Original Death Claims (U.S. Department of Veterans Affairs)
M21-1MR, Part III, Subpart ii, Chapter 2, Section C
Section C. Original Death Claims
Overview
In this Section
/ This section contains the following topics:Topic / Topic Name
9 / Applications for VA Death Benefits
10 / Policies Regarding Original Death Claims
11 / General Information About Claims for Accrued Benefits
12 / General Information About Claims for Death Compensation
13 / Claims for Social Security Survivors’ Benefits
14 / Claims Filed Through the Social Security Administration (SSA)
9. Applications for VA Death Benefits
Introduction
/ This topic contains information about applications for Department of Veterans Affairs (VA) death benefits, including· notifying a deceased Veteran’s estate of benefits to which dependents and others may be entitled
· requirement for a formal application, and
· VA’s obligation to address a claimant’s entitlement to multiple death benefits.
Change Date
/ April 7, 2014a. Notifying a Deceased Veteran’s Estate of Benefits to Which Dependents and Others May Be Entitled
/ When a Department of Veterans Affairs (VA) employee processes the first notice of a Veteran’s death (FNOD), the Hines Information Technology Center (ITC) automatically issues a letter to the Veteran’s estate containing information about death benefits to which the Veteran’s dependents and others may be entitled. These benefits include:· burial benefits
· death pension
· dependency and indemnity compensation (DIC), and
· educational benefits under 38 U.S.C. Chapter 35.
Note: The letter from the Hines ITC does not discuss accrued benefits.
References: For more information about
· accrued benefits, see M21-1MR, Part III, Subpart ii, 2.C.11, or
processing FNODs, see M21-1MR, Part III, Subpart ii, Chapter 8.
b. Requirement for a Formal Application
/ 38 CFR 3.152 and 38 CFR 3.153 require claimants to complete and submit a form prescribed by the Secretary of the VA, or jointly prescribed by the Secretary and the Commissioner of Social Security, when filing an original claim for VA death benefits. The prescribed forms are:· VA Form 21-534, Application for Dependency and Indemnity Compensation or Death Pension and Accrued Benefits by a Surviving Spouse or Child
· VA Form 21-534a, Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In-Service Death Only
· VA Form 21-534EZ, Application for DIC, Death Pension, and/or Accrued Benefits
· VA Form 21-535, Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation when Applicable), and
· VA Form 21-4182, Supplement to Social Security Form: Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation, Where Applicable) from the Department of Veterans Affairs.
c. VA’s Obligation to Address a Claimant’s Entitlement to Multiple Death Benefits
/ VA designed most of the applications referenced in M21-1MR, Part III, Subpart ii, 2.C.9.b so that claimants may apply for multiple death benefits without filing separate applications for each one. By doing so, however, VA obligated itself to determine a claimant’s entitlement to each of the benefits named in the title of the application submitted by the claimant.Examples: The table below contains examples of the principle expressed in this block.
When ... / Then VA is obligated to address the claimant’s entitlement to ...
a surviving parent submits VA Form 21-535 / · DIC, and
· accrued benefits.
a surviving spouse or child submits
· VA Form 21-534, or
· VA Form 21-534EZ / · DIC
· death pension, and
· accrued benefits.
Exception: Claimants may use Block 16 of VA Form 21-534EZ to indicate the specific death benefit to which they are seeking entitlement. VA is under no obligation to address a claimant’s entitlement to all three death benefits named in the title of this form if
· the claimant identifies at least one death benefit in Block 16, and
· leaves those sections of the application blank that refer exclusively to the other (non-identified) benefits named in Block 16.
10. Policies Regarding Original Death Claims
Change Date
/ April 7, 2014a. Policies Regarding Original Death Claims
/ The table below contains references to blocks within M21-1MR, Part III, Subpart ii, 2.B.8 that discuss policies regarding original claims for any VA benefit:Policy / Reference
Handling original claims that are not filed on one of the prescribed forms in M21-1MR, Part III, Subpart ii, 2.C.9.b. / M21-1MR, Part III, Subpart ii, 2.B.8.a
Handling a claimant’s use of an obsolete form / M21-1MR, Part III, Subpart ii, 2.B.8.b
What constitutes a substantially complete application / M21-1MR, Part III, Subpart ii, 2.B.8.c
Handling claims VA receives after processing an original claim / M21-1MR, Part III, Subpart ii, 2.B.8.d
VA’s obligation to provide applications for benefits
Note: Send VA Form 21-530, Application for Burial Benefits, to a potential claimant only upon receipt of a request for or inquiry about burial benefits. / M21-1MR, Part III, Subpart ii, 2.B.8.e
Determining the proper effective date of claim for claims establishment purposes / M21-1MR, Part III, Subpart ii, 2.B.8.f
Handling the discovery of a claim on which VA failed to take action / M21-1MR, Part III, Subpart ii, 2.B.8.g
11. General Information About Claims for Accrued Benefits
Introduction
/ This topic contains general information about accrued benefits, including· definition of accrued benefits
· action to take when no accrued benefits exist, and
· action to take when accrued benefits exist.
