Section A – General Information on Relationship and Dependency

Updated Dec 13, 2024

In This Section

This section contains the following topics:

Topic	Topic Name
1	General Policies Surrounding the Issues of Relationship and Dependency
2	Burden of Proof and the Weighing of Evidence
3	Jurisdiction Over Relationship Determinations
4	Handling Notices and Claims From Beneficiaries and Claimants Regarding Their Dependents
5	Determining Whether and How to Undertake Development When the Benefit Is Disability Compensation or Dependency and Indemnity Compensation (DIC)
6	Determining Whether and How to Undertake Development When the Benefit Is Pension
7	Requirement for Disclosure of Social Security Numbers (SSNs) to the Department of Veterans Affairs (VA)
8	Medical Records That Reveal the Existence of a Dependent That Is Not on a Veteran’s Award

1. General Policies Surrounding the Issues of Relationship and Dependency

Introduction

This topic contains general policies surrounding the issues of relationship and dependency, including

definition of
- relationship, and
- dependency
importance of establishing the relationship of an individual to a Veteran
circumstances under which VA
- assumes financial dependency exists, and
- requires proof of financial dependency
considering the existence of dependents when determining entitlement to disability and survivors benefits
handling claims for benefits for or from an individual that VA does not recognize as a Veteran’s dependent
interplay between Federal, State, and foreign laws, and
duty of claimants to report familial relationships and family composition.

Change Date

February 15, 2022

VII.i.1.A.1.a. Definition: Relationship

The term relationship refers to an individual’s legal status with respect to the Veteran.

Examples:

Can the individual be recognized as the Veteran’s child?
Have the individual and the Veteran fulfilled the requirements for a legal marriage?

References: For a definition of

spouse, see 38 CFR 3.50
child, see 38 CFR 3.57, and
parent, see 38 CFR 3.59.

VII.i.1.A.1.b. Definition: Dependency

The term dependency refers to the question of whether or not an individual relies on a Veteran for financial support.

VII.i.1.A.1.c. Importance of Establishing the Relationship of an Individual to a Veteran

Establishing an individual’s relationship to a Veteran is critical because

the Department of Veterans Affairs (VA) may pay additional disability compensation to a Veteran for dependent(s) if the Veteran’s service-connected (SC) disability rating is at least 30 percent
VA may pay additional Dependency and Indemnity Compensation (DIC) to a surviving spouse for children that VA recognizes as a child of the Veteran on whose death the DIC award is based
the existence of dependents and the amount of their income is a factor in determining entitlement in both Veterans Pension and Survivors Pension cases, and
a claimant’s entitlement to survivors benefits, such as DIC and Survivors Pension, is contingent on the relationship of the claimant to the Veteran on whose death the benefit is based.

References: For more information on

claims processor responsibilities
- when promulgating a rating decision that assigns an overall SC disability rating of at least 30 percent to a Veteran whose overall SC disability rating prior to the rating decision was less than 30 percent, see M21-1, Part VII, Subpart i, 1.C.1.b, and
- each time the rating activity assigns an overall SC disability rating of at least 30 percent, see M21-1, Part VII, Subpart i, 1.C.1.e
establishing the existence of a familial relationship between a Veteran and another individual, see 38 CFR 3.50 through 38 CFR 3.60
the payment of additional
- disability compensation for dependents, see 38 CFR 3.4(b)(2), and
- DIC for children of a deceased Veteran, see 38 CFR 3.10(e)(1), and
establishing an individual as a Veteran’s parent, see M21-1, Part VII, Subpart i, 4.A.

VII.i.1.A.1.d. Circumstances Under Which VA Assumes Financial Dependency Exists

Once VA determines a marital relationship exists between a Veteran and spouse, VA assumes the spouse is financially dependent on the Veteran. Similarly, once VA establishes that an individual is the child of a Veteran, VA assumes the child is financially dependent on the Veteran. VA does not require proof of financial dependency under either of these circumstances.

References: For more information on

determining whether a marital relationship exists, see
- M21-1, Part VII, Subpart i, 2.A
- 38 CFR 3.50 (spouse and surviving spouse)
- 38 CFR 3.52 (marriages deemed valid)
- 38 CFR 3.53 (continuous cohabitation)
- 38 CFR 3.54 (marriage dates), and
- 38 CFR 3.55 (reinstatement of a surviving spouse’s eligibility based on termination of a marital relationship), and
determining whether an individual is the child of a Veteran, see
- M21-1, Part VII, Subpart i, 3.A
- 38 CFR 3.57, and
- 38 CFR 3.58 (child given up for adoption).

VII.i.1.A.1.e. Circumstances Under Which VA Requires Proof of Financial Dependency

VA requires proof of financial dependency in order to pay

additional compensation for a parent to a Veteran whose SC disability rating is at least 30-percent, or
DIC to the parent of a Veteran whose death was service-related.

References: For more information on determining whether

an individual is the parent of a Veteran, see
- M21-1, Part VII, Subpart i, 4.A, and
- 38 CFR 3.59, and
the parent of a Veteran is financially dependent on the Veteran, see M21-1, Part VII, Subpart i, 4.B.

VII.i.1.A.1.f. Considering the Existence of Dependents When Determining Entitlement to Disability and Survivors Benefits

The existence of dependents is not a factor in determining entitlement to disability compensation or DIC. However, the existence of dependents is a factor in determining entitlement to pension. Persons who claim entitlement to income-based benefits must report all dependents and their income and net worth.

When VA receives a claim for pension, claims processors must follow the instructions in M21-1, Part VII, Subpart i, 1.A.6, during the initial development phase, if any of the following is missing:

information regarding the number of dependents a claimant has
evidence or information required to establish the existence of a familial relationship between a Veteran and a dependent(s), and/or
each dependent’s income and net worth.

Reference: For more information on considering the income of dependents when determining entitlement to pension, see

38 CFR 3.23(d)(4), and
38 CFR 3.24.

VII.i.1.A.1.g. Handling Claims for Benefits for or From an Individual That VA Does Not Recognize as a Veteran’s Dependent

If a claimant lacks status as the dependent of a Veteran for VA purposes, deny the claim without further development. Similarly, deny a claim from a Veteran or surviving spouse for additional benefits for an individual whom VA cannot recognize as the dependent of a Veteran for VA purposes.

Examples:

A deceased Veteran’s grandchild, whom the Veteran never adopted, claims entitlement to VA survivor’s benefits.
A Veteran claims entitlement to additional benefits for a foster child.

Reference: For more information on individuals whom VA may recognize as a Veteran’s dependent, see

M21-1, Part VII, Subpart i, 1.A.1.a, and
O’Brien v. Wilkie, 30 Vet.App. 21 (2018).

VII.i.1.A.1.h. Interplay Between Federal, State, and Foreign Laws

VA benefit programs are authorized by Federal law (38 U.S.C.) that determines who is and who is not eligible for benefits. Some of the rules concerning VA’s recognition of a familial relationship between a Veteran and another individual are unique to VA benefit programs.

Example: The continuous cohabitation requirement of 38 CFR 3.53.

In many instances, VA incorporates State law or the law of foreign countries by reference. When making decisions on the issue of relationship, State law is relevant only to the extent that it is incorporated by reference into the body of Federal law governing VA eligibility determinations.

Example: 38 CFR 3.1(j) refers to local law for determining the basic validity of a marriage.

Note: When a determination regarding the validity of a marriage depends on whether a prior marriage ended before the date of the current marriage, see the document titled Divorce Effective Date Table on Compensation Service’s Job Aids webpage.

VII.i.1.A.1.i. Duty of Claimants to Report Familial Relationships and Family Composition

Family composition is determined objectively under applicable VA regulations. Claimants must accurately report familial relationships and family compositions when requested to do so by VA.

Claimants seeking entitlement to disability compensation or DIC have the option of claiming or not claiming dependents. However, claimants seeking entitlement to any of VA’s income-based benefits must

report all dependents and their income, and
not manipulate family composition to maximize benefits.

Example: Failure of a pension claimant to report a spouse with income or substantial assets would be considered manipulation to maximize benefits.

2. Burden of Proof and the Weighing of Evidence

Introduction

This topic contains information on a claimant’s burden of proof and the weighing of evidence, including

Change Date

December 15, 2017

VII.i.1.A.2.a. Responsibilities of VA and Claimants for Securing Evidence

VA must make reasonable efforts to assist a claimant in securing evidence, but the claimant always has the initial burden of proof. This means that unless the claimant furnishes evidence on each element needed to establish the point at issue, VA must deny the claim.

Example: A claimant alleging the existence of a deemed-valid marriage must meet the requirements in 38 CFR 3.52 to establish the marriage as valid for VA purposes. If no evidence is provided showing the claimant meets those requirements, VA must deny the claim. Nevertheless, VA may, because of its duty to assist, provide reasonable assistance to secure the evidence.

References: For more information on

VA’s duty to assist in developing claims, see
- M21-1, Part I, Subpart i, 1.A
- M21-1, Part III, Subpart i, 2.A.1, and
- 38 CFR 3.159, and
the requirements for establishing a deemed-valid marriage, see M21-1, Part VII, Subpart i, 2.D.7-10.

VII.i.1.A.2.b. Accepting Entries a Claimant Makes on VA Form 21-686c as Proof of an Event

Except as noted in 38 CFR 3.204(a)(2), VA will accept the entries a claimant or beneficiary makes on VA Form 21-686c, Application Request to Add and/or Remove Dependents, as sufficient proof of

marriage
dissolution of a marriage
birth of a child
introduction of a stepchild into a Veteran’s family, or
death of a dependent.

Notes:

Unless there are inconsistencies in a claimant’s statement, the policy described in the above paragraph allows regional offices (ROs) to establish the existence of a familial relationship between a Veteran and another individual without reviewing the claims folder.
It is appropriate to request further evidence from a claimant if there is substantial reason to challenge the entries on VA Form 21-686c. (A substantial reason is something beyond mere suspicion or doubt.)

VII.i.1.A.2.c. Evaluating and Weighing Evidence

Once all procurable evidence is of record, claims processors must

evaluate the competency, credibility, and persuasiveness of the evidence, and
determine if the competent and credible evidence in favor of the claimant’s position is of equal or greater weight than the evidence to the contrary.

Use the table below to determine whether or not a point is established.

If scales weighing the evidence …

Then …

tip in favor of the claimant

the point is established.

tip against the claimant

the point is not established.

are approximately balanced

resolve reasonable doubt in favor of the claimant.

Reference: For more information on resolving reasonable doubt in a claimant’s favor, see

M21-1, Part X, Subpart v, 1.C.2.f, and
38 CFR 3.102.

Reference: For more information on adding a dependent to the award of a Veteran entitled to disability compensation, see M21-1, Part VII, Subpart i, 1.C.1 and 2.

