**CHAPTER 23. LETTER GENERATION**

**CONTENTS**

PARAGRAPH PAGE

**SUBCHAPTER I. RDPC LETTER GENERATION**

23.01 General 23-I-1

23.02 On-line Processing 23-I-1

23.03 Batch Processing 23-I-2

**SUBCHAPTER II. ACKNOWLEDGMENT LETTERS**

23.04 General 23-II-1

23.05 Letter Selection 23-II-1

**SUBCHAPTER III. DEVELOPMENT LETTERS**

23.06 General 23-III-1

23.07 Paragraph Selection 23-III-1

23.08 Letter Generation Requirements 23-III-1

**SUBCHAPTER IV. DISALLOWANCE LETTERS**

23.09 General 23-IV-1

23.10 Letter Selection 23-IV-1

**SUBCHAPTER V. COMPENSATION AND PENSION AWARD LETTERS**

23.11 General 23-V-1

23.12 Letter and Paragraph Selection 23-V-1

**SUBCHAPTER VI. BURIAL LETTERS**

23.13 General 23-VI-1

23.14 Letter and Paragraph Selection 23-VI-1

**CHAPTER 23. LETTER GENERATION**

**SUBCHAPTER I. RDPC LETTER GENERATION**

**23.01 GENERAL**

a\. Several basic types of letters are generated at the RDPC\'s. They
are acknowledgment, development, compensation and pension disallowance,
compensation and pension award, burial award and burial disallowance
letters. As well, development paragraphs can be added to award letters
when simultaneous award and development actions are taken.

b\. The generation of acknowledgment, development, disallowance and
award letters involves a combination of on-line and end-of-day (batch)
processing. The on-line portion of the processing determines the general
letter type, e.g., acknowledgment, development, while the end-of-day
processing selects the specific paragraphs and fill-in data to be
included in the letter.

**23.02 ON-LINE PROCESSING**

a\. The basic type of letter is determined during on-line processing.
Whether or not a letter is to be generated and the type of letter are
determined by operator actions and system design considerations when
processing specific commands. The commands and associated letter types
are:

COMMAND TYPE OF LETTER

CEST Acknowledgment

CDEV Development

CAUT Award, disallowance and combined award/development

b\. Operator actions and system design considerations which affect
letter generation are:

\(1\) The processing of a CEST command results in an acknowledgment
letter unless another letter is to be generated the same day.

\(2\) The use of the CDEV command results in a development letter unless
an award is authorized on the same day (the letters will be combined)
and the operator does not suppress the award letter.

\(3\) When the CAUT command is used and the issue authorized, an award
or disallowance letter generates unless the operator suppresses the
letter on the 501 Screen or unless the system indicates at GAP
processing that the letter is being automatically suppressed.

\(4\) If an issue is cancelled (PCAN) or cleared (PCLR) on the same day
as, but subsequent to, an establishment (CEST) or development (CDEV)
action, no letter is generated.

**23.03 BATCH PROCESSING**

a\. Following the close of the on-line system each day, several batch
processing runs are initiated at each RDPC. The end-of-day runs include
generation and printing of acknowledgment, development, disallowance and
award letters.

b\. During end-of-day letter processing, the letter records created
during the on-line day are accessed to determine which issues in the PIF
require a letter and the basic type of letter. Depending on the basic
letter type, the end-of-day letter generation checks the identified
issues for presence, absence and specific values in a number of fields.
The result of these checks determines the specific paragraph to be
selected as well as any fill-in data. Also, the selection of some
paragraphs results in the suppression of other paragraphs.

c\. The last paragraph of all generated acknowledgment, development,
disallowance and award letters will be as follows:

IF YOU RESIDE IN THE CONTINENTAL UNITED STATES, ALASKA,

HAWAII OR PUERTO RICO, YOU MAY CONTACT VA WITH QUESTIONS

AND RECEIVE FREE HELP BY CALLING OUR TOLL-FREE NUMBER

1-800-827-1000 (FOR HEARING IMPARIED TDD 1-800-829-4833).

**SUBCHAPTER II. ACKNOWLEDGMENT LETTERS**

**23.04 GENERAL**

An acknowledgment letter is generated to notify a claimant that his or
her application has been received and is being considered. It also
informs the claimant of the file number assigned to the claim and where
to write concerning the claim.

**23.05 LETTER SELECTION**

a\. Acknowledgment letters are generated by a combination of on-line and
batch processing as previously described.

b\. The use of the CEST command generates an acknowledgment letter
unless:

\(1\) Y is entered in the SUPPRESS ACKNOWLEDGMENT LETTER field on the
101 Screen.

\(2\) Any other action resulting in a letter is taken on the same day.

\(3\) The end product is 170, 290, 310, 320, 330, 400, 500, 680, 690 or
any increment thereof.

c\. The acknowledgment letter has a standard format used for all claims.
The wording of the letter is as follows:

We have received your application for benefits. It is our sincere desire
to decide your case

promptly. However, as we have a great number of claims, action on yours
may be delayed. We are now in the process of deciding whether additional
evidence or information is needed. If we need anything else from you, we
will contact you, so there is no need to contact us in the

meantime. If you do write us, be sure to show file number and full name,
or have it at hand if you call.

d\. A generated letter is sent to the claimant when the PIF End Product
is in the 110, 140, 180 or 190 series (except for Agent Orange and
Radiation cases), the case has not been GAP\'ed and the time between
DATE OF ESTABLISHMENT and current processing date is exactly 90 days,
180 days or 270 days. Generation of this letter is automatic and does
not require any action by the regional office. No regional office copy
of the letter will be produced. The text of the letter will be the same
for all three instances and will read as follows:

We are still processing your application for benefits. We apologize for
the delay. You will be notified upon completion of processing. If you
need to contact us, be sure to show the file

number and full name of the veteran.

**SUBCHAPTER III. DEVELOPMENT LETTERS**

**23.06 GENERAL**

a\. The RDPC produces development letters for evidence and information
requested on screens 201, 202, 203, 204, 205, 206 and 207 under the
CDEV, CDAT, CADJ and CAUT commands. Although letters requested on the
208 and 209 Screens do not always request information, they are treated
as development letters by the system.

b\. The on-line and batch processing for development letters conforms to
the description provided in subchapter I.

**23.07 PARAGRAPH SELECTION**

a\. Generally, a development selection is made by inserting X for each
specific item unless otherwise indicated under selection criteria.

b\. The selection of specific development paragraphs is directly related
to operator entries on the 200-level screens. Paragraphs referencing the
202 Screen are printed on VA Form 00-3101, Request for Information. This
is sent to a service department to request information about the
claimant. Up to 11 lines of information may be printed on a single form.
No development paragraphs are printed for any 201 Screen entries.

c\. Paragraphs relating to the other development screens (203, 204, 206,
207, 208 and 209) are also included in this subchapter.

d\. If multiples of the same enclosure are indicated because two or more
paragraphs require the same enclosure, only release of a single form
will be indicated on the enclosure line. The exception to this procedure
occurs when a development item with a multiple forms indicator is
selected.

**23.08 LETTER GENERATION REQUIREMENTS**

a\. All letters generated to the claimant from data on the claims
development screens are printed two or three times. One copy goes to the
claimant, one copy to the regional office and, if designated, one copy
to the service organization.

b\. A separate C&P development letter is not generated if an award is
generated on the same day. When the award is generated, the development
data are saved and incorporated into the award letter. This only applies
when the generated award action is an award transaction 11 or 13.

**DEVELOPMENT OPENING AND CLOSING PARAGRAPHS**

Paragraph Paragraph Content Selection Criteria

Number

200001 We are working on your claim. However, we need more Standard
opening paragraph

information before we can finish our action: for all development letters

except when development

paragraphs are added to an

award letter.

200100 We need this information to determine the amount of Generated as
the closing

money wecan pay you. Our request is allowed by law paragraph when there
is no

(38 U.S.C. 501(a)and 501(b)). We will disclose it outside enclosure,
except for Screens

the Department of Veterans Affairs only if law permits. 205 and 207.

