### Section C. Original Death Claims

#### Overview

+------------+---------------------------------------------------------+
| #          | > This section contains the following topics:           |
| #### In th |                                                         |
| is Section |                                                         |
+------------+---------------------------------------------------------+

  ------------ ---------------------------------------------- ------------
  Topic        Topic Name                                     See Page

  9            Identification of Original Death Claims        2-C-2

  10           Policies for Original Death Claims             2-C-3

  11           Claims Involving Accrued Benefits              2-C-5

  12           Claims Involving Death Compensation            2-C-9
               Entitlement                                    

  13           Claims for Social Security Survivors' Benefits 2-C-11

  14           Supplemental Attachments to SSA Forms          2-C-12
  ------------ ---------------------------------------------- ------------

#### 9. Identification of Original Death Claims

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on the identification |
| troduction | > of original death claims. It includes information on  |
|            |                                                         |
|            | -   what constitutes an original death claim            |
|            |                                                         |
|            | -   applications for death benefits                     |
|            |                                                         |
|            | -   death claims by a surviving spouse or child, and    |
|            |                                                         |
|            | -   death claims by a parent.                           |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > An original death claim is an initial formal          |
| #### a. Wh | > application on a form prescribed by the Secretary of  |
| at Constit | > the Department of Veterans Affairs (VA).              |
| utes an Or |                                                         |
| iginal Dea |                                                         |
| th Claim?  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > The following forms are applications for death        |
| ## b. VA A | > benefits:                                             |
| pplication |                                                         |
| s for Deat | -   *VA Form 21-534*, *Application for Dependency and   |
| h Benefits |     Indemnity Compensation or Death Pension and Accrued |
|            |     Benefits by a Surviving Spouse or Child*            |
|            |                                                         |
|            | -   *VA Form 21-535, Application for Dependency and     |
|            |     Indemnity Compensation by Parent(s)*, and           |
|            |                                                         |
|            | -   *VA Form 21-4182, Supplement to Social Security     |
|            |     Form: Application for Dependency and Indemnity      |
|            |     Compensation or Death Pension (Including Accrued    |
|            |     Benefits) from VA.*                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > A death claim submitted on *VA Form 21-534*           |
| c. Claims  | > constitutes a claim for                               |
| by a Survi |                                                         |
| ving Spous | -   Dependency and Indemnity Compensation (DIC)         |
| e or Child |                                                         |
|            | -   death pension, and                                  |
|            |                                                         |
|            | -   accrued benefits.                                   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### d    | > Consider a claim for compensation or DIC by a parent  |
| . Claims b | > as a claim for accrued benefits.                      |
| y a Parent |                                                         |
+------------+---------------------------------------------------------+

#### 10. Policies for Original Death Claims

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains policies for original death       |
| troduction | > claims. It includes                                   |
|            |                                                         |
|            | -   general policy information, and                     |
|            |                                                         |
|            | -   information regarding                               |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   unsigned applications, and                          |
|            |                                                         |
|            | -   requests for burial benefits.                       |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Per [38 U.S.C.                                        |
|  a. Genera | > 5101](http://assembler.law.cornell.edu/               |
| l Policy o | uscode/html/uscode38/usc_sec_38_00005101----000-.html), |
| n Completi | > an individual must file a specific claim on the form  |
| on of the  | > prescribed by the Secretary, or jointly with the      |
| Appropriat | > Secretary of Health and Human Services, to receive    |
| e VA Form  | > death benefits under the laws administered by VA.     |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. U | > Upon receipt of an unsigned application for death or  |
| nsigned Ap | > burial benefits, review the application and all the   |
| plications | > evidence.                                             |
|            | >                                                       |
|            | > If review shows that the claimant is *not* entitled   |
|            | > to the benefits                                       |
|            |                                                         |
|            | -   formally deny the claim, and                        |
|            |                                                         |
|            | -   notify the                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   claimant, and                                       |
|            |                                                         |
|            | -   representative.                                     |
|            |                                                         |
|            | > ***Note***: If you receive additional evidence that   |
|            | > may result in a grant, photocopy the application, and |
|            | > return the original to the claimant for a signature.  |
|            | >                                                       |
|            | > ***Reference***: For more information about unsigned  |
|            | > applications and identification of informal claims,   |
|            | > see [M21-1MR, Part III, Subpart ii,                   |
|            | > 2.D.15](../pt03_sp02_ch02_secD.xml#III.ii.2.D.15).    |
+------------+---------------------------------------------------------+