Change Date
/ April 7, 2014a. Definition: Accrued Benefits
/ Accrued benefits are benefits to which a Veteran was entitled on the date of his/her death, but VA had not yet paid. These benefits often exist because a Veteran with a pending claim died before VA· decided his/her claim, and/or
· promulgated a decision on his/her claim.
Reference: For more information about accrued benefits, see M21-1MR, Part VIII, Chapter 1.
b. Action to Take When No Accrued Benefits Exist
/ When processing one of the applications listed in M21-1MR, Part III, Subpart ii, 2.C.9.b (except VA Form 21-534a), take the following actions if no accrued benefits exist:· deny the claim without development, and
· explain in the corresponding decision notice that VA denied the claim because no accrued benefits exist.
c. Action to Take When Accrued Benefits Exist
/ As stated in M21-1MR, Part III, Subpart ii, 2.C.9.a, the letter that the Hines ITC sends to a Veteran’s estate when an FNOD is processed does not discuss accrued benefits. Accordingly, if accrued benefits exist, VA has an obligation to notify those individuals who are potentially entitled to the benefits.Reference: For more information about notifying individuals with potential entitlement to accrued benefits, see M21-1MR, Part VIII, Chapter 2.
12. General Information About Claims for Death Compensation
Introduction
/ This topic contains general information about claims for death compensation, including· circumstances under which death compensation is payable
· election of DIC in lieu of death compensation, and
· action to take if death compensation is the greater benefit for a surviving parent.
Change Date
/ April 7, 2014a. Circumstances Under Which Death Compensation Is Payable
/ Prior to 1957, the basic benefit payable for service-connected death was death compensation. This benefit was payable under the following circumstances:· death occurred prior to January 1, 1957, or
· an in-service waiver of insurance premiums under 38 U.S.C. 1924 was in effect at the time of death, and death occurred
- on or after May 1, 1957, but
- prior to January 1, 1972.
Important: The parent(s) of a deceased Veteran must also meet the requirements set forth in 38 CFR 3.250 in order to establish entitlement to death compensation.
b. Election of DIC in Lieu of Death Compensation
/ Claimants and beneficiaries with entitlement to death compensation have the right to elect DIC under certain circumstances.Follow the steps in the table below upon receipt of one of the applications listed in M21-1MR, Part III, Subpart ii, 2.C.9.b from a claimant/beneficiary that is entitled to death compensation.
Step / Action
1 / Is the claimant/beneficiary entitled to DIC?
· If yes, proceed to the next step.
· If no,
- pay/continue paying death compensation, and
- proceed no further.
2 / Did VA receive the application on or after January 1, 1972?
· If yes, proceed to the next step.
· If no,
- pay/continue paying death compensation, and
- proceed no further. (The claimant/beneficiary may not elect DIC.)
3 / Is the amount of DIC that is payable greater than the amount of death compensation that is payable?
· If yes, proceed to the next step.
· If no, take the actions described in the table below.
Step / Action
1 / Pay/Continue paying death compensation.
2 / Notify the claimant/beneficiary that
· VA is paying death compensation because it is the greater benefit, and
· the claimant/beneficiary still has the right to elect DIC.
3 / Proceed no further.
b. Election of DIC in Lieu of Death Compensation (continued)
Step / Action
4 / Assume the claimant/beneficiary is electing DIC in lieu of death compensation and award benefits accordingly. In the decision notice, inform the claimant/beneficiary
· VA awarded DIC as the greater benefit, and
· the claimant/beneficiary still has the right to elect death compensation.
5 / Did the claimant/beneficiary ask VA to cancel the election of DIC before his/her financial institution received the second payment of DIC?
If yes, award death compensation from the same date VA awarded DIC (minus the amount of DIC VA previously paid).
If no, the election of DIC becomes final.
Reference: For more information about
· handling claims for DIC and death compensation, see M21-1MR, Part IV, Subpart iii, or
· elections to receive DIC, see
- M21-1MR, Part IV, Subpart iii, 3.H.40, and
- 38 CFR 3.702.
Continued on next page
12. General Information About Claims for Death Compensation, Continued
c. Action to Take If Death Compensation is the Greater Benefit for a Surviving Parent
/ Upon receipt of VA Form 21-535 from a surviving parent, ask the parent to complete and return VA Form 21-509, Statement of Dependency of Parent(s) if· the circumstances described in M21-1MR, Part III, Subpart ii, 2.C.12.a exist, and
· the rate of DIC payable to the parent is less than the rate of death compensation payable.