3. Jurisdiction Over Relationship Determinations

Introduction

This topic explains who has jurisdiction over relationship determinations, including

Change Date

February 15, 2022

VII.i.1.A.3.a. Jurisdiction Over Questions Involving Facts

The authorization activity has exclusive jurisdiction over questions involving facts of relationship or dependency. Questions of fact differ from questions requiring the interpretation of law.

Example: The issue of whether Bob was below the age of majority when married to Linda is a question of fact. The issue of whether Bob being underage renders their marriage void is a question of law.

VII.i.1.A.3.b. Who Has the Authority to Resolve Issues Involving Relationship and Dependency

The authorization activity has the authority to resolve issues involving relationship and dependency without District Counsel input if

there is no doubt as to the legal effect of the facts found
it is apparent that the case in question is identical to an existing District Counsel or Office of General Counsel (OGC) opinion, or
the case in question is not identical, but the facts and questions of law involved are substantially the same with respect to material facts and controlling legal principles as an existing District Counsel or OGC opinion.

VII.i.1.A.3.c. When Administrative Decisions Are Required

The table below lists issues involving relationship or dependency that require resolution through an administrative decision.

Issues Requiring an Administrative Decision	Additional Information
Deemed valid marriage.	See M21-1, Part VII, Subpart i, 2.D.7.g.
Deemed valid common law marriage.	See M21-1, Part VII, Subpart i, 2.B.7.
Continuous cohabitation cannot be established.	No administrative decision is required if continuous cohabitation is established. M21-1, Part VII, Subpart i, 2.D.6.g.
Inference of remarriage.	See M21-1, Part VII, Subpart i, 2.E.2.i.
Fraudulent annulment.	An administrative decision with three signatures is required. See M21-1, Part VII, Subpart i, 2.E.10.b.
Parental relationship between a Veteran and an adopted child cannot be established.	See M21-1, Part VII, Subpart i, 3.B.2.i.
Validity of an adoption decree is questionable.	See M21-1, Part VII, Subpart i, 3.B.2.i.
Parental relationship between a Veteran and a stepchild cannot be established.	No administration decision is required to remove a stepchild from an award because the child’s parent is separated from the Veteran.
Parental relationship between a Veteran and an illegitimate (biological) child cannot be established.	—
Contested claim.	See M21-1, Part VI, Subpart iii, 3.C.1.
A foster parent cannot be established as a Veteran’s parent.	See M21-1, Part VII, Subpart i, 4.A.6.g and h.
Benefits are not payable because of parental abandonment.	See M21-1, Part VII, Subpart i, 4.A.8.h.
Financial dependency of parents is established and the parent’s estate exceeds $80,000.	An administrative decision on **VA Form 21-5427, Corpus of Estate Determination is required. See M21-1, Part VII, Subpart i, 4.B.4**.
Financial dependency of parents is denied based on net worth.	See M21-1, Part VII, Subpart i, 4.B.4.

Notes:

The preceding list is not all-inclusive. Other issues may arise that require resolution by administrative decision.
All administrative decisions require two signatures unless otherwise indicated.

Reference: For more information on administrative decisions, see M21-1, Part X, Subpart v, 1.C.1.

VII.i.1.A.3.d. When ROs Must Request an Opinion From District Counsel

The table below contains a description of situations in which ROs must request an opinion from District Counsel.

Situations Requiring a District Counsel Opinion	Reference
A claimant alleges a marriage is void.	M21-1, Part VII, Subpart i, 2.A.6.d
There is a question as to the validity of a second marriage, such as whether a common law marriage automatically arises if an individual was previously married and the spouse dies.	M21-1, Part VII, Subpart i, 2.A.7.a
There is a question as to the validity of a tribal marriage proxy marriage under State law, or transsexual marriage under State law.	M21-1, Part VII, Subpart i, 2.C.1
There is a question concerning the validity of a divorce in cases in which a surviving spouse attempts to establish entitlement based on a court decree setting aside or vacating the divorce.	M21-1, Part VII, Subpart i, 2.D.1.d
There is a question as to whether the length of a fetus’s gestation constitutes a birth under the law of the jurisdiction in which the fetus was delivered.	M21-1, Part VII, Subpart i, 2.D.2.d
There are questions as to the legal effect of an adoptive placement agreement or interlocutory adoption decree or order.	M21-1, Part VII, Subpart i, 3.B.2.e and i
It becomes necessary to determine whether the child referenced in the scenarios below is a child for VA purposes. *Scenario #1: A female Veteran marries another female. The Veteran’s spouse has a child while they are married. The Veteran does not adopt the child. Scenario #2*: A male Veteran marries another male. The Veteran’s spouse fathers a child while they are married. The Veteran does not adopt the child.	M21-1, Part VII, Subpart i, 3.B.6.b

VII.i.1.A.3.e. Procedure for Submitting a Request for an Opinion to District Counsel

The table below contains instructions for submitting a request for an opinion to District Counsel.

Step	Action
1	Completely develop for pertinent evidence surrounding the issue. *Note*: This includes performing any necessary field examinations.
2	Prepare a request for an opinion in memorandum format, setting forth the question together with a statement of facts.
3	Is the RO processing the corresponding claim in a paperless environment? If yes, go to the next step. If no, go to Step 6.
4	Download relevant documents from the claimant’s electronic claims folder (eFolder).
5	E-mail the documents, along with the request for an opinion, to the District Counsel office having jurisdiction over the geographical area where the claimant resides. Disregard the remaining steps in this table. *Exception: The Manila RO submits requests for legal opinions to OGC. Because OGC has access to eFolders, there is no need to download and e-mail documents from the eFolder to OGC. Note*: If the documents are too large to send in an e-mail, save the documents onto a compact disc (CD), and send the CD and the request to the appropriate District Counsel office.
6	Attach the request to the claims folder.
7	Send the request and the claims folder to the District Counsel office having jurisdiction over the geographical area where the claimant resides. *Exception: The Manila RO submits requests for legal opinions to OGC. Reference: For more information on District Counsel office jurisdiction and contacting a District Counsel office, see https://www.va.gov/OGC/DistrictOffices.asp*.

4. Handling Notices and Claims From Beneficiaries and Claimants Regarding Their Dependents

Introduction

This topic contains instructions for handling notices and claims from beneficiaries and claimants regarding their dependents, including

Change Date

February 15, 2022

VII.i.1.A.4.a. Forms Claimants Must Use to Initiate the Process of Adding a Dependent to Their Award

Effective March 24, 2015, a claimant must submit VA Form 21-686c or one of the prescribed forms listed in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, to initiate the process of adding a dependent to the award.

Follow the instructions in M21-1, Part VII, Subpart i, 1.A.4.f if a claimant submits a request to add a dependent using anything other than a prescribed form.

References: For more information on

the authority of VA-recognized representatives to submit VA Form 21-686c on a claimant’s behalf, see M21-1, Part VII, Subpart i, 1.A.4.i, and
adding a dependent to an award of
- disability compensation, see M21-1, Part VII, Subpart i, 1.C.1 and 2
- pension, see M21-1, Part IX, Subpart iii, 1.F.1 and 2, and
- DIC, see M21-1, Part XII, Subpart i, 3.A.

VII.i.1.A.4.b. Controlling Claims for Additional Compensation for a Dependent

When VA receives one of the prescribed forms listed in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, that is substantially complete, follow the instructions in M21-1, Part III, Subpart i, 2.F.2.a, for adding dependency claim for [insert name of dependent] as a contention for each dependent the Veteran is claiming.

Note: When adding dependency claim for [insert name of dependent] as a contention, select No in the MEDICAL field, and select the Administrative Issue option from the drop-down menu next to the CLASSIFICATION field.

Follow the additional instructions in the table below when VA receives a claim for additional compensation for a dependent(s) in conjunction with or while a claim for service connection (SC) and/or a higher disability rating is pending.

If VA receives a claim for additional compensation for a dependent …

Then …

in conjunction with or while an original claim for SC is pending

Do not establish an end product (EP) 130.

Exception: Claims processors may establish an EP 130 while an original claim for SC is pending if

the rating activity
- assigns a combined disability rating of at least 30 percent, and
- defers one or more rating issues (that require resolution by rating decision) for additional development, and
VA subsequently receives a claim from the Veteran for additional compensation for a dependent.

in conjunction with or while a non-original claim for disability compensation is pending

establish an EP 130
if the Veteran’s overall SC disability rating is currently (before the rating activity decides the pending claim) less than 30 percent, add the dependency claim for [insert name of dependent] contention under the EP 130, and
add the Resolution of Pending Rating EP tracked item.

References: For more information on

handling forms that are not substantially complete, see Steps 2 through 9 of the table in M21-1, Part VII, Subpart i, 1.A.5.d, and
the Veterans Benefits Management System (VBMS), see the VBMS Core User Guide.

VII.i.1.A.4.c. Claims From Veterans With an Overall Disability Rating That Is Less Than 30 Percent

Follow the instructions in the table below when a Veteran with an overall SC disability rating that is less than 30 percent files a claim for additional compensation for a dependent(s).

If the Veteran has …	Then …
at least one SC disability	deny the claim administratively
no SC disabilities	treat the claim as a request for application for disability compensation.

Exception: Disregard the instructions in the table above if a rating EP is currently pending. In this case, postpone a decision on the claim for additional compensation for a dependent(s) until after the rating activity makes its decision. (The Rules-Based Processing System (RBPS) currently makes no accommodation for this exception.)

References: For more information on

controlling claims for additional compensation for a dependent(s) when a rating EP is concurrently pending, see M21-1, Part VII, Subpart i, 1.A.4.b
RBPS, see M21-1, Part VII, Subpart i, 1.D, and
requests for an application, see M21-1, Part II, Subpart iii, 2.G.1.

VII.i.1.A.4.d. Handling a Form That Contains Conflicting Information

If one of the forms in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, is complete but contains information that conflicts with other evidence of record, attempt to obtain clarification by telephone.

If efforts to obtain clarification by telephone are unsuccessful,

follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e, for documenting the unsuccessful attempt, and
use the table below to determine the next action(s) to take.

If …	Then …
the claimant is a Veteran with a running award of disability compensation based on an overall SC disability rating of at least 30 percent, or surviving spouse with a running award of DIC	follow the procedure described in M21-1, Part VII, Subpart i, 1.A.5.d, *starting with Step 13*, treating the conflicting information as missing information or information the claimant failed to provide.
the claimant is a Veteran or surviving spouse with a running award of pension	follow the procedure described in M21-1, Part VII, Subpart i, 1.A.6.b, *starting with Step 5*, treating the conflicting information as missing information or information the claimant failed to provide.
the claimant is a Veteran that currently has SC disabilities with a combined evaluation of less than 30 percent, and a rating EP is pending	follow the instructions in the table in M21-1, Part VII, Subpart i, 1.A.5.e, *starting with Step 4, treating the conflicting information as missing information or information the claimant failed to provide. Exception*: If the rating EP, when resolved, could not result in the assignment of a disability rating of at least 30 percent, no further action is needed to clarify the discrepancy.
the claimant is a surviving spouse to whom VA is not currently paying DIC, and a claim for DIC is pending
the claimant is a Veteran or surviving spouse to whom VA is not currently paying pension, and a claim for pension is pending	send a letter to the claimant that asks for clarification. *Note: If the claimant fails to resolve the conflicting information, follow the instructions in M21-1, Part VII, Subpart i, 1.A.6.e*, treating the conflicting information as missing information or information the claimant failed to provide.