Continued on next page

10\. Policies for Original Death Claims, Continued

+------------+---------------------------------------------------------+
| ##### c    | > Upon receipt of a request for a burial application or |
| . Requests | > an inquiry about burial benefits                      |
|  for Buria |                                                         |
| l Benefits | -   transmit *VA Form 21-530, Application for Burial    |
|            |     Benefits* via the Benefits Delivery Network (BDN)   |
|            |     209 screen, or                                      |
|            |                                                         |
|            | -   use a personal computer-generated letter (PCGL).    |
|            |                                                         |
|            | > ***Note***: Send *VA Form 21-530* only upon request   |
|            | > or inquiry about burial benefits.                     |
+------------+---------------------------------------------------------+

#### 11. Claims Involving Accrued Benefits

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information about sending         |
| troduction | > applications on claims involving accrued benefits. It |
|            | > includes information on                               |
|            |                                                         |
|            | -   the definition of ***accrued benefits***            |
|            |                                                         |
|            | -   handling a claim with no accrued benefits           |
|            |                                                         |
|            | -   handling a claim with accrued benefits              |
|            |                                                         |
|            | -   determining which application to send               |
|            |                                                         |
|            | -   handling claims when a separate application is not  |
|            |     required, and                                       |
|            |                                                         |
|            | -   policies for the development letter.                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a    | > ***Accrued benefits*** are benefits to which a        |
| . Definiti | > veteran was entitled on the date of death, but were   |
| on: Accrue | > not paid. Often, the benefits were not paid as the    |
| d Benefits | > result of a claim that was pending but never finally  |
|            | > adjudicated due to the death of the veteran.          |
|            | >                                                       |
|            | > An accrued benefit decision is based on               |
|            |                                                         |
|            | -   existing ratings or decisions, or                   |
|            |                                                         |
|            | -   evidence on file on the date of death.              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. C | > If accrued benefits do *not* exist                    |
| laims with |                                                         |
|  No Accrue | -   deny the claim for accrued benefits *without*       |
| d Benefits |     development, and                                    |
|            |                                                         |
|            | -   explain that VA denied the claim because no accrued |
|            |     amount exists.                                      |
+------------+---------------------------------------------------------+

Continued on next page

11\. Claims Involving Accrued Benefits, Continued

+------------+---------------------------------------------------------+
| ##### c    | > If accrued benefits exist, use the table below to     |
| . Claims w | > determine whether to forward a separate application   |
| ith Accrue | > to the beneficiary.                                   |
| d Benefits |                                                         |
+------------+---------------------------------------------------------+

+-------------------------------------+--------------------------------+
| If ...                              | Then a separate application is |
|                                     | ...                            |
+-------------------------------------+--------------------------------+
| -   accrued benefits are due and    | *not* required.                |
|     payable on the death of a       |                                |
|     veteran, and                    |                                |
|                                     |                                |
| -   a Veterans Service              |                                |
|     Representative (VSR) has        |                                |
|     forwarded *VA Form 21-534* or   |                                |
|     *21-535* to the claimant        |                                |
+-------------------------------------+--------------------------------+
| it is not in order to initiate a    | -   required, and              |
| claim on *VA Form 21-534* or *VA    |                                |
| Form 21-535* because the only issue | -   one of the following forms |
| is accrued benefits, as opposed to  |     should be sent:            |
| DIC and/or death pension            |                                |
|                                     | ```{=html}                     |
|                                     | <!-- -->                       |
|                                     | ```                            |
|                                     | -   *VA Form 21-614,           |
|                                     |     Application for Accrued    |
|                                     |     Amounts of Veteran's       |
|                                     |     Benefits Payable to Widow, |
|                                     |     Widower, Child, or         |
|                                     |     Dependent Parents*         |
|                                     |                                |
|                                     | -   *VA Form 21-601*,          |
|                                     |     *Application for           |
|                                     |     Reimbursement from Accrued |
|                                     |     Amounts Due a Deceased     |
|                                     |     Beneficiary*, or           |
|                                     |                                |
|                                     | -   *VA Form 551, Application  |
|                                     |     for Accrued Benefits by    |
|                                     |     Veteran's Spouse, Child,   |
|                                     |     or Dependent Parent*.      |
+-------------------------------------+--------------------------------+

