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M21-1, Part IX, Subpart ii, Chapter 1, Section C – Development

Overview


In This Section

This section contains the following topics:

 1.  Obtaining Information From SSA to Determine Eligibility for the Special Allowance Under 38 U.S.C. 1312(a)

 


Introduction

This topic contains information on obtaining information from the SSA to determine eligibility for the special allowance under 38 U.S.C. 1312(a), including

Change Date

May 18, 2015

IX.ii.1.C.1.a. Using VA Form 21-4180 to Obtain Information From SSA

Use VA Form 21-4180, Request for Certification by Social Security Administration, to obtain information from the Social Security Administration (SSA) as to whether or not the special allowance under 38 U.S.C. 1312(a) may be payable to an eligible survivor or survivors.

IX.ii.1.C.1.b. When to Use VA Form 21-4180

Send VA Form 21-4180 to SSA if
  • the Department of Veterans Affairs (VA) receives a specific inquiry or claim for the special allowance, and
  • SSA Form 101Determination of AwardSSA Form 101CDetermination of Award, or SSA Form 101U3Determination of Award, is not of record.
Reference:  For more information on the certification of entitlement by SSA, seeM21-1, Part IX, Subpart ii, 1.C.2.

IX.ii.1.C.1.c.  Preparing VA Form 21-4180 for Referral to SSA

Follow the steps in the table below to refer VA Form 21-4180 to SSA.
Step
Action
1
Prepare VA Form 21-4180, Part 1.
Reference:  For more information on how to complete the items on VA Form 21-4180, Part 1, see M21-1, Part IX, Subpart ii, 1.C.1.d.
Note:  For paper claims folders,
  • flash file a copy of VA Form 21-4180 in the claims folder, and
  • when the original is returned, dispose of the copy.
2
  • Address and mail VA Form 21-4180 to the appropriate SSA Program Service Center (PSC), and
  • establish a 90-day suspense.
Reference:  For more information on addressing and mailing VA Form 21-4180, see M21-1, Part IX, Subpart ii, 1.C.1.e.
3
Has a reply been received from SSA before the end of the 90-day suspense period?
  • If yes, take appropriate action as shown in M21-1, Part IX, Subpart ii, 1.C.2.d.
  • If no,
    • send a follow-up by submitting another VA Form 21-4180, which may be a reproduction of the claims folder copy, prominently marked SECOND REQUEST, and
    • maintain a 30-day suspense for response to the follow-up.
4
Has the reply been received from SSA before the end of the 30-day follow-up suspense period?
Note:  Do not withhold the referral of VA Form 21-4180 to develop for any evidence that may be required to complete the claim.

IX.ii.1.C.1.d.  Completing VA Form 21-4180

Use the table below for instructions on how to complete the items on VA Form 21-4180, Part I.
Item
Description
1, 5, and 6
Provide the Veteran’s
  • full name
  • date of birth, and
  • date of death.
Note:  This information is of particular importance for SSA purposes when the Social Security number (SSN) is unknown or not correct.
2
Provide the complete address of the regional office (RO) submitting the form.
Note:  Since SSA returns these forms in a window envelope, write the address so that the complete address can be seen in the window.
3
Enter the VA claim number.
4
Enter either
  • the Veteran’s SSN, if known, or
  • Unknown.
7
List the following claimants, as applicable:
  • the surviving spouse
  • all children under age 18 or helpless, and
  • parents.
Important:
  • It is necessary to list all the possible claimants whether or not a claim has been filed, such as
    • surviving spouse
    • children, and
    • parents.
  • When parents are listed, make a notation as to whether or not they have filed a claim for VA benefits.
8
Obtain the signature of the Veterans Service Center Manager.
14
Enter the appropriate SSA PSC as described in M21-1, Part IX, Subpart ii, 1.C.1.e.

IX.ii.1.C.1.e.  Addressing and Mailing VA Form 21-4180

Use the table below to determine how to address and dispatch the completed VA Form 21-4180 to SSA.
If …
Then address VA Form 21-4180 to the …
the Veteran’s SSN is known
appropriate SSA PSC as described inM21-1, Part III, Subpart iii, 3.A.6.
the Veteran’s SSN is unknown
SSA district office nearest the transmitting RO as described in M21-1, Part III, Subpart iii, 3.A.5.
the Veteran is a foreign claimant
Division of Foreign Claims
Social Security Administration
P. O. Box 1756
Baltimore, MD 21203.