Use the information the parent provides on the form to determine whether, based on the criteria in 38 CFR 3.250, the parent was dependent on the Veteran prior to the Veteran’s death.
13. Claims for Social Security Survivors’ Benefits
Change Date
/ April 7, 2014a. Processing Form SSA-24
/ Follow the instructions in the table below upon receipt of Form SSA-24, Application for Survivors Benefits, as an attachment to VA Form 21-534 or VA Form 21-535.Step / Action
1 / Stamp the date of receipt on both forms.
2 / Enter the correct VA file number in Block 12 of Form SSA-24.
3 / Fax or mail Form SSA-24 to the appropriate Social Security Administration (SSA) office, according to the instructions in the table below.
Note: There is no need to prepare a cover letter for the form or complete blocks 20 and 21 of the form.
If the applicant … / Then …
entered a social security number (SSN) in Block 3 of Form SSA-24 / fax the form to the SSA program service center (PSC) of jurisdiction, using information from the table in M21-1MR, Part III, Subpart iii, 3.A.7.d.
Important: The first three-digits of the SSN in Block 3 of Form SSA-24 represent the “account number” referenced in the column heading of the table.
did not enter an SSN in Block 3 of Form SSA-24 / mail the form to the nearest SSA field office.
Note: Use the SSA Office Locator to identify the nearest SSA field office and its address.
Exception: Manila regional office (RO) employees should follow locally established procedures for referring Form SSA-24 to the SSA activity located in that office.
14. Claims Filed Through the Social Security Administration (SSA)
Introduction
/ This topic contains information about claims for VA death benefits that are filed through the SSA, including· applications for survivor’s benefits filed with the SSA, and
· processing VA Form 21-4182.
Change Date
/ April 7, 2014a. Applications for Survivor’s Benefits Filed With the SSA
/ An application for survivor’s benefits filed with the SSA on or after January 1, 1957, because of the death of a Veteran· constitutes a claim for VA death benefits, and
· is considered to have been received by VA as of the date of receipt by the SSA.
Reference: For more information about claims filed with the SSA, see
· M21-1MR, Part IV, Subpart iii, 3.A.4, and
· 38 CFR 3.153.
b. Processing VA Form 21-4182
/ If the SSA receives VA Form 21-4182 as a supplemental attachment to an application for Social Security benefits, SSA personnel forward the form to VA. VA accepts the form as a formal but incomplete claim for death benefits.Upon receipt of VA Form 21-4182, process it according to the instructions in the table below.
Step / Action
1 / Has the claimant already submitted a completed and signed VA Form 21-534 or VA Form 21-535?
· If yes, proceed to Step 4.
· If no, proceed to the next step.
Continued on next page
14. Claims Filed Through the Social Security Administration (SSA), Continued
Step / Action
2 / Send to the claimant
VA Form 21-534 (if the claimant is a surviving spouse or child), or
VA Form 21-535 (if the claimant is a surviving parent).
Advise the claimant to provide on the form only that information that does not already appear on VA Form 21-4182.
3 / As soon as the claimant returns VA Form 21-534 or VA Form 21-535, proceed to Step 10.
4 / Is a claim for death benefits from the claimant already pending?
· If yes, proceed to the next step.
· If no, proceed to Step 7.
5 / Is the date SSA received VA Form 21-4182 prior to the date VA received the pending claim for death benefits?
· If no, proceed to the next step.
· If yes,
- change the date of claim of the pending end product (EP) to the date SSA received the form, and
- proceed to the next step.
6 / Is the claim being processed in a paperless environment?
· If yes,
- upload VA Form 21-4182 into the corresponding electronic claims folder (eFolder), and
- proceed no further.
· If no,
- file down VA Form 21-4182 in the corresponding claims folder, and
- proceed no further.
7 / Was the prior claim for entitlement to death benefits granted?
· If yes, proceed to the next step.
· If no, proceed to Step 9.
8 / Is an earlier effective date warranted based on the date SSA received VA Form 21-4182?
· If yes, proceed to Step 10.
· If no, proceed to the next step.
9 / Was the prior claim processed in a paperless environment?
· If yes,
- upload VA Form 21-4182 into the corresponding eFolder, and
- proceed no further.
· If no,
- file down VA Form 21-4182 in the corresponding claims folder, and
- proceed no further.
10 / Establish the appropriate EP, using the date SSA received the form as the date of claim.
References: For information about
· choosing the appropriate EP, see M21-4, Appendix C, or
· establishing an EP in
- Share, see the Share User’s Guide, or
- VBMS, see the job instruction sheet titled Claim Establishment.
11 / Is development action required?
· If yes, refer the claim for development action.
· If no, refer the claim to the appropriate decision-maker (a Rating Veterans Service Representative (RVSR) if a rating decision is required; a Veterans Service Representative (VSR) if no rating decision is required).
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