+-----------------------------------------------------------------------+
| > ***References***: For more information on                           |
|                                                                       |
| -   which application form to send, see [M21-1MR, Part III, Subpart   |
|     ii, 2.C.11.d](../pt03_sp02_ch02_secC.xml#III.ii.2.C.11.d), and    |
|                                                                       |
| -   development of claims for accrued benefits, see [M21-1MR, Part    |
|     VIII, 2](../pt08_ch02.xml#VIII.2).                                |
+-----------------------------------------------------------------------+

Continued on next page

11\. Claims Involving Accrued Benefits, Continued

+------------+---------------------------------------------------------+
| #####      | > Use the table below to determine which form to send   |
| d. Determi | > if VA requires a separate application.                |
| ning Which |                                                         |
|  Applicati |                                                         |
| on to Send |                                                         |
+------------+---------------------------------------------------------+

+---------------------------+------------------------------------------+
| If ...                    | Then send ...                            |
+---------------------------+------------------------------------------+
| accrued entitlement       | *VA Form 21-614* to the veteran's        |
| exists to                 | surviving beneficiaries, in the order    |
|                           | listed:                                  |
| -   disability            |                                          |
|     compensation or       | -   spouse                               |
|     pension               |                                          |
|                           | -   child or children, or                |
| -   annual clothing       |                                          |
|     allowance, or         | -   parents.                             |
|                           |                                          |
| -   education and         | ***Reference***: For more information,   |
|     training allowance    | see [38 CFR                              |
|                           | 3.1000](http://www.warms.vba.va.         |
|                           | gov/regs/38CFR/BOOKB/PART3/S3_1000.DOC). |
+---------------------------+------------------------------------------+
| there is entitlement to   | VA Form 551 to the veteran's surviving   |
| amounts withheld from the | beneficiaries, in the order listed:      |
| veteran's award because   |                                          |
| of                        | -   spouse                               |
|                           |                                          |
| -   hospital treatment,   | -   child or children, or                |
|     or                    |                                          |
|                           | -   parents.                             |
| -   institutional or      |                                          |
|     domiciliary care      | ***Reference***: For more information,   |
|                           | see                                      |
|                           |                                          |
|                           | -   [38 CFR                              |
|                           |     3.551](http://www.warms.vba.va       |
|                           | .gov/regs/38CFR/BOOKB/PART3/S3_551.DOC), |
|                           |     and                                  |
|                           |                                          |
|                           | -   [38 CFR                              |
|                           |     3.1001](http://www.warms.vba.va.     |
|                           | gov/regs/38CFR/BOOKB/PART3/S3_1001.DOC). |
+---------------------------+------------------------------------------+
| it appears that no person | *VA Form 21-601* to the prospective      |
| is entitled by            | claimant as the person who bore the      |
| relationship              | expense of the last illness and burial   |
|                           |                                          |
|                           | > ***Example***: Use this form when      |
|                           |                                          |
|                           | -   there is no entitled child or        |
|                           |     dependent parent, and                |
|                           |                                          |
|                           | -   the surviving spouse's entitlement   |
|                           |     to recurring death benefits is       |
|                           |     barred because he/she was not        |
|                           |     married to the veteran within the    |
|                           |     delimiting period.                   |
|                           |                                          |
|                           | ***Reference***: For information on the  |
|                           | delimiting period, see [38 CFR           |
|                           | 3.54(a)(3)](http://www.warms.vba.va      |
|                           | .gov/regs/38CFR/BOOKB/PART3/S3_354.DOC). |
+---------------------------+------------------------------------------+

