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Updated Mar 26, 2024

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

1.  General Information on Accrued Rating Decisions

Introduction
This topic contains general information on accrued rating decisions, including

Change Date
March 26, 2024

XI.ii.3.D.1.a.  When to Make Accrued Rating Decisions
Address accrued in a rating decision when, after the original claimant’s death, there is an accrued claim and
  • an issue within the jurisdiction of the rating activity for claims pending at death, including
    • informal claims received before March 24, 2015
    • initial and supplemental claims
    • higher-level reviews (HLR)
    • previously denied claims that had new and material evidence to support the claim in or deemed in the claims folder at the date of death, and
    • claims of clear and unmistakable error (CUE) pending at death, and
  • any substantive appeals or administrative appeals pending at the time of death.
Notes:
  • The evidence requirements for an accrued decision based on new and relevant evidence are the same as the evidence requirements imposed on the original claimant to support a supplemental claim.
  • Benefits are not payable when a claim for accrued benefits raises a CUE in a previously denied finally adjudicated claim.
References:  For more information on

XI.ii.3.D.1.b.  Procedures Governing Accrued Rating Decisions
Accrued rating decisions are governed by the same procedures applicable to other ratings.
Reference:  For more information on general rating decision procedures, see M21-1, Part V, Subpart i, 1.A.

XI.ii.3.D.1.c.  Determining the Retroactive Period Based on the Date of Death
The table below shows the limitations in the retroactive period covered by the rating decision based on the date of the original claimant’s death.
If death occurred …
Then the retroactive period covered by the rating decision is …
  • on or after January 1, 1958, but
  • before October 9, 1996
limited to any one-year period before death.
  • on or after October 9, 1996, but
  • before December 16, 2003
limited to any two-year period before death.
on or after December 16, 2003
not limited.
Exception:  When accrued benefits are payable to the survivors or estate of a Nehmer class member under 38 CFR 3.816(f), there is no limitation in the retroactive period, regardless of the date of death.
References:  For more information on

XI.ii.3.D.1.d.  Considering a Rating Decision Based on the Date of Death
A rating decision dated
  • prior to the claimant’s death is valid and may be processed by authorization for accrued purposes, or
  • after the claimant’s death is not valid and may not be processed by authorization for accrued purposes.
Notes:
  • If a valid rating decision cannot be promulgated, create a Veterans Benefits Management System (VBMS) note to serve as a flash for potential accrued benefits.  Add the following VBMS note to the Rating Decision:  Potential benefits under PL 110-389, the Veterans’ Benefits Improvement Act of 2008.
  • Whether or not a rating decision has been promulgated has no impact on the validity of the rating decision for accrued benefit purposes.
Example:  The Veteran submitted a compensation claim for coronary artery disease (CAD) on February 1, 2023.  An award was authorized on April 15, 2023, granting CAD based on a rating decision dated dated April 11, 2023.  The benefit payment was returned as undeliverable on April 20, 2023, because the Veteran died on April 1, 2023.  The Veteran’s surviving spouse submitted a claim for accrued benefits on April 22, 2023.
Result:  A new rating decision is required because the rating decision is dated after the Veteran’s death.

XI.ii.3.D.1.e.  Consideration of Evidence for Requests for Substitution
Review the table below to determine what evidence to consider in the rating decision.
If a request for substitution has …
Then base the rating decision …
been granted and the claim pending at death was
  • a formal claim
  • an initial claim
  • supplemental claim, or
  • legacy appeal
  • on evidence contained within the file on the date of death, and
  • additional evidence submitted by the substitute claimant who has the same rights as that of the deceased claimant.
Reference:  For information on the rights of a substitute claimant, see M21-1, Part XI, Subpart ii, 3.B.3.
been granted and the claim pending at death was a request for an HLR
on evidence contained within the file on the date of the notification letter addressing the issue that the request is based on
not been granted
on the evidence contained within the file on the date of death.
Reference:  For information on evidence in the file at the date of death, see M21-1, Part XI, Subpart ii, 3.A.4.
Note:  The monetary benefit sought in both situations is called an accrued benefit.

XI.ii.3.D.1.f.  Obtaining All Evidence for Accrued Claims
The following evidence must be in the claims folder even if the reports are not reduced to writing or are not physically placed in the claims folder until after death:
  • service department records at the Records Management Center
  • reports of Department of Veterans Affairs (VA) hospitalization
  • reports of hospitalization, treatment, or examinations authorized by VA, and
  • reports of autopsy made by VA on the date of death.
References:  For more information on

XI.ii.3.D.1.g.  Payment of Accrued Benefits for the Month of Death
The Veteran’s rate for the month of death is generally not payable as an accrued benefit.  It is available only to the surviving spouse under 38 U.S.C. 5110(d) and 38 U.S.C. 5310.
A rating decision is required, however, if it is needed to establish the Veteran’s rate of benefits for the month of death for payment purposes for the surviving spouse under 38 U.S.C. 5310.
References:  For more information on

2.  Preparing the Rating Decision

Introduction
This topic contains information on accrued rating decisions, including

Change Date
February 19, 2019

XI.ii.3.D.2.a.  Format for an Accrued Rating Decision
Prepare an accrued rating decision in the same format as a rating decision for disability or survivor benefits.
Reference:  For more information on completing an accrued benefit rating decision narrative, see M21-1, Part V, Subpart iv, 1.A.7.

XI.ii.3.D.2.b.  Addressing the Issue of Accrued or Substitution in the Rating Decision
The issue statement for an accrued claim should be worded as Entitlement to Accrued Benefits, even if the accrued is a result of a request for substitution.

XI.ii.3.D.2.c.  Handling the Accrued Rating Decision
Use the information in the table below to handle the accrued rating decision.
If an accrued rating decision is …
Then …
favorable
use the template language generated by selecting the accrued grant radio button in VBMS – Rating.
Note:  The accrued template is only available for selection if the Veteran is deceased. When generated, the accrued grant template will appear at the top of the first page of the Codesheet below the data tables.
Reference:  For more information, see the VBMS Rating User Guide.
unfavorable, because necessary evidence was not received to support the claim
include that discussion in the reasons for decision.

XI.ii.3.D.2.d.  Preparing the Coded Conclusion for Accrued Claims
Prepare the coded conclusion in the same manner as for live or survivor cases.
Reference:  For more information about preparing the coded conclusion, see M21-1, Part V, Subpart iv, 1.C.