 

2.  Handling Certification of Entitlement for the Special Allowance Under 38 U.S.C. 1312(a) by SSA


Introduction

This topic contains information on the certification of entitlement for the special allowance under 38 U.S.C. 1312(a), including

Change Date

May 15, 2015

IX.ii.1.C.2.a.  Certifying Entitlement for the Special Allowance Under 38 U.S.C. 1312(a)

The table below describes the process followed by SSA to certify entitlement for the special allowance under 38 U.S.C. 1312(a).
Stage
Description
1
Receives notice of death from the service department.
2
Determines whether there are survivors eligible for the special allowance under 38 U.S.C. 1312(a).
Reference:  For more information on the actions taken by SSA after determining the claimant’s entitlement to the special allowance, seeM21-1, Part IX, Subpart ii, 1.C.2.b.
3
Takes action as appropriate depending on the eligibility determination.
References:  For more information on

IX.ii.1.C.2.b.  SSA Actions After Determining Eligibility

The table below describes the action SSA takes to certify a claimant’s entitlement to the special allowance under 38 U.S.C. 1312(a).
When SSA determines that …
Then SSA …
there are survivors eligible for the special allowance
  • returns VA Form 21-4180 with the appropriate notations
  • furnishes a copy of an award letter
  • furnishes enclosures for the award letter as described inM21-1, Part IX, Subpart ii, 1.D.2, and
  • furnishes one of the following forms to VA as authority for payment:
    • SSA Form 101
    • SSA Form 101C, or
    • SSA Form 101U3.
  • there is no survivor eligible to receive the special allowance, or
  • the special allowance is notpayable because there is entitlement to an old-age and survivors insurance payment
  • denies the claim, and
  • notifies the claimant.
Note:  VA is not responsible for furnishing a notice of denial or review rights, except for an adverse determination as described in M21-1, Part IX, Subpart ii, 1.B.1, and then only if there is a specific claim for the special allowance.

IX.ii.1.C.2.c.  Information That Must Be Provided on SSA Forms 101, 101C, or 101U3

Do not take award action to pay the special allowance unless the SSA Forms 101,101C, or 101U3 furnished by SSA contain the
  • name and address of each beneficiary
  • monthly rate of payment
  • first month of entitlement, and
  • notation Do not certify.  VA Payment Only.

IX.ii.1.C.2.d.  Action Taken by VA When SSA Returns VA Form 21-4180

Use the table below to determine the action to take when SSA returns VA Form 21-4180.
If …
Then …
VA Form 21-4180, Item 10A, is checked
  • the special allowance is payable
  • take adjudicative action on all pending claims, and
  • when all claims are finalized, transfer the deceased Veteran’s claims folder to the Philadelphia Pension Management Center (PMC) for payment of the special allowance.
Reference:  For more information on the jurisdiction for payment of the special allowance, see M21-1, Part IX, Subpart ii, 1.A.2.
VA Form 21-4180, Item 11A, is checked
  • the special allowance is notpayable
  • add the VA Form 21-4180 to the deceased Veteran’s claims folder, and
  • take no further action.
VA Form 21-4180, Item 11B, is checked
  • send a letter to the surviving spouse advising of possible entitlement at age 60, and
  • inform the surviving spouse that he/she should contact VA at age 60.
Note:  This does not affect the jurisdiction of the claims folder.
VA Form 21-4180, Item 11C, is checked
there is no one eligible to receive Social Security benefits.
Note:  Take no further action.
Note:  When the certification of entitlement by SSA is received in an RO and not the Philadelphia PMC, take action as provided in M21-1, Part IX, Subpart ii, 1.A.2.b.

IX.ii.1.C.2.e.  Action Taken by VA if Entitlement Certified by SSA Is Not Payable

If VA determines that entitlement certified by SSA on SSA Forms 101101C, or101U3 is not payable for any reason, notify the SSA PSC that made the certification.

IX.ii.1.C.2.f.  Action Taken by VA on Receipt of an Incomplete VA Form 21-4180

Use the table below to determine what action to take when SSA returns an incomplete VA Form 21-4180 because the claimant failed to respond to correspondence from SSA.
If the …
Then …
VA Form 21-4180 contains the most recent address of the claimant as shown in the claims folder
  • add the VA Form 21-4180 to the deceased Veteran’s claims folder
  • annotate VA Form 21-4180with NAN (nactionnecessary), and
  • include
    • the initials of the employee making the annotation, and
    • the current date.
claims folder contains a more recent address
  • send another VA Form 21-4180 containing the most recent address of record to the SSA PSC, and
  • annotate VA Form 21-4180 to show it is being submitted due to the receipt of a current address.
Note:  If the claims folder is an electronic claims folder, add the annotation in the Veterans Benefits Management System in the SUBJECT field under DOCUMENT PROPERTIES of the VA Form 21-4180.

IX.ii.1.C.2.g.  When Recertification for the Special Allowance Under 38 U.S.C. 1312(a) Is Required

If an award of special allowance is delayed by VA for more than one year after the date of approval of the SSA Forms 101101C, or 101U3 by the servicing SSA PSC, contact that office by letter requesting verification of continued eligibility before processing an award.
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