Continued on next page

11\. Claims Involving Accrued Benefits, Continued

+------------+---------------------------------------------------------+
| ##         | > Follow the steps in the table below if VA does *not*  |
| ### e. Sep | > require a separate *VA Form 21-534* or *VA Form       |
| arate Appl | > 21-535*.                                              |
| ication No |                                                         |
| t Required |                                                         |
+------------+---------------------------------------------------------+

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 1     | Inform the preferred beneficiary that he/she must file for   |
|       | accrued benefits within one year of the veteran's death.     |
|       |                                                              |
|       | ***Exceptions***:                                            |
|       |                                                              |
|       | -   If accrued lump sum is payable under [38 CFR             |
|       |     3.1001](htt                                              |
|       | p://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_1001.DOC) |
|       |     because the veteran died while receiving hospital        |
|       |     treatment, institutional care, or domiciliary care,      |
|       |     advise the beneficiary that he/she must file the         |
|       |     application within five years of the veteran's death.    |
|       |                                                              |
|       | -   If only proceeds of returned and canceled checks are     |
|       |     payable under [38 CFR                                    |
|       |     3.1003](htt                                              |
|       | p://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_1002.DOC) |
|       |     because the payee died prior to negotiating the checks,  |
|       |     do not mention a time limit on filing a claim for these  |
|       |     accrued amounts.                                         |
|       |                                                              |
|       | > ***Reference***: For more information on eligibility for   |
|       | > accrued benefits, see [M21-1MR, Part VIII,                 |
|       | > 1](../pt08_ch01.xml#VIII.1).                               |
+-------+--------------------------------------------------------------+
| 2     | State in the development letter the approximate amount of    |
|       | accrued benefits due and payable, if known.                  |
+-------+--------------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > In the development letter                             |
| ## f. Poli |                                                         |
| cies for D | -   state the approximate amount of accrued benefits    |
| evelopment |     due and payable, if known, and                      |
|            |                                                         |
|            | -   advise the beneficiary that accrued benefits are    |
|            |     *not* payable unless the beneficiary files the      |
|            |     claim within the appropriate time period.           |
|            |                                                         |
|            | > Use the table below to determine the appropriate time |
|            | > period for the beneficiary to file the claim.         |
+------------+---------------------------------------------------------+

+----------------------------+-----------------------------------------+
| For ...                    | The beneficiary must file within ...    |
+----------------------------+-----------------------------------------+
| -   *VA Form 21-614*, or   | *one* year of the veteran's death.      |
|                            |                                         |
| -   *VA Form 21-601*       |                                         |
+----------------------------+-----------------------------------------+
| > *VA Form 511*            | *five* years of the veteran's death.    |
+----------------------------+-----------------------------------------+

#### 12. Claims Involving Death Compensation Entitlement

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on claims involving   |
| troduction | > death compensation entitlement. It includes           |
|            | > information on                                        |
|            |                                                         |
|            | -   eligibility for death compensation                  |
|            |                                                         |
|            | -   assumed election of DIC                             |
|            |                                                         |
|            | -   policies for informing the claimant                 |
|            |                                                         |
|            | -   claimant rejection of DIC, and                      |
|            |                                                         |
|            | -   claims by parents.                                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > Prior to 1957, the basic benefit payable for          |
| ## a. Elig | > service-connected (SC) death was death compensation.  |
| ibility fo | > This benefit was payable under the following          |
| r Death Co | > circumstances:                                        |
| mpensation |                                                         |
|            | -   death occurred prior to January 1, 1957, or         |
|            |                                                         |
|            | -   an in-service waiver of insurance premiums under    |
|            |     [38 U.S.C.                                          |
|            |     1924](http://assembler.law.cornell.edu              |
|            | /uscode/html/uscode38/usc_sec_38_00001924----000-.html) |
|            |     was in effect at death which occurred               |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   on or after May 1, 1957, but                        |
|            |                                                         |
|            | -   prior to January 1, 1972.                           |
|            |                                                         |
|            | > ***Note***: Beneficiaries have since acquired the     |
|            | > right to elect DIC.                                   |
|            | >                                                       |
|            | > ***Reference***: For more information on eligibility  |
|            | > requirements for death compensation, see M21-1MR,     |
|            | > Part IV, Subpart iii, 3.G.26 (TBD) or [M21-1, Part    |
|            | > IV, 20.44 through                                     |
|            | > 20.50](htt                                            |
|            | p://www.warms.vba.va.gov/admin21/m21_1/part4/ch20.doc). |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > If death compensation is the basic benefit, consider  |
| ### b. Ass | > *VA Form 21-534* or                                   |
| umed Elect | >                                                       |
| ion of DIC | > *21-535* a claim for DIC *if*                         |
|            |                                                         |
|            | -   the claimant filed the form on or after January 1,  |
|            |     1972                                                |
|            |                                                         |
|            | -   the records show DIC would be the greater benefit,  |
|            |     and                                                 |
|            |                                                         |
|            | -   the claimant confirms the election.                 |
|            |                                                         |
|            | > ***Reference***: For more information about assumed   |
|            | > election, see [38 CFR                                 |
|            | > 3.702(a)](http://w                                    |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_702.DOC). |
+------------+---------------------------------------------------------+

