skills/complete-veteran-benefits/references/research-playbooks.md

# Research Playbooks

Use the section matching the request. For appeal lanes and time limits, also read
[review-and-deadlines.md](review-and-deadlines.md). For amounts and combined
ratings, read [calculations.md](calculations.md).

Contents: A ratings; B service connection; C denials; D examinations; E effective
dates/pay; F CUE; G military disability; H retired pay; I health coverage;
J state benefits; K full audit.

## A. Rating analysis

1. Identify diagnosis, manifestations, and rating period.
2. Retrieve applicable Part 4 criteria.
3. Identify Diagnostic Code and realistic alternatives.
4. Retrieve applicable DBQ.
5. Map evidence to each plausible rating level.
6. Check general rating provisions.
7. Check separate ratings and pyramiding.
8. Check staged ratings.
9. Check TDIU and SMC.
10. State the supported range, not a guaranteed result.

Output:
- applicable code(s);
- criteria comparison;
- favorable evidence;
- unfavorable or missing evidence;
- higher-rating obstacles;
- ancillary issues.

## B. Service connection

1. Confirm qualifying service.
2. Confirm current disability/condition.
3. Identify in-service event, injury, disease, or exposure.
4. Identify every reasonable theory.
5. Check presumptions.
6. Check secondary causation/aggravation.
7. Evaluate nexus evidence.
8. Evaluate competent lay evidence.
9. Identify gaps.
10. Rank strongest theory and alternatives.

## C. Denial review

1. Read the actual decision when available.
2. Extract issue, favorable findings, evidence considered, reasons, and missing
   element.
3. Reconstruct procedural history.
4. Check correct law/version.
5. Check duty to assist.
6. Check examination adequacy.
7. Identify whether new evidence exists.
8. Compare Supplemental Claim, HLR, and Board review.
9. Check continuous pursuit/deadline.
10. Recommend the lane that matches the defect.

## D. C&P adequacy

1. Identify condition and examination type.
2. Retrieve applicable DBQ/exam requirements.
3. Compare report with history, lay reports, testing, flare-ups, functional
   impairment, occupational impact, and medical rationale.
4. Identify omissions or contradictions.
5. Retrieve precedent if adequacy turns on legal interpretation.
6. Distinguish unfavorable from inadequate.

## E. Effective date / back pay

1. Build exact procedural timeline.
2. Retrieve effective-date statute/regulation applicable to each period.
3. Identify Intent to File.
4. Identify original claim and review dates.
5. Check continuous pursuit.
6. Check increase-specific rules.
7. Check liberalizing law/presumption.
8. Check dependency dates if relevant.
9. Consider CUE only when the legal standard is actually implicated.
10. Use historical rates to calculate back pay.

## F. CUE

1. Identify exact final decision.
2. State exact alleged error.
3. Freeze legal inquiry to law applicable at that time.
4. Determine evidence in the record at that time.
5. Separate weighing disagreement from legal/factual error.
6. Research controlling CUE precedent.
7. Ask whether result would have been manifestly different.

## G. MEB / PEB / IDES

1. Identify service branch and status.
2. Identify current stage.
3. Identify potentially unfitting conditions.
4. Retrieve current DoDI 1332.18.
5. Retrieve service-specific rules.
6. Retrieve Title 10 authority.
7. If VA ratings are involved, separately retrieve VA rating criteria.
8. Distinguish fitness, DoD compensability, VA service connection, and VA rating.
9. Explain DoD and VA consequences separately.

## H. CRDP / CRSC / retired pay

1. Identify retirement type.
2. Identify years of service.
3. Identify VA rating.
4. Identify combat-related determination when CRSC is involved.
5. Retrieve Title 10.
6. Retrieve current DoD FMR chapter.
7. Retrieve current DFAS guidance.
8. Analyze VA waiver/offset interaction.
9. Analyze tax treatment separately.
10. State which agency decides each issue.

## I. TRICARE / Medicare / TFL

1. Identify sponsor and beneficiary status.
2. Identify active/retired/survivor/dependent category.
3. Identify age and Medicare entitlement.
4. Verify DEERS assumptions.
5. Retrieve current TRICARE eligibility guidance.
6. Retrieve current manual section when detailed policy matters.
7. For TFL, verify current Medicare Part A/Part B requirements.
8. Analyze prescription coverage separately.
9. Analyze dental/vision separately when asked.

## J. State or local benefit

1. Identify state and municipality/county if relevant.
2. Identify benefit.
3. Retrieve current statute.
4. Retrieve administering-agency guidance.
5. Determine residency, disability threshold, wartime/combat requirement,
   discharge requirement, income/asset test, ownership, deadline, and
   local-option status.
6. Verify local implementation.
7. Give filing steps.

## K. Full claim audit

Build:

### Timeline
Service, diagnoses, claims, exams, decisions, reviews, appeals.

### Issue matrix
For each condition:
- service-connection status;
- theory;
- current rating;
- Diagnostic Code;
- effective date;
- favorable findings;
- key evidence;
- missing evidence;
- procedural posture.

### Legal audit
For each issue:
- statute;
- regulation;
- precedent;
- M21-1 when relevant;
- historical-law question.

### Evidence audit
Identify:
- favorable evidence;
- unfavorable evidence;
- contradictions;
- missing records;
- examination defects;
- nexus gaps;
- lay-evidence opportunities.

### Rating audit
Check:
- underrating;
- alternate codes;
- separate ratings;
- bilateral factor;
- combined rating;
- staged ratings;
- TDIU;
- SMC.

### Effective-date audit
Check:
- Intent to File;
- continuous pursuit;
- earlier pending matters;
- review deadlines;
- liberalizing law;
- CUE only if genuinely implicated.

### Action plan
Rank by:
- deadline;
- likely impact;
- legal strength;
- evidence burden;
- downside/risk.

Prioritize issues that could materially change entitlement, percentage,
effective date, or benefit amount.