VII.i.1.A.4.e. Incomplete Forms and Claims Requiring Additional Evidence/Information

If a claimant submits one of the forms in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, and the form is incomplete or VA requires additional evidence/information in order to grant the claim, follow the instructions in

M21-1, Part VII, Subpart i, 1.A.5, if the benefit is disability compensation or DIC, or
M21-1, Part VII, Subpart i, 1.A.6, if the benefit is pension.

VII.i.1.A.4.f. Action to Take Upon Receipt of a Request to Add a Dependent That Was Not Submitted on a Prescribed Form

If a claimant submits a request to add a dependent but fails to use one of the forms referenced in M21-1, Part II, Subpart iii, 1.A.1.a, first attempt to contact the claimant by telephone for the purpose of completing VA Form 21-686c and/or VA Form 21-674, Request for Approval of School Attendance, on the claimant’s behalf.

If attempts to contact the claimant by telephone are unsuccessful, follow the instructions in M21-1, Part II, Subpart iii, 2.G.1.a.

Reference: For more information on the authority of RO employees to complete and sign VA Form 21-686c and VA Form 21-674 on a claimant’s behalf, see M21-1, Part VII, Subpart i, 1.A.4.j.

VII.i.1.A.4.g. Notification From a Beneficiary That Will Result in Removal of a Dependent From the Beneficiary’s Award

VA does not require beneficiaries to use a specific form to report a change in a dependent’s status that will result in removal of the dependent from the beneficiary’s award. A beneficiary may report such changes

in writing
by telephone or e-mail, or
through a VA claims-submission service website.

When a beneficiary requests removal of a dependent, the beneficiary must, at a minimum, provide VA with the date (month, day, and year) of the event (such as death or marriage of a child) that necessitates such action. If the beneficiary fails to provide this information, follow the instructions in M21-1, Part VII, Subpart i, 1.C.4.f.

Important:

If a beneficiary does not provide the location of the event that necessitates removal of a dependent from the beneficiary’s award, follow the instructions in M21-1, Part VII, Subpart i, 1.C.4.f.
VA employees must follow the instructions in M21-1, Part III, Subpart i, 2.D.1.f when obtaining an oral statement (such as a statement obtained by telephone) from a claimant or beneficiary.
If an employee receives a statement from a beneficiary over the telephone that will reduce the beneficiary’s award, and the employee fails to properly identify the beneficiary, VA must provide the beneficiary due process before reducing the award.

References: For more information on

due process and the requirement to provide notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.A, and
adjusting benefits based on the loss of a dependent, see M21-1, Part VII, Subpart i, 1.C.4.

VII.i.1.A.4.h. Possible Retroactive Restoration of Benefits

Per 38 CFR 3.103(b)(4), VA retroactively restores benefits it reduced, discontinued or otherwise adversely affected based on information it obtained orally if, within 30 days of the date VA issued the notice of adverse action, the beneficiary or the fiduciary asserts that the adverse action was based upon information or statements that were

inaccurate, or
not provided by the beneficiary or the fiduciary.

Note: Restoration of benefits under 38 CFR 3.103(b)(4) will not preclude VA from taking subsequent action that adversely affects benefits.

VII.i.1.A.4.i. Acceptability of VA Form 21-686c From a VA-Recognized Representative

38 CFR 3.160(a)(2) allows VA to accept a VA Form 21-686c that a VA-recognized representative (power of attorney or employee of a Veterans service organization) completes, signs, and submits to VA on a claimant’s behalf as if submitted by the claimant.

Important:

If information a representative provides on VA Form 21-686c will result in a reduction or discontinuance of benefits, VA must
- attempt to contact the beneficiary by telephone to confirm the entries the representative made on the form, and
- document the attempt(s) according to the instructions in M21-1, Part III, Subpart iii, 1.B.1.e.
If attempts to contact the beneficiary by telephone are unsuccessful, VA must provide the beneficiary with notice of proposed adverse action before reducing/discontinuing benefits.

Rationale: The beneficiary’s representative is considered a “third-party” for the purpose of determining whether VA must offer the beneficiary due process before making an adverse adjustment to the award based on information VA obtained from the representative.

Reference: For more information on due process and the requirement to issue notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.A.

VII.i.1.A.4.j. Acceptability of a VA Form 21-686c or VA Form 21-674 That an RO or Call Center Employee Completes and Signs

VA authorizes its RO and call center employees to

complete VA Form 21-686c and VA Form 21-674, using information obtained from a claimant over the telephone, and
sign the form on the claimant’s behalf.

Note: The form must include clear identification of the employee executing the form through a digital signature or, when electronic submission is not available, a wet signature.

Important:

Treat a VA Form 21-686c or VA Form 21-674 that an RO or call center employee completes and signs on a claimant’s behalf as valid and direct communication from the claimant on a form VA has prescribed for reporting changes in the status or number of the claimant’s dependents.
Do not treat a VA Form 21-686c or VA Form 21-674 that an RO or call center employee completes and signs on a claimant’s behalf as communication from a third party simply because the claimant did not personally complete and sign the form.
Call center employee signatures can be identified by the inclusion of either a station designation (such as 325/NCC) or their position title (such as Legal Administrative Specialist or Public Contact Representative) along with the employee’s name.

5. Determining Whether and How to Undertake Development When the Benefit Is Disability Compensation or DIC

Introduction

This topic contains information for determining whether and how to undertake development when the benefit is disability compensation or DIC, including

general information about claims development
timing of development actions
additional information/guidance relevant to claims development
handling an incomplete
- form, and
- form when eligibility for additional benefits for dependents does not currently exist but a rating EP or claim for DIC is pending
handling a September 2018 or later version of VA Form 21-686c that is
- incomplete, and
- incomplete when eligibility for additional benefits for dependents does not currently exist but a rating EP or claim for DIC is pending, and
creating a letter that requests evidence/information VA requires to recognize an individual as a dependent.

Change Date

February 15, 2022

VII.i.1.A.5.a. General Information About Claims Development

If a claimant submits a September 2018 or later version of VA Form 21-686c and fails to provide with the form all the evidence/information the form specifically instructs the claimant to provide, claims processors may not undertake development to obtain the missing evidence/information. Instead, they must follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.f.

The policy expressed in the previous paragraph does not relieve VA of its obligation to assist a claimant in obtaining documentary evidence (when required) of a life event (such as a birth, death, marriage, or divorce) if the claimant indicates an inability to provide it.

Follow the instructions in the table below, taking into account the provisions of M21-1, Part VII, Subpart i, 1.A.5.c, in those rare instances when VA receives a substantially complete September 2018 or later version of VA Form 21-686c, but

evidence/information required to decide the claim is missing, and
the form does not specifically instruct the claimant to provide the evidence/information that is missing

If …	Then …
the claimant is a Veteran with a running award of disability compensation based on an overall SC disability rating of at least 30 percent, or surviving spouse with a running award of DIC	follow the instructions in the table in M21-1, Part VII, Subpart i, 1.A.5.d, starting with Step 10.
the claimant is a Veteran that does not have an overall SC disability rating of at least 30 percent, and a rating EP is pending	follow the instructions in the table in M21-1, Part VII, Subpart i, 1.A.5.e, *after* following the instructions in *Steps 10 and 11* of the table in M21-1, Part VII, Subpart i, 1.A.5.d. *Exception: In the situation described under the Important* sublabel in *Step 10* of the table in M21-1, Part VII, Subpart i, 1.A.5.d, disregard the other instructions in the preceding paragraph, and follow the instructions in M21-1, Part VII, Subpart i, 1.C.1.e.
the claimant is a surviving spouse to whom VA is not currently paying DIC, and a claim for DIC is pending	follow the instructions in the table in M21-1, Part III, Subpart iii, 5.A.5.e, *after* following the instructions in *Steps 10 and 11* of the table in M21-1, Part VII, Subpart i, 1.A.5.d.
the claimant is a Veteran with no SC disabilities, and no rating EP is pending	treat the VA Form 21-686c as a request for an application (for disability compensation or DIC) without undertaking any development.
the claimant is a surviving spouse that is not currently entitled to DIC, and no claim for DIC is pending
the claimant is a Veteran with at least one SC disability the Veteran’s overall SC disability rating is less than 30 percent, and no rating EP is pending	deny the claim without undertaking any development.

References: For more information on

VA’s obligation to assist claimants in obtaining the documentary evidence described in this block, see M21-1, Part III, Subpart i, 2.A.1.a-e
handling VA Form 21-686c that are not substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f, see Steps 2 through 9 of the table in M21-1, Part VII, Subpart i, 1.A.5.d, and
requests for an application, see M21-1, Part II, Subpart iii, 2.G.1.

VII.i.1.A.5.b. Timing of Development Actions

To ensure the establishment of benefits in a timely manner, undertake any development necessary to establish entitlement to additional disability compensation or DIC for dependents during the initial development phase of claims processing when

VA receives a claim for
- SC and/or a higher disability rating from a Veteran, or
- DIC from a surviving spouse
the claimant reports the existence of one or more dependents on one of the forms listed in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, and
evidence/information required to establish the Veteran’s relationship to the dependent(s) is not of record.

The upfront development referenced in the above paragraph must be undertaken, even if the claim is from a Veteran whose overall SC disability rating is currently less than 30 percent.

Important:

Disregard the instructions in this block if M21-1, Part VII, Subpart i, 1.A.5.a, prohibits claims processors from undertaking development.
Follow the instructions in M21-1, Part VII, Subpart i, 1.C.1.d, if
- the claimant is a Veteran who is eligible for additional compensation for dependents by virtue of a rating decision that is awaiting promulgation
- the upfront development described in the opening paragraph of this block was mistakenly overlooked, and
- either of the following is true
  - an EP 130 is not pending (because, for example, an EP 010 or 110 is concurrently pending), or
  - one of the ROs/restricted access claim centers (RACCs) identified in M21-1, Part VII, Subpart i, 1.A.1.b, is promulgating the rating decision in connection with a special mission or under a special circumstance.

VII.i.1.A.5.c. Additional Information/Guidance Relevant to Claims Development

This block contains additional information/guidance claims processors must consider in those situations in which it is appropriate to undertake development.

