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M21-1, Part III, Subpart iii, Chapter 5, Section A – General Information on Relationship and Dependency

Overview


In This Section

This section contains the following topics:

1.  General Policies Surrounding the Issues of Relationship and Dependency

 


Introduction

This topic contains general policies for establishing dependency and the existence of familial relationships, including

Change Date

February 19, 2019

III.iii.5.A.1.a.  Definition:  Relationship

The term relationship refers to an individual’s legal status with respect to the Veteran.
Examples:
  • Can the individual be recognized as the Veteran’s child?
  • Have the individual and the Veteran fulfilled the requirements for a legal marriage?
References:  For a definition of

III.iii.5.A.1.b.  Definition:  Dependency

The term dependency refers to the question of whether or not an individual is financially “dependent” on a Veteran.

III.iii.5.A.1.c.  Importance of Establishing the Relationship of an Individual to a Veteran

Establishing an individual’s relationship to a Veteran is critical in determining benefits because
  • the Department of Veterans Affairs (VA) may pay additional disability compensation to a Veteran for his/her dependent(s) if the Veteran has a combined disability rating of at least 30 percent
  • VA may pay additional Dependency and Indemnity Compensation (DIC) to a surviving spouse for any of his/her children that VA recognizes as children of the Veteran on whose death the DIC award is based
  • the existence of dependents and the amount of their income is a factor in determining entitlement in both Veterans pension and survivors pension cases, and
  • a claimant’s entitlement to survivors benefits, such as DIC and survivors pension, is contingent on his/her relationship to the Veteran on whose death the benefit is based.
References:  For more information on

III.iii.5.A.1.d.  Circumstances Under Which VA Assumes Financial Dependency Exists

Once VA determines that a marital relationship exists between a Veteran and his/her spouse, VA assumes the spouse is financially dependent on the Veteran.  Similarly, once VA establishes that an individual is the child of a Veteran, VA assumes the child is financially dependent on the Veteran.  VA does not require proof of financial dependency under either of these circumstances.
References:  For more information on

III.iii.5.A.1.e.  Circumstances Under Which VA Requires Proof of Financial Dependency

VA requires proof of financial dependency in order to pay
  • additional compensation for a parent to a Veteran whose service-connected (SC) disability(ies) is(are) at least 30-percent disabling, or
  • DIC to the parent of a Veteran whose death was service-related.
References:  For more information on determining whether

III.iii.5.A.1.f.  Issues to Consider When Determining Whether Dependency and/or a Familial Relationship Exists

This block discusses the issues regional offices (ROs) must consider when determining whether dependency and/or a familial relationship exists between a Veteran and another individual.
  • Attempt to resolve inconsistencies in the information a claimant provides on VA Form 21-686cDeclaration of Status of Dependents, through telephone contact.
  • Piecemeal development and unnecessary development
    • impose an unwarranted burden on claimants, and
    • delay claims processing.
  • Do not undertake development for information or evidence without first ascertaining whether or not it is already of record.
  • As explained in M21-1, Part III, Subpart iii, 5.K.1.b, every eight years, VA requires surviving spouses in receipt of DIC to verify their marital status and Veterans in receipt of disability compensation to verify the status of their dependents.  Accordingly, information that is already of record regarding the marital status of a surviving spouse in receipt of DIC or the status of the dependents of a Veteran in receipt of disability compensation is considered valid for the purpose of making entitlement determinations for up to eight years from the date VA received it.
  • Each time the rating activity assigns a combined disability rating of at least 30 percent, follow the instructions in M21-1, Part III, Subpart iii, 5.L.1.b.
Reference:  Follow the instructions in M21-1, Part III, Subpart iii, 1.B.1.e and fwhen obtaining information from a claimant or beneficiary over the telephone.

III.iii.5.A.1.g.  Undertaking Development When Processing Claims for Pension

The existence of dependents is a factor in determining entitlement to pension.  Persons who claim entitlement to income-based benefits must report all dependents and their income and net worth.
If any of the following is necessary to process a claim for pension, request it up front, during initial development:
  • information regarding the number of dependents a claimant has
  • additional evidence or information required to establish the existence of a familial relationship between a Veteran and his/her dependent(s), and/or
  • each dependent’s income and net worth.
Reference:  For more information on considering the income of dependents when determining entitlement to pension, see

III.iii.5.A.1.h.  Undertaking Development When Processing Claims for Disability Compensation

The existence of dependents is not a factor in determining entitlement to disability compensation.  Nevertheless, in order to ensure a Veteran receives all the benefits to which he/she is entitled in a timely manner, undertake any development necessary to establish entitlement to additional compensation for dependents during the initial development phase of claims processing when
  • VA receives a claim for disability compensation
  • the Veteran reports the existence of one or more dependents (that are not currently on the Veteran’s award) on one of the forms listed in M21-1, Part III, Subpart ii, 2.B.1.b, and
  • evidence/information required to establish the Veteran’s relationship to the dependent(s) is not of record.
The upfront development referenced in the above paragraph must be undertaken, even if the Veteran’s combined disability rating is currently less than 30 percent,unless there is no reasonable possibility that a favorable decision on the Veteran’s claim will result in the assignment of a combined disability rating of at least 30 percent.
Example:  If service connection for tinnitus is the only issue a Veteran raises in his/her original claim for disability compensation, it is unnecessary to undertake the upfront development referenced in this block because the highest disability rating VA may assign for tinnitus is 10 percent.
Note:  Follow the instructions in M21-1, Part III, Subpart iii, 5.L.1.c and e if
  • the upfront development described in the opening paragraph of this block was mistakenly overlooked, and
  • a rating decision has been completed and is awaiting promulgation.

