Select Page

M21-1, Part III, Subpart vi, Chapter 6, Section A – General Information on Contested Claims

Overview

In This Section

This section contains the following topics:
Topic
Topic Name
1
2

1.  Identifying Contested Claims


Introduction

This topic contains information on identifying contested claims, including

Change Date

February 25, 2019

III.vi.6.A.1.a.  Definition:  Contested Claim

contested claim exists when
  • a favorable decision on one claim requires
  • the denial of a claim from a separate claimant, or
  • payment of a lesser benefit to a separate claimant, and
  • one claimant may contest
    • the other claimant’s entitlement to that benefit, or
    • payment of that benefit to the other claimant.

III.vi.6.A.1.b.  Apportionment Claims

A claim for an apportionment of a beneficiary’s Department of Veterans Affairs (VA) benefits is one type of contested claim.
Reference:  For more information about apportionment claims, see M21-1, Part III, Subpart v, 3.

III.vi.6.A.1.c.  Claims Involving a Contested Relationship

A contested claim automatically arises if two people
  • allege to be a deceased Veteran’s legal surviving
  • spouse
  • mother, or
  • father, and
  • file a formal claim for the same benefit.
Note:  This principle applies to all claims for which entitlement to VA benefits is based on the claimant’s relationship to the Veteran.

III.vi.6.A.1.d.  Other Types of Contested Claims

Consider a claim contested if
  • VA receives formal claims for entitlement to the same benefit from two claimants, and
  • one of the claimants protests the payment of benefits to the other claimant.
Notes:
  • Consider evidence in support of a claim a protest.
  • A protest against payment must be based on the claimant’s assertion of his/her own entitlement.
  • One claimant’s assertion that another claimant does not deserve a benefit is not a valid protest.
Examples:
  • The natural mother of a Veteran protests the payment of Parents’ Dependency and Indemnity Compensation to the Veteran’s adoptive mother and claims that she, as the natural mother, is the parent whom VA should recognize as the legal surviving mother.
  • A person files a claim for accrued benefits as the payer of the expenses of a Veteran’s last illness and burial and alleges the other claimant for accrued benefits is not the Veteran’s legal surviving spouse.

III.vi.6.A.1.e.  Claims for the Payment of Attorney Fees From Past-Due Benefits

VA’s failure to withhold 20 percent of past-due benefits for the payment of attorney fees, as well as its denial of the payment of attorney fees from past-due benefits, are appealable to the Board of Veterans’ Appeals.
This type of claim involves two parties, the claimant and the representative.  Such claims must, therefore, be handled as contested claims, as VA may be required to attempt to collect from the claimant fees owed to the attorney.
Important:  The option to request decision review via higher-level review or supplemental claim, as referenced in 38 CFR 3.2500, is not available to parties in a contested claim.
Reference:  For more information on withholding benefits for the payment of attorney fees, see M21-1, Part I, 3.C.

2.  Handling a Claim That Is in Contest a With a Pending Claim or the Payment of Benefits in a Running Award


Change Date
May 9, 2018

III.vi.6.A.2.a.  Handling a Claim That Is in Contest With a Pending Claim or the Payment of Benefits in a Running Award

Follow the steps in the table below upon receipt of a claim that, according to the information in M21-1, Part III, Subpart vi, 6.A.1, is in contest with
  • a pending claim from another claimant, or
  • VA’s payment of benefits to another person.
Step
Action
1
Review the facts of the case.
2
Is there any possibility the subsequent claimant is entitled to the benefit he/she is claiming?
  • If yes, proceed to the next step.
  • If no,
3
Is a claim for the same benefit from another claimant currently pending?
  • If yes, proceed to the next step.
  • If no, proceed to Step 6.
4
  • Prepare a letter that notifies the subsequent claimant of the facts of the case and informs his/her that
    • a claim for the same benefit from another person is currently pending, and
    • VA is treating the claim as a contested claim.
  • If additional evidence is required to decide the claim, follow the instructions in M21-1, Part III, Subpart vi, 6.B.
5
  • Notify the other claimant that VA
    • has received a claim for the same benefit from another person
    • is treating the claim as a contested claim, and
    • has given the subsequent claimant 30 days to respond to notice of the contested claim.
  • Proceed to Step 8.
6
  • Prepare a letter that notifies the subsequent claimant of the facts of the case and informs him/her that VA
    • is currently paying the benefit he/she is claiming to another person, and
    • is treating his/her claim as a contested claim.
  • If additional evidence is required to decide the claim, follow the instructions in M21-1, Part III, Subpart vi, 6.B.
7
Notify the beneficiary that VA
  • has received a claim for the same benefit the beneficiary is receiving
  • is treating the claim as a contested claim, and
  • has given the subsequent claimant 30 days to respond to notice of the contested claim.
Important:  Do not suspend payments to the beneficiary at any point in the procedure described in this table.
8
After 30 days have passed, follow the instructions in M21-1, Part III, Subpart vi, 6.C.
Important:  While a contested claim is pending, keep all contesting parties informed of
  • the status of the claim
  • any processing delays, and
  • actions VA has taken, such as development action.
Transmittal-05_10_07.doc May 18, 2019 32 KB
5-9-18_Key-Changes_M21-1III_vi_6_SecA.docx May 18, 2019 57 KB
2-25-19_Key-Changes_M21-1III_vi_6_SecA.docx May 18, 2019 43 KB
Historical_M21-1III_vi_6_SecA_5-9-18.docx May 18, 2019 44 KB
Historical_M21-1III_vi_6_SecA_4-27-15.doc May 18, 2019 58 KB
Change-April-27-2015-Transmittal-Sheet-M21-1III_vi_6_SecA_TS.docx May 18, 2019 37 KB
Did this article answer your question?

Leave a Reply





Pin It on Pinterest

Share This