Avoid unnecessary development and piecemeal development, as such actions
- impose an unwarranted burden on claimants, and
- delay claims processing.
Do not undertake development for information or evidence without first ascertaining whether or not it is already of record.
As explained in M21-1, Part VII, Subpart i, 1.B.1, every eight years, VA requires Veterans in receipt of disability compensation to verify the status of their dependent(s). Accordingly, information that is already of record regarding the status of the dependent(s) of a Veteran is considered valid for the purpose of making entitlement determinations for up to eight years from the date VA received it. (The age of information of record is measured from the date VA received it to the current date.)

VII.i.1.A.5.d. Handling an Incomplete Form

The form a claimant uses to initiate the process of adding a dependent to an award must be substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f.

A form may be substantially complete but fail to provide all the evidence/information VA requires to add a dependent to a claimant’s award.

Follow the instructions in the table below when

VA receives one of the forms identified in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, that is incomplete in any way, and
the benefit at issue is disability compensation or DIC.

Exceptions:

Do not treat a form as incomplete, for the purpose of development, if a claimant fails to provide
- the name of the State in which an event (such as the birth of a child or a marriage) took place, when the city in which the event took place is well known (such as Atlanta or Chicago)
- required information (such as the date of birth) on the form, when the missing information is shown on documentary evidence (such as a birth certificate) the claimant submits in support of the claim or is already of record, or
- the last name of the current spouse.
If the incomplete form is a September 2018 or later version of VA Form 21-686c,
- disregard the instructions in the table below, and
- follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.f.
If the form the claimant submitted requires the claimant to provide the number of prior marriages for the spouse, do not treat the form as incomplete if the claimant fails to provide the number, unless
- there is reason to question the number of prior marriages the claimant and the spouse had
- there is a conflict regarding the marital history the claimant reported that having the number of prior marriages would resolve, or
- there is a reasonable indication of fraud or misrepresentation of the relationship in question.
Follow the instructions in M21-1, Part VII, Subpart i, 1.A.4.c, instead of the instructions in the table below or the instructions in M21-1, Part VII, Subpart i, 1.A.5.f if the claimant is a Veteran whose overall SC disability rating is less than 30 percent and no rating EP is pending.

Important: The instructions in the table below were written based on an assumption the claimant is a Veteran with a running award of disability compensation based on an overall SC disability rating of at least 30 percent or a surviving spouse with a running award of DIC. If this is not the case, but a rating EP or claim for DIC is pending,

stop at Step 10 of the table below, and
follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.e.

Step	Action
1	Is the form substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f? If yes, go to Step 9. If no, go to the next step.
2	Print the form, selecting Adobe PDF (portable document format) as the printer.
3	Electronically highlight the blocks on the form that require completion.
4	Was an EP established based on receipt of the incomplete form? If yes, change the pending EP to an EP 400, Correspondence. If no, establish an EP 400, Correspondence.
5	Prepare a letter using the Incomplete Application letter in the Letter Creator tool that instructs the claimant to complete those portions of the form that are highlighted, and informs the claimant that VA will not pay benefits based upon submission of the form unless the completed form is returned within one year.
6	Combine the PDF versions of the letter generated by the Letter Creator tool and highlighted form into a single document, using Adobe Pro. Upload a copy of the document into the appropriate eFolder.
7	Send the document to the claimant and representative, if applicable, via Package Manager.
8	Clear the EP 400 and disregard the remaining steps in this table. Take no further action until the claimant returns the completed form.
9	Establish EP control based on the benefit claimed, unless the appropriate EP is already pending. *Important: Disregard the remaining steps in this table and follow the instructions in M21-1, Part VII, Subpart i, 1.C.1.d, if a claims processor discovers the incomplete form referenced in this block while promulgating a rating decision that assigns an overall SC disability rating of at least 30 percent to a Veteran whose overall SC disability rating prior* to the rating decision was less than 30 percent, and either of the following is true: an EP 130 is *not* pending (because, for example, an EP 010 or 110 is concurrently pending), or one of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 2.B.1.b, is promulgating the rating decision in connection with a special mission or under a special circumstance. *Reference: For more information on handling a claim for additional compensation for a dependent(s) that is received in conjunction with or while a claim for SC and/or a higher disability rating is pending, see M21-1, Part VII, Subpart i, 1.A.4.b*.
10	Attempt to obtain any missing evidence/information from the claimant by telephone.
11	Were attempts to obtain the missing evidence/information by telephone successful? If yes, go to Step 17. If no, go to the next step. *Note: If documentary evidence, such as a birth certificate, is missing, and the claimant is unable to provide it within 24 hours (by e-mail, through a VA claims-submission service website, or in person), go to the next step. Follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e*, for documenting attempts to obtain evidence/information by telephone.
12	Follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.h, for preparing and sending a letter to the claimant that asks for the missing evidence/information. *Note: The development activity is responsible for adding the tracked item referenced in M21-1, Part VII, Subpart i, 1.A.5.h* when development is completed in Modern Awards Processing – Development (MAP-D).
13	Does sufficient evidence/information exist to allow VA to add to the claimant’s award at least one of the dependents listed on the form? If yes, go to the next step. If no, go to Step 17.
14	Add to the claimant’s award those dependents for whom the claimant has provided all the evidence/information VA requires. Leave pending the EP used to add the dependent(s) to the claimant’s award.
15	Notify the claimant of the action taken.
16	Allow the claimant 30 days to respond to the letter (referenced in Step 12). Go to the next step after the *earlier* of the following occur: VA receives a response to the development letter, or the 30-day response period expires.
17	Grant or deny entitlement to benefits based on the evidence/information of record. Notify the claimant of the decision. *Important: If a claimant is eligible for additional benefits for a dependent but VA denies entitlement because the claimant failed to provide the evidence/information VA requested, inform the claimant that unless VA receives the evidence/information required to add the dependent within one year of the decision notice, VA cannot pay benefits for the dependent based on the present claim, and instruct the claimant to complete VA Form 20-0995, Decision Review Request: Supplemental Claim, and return it with the missing evidence/information. Reference: For more information on preparing decision notices, see M21-1, Part VI, Subpart i, 1.B*.

Reference: For more information on handling an incomplete application, see 38 U.S.C. 5102(b) and (c).

VII.i.1.A.5.e. Handling an Incomplete Form When Eligibility for Additional Benefits for Dependents Does Not Currently Exist But a Rating EP or Claim for DIC Is Pending

After taking the action described in Step 10 of the step-action table in M21-1, Part VII, Subpart i, 1.A.5.d, follow the instructions in the table below under either of the following situations:

eligibility for additional compensation for a dependent(s) does not currently exist because the Veteran has no SC disabilities or the overall SC disability rating is less than 30 percent, but a rating EP is pending, or
entitlement to DIC does not currently exist, but a claim for entitlement is pending.

Step	Action
1	Were attempts to obtain missing evidence/information from the claimant by telephone successful? If yes, go to the next step after resolving the rating EP or DIC claim. If no, go to Step 4.
2	If any of the following are true, go to the next step. Otherwise, go to Step 6. A DIC claim is pending. An EP 010 or 110 is pending. One of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 3.1.c, has jurisdiction over the pending claim. Important: In those rare instances when an EP 130 and an EP 010 or 110 are concurrently pending, go to Step 6 unless one of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 3.1.c, has jurisdiction over the pending claim.
3	Was the rating EP or DIC claim resolved in the claimant’s favor? If yes, determine whether the claimant is entitled to additional benefits for claimed dependents and, if so, add to the claimant’s award those individuals for whom the evidence/information VA requires to recognize an individual as a dependent exists, and go to Step 10. If no, notify the claimant of the decision, and disregard the remaining steps in this table. *Note*: There is no need to address in a decision notice the issue of entitlement to additional benefits for dependents if entitlement to disability compensation or DIC does not exist or the Veteran has no SC disabilities.
4	Follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.h, for preparing and sending a letter to the claimant that asks for the missing evidence/information. Go to the next step after resolving the EP or DIC claim.
5	If any of the following are true, go to Step8. Otherwise, go to the next step. A DIC claim is pending. An EP 010 or 110 is pending. One of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 3.1.c, has jurisdiction over the pending claim. Important: In those rare instances when an EP 130 and an EP 010 or 110 are concurrently pending, go to the next step unless one of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 3.1.c, has jurisdiction over the pending claim.
6	Close the Resolution of Pending Rating EP tracked item associated with the pending EP 130, if it was established.
7	Take no further action after promulgating the rating decision and notifying the Veteran of its outcome. *Important: If the rating activity assigned an overall SC disability rating of at least 30 percent, notify the Veteran in the decision notice that the claim for additional compensation for dependents will be addressed in a separate decision notice. Notes: The action described in Step 6 initiates transfer of the pending EP 130 for resolution. If, after resolution of the rating EP, the Veteran still has no SC disabilities, EP 130 may be cleared without taking further action. Notification of the Veteran, in this case, is unnecessary. If a Veteran is eligible for additional benefits for a dependent but entitlement is denied because the Veteran failed to provide the evidence/information VA requested, follow the instructions under the Important* sublabel *in Step 10* when notifying the Veteran of the denial.
8	Was the rating EP or DIC claim resolved in the claimant’s favor? If yes, go to the next step. If no, notify the claimant of the decision, and disregard the remaining steps in this table. *Note*: There is no need to address in a decision notice the issue of entitlement to additional benefits for dependents if entitlement to DIC does not exist or the Veteran has no SC disabilities.
9	Determine whether the claimant is entitled to additional benefits for claimed dependents and, if so, add to the claimant’s award those individuals for whom the evidence/information VA requires to recognize an individual as a dependent exists. *Important: If the pending claim is from a Veteran for SC and/or a higher disability rating, make the determination referenced in this step based on the evidence/information of record, without* regard to the amount of time that has passed since the letter referenced in Step 4 was sent, or surviving spouse for DIC, do not make the determination referenced in this step or move to the next step until the claimant has had 30 days to respond to the letter referenced in Step 4.
10	Notify the claimant of the decisions regarding entitlement to DIC or disability compensation and/or a higher disability rating, and additional benefits for dependents. *Important: If a claimant is eligible for additional benefits for a dependent but VA denies entitlement because the claimant failed to provide the evidence/information VA requested, inform the claimant that unless VA receives the evidence/information required to add the dependent within one year of the decision notice, VA cannot pay benefits for the dependent based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the missing evidence/information.

Reference: For more information on preparing decision notices, see M21-1, Part VI, Subpart i, 1.B.

VII.i.1.A.5.f. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete

Follow the steps in the table below when VA receives a September 2018 or later version of VA Form 21-686c that is incomplete in any way.