III.iii.5.A.1.i.  Additional Instructions for Handling Concurrently Pending Claims for Disability Compensation and Additional Compensation for a Dependent

The table below contains additional instructions for handling a claim for additional compensation for a dependent that VA receives
  • in conjunction with a claim for disability compensation, or
  • while an end product (EP) 110, 010, 020, or 040 is pending.
If VA receives a claim for additional compensation for a dependent …
Then …
  • in conjunction with an original claim for disability compensation, or
  • while an EP 110 or 010 is pending
follow the instructions in M21-1, Part III, Subpart iii, 1.F.2.a for adding Dependency as a contention in the applicable claims-processing system for each dependent the Veteran is claiming.
Important:
  • Do not establish an EP 130.
  • If additional information/evidence is required to add the dependent to the Veteran’s award, first attempt to obtain it by telephone.
  • If a written request for information/evidence is necessary, follow the instructions in M21-1, Part III, Subpart iii, 5.A.1.j.
Exception:  ROs may establish an EP 130 while an EP 110 or 010 is pending if
  • the rating activity
    • assigns a combined disability rating of at least 30 percent, and
    • defers one or more rating issues for additional development, and
  • VA subsequently receives a claim from the Veteran for additional compensation for a dependent.
  • in conjunction with a non-original claim for disability compensation, or
  • while an EP 020 or 040 is pending
unless there is no reasonable possibility that, when VA processes the EP 020 or 040, the Veteran’s combined disability rating will be at least 30 percent,
  • establish an EP 130
  • follow the instructions in M21-1, Part III, Subpart iii, 1.F.2.a for adding Dependency as a contention in the applicable claims-processing system for each dependent the Veteran is claiming, and
  • follow the instructions in the table below.
If the Veteran’s combined disability rating is …
Then …
at least 30 percent before VA processes the EP 020 or 040
process the claim for additional compensation for the dependent(s) under EP 130 without waiting for resolution of the claim controlled by the EP 020 or 040.
Important:
  • If additional information/evidence is required to add the dependent(s) to the Veteran’s award, first attempt to obtain it by telephone.
  • If a written request for information/evidence is necessary, follow the instructions in M21-1, Part III, Subpart iii, 5.A.1.j.
less than 30 percent before VA processes the EP 020 or 040
  • follow the instructions inM21-1, Part III, Subpart iii, 5.L.1.f, and
  • clear the EP 130 once the issue of the Veteran’s entitlement to additional compensation for the dependent(s) is decided.
 
Note:  When adding Dependency as a contention, select No in the MEDICAL field, and select the Administrative Issue option from the drop-down menu next to the CLASSIFICATION field.
References:  For more information about

III.iii.5.A.1.j.  Creating a Letter That Requests Information/ Evidence VA Requires to Recognize an Individual as a Dependent

The table below contains instructions for creating a letter in VBMS that requests missing information/evidence that VA requires in order to recognize an individual as a Veteran’s dependent.
Note:  When VBMS is not available, or when the use of VBMS to create the letter referenced in the above paragraph is not appropriate, follow the instructions in theMAP-D User’s Guide to create the same type of development letter and add a corresponding tracked item in MAP-D.
Example:  Pension management centers (PMCs) currently use MAP-D instead of VBMS to create development letters.
Step
Action
1
Is the creation of a development letter to the Veteran already underway in VBMS?
  • If yes, proceed to Step 6.
  • If no, proceed to the next step.
2
Select the LETTERS tab in VBMS.
3
Click on the ADD NEW LETTER button.
4
If an initial development letter has already been released, selectSubsequent Development Letter as the letter type.
5
Click the ADD LETTERS button in the top, right-hand corner of the screen.
6
In the ASSOCIATED DEVELOPMENT ACTIONS section of the screen, click on the ADD button.
7
Select Custom Development Action from the drop-down box in the CHOOSE A CATEGORY field.
8
Click on the ADD button.
9
Click on the SUBMIT button.
10
Select What We Need from the drop-down box at the top of the DEV ACTIONS column.
11
Enter Evidence/Information Required to Recognize [insert the name of the claimed dependent] as a Dependent in the next field in the DEV ACTIONS column.
12
Enter the following text in the last field in the DEV ACTIONS column: In order to add your dependent, [insert the name of the claimed dependent], to your award, we need [describe the information/evidence that is missing].
 
Note:  Completing the steps in the above table and finalizing the development letter will result in the creation of a tracked item in VBMS for return of the missing information/evidence referenced in Step 12.
Reference:  For more information about using VBMS, see the VBMS User Guide.