200101 Please send us the requested information as fast as Generated as
the closing

possible, preferably within 60 days. You should send us paragraph for
letters

the information we need quickly so we can work on your requested on
Screen 205.

claim sooner.

200900 The copy of the public document that you send us must be
Generated whenever a

certified. This means that it must be issued by the public paragraph is
selected which official or office in charge of those documents. Do not
send requests submission of

a notarized copy. We will not be able to pay benefits based documentary
evidence in

on a notarized copy. Many states will give a free certified support of a
claim for a

copy of a public document when that document is needed dependent. Prints
prior to

by the Department of Veterans Affairs. 200906 or 200991, as

applicable.

200905 If you send us the following evidence or information, we may
\"Bridge\" paragraph used to

be able to increase your payments. separate award paragraphs

from development

paragraphs when letters are

combined.

200906 Please send us this evidence as soon as possible, preferably
Closing paragraph when award

within 60 days. The faster you send us the information we and
development letters are

need, the sooner we can work on your claim. We must receive combined.

it within one year from the date of this letter. If we do not

receive it within one year, we will not be able to pay any

additional benefits for any period before the date we receive

it. Be sure to write the veteran\'s full name and VA file

number on all evidence or forms that you send us.

200991 Please send us this evidence as soon as possible, preferably
Standard development letter

within 60 days. The faster you send us the information we closing
paragraph for C&P.

need, the sooner we can work on your claim. We must receive This
paragraph will precede

it within one year from the date of this letter. If we do not paragraph
200100 when that

receive it within one year, we will not be able to pay the paragraph is
generated.

benefit you are claiming for any period before the date it is

received. Be sure to write the veteran\'s full name and VA file

number on all evidence or forms that you send us.

200993 ENCL:Generated for all

development letters

containing paragraphs

requiring enclosures. Fill-in is

the enclosure(s) indicated in

the paragraphs. In the event

that multiples of the same

enclosure are indicated

because two or more

paragraphs require the same

enclosure, release of only a

single form will be indicated

in the enclosure line. The

exception to this procedure

occurs if a development item

with a multiple form indicator

is selected.

**DEVELOPMENT PARAGRAPHS**

**General Claimant Data\--Screen 203**

Paragraph Paragraph Content Selection Criteria

Number

203101 Complete and return the enclosed VA Form 21- showing IMPROVED
PENSION

all the income you have received and expect to receive from Two income
Periods Entered

through . Also, show all the Enclosure: See NOTE below

income you expect to receive beginning through

. Please read the instructions on VA Form

21-0510 before you complete VA Form 21- .

203102 Complete and return the enclosed VA Form 21- showing IMPROVED
PENSION

all the income you received and expect to receive from One Income Period
Entered

through . Please read the instructions Enclosure: See NOTE below

on VA Form 21-0510 before you complete VA Form

21- .

203103 Complete and return the enclosed VA Form 21- . Please EVR TYPE
OTHER THAN

read the instructions on VA Form 21-0510 before completing IMPROVED
Enclosure: See

VA Form 21-[. .]{.underline} NOTE below

**[NOTE]{.underline}**: The forms to be enclosed and the form numbers to
be inserted in the blanks within the paragraphs are determined by screen
entries as follows:

**[ENTRY IN]{.underline}: [PAYEE NO.]{.underline} [FORM
NO]{.underline}**

OLD LAW 00 21-0511V-1

OLD LAW 10 21-0511S-1

SECTION 306 00 21-0512V-1

SECTION 306 10 21-0512S-1

OLD LAW or 306 4 or 5, 11-19 or 31-39 21-0513-1

DIC 50/60 21-0514-1

IMPROVED 00 21-0516-1

IMPROVED SPOUSE 00 21-0516-1

IMPROVED CHILD/REN 00 21-0517-1

IMPROVED 10 21-0518-1

IMPROVED CHILD/REN 10 21-0519S-1

IMPROVED 11-19 or 31-39 21-0519C-1

**VA Form 21-8983 is enclosed with each letter generated.**

203104 A review of your file shows we have never received a VA Form
Enclosure: VAF 21-526

21-526, Veterans Application for Compensation or Pension , from

you. We cannot complete processing on your claim without this

form. Please complete and return the enclosed application as

quickly as possible.

203110 Please complete and return the enclosed VA Form 21-527 527

Income\--Net Worth and Employment Statement. Enclosure: VAF 21-527

203123 Because of the value of your assets, including property (not
8049\--GENERAL EXPENSES

your home) and cash, we need a report of your expenses. Enclosure: VAF
21-8049

Complete and return Sections I, II, III, IV and V on VA Form

21-8049. When we receive this information, we will decide

whether you are entitled to pension.

203112 Please furnish a copy of latest Social SS AWARD LETTER

Security Award Letter. If you do not have this letter, SCREEN DROP-IN

send us a statement from the Social Security Administration.
[ENTRY]{.underline}

This statement should show their monthly benefit rate and P your

effective date of benefit or should show that they disallowed S your
spouse\'s

the claim. C your children\'s

F all family members

203113 Show your business or rental income on VA Form 21-4185.
BUSINESS/RENTAL

Enclosure: VAF 21-4185

203111 If you paid your spouse\'s just debts and expenses of last
8049\--LAST EXPENSES

illness and burial, we may deduct those payments from your Enclosure:
VAF 21-8049

income. This may increase your VA pension. If you paid any (For payee
50/60 only)

of these expenses or debts, please complete Section VI on the

enclosed VA Form 21-8049 and return it to us.

203114 If you paid your spouse\'s/child\'s just debts and expenses of
8049\--LAST EXPENSES

last illness and burial, we may deduct those payments from Enclosure:
VAF 21-8049

your income. This may increase your VA pension. If you paid (For payee
00 or 10)

any of these expenses or debts, please complete Section VI on

the enclosed VA Form 21-8049 and return it to us.

203115 Please send us a copy of latest RET/ANNUITY LETTER

retirement or annuity award letter. If you do not have that SCREEN
DROP-IN

letter, send us a statement from the organization paying the
[ENTRY]{.underline}

retirement or annuity. This statement should show the rate P your

paid and the effective date. S your spouse\'s

B your and your spouse\'s

203116 Complete and return VA Form 21-4165 concerning your farm
FARMING/INCOME

income. Enclosure: VAF 21-4165

203117 Please complete section VII on the enclosed VA Form 21-8049
8049\--INSURANCE

and return it to us. Be sure to show ALL the insurance you Enclosure:
VAF 21-8049

received or expect to receive INCLUDING VA insurance.

203120 Tell us whether you are receiving or expect to receive sick
SICK/WORKER\--

benefits, worker\'s compensation or unemployment compensation. UNEMPLOY
COMP

If so, please give the beginning date, weekly amount and date Enclosure:
VAF 21-4138

payments will stop.

203118 Report the total amount of medical expenses you paid for FAMILY
MED EXPENSE\--

yourself, your spouse and your children. Also include medical
FROMdrop-in: dates entered

expenses you paid for relatives you support or who live with on 203
Screen

you. You should report these expenses if you paid them Enclosure: VAF
21-8416

during the period to . You may

include premiums paid for health, sickness and hospital

insurance. Also include nursing home expenses you paid.

Do not report any expenses for which you have received or

expect to receive payment.

203119 Tell us whether you have received or expect to receive ACCRUED
WAGES

severance pay, back wages, or vacation pay from your last Enclosure: VAF
21-4138

employer. If you are receiving these benefits, please show

the amount and date received.

203141 We cannot increase your current pension benefits to pay for
ELECTION NOTICE

Aid and Attendance or Housebound allowances, more Enclosure: VAF 21-4138

dependents, or more pension because your countable income

is lower. To receive increased monthly benefits, you must

choose benefits under the Improved Pension program.

Before electing Improved Pension, you should know that we

include the income of all family members to determine your

eligibility and the monthly amount payable. Also, much of the

income we exclude under your current pension program must be

counted in the Improved Pension program.

Once you have elected Improved Pension benefits and cashed

your first check, you would not be able to reelect your

original benefit. You cannot return to the protected pension

program unless you send back the first Improved Pension

payment. If you receive your payments by Direct Deposit or

Electronic Funds Transfer (DD/EFT), and you decide you want to

stay with the protected pension program, you must tell us

BEFORE your bank receives the second payment. If your

election of Improved Pension does not result in greater

benefits, we will not accept it.

