Select Page

M21-1, Part III, Subpart iii, Chapter 5, Section K – Verification of Marital Status and the Status of Dependents

Overview


In This Section

This section contains the following topics:

1.  Periodic Verification of Marital Status and the Status of Dependents


Introduction

This topic contains information about the method the Department of Veterans Affairs (VA) uses to periodically verify the marital status of surviving spouses and the status of Veterans’ dependents, including

Change Date

September 7, 2018

III.iii.5.K.1.a.Method for Issuing VA Form 21-0538 and VA Form 21-0537

Each month, the Hines Information Technology Center (ITC) automatically releases
Notes:
  • One non-consecutive terminal digit (from among all claim numbers) is selected each month.
  • Cases are selected for review according to claim numbers as they existed at the time of their initial review.
  • The month of selection does not change in subsequent reviews, even though a claim number may be changed.
  • Cases are automatically selected for review eight years subsequent to the month an initial award of
    • additional benefits for a dependent is processed, or
    • DIC to a surviving spouse is processed.

III.iii.5.K.1.b.  Purpose of VA Form 21-0538 and VA Form 21-0537

Completion of VA Form 21-0538 and VA Form 21-0537 by beneficiaries allows the Department of Veterans Affairs (VA) to verify the following approximately once every eight years:
  • status of the dependents of all Veterans in receipt of additional compensation for a spouse and/or child(ren), and
  • marital status of surviving spouses in receipt of DIC.
Reference:  For more information on a beneficiary’s obligation to periodically certify continued eligibility to benefits, see

III.iii.5.K.1.c.  Time Limit for Responding to a Request for Completion of VA Form 21-0538 or VA Form 21-0537

  • instruct beneficiaries to respond within 60 days from the date of the request for completion of the form, and
  • inform beneficiaries that failure to respond will result in the reduction or discontinuation of benefits.
Note:  A 60-day diary is automatically established in the corporate record upon release of the forms.

III.iii.5.K.1.d.  Action to Take When Automatic Issuance of a Questionnaire Fails

When the Hines ITC cannot issue VA Form 21-0538 or VA Form 21-0537, an 800 series work item (labeled Dependency Verification Letter Not Sent) is generated.  When the work item appears in a regional office’s (RO’s) inventory, the RO must
  • send the appropriate questionnaire to the beneficiary with a letter requesting its completion
  • establish a diary under diary code 30, Local Regional Office Special Use, that expires the month after a 60-day period that begins the later of the following dates:
    • the date the work item was issued to the RO, or
    • the date the RO sent the request for completion of the questionnaire to the beneficiary, and
  • clear the pending 800 series work item.
References:  For more information about

2.  Initial Screening of Questionnaires


Introduction

This topic contains information on the initial screening of questionnaires, including

Change Date

April 18, 2019

III.iii.5.K.2.a.  Processing VA Form 21-0538

Follow the steps in the table below upon receipt of a completed VA Form 21-0538.
Notes:

Step
Action
1
Cancel the corresponding diary.
References:  For more information about cancelling diaries in
2
Compare the dependents listed on the questionnaire against those that were on the Veteran’s award as of the date VA sent the questionnaire to the Veteran.
Notes:
  • Take the action described in M21-1, Part III, Subpart iii, 5.K.6 in conjunction with the action taken in this step.
  • Only those dependents that were on the Veteran’s award on the date VA sent VA Form 21-0538 to the Veteran for completion are subject to verification.
3
Do the dependents listed on the questionnaire match those that were on the Veteran’s award as of the date VA sent the questionnaire to the Veteran?
  • If yes, proceed to the next step.
  • If no, or if there are no dependents currently on the Veteran’s award, proceed to Step 6.
4
Create a permanent, Veteran-level note in the claims-processing system that indicates the questionnaire revealed nothing to warrant an adjustment in the Veteran’s benefits.
5
Clear an end product (EP) 692 and disregard the remaining steps in this table.
6
Establish EP 130, Dependency Verification – 0538, using the date VA received the questionnaire as the date of claim.
7
Does review of the claims folder resolve discrepancies between the dependents listed on the questionnaire and those currently on the Veteran’s award?
  • If yes,
    • create a permanent, Veteran-level note in the claims-processing system that indicates discrepancies on the questionnaire were resolved by review of the claims folder (or consultation with the Veteran), thereby rendering an adjustment of the Veteran’s benefits unnecessary, and
    • clear the pending EP 130.
  • If no, undertake development to resolve the inconsistencies.
Note:  A telephone call to the Veteran might immediately resolve any issues that arise while processing the questionnaire.
References:  For more information about adding notes in

III.iii.5.K.2.b.  Processing VA Form 21-0537

Follow the steps in the table below upon receipt of a completed VA Form 21-0537.
Notes:

  • A surviving spouse may satisfy the requirement to complete VA Form 21-0537 by contacting a VA employee by telephone and providing to the employee the same information VA Form 21-0537 requires the surviving spouse to provide.  The employee that takes the surviving spouse’s call must
  • Follow the instructions in the table below regardless of whether a surviving spouse verifies his/her marital status by telephone or by submitting a VA Form 21-0537.
Step
Action
1
Take the action described in M21-1, Part III, Subpart iii, 5.K.6.
2
Has the surviving spouse remarried?