III.iii.5.A.1.k.  Handling Claims for Benefits for or From an Individual That VA Does Not Recognize as a Veteran’s Dependent

If a claimant lacks status as the dependent of a Veteran for VA purposes, deny his/her claim without further development.  Similarly, deny a claim from a Veteran or surviving spouse for additional benefits for an individual whom VA cannot recognize as the dependent of a Veteran for VA purposes.
Examples:
  • A deceased Veteran’s grandchild, who was never adopted as the Veteran’s child, claims entitlement to VA survivor’s benefits.
  • A Veteran claims entitlement to additional benefits for a foster child.
Reference:  For more information on whom VA may recognize as a Veteran’s dependent, see

III.iii.5.A.1.l.  Interplay Between Federal, State, and Foreign Laws

VA benefit programs are authorized by Federal law (38 U.S.C.) that determines who is and who is not eligible for benefits.  Some of the rules concerning VA’s recognition of a familial relationship between a Veteran and another individual are unique to VA benefit programs.
Example:  The continuous cohabitation requirement of 38 CFR 3.53.
In many instances, VA incorporates State law or the law of foreign countries by reference.  When making decisions on the issue of relationship, State law is relevant only to the extent that it is incorporated by reference into the body of Federal law governing VA eligibility determinations.
Example:  38 CFR 3.1(j) refers to local law for determining the basic validity of marriage.

III.iii.5.A.1.m.  Duty of Claimants to Report Familial Relationships and Family Composition

Family composition is determined objectively under applicable VA regulations.  Claimants must accurately report familial relationships and family compositions when requested to do so by VA.
Claimants seeking entitlement to disability compensation have the option of claiming or not claiming dependents.  However, claimants seeking entitlement to any of VA’s income-based benefits must
  • report all dependents and their income, and
  • not manipulate family composition to maximize benefits.
Example:  Failure of a pension claimant to report a spouse with income or substantial assets would be considered manipulation to maximize benefits.

 

2.  Burden of Proof and the Weighing of Evidence

 


Introduction

This topic contains information on a claimant’s burden of proof and the weighing of evidence, including

Change Date

December 15, 2017

III.iii.5.A.2.a.  Responsibilities of VA and Claimants for Securing Evidence

VA must make reasonable efforts to assist a claimant in securing evidence, but the claimant always has the initial burden of proof.  This means that unless the claimant furnishes evidence on each element needed to establish the point at issue, VA must deny his/her claim.
Example:  A claimant alleging the existence of a deemed-valid marriage must meet the requirements in 38 CFR 3.52 to establish the marriage as valid for VA purposes.  If the claimant fails to provide evidence showing he/she meets those requirements, VA must deny his/her claim.  Nevertheless, VA may, because of its duty to assist, provide reasonable assistance to secure the evidence.
References:  For more information on

III.iii.5.A.2.b.  Accepting Entries a Claimant Makes on VA Form 21-686c as Proof of an Event

Except as noted in 38 CFR 3.204(a)(2), VA will accept the entries a claimant or beneficiary makes on VA Form 21-686c as sufficient proof of
  • marriage
  • dissolution of a marriage
  • birth of a child
  • introduction of a stepchild into a Veteran’s family, or
  • death of a dependent.
Notes:
  • Unless there are inconsistencies in a claimant’s statement, the policy described in the above paragraph allows ROs to establish the existence of a familial relationship between a Veteran and another individual withoutreviewing the claims folder.
  • It is appropriate to request further evidence from a claimant if there is substantial reason to challenge his/her entries on VA Form 21-686c.  (A substantial reason is something beyond mere suspicion or doubt.)

III.iii.5.A.2.c.  Evaluating and Weighing Evidence

Once all procurable evidence is of record, claims processors must
  • evaluate the competency, credibility, and persuasiveness of the evidence, and
  • determine if the competent and credible evidence in favor of the claimant’s position is of equal or greater weight than the evidence to the contrary.
Use the table below to determine whether or not a point is established.
If scales weighing the evidence …
Then …
tip in favor of the claimant
the point is established.
tip against the claimant
the point is not established.
are approximately balanced
resolve reasonable doubt in favor of the claimant.
Reference:  For more information about resolving reasonable doubt in a claimant’s favor, see

3.  Jurisdiction Over Relationship Determinations

 


Introduction

This topic explains who has jurisdiction over relationship determinations, including

Change Date

February 19, 2019

III.iii.5.A.3.a.  Jurisdiction Over Questions Involving Facts

The authorization activity has exclusive jurisdiction over questions involving facts of relationship or dependency.  Questions of fact differ from questions requiring the interpretation of law.
Example:  The issue of whether Bob was below the age of majority when he married Linda is a question of fact.  The issue of whether his being underage renders their marriage void is a question of law.

III.iii.5.A.3.b.  Who Has the Authority to Resolve Issues Involving Relationship and Dependency

The authorization activity has the authority to resolve issues involving relationship and dependency without Regional Counsel input if
  • there is no doubt as to the legal effect of the facts found
  • it is apparent that the case in question is identical to an existing Regional Counsel or Office of General Counsel (OGC) opinion, or
  • the case in question is not identical, but the facts and questions of law involved are substantially the same with respect to material facts and controlling legal principles as an existing Regional Counsel or OGC opinion.

