15.9. System Procedures
a. When a Veteran rating decision is processed that initially establishes service connection or entitlement to 38 U.S.C. 1151 benefits, the Veteran is informed by VBA’s Veterans Service Center of potential entitlement to the clothing allowance benefit. The
Veteran is instructed accordingly by the notification letter released by VBA’s Veterans Service Center to apply for the clothing allowance benefit utilizing VA Form 10-8678, Application for Annual Clothing Allowance, located at: VA Form 10-8678 Application for Annual Clothing Allowance. and submitting it to the nearest Prosthetic and Sensory Aids Service. All foreign clothing allowance claims are submitted by the claimant to the nearest VBA Regional Office for processing. NOTE: Multiple clothing allowances are not authorized prior to the 2012 clothing allowance cycle. The Veteran is allowed from the date of eligibility until July 31st of the following year to apply.
Example: A Veteran’s service-connected disability is established on March 2, 2011. If entitled, the Veteran’s clothing allowance benefit or anniversary date is August 1, 2011. The Veteran can apply any time between March 2, 2011, and July 31, 2012, for the clothing allowance benefit.
b. When Veteran Service Organizations or personnel at the VA medical facility or VBA Regional Office identifies a Veteran with potential eligibility, assistance to complete the form is provided to the Veteran by completing VA Form 10-8678, Application for Annual Clothing Allowance. Once the completed application is received via mail or in person, the nearest VHA Prosthetic and Sensory Aids Service (PSAS) will process within 5 business days. *All foreign clothing allowance claims are accepted and processed at the designated VA medical facility. Documentation of all actions, favorable or unfavorable, is recorded in the Veterans electronic prosthetic record.
*South America, Central America and Mexico territories (Houston PSAS); European countries and territories (Pittsburg PSAS); and Canada and surrounding foreign territories (Denver PSAS).
c. When the Veteran applies for a clothing allowance and there is no record of a prescription for the prosthetic, orthopedic appliance and/or skin medication, an administrative review and/or physical evaluation is scheduled by the Under Secretary for Health designee prior to making a determination. The Under Secretary for Health designee, usually the Prosthetic Representative, will follow guidance in paragraph 6 on “Evaluations/Re-evaluations” of this Handbook. NOTE: Reasonable doubt is resolved in favor of the Veteran.
d. When the entitlement determination is favorable, the Prosthetic Representative will annotate VA Form 10-2319, Automated Date Processing (ADP), Record of Prosthetic Service, on page 6; to reflect receipt of VA Form 10-8678, as follows:
(1) Access the Add/Edit Clothing Allowance option under the PSC/Entitlement Records section of the Prosthetic and Sensory Aids Service (PSAS) official's menu. Enter the Veterans name at the prompt, and then complete the remainder of the fields beginning with the date the claim is processed by the PSAS activity.
(2) Enter the name of the Prosthetic Representative determining the clothing allowance entitlement decision. Enter appropriate identifying information at the “Clothing Allowance Description” prompt, including the appliance for which the claim is approved per the following format:
e. When entitlement is unfavorable, annotate VA Form 10-2319 (ADP), Record of Prosthetic Service, on page 6 to reflect receipt of VA Form 10-8678, as follows:
(1) Access the Add/Edit Clothing Allowance option under the PSC/Entitlement Records section of the PSAS official’s menu. Enter the Veterans name at the prompt, and then complete the remainder of the fields beginning with the date the claim is processed by the PSAS activity.
(2) Enter the name of the Prosthetic Representative determining the clothing allowance entitlement decision. Enter appropriate identifying information at the “Clothing Allowance Description” prompt to include the appliance for which the claim is disapproved per the following format:
Desc: FY12 Wyatt Ointment-denial 1173.15 Sec D,e3; Rt Knee Brace–Denial
1173.15 Sec D,e1.
(a) Appliance causing wear or tear is not worn, or skin medication causing damage is not used;
(b) Appliance not worn for service-connected condition, or skin medication not used for service-connected condition; and/or
(c) Appliance worn not medically prescribed, or skin medication used not medically prescribed; and
f. Notification letters for all determinations, favorable or unfavorable, are sent to each Veteran and, if applicable, their designated Power of Attorney. In the case of denials, a VA Form 4107, Your Rights to Appeal our Decision, will accompany all
favorable and unfavorable entitlement decisions.
g. Appeals are handled according to the local official appeals process administered by the Chief Business Officer and VBA’s Regional Office. Boards of Veterans Appeals Handbooks/Directives are located at: https://www.bva.va.gov/.
(1) No clothing allowance award is terminated, reduced or otherwise adversely affected unless the Veteran is notified of such adverse action, and is provided a period of 60 days in which to submit evidence for the purpose of showing that the adverse action is not warranted (38 CFR 3.103(b)(2)).
(2) If the Veteran does not submit any evidence to support such adverse action, then the Prosthetic Representative will terminate or reduce the clothing allowance benefit.
h. PSAS is responsible for the award action on the annual re-certification portion of the clothing allowance benefit. However, the funding for the clothing allowance remains in the VBA benefit appropriation. The Veterans Integrated Service Network (VISN)
Prosthetic Representative (VPR) coordinates the award action at the VA medical facility level and ensures all appropriate staff are trained in the procedures of processing payment for clothing allowance benefits in VETSNET as applicable. All training and user guides are accessible under the clothing allowance folder located on the Prosthetic and Sensory Aids Web site at: https://www.prosthetics.va.gov/psas/index.asp NOTE: This is an internal VA Web site and is not available to the public.