Important:

In those rare instances when VA Form 21-686c does not ask the claimant for all the evidence/information VA requires to determine entitlement to additional benefits for dependents (such as the birth certificate and adoption decree referenced in M21-1, Part VII, Subpart i, 3.B.4.e), and the claimant fails to submit such evidence/information,
disregard the instructions in the table below, and
follow the instructions in the applicable row of the table in M21-1, Part VII, Subpart i, 1.A.5.a.
The instructions in the table below were written based on an assumption the claimant is a surviving spouse with a running award of DIC or a Veteran with a running award of disability compensation based on an overall SC disability rating of at least 30 percent. If this is not the case, but a claim for DIC or SC and/or a higher disability rating is pending, follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.g.

Step	Action
1	Is the form substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f? If yes, go to the next step. If no, disregard the remaining steps in this table, and complete the actions described in *Steps 2 through 8* of the table in M21-1, Part VII, Subpart i, 1.A.5.d.
2	Establish EP control based on the benefit claimed, unless the appropriate EP is already pending. Reference: For more information on handling a claim for additional compensation for a dependent(s) that is received in conjunction with or while a claim for SC and/or a higher disability rating is pending, see M21-1, Part VII, Subpart i, 1.A.4.b.
3	Does sufficient evidence/information exist to allow VA to add to the claimant’s award at least one of the dependents listed on the form? If yes, go to Step 6. If no, go to the next step. Note: When the claimant provides dependency information for multiple dependents, some of which is incomplete and some of which is complete, follow the corresponding steps in this table for each dependent and provide a combined notification.
4	Deny entitlement to additional benefits for the claimed dependent(s).
5	Notify the claimant of the decision. Disregard the remaining steps in this table. *Important: In the decision notice, identify the missing evidence/information that prevented VA from awarding the additional benefits inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot pay benefits for the dependent(s) based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the missing evidence/information. Do not maintain EP control for a response to the notice.
6	Add to the claimant’s award those dependents for whom the claimant has provided all the evidence/information VA requires.
7	Notify the claimant of the action taken. *Important: In the decision notice, identify the evidence/information that is missing for the remaining dependent(s) inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot pay benefits for the dependent(s) based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the evidence/information that is missing for the remaining dependent(s). Do not maintain EP control for a response to the notice.

References: For more information on

preparing decision notices, see M21-1, Part VI, Subpart i, 1.B, and
requesting documentary evidence of a life event from custodians of public records, see M21-1, Part III, Subpart i, 2.A.1.e.

VII.i.1.A.5.g. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete When Eligibility for Additional Benefits for Dependents Does Not Currently Exist But a Rating EP or Claim for DIC Is Pending

Follow the steps in the table below when

VA receives a September 2018 or later version of VA Form 21-686c that is incomplete in any way
the claimant is a
- Veteran that is not eligible for additional compensation for dependents because
  - there are no SC disabilities, or
  - the overall SC disability rating is less than 30 percent, or
- surviving spouse that is not currently entitled to DIC, and
a claim for one of the following is currently pending:
- SC and/or a higher disability rating, or
- entitlement to DIC.

Important: In those rare instances when VA Form 21-686c does not ask the claimant for all the evidence/information VA requires to determine entitlement to additional benefits for dependents (such as the birth certificate and adoption decree referenced in M21-1, Part VII, Subpart i, 3.B.2), and the claimant fails to submit such evidence/information,

disregard the instructions in the table below, and
follow the instructions in the applicable row of the table in M21-1, Part VII, Subpart i, 1.A.5.a.

Step	Action
1	Is the form substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f? If yes, go to the next step. If no, disregard the remaining steps in this table, and complete the actions described in *Steps 2 through 8* of the table in M21-1, Part VII, Subpart i, 1.A.5.d.
2	Establish EP control of the claim for additional compensation for a dependent(s) unless the appropriate EP is already pending. Go to the next step after resolving the claim for SC and/or a higher disability rating, or DIC. Reference: For more information on handling a claim for additional compensation for a dependent(s) that is received in conjunction with or while a claim for SC and/or a higher disability rating is pending, see M21-1, Part VII, Subpart i, 1.A.4.b.
3	If any of the following are true, go to the Step 6. Otherwise, go to the next step. A DIC claim is pending. An EP 010 or 110 is pending. One of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 2.B.1.b, has jurisdiction over the pending claim. Important: In those rare instances when an EP 130 and an EP 010 or 110 are concurrently pending, go to the next step unless one of the ROs/RACCs identified in M21-1, Part II, Subpart ii, 2.B.1.b, has jurisdiction over the pending claim.
4	Close the Resolution of Pending Rating EP tracked item if it was established.
5	Take no further action after promulgating the rating decision and notifying the Veteran of its outcome. Important: If the rating activity assigned an overall SC disability rating of at least 30 percent, notify the Veteran in the decision notice that the claim for additional compensation for dependents will be addressed in a separate decision notice. Notes: The action described in Step 4 initiates transfer of the pending EP 130 for resolution. If, after resolution of the rating EP, the Veteran still has no SC disabilities, EP 130 may be cleared without taking further action. Notification of the Veteran, in this case, is unnecessary. If a Veteran is eligible for additional benefits for a dependent but entitlement is denied because the Veteran failed to provide the evidence/information VA requires to recognize an individual as a dependent, follow the instructions under the Important sublabel in Step 7 when notifying the Veteran of the denial.
6	Was the rating EP/DIC claim resolved in the claimant’s favor? If yes, determine whether the claimant is entitled to additional benefits for claimed dependents and, if so, add to the claimant’s award those individuals for whom the evidence/information VA requires to recognize an individual as a dependent exists, and go to Step 7. If no, notify the claimant of the decision(s), and disregard the remaining steps in this table. Note: There is no need to address in the referenced decision notice the issue of entitlement to additional benefits for dependents if entitlement to DIC does not exist or the Veteran has no SC disabilities.
7	Notify the claimant of the decisions regarding entitlement to DIC or disability compensation and/or a higher disability rating, and additional benefits for dependents. *Important: If a claimant is eligible for additional benefits for a dependent but VA denies entitlement because the claimant failed to provide the evidence/information VA requires to recognize an individual as a dependent, inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot pay benefits for the dependent based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the evidence/information that is missing for the remaining dependent(s).

Reference: For more information on preparing decision notices, see M21-1, Part VI, Subpart i, 1.B.

VII.i.1.A.5.h. Creating a Letter That Requests Information/ Evidence VA Requires to Recognize an Individual as a Dependent

The table below contains instructions for creating a letter in VBMS that requests missing information/evidence that VA requires in order to recognize an individual as a Veteran’s dependent.

Note: Pension management centers (PMCs) currently use MAP-D instead of VBMS to create development letters in some instances. Accordingly, PMCs must follow the instructions in the MAP-D User Guide to create the same type of development letter and add a corresponding tracked item in MAP-D.

Step	Action
1	Is the creation of a development letter to the Veteran already underway in VBMS? If yes, go to Step 6. If no, go to the next step.
2	Select the LETTERS tab in VBMS.
3	Click on the ADD NEW LETTER button.
4	If an initial development letter has already been released, select Subsequent Development Letter as the letter type.
5	Click the ADD LETTERS button in the top, right-hand corner of the screen.
6	In the ASSOCIATED DEVELOPMENT ACTIONS section of the screen, click on the ADD button.
7	Is an appropriate pre-programmed development action available? If yes, select the appropriate pre-programmed development action, and disregard the remaining steps of this table. If no, go to the next step.
8	Select Custom Development Action from the drop-down box in the CHOOSE A CATEGORY field.
9	Click on the ADD button.
10	Click on the SUBMIT button.
11	Select What We Need from the drop-down box at the top of the DEV ACTIONS column.
12	Enter Evidence/Information Required to Recognize [insert the name of the claimed dependent] as a Dependent in the next field in the DEV ACTIONS column.
13	Enter the following text in the last field in the DEV ACTIONS column: In order to add your dependent, [insert the name of the claimed dependent], to your award, we need [describe the information/evidence that is missing].

Note: Completing the steps in the above table and finalizing the development letter will result in the creation of a tracked item in VBMS for return of the missing information/evidence referenced in Step 13.

Reference: For more information on using VBMS, see the VBMS Core User Guide.

6. Determining Whether and How to Undertake Development When the Benefit Is Pension

Introduction

This topic contains information for determining whether and how to undertake development when the benefit is pension, including

general information about claims development
handling an incomplete form
- pension, and
- when entitlement to pension has not been established, but a claim is pending, and
handling a September 2018 or later version of VA Form 21-686c that is
- incomplete, and
- incomplete when basic entitlement to pension exists but no award is running.

Change Date

February 15, 2022

VII.i.1.A.6.a. General Information About Claims Development

If a claimant submits a September 2018 or later version of VA Form 21-686c and fails to provide with the form all the evidence/information the form specifically instructs the claimant to provide, claims processors must follow the instructions in the table in M21-1, Part VII, Subpart ii, 1.A.6.d. They may not undertake development to obtain the missing evidence/information, except for the telephone development (to obtain income/net worth information) described in

Step 4 of the table in M21-1, Part VII, Subpart i, 1.A.6.d, and
Step 2 of the table in M21-1, Part VII, Subpart i, 1.A.6.e.

The policy expressed in the previous paragraph does not relieve VA of its obligation to assist a claimant in obtaining documentary evidence (when required) of a life event (such as a birth, death, marriage, or divorce) if the claimant indicates an inability to provide it.

In those rare instances when VA receives a substantially complete September 2018 or later version of VA Form 21-686c, evidence/information required to decide the claim is missing, and the form does not specifically instruct the claimant to provide the evidence/information that is missing, claims processors must follow the instructions in the table below, taking into account the provisions of M21-1, Part VII, Subpart i, 1.A.5.c.

If …	Then …
VA is currently paying pension to the claimant	follow the instructions in the table in M21-1, Part VII, Subpart i, 1.A.6.b, starting with Step 2.
entitlement to pension has not been established, but a claim for pension is pending	establish EP control based on the benefit claimed, unless the appropriate EP is already pending attempt to obtain any missing evidence/information from the claimant by telephone, and follow the instructions in the table in M21-1, Part VII, Subpart i, 1.A.6.c.
entitlement to pension has not been established, and no claim for pension is pending	treat the VA Form 21-686c as a request for an application (for pension) without undertaking any development.

References: For more information on

VA’s obligation to assist claimants in obtaining the documentary evidence described in this block, see M21-1, Part III, Subpart i, 2.A.1.a-e
handling VA Forms 21-686c that are not substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f, see Steps 2 through 9 of the table in M21-1, Part VII, Subpart i, 1.A.5.d, and
requests for an application, see M21-1, Part II, Subpart iii, 2.G.1.

VII.i.1.A.6.b. Handling an Incomplete Form – Pension

The form a claimant uses to initiate the process of adding a dependent must be substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f.

A form may be substantially complete but fail to provide all the evidence/information VA requires to add a dependent to a claimant’s award.