III.iii.5.A.3.c.  When Administrative Decisions Are Required

The table below lists issues involving relationship or dependency that require resolution through an administrative decision.
Issues Requiring an Administrative Decision
Additional Information
Deemed valid marriage.
Deemed valid common law marriage.
Whether a common law marriage between a surviving spouse and Veteran may be “deemed valid” even though the parties did not reside in a State that recognizes common law marriages.
Adverse decisions must articulate the information in M21-1, Part III, Subpart iii, 5.C.7.
Continuous cohabitation cannot be established.
Inference of remarriage.
Fraudulent annulment.
Parental relationship between a Veteran and an adopted child cannot be established.
Validity of an adoption decree is questionable.
Parental relationship between a Veteran and a stepchild cannot be established.
No administration decision is required toremove a stepchild from an award because the child’s parent is separated from the Veteran.
Parental relationship between a Veteran and an illegitimate (biological) child cannot be established.
Contested claim.
A foster parent cannot be established as a Veteran’s parent.
Benefits are not payable because of parental abandonment.
Financial dependency of parents is established and the parent’s estate exceeds $80,000.
Financial dependency of parents is denied based on net worth.
 
Notes:
  • The preceding list is not all-inclusive. Other issues may arise that require resolution by administrative decision.
  • All administrative decisions require two signatures unless otherwise indicated.
Reference:  For more information about administrative decisions, see M21-1, Part III, Subpart v, 1.A.1.

III.iii.5.A.3.d.  When ROs Must Request an Opinion From Regional Counsel

The table below contains a description of situations in which ROs must request an opinion from Regional Counsel.
Situations Requiring a Regional Counsel Opinion
Reference
A claimant alleges a marriage is void.
There is a question as to the validity of a second marriage, such as whether a common law marriage automatically arises if an individual was previously married and the spouse dies.
There is a question as to the validity of a
  • tribal marriage
  • proxy marriage under State law, or
  • transsexual marriage under State law.
There is a question concerning the validity of a divorce in cases in which a surviving spouse attempts to establish entitlement based on a court decree setting aside or vacating the divorce.
There is a question as to whether the length of a fetus’s gestation constitutes a birth under the law of the jurisdiction in which the fetus was delivered.
There are questions as to the legal effect of an adoptive placement agreement or interlocutory adoption decree or order.
It becomes necessary to determine whether the child referenced in the scenarios below is a child for VA purposes.
Scenario #1:
  • A female Veteran marries another female.
  • The Veteran’s spouse has a child while they are married.
  • The Veteran does not adopt the child.
Scenario #2:
  • A male Veteran marries another male.
  • The Veteran’s spouse fathers a child while they are married.
  • The Veteran does not adopt the child.

III.iii.5.A.3.e.  Procedure for Submitting a Request for an Opinion to Regional Counsel

The table below contains instructions for submitting a request for an opinion to Regional Counsel.
Step
Action
1
Completely develop for pertinent evidence surrounding the issue.
Note:  This includes performing any necessary field examinations.
2
Prepare a request for an opinion in memorandum format, setting forth the question together with a statement of facts.
3
Is the RO processing the corresponding claim in a paperless environment?
  • If yes, proceed to the next step.
  • If no, proceed to Step 6.
4
Download relevant documents from the claimant’s electronic claims folder (eFolder).
5
  • E-mail the documents, along with the request for an opinion, to the Regional Counsel of the RO having jurisdiction over the geographical area where the claimant resides.
  • Proceed no further.
Exception:  The Manila RO submits requests for legal opinions to the OGC.  Because the OGC has access to eFolders, there is no need to download and e-mail documents from the eFolder to the OGC.
Note:  If the documents are too large to send in an e-mail,
  • save the documents onto a compact disc (CD), and
  • send the CD and the request to the appropriate Regional Counsel.
6
Attach the request to the claims folder.
7
Send the request and the claims folder to the Regional Counsel of the RO having jurisdiction over the geographical area where the claimant resides.
Exception:  The Manila RO submits requests for legal opinions to the OGC.
Reference:  For more information on contacting a Regional Counsel office for the RO having jurisdiction over the geographical area where the claimant resides, seehttps://vaww.ogc.vaco.portal.va.gov/offices/SitePages/Home.aspx.

4.  Handling Notices and Claims From Beneficiaries and Claimants Regarding Their Dependents


Introduction

This topic contains instructions for handling notices and claims from beneficiaries and claimants regarding their dependents, including

Change Date

February 19, 2019

III.iii.5.A.4.a.  Forms Claimants Must Use to Initiate the Process of Adding a Dependent to Their Award

Effective March 24, 2015, a claimant must submit VA Form 21-686c, or one of the prescribed forms listed in M21-1, Part III, Subpart ii, 2.B.1.b to initiate the process of adding a dependent to his/her award.
Follow the instructions in M21-1, Part III, Subpart iii, 5.A.4.d if