If you need further information on the Improved Pension

program, please contact a Veterans Benefits Counselor at the

toll-free number found in your telephone directory. To choose

Improved Pension, you should state on the enclosed VA Form

4138: \"I elect to receive benefits under the Improved Pension

program\". Be sure to include the income for each of your dependents.

203142 Please complete VA Form 21-0571. We need this information for
HARDSHIP EXPENSES

your claim for exclusion of your child\'s or children\'s income.
Enclosure: VAF 21-0571

203121 Complete and return VA Form 21-4142 because we need your 4142

permission to obtain a record of medical Enclosure: VAF 21-4142 (2)

treatment. If you wish, you may contact the doctor or Drop-in: For
fiduciary case,

hospital yourself and tell them to send us this information. \"the
veteran\'s\". For

This may reduce the amount of time it takes to process your all others,
\"your.\"

claim.

203122 A copy of the veteran\'s death certificate. DEATH CERTIFICATE

203124 Send us a report from your physician covering any recent A/A
MEDICAL EVIDENCE

medical treatment or examination. If you have not recently Enclosure:
VAF 21-4138

been examined or been treated, inform us and we will

schedule a VA examination for you.

203125 If you are a patient in a nursing home, submit a statement A/A
NURSING HOME

signed by an official of the nursing home that you are Enclosure: VAF
21-4138

currently a patient because of physical or mental incapacity,

the date of admission, whether or not you are receiving

Medicaid-covered nursing home care and, if so, the date

Medicaid coverage began.

203126 To help us determine your entitlement to the \"Housebound\"
HOUSEBOUND

benefit, send us a statement covering the results of any recent

medical treatment or examination. The statement should contain

the date of examination, your complaints, clinical findings and

diagnoses. If you have not recently been examined or treated,

inform us and we will schedule a VA examination for you.

203127 If you have recently received treatment for any claimed RECENT
TREATMENT

disability, please furnish the name and address of the doctor
Enclosures: VAF 21-4138 and

or hospital providing that treatment. You should also show VAF 21-4142

the condition(s) treated, and the date(s) of treatment. Also

complete and return VA Form 21-4142 to permit release of that

information. You may wish to contact the doctor or hospital

yourself and request the release of this information. This

may reduce the amount of time we need to complete action on

your claim. If you have not been treated recently, please

tell us as soon as possible.

203128 If you have recently received treatement at a VA facility or at
TREATMENT VA FACILITY

VA expense, please tell us the dates and places of treatment. Enclosure:
VAF 21-4138

We will get reports of that treatment.

203129 Please complete and return the enclosed VA Form 21-4176
ACCIDENT/INJ

regarding your accident on . Drop-In: date as entered

Enclosure: VAF 21-4176

203130 The type of illness, disease or injury for which you are NATURE
OF DISABILITY

claiming benefits. Enclosure: VAF 21-4138

203131 Identify the disabilities for which you were treated before PRIOR
TREATMENT

you went into service. Give us the dates of treatment and the
Enclosures: VAF 21-4138 and

names and addresses of the doctors and hospitals. Complete VAF 21-4142

and return VA Form 21-4142 to permit release of information

from them. You may wish to contact the doctor or hospital

yourself and request release of this information. This may

reduce the amount of time it takes to process your claim.

203133 A statement of the date (month and year) you last worked. DATE
LAST WORKED

Enclosure: VAF 21-4138

203132 Please send us evidence showing that your claimed disabilities
TREATMENT SINCE

have been treated since your discharge from service. DISCHARGE

The best types of evidence to give us are statements from Enclosure: VAF
21-4138

doctors who have treated you since your discharge. The

statements should show dates of examination or treatment,

findings, and diagnoses.

203134 If you are now employed, state the type of work you do, the
CURRENT EMPLOYMENT

number of hours you work each day and week, and your Enclosure: VAF
21-4138

earnings. If you are not working, give the date you last worked.

203135 A statement of the dates and places you were held as a POW STATUS

prisoner of war. Enclosure: VAF 21-4138

203140 We are considering your spouse\'s entitlement to the \"Aid A/A
SPOUSE

and Attendance\" benefit. If your spouse is a patient in a

nursing home, send us a statement signed by an official of

the nursing home stating that your spouse is now a patient

of the nursing home because of mental or physical incapacity.

The statement must also include the date of admission.

If your spouse is not a patient in a nursing home, send a

report of any recent medical treatment or examination. If

available, the statement should contain the complaints,

clinical findings, diagnosis and prognosis.

203136 has not answered our request HOSPITAL/DOCTOR

for a report of your medical treatment. Will you REPORT

please get it for us as soon as possible? Enclosure: VAF 21-4138

Drop-in: Name of hospital or doctor, as entered

(40 positions)

203137 The service department has been unable to locate records of
TREATMENT FOR:

your treatment for: Enclosure: VAF 21-4138

To help them, please give the following information about Drop-in:
Claimed

eachisability: date(s) and place(s) of treatment as best as condition(s)
as entered

you can remember, including name, number, or location of (Maximum of 50
positions)

hospitals, aid stations, infirmaries, etc. which treated you.

Also give the organization you were assigned to when

the injury, illness, or disease happened. You could also send

statements from fellow servicemembers, doctors, or other

persons who had personal knowledge of your disability during

service or at the earliest date following discharge.

203138 Send the original or a certified copy of SERVICE RECORDS (DD214)

separation papers (DD214 or other document) from service. Enclosure: VAF
21-4138

This must contain information about length and time of Payee 00: Drop-in
1.

service and type of discharge. A copy of the original your; Drop-in 2.
yourself

document can beaccepted by VA if the copy was issued Payee Other than
00:

by the service department. If that is unavailable, send a Drop-in 1. the
veteran\'s

copy issued by apublic custodian of records who certifies Drop-in 2. the
veteran\'s

that it is a trueand exact copy of a service department-issued

document in the custodian\'s custody. If the original or

certified copy is unavailable, send any available documents

or information concerning any periods of service for

including dates of service, branch, service number,

organization unit, etc.

203139 We requested your service medical records from the service
MEDICAL RECORDS

department. If you have any service records in your

possession, please send us a copy. However, we will not deny

your claim just because you do not have copies of your service

records in your possession.

**DEVELOPMENT PARAGRAPHS**

**Dependency Data\--Screen 204**

**a. Marital Data.**

Paragraph Paragraph Content Selection Criteria

Number

204103 A certified copy of the public record ending your marriage to
PROOF OF ISSOLUTION\-- , for example, a divorce decree or death PRIOR
MARRIAGE

certificate. Drop-in: Name of claimant\'s

previous spouse as entered

in CLAIMANT field

204104 A certified copy of the public record ending your previous PROOF
OF DISSOLUTION

marriages, for example, a divorce decree or death certificate \--PRIOR
MARRIAGE

Generated when no names are entered in CLAIMANT

or SPOUSE fields

204105 A certified copy of the public record ending PROOF OF DISSOLUTION

marriage to , for example, a divorce decree or \--PRIOR MARRIAGE

death certificate. Drop-ins Payee 00: 1) your

spouse\'s 2) name as entered

Drop-ins Payee 10: 1) the

veteran\'s 2) name as

entered

[2]{.underline}04106 A certified copy of the public record ending PROOF
OF DISSOLUTION

previous marriages, for example, a divorce decree or death \--PRIOR
MARRIAGE

certificate. Drop-in Payee 00: your

spouse\'s Drop-in Payee 10:

the veteran\'s

204107 Send us a certified copy of your marriage certificate. MARRIAGE
CERTIFICATE

204109 Please give us information about your relationship, such as:
COMMON LAW (VETERAN)

\(1\) What did you agree your relationship would be at the Enclosures:
VAF 21-4170

time you began living together; VAF 21-4171 (2)

\(2\) How long you lived together; VAF 21-4138

\(3\) Places and dates of residence while you were living together;

\(4\) Whether or not you had children. (If you did, send us a certified
copy

of each child\'s birth record);

\(5\) Whether you were members of any church or organization as husband
and wife;

\(6\) Whether together you entered into any business transaction or
signed any legal

document, or owned any real estate.