III.iii.5.K.2.c.  Questionnaires Showing the Surviving Spouse Has Not Remarried

Follow the steps in the table below if the surviving spouse named on a questionnaire has not remarried since the death of the Veteran.
Step
Action
1
Establish EP 692.
2
Create a permanent note in the claims-processing system that indicates the questionnaire revealed nothing to warrant an adjustment of the surviving spouse’s benefits.
References:  For more information about adding notes in
3
Associate the note with the pending EP 692.
4
Clear the EP 692.
5
Cancel the corresponding diary.
References:  For more information about cancelling diaries in

III.iii.5.K.2.d.  Questionnaires Showing the Surviving Spouse Has Remarried

Use the table below to determine the actions to take if a surviving spouse has remarried since the death of the Veteran.
Note:  If the surviving spouse remarried after age 57, award adjustment might be unnecessary.
Reference:  For additional information on the remarriage of a surviving spouse after age 57, see
If …
Then …
VA did not pay DIC to the surviving spouse during the period of remarriage
follow the instructions in M21-1, Part III, Subpart iii, 5.K.2.c.
  • VA paid DIC to the surviving spouse during the period of remarriage, or
  • the surviving spouse reports termination of the remarriage

III.iii.5.K.2.e.  Unsigned and/or Incomplete Questionnaires

Follow the instructions in the table below if a beneficiary fails to sign a questionnaire or it is otherwise incomplete.
Notes:
  • A questionnaire is acceptable for the purpose of verifying continued eligibility to benefits only if it bears the “wet” signature of the beneficiary that completed it.
  • VA will accept a questionnaire that a beneficiary completes, signs, and faxes to VA.
Step
Action
1
Cancel the diary referenced in M21-1, Part III, Subpart iii, 5.K.1.c.
2
Which questionnaire did VA send to the beneficiary?
  • If VA sent VA Form 21-0538, proceed to the next step
  • If VA sent VA Form 21-0537,
    • establish EP 130, with a suspense date that is 30 days from the current date, and
    • proceed to Step 4.
3
Establish EP 130, Dependency Verification – 0538, with a suspense date that is 30 days from the current date.
4
Attempt to contact the beneficiary by telephone.
  • If the beneficiary failed to sign the questionnaire, confirm with the beneficiary the entries he/she made on the questionnaire.
  • If the questionnaire is incomplete, obtain the missing information from beneficiary.
5
Was telephone contact made with the beneficiary?
  • If yes,
  • If no, proceed to Step 7.
Note:  Document unsuccessful attempts to contact the Veteran  by telephone as a permanent note in VBMS or MAP-D.
References:  For more information about adding notes in
6
Note:  Claims processors may provide the notice referenced in Step 22 of the procedure described in M21-1, Part III, Subpart iii, 5.K.4.b, or Step 21 of the procedure described in M21-1, Part III, Subpart iii, 5.K.4.cby telephone (during the telephone call referenced in Step 4 of this table) if
  • VA Form 21-0538 shows no change in the status of the Veteran’s dependents, or
  • VA Form 21-0537 shows no change in the surviving spouse’s marital status.
7
Return the questionnaire to the beneficiary for completion.
8
Follow the instructions in the table below.
If VA sent the beneficiary …
And the beneficiary …
Then …
returns the form within 30 days
follow the instructions inStep 22 of the procedure described in M21-1, Part III, Subpart iii, 5.K.4.b.
does not return the form within 30 days
  • clear the EP established in Step 3 (unless the EP must remain pending to control an issue unrelated to the beneficiary’s failure to return the questionnaire), and
  • follow the instructions in M21-1, Part III, Subpart iii, 5.K.4.b,beginning with Step 10.
returns the form within 30 days
follow the instructions in Step 21 of the procedure described in M21-1, Part III, Subpart iii, 5.K.4.c.
does not return the form within 30 days

III.iii.5.K.2.f. Notifying Other Business Lines of a Change in Status

Follow the instructions in the table below to determine whether it is necessary to notify other business lines when a change in status is shown on VA Form 21-0537or VA Form 21-0538.
If …
And the Benefits Delivery Network shows …
Then …
  • VA Form 21-0537shows a surviving spouse’s marital status has changed, or
    • the marriage between a Veteran and his/her spouse has ended, or
    • the Veteran’s spouse has died
the spouse/surviving spouse is receiving education benefits from VA
follow the instructions in M21-1, Part III, Subpart iii, 6.C.3.b for notifying the regional processing office of jurisdiction.
Important:
  • Include in the notice
    • the name of the spouse/surviving spouse
    • the corresponding claim number
    • an explanation of the reason for the change in status (such as remarriage of the surviving spouse or divorce of the spouse from the Veteran)
    • the date of the event that resulted in the change in status, and
    • the effective date of the corresponding award adjustment (if an award adjustment was made).
  • Upload a copy of the e-mail into the appropriate eFolder.
VA Form 21-0538 shows the status of any of a Veteran’s dependents has changed
the Veteran is receiving training under38 U.S.C. Chapter 31
e-mail notice to the Vocational Rehabilitation and Employment (VR&E) mailbox of the RO that has custody of the Veteran’s Counseling/Evaluation/Rehabilitation folder.
Important:
  • Include in the e-mail
    • the Veteran’s name and claim number
    • the name of the dependent whose status has changed
    • an explanation of the reason for the change in status (such as death or divorce)
    • the date of the event that resulted in the change in status, and
    • the effective date of the corresponding award adjustment.
  • Upload a copy of the e-mail into the Veteran’s eFolder.
Example:  The mailbox for the Salt Lake City RO’s VR&E office is VAVBASLC/RO/VRE.