References:  For information about


III.iii.5.A.4.b.  Handling an Incomplete Form

The form a claimant uses to initiate the process of adding a dependent to his/her award must be “substantially complete,” which means it must
  • bear the claimant’s signature
  • provide the claimant’s name and relationship to the Veteran, if applicable, and
  • contain enough information to identify
    • the Veteran, and
    • the benefit the claimant is seeking.
A form may be substantially complete but fail to provide all the evidence/information VA requires to add a dependent to a claimant’s award.
Follow the instructions in the table below upon receipt of one of the forms identified in M21-1, Part III, Subpart ii, 2.B.1.b that is incomplete in any way.
Step
Action
1
Is the form substantially complete, according to the requirements described in the opening paragraph of this block?
  • If yes, proceed to Step 7.
  • If no, proceed to the next step.
2
Print or make a copy of the form.
3
Highlight the blocks that require completion.
4
Was an EP established based on receipt of the incomplete form?
  • If yes, change the pending EP to an EP 400.
  • If no, establish an EP 400.
5
Attach the form to a letter that
  • instructs the claimant to complete those portions of the form that are highlighted, and
  • informs the claimant that VA will not pay benefits based upon submission of the form unless he/she returns the completed form within one year.
Note:  The Incomplete Application letter in the Letter Creator tool may be used to generate the letter referenced in this step.
6
Clear the EP 400 and take no further action until the claimant returns the completed form.  Proceed to Step 7 only upon receipt of the substantially completed form.
7
Establish EP control based on the benefit claimed, unless the appropriate EP is already pending.
8
Attempt to obtain any missing evidence/information from the claimant by telephone.  If the claimant cannot be reached by telephone, request the evidence/information by letter.
Notes:
  • When telephone contact is made with a claimant,
  • Document any unsuccessful attempts to contact a claimant by telephone as a permanent note in the applicable claims-processing system.
Reference:  For more information about leaving a note in
9
  • Allow the claimant 30 days to provide the missing evidence/information.
  • Proceed to the next step after receiving the missing evidence/information or following expiration of the 30-day response period, whichever occurs first.
10
  • Grant or deny entitlement to benefits based on the evidence of record.
  • Notify the claimant of the decision according to the instructions in M21-1, Part III, Subpart v, 2.B.
Important:
  • Follow the instructions in M21-1, Part III, Subpart iii, 5.L.1.f if a Veteran with a combined disability rating that is less than 30 percent files a claim for additional compensation for a dependent.
  • If a claimant is eligible for additional benefits for a dependent but VA denies entitlement because the claimant failed to provide the evidence/information VA requested,
    • list in the decision notice the evidence VA considered, and
    • inform the claimant that unless VA receives the evidence/information required to add the dependent within one year of the decision notice, VA cannot pay benefits for the dependent based on the present claim.
 
Note:  Do not treat a form listed in M21-1, Part III, Subpart ii, 2.B.1.b as incomplete if a claimant fails to provide
  • the name of the State in which an event (such as marriage or birth of a child) took place, when the city in which the event took place is well known (such as Atlanta or Chicago)
  • required information (such as the date of birth) on the form, when the missing information is shown on documentary evidence (such as a birth certificate) the claimant submits in support of his/her claim, or
  • the last name of his/her current spouse.
References:
  • For more information about handling an incomplete application, see 38 U.S.C. 5102(b) and (c).
  • See M21-1, Part III, Subpart iii, 5.A.1.h and i for more information about handling a claim for additional compensation for a dependent that is received
    • in conjunction with a claim for disability compensation, or
    • while an EP 110, 010, 020, or 040 is pending.

III.iii.5.A.4.c.  Blocks on VA Form 21-686c That a Claimant May Leave Blank

The table below describes individual blocks on VA Form 21-686c that a claimant may leave blank without rendering the form incomplete.
Exception:  The completion of Blocks 6 and 8 on VA Form 21-686c is not optional if a PMC is processing the form.
Block
Caveats
6
If a Veteran entered a number in Block 6, the number of marriages he/she listed in Blocks 7A through 7E must match the number he/she entered in Block 6.
8
  • If a Veteran entered a number in Block 8 that is greater than one, the number of marriages he/she listed in Blocks 9A through 9D must match the number he/she entered in Block 8, minus the current marriage.
  • If a surviving spouse entered a number in Block 8, the number of marriages he/she listed in Blocks 9A through 9D must match the number he/she entered in Block 8.
9A through 9D
Veteran may leave Blocks 9A through 9D blank if the Veteran also
  • left Block 8 blank, or
  • entered 1 or in Block 8.
 
Note:  If discrepancies with regard to the completion of VA Form 21-686c exist, contact the claimant for clarification.

III.iii.5.A.4.d.  Action to Take Upon Receipt of a Request to Add a Dependent That Was Not Submitted on a Prescribed Form

If a claimant submits a request to add a dependent to his/her award but fails to use one of the forms referenced in M21-1, Part III, Subpart ii, 2.B.1.b, first attempt to contact the claimant by telephone for the purpose of completing VA Form 21-686cand/or VA Form 21-674 on the claimant’s behalf.
If attempts to contact the claimant by telephone are unsuccessful, send the claimant a letter containing the verbiage shown in the sample letter below.
Reference:  For more information about the authority of RO employees to complete and sign VA Form 21-686c and VA Form 21-674 on a claimant’s behalf, see M21-1, Part III, Subpart iii, 5.A.4.h.
Dear [Enter the claimant’s first and last name]:
We received your correspondence indicating that you would like to file a claim to add a dependent to your award. VA regulations now require all claims to be submitted on a standardized form.
What Should You Do?
In order for us to begin processing your claim, you must complete, sign, and return a VA Form 21-686c, Declaration of Status of Dependents. You may also submit your claim through eBenefits. For more information regarding eBenefits, please see below.
If you are claiming an unmarried child over the age of 18 but under the age of 23, who is attending school, you must also complete, sign, and return a VA Form 21-674, Request for Approval of School Attendance.
We will take no further action until we receive your completed application for benefits. To locate the appropriate form(s), please visit the following website:www.va.gov/vaforms.
What is eBenefits?
eBenefits provides electronic resources in a self-service environment to Servicemembers, Veterans, and their families. Use of these resources often helps us serve you faster! Through the eBenefits website you can:
● Submit claims for benefits and/or upload documents directly to the VA
● Request to add or change your dependents
● Update your contact and direct deposit information and view payment history
● Request Veterans Service Officer representation
● Track the status of your claim or request for review of a previously-decided claim
● Obtain verification of military service, civil service preference, or VA benefits
● And much more!
Enrolling in eBenefits is easy. Just visit http://www.ebenefits.va.gov/ for more information. If you submit a claim in the future, consider filing through eBenefits. Filing electronically, especially if you participate in our fully developed claim program, may result in a faster decision than if you submit your claim through the mail.
[Veterans Service Organization (VSO) Decision Point]
  
[If the claimant has a VSO or VA-recognized power of attorney (POA), insert the following text.]
  