Continued on next page

12\. Claims Involving Death Compensation Entitlement, Continued

+------------+---------------------------------------------------------+
| #          | > If *VA Form 21-534* or *21-535* appears to be a claim |
| #### c. In | > for DIC, fully inform the claimant of                 |
| forming th |                                                         |
| e Claimant | -   the award of DIC, determined as the greater benefit |
|            |     on the basis of evidence of record, and             |
|            |                                                         |
|            | -   his/her right to receive death compensation.        |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > If the claimant rejects DIC, award death compensation |
| # d. Claim |                                                         |
| ant Reject | -   if otherwise in order, and                          |
| ion of DIC |                                                         |
|            | -   subject to the prior payment at the DIC rate.       |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Send the parent *VA Form 21-509, Statement of         |
| e. Claims  | > Dependency of Parent(s)* to determine if the parent   |
| by Parents | > meets the dependency criteria of [38 CFR              |
|            | > 3.250](http://                                        |
|            | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_250.DOC) |
|            | > for payment of death compensation *if*                |
|            |                                                         |
|            | -   a parent makes a claim, and                         |
|            |                                                         |
|            | -   the DIC rate based on reported income would be less |
|            |     than the death compensation rate.                   |
+------------+---------------------------------------------------------+

#### 13. Claims for Social Security Survivors' Benefits

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on claims for Social  |
| troduction | > Security Survivors' Benefits. It includes information |
|            | > on                                                    |
|            |                                                         |
|            | -   processing *Form SSA-24*, *Application for          |
|            |     Survivors Benefits,* and                            |
|            |                                                         |
|            | -   releasing *Form SSA-24* to the Social Security      |
|            |     Administration (SSA).                               |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Upon receipt of *Form SSA-24, Application for         |
| #### a. Pr | > Survivors Benefits,* in conjunction with *VA Form     |
| ocessing F | > 21-534* or *VA Form 21-535*,                          |
| orm SSA-24 |                                                         |
|            | -   date stamp the date of receipt on                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   *Form SSA-24*, and                                  |
|            |                                                         |
|            | -   the VA form, and                                    |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   enter the correct VA file number in Item 12 of      |
|            |     *Form SSA-24*.                                      |
|            |                                                         |
|            | > ***Note***: If located in the Manila regional office  |
|            | > (RO), follow the procedures for providing referrals   |
|            | > to the Social Security Administration (SSA) activity  |
|            | > located in that office.                               |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b    | > Send *Form SSA-24* to the SSA without completing the  |
| . Releasin | > items for evidence "received" or "requested" blocks   |
| g Form SSA | > on the form.                                          |
| -24 to SSA | >                                                       |
|            | > Use the table below to determine how to send the      |
|            | > form.                                                 |
+------------+---------------------------------------------------------+