3.  Award Adjustments Based on Information Provided on a Questionnaire


Introduction

This topic contains information on award adjustments that may be necessary based on information a beneficiary provides on a questionnaire, including

Change Date

September 7, 2018

III.iii.5.K.3.a.Determining Whether Due Process Is Necessary

With few exceptions, the due process procedures set forth in M21-1, Part I, 2 mustbe followed prior to the reduction or discontinuation of benefits.
Award adjustments based on information a beneficiary provides, however, do notrequire due process.  In these cases, provide the beneficiary
  • contemporaneous notice of the reduction or discontinuation of benefits, and
  • the reason for the effective date of the reduction.
Note:  Awards may be adjusted based on information the beneficiary provides by telephone.
Reference:  For more information about providing contemporaneous notice of a reduction or discontinuation of benefits, see M21-1, Part I, 2.D.

III.iii.5.K.3.b.  Processing a VA Form 21-0538 That Reveals the Loss of a Dependent

Follow the steps in the table below if a Veteran
  • reports the loss of a dependent on his/her questionnaire, and
  • provides the date of the event that resulted in the loss of the dependent.
Note:  If the Veteran did not provide the date of the event, follow the instructions inM21-1, Part III, Subpart iii, 5.K.3.d.
Step
Action
1
Adjust the Veteran’s award according to the instructions in M21-1, Part III, Subpart iii, 5.L.4.
2
Follow the instructions in the table below.
If the award is adjusted in …
Then …
VETSNET
annotate the award print to reflect the basis for the adjustment.
VBMS
briefly explain the basis for the adjustment in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
3
Notify the Veteran of the award adjustment.

III.iii.5.K.3.c.  Processing a VA Form 21-0537 That Shows the Surviving Spouse Has Remarried

Follow the steps in the table below if a surviving spouse in receipt of DIC reports on his/her questionnaire that he/she has remarried.
Exception:  If a surviving spouse remarries after age 57, it might be unnecessaryto discontinue DIC.
Reference:  For more information on the effect of a surviving spouse’s remarriage, see M21-1, Part IV, Subpart iii, 3.D.
Step
Action
1
Discontinue the surviving spouse’s benefits.
2
Follow the instructions in the table below.
If benefits are discontinued using …
Then …
VETSNET
annotate the award print to reflect the basis for the discontinuance.
VBMS
briefly explain the basis for the discontinuance in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
3 Notify the surviving spouse of the action taken.

III.iii.5.K.3.d.  Processing a VA Form 21-0538 That Does Not Show the Date of Change in a Dependent’s Status

If a Veteran reports a change in the status of his/her dependent(s) on VA Form 21-0538 but does not provide the date of the change, attempt to contact the Veteran by telephone to obtain the missing information.
Follow the instructions in the table below only if attempts to obtain the missing information from the Veteran by telephone are unsuccessful.
Note:  Follow the instructions in M21-1, Part III, Subpart iii, 1.B.1.e for documenting successful and unsuccessful attempts to contact a beneficiary by telephone.
Step
Action
1
Remove the dependent (whose status has changed) from the Veteran’s award effective the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share.
2
Follow the instructions in the table below.
If benefits are adjusted using …
Then …
VETSNET
annotate the award print to reflect the basis for the reduction.
VBMS
briefly explain the basis for the reduction in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
3
Return the questionnaire to the Veteran with a request to provide the missing information and return the questionnaire within 30 days.
4
Establish EP 130, Dependency Verification – 0538, with a suspense date that is 30 days from the current date.
5
Did the beneficiary return the questionnaire within 30 days?
  • If yes,
  • If no, proceed to the next step.
6
Clear the EP established in Step 4.
7
Establish EP 600.
  • Use the current date as the date of claim.
  • Enter a suspense date that is 65 days from the date of the notice of proposed adverse action discussed in the next step.
  • Add the Potential Under/Overpayment special issue.
8
Send a notice of proposed adverse action to the Veteran.  In the notice, inform the Veteran that
  • VA plans to reduce his/her benefits because he/she failed to return the questionnaire, and
  • the proposed reduction
    • will be effective the first of the month following the date the Veteran last verified the status of the dependent in question, and
    • could result in the creation of an overpayment, which VA may require the Veteran to pay.
Note:  To determine the date a Veteran last verified the status of a dependent, search the claims folder for the most recent communication with the Veteran that provides such verification.
Examples:  The date a Veteran last verified the status of his/her dependent could be
Reference:  For more information on elements that must be included in a notice of proposed adverse action, see M21-1, Part I, 2.B.2.
9
Did the Veteran return the questionnaire within 65 days?
  • If yes,
  • If no, proceed to the next step.
10
Remove the dependent from the Veteran’s award effective the date proposed in Step 8.
11
Follow the instructions in the table below.
If benefits are reduced using …
Then …
VETSNET
annotate the award print to reflect the basis for the reduction.
VBMS
briefly explain the basis for the reduction in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
12
Notify the Veteran of the action taken in Step 10.