We sent a copy of this letter to [enter the name of the VSO/POA], who you have appointed as your representative. If you have questions or need assistance, you may also contact your representative.
[If the claimant has no VSO or VA-recognized POA, insert the following text.]
  
We have no record of you appointing a service organization or representative to assist you with your claim. You may contact us for a listing of the recognized Veterans’ service organizations and/or representatives. Veterans’ service organizations, which are recognized or approved to provide services to the veteran community, can also help you with any questions.
Thank you,
Regional Office Director
Enclosure(s): Where to Send Your Written Correspondence
cc: [Enter the name of the claimant’s POA, if applicable]

III.iii.5.A.4.e.  Notification From a Beneficiary That Will Result in Removal of a Dependent From the Beneficiary’s Award

VA does not require beneficiaries to use a specific form to report a change in a dependent’s status that will result in removal of the dependent from the beneficiary’s award.  A beneficiary may report such changes
  • in writing
  • by telephone, e-mail, or fax, or
  • through eBenefits.
When a beneficiary requests removal of a dependent, he/she must, at a minimum, provide VA with the date (month, day, and year) of the event (such as death or marriage of a child) that necessitates such action.  If the beneficiary fails to provide this information, follow the instructions in M21-1, Part III, Subpart iii, 5.L.4.f.
Important:
  • If a beneficiary does not provide the location of the event that necessitates removal of a dependent from the beneficiary’s award, follow the instructions in M21-1, Part III, Subpart iii, 5.L.4.f.
  • VA employees must follow the instructions in M21-1, Part III, Subpart iii, 1.B.1.f when obtaining an oral statement (such as a statement obtained by telephone) from a claimant or beneficiary.
  • If an employee receives a statement from a beneficiary over the telephone that will reduce the beneficiary’s award, and the employee fails to properly identify the beneficiary, VA must provide the beneficiary due process before reducing his/her award.
References:  For more information about

III.iii.5.A.4.f.  Possible Retroactive Restoration of Benefits

Per 38 CFR 3.103(b)(4), VA retroactively restores benefits it reduced, discontinued or otherwise adversely affected based on information it obtained orally if, within 30 days of the date VA issued the notice of adverse action, the beneficiary or his/her fiduciary asserts that the adverse action was based upon information or statements that were
  • inaccurate, or
  • not provided by the beneficiary or his/her fiduciary.
Note:  Restoration of benefits under 38 CFR 3.103(b)(4) will not preclude VA from taking subsequent action that adversely affects benefits.

III.iii.5.A.4.g.  Acceptability of VA Form 21-686c From a VA-Recognized Representative

38 CFR 3.160(a)(2) allows VA to accept a VA Form 21-686c that a VA-recognized representative (POA or employee of a VSO) completes, signs and submits to VA on a claimant’s behalf as if the claimant submitted it himself/herself.
Important:
  • If information a representative provides on VA Form 21-686c will result in a reduction or discontinuance of benefits, VA must attempt to contact the beneficiary by telephone to confirm the entries the representative made on the form.
    • If telephone contact is made with the beneficiary,
      • document the substance of the call on VA Form 27-0820, and
      • associate the form with the claims folder.
    • Document unsuccessful attempts to contact a beneficiary by telephone as a permanent note in the applicable claims processing system.
  • If attempts to contact the beneficiary by telephone are unsuccessful, VA must provide the beneficiary with notice of proposed adverse action before reducing/discontinuing benefits.
Rationale:  The beneficiary’s representative is considered a “third-party” for the purpose of determining whether VA must offer the beneficiary due process before making an adverse adjustment to his/her award based on information VA obtained from the representative.
References:  For more information about

III.iii.5.A.4.h.  Acceptability of a VA Form 21-686c or VA Form 21-674 That an RO or Call Center Employee Completes and Signs

VA authorizes its RO and call center employees to
  • complete VA Form 21-686c and VA Form 21-674, using information they obtain from a claimant over the telephone, and
  • sign the form on the claimant’s behalf.
Note:  The form must include clear identification of the employee executing the form through a digital signature or a wet signature, when electronic submission isnot available.
Important:
  • Treat a VA Form 21-686c or VA Form 21-674 that an RO or call center employee completes and signs on a claimant’s behalf as valid and direct communication from the claimant on a form VA has prescribed for reporting changes in the status or number of the claimant’s dependents.
  • Do not treat a VA Form 21-686c or VA Form 21-674 that an RO or call center employee completes and signs on a claimant’s behalf as communication from a third party simply because the claimant did not personally complete and sign the form.
  • Call center employee signatures can be identified by the inclusion of either a station designation (such as 325/NCC) or their position title (such as Legal Administrative Specialist or Public Contact Representative) along with the employee’s name.

