Appendix D to Part 282 - Processing a Claim
32:2.1.1.1.59.0.1.6.31 : Appendix D
Appendix D to Part 282 - Processing a Claim
(a) Initial Component Processing. Upon receipt of a
claim, the Component concerned must:
(1) Date stamp the claim on the date received.
(2) Determine whether the claim was received within the required
time limit (time limits are summarized at Appendix C to this part,
paragraph (f)) and follow the procedures in paragraph (b) of this
Appendix if the claim was not timely.
(3) Investigate the claim.
(4) Decide whether the claimant provided clear and convincing
evidence that proves all or part of the claim.
(5) Issue an initial determination that grants the claim to the
extent proved or denies the claim, as appropriate. The initial
determination must state how much of the claim is granted and how
much is denied, and must explain the reasons for the
determination.
(6) Notify the claimant of the initial determination. The
Component must send the claimant a copy of the initial
determination and a notice that explains:
(i) The action the Component shall take on the claim, if the
initial determination is or becomes a final action (the finality of
an initial determination is explained at paragraph (c) of this
Appendix); and
(ii) The procedures the claimant must follow to appeal an
initial determination that denies all or part of the claim (those
appeal procedures are explained at Appendix E to this part), if
applicable.
(b) Untimely Claims. When the Component concerned
determines that a claim was not received within the statutory time
limit, the Component must make an initial determination of untimely
receipt. (The statutory time limits are explained in Appendix C to
this part, paragraph (f).)
(1) The initial determination must cite the applicable statute
and explain the reasons for the finding of untimely receipt. The
Component must send the initial determination to the claimant with
a notice that:
(i) States the claim was not received within the statutory time
limit and, therefore, may not be considered, unless that finding is
reversed on appeal, and explains how the claimant may appeal the
finding (those appeal procedures are explained at Appendix E to
this part); and either
(ii) If the claim does not qualify under 31 U.S.C. 3702(e),
states that the statutory time limit may not be extended or waived;
or
(iii) If the claim does qualify under 31 U.S.C. 3702(e), states
that the claim may be further considered only if the time limit is
waived, and explains how the claimant may apply for a waiver.
(Paragraph (d) of this Appendix explains which claims qualify and
the procedures for applying for a waiver).
(2) Except in cases where a claimant has applied under paragraph
(d) of this Appendix to request a waiver of the time limit, the
Component must return the claim to the claimant when the initial
determination becomes a final action with a notice that the finding
in the initial determination is final and, therefore, the claim may
not be considered. If the claim qualifies under 31 U.S.C. 3702(e),
the notice must also state that the claimant may resubmit the claim
with an application under paragraph (d) of this Appendix.
(c) Finality of an Initial Determination. An initial
determination that grants all of a claim is a final action when it
is issued. Otherwise, an initial determination (including one of
untimely receipt) is a final action if the Component concerned does
not receive an appeal within 30 days of the date of the initial
determination (plus any extension of up to 30 additional days
granted by the Component concerned for good cause shown).
(d) Waiver of Certain Time Limits. When the Component
concerned determines that a claim was not received within the
statutory time limit in 31 U.S.C. 3702(b) or (c), the claimant may
request a waiver of the time limit. Waiver is permitted only for
those claims that satisfy the requirements of 31 U.S.C. 3702(e). 1
This provision confers no right or entitlement on a claimant. It is
solely within the discretion of the Secretary of Defense whether to
grant such a waiver in a particular case.
1 When this part was issued, 31 U.S.C. 3702(e) allowed time
limit waivers only for claims up to $25,000 for Uniformed Service
member's pay, allowances, travel, transportation, payments for
unused accrued leave, retired pay, and survivors benefits. Since 31
U.S.C. 3702(e) could be amended at any time to modify these
restrictions, always consult the current provisions of that Section
to determine which claims are included.
(1) The claim must contain the information and documents that
are generally required for claims (those requirements are explained
at Appendix C to this part, paragraph (c)).
(2) The Component concerned must investigate the claim and make
an initial determination concerning the merits of the claim.
(3) If the initial determination grants all or part of the
claim, and if the Secretary concerned agrees with the
determination, the Secretary may request or recommend that the time
limit be waived. 2 Requests and recommendations must be in writing
and signed by the Secretary concerned. (This authority may not be
delegated below the level of an Assistant Secretary.)
2 31 U.S.C. 3702(e) currently requires a Secretarial request
only in the case of a claim by or with respect to a member of the
Uniformed Services who is not under the jurisdiction of the
Secretary of a Military Department. As a matter of policy, the
Department of Defense currently requires a Secretarial
recommendation in all other cases.
(i) The Secretary concerned shall forward the request or
recommendation to the following address: Defense Office of Hearings
and Appeals, Claims Division, P.O. Box 3656, Arlington, VA
22203-1995.
(ii) The entire record concerning the claim, including the
initial determination, must be attached to the request.
(4) The Director, DOHA, must review the request and the written
record and must:
(i) Grant the request and waive the statutory time limit, if the
Director finds that all or part of the claim has been proven. The
Director may also modify the finding concerning the amount of the
claim that has been proven.
(ii) Deny the request, if the Director finds that no part of the
claim has been proven.
(iii) Notify the Secretary concerned and the claimant of the
decision and the reasons for the findings.
(5) In the event the Director, DOHA, denies the request, or
grants the request but modifies the finding concerning the amount
of the claim proven, the Secretary concerned or the claimant may
request reconsideration (the procedures are explained at Appendix E
to this part). The Director's decision is a final action if the
Director does not receive a request for reconsideration within 30
days of the date of the Director's decision (plus any extension of
up to 30 additional days granted by the Director for good cause
shown).