\(7\) If you answered \"Yes\" to either question 5 or 6 (or both),
please furnish complete details.

Have your spouse complete VA Form 21-4170 and have the two enclosed VA
Forms

21-4171 completed by persons who have personal knowledge of your
relationship.

204110 Complete and return VA Form 21-4170. Also, have each COMMON
LAW\--PAYEE

of the two VA Forms 21-4171 completed by a person who 10; Enclosure: VA
Form

saw the relationship which existed between you and the 21-4170: VA Form
21-4171 (2)

veteran. If you had children, send us a certified copy of the

birth record for each child.

204115 Do you and your spouse live together? If you are separated,
SEPARATION

show the date you separated, the amount you contribute Enclosure: VAF
21-4138

to your spouse\'s support, and your spouse\'s present address.

204112 Evidence we have shows you and the veteran did not live
COHABITATION

together continuously from the date of your marriage until the
QUESTIONABLE

date of the veteran\'s death. Therefore, we need your Enclosure: VA Form
21-

statement on VA Form 21-4138, together with statements 4138 (3)

from two other persons, showing:

\(1\) Date, place, and full explanation of the cause of each separation;

\(2\) Whether you and the veteran intended to again live together;

\(3\) What attempts you or the veteran made to resolve or settle your
problems;

\(4\) The amounts and dates of the veteran\'s contribution to

your support during each separation;

\(5\) All dates and places where you and the veteran lived

from the date of your last separation to the date of the

veteran\'s death. Also, was there a written agreement or

court order of separation? If so, send us a copy. Did you

or the veteran ever apply for divorce or annulment? If so,

give the date and results of the court action and furnish a

certified copy of the divorce decree, if any.

204114 On VA Form 21-4138, please state whether you lived COHABITATION
NOT

continuously with the veteran from the date of your marriage INDICATED
Enclosure:

until the date of death. If you did not, give the dates and VAF 21-4138

reasons for each separation.

204113 We have received a request for an apportionment (a share) of
APPORTIONMENT

your VA benefits for your dependents not living with you. (Indicator
only)Enclosure: To help us decide, please give us the following
information VAF 21-4138 (Also prints

on VA Form 21-4138: 204139)

\(1\) Itemize your monthly income from all sources. Identify each
source.

\(2\) Show the value of all your property, such as stocks,

bonds, bank accounts or real estate owned by you.

\(3\) Provide a list of the average monthly expenses for

yourself and for all dependents living with you.

\(4\) State the average monthly amount you give to support

your spouse and/or children who do not live with you.

\(5\) If you have remarried, show your spouse\'s monthly income.

204138 We are withholding \$ monthly from your benefit APPORTIONMENT IND

effective while we review the request for an WITH AMT, EFF DATE

apportionment (a share of your benefits). The law AND PROPOSED DATE

allowing an apportionment of VA benefits is 38 U.S.C. 5307. Enclosure:
VAF 21-0506

If we allow an apportionment of your benefits, we will reduce
Drop-ins: 1) Withholding

your award y the monthly amount of the apportionment as entered. 2)
Effective date

we grant starting . as entered. 3) Proposed date

as entered.

204139 You should give us the information we have requested
APPORTIONMENT\--

within 60 days. Otherwise, we will make our decision Printed after
paragraph

then on the evidence we have received from the person 204113

asking for the apportionment.

204140 If you continue to accept payments at the present rate until
APPORTIONMENT\--

the date shown above and we grant the apportionment, Printed after
204138

you will have to repay a part of these benefits.

However, if you agree with the proposed apportionment, you can

send us, in addition to the evidence requested above, a

statement that you agree and request immediate adjustment of

your payments. If you do not agree but want to avoid the

chance of being overpaid, you can request an immediate

adjustment. If you do, and our final review shows an

apportionment should not be granted, we will pay you the

monies we withheld.

204108 Tell us if, at the time of your marriage, you knew of any DEEMED
VALID

reasons why you and the veteran were not free to marry. Enclosure: VAF
21-4138

Also, give us your statement telling us if, at the time you

married the veteran, you were aware of any legal reason you could not

marry. Tell us also whether you lived continuously with the

veteran from the date of the marriage until his/her death.

204100 Complete and return the enclosed VA Form 21-686C, 686C

Declaration of Status of Dependents. Enclosure: VAF 21-686C

204101 Send us a certified copy of the public record that ended your
8796

remarriage such as an annulment decree. Also complete the Enclosure: VAF
21-8796

enclosed VA Form 21-8796, Statement of Termination of

Marital Relationship.

204102 Complete and return the enclosed VA Form 21-4103, 4103

Information from Remarried Widow/er. Enclosure: VAF 21-4103

**b. Children\'s Data.**

204116 On VA Form 21-686C, please give the full name, date, 686C

place of birth, and Social Security Number of each of Enclosure: VA Form
21-686C

and the name and address of the person with whom

the child lives.

204128 The date and place of birth for: DATE OF BIRTH

XXXXXXXXXX Enclosure: VAF 21-4138

XXXXXXXXXX XXXXX = Children\'s

XXXXXXXXXX names as entered; otherwise,

each child

204119 Submit a certified copy of the public record of birth BIRTH
RECORD

showing the names of both parents for: Drop-in: Children\'s names as

XXXXXXXXXX entered; otherwise each child

XXXXXXXXXX

XXXXXXXXXX

204121 A certified copy of the court order of adoption for: ADOPTION

XXXXXXXXXX Drop-in: Children\'s names as

XXXXXXXXXX entered; otherwise, each child

XXXXXXXXXX

If the adoption has not been completed, submit a certified

copy of the placement order.

204122 For: XXXXXXXXXX STEPCHILD

XXXXXXXXXX Enclosure: VA Form 21-4138

XXXXXXXXXX Drop-in: Children\'s names as

\(1\) A certified copy of the birth certificate showing the entered;
otherwise, each child

mother\'s name.

\(2\) A certified copy of the certificate of marriage of the

veteran and other parent of the child, and,

204123 (3) State whether that child is a member of your
STEPCHILD\--PAYEE 00

household and became a member of your Follows paragraph 204122

[household before age 18.]{.underline}

204124 (3) State whether the child was a member of the STEPCHILD\--OTHER
THAN veteran\'s household when the veteran died. Also PAYEE 00

state whether that child lived with the veteran before Follows paragraph
204122

age 18.

204117 Please complete VA Form(s) 21-674 for the following 674(X)

children who are attending school: A one-position field is

XXXXXXXXXX provided to indicate if more

XXXXXXXXXX than one form is to be

XXXXXXXXXX released

Enclosure: VA Form 21-674

XXXXXX = Children\'s

names as entered

204118 Please complete Part I of the enclosed VA Form 21-674B 674B(X)

for the following children who will begin school attendance A
one-position field is

in the future: provided to indicate if more

XXXXXXXXXX than one form is to be

XXXXXXXXXX released

XXXXXXXXXX Enclosure: VA Form 21-674B

Return the form(s) after school begins. We must receive the XXXXXX =
Children\'s names

form within 60 days after school begins or we will reduce or as entered

stop your benefits.

204126 For: XXXXXXXXXX ILLEGITIMATE\--PAYEE 00

XXXXXXXXXX Enclosure: VAF 21-4138

XXXXXXXXXX XXXXXX = Children\'s names

\(1\) If the child is yours, a certified copy of the public as entered;
otherwise, each

record of birth or church record of baptism; child

\(2\) If the child is your spouse\'s, furnish proof of birth as

shown above, a certified copy of your marriage certificate

and your statement showing whether the child lives in your

home and lived there before age 18. Also, state when the

child became a member of your household.

204127 For: XXXXXXXXXX ILLEGITIMATE - PAYEE

XXXXXXXXXX 10\--19 or 31-39.

XXXXXXXXXX Enclosure: VAF 21-4138

Please send us a certified copy of the public record of XXXXXX =
Children\'s

birth. If the public record does not show that the veteran names as
entered; otherwise,

was the one who gave the information and was named as each child

the father of the child, send us as much of the following

evidence as possible.