5.  Requirement for Disclosure of SSNs to the VA

 


Introduction

This topic contains information about the requirement that beneficiaries and claimants disclose to VA their SSN and the SSNs of their dependents, including

Change Date

February 19, 2019

III.iii.5.A.5.a.  Regulatory Basis for Requiring Disclosure of SSNs

38 CFR 3.216 requires beneficiaries and claimants to disclose to VA their Social Security number (SSN) and the SSNs of their dependents as a condition of receiving or continuing to receive compensation or pension.
Important:
  • 38 CFR 3.216 does not require beneficiaries, claimants, or dependents to obtain an SSN to receive VA benefits if no SSN has been assigned.
  • If an SSN has neither been assigned to nor requested for an individual, the claimant or beneficiary must attest to this fact in a certified statement.
  • Neither a certified statement nor further development to obtain an SSN is necessary if a claimant or beneficiary indicates no SSN has been assigned to an individual because the individual is a nonresident alien, as referenced in M21-1, Part III, Subpart iii, 5.A.5.c.
Reference:  For more information about the certified statement referenced in this block, see M21-1, Part III, Subpart iii, 5.A.5.g.

III.iii.5.A.5.b.  Why SSNs Are Important to VA

SSNs are important to VA because they enable VA to conduct data exchanges with other agencies.  These data exchanges
  • provide VA with important information, such as verified Social Security income
  • allow VA to conduct independent verification of a claimant’s income using Federal tax information, and
  • help minimize overpayments.

III.iii.5.A.5.c.  Nonresident Aliens Without SSNs

Many nonresident aliens do not have SSNs, and VA does not require them to obtain one.  Accordingly, it is unnecessary to request an SSN (or a certified statement indicating that no SSN has been assigned to or requested) for an individual who
  • has no SSN
  • is not a United States citizen, and
  • resides outside
    • the United States
    • the Commonwealth of Puerto Rico
    • the Virgin Islands
    • American Samoa
    • Guam, or
    • the Northern Marianas.

III.iii.5.A.5.d. Relevance of the Assignment of an ITIN

Upon receipt of notice that an individual with no SSN has an individual tax identification number (ITIN), make no further attempts to obtain
  • that individual’s SSN, or
  • a certified statement that no SSN has been requested for or assigned to that individual.
Note:  The assignment of an ITIN to an individual by the Internal Revenue Service is an indication that
  • no SSN has been assigned to that individual, and
  • that individual is not eligible for an SSN.

III.iii.5.A.5.e.  Guidelines for Requesting an SSN From a Beneficiary or Claimant

Follow the instructions in the table below for requesting an SSN from a beneficiary or claimant.
If …
Then …
a claimant failed to provide an SSN on an application for benefits, to include those listed inM21-1, Part III, Subpart ii, 2.B.1.b
follow the instructions in the table below.
If …
Then …
  • no award is running, and
  • the claimant’sor Veteran’sSSN is missing
  • no award is running, and
  • dependent’sSSN is missing

Reference:  For information about EP control of concurrent claims for disability compensation and additional benefits for dependents, see

  • the claimant is attempting to add onedependent to an existing award, and
  • the dependent’s SSN is missing
follow the instructions in M21-1, Part III, Subpart iii, 5.A.4.b starting with Step 8.
the claimant is attempting to addmultiple dependents to an existing award, and some, but not all, of the dependents’ SSNs are missing
  • follow the instructions inM21-1, Part III, Subpart iii, 5.A.4.bstarting with Step 8
  • process the application to add the dependents for whom all required evidence/information is of record without waiting for a response from the claimant, and
  • leave the EP that is controlling the claim pending until the earlier of the following events:
    • VA obtains the missing SSN(s), or
    • the 30-day response period expires.
VA requires an SSN for an individual to or for whom VA is already paying benefits
attempt to obtain the missing SSN by telephone. If the SSN must be requested by letter,
  • furnish the beneficiary with VA Form 21-4138, Statement in Support of Claim, and
  • advise the beneficiary that
    • disclosure of the SSN is mandatory if
      • the Social Security Administration (SSA) has assigned an SSN, or
      • the beneficiary has requested the assignment of an SSN, and
    • failure to furnish the SSN (or a certified statement that no SSN has been assigned or requested) will result in a reduction in or discontinuance of the beneficiary’s award.
Notes:
  • Follow the due process procedures discussed inM21-1, Part I, 2, before reducing or discontinuing an award because a beneficiary failed to provide VA with an SSN.
  • Per 38 CFR 3.500(w), the effective date of a reduction in or discontinuance of an award because a beneficiary failed to provide an SSN is the last day of the month (first day of the month for award-adjustment purposes) following a 60-day period that begins on the date VA requested the SSN.
 
Note:  If a beneficiary or claimant has requested the assignment of an SSN, but SSA has not yet provided one,
  • send a letter to the beneficiary or claimant, asking him/her to provide the SSN within 30 days, and
  • take no action to award benefits to or for the individual that has no SSN until the beneficiary or claimant provides it.

III.iii.5.A.5.f.  Requirement for an SSN for Children

Beneficiaries/claimants must provide an SSN (or a certified statement that no SSN has been assigned or requested) for all children, regardless of
  • a child’s age, or
  • whether the child is the claimant or a dependent.