III.iii.5.K.3.e.Processing a VA Form 21-0537 That Does Not Show the Date of Change in a Surviving Spouse’s Marital Status

If a surviving spouse reports a change in his/her marital status on VA Form 21-0537 but does not provide the date of the change, attempt to contact the surviving spouse by telephone to obtain the missing information.
Follow the instructions in the table below only if attempts to obtain the missing information from the surviving spouse by telephone are unsuccessful.
Note:  Follow the instructions in M21-1, Part III, Subpart iii, 1.B.1.e for documenting successful and unsuccessful attempts to contact a beneficiary by telephone.
Step
Action
1
Suspend the surviving spouse’s award.
2
Follow the instructions in the table below.
If benefits are adjusted using …
Then …
VETSNET
annotate the award print to reflect the basis for the suspension.
VBMS
briefly explain the basis for the suspension in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
3
Return the questionnaire to the beneficiary with a request to provide the missing information and return the questionnaire within 30 days.
4
Establish EP 130 with a suspense date that is 30 days from the current date.
5
Did the beneficiary return the questionnaire within 30 days?

III.iii.5.K.3.f.Processing a VA Form 21-0538 That Reveals the Existence of an Additional Dependent

Consider the reporting of an additional dependent on VA Form 21-0538 a claim for the additional compensation VA pays for dependents.
Although a Veteran may initiate a claim for additional benefits for dependents using VA Form 21-0538, information contained on this form, alone, is inadequate for the purpose of determining entitlement.
The table below describes additional actions ROs must take upon receipt of a VA Form 21-0538 on which a Veteran has listed a dependent that is not currently on his/her award.
If …
Then …
the dependent is
  • a child under the age of 18, or
  • a spouse
  • establish EP 130 (unless an EP 130 is already pending under which VA is processing the VA Form 21-0538), and
  • either send the Veteran VA Form 21-686c for completion or call the Veteran and obtain the information required to complete the form over the telephone.
  • the dependent is a child between the ages of 18 and 23, and
  • there is no indication the child is permanently incapable of self-support
the dependent is a child that the Veteran claims is permanently incapable of self-support
  • establish EP 020, Helpless Child(unless an EP 020 is already pending)
  • either send the Veteran VA Form 21-686c for completion or call the Veteran and obtain the information required to complete the form over the telephone, and
  • follow the instructions in M21-1, Part III, Subpart iii, 7.
Exception:  There may be no need to attempt to obtain the information contained on a completed VA Form 21-686c (as the text in the above table instructs) if VA paid the Veteran additional benefits for the same dependent at some point in the past (based on information contained on a completed VA Form 21-686c) then later removed the dependent from the Veteran’s award.
Notes:
  • 38 CFR 3.401 governs the effective date of an increase in compensation for additional dependents.
  • If entitlement to increased benefits arises due to a liberalizing law or issue, apply the provisions of 38 CFR 3.114 when choosing an effective date.

Reference:  For more information about the acceptability of VA Form 21-686c orVA Form 21-674 that an RO or VA call center employee completes on a claimant’s behalf, see M21-1, Part III, Subpart iii, 5.A.4.h.


4.  Failure to Return a Questionnaire


Introduction

This topic contains instructions for handling a beneficiary’s failure to return a questionnaire, including

Change Date

April 18, 2019

III.iii.5.K.4.a.  How ROs Are Alerted That a Beneficiary Has Failed to Return a Questionnaire

If the diary referenced in M21-1 Part III, Subpart iii, 5.K.1.c is not cancelled within 60 days from the date of the computer-generated request for completion of VA Form 21-0538 or VA Form 21-0537, an 800 series work item (labeled Return of Dependency Verification Form) is generated to alert ROs that the diary established to control for return of the form has expired.
Follow the instructions in


III.iii.5.K.4.b. Processing a Work Item That Was Generated Because a Veteran Failed to Return VA Form 21-0538