+----------------------------------+-----------------------------------+
| If Form SSA-24 ...               | Then send the form ...            |
+----------------------------------+-----------------------------------+
| shows the Social Security number | -   without a cover letter, and   |
| (SSN)                            |                                   |
|                                  | -   to the appropriate program    |
|                                  |     center listed in M21-1MR,     |
|                                  |     Part III, Subpart iii, 3.A.6  |
|                                  |     (TBD) or [M21-1, Part III,    |
|                                  |                                   |
|                                  |  9.02a](http://www.warms.vba.va.g |
|                                  | ov/admin21/m21_1/part3/ch09.doc). |
+----------------------------------+-----------------------------------+
| does *not* show the SSN          | to the parallel SSA district      |
|                                  | office listed in M21-1MR, Part    |
|                                  | III, Subpart iii, 3.A.7 (TBD) or  |
|                                  | [M21-1, Part III,                 |
|                                  | 9.02b](http://www.warms.vba.va.g  |
|                                  | ov/admin21/m21_1/part3/ch09.doc). |
+----------------------------------+-----------------------------------+

#### 14. Supplemental Attachments to SSA Forms

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on supplemental       |
| troduction | > attachments to SSA application forms. It includes     |
|            | > information on                                        |
|            |                                                         |
|            | -   applications for survivor's benefits                |
|            |                                                         |
|            | -   applications for death benefits, and                |
|            |                                                         |
|            | -   the procedure for handling death claims.            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > An application for survivor's benefits filed with SSA |
|  a. Applic | > on or after January 1, 1957, because of the death of  |
| ations for | > a veteran                                             |
|  Survivor' |                                                         |
| s Benefits | -   constitutes a claim for VA death benefits, and      |
|            |                                                         |
|            | -   is considered to have been received by VA as of the |
|            |     date of receipt by the SSA.                         |
|            |                                                         |
|            | > ***Reference***: For more information about claims    |
|            | > filed with the SSA, see                               |
|            | >                                                       |
|            | > M21-1MR, Part IV, Subpart iii, 3.A.4 (TBD) or [M21-1, |
|            | > Part IV,                                              |
|            | > 26.01h](htt                                           |
|            | p://www.warms.vba.va.gov/admin21/m21_1/part4/ch26.doc). |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. A | > If SSA receives *VA Form 21-4182*, as a supplemental  |
| pplication | > attachment to Social Security application forms, SSA  |
| s for Deat | > personnel forward the form to VA.                     |
| h Benefits | >                                                       |
|            | > *VA Form 21-4182* constitutes an initial claim for    |
|            | > any or all of the following death benefits:           |
|            |                                                         |
|            | -   DIC                                                 |
|            |                                                         |
|            | -   death pension, and/or                               |
|            |                                                         |
|            | -   accrued benefits.                                   |
+------------+---------------------------------------------------------+

Continued on next page

14\. Supplemental Attachments to SSA Forms, Continued

+------------+---------------------------------------------------------+
| ###        | > Follow the steps in the table below to handle a claim |
| ## c. Hand | > submitted on *VA Form 21-4182.*                       |
| ling Claim |                                                         |
| s for Deat |                                                         |
| h Benefits |                                                         |
+------------+---------------------------------------------------------+

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 1     | -   Accept *VA Form 21-4182* as a formal but incomplete      |
|       |     claim for death benefits, and                            |
|       |                                                              |
|       | -   consider the date of receipt in the SSA as the date on   |
|       |     which a claim for death benefits was filed with VA.      |
|       |                                                              |
|       | > ***Reference***: For more information about the file date, |
|       | > see [38 CFR                                                |
|       | > 3.153](htt                                                 |
|       | p://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_153.DOC). |
+-------+--------------------------------------------------------------+
| 2     | > If *VA Form 21-4182* is the initial claim for VA death     |
|       | > benefits                                                   |
|       |                                                              |
|       | -   send the claimant *VA Form 21-534* or *21-535*, as       |
|       |     appropriate, and                                         |
|       |                                                              |
|       | -   advise the claimant to provide only the information that |
|       |     does not already appear on *VA Form 21-4182*.            |
+-------+--------------------------------------------------------------+
| 3     | Establish a pending-issue control.                           |
+-------+--------------------------------------------------------------+
| 4     | Refer the claim for initial development action.              |
+-------+--------------------------------------------------------------+