III.iii.5.A.5.g.  Determining the Credibility of a Statement That No SSN Has Been Assigned or Requested

Absent evidence to the contrary, accept as credible a statement from a beneficiary or claimant that no SSN has been assigned or requested, unless the individual who reportedly has no SSN
  • receives Social Security or other Federal benefits, or
  • has an account at a bank or other financial institution.
When the conditions described in the above bullets exist, follow the instructions in the table below.
Important:
  • Oral certification that no SSN has been assigned or requested is acceptable only if the individual who reportedly has no SSN is a non-resident alien, as referenced in M21-1, Part III, Subpart iii, 5.A.5.c.  In all other cases, a written and signed statement from the claimant or beneficiary is required.
  • Beneficiaries/claimants may submit the certified statement referenced in this block electronically, in person, or by mail.
Step
Action
1
Is VA already paying benefits to or for the individual who reportedly has no SSN?
  • If yes, proceed to the next step.
  • If no, proceed to Step 4.
2
Issue notice of proposed adverse action to the beneficiary.  In the notice,
  • ask the beneficiary to furnish a statement from SSA confirming that SSA has not assigned an SSN to the individual in question, and
  • inform the beneficiary that if he/she does not provide the statement within 60 days, VA will discontinue benefits payable to or for the individual in question effective the first day of the month following a 60-day period that begins on the date VA requested the statement.
Reference:  For more information about issuing notice of proposed adverse action, see M21-1, Part I, 2.B.
3
Did the beneficiary provide the statement from SSA within 65 days of the date of the notice of proposed adverse action?
  • If yes,
    • notify the beneficiary that VA will not take the action proposed in the notice of proposed adverse action, and
    • disregard the remaining steps in this table.
  • If no,
    • discontinue benefits payable to or for the individual in question effective the first day of the month following a 60-day period that begins on the date VA requested the statement
    • notify the beneficiary of the action taken, and
    • disregard the remaining steps in this table.
4
Ask the claimant to furnish a statement from SSA confirming that SSA has not assigned an SSN to the individual in question.  Allow the claimant 30 days to respond.
5
Did the claimant provide the statement from SSA within 30 days?
  • If yes, award benefits to or for the individual in question if entitlement otherwise exists.
  • If no,
    • deny the claim for benefits, and
    • notify the claimant of the denial and the reason for it.
 
Reference:  For more information about preparing decision notices, see M21-1, Part III, Subpart v, 2.B.

III.iii.5.A.5.h.  Action to Take Following Receipt of Notice That No SSN Has Been Assigned or Requested

Follow the instructions in the table below following receipt of notice that no SSN has been assigned to or requested for a beneficiary or a dependent.
If no SSN was assigned to or requested for a …
Then update the corporate record by …
Veteran
  • accessing the PERSON DETAILS screen in Participant Profile, and
  • selecting SSA Verified No Number Existsfrom the drop-down box in the SSN VERIFICATION STATUS field.
  • non-Veteran beneficiary, or
  • dependent
  • accessing the DEPENDENTS screen in Share
  • selecting the name of the beneficiary or dependent that has no SSN
  • clicking on the MODIFY button, and
  • selecting 9-SSA Verified No Number Existsfrom the drop-down box in the SSN VERIFIED? field.

6.  Medical Records That Reveal the Existence of a Dependent That Is Not on a Veteran’s Award


Introduction

This topic contains information about medical records that reveal the existence of a dependent that is not on a Veteran’s award, including

Change Date

June 8, 2015

III.iii.5.A.6.a.  Action to Take When Medical Records Reveal the Existence of a Dependent That Is Not on a Veteran’s Award

Review of a Veteran’s medical records will occasionally reveal the existence of a spouse or child that has not been added to a Veteran’s award.  Upon discovering such information, follow the instructions in the table below.
Important:  RO employees should not routinely review medical records for thesole purpose of identifying dependents that have not been added to a Veteran’s award.
Step
Action
1
Is the Veteran receiving pension, or does the Veteran have a combined disability rating of at least 30 percent for SC disabilities?
  • If yes, proceed to the next step.
  • If no, proceed no further. The Veteran lacks eligibility to have a dependent on his/her award.
2
Send the Veteran VA Form 21-686c for completion.
Important:  If the Veteran is receiving pension, also send him/her one of the following forms for completion:

III.iii.5.A.6.b.  Assigning an Effective Date Based on Information About Dependents That VA Discovers in Medical Records

When a Veteran returns the VA Form 21-686c that VA sent in accordance with the instructions in M21-1, Part III, Subpart iii, 5.A.6.a, determine whether VA may recognize the individual named on the form as the Veteran’s dependent.
If the relationship between the Veteran and the individual named on the form can be established, add the individual to the Veteran’s award effective the earlier of the following dates:
  • the first of the month following the month VA received the signed and completed VA Form 21-686c, or
  • the first of the month following the date of the event that allowed the Veteran to add a dependent to his/her award if the Veteran submitted a signed and completed VA Form 21-686c within one year of that date.
Example:  An “event,” for the purpose of this block, might include
  • marriage
  • birth of a child, or
  • the assignment of a disability rating of 30 percent or higher for SC disabilities.
References:  For more information about determining the proper effective date for adding a dependent to a Veteran’s award, see
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