The table below contains instructions for processing a work item that was generated because a Veteran failed to return VA Form 21-0538.
Important:  Only those dependents that were on the Veteran’s award on the date VA sent VA Form 21-0538 to the Veteran for completion are subject to verification.
Step
Action
1
Review the claims folder and mail portal to determine whether the Veteran submitted the questionnaire and VA personnel failed to cancel the corresponding diary.
Important:
  • As indicated in M21-1, Part III, Subpart iii, 5.K.2.a, a Veteran may verify the status of his/her dependent(s) by telephone instead of submitting VA Form 21-0538.  If a VA Form 27-0820 is of record that confirms a Veteran verified the status of his/her dependent(s) by telephone, treat the VA Form 27-0820as a completed questionnaire.
  • Treat as a completed questionnaire a VA Form 21-686c that meets the following criteria.
    • VA must have received the form no earlier than one year before the date of the work item.
    • The form must account for all of the dependents for whom the Veteran was receiving additional compensation as of the date VA sent VA Form 21-0538 to the Veteran for completion.
    • The Veteran (or VA-designated fiduciary) must havepersonally signed the form.
2
Is the questionnaire of record?
  • If yes,
    • cancel the corresponding work item, and
    • proceed to the next step.
  • If no,
    • clear the corresponding work item, and
    • proceed to Step 4.
3
Was the questionnaire already processed?
  • If yes,
    • ensure any necessary award adjustments were made, and
    • take no further action.
  • If no,
4
  • Establish EP 130, Dependency Verification.
  • Add the Potential Under/Overpayment special issue.
5
Attempt to contact the Veteran by telephone.
6
Was telephone contact made with the Veteran?
  • If yes, proceed to the next step.
  • If no, proceed to Step 9.
Important:  Document unsuccessful attempts to contact the Veteran by telephone as a permanent note in
  • VBMS, if any necessary award adjustments will be made in VBMS, or
  • MAP-D, if any necessary award adjustments will be made in VETSNET.
References:  For more information about adding notes in
7
Ask the Veteran to provide the same information VA Form 21-0538requires him/her to provide.
8
Follow the instructions in the table below.
If the Veteran …
Then …
  • provided the same information VA Form 21-0538 requires him/her to provide, and
  • reported no change in the status of his/her dependent(s)
  • record the information onVA Form 27-0820
  • treat the VA Form 27-0820as a completed questionnaire
  • inform the Veteran (while on the telephone with him/her) that his/her benefits will continue at the current rate, and
  • disregard the remaining steps in this table.
  • provided the same information VA Form 21-0538 requires him/her to provide, and
  • reported changes in the status of his/her dependent(s)
did not provide the same information VA Form 21-0538requires him/her to provide
  • document the conversation with the Veteran on VA Form 27-0820, and
  • proceed to the next step.
Important:
  • If a Veteran provides the same information VA Form 21-0538requires except for the date of a change in a dependent’s status,
  • If the Veteran is unable to provide (by telephone) all of the information VA Form 21-0538 requires, allow the Veteran until the end of the next business day to provide the missing information (by telephone).  If the Veteran provides the missing information by the end of the next business day, proceed to Step 22.  Otherwise, proceed to the next step.
9
Clear the pending EP 130.
10
  • Establish EP 600 with a suspense date that is 65 days from the date of the notice of proposed adverse action discussed in the next step.
  • Add the Potential Under/Overpayment special issue.
11
Send a notice of proposed adverse action to the Veteran.  In the notice, inform the Veteran that
  • VA plans to reduce his/her benefits because he/she failed to return a completed questionnaire, and
  • the proposed reduction
    • will be effective the first of the month following the date the Veteran last verified the status of the dependent(s) in question, and
    • could result in the creation of an overpayment, which VA may require the Veteran to pay.
Note:  To determine the date a Veteran last verified the status of his/her dependent(s), search the claims folder for the most recent communication with the Veteran that provides such verification.
Examples:  The date a Veteran last verified the status of his/her dependent(s) could be
  • the date VA last received a VA Form 21-686c or other form listed in M21-1, Part III, Subpart ii, 2.B.1.b, that shows the status of the Veteran’s dependent(s), or
  • the date of the last documented telephone conversation with the Veteran regarding the status of his/her dependent(s).
Reference:  For more information on elements that must be included in a notice of proposed adverse action, see M21-1, Part I, 2.B.2.
12
Did VA receive the questionnaire within the additional 65-day period?
  • If yes, proceed to Step 22.
  • If no, proceed to the next step.
Exception:  Proceed to Step 19 if
  • VA did not receive the questionnaire, and
  • VA has already removed from the Veteran’s award all of the dependents or the only dependent whose status the Veteran must verify (because, for example, the dependent child(ren) turned 18 or stopped attending school shortly after VA issued the questionnaire).
Important:  Treat as a completed questionnaire a VA Form 21-686cthat a Veteran personally signs and returns to VA in response to the notice of proposed adverse action referenced in Step 11.
13
Remove from the Veteran’s award the dependent(s) whose status the Veteran failed to verify.
Important:  Remove the dependent(s) from the Veteran’s award effective the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share.
14
Follow the instructions in the table below.
If benefits are reduced using …
Then …
VETSNET
annotate the award print to reflect the basis for the reduction.
VBMS
briefly explain the basis for the reduction in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
15
Prepare a decision notice informing the Veteran that

  • VA has removed from his/her award the dependent(s) whose status the Veteran failed to verify, effective the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share, and
  • VA will remove from his/her award the same dependent(s) from an earlier effective date (the first of the month following the date the Veteran last verified the status of his/her dependent(s), as proposed in the notice of proposed adverse action referenced in Step 11) if the Veteran does not provide verification within 90 days.
16
Establish a diary under diary code 30, Local Regional Office Special Use, that expires the month after a 90-day period that begins on the current date.
References:  For more information about establishing diaries in
17 Proceed to the next step when the earlier of the following occurs:

  • the Veteran verifies the status of his/her dependents, or
  • the diary established in Step 16 expires.
Note:  Expiration of the diary established in Step 16 triggers the generation of an 810 work item labeled 631 Diary Due Date/Reason/Legend.
18
Follow the instructions in the table below.
If the Veteran …
Then …
returned VA Form 21-0538 or verified the status of his/her dependent(s) through other acceptable means
  • clear the diary established in Step 16 (if it is still pending)
  • establish EP 130, using the date VA received verification as the date of claim, and
  • proceed to Step 22.
has not yet verified the status of his/her dependents
  • establish EP 130, using the date of the 810 work item referenced in Step 17 as the date of claim
  • add the Potential Under/Overpaymentspecial issue, and
  • proceed to the next step.
19
Remove the dependent(s) whose status the Veteran failed to verify effective the date proposed in Step 11 (the first of the month following the date the Veteran last verified the status of the dependent(s) in question).
Important:  ROs must be prudent in their management of pending diaries.  If an RO were to clear the diary established in Step 16 for a reason other than that specified in Step 18, removal of the Veteran’s dependents from the proper effective date might never occur.
20
Follow the instructions in the table below.
If benefits are reduced using …
Then …
VETSNET
annotate the award print to reflect the basis for the reduction.
VBMS
briefly explain the basis for the reduction in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
21
  • Notify the Veteran of the action taken in Step 19.
  • Disregard the remaining step in this table.
22
Follow the instructions in the table below.
If the Veteran reports …
And …
Then …
no change in the status of his/her dependent(s)
VA is already paying the Veteran additional benefits for all of the dependents he/she lists on the questionnaire
  • notify the Veteran that benefits will continue at the current rate, and
  • clear the related, pending EP(s).
the Veteran concurrently notifies VA of the existence of at least one dependent who is notcurrently on the Veteran’s award
  • notify the Veteran that he/she will continue to receive benefits for the dependents whose status he/she verified, and
  • follow the instructions in M21-1, Part III, Subpart iii, 5.K.3.f.
Note:  If the Veteran is entitled to benefits for the additional dependent(s),
  • add the dependent(s) to the Veteran’s award under EP 130, and
  • clear any other related EP (such as EP 600) that is still pending.
VA previously reduced the Veteran’s benefits because he/she failed to return the questionnaire
  • restore the payment of additional benefits for the dependent(s) the Veteran verified, effective the date VA previously reduced benefits because the Veteran failed to return the questionnaire, and
  • notify the Veteran of the action taken.
a change in the status of any of his/her dependents that will require the removal of at least one dependent from the Veteran’s award
follow the instructions in M21-1, Part III, Subpart iii, 5.K.3, adjusting the Veteran’s award under the EP 130 or 600 (whichever is pending).
the Veteran concurrently notifies VA of the existence of at least one dependent who is notcurrently on the Veteran’s award
follow the instructions in M21-1, Part III, Subpart iii, 5.K.3.f, and
  • if all of the evidence/information required to add the new dependent(s) to the Veteran’s award is obtained before action is taken to remove the dependent(s) whose status has changed,
    • add and remove dependents, as appropriate, under the EP 130, and
    • clear any other related EP (such as EP 600) that is still pending, or
  • if evidence/information required to add the new dependent(s) must still be obtained,
    • remove the dependent(s) whose status has changed under the EP 130 or 600 (whichever is pending), and
    • clear any other related EP (such as EP 600) that is still pending.
Note:  If action to remove from the Veteran’s award the dependent(s) whose status has changed was taken under EP 130, undertake development to obtain the evidence/information required to add the new dependent(s) under the same EP and leave the EP running to control for return of the evidence/information.  Otherwise, establish a new EP 130 to control for return of the evidence/information.
Note:  VA will accept a completed questionnaire (or VA Form 21-686c that meets the criteria set forth in Step 1 of the table above) from a Veteran whose benefits it reduced because the Veteran failed to return a completed questionnaire, regardless of the amount of time that has passed since the award adjustment.  When this occurs,

  • establish EP 130, and
  • follow the instructions in Step 22 of the table above.
Reference:  For more information about notifying a Veteran of a decision VA made and/or an action VA took, see M21-1, Part III, Subpart v, 2.B.

III.iii.5.K.4.c.  Processing a Work Item That Was Generated Because a Surviving Spouse Failed to Return VA Form 21-0537

