M21-1, Part V, Subpart i, Chapter 3, Section B – Income and Net Worth Development Forms and Acceptable Statements

Introduction

Introduction

• application forms for original and reopened pension and Parents’ DIC claims, and
• forms used to supplement or clarify income information provided on an application.

Change Date

V.i.3.B.1.a.  Application Forms for Pension and Parents’ DIC

• pension, and
• Parents’ Dependency and Indemnity Compensation (DIC).

V.i.3.B.1.b.  Obtaining Supplemental Income and Net Worth Information

• clarify or supplement income and net worth information furnished on the application, or
• request income or net worth information in connection with the original claim, any other new claim, or a supplemental claim.

Introduction

• EVR forms used to develop basic income and net worth information after an original application has been filed
• releasing EVR forms from a regional office (RO)
• forms to use to determine if an pension claimant has dependents
• recording “from/thru” dates on pension EVR forms, and
• recording “from/thru” dates on pension EVR forms according to development period.

Change Date

V.i.3.B.2.a.  EVR Forms for Developing Basic Income/Net Worth Information 

• VA Form 21P-0512s-1, Old Law and Section 306 Eligibility Verification Report (Surviving Spouse)
• VA Form 21P-0512V-1, Old Law and Section 306 Eligibility Verification Report (Veteran)
• VA Form 21P-0513-1, Old Law and Section 306 Eligibility Verification Report (Children Only)
• VA Form 21P-0514-1, DIC Parent’s Eligibility Verification Report
• VA Form 21P-0516-1, Improved Pension Eligibility Verification Report (Veteran With No Children)
• VA Form 21P-0517-1, Improved Pension Eligibility Verification Report (Veteran With Children)
• VA Form 21P-0518-1, Improved Pension Eligibility Verification Report (Surviving Spouse With No Children), or
• VA Form 21P-0519C-1, Improved Pension Eligibility Verification Report (Child or Children).

V.i.3.B.2.b.  Releasing EVR Forms From an RO

V.i.3.B.2.c.  Determining If an Pension Claimant Has Dependents

• VA Form 21P-0517-1, in a disability pension case, or
• VA Form 21-0519S–1, Improved Pension Eligibility Verification Report (Surviving Spouse with Children), in a Survivors Pension case.

V.i.3.B.2.d.  Recording From/Thru Dates on Pension EVR Forms

• “from” date space, write the
  • date of pension entitlement, if known, or
  • current date, if the date of pension entitlement is not known, and
• “thru” date space, write the date that is 12 months from the end of the month of the “from” date.

• “10/28/13” as the “from” date, and
• “10/31/14” as the “thru” date.

V.i.3.B.2.e.  Recording From/Thru Dates on Pension EVR Forms According to Development Period

• less than six months
  • write the “from/thru” dates in just one of the spaces, and
  • draw a line through the other space, or
• more than six months, write the “from/thru” dates in both spaces, with the “from/thru” dates on the right-hand side of the form being used for the calendar year following the first date on the left-hand side of the form.

• “10/28/13” and “10/31/14” as the “from/thru” dates on the left-hand side of the form, and
• “1/01/14” and “12/31/14” as the “from/thru” dates on the right-hand side of the form.

Change Date

V.i.3.B.3.a.  Forms for Developing Specific Types of Income

• development procedures in MAP-D, see the MAP-D User’s Guide, and
• handling outdated forms, see M21-1, Part III, Subpart iii, 1.C.7.d.

Introduction

• claimant requirements for submitting information
• procedures for oral communications, and
• retroactive restoration of benefits.

Change Date

V.i.3.B.4.a.  Claimant Requirements for Submitting Information

V.i.3.B.4.b.  Procedures for Oral Communications

• use the information furnished to reduce or terminate benefits, and
• furnish the beneficiary contemporaneous notice of the adverse action.

V.i.3.B.4.c.  Retroactive Restoration of Benefits

• information or statements that were inaccurate, or
• information that was not provided by the beneficiary or his/her fiduciary.