Follow the instructions in the table when

VA receives one of the forms identified in the last row of the table in M21-1, Part II, Subpart iii, 1.A.1.a, that is incomplete in any way, and
the benefit at issue is pension.

Exceptions:

Do not treat a form as incomplete, for the purpose of requiring development, if a claimant fails to provide
- the name of the State in which an event (such as the birth of a child or a marriage) took place, when the city in which the event took place is well-known (such as Atlanta or Chicago)
- required information (such as the date of birth) on the form, when the missing information is shown on documentary evidence (such as a birth certificate) the claimant submits in support of the claim, or
- the last name of the current spouse.
If the incomplete form is a September 2018 or later version of VA Form 21-686c,
- disregard the instructions in the table below, and
- follow the instructions in M21-1, Part VII, Subpart i, 1.A.6.d.
If the form the claimant submitted requires the claimant to provide the number of prior marriages for the spouse, do not treat the form as incomplete if the claimant fails to provide the number, unless
- there is reason to question the number of prior marriages the claimant and spouse had
- there is a conflict regarding the marital history the claimant reported that having the number of prior marriages would resolve, or
- there is a reasonable indication of fraud or misrepresentation of the relationship in question.

Important: The instructions in the table below were written based on an assumption the claimant has a running award. If the claimant does not have a running award, but a claim for pension is pending,

stop at Step 3 of the table below, and
follow the instructions in M21-1, Part VII, Subpart i, 1.A.6.c.

Step	Action
1	Is the form substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f? If yes, go to the next step. If no, disregard the instructions in the table below, and follow the instructions in *Steps 2 through 8* of the table in M21-1, Part VII, Subpart i, 1.A.5.d.
2	Establish EP control based on the benefit claimed, unless the appropriate EP is already pending.
3	Attempt to obtain any missing evidence/information from the claimant by telephone.
4	Were attempts to obtain the missing evidence/information by telephone successful? If yes, go to Step 16. If no, go to the next step. *Notes: If documentary evidence, such as a birth certificate, is missing, and the claimant is unable to provide it within 24 hours (by e-mail, through a VA claims-submission service website, or in person), go to the next step. Follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e*, for documenting attempts to obtain evidence/information by telephone.
5	Did the claimant fail to provide information regarding a dependent’s income? If yes, go to the next step. If no, go to Step 11.
6	Clear the pending EP and establish EP 600.
7	Send a notice of proposed adverse action to the claimant. In the notice, inform the claimant that unless information regarding the dependent’s income is provided to VA within 60 days, VA must discontinue the claimant’s award effective the first of the month following the month the dependent’s income became available to the claimant. Go to the next step after the claimant responds or after the 65-day response period ends, whichever occurs first. *Note: Follow the instructions in M21-1, Part X, Subpart ii, 3.B.3*, if the claimant requests a hearing in response to the notice of proposed adverse action.
8	Did the claimant provide the missing income information? If yes, go to Step 10. If no, go to the next step.
9	Discontinue the claimant’s award as proposed in the notice of proposed adverse action. Prepare and send a decision notice to the claimant. Disregard the remaining steps in this table. *Note: When preparing the decision notice, inform the claimant that the missing income information must be provided within one year from the date of the decision notice to provide the missing income information, and instruct the claimant to complete VA Form 20-0995* and return it with the missing information.
10	Does sufficient evidence/information exist to allow VA to add *all* claimed dependent(s) to the claimant’s award? If yes, add the dependent(s) to the claimant’s award prepare and send a decision notice to the claimant, and disregard the remaining steps in this table. If no, go to the next step.
11	Does sufficient evidence/information exist to allow VA to add to the claimant’s award at least one of the dependents listed on the form? If yes, go to the next step. If no, follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.h for preparing and sending a letter to the claimant that asks for the missing evidence/information, and go to Step 15.
12	Add to the claimant’s award those dependents for whom the claimant has provided all the evidence/information VA requires. Include the income of unestablished dependent(s) when calculating the claimant’s income for VA purposes (IVAP). Leave pending the EP used to add the dependent(s) to the claimant’s award. *Exception: Do not* include the income of a claimed dependent who is an individual, such as a parent or unadopted grandchild, that VA does not consider a dependent for pension purposes. *Reference: For more information on the instructions contained in this step, see M21-1, Part IX, Subpart iii, 1.F.2.h*.
13	Notify the claimant of the action taken, and follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.h, for preparing and sending a letter to the claimant that asks for the missing evidence/information. Important: The letter must ask the claimant to provide the evidence/information that is missing for the remaining dependent(s), and inform the claimant that although one year from the date of the decision notice is ultimately allowed to provide the missing evidence/information, VA will make a decision on the claim involving the remaining dependent(s) after 30 days.
14	Add a tracked item for the missing evidence/information.
15	Allow the claimant 30 days to provide the missing evidence/information. Go to the next step after receiving the missing evidence/information or after the 30-day response period ends, whichever occurs first.
16	Decide the claim based on the evidence/information of record. Notify the claimant of the decision. *Important: If a dependent was not added to a claimant’s award because the claimant failed to provide the evidence/information VA requested, inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot add the child to the claimant’s award based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the missing information.

Reference: For more information on notifying claimants of a VA decision, see M21-1, Part VI, Subpart i, 1.B.

VII.i.1.A.6.c. Handling an Incomplete Form – No Running Award but a Claim for Pension Is Pending

After taking the action described in Step 3 of the table in M21-1, Part VII, Subpart i, 1.A.6.b, follow the instructions in the table below if entitlement to pension has not been established but a claim is pending.

Step

Action

1

Were attempts to obtain missing evidence/information from the claimant by telephone successful?

If yes, go to the next step after determining whether basic entitlement to pension exists.
If no, go to Step 5.

Note: Follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e, for documenting attempts to obtain evidence/information by telephone.

2

Does basic entitlement to pension exist?

If yes, go to the next step.
If no,
- notify the claimant of the decision, and
- disregard the remaining steps in this table.

Note: There is no need to address in a decision notice the issue of entitlement to benefits for dependents if basic entitlement to pension does not exist.

3

Determine whether the claimant is entitled to benefits for claimed dependents.

4

Notify the claimant of the decisions regarding entitlement to
- pension, and
- benefits for dependents.
Disregard the remaining steps in this table.

5

Follow the instructions in M21-1, Part VII, Subpart i, 1.A.5.h, for preparing and sending a letter to the claimant that asks for the missing evidence/information.
Go to the next step after determining whether basic entitlement to pension exists.

6

Does basic entitlement to pension exist?

If yes, go to the next step after giving the claimant 30 days to respond to the letter referenced in Step 5.
If no,
- notify the claimant of the decision, and
- disregard the remaining steps in this table.

Note: There is no need to address in a decision notice the issue of entitlement to benefits for dependents if basic entitlement to pension does not exist.

7

Did the claimant provide the missing evidence/information?

If yes, go to Step 9.
If no, go to the next step.

8

Follow the instructions in the table below.

If …

Then …

information regarding a dependent’s income is missing

deny entitlement to pension according to the instructions in M21-1, Part IX, Subpart iii, 1.F.2.k
in the decision notice,
- notify the claimant that unless VA receives the missing information within one year of the decision notice, VA cannot pay benefits based on the present claim, and
- instruct the claimant to complete VA Form 20-0995 and return it with the missing information, and
disregard the remaining steps in this table.

any other evidence/information required to add a dependent is missing

follow the instructions in M21-1, Part IX, Subpart iii, 1.F.2.h, awarding benefits if appropriate, and
go to Step 10.

9

Determine whether the claimant is entitled to benefits for the claimed dependent(s).

10

Notify the claimant of the decisions regarding entitlement to

pension, and
benefits for dependents.

Important: If VA denies entitlement to benefits because the claimant failed to provide the evidence/information VA requested,

inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot pay benefits based on the present claim, and
instruct the claimant to complete VA Form 20-0995 and return it with the missing evidence/information.

Reference: For more information on preparing decision notices, see M21-1, Part VI, Subpart i, 1.B.

VII.i.1.A.6.d. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete – Pension

Follow the steps in the table below when

VA receives a September 2018 or later version of VA Form 21-686c that is incomplete in any way, and
the benefit at issue is pension.

Important:

In those rare instances when VA Form 21-686c does not ask the claimant for all the evidence/information VA requires to add a claimed dependent to the claimant’s award (such as the birth certificate and adoption decree referenced in M21-1, Part VII, Subpart i, 3.B.4.e), and such evidence/information is missing,
- disregard the instructions in the table below, and
- follow the instructions in the applicable row of the table in M21-1, Part VII, Subpart i, 1.A.6.a.
The instructions in the table below were written based on an assumption the claimant has a running award. If basic entitlement to pension has not been established, but a claim for pension is pending, take only the actions described in Step 1 and (if applicable) Step 2 of the table below.

If decision makers ultimately determine basic entitlement to disability or survivor pension exists,

disregard the remaining instructions in the table below, and
follow the instructions in M21-1, Part VII, Subpart i, 1.A.6.e.