\(1\) Any document which the veteran wrote and signed stating

that the child was his;

\(2\) a court document stating that the veteran was the

child\'s father;

\(3\) A copy of a church record showing that the veteran was

the one who gave the information and named himself as father

of the child;

\(4\) Statements of persons who know that the veteran accepted

the child as his;

\(5\) Statements from the service department or public

agencies such as school or welfare agencies which show that

the veteran stated that he was the father of the child.

204120 The name and address of the person having custody of: CUSTODY

XXXXXXXXXX Enclosure: VA Form 21-4138

XXXXXXXXXX Drop-in: Children\'s names as

XXXXXXXXXX entered; otherwise, each child

204125 We need the information listed below so we can decide if the
HELPLESS

following children listed on your application are helpless: Enclosure:
VA Form 21-4138(3)

XXXXXXXXXX Drop-in: Children\'s names as XXXXXXXXXX entered; otherwise,
each child

XXXXXXXXXX

\(1\) A statement from a physician who knows of the child\'s

condition showing the extent of disability, diagnosis,

prognosis, and date of onset.

\(2\) If the child has ever been in an institution for

treatment, training or custodial care, send a statement from

the institution. The statement should explain the child\'s

condition at entrance and discharge. This statement should

also show whether any improvement occurred or can be expected.

\(3\) If the child ever attended school, send a statement from

a school official showing whether any progress occurred or

can be expected.

\(4\) If the child has ever been employed, send a statement

showing dates and amount of earnings.

\(5\) If you cannot supply the above evidence, send us

statements from at least two persons who know of the child\'s

condition at age 18 and after.

**c. Parental Data.**

204129 Are you claiming benefits as the veteran\'s natural parent or
PARENTAL STATUS

foster parent? Enclosure: VAF 21-4138

204130 Was the veteran a member of your family? Did the veteran
ABANDONMENT

live with you or was the veteran under your control all the Enclosure:
VAF 21-4138

time before the age of majority? If not, please explain. Also,

send the name(s) and address(es) of all other persons who had

control of the veteran before the age of majority. Provide

details such as why and when the veteran was not under your

control and when those who had control prior to age 18

exercised that control.

204134 Please tell us whether the veteran left a widow(er) or any
SURVIVORS

children. If so, furnish the name and address of the Enclosure: VAF
21-4138

widow(er) and custodian of any children.

204135 Please fill out VA Form 21-509. If two parents or one parent
509\--PAYEE 50 or 60

with a non-parent spouse are applying, show the income and Enclosure:
VAF 21-509

assets for each person. Both persons must sign the form.

204136 Your parent or parents should fill out the enclosed VA Form
509\--PAYEE 00

21-509, Statement of Dependency of Parent(s). Enclosure: VAF 21-509

204131 A certified copy of the veteran\'s birth record showing VETS
BIRTH RECORD\--

parents\' names. PAYEE 50 or 60

204132 A certified copy of your birth record showing parents\' VETS
BIRTH RECORD\--

names. PAYEE 00

204133 Are you now married? If married, are you living with your MARITAL
STATUS

spouse? If not, tell us the date of separation. Enclosure: VAF 21-4138

204137 Please complete the enclosed VA Form 21-524. LOCO PARENTIS

Enclosure: VAF 21-524

**DEVELOPMENT PARAGRAPHS**

**Burial/Reimbursement Data\--Screen 206**

Paragraph Paragraph Content Selection Criteria

Number

When one of these four paragraphs is generated, it is to STATEMENT OF

be supported by ALL TRANSPORTATION EXPENSES, TRANSPORTATION

or any combination of those items in CONCERNING . CHARGES FROM:

CHARGES FOR

206100 The funeral director\'s signed statement setting forth his/her
UNDERTAKER

specific transportation charge, if any, for:

206101 A statement, over your signature, setting forth your CLAIMANT

specific transportation charge, if any, for:

206102 A signed statement from the funeral director at the place of
INITIAL UNDERTAKER

death, setting forth his/her specific transportation charge,

if any, for:

206103 A signed statement from the funeral director at the place of
FINAL UNDERTAKER

burial, setting forth his/her specific transportation charge,

if any, for:

206104 Removal of remains from a hospital, railroad station, or
CONCERNING CHARGES FOR:

airport; use of hearse to railroad station, airport or ALL
TRANSPORTATION

cemetery; an outside shipping case; a vault, with an EXPENSE

explanation showing whether it was used as a shippping case

as well as for burial purposes; or a shipping permit with

an explanation concerning its use.

206105 Removal of remains from the hospital. CONCERNING CHARGES FOR
REMOVAL FROM

HOSPITAL

206106 Removal of remains from the railroad station. CONCERNING CHARGES

FOR REMOVAL FROM

RAILROAD

206107 Removal of remains from the airport. CONCERNING CHARGES

FOR REMOVAL FROM

AIRPORT

206108 Hearse to the cemetery. CONCERNING CHARGES

FOR HEARSE TO CEMETERY

206109 Hearse to the railroad station. CONCERNING CHARGES

FOR HEARSE TO

RAILROAD STATION

206110 Hearse to the airport. CONCERNING CHARGES

FOR HEARSE TO

AIRPORT

206112 The outside shipping case. CONCERNING CHARGES FOR OUTSIDE
SHIPPING

CASE

206113 The vault, with an explanation showing whether it was used
CONCERNING CHARGES

as a shipping case as well as for burial purposes. FOR OUTSIDE SHIPPING

CASE

206114 The shipping permit. CONCERNING CHARGES

FOR SHIPPING PERMIT

206115 The \"permit\" shown on the funeral bill with an explanation
CONCERNING CHARGES

concerning its use. FOR EXPLANATION OF

PERMIT

206118 Submit the original or a certified copy of the deceased SERVICE
RECORD

veteran\'s separation papers (DD214 or equivalent) from Enclosure: VAF
21-4138

service which contain information as to the length, time and

character of service. A copy of the original document is

acceptable by the VA for verification of service if the copy

was issued by the service department or by a public custodian

of records who certifies that it is a true and exact copy of

a service department issued document in the custodian\'s

custody. If the original or certified copy is unavailable,

furnish any available documents or information concerning any

periods of service for the deceased veteran including dates

of service, branch, service number, or organization unit, etc.

206119 A certified copy of the veteran\'s death certificate. The PROOF
OF DEATH

certification must be made by the custodian of public

records. Certified copies are often furnished free of

charge for VA claims. (A certification by notary public

is not sufficient.)

206120 A funeral bill showing the name of the deceased, the nature
NONRECEIPTED

and cost of the services, and all credits. FUNERAL BILL

206121 A receipted funeral bill showing the name of the person for
RECEIPTED FUNERAL

whom the services were performed and the name of the BILL

person from whom payments were received.

206122 Submit receipted bills (preferably on the printed billheads
RECEIPTED BILLS

showing that payment has been made) of all creditors whose

services were performed in connection with the expense of

last illness and burial of the veteran or deceased

beneficiary. These statements must show the name of the

deceased and the services performed.

206123 A receipted bill of the funeral director who performed the
INITIAL UNDERTAKERS

initial services or his/her statement that no charges were BILL

made. The funeral director who performs the initial service

has priority for payment of the burial allowance over a

funeral director who performed subsequent services.

206124 A receipt from the railroad ticket agent covering the fare
RAILROAD FARE

for shipment of the remains including the charge for the RECEIPT

shipping case, showing the name of the person whose body was

transported, the cost of two one-way tickets plus tax

required for this method of transportation, and the name of

the person who paid the fare.

206127 A receipted cemetery bill showing the name of the CEMETERY/PLOT

person for whom services were performed, the cost RECEIPT

including the plot, and/or opening and closing charges

and the name of the person who paid the bill.

206126 A receipt from the airline ticket agent covering the fare for
AIRLINE FARE RECEIPT

shipment of the remains including the charge for the shipping

case, showing the name of the person whose body was

transsported, and the name of the person who paid the fare.