The table below contains instructions for processing a work item that was generated because a surviving spouse failed to return VA Form 21-0537.
Step
Action
1
Review the claims folder and mail portal to determine whether the surviving spouse submitted the questionnaire and VA personnel failed to cancel the corresponding diary.
Important:
  • As indicated in M21-1, Part III, Subpart iii, 5.K.2.b, a surviving spouse may verify his/her marital status by telephone instead of submitting VA Form 21-0537.  If a VA Form 27-0820 is of record that confirms a surviving spouse verified his/her marital status by telephone, treat the VA Form 27-0820 as a completed questionnaire.
  • Treat as a completed questionnaire a VA Form 21-686c that meets the following criteria.
    • VA must have received the form no earlier than one year before the date of the work item.
    • The form must account for the surviving spouse’s current marital status.
    • The surviving spouse (or VA-designated fiduciary) must have personally signed the form.
  • Do not treat as a completed questionnaire a VA Form 21-686c that someone completed on a surviving spouse’s behalf under the provisions of M21-1, Part III, Subpart iii, 5.A.4.g or h.
2
Is the questionnaire of record?
  • If yes,
    • cancel the corresponding work item, and
    • proceed to the next step.
  • If no,
    • clear the corresponding work item, and
    • proceed to Step 4.
3
Was the questionnaire already processed?
4
Establish EP 130.
5
Attempt to contact the surviving spouse by telephone and obtain from him/her the same information that the VA Form 21-0537 requires the surviving spouse to provide.
6
Follow the instructions in the table below.
If …
Then …
  • telephone contact was made with the surviving spouse
  • the surviving spouse provided the same information VA Form 21-0537 requires him/her to provide, and
  • the surviving spouse reported no change in his/her marital status
  • document the details of the call on VA Form 27-0820
  • treat the VA Form 27-0820as a completed questionnaire
  • inform the surviving spouse (while on the telephone with him/her) that his/her benefits will remain unchanged, and
  • disregard the remaining steps in this table.
  • telephone contact was made with the surviving spouse
  • the surviving spouse provided the same information VA Form 21-0537 requires him/her to provide, and
  • the surviving spouse reported that his/her marital status has changed
  • telephone contact was made with the surviving spouse
  • the surviving spouse cannot or will notprovide the same information VA Form 21-0537 requires him/her to provide
  • document the conversation with the surviving spouse onVA Form 27-0820, and
  • proceed to the next step.
attempts to contact the surviving spouse by telephone were unsuccessful
  • document the attempts to contact the surviving spouse as a permanent note in
    • MAP-D, if any necessary award adjustments will be made in VETSNET, or
    • VBMS, if any necessary award adjustments will be made in VBMS, and
  • proceed to the next step.
References:  For more information about adding notes in
7
Clear the EP 130 established in Step 4.
8
Establish EP 600 with a suspense date that is 65 days from the date of the notice of proposed adverse action discussed in the next step.
9
Send a notice of proposed adverse action to the surviving spouse.  In the notice, inform the surviving spouse that
  • VA plans to discontinue his/her benefits because he/she failed to return a completed questionnaire, and
  • the proposed action
    • will be effective the first of the month following the date the surviving spouse last verified his/her marital status, and
    • could result in the creation of an overpayment, which VA may require the surviving spouse to pay.
Note:  To determine the date a surviving spouse last verified his/her marital status, search the claims folder for the most recent communication with the surviving spouse that provides such verification.
References:  For more information on
10
Was the questionnaire received within the additional 65-day period?
  • If yes, proceed to Step 21.
  • If no, proceed to the next step.
Important:  Treat as a completed questionnaire a VA Form 21-686cthat a surviving spouse personally signs and returns to VA in response to the notice of proposed adverse action referenced in Step 9.
11
Has the surviving spouse’s award already been suspended?
  • If yes,
    • clear the pending EP 600, and
    • proceed to Step 14.
  • If no, proceed to the next step.
12
Suspend benefits under the pending EP 600.
13
Follow the instructions in the table below.
If benefits are suspended using …
Then …
VETSNET
annotate the award print to reflect the basis for the suspension.
VBMS
briefly explain the basis for the suspension in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
14
Notify the surviving spouse that if he/she does not provide VA with the completed questionnaire within six months, VA will
  • retroactively discontinue benefits, effective the date specified in the notice of proposed adverse action, and
  • create an overpayment in the surviving spouse’s account.
15
Establish a diary under diary code 30, Local Regional Office Special Use, that expires the month after a six-month period that begins on the date of the award that suspended benefits
16
Did the surviving spouse return the questionnaire?
  • If yes, proceed to Step 21.
  • If no, proceed to the next step when the diary established in Step 15 has expired.
17
Establish an EP 130.
18
Retroactively discontinue benefits as proposed in Step 14.
19
Follow the instructions in the table below.
If benefits are discontinued using …
Then …
VETSNET
annotate the award print to reflect the basis for the discontinuance.
VBMS
briefly explain the basis for the discontinuance in the OTHER PRINT REMARKS field on the PRINT REMARKS screen.
20
  • Notify the surviving spouse of the action taken.
  • Disregard the remaining steps in this table.
21
Follow the instructions in the table below upon receipt of a completed questionnaire.
If the surviving spouse reports …
And …
Then …
no change in his/her marital status
VA is already paying benefits to the surviving spouse
  • notify the surviving spouse that benefits will continue at the current rate, and
  • clear the related, pending EP.
VA previously suspended or discontinued benefits because the surviving spouse failed to return the questionnaire
  • resume benefits under the pending EP at the prior rate and from the date VA previously suspended or discontinued them, and
  • notify the surviving spouse of the action taken.
his/her marital status has changed
follow the instructions in M21-1, Part III, Subpart iii, 5.K.3.c, discontinuing benefits, if necessary, under the pending EP.
Note:  VA will accept a completed questionnaire or VA Form 21-686c that meets the criteria set forth in Step 1 of the table above) from a surviving spouse whose benefits it discontinued because the surviving spouse failed to return the questionnaire, regardless of the amount of time that has passed since benefits were discontinued.  When this occurs,
  • establish EP 130, and
  • follow the instructions in Step 21 of the table above.
Reference:  For more information about notifying a beneficiary of a decision VA made and/or an action VA took, see M21-1, Part III, Subpart v, 2.B.