Step	Action
1	Is the *VA Form 21-686c* substantially complete, as defined in M21-1, Part I, Subpart i, 1.A.4.f? If yes, go to the next step. If no, disregard the remaining steps in this table, and complete the actions described in *Steps 2 through 9* of the table in M21-1, Part VII, Subpart i, 1.A.5.d.
2	Establish EP control based on the benefit claimed, unless the appropriate EP is already pending.
3	Is the form incomplete by virtue of the fact that the claimant failed to submit the proper income reporting form that *VA Form 21-686c* instructs the claimant to provide? If yes, go to the next step. If no, go to Step 11. Note: If the claimant submitted a VA Form 21P-0516-1, Improved Pension Eligibility Verification Report (Veteran With No Children), or VA Form 21P-0517-1, Improved Pension Eligibility Verification Report (Veteran With Children), but failed to provide all the income/net worth information the form requires, go to the next step.
4	Make one attempt to obtain missing income/net worth information from the claimant by telephone. Important: Follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e, for documenting successful and unsuccessful attempts to obtain information from a claimant by telephone.
5	Was the missing income/net worth information obtained from the claimant by telephone? If yes, go to Step 10. If no, go to the next step.
6	Clear the pending EP and establish EP 600.
7	Send a notice of proposed adverse action to the claimant. In the notice, inform the claimant that unless information regarding the dependent’s income is provided within 60 days, VA must discontinue the claimant’s award effective the first of the month following the month the dependent’s income became available to the claimant. Go to the next step after the claimant responds or after the 65-day response period ends, whichever occurs first. *Note: Follow the instructions in M21-1, Part X, Subpart ii, 3.B.3*, if the claimant requests a hearing in response to the notice of proposed adverse action.
8	Did the claimant provide the missing income/net worth information? If yes, go to Step 10. If no, go to the next step.
9	Discontinue the claimant’s award as proposed in the notice of proposed adverse action. Prepare and send a decision notice to the claimant. Disregard the remaining steps in this table. *Note: When preparing the decision notice, inform the claimant the missing income information must be provided within one year from the date of the decision notice, and instruct the claimant to complete VA Form 20-0995* and return it with the missing information.
10	Does sufficient evidence/information exist to allow VA to add *all* claimed dependent(s) to the claimant’s award? If yes, add the dependent(s) to the claimant’s award prepare and send a decision notice to the claimant, and disregard the remaining steps in this table. If no, go to the next step.
11	Does sufficient evidence/information exist to allow VA to add to the claimant’s award at least one of the dependents listed on the form? If yes, go to Step 14. If no, go to the next step.
12	Deny the claim but include the income of unestablished dependent(s) when calculating the claimant’s IVAP. *Exception: Do not* include the income of a claimed dependent who is an individual, such as a parent or unadopted grandchild, that VA does not consider a dependent for pension purposes. *Reference: For more information on the instructions contained in this step, see M21-1, Part IX, Subpart iii, 1.F.2.h*.
13	Notify the claimant of the decision. Disregard the remaining steps in this table. *Important: In the decision notice, identify the missing evidence/information that prevented VA from adding the dependent(s) to the claimant’s award inform the claimant that unless VA receives the evidence/information within one year of the decision notice, VA cannot add the dependent(s) to the claimant’s award based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the missing evidence/information. Do not maintain EP control for a response to the notice.
14	Add to the claimant’s award those dependents for whom the claimant has provided all the evidence/information VA requires. Include the income of unestablished dependent(s) when calculating the claimant’s IVAP. *Exception: Do not* include the income of a claimed dependent who is an individual, such as a parent or unadopted grandchild, that VA does not consider a dependent for pension purposes. *Reference: For more information on the instructions contained in this step, see M21-1, Part IX, Subpart iii, 1.F.2.h*.
15	Notify the claimant of the action taken. *Important: In the decision notice, identify the evidence/information that is missing for the remaining dependent(s) inform the claimant that unless VA receives the evidence/information within one year of the decision notice, VA cannot add the dependent(s) to the claimant’s award based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the evidence/information that is missing for the remaining dependent(s). Do not maintain EP control for a response to the notice.

Reference: For more information on notifying claimants of a VA decision, see M21-1, Part VI, Subpart i, 1.B.

VII.i.1.A.6.e. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete – Basic Entitlement to Pension Exists but No Award Is Running

Follow the instructions in the table below if

no award is currently running, but VA has determined basic entitlement to pension exists, and
the claimant submitted a September 2018 or later version of VA Form 21-686c that is substantially complete but lacks the evidence/information VA requires to add the claimed dependent(s) to the claimant’s award.

Important: In those rare instances when VA Form 21-686c does not ask the claimant for all the evidence/information VA requires to add a claimed dependent to the claimant’s award (such as the birth certificate and adoption decree referenced in M21-1, Part VII, Subpart i, 3.B.4.e), and such evidence/information is missing,

disregard the instructions in the table below, and
follow the instructions in the applicable row of the table in M21-1, Part VII, Subpart i, 1.A.6.a.

Step	Action
1	Is the form incomplete by virtue of the fact that the claimant failed to submit the proper income reporting form that VA Form 21-686c instructs the claimant to provide? If yes, go to the next step. If no, go to Step 6. Note: If the claimant submitted a VA Form 21P-0516-1 or VA Form 21P-0517-1 but failed to provide all the income/net worth information the form requires, go to the next step.
2	Make one attempt to obtain missing income/net worth information from the claimant by telephone. Important: Follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e, for documenting successful and unsuccessful attempts to obtain information from a claimant by telephone.
3	Was the missing income/net worth information obtained from the claimant by telephone? If yes, go to Step 6. If no, go to the next step.
4	Deny the claim for pension.
5	Notify the claimant of the decision. Disregard the remaining steps in this table. *Important: In the decision notice, identify the evidence/information regarding the claimant’s dependent(s) that is missing inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot award benefits based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the missing evidence/information. Do not maintain EP control for a response to the notice.
6	Determine whether the claimant’s IVAP exceeds the maximum annual pension rate (MAPR). Include the income of *all* claimed dependents when calculating the claimant’s IVAP. When determining the MAPR, recognize as dependents only those for whom the requisite evidence/information exists to do so. *Exception: Do not* include the income of a claimed dependent who is an individual, such as a parent or unadopted grandchild, that VA does not consider a dependent for pension purposes. *Reference: For more information on the instructions contained in this step, see M21-1, Part IX, Subpart iii, 1.F.2.h*.
7	Does the claimant’s IVAP exceed the MAPR? If yes, go to the next step. If no, go to Step 10.
8	Deny the claim for pension.
9	Notify the claimant of the decision. Disregard the remaining steps in this table. *Important: If adding all* of the claimed dependent(s) to the claimant’s award would reduce the IVAP below the MAPR, identify in the decision notice the evidence/information that is missing regarding the individuals VA excluded when determining the claimant’s MAPR inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot award benefits based on the present claim, and instruct the claimant to complete VA Form 20-0995 and return it with the missing evidence/information. Do not maintain EP control for a response to the notice.
10	Award pension.
11	Notify the claimant of the decision. *Important: In the decision notice, identify the evidence/information regarding the claimant’s dependent(s) that is missing inform the claimant that unless VA receives the missing evidence/information within one year of the decision notice, VA cannot add the dependent(s) to the claimant’s award based on the present claim, and instruct the claimant to complete VA Form 20-0995* and return it with the missing evidence/information. Do not maintain EP control for a response to the notice.

Reference: For more information on notifying claimants of a VA decision, see M21-1, Part VI, Subpart i, 1.B.

7. Requirement for Disclosure of SSNs to VA

Introduction

This topic contains information about the requirement that beneficiaries and claimants disclose to VA their SSN and the SSNs of their dependents, including

Change Date

February 15, 2022

VII.i.1.A.7.a. Regulatory Basis for Requiring Disclosure of SSNs

38 CFR 3.216 requires beneficiaries and claimants to disclose to VA their Social Security number (SSN) and the SSNs of their dependents as a condition of receiving or continuing to receive compensation or pension.

Important:

38 CFR 3.216 does not require beneficiaries, claimants, or dependents to obtain an SSN to receive VA benefits if no SSN has been assigned.
If an SSN has neither been assigned to nor requested for an individual, the claimant or beneficiary must attest to this fact in a certified statement.
Neither a certified statement nor further development to obtain an SSN is necessary if a claimant or beneficiary indicates no SSN has been assigned to an individual because the individual is a nonresident alien, as referenced in M21-1, Part VII, Subpart i, 1.A.7.c.

Reference: For more information on the certified statement referenced in this block, see M21-1, Part VII, Subpart i, 1.A.7.g.

VII.i.1.A.7.b. Why SSNs Are Important to VA

SSNs enable VA to conduct data exchanges with other agencies. These data exchanges

provide VA with important information, such as verified Social Security income
allow VA to conduct independent verification of a claimant’s income using Federal tax information, and
help minimize overpayments.

VII.i.1.A.7.c. Nonresident Aliens Without SSNs

Many nonresident aliens do not have SSNs, and VA does not require them to obtain one. Accordingly, it is unnecessary to request an SSN (or a certified statement indicating that no SSN has been assigned or requested) for an individual who

has no SSN
is not a U.S. citizen, and
resides outside
- the U.S.
- the Commonwealth of Puerto Rico
- the Virgin Islands
- American Samoa
- Guam, or
- the Northern Marianas.

VII.i.1.A.7.d. Relevance of the Assignment of an ITIN

Upon receipt of notice that an individual with no SSN has an individual tax identification number (ITIN), make no further attempts to obtain

that individual’s SSN, or
a certified statement that no SSN has been requested for or assigned to that individual.

Note: The assignment of an ITIN to an individual by the Internal Revenue Service is an indication that

no SSN has been assigned to that individual, and
that individual is not eligible for an SSN.

VII.i.1.A.7.e. Guidelines for Requesting an SSN From a Beneficiary or Claimant

Follow the instructions in the table below for requesting an SSN from a beneficiary or claimant.

If …

Then …

a claimant failed to provide an SSN on an application for benefits, to include those listed in M21-1, Part III, Subpart ii, 2.B.1.b

follow the instructions in the table below.

If …

Then …

no award is running, and
the claimant’s or Veteran’s SSN is missing

treat the application as incomplete, and
take the actions described in Steps 2 through 9 of the table in M21-1, Part VII, Subpart i, 1.A.5.d, regardless of the type of benefit the claimant is seeking.

a dependent’s SSN is missing

follow the instructions in

M21-1, Part VII, Subpart i, 1.A.5.d, if the benefit is disability compensation or DIC, and
M21-1, Part VII, Subpart i, 1.A.6.b, if the benefit is pension.

Note: If a claimant has requested the assignment of an SSN, but the Social Security Administration (SSA) has not yet provided one,

send a letter to the claimant, requesting the SSN within 30 days, and
take no action to award benefits to or for the individual that has no SSN until the claimant provides it.

VA requires an SSN for an individual to or for whom VA is already paying benefits

attempt to obtain the missing SSN by telephone. If the SSN must be requested by letter,

furnish the beneficiary with VA Form 21-4138, Statement in Support of Claim, and
advise the beneficiary that
- disclosure of the SSN is mandatory if
  - SSA has assigned an SSN, or
  - the beneficiary has requested the assignment of an SSN, and
- failure to furnish the SSN (or a certified statement that no SSN has been assigned or requested) will result in a reduction in or discontinuance of the beneficiary’s award.

Notes:

Follow the due process procedures discussed in M21-1, Part I, Subpart i, 1.B, before reducing or discontinuing an award because a beneficiary failed to provide VA with an SSN.
Per 38 CFR 3.500(w), the effective date of a reduction in or discontinuance of an award because a beneficiary failed to provide an SSN is the last day of the month (first day of the month for award-adjustment purposes) following a 60-day period that begins on the date VA requested the SSN.

VII.i.1.A.7.f. Requirement for an SSN for Children

Beneficiaries/claimants must provide an SSN (or a certified statement that no SSN has been assigned or requested) for all children, regardless of

a child’s age, or
whether the child is the claimant or a dependent.

VII.i.1.A.7.g. Determining the Credibility of a Statement That No SSN Has Been Assigned or Requested

Absent evidence to the contrary, accept as credible a statement from a beneficiary or claimant that no SSN has been assigned or requested, unless the individual who reportedly has no SSN

receives Social Security or other Federal benefits, or
has an account at a bank or other financial institution.

When the conditions described in the above bullets exist, follow the instructions in the table below.

