Decision Logic Table - Criteria for determining initial and subsequent steps concerning data procurement requests and referral actions

Figure 2-5.2: Decision Logic Table - Criteria for determining initial and subsequent steps concerning data procurement requests and referral actions

CASE DECISION LOGIC TABLE

Instructions for using Decision Logic Table (DLT):

1. Assume ALL B/R file(s) have been pulled, analyzed, and contain insufficient information, and BIRLS is queried.

2. The Decision Logic Table IS NOT applicable to requests from the VA.

3. A request indicating "VA home loan," "GI loan," "buying house," etc. is NOT considered a request for VA benefits.

RULE 1.   REQUEST FOR SERVICE INFORMATION
                    -C FILE AT RMC, VARO, or NARA FACILITY
                    -FAR SHOWS QM RECORD(S) ARE/ARE NOT AVAILABLE

STEP 1

STEP 2

STEP 3

a. If request is NOT for VA benefits and QM/QT record(s) are not attached, then request appropriate QM/QT record(s) (see NPRC 1865.111, pars. 6 and 7).

b. If request is for VA benefits, then refer requester to the VA using NA Form 13045.

a. When search report is received and QM/QT record(s) DO NOT contain sufficient information, and:

(1) C file is located at a VARO or NARA facility, then request records using NA Form 13023 or NA Form 13160 (see fig. 2-6.1or 2-6.2). Send requester delay notice using NA Form 13024.

(2) C File is located at VA Central Office, then refer requester to the VA using NA Form 13045.

a. When response to NA Form 13023/NA Form 13160 is received and VA records DO NOT contain sufficient information, then see NPRC 1865.111, figs.16 or 17.

RULE 2. REQUEST FOR MEDICAL INFORMATION
-C FILE AT RMC
-QM C/QT H RECORDS ARE/ARE NOT AVAILABLE

STEP 1

STEP 2

STEP 3

a. If request is NOT for VA benefits, and the QM C and/or QT H record is/are available, then request the record(s).

b. If request is for VA benefits, then refer requester to the VA using NA Form 13060.

NOTE: If QT H record is available, obtain applicable information and attach to the referral response.

a. When search report is received and the QM C and/or QT H record(s) is/are attached, then send medical records using NA Form 13045.

b. (1) If requester expresses any dissatisfaction with the VA, and/or implies or expresses desire NOT to go to the VA for the requested record, then request records using NA Form 13023.

(2) If requester SPECIFICALLY requests copies of morning or sick reports, then send requester NA Form 13055.

a. (1) NO QM C or QT H record is available, then request VA records using NA Form 13023 (see fig. 2-6.1). Send requester delay notice using NA Form 13024.

(2) When response to NA Form 13023 is received from RMC, and VA records DO NOT contain sufficient information, then send requester NA Form 13055, Request for Information Needed to Reconstruct Medical Data.

RULE 3.   REQUEST FOR MEDICAL INFORMATION
                    -C FILE AT VARO OR NARA FACILITY
                    -QM C/QT H RECORDS ARE/ARE NOT AVAILABLE

STEP 1	STEP 2	STEP 3
a. Regardless of the reason for requesting the information, refer the requester to the VA using NA Form 13045. NOTE: If QT H record is available, obtain applicable information and attach to NA Form 13045.	a. (1) If requester expresses any dissatisfaction with the VA, and/or implies or expresses desire NOT to go to the VA for the requested record, then request records using NA Form 13023/NA Form 13160. (2) If requester SPECIFICALLY requests copies of morning or sick reports, then send requester NA Form 13055.	a. When response to NA Form 13023/NA Form 13160 is received and VA records DO NOT contain sufficient information then send requester NA Form 13055.