III.iii.5.K.4.d.  Handling Cases in Which a Veteran With a Running Apportionment Fails to Return a Questionnaire

Apportionments are not affected by a Veteran’s failure to return VA Form 21-0538.
If there is a running apportionment and the primary beneficiary fails to return the questionnaire after due process expires, VA will remove the dependent(s) from the primary beneficiary’s award but will not take any action on the running apportionment.

5.  Questionnaires Returned as Undeliverable


Introduction

This topic contains information about handling questionnaires that are returned as undeliverable due to an erroneous address, including the actions to take when the correct address of the intended recipient of the questionnaire is

Change Date

September 7, 2018

III.iii.5.K.5.a.  Correct Address of the Intended Recipient of the Questionnaire Is Known

If the address on the questionnaire is incorrect, and the correct address is known,
  • re-send the questionnaire to the correct address
  • establish a diary under diary code 30, Local Regional Office Special Use, that expires the month after a 60-day period that begins on the current date (to control for return of the questionnaire)
  • correct the address in the corporate record, and
  • treat the re-sent questionnaire as an initial mailing.
References:  For more information about establishing diary controls in

III.iii.5.K.5.b.  Correct Address of the Intended Recipient of the Questionnaire Is Unknown

Follow the steps in the table below if the correct address of the intended recipient of the questionnaire is unknown.
Step
Action
1
Attempt to obtain a current address by following the instructions in M21-1, Part III, Subpart ii, 1.B.6.d.
2
Was a new mailing address obtained?
  • If yes,
  • If no,
    • clear EP 130, and
    • proceed to the next step.
3
Follow the instructions in the table below.
If the undeliverable questionnaire is a …
Then follow the instructions in 
M21-1, Part III, Subpart iii, 5.K.4.b,beginning with Step 10.

 

6.  Maintaining Data in the Corporate Record

 


Change Date

May 12, 2015

III.iii.5.K.6.a.  Maintaining Data in the Corporate Record

Upon receipt of a completed questionnaire, compare the information on the questionnaire against data in the corporate record that identifies a dependent or surviving spouse.  This specifically includes
  • dates of birth
  • Social Security numbers (SSNs), and
  • the spelling of names.
If discrepancies exist or data is missing from the corporate record, use information from the questionnaire to update the corporate record.
References:  For more information on

 

7.  Questionnaires With Claims Folders at Other Locations

 


Change Date

September 7, 2018

III.iii.5.K.7.a.  Questionnaires With Claims Folders at Other Locations

Follow the procedures in the table below upon receipt of a questionnaire, the corresponding claims folder for which is located at
  • the Record Management Center (RMC) in St. Louis, or
  • another RO.
If the claims folder is …
And review of the claims folder is …
Then …
located at RMC
necessary to confirm
  • marital status, or
  • the status of a dependent
  • cancel the corresponding diary
  • establish an EP 130
  • request the claims folder from RMC, and
  • process the questionnaire after the claims folder becomes available in an electronic format.
Note:  Upon receipt of a request for a claims folder, RMC sends the claims folder to a vendor for “scanning” (conversion into an electronic format).
located at RMC
not necessary to confirm
  • marital status, or
  • the status of a dependent
process the questionnaire without requesting the claims folder from RMC.
located at another RO
route the questionnaire for processing to the RO with jurisdiction over the claims folder only if the RO that received the questionnaire cannot process it without reviewing the claims folder.
Note:  EP credit goes only to the RO that completes
  • final review of the questionnaire, and
  • any necessary award action.
Historical_M21-1III_iii_5_SecK_12-5-16.doc May 12, 2019 335 KB
Historical_M21-1III_iii_5_SecK_10-7-16.doc May 12, 2019 315 KB
Historical_M21-1III_iii_5_SecK_12-1-16.doc May 12, 2019 333 KB
Historical_M21-1III_iii_5_SecK_7-10-17.doc May 12, 2019 393 KB
Historical_M21-1III_iii_5_SecK_5-2-17.doc May 12, 2019 386 KB
Historical_M21-1III_iii_5_SecK_4-17-17.doc May 12, 2019 386 KB
Historical_M21-1III_iii_5_SecK_9-7-18.docx May 12, 2019 104 KB
4-18-19_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 89 KB
Historical_M21-1III_iii_5_SecK_2-24-16.doc May 12, 2019 204 KB
Historical_M21-1III_iii_5_SecK_5-12-15.doc May 12, 2019 188 KB
2-24-16_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 78 KB
4-25-16_Key_Changes_M21-1III_iii_5_SecK.docx May 12, 2019 82 KB
5-2-17_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 105 KB
1-10-17_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 104 KB
9-7-18_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 91 KB
10-28-15_Key-Changes-M21-1III_iii_5_SecK.docx May 12, 2019 78 KB
11-1-16_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 90 KB
12-5-16_Key-Changes_M21-1III_iii_5_SecK.docx May 12, 2019 92 KB
Historical_M21-1III_iii_5_SecK_1-10-17.doc May 12, 2019 373 KB
transmittal-sheetM21-1MRIII_iii_5_K_T.doc May 12, 2019 77 KB
Change-May-12-2015-Transmittal-Sheet-M21-1MRIII_iii_5_SecK_TS.docx May 12, 2019 44 KB
Did this article answer your question?

Leave a Reply





Pin It on Pinterest

Share This