Important:

Oral certification that no SSN has been assigned or requested is acceptable only if the individual who reportedly has no SSN is a non-resident alien, as referenced in M21-1, Part VII, Subpart i, 1.A.7.c. In all other cases, a written and signed statement from the claimant or beneficiary is required.
Beneficiaries/claimants may submit the certified statement referenced in this block electronically, in person, or by mail.

Step	Action
1	Is VA already paying benefits to or for the individual who reportedly has no SSN? If yes, go to the next step. If no, go to Step 4.
2	Issue notice of proposed adverse action to the beneficiary. In the notice, ask the beneficiary to furnish a statement from SSA confirming that SSA has not assigned an SSN to the individual in question, and inform the beneficiary that if the statement is not provided within 60 days, VA will discontinue benefits payable to or for the individual in question effective the first day of the month following a 60-day period that begins on the date VA requested the statement. *Reference: For more information on issuing notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.A*.
3	Did the beneficiary provide the statement from SSA within 65 days of the date of the notice of proposed adverse action? If yes, notify the beneficiary that VA will not take the action proposed in the notice of proposed adverse action, and disregard the remaining steps in this table. If no, discontinue benefits payable to or for the individual in question effective the first day of the month following a 60-day period that begins on the date VA requested the statement notify the beneficiary of the action taken, and disregard the remaining steps in this table. Important: When preparing the decision notice referenced in the preceding bullet, inform the beneficiary that the statement from SSA must be provided within one year, and instruct the beneficiary to complete *VA Form 20-0995* and return it with the statement.
4	Ask the claimant to furnish a statement from SSA confirming that SSA has not assigned an SSN to the individual in question. Allow the claimant 30 days to respond.
5	Did the claimant provide the statement from SSA within 30 days? If yes, award benefits to or for the individual in question if entitlement otherwise exists. If no, deny the claim for benefits, and notify the claimant of the denial and the reason for it. Important: When preparing the decision notice referenced in the preceding bullet, inform the claimant that unless VA receives the statement from SSA within one year of the decision notice, VA cannot award benefits based on the present claim, and instruct the claimant to complete *VA Form 20-0995* and return it with the statement.

Reference: For more information on preparing decision notices, see M21-1, Part VI, Subpart i, 1.B.

VII.i.1.A.7.h. Action to Take Following Receipt of Notice That No SSN Has Been Assigned or Requested

Follow the instructions in the table below following receipt of notice that no SSN has been assigned to or requested for a beneficiary or a dependent.

If no SSN was assigned to or requested for a …	Then update the corporate record by …
Veteran	accessing the PERSON DETAILS screen in Participant Profile, and selecting SSA Verified No Number Exists from the drop-down box in the SSN VERIFICATION STATUS field.
non-Veteran beneficiary, or dependent	accessing the DEPENDENTS screen in Share selecting the name of the beneficiary or dependent that has no SSN clicking on the MODIFY button, and selecting 9-SSA Verified No Number Exists from the drop-down box in the SSN VERIFIED? field.

8. Medical Records That Reveal the Existence of a Dependent That Is Not on a Veteran’s Award

Introduction

This topic contains information about medical records that reveal the existence of a dependent that is not on a Veteran’s award, including

Change Date

February 15, 2022

VII.i.1.A.8.a. Action to Take When Medical Records Reveal the Existence of a Dependent That Is Not on a Veteran’s Award

Review of a Veteran’s medical records will occasionally reveal the existence of a spouse or child that has not been added to a Veteran’s award. Upon discovering such information, follow the instructions in the table below.

Important: RO employees should not routinely review medical records for the sole purpose of identifying dependents that have not been added to a Veteran’s award.

Step

Action

1

Is the Veteran receiving pension, or does the Veteran have an overall disability rating of at least 30 percent?

If yes, go to the next step.
If no, disregard the remaining step in this table. The Veteran lacks eligibility to have a dependent on the award.

2

Send the Veteran VA Form 21-686c for completion.

Important: If the Veteran is receiving pension,

also send one of the following forms for completion:
- VA Form 21P-0516-1, or
- VA Form 21P-0517-1, and
follow the procedures in M21-1, Part VII, Subpart i, 1.A.6.b beginning with Step 2.

VII.i.1.A.8.b. Assigning an Effective Date Based on Information About Dependents That VA Discovers in Medical Records

When a Veteran returns the VA Form 21-686c that VA sent in accordance with the instructions in M21-1, Part VII, Subpart i, 1.A.8.a, determine whether VA may recognize the individual named on the form as the Veteran’s dependent.

If VA can recognize as a dependent the individual named on the form, add the individual to the Veteran’s award effective the earlier of the following dates:

the first of the month following the month VA received the signed and completed VA Form 21-686c, or
the first of the month following the date of the event that allowed the Veteran to add a dependent to the award if the Veteran submitted a signed and completed VA Form 21-686c within one year of that date.

Example: An “event,” for the purpose of this block, might include

marriage
birth of a child, or
the assignment of an overall SC disability rating of at least 30 percent.

Reference: For more information on determining the proper effective date for adding a dependent to a Veteran’s award, see

M21-1, Part VII, Subpart i, 1.C.2 (awards of disability compensation only), and
38 CFR 3.401(b).

38 CFR Part 3 (Click to Open)

38 CFR Part 4 (Click to Open)

VA Disability Codes [Click to Expand]

M21-1 Table of Contents

M21-5 Table of Contents

In This Section

1. General Policies Surrounding the Issues of Relationship and Dependency

Introduction

Change Date

VII.i.1.A.1.a. Definition: Relationship

VII.i.1.A.1.b. Definition: Dependency

VII.i.1.A.1.c. Importance of Establishing the Relationship of an Individual to a Veteran

VII.i.1.A.1.d. Circumstances Under Which VA Assumes Financial Dependency Exists

VII.i.1.A.1.e. Circumstances Under Which VA Requires Proof of Financial Dependency

VII.i.1.A.1.f. Considering the Existence of Dependents When Determining Entitlement to Disability and Survivors Benefits

VII.i.1.A.1.g. Handling Claims for Benefits for or From an Individual That VA Does Not Recognize as a Veteran’s Dependent

VII.i.1.A.1.h. Interplay Between Federal, State, and Foreign Laws

VII.i.1.A.1.i. Duty of Claimants to Report Familial Relationships and Family Composition

2. Burden of Proof and the Weighing of Evidence

Introduction

Change Date

VII.i.1.A.2.a. Responsibilities of VA and Claimants for Securing Evidence

VII.i.1.A.2.b. Accepting Entries a Claimant Makes on VA Form 21-686c as Proof of an Event

VII.i.1.A.2.c. Evaluating and Weighing Evidence

3. Jurisdiction Over Relationship Determinations

Introduction

Change Date

VII.i.1.A.3.a. Jurisdiction Over Questions Involving Facts

VII.i.1.A.3.b. Who Has the Authority to Resolve Issues Involving Relationship and Dependency

VII.i.1.A.3.c. When Administrative Decisions Are Required

VII.i.1.A.3.d. When ROs Must Request an Opinion From District Counsel

VII.i.1.A.3.e. Procedure for Submitting a Request for an Opinion to District Counsel

4. Handling Notices and Claims From Beneficiaries and Claimants Regarding Their Dependents

Introduction

Change Date

VII.i.1.A.4.a. Forms Claimants Must Use to Initiate the Process of Adding a Dependent to Their Award

VII.i.1.A.4.b. Controlling Claims for Additional Compensation for a Dependent

VII.i.1.A.4.c. Claims From Veterans With an Overall Disability Rating That Is Less Than 30 Percent

VII.i.1.A.4.d. Handling a Form That Contains Conflicting Information

VII.i.1.A.4.e. Incomplete Forms and Claims Requiring Additional Evidence/Information

VII.i.1.A.4.f. Action to Take Upon Receipt of a Request to Add a Dependent That Was Not Submitted on a Prescribed Form

VII.i.1.A.4.g. Notification From a Beneficiary That Will Result in Removal of a Dependent From the Beneficiary’s Award

VII.i.1.A.4.h. Possible Retroactive Restoration of Benefits

VII.i.1.A.4.i. Acceptability of VA Form 21-686c From a VA-Recognized Representative

VII.i.1.A.4.j. Acceptability of a VA Form 21-686c or VA Form 21-674 That an RO or Call Center Employee Completes and Signs

5. Determining Whether and How to Undertake Development When the Benefit Is Disability Compensation or DIC

Introduction

Change Date

VII.i.1.A.5.a. General Information About Claims Development

VII.i.1.A.5.b. Timing of Development Actions

VII.i.1.A.5.c. Additional Information/Guidance Relevant to Claims Development

VII.i.1.A.5.d. Handling an Incomplete Form

VII.i.1.A.5.e. Handling an Incomplete Form When Eligibility for Additional Benefits for Dependents Does Not Currently Exist But a Rating EP or Claim for DIC Is Pending

VII.i.1.A.5.f. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete

VII.i.1.A.5.g. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete When Eligibility for Additional Benefits for Dependents Does Not Currently Exist But a Rating EP or Claim for DIC Is Pending

VII.i.1.A.5.h. Creating a Letter That Requests Information/ Evidence VA Requires to Recognize an Individual as a Dependent

6. Determining Whether and How to Undertake Development When the Benefit Is Pension

Introduction

Change Date

VII.i.1.A.6.a. General Information About Claims Development

VII.i.1.A.6.b. Handling an Incomplete Form – Pension

VII.i.1.A.6.c. Handling an Incomplete Form – No Running Award but a Claim for Pension Is Pending

VII.i.1.A.6.d. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete – Pension

VII.i.1.A.6.e. Handling a September 2018 or Later Version of VA Form 21-686c That Is Incomplete – Basic Entitlement to Pension Exists but No Award Is Running

7. Requirement for Disclosure of SSNs to VA

Introduction

Change Date

VII.i.1.A.7.a. Regulatory Basis for Requiring Disclosure of SSNs

VII.i.1.A.7.b. Why SSNs Are Important to VA

VII.i.1.A.7.c. Nonresident Aliens Without SSNs

VII.i.1.A.7.d. Relevance of the Assignment of an ITIN

VII.i.1.A.7.e. Guidelines for Requesting an SSN From a Beneficiary or Claimant

VII.i.1.A.7.f. Requirement for an SSN for Children

VII.i.1.A.7.g. Determining the Credibility of a Statement That No SSN Has Been Assigned or Requested

VII.i.1.A.7.h. Action to Take Following Receipt of Notice That No SSN Has Been Assigned or Requested

8. Medical Records That Reveal the Existence of a Dependent That Is Not on a Veteran’s Award

Introduction

Change Date

VII.i.1.A.8.a. Action to Take When Medical Records Reveal the Existence of a Dependent That Is Not on a Veteran’s Award

VII.i.1.A.8.b. Assigning an Effective Date Based on Information About Dependents That VA Discovers in Medical Records