206129 Certain transportation expenses are payable when death DEATH IN
VA HOSPITAL

of a veteran occurs while hospitalized by the veterans

administration. To file, furnish a statement of account

itemized to show the cost of charges for transportation from

the hopital to the funeral home and from the funeral home

to the cemetery. This statement must be received within one

year from the date of this letter.

206130 Certain transportation expenses may be payable for BURIAL
NATIONAL

transporting the body of a deceased veteran to a national CEMETERY

cemetery. To make a claim, furnish a statement of account COMPENSABLE

itemized to show the cost of all transportation charges, this DISABILITY

statement must be received within 1 year from the date of (The standard
closing

this letter. paragraph for C&P letters is suppressed)

206131 State on the enclosed form whether you were reimbursed
REIMBURSEMENT NON- from any source for any of the expenses paid by you.
If so, VA SOURCES

specify amount and source. Enclosure: VAF 21-4138

206132 Was the insurance used in payment of the expenses INSURANCE

paid to the estate of the veteran or designated beneficiary? BENEFICIARY

If to a beneficiary, give name and relationship. Enclosure: VAF 21-4138

206133 A statement over the signature of the funeral director
IDENTIFICATION OF

showing the name of the person from whom payment was PAYER OF BILL

received.

206134 Advise us on the enclosed form whether deceased OTHERS ENTITLED
BY

veteran was survived by a spouse, children or parents. RELATIONSHIP

Enclosure: VAF 21-4138

206128 A receipted headstone bill showing the name of HEADSTONE RECEIPT

the person for whom the headstone was furnished and the

name of the person who paid for the headstone.

206150 A receipted bill for additional engraving of the veteran\'s
ADD\'L ENGRAVING

existing headstone or marker showing the name of the deceased

person for whom the services were performed and the name of

the person who paid for the engraving.

206135 The enclosed reimbursement waiver should be signed by
REIMBURSEMENT

. WAIVER

Enclosure: VAF 21-5328 or

VAF 21-601

Drop-in: Name as entered.

206136 State on the enclosed form whether other person(s) paid any OTHER
CLAIMANTS

portion of the deceased veteran\'s last illness or burial REIMBURSEMENT

expenses. If so, furnish name(s) and address(es). Enclosure: VAF 21-5328
or

VAF 21-601

206125 A certified copy of the letter of administration or letters
LETTERS OF

testamentary. ADMINISTRATION

206160 Please submit the required evidence as fast as possible, CLOSING
PARAGRAPH

preferably within 60 days. If we do not receive this evidence FOR BURIAL

within one year from the date of this letter, we might not be
DEVELOPMENT

able to pay benefits on this claim. Please be sure to enter LETTERS WHEN
AN

the veteran\'s name and VA file number on all evidence or ENCLOSURE IS
NOT

forms submitted. INCLUDED

**DEVELOPMENT PARAGRAPHS**

**Disability/Death Claim Letters\--Screen 208**

Paragraph Paragraph Content Selection Criteria

Number

208121 The Hearing Officer has reviewed your claim for disability
EVIDENCE REVIEWED

benefits based upon all the evidence we have including AND HEARING
OFFICER

Drop-in: Evidence as entered

(maximum of 60 positions)

208122 The evidence we reviewed does not change our DISABILITY

previous decision. EVALUATED AND

HEARING OFFICER

Drop-in: Conditions as

entered (6 lines, 30

characters each) followed by 290 screen data

208100 We have reviewed your claim for disability benefits based on
EVIDENCE REVIEWED

all the evidence we have including: Drop-in: Evidence as

entered (Maximum 60

positions)

208101 The evidence does not provide reasons for any change DISABILITY
EVALUATED

in our previous decision about the following condition(s) Drop-in:
Conditions as

entered (6 lines, 30

characters each) followed

by 290 Screen data

208120 Since you did not report for your scheduled examination, FAILURE
TO REPORT\--

VA regulations VA EXAM\--CLAIM

require applicants for disability compensation or pension Drop-ins: 1)
Denied: We

or persons receiving such benefits to undergo an examination have no
choice but to deny

when requested. We cannot take further action unless you your claim. 2)
Discontinued:

inform us of your willingness to report for an examination. We have had
to discontinue

We will then reschedule your examination and reconsider your payments.
3) Reduced:

your claim when the examination is completed. Important We have had to
reduce your

please show your full name and VA file number on all payments. (Followed
by 290

correspondence or evidence submitted. Screen data)

208102 We must deny your claim for special monthly pension. SPECIAL
MONTHLY

Specialmonthly pension is payable to a person receiving PENSION DENIED
A&A

pension who needs Aid and Attendance or is Housebound. (ONLY) (Followed
by 290

To meet the pension who requirements for the Aid and Screen Data)

Attendance benefit, the law requires a claimant must be:

\(1\) So disabled that the person requires the regular help of

another person to eat, bathe, dress and undress or take care

of the needs of nature; or

\(2\) Blind or so nearly blind as to have corrected visual

acuity of 5/200 or less in both eyes; or

\(3\) A patient in a nursing home because of mental or

physical incapacity.

The evidence shows your disabilities are severely disabling and limit
your

activities, but they are not disabling enough to meet the requirements
of the

law. Also, you are not a patient in a nursing home.

(Data as entered on the 290 Screen)

208125 If, in the future, you feel you meet the requirements of the

law for additional benefits, you may reopen your claim.

208103 We must deny your claim for special monthly pension. SPECIAL
MONTHLY

Special monthly pension is payable to a person receiving PENSION DENIED

pension who needs Aid and Attendance or is Housebound. A&A AND
HOUSEBOUND

To meet the requirements for the Aid and Attendance (Followed by 290
Screen

benefit, the law requires a claimant must be: Data)

\(1\) So disabled that the person requires the regular help of

another person to eat, bathe, dress and undress or take care

of the needs of nature; or

\(2\) Blind or so nearly blind as to have corrected visual

acuity of 5/200 or less in both eyes; or

\(3\) A patient in a nursing home because of mental or

physical incapacity.

208108 To be eligible for the Housebound benefit, you must have one

permanent disability rated 100% disabling with an additional

disability or disabilities rateable at 60% or more. We can

also pay the Housebound benefit if you have permanent

disabilities that confine you to the home.

The evidence we have shows your disabilities are severely

disabling and limit your activities, but are not sufficiently

disabling to meet the requirements of the law. Also, you are

not a patient in a nursing home.

(Data entered on 290 Screen)

208125 If, in the future, you feel you meet the requirements of the

law for additional benefits, you may reopen your claim.

208104 We must deny your claim for special monthly pension. SPECIAL
MONTHLY

Special monthly pension is payable to a pension beneficiary PENSION
DENIED

who needs Aid and Attendance or is Housebound. HOUSEBOUND (ONLY)

To be eligible for the housebound benefit, you must have (Followed by
290 Screen

one permanent disability rated 100% disabling with an Data)

additional disability or disabilities ratable at 60% or more. We

can also pay the housbound benefit if you have permanent

disabilities that confine you to the home.

The evidence we have shows your disabilities are severely

disabling and limit your activities, but they are not

sufficiently disabling to meet the requirements of the law.

(Data entered on 290 Screen)

208125 If, in the future, you feel you meet the requirements of the

law for additional benefits, you may reopen your claim.

208105 We need evidence that your service-connected REQUEST FOR

has increased in severity to EVIDENCE SC INC

evaluate your claim for increased compensation. CLAIMED

examination, diagnosis, and any clinical or laboratory Drop-in: S/C
condition as

You may send us a doctor\'s statement which shows entered (25 positions

the date of findings. maximum)

If you have recently been treated at a VA medical facility,

tell us the date and place you were treated. We will get a

report of your treatment.

You are entitled to necessary treatment by VA for any

service-connected disability. You may request treatment at

any VA medical facility. After treatment, you can have the VA

medical facility send us a complete report.

You should send this evidence as quickly as possible,

preferably within 60 days. The faster you get this

information to us, the quicker we can process your claim. In

any case, we must receive it within one year from the date of

this letter. If we don\'t receive it within one year, and

entitlement to benefits is established, we can pay you only

from the date VA receives the evidence.

