furnish the equivalent pay grade from the record or the appropriate grade conversion table. NOTE: See NPRC 1865.107, fig. 2-5, for instructions on processing fire related inquiries.
26 Continued veteran held a higher grade/rating refer VA. 3101 and record to the appropriate military service department for determination. Prepare NA Form 13008, Loan or Transfer of Records, as a transmittal. Show "Pay grade determination" in remarks. Check the appropriate address block as follows:

Air Force. Send to: 
AFMPC
San Antonio, TX 78233

Office symbol: "DPMDOA" for enlisted personnel and "DPMDOO" for officers

Army. Send to: 
ARPERCEN 
(living veterans - PAS-EAV; deceased - PAS-AC)

Coast Guard. Send to: 
Commandant, USCG
Washington, DC 20593-0001

Marine Corps. Send to: 
Commandant USMC (MMRB-10)
Quantico, VA. through MCLNO

Navy. Send to: 
NMPC (312) Washington, DC through NAVLNO 

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
27

 

 201 file

 

 (1) Air Force

 

 send copy of AF Form 7, Airman Military Record, or equivalent (enlisted), or AF Form 11, Officer Military Record, or equivalent (officer), and all derogatory ant complimentary material.
27

 

 Continued

 

 (2) Army non-fire-related

 

 send copy of DA Form 20, Enlisted Qualification Record, or equivalent, or DA Form 66, Officer Qualification Record, or equivalent, and all derogatory and complimentary material.
27

 

 Continued

 

 (3) Army fire-related

a. service record available 
(WWII - service record book)

 send copies of pages 4 through 8 of the service Record and all derogatory and complimentary material.
27 Continued b. service record available
(PWWII - flat record)		 send copies of pages 1 through 3 of the Service Record and all derogatory and complimentary material.
27
 

 

 Continued
 

 

 c. service record not available

 

 return VA. 3101 with fire stamp. If service has not been verified and the request does not contain sufficient data to reconstruct record, attach NA 13075, Questionnaire About Military Service. See 1865.107, fig. 2-1, Part 3 of 3.
27

 

 Continued (4) Marine Corps send copies of pages 3, 9, 12, and 13 of the Enlisted Personnel File (or equivalent pages from records of other eras) and all other derogatory and complimentary material.
27

 

 Continued

 

 (5) Navy

 

 send copies of pages 4 through 9 and 13 of the enlisted Service Jacket (or equivalent pages from records of other eras) and all other derogatory and complimentary material.
NOTE: Efficiency ratings and/or information about character and conduct may be sent directly to the VA in response to a general request for a "201 file." However, note the distinction between Rule 27 and Rule 13, which states that when character, conduct, and/or efficiency ratings are specifically requested, the request and records are forwarded to the VA Liaison Officer for disposition.
27 Continued  (6) Coast Guard send copies of CG Forms 3303 through 3307 and CG Form 3312A and all derogatory and complimentary material.

NOTE: Some examples of derogatory material are court-martial records, articles 15's, letters of reprimand, and counseling reports. Examples of complimentary material are citations for awards and decorations, and letters of appreciation or commendation. Performance reports and efficiency ratings could be derogatory or complimentary.

 
 
A
B
C
R
U
L
E		 If guide in figure 1 or figure 2 calls for, or if VA. specifically requests: and if: clerk will:
28 Records of exposure to herbicides, defoliants, or Agent Orange   send a copy of DD Form 214 if no specific document is requested and the DD Form 214 contains evidence of service in Southeast Asia. Send specific documents if requested. If DD Form 214 does not contain the required evidence and other specific documents are not requested, send copies of appropriate forms that verify service in Southeast Asia; e.g.,

Army - DA Form 20

DA Form 66

Air Force - AF Form 7

AF Form 11

Navy - NAVPERS 601-12

NAVPERS 601-13

Marine Corps - NAVMC 118(3) - PD

NAVMC 118(9) - PD

Sea & Air Travel

Embarkation Slips

Coast Guard - CG Form 3307