Page 3.Director (00/21)not the Veteran returns a completed VA Form 21-8940:
the Veteran fails to complete and return theVA Form 21-8940
administratively deny the claim
(see below).the Veteran returns the VA Form 21-8940 send VA Form 21-4192,
Request for Employment Information in Connectionwith Claim for Disability Benefit
, to theformer employer(s) listed on the form for which the Veteran worked during his lastyear of employment.
: Request VA Form(s) 21-4192 for theVeteran’s last year of employment
the Veteran has not worked for five years or more.the Veteran with multiple service-connecteddisabilities returns the VA Form 21-8940 but does not identify which service-connected disability(ies) causesunemployabilitycontact the Veteran by telephone to gather that information.
Document the results of the call on VAForm 27-0820,
Report of General Information.
the Veteran with multiple service-connecteddisabilities returns the VA Form 21-8940 but does not identify which service-connected disability(ies) causesunemployability
reasonable efforts to telephone the Veteranare not successfulsend the Veteran a letter requesting he or she identify which service-connecteddisability(ies) are believed to causeunemployability.
: If the Veteran does not respondwithin 30 days from the date of the writtenrequest for clarification, or will not identifyone or more service-connected disabilitiesas the basis for the claim,
administrativelydeny the claim
Do not deny TDIU evaluations solely because an employer failed to returna completed VA Form 21-4192. SeeM21-1MR.IV.ii.2.F.25.e.
Follow the guidance in the table below to complete an administrative denial:
1In VETSNET Awards, complete a Benefit Eligibility Decision using thereason “Failure to Furnish Requested Evidence.”2In PCGL (this letter is not currently available in VBMS), select the “Failureto Prosecute” template.