Please show your full name and VA file number on all

correspondence or evidence submitted.

208106 We are reviewing a claim for VA disability benefits from 4192
FROM EMPLOYER

, SSN , who has stated Enclosure: VAF 21-4192

that he/she was recently employed by you. Drop-in: Claimant\'s name

To help us evaluate this claim, please complete the enclosed (25
positions) and Social

VA Form 21-4192 as quickly as possible and return it Security number (11
positions)

to the VA office identified above. as entered

208107 We decided that the evidence you submitted to reopen your EVID
NOT NEW AND

claim, which we earlier disallowed, is not new and material. MATERIAL
Followed by

Because the evidence you submitted does not give us a new data entered
on the 290 Screen

basis for reconsideration of your claim, we cannot reopen your

claim.

208109 We must deny your claim for dependency and indemnity SC DEATH
DENIED

compensation. We made this decision because the evidence Followed by
data entered on

we have does not show that the veteran\'s death was the 290 Screen

caused by disease or injury incurred in or aggravated by

military service.

This decision will have no effect on any benefit payments

which we may have previously awarded you.

208110 Our action on your claim for benefits will EVIDENCE REQUESTED

be delayed. We are waiting for information that we BY VA\--SVC

requested from your military records. Drop-in: Disability for

CPL; Death for CPD

208113 This concerns your claim for benefits. EVIDENCE REQUESTED

There is adelay in getting military records from the service BY VA -
DELAY Drop-in:

department. We are making every effort to get your military Disability
for CPL; Death

records. We need these records to evaluate your claim. If for CPD

you have any military records which have not been previously

sent to VA, please send them to us as quickly as possible. This

may reduce the amount of time we need to review your claim.

208111 Our action on your claim for benefits will be EVIDENCE REQUESTED

delayed. We are waiting for information that we requested BY VA\--VA
HOSP

from your VA hospital records. Drop-in: Disability for CPL;

Death for CPD

208112 We are going to schedule you for an examination to see EVIDENCE
REQUESTED

if your disability has changed. We must do this because BY VA\--VA EXAM

information shows that your disability might get better.

If your condition is better, you may get lower benefits. We

will not lower or stop your benefits without giving you the

chance to send us other evidence. You may also ask for a

hearing.

If the examination shows that your condition is worse, we may

raise your benefits.

You will get another letter telling you when and where to go

for the examination. We will tell you far enough in advance

to allow you to make any necessary arrangements.

Please be sure to show up for the examination. If you cannot

keep the appointment, call the medical office shown on the

letter. They can give you a new appointment. We may lower or

stop your benefit payments if you do not keep the appointment

without a good reason.

208114 Our action on your claim for benefits is delayed EVIDENCE
REQUESTED

until we receive information that we requested from military BY VA\--VA
HOSP and SVC

records and VA hospital records. Drop-in: Disability for

CPL; Death for CPD

208119 We are making arrangements for your physical examination. VA
EXAM\--PENDING

We will notify you soon of the time and place of the CLAIM

examination. If you do not report for this examination, we may

disallow your claim or you may receive less money than you

might otherwise have received.

208118 We cannot grant your claim for payment of the 100 percent
INDIVIDUAL

rate due to individual unemployability. UNEMPLOYABILITY

To be entitled to that benefit, you must be unable to get or DENIED
(Followed by 290

follow a substantially gainful occupation because of Screen Data)

service-connected disability.

The evidence we have does not show that you are unable to get

or follow a substantially gainful occupation because of your

service-connected disability.

**DEVELOPMENT PARAGRAPHS**

**Miscellaneous Letters\--Screen 209**

Paragraph Paragraph Content Selection Criteria

Number

209180 A veteran who is enrolled in a high school or elementary
ELECTION\--HIGH SCHOOL

training program may receive the cost of tuition and fees Enclosure: VAF
21-4138

with no charge to entitlement, or may elect to receive the

institutional rate with an appropriate charge to entitlement, unless

you elect to receive the institutional rate, payment will be made

based on the tuition and fees reported by your school. In-

stances where no tuition and fees are charged will result in no

VA benefit payments for that enrollment period.

To elect the institutional rate, you should state on the

enclosed VA Form 21-4138, \"I elect to receive payment for my

elementary or secondary program at the monthly rate with the

appropriate charge to entitlement, in place of tuition and

fees\". Once this election is made, it may only be changed at

the beginning of a new enrollment period.

The requested evidence should be submitted to this office with-

in 60 days, and in any case must be received by the VA within

one year from the date of this letter.

209190 We have carefully considered your application for a DEL DATE
EXT\--NOT

delimiting date extension based on disability. TIMELY FILED

Certain time limits are applicable for a claim to be given

further consideration. It must have been received in the veter-

ans administration within one year of your original delimiting

date or within one year after your disability ceased, whichever

date was later, because your application was not received with-

in these stated time limits, we must deny your claim. We regret

that a more favorable determination cannot be made.

209220 We have carefully considered your application for a DEL DATE
EXT\--NO

delimiting date extension due to disability based on , QUAL DISABILITY

all evidence of recordincluding the medical and employment

information recently received.

The evidence which you have submitted does not show that you

were prevented from initiating or completing a training program

or pursuing full time employment because of disability during

your delimiting period. As a result, we must deny your claim.

We regret that a more favorable determination cannot be made.

209230 We are sincerely sorry to learn of the veteran\'s death. We CH 32
DEATH REFUND

realize this is a difficult adjustment period for you and wish
Enclosure: VAF 21-4138

to offer assistance.

Our records show that the veteran made voluntary education

contributions while in service so funds would be available at a

later date for educational or vocational training. There are

usued contributions in his account which are payable to his

beneficiaries or estate. You may be entitled to either all or a

portion of this refund.

You must make a written request for refund before any funds can

be disbursed. Please use the enclosed VA Form 21-4138 to make

your request for refund. Be sure to sign the form and return it

to the address shown above.

209240 You have been awarded educational assistance based CH32/SEC 903
KICKER

on your application and your training facility\'s certification of

your enrollment. You will receive a computer generated

letter in the near future showing your monthly rate and

effective dates.

Our records show that your entitlement includes a pending

department of defense bonus contribution (\"kicker\"). The

monthly rate you were authorized does not include this

contribution. We have taken action to have these funds

transferred to your account. When this action is completed,

your monthly rate will be increased and you will receive an

adjustment check.

209250 You have been awarded educational assistance based on a CH32/SEC
903 SERVICE

recently received enrollment certification. You will receive
REQUIREMENTS

a computer generated letter in the near future showing

your monthly rate and effective dates. Please note that the

beginning date of your award is later than the first date of

your enrollment period.

Under veterans administration regulation, the benefits to

which you are entitled are generally payable to an individual

only upon discharge from service, completion of the first

period of active duty for which obligated, or completion of

six years of active duty, whichever occurs first. Because the

first date of the term for which you have requested benefits

occurs before any of the conditions listed above, the beginning

date of your award represents the earliest effective date

allowable under the law.

209050 The last VA check to has been RETURNED CHECK

returned. Drop-in: Name as entered

Please give us the information requested below and return (maximum 25
positions)

this letter to us as soon as possible.

Reason for return of check:

If the payee died, please show date and place of death:

Your relationship to payee:

(Your signature)

209260 We are considering your claim for an apportionment (a share)
APPORTIONMENT DATA\--

of the veteran\'s benefits. To help us decide, please use the CLAIMANT
Enclosure:

enclosed VA Form 21-4138 to furnish the following: VAF 21-4138

\(1\) An itemized list of your monthly income from all

sources, showing each source.

\(2\) A list of the property you own, such as stocks, bonds,

bank accounts or real estate, and its value.

\(3\) An itemized list of your average monthly expenses for

yourself and for any of the veteran\'s dependents living with you.

Please send this to us within 60 days. If it is not received

within 60 days, we will make our decision based on whatever

evidence we have received from you and the veteran.

209270 Your application did not contain Social SSN REQUEST

Security number(s). The law requires that you give VA Drop-in:
SELF\--Your

this information. If you don\'t, we cannot pay benefits to or
DEPENDENTS\--Your

on behalf of any person for whom we have no Social Security dependents

number. 38 U.S.C. 5101(c). SELF and DEPENDENTS\--

Your and your dependents

You are not required to obtain a Social Security number to obtain

VA benefits if one has not been assigned. Therefore,if the person

or persons listed above do not have a number,please explain why not.

Please send this evidence to us as soon as possible,

preferably within 60 days. In any case, it must be received

by VA within one year of this letter, otherwise, if

entitlement to benefits is established, payments can be

authorized only from the date VA receives the evidence.

209075 Because we have not received the income statement we EVR NOT
RETURNED

sent to you recently, we stopped your payments effective Drop-in: Date
entered

. We can make no further payments until Enclosure: Form as

we receive your report of income. If we receive the income indicated in
ENCLOSE

report before December 31 of this year, we may resume EVR FORM field

payments from the date they were stopped if you remain

entitled. Please use the attached form to give us the report

if you lost your income statement.

If you have mailed the income statement within the last few

days, we will review it. If you are entitled to payments this

year, we will send them as quickly as possible.

209100 Because we have not received the income statement we EVR NOT
RETURNED and

sent to you recently, we stopped your payments effective OVERPAYMENT

. We can make no further payments until Drop-in: Date as entered

we receive your report of income. If we receive the income Enclosure:
Form as entered in

report within 2 years of the termination date shown above, ENCLOSE EVR
FORM field

we may resume payments from that date if you remain entitled.

Please use the attached form to give us the report if you lost

your income statement.

If you have mailed the income statement within the last few

days, we will review it. If you are entitled to payments this

year, we will send them as quickly as possible.

This termination resulted in an overpayment of benefits which

we paid you. We will notify you shortly of the exact amount

of the overpayment and give you information about repayment.

209110 You may be entitled to compensation at the 100 percent rate
UNEMPLOYABILITY

if you are unable to secure and follow a substantially

gainful occupation because of your service-connected

disabilities. If you believe that you qualify, please

complete and return the enclosed VA Form 21-8940, Veteran\'s

Application for Increased Compensation Based on

Unemployability.

209280 We did not accept your election of Improved Pension ELECT OF
IMPROVED

because you would not be paid more than you now receive. PENSION NOT ADV

Under Improved Pension, you would be entitled to Drop-in: Amount as
entered

receive only monthly. As you already receive

this amount or more, we have not accepted your election. We

will not take any further action on your election unless you tell

us to do so in writing.

Your present monthly rate will continue unchanged unless your

net worth becomes excessive or your income exceeds a certain

limit. This limit increases each year by the same percentage

that Social Security benefits increase. If you have any

unexpected changes in your income or dependency, other than

normal Social Security cost-of-living increases, you must

report such changes to us within the same month they occur.

Prompt notice will allow us to quickly make any required

adjustment to your pension award.

You may elect Improved Pension again at any time in the future

and we will then determine whether it is to your advantage.

209150 We have not received the VA Form 21-674b that we 674B NOT
RETURNED

previously sent you to verify that is Enclosure: VAF 21-674B

attending school. As we have not received it within 60 days Child\'s
name as entered

after the child was scheduled to begin school, we stopped

benefits for the child. If the child did begin school, please

complete and return to us the enclosed VA Form 21-674b as

quickly as possible.

209288 We are very sorry to learn of the veteran\'s death. We realize
INITIAL DEATH NOTICE

that this is a difficult time for the veteran\'s family. We 534/535

wish to help the surviving spouse, children and parents to Enclosure:
VAF 21-534 or

apply for benefits to which they may be entitled. We explain VAF 21-535
as indicated

the benefits in the enclosed application form which you should

complete and return to us.

Unless you file a claim for DEPENDENCY AND INDEMNITY

COMPENSATION within ONE YEAR from the date of death, that

benefit, if awarded, is only payable from the date VA receives your
claim.

Unless you file a claim for PENSION within 45 DAYS from date

of death, that benefit, if awarded, is only payable from the

date VA receives your claim.

Because an earlier effective date for PENSION BENEFITS may not

be to your advantage, you should contact VA, your service

organization or legal representative for advice before you

file a claim for pension.

209290 We are very sorry to learn of the veteran\'s death. We realize
INITIAL DEATH NOTICE

that this is a difficult time for the veteran\'s family. We \--ACCRUED

wish to help the surviving spouse, children and parents to Enclosure:
VAF 21-534 or

apply for benefits to which they may be entitled. We explain VAF 21-535
as indicated

the benefits in the enclosed application form which you

should complete and return to us.

Unless you file a claim for DEPENDENCY AND INDEMNITY

COMPENSATION within ONE YEAR from the date of death, that

benefit, if awarded, is only payable from the date VA receives

your claim.

Unless you file a claim for PENSION within 45 DAYS from date

of death, that benefit, if awarded, is only payable from the

date VA receives your claim

Because an earlier effective date for PENSION BENEFITS may not

be to your advantage, you should contact VA, your service

organization or your legal representative for advice before

you file a claim for pension.

We may pay an accrued benefit based on the veteran\'s award or

pending claim at date of death. To claim any accrued

benefits, complete and return the enclosed form. We must

receive it within ONE YEAR from the date of death.

209160 We received your statement showing that you remarried. PENSION
WIDOW/ER

We suspended payments on your award. Do not sign or REMARRIED Drop-in:
PT I,

cash any checks you have received since your PT II, PT III orPT IV as

remarriage. Please return those checks to the Division of entered

Disbursement, Treasury Department, at the city and state Enclosure: VAF
21-4103

where the checks were issued. That address is shown on the

front of the check.

So that we may adjust your benefits, please complete

of the enclosed VA Form 21-4103 and return it

to this office as quickly as possible.

209294 The following information pertains to benefits which may be
BURIAL BENEFIT

payable because of the recent death of the veteran. NOTICE\--BURIAL

Enclosure: VAF 21-530

An amount not to exceed \$300 may be allowed on the veteran\'s

funeral expenses, including those expenses incurred at place of

burial. An amount not to exceed \$150 may be allowed for expenses

actually incurred as a plot or interment allowance if the veteran is not

buried in a national cemetery or other cemetery under the jurisdiction

of the United States.

If death resulted from a service-connected disability, an

amount not to exceed \$1500 may be allowed.

An additional amount to cover transportation of the body to

place of burial may be allowed if the veteran died while hos-

pitalized as a veterans administration patient, without regard

to place of burial; or is buried in a national cemetery, and

either died as a result of a service-connected condition, or

had a compensable service-connected condition at the time of

death. Each charge for transportation of the body, including

removal from the common carrier, and the cemetery, should be

listed separately in the bill, showing the points between which

transportation was furnished.

A claim must be filed on VA Form 21-530 within 2 years from the

date of the veteran\'s permanent burial or cremation.

209298 The following information pertains to benefits which may be
BURIAL BENEFIT

payable because of the recent death of the veteran. NOTICE\--PLOT

Enclosure: VAF 21-530

An amount not to exceed \$150 may be allowed for expense

actually incurred as a plot or interment allowance if the veteran

is buried without cost for plot or interment in a cemetery,

or section of a cemetery, owned by a state, or any agency or

political subdivision of a state, used only for interment of

persons otherwise eligible for burial in a national cemetery

(payment is made directly to the state, state agency, or

political subdivision, such as a county or city); or

has no next of kin or other person claiming the body and

there are not sufficient available resources in the veteran\'s

estate to cover burial and funeral expenses.

A claim must be filed on VA form 21-530 within 2 years from the

date of the veteran\'s permanent burial or cremation.

209300 This concerns benefits which VA may pay because of the Enclosure:
VAF 21-601

veteran\'s recent death.

There are accrued amounts that were due and unpaid to the

deceased veteran prior to his/her death. We may pay these

amounts to the person who paid the expense of the last illness

and burial. A claim must be filed on VA Form 21-601, copy

enclosed, within ONE YEAR from the date of death.

209302 This concerns benefits which VA may pay because of the BURIAL
BENEFIT

veteran\'s recent death. NOTICE - 6898

Enclosure: VAF 21-6898

There are benefits deposited by VA into the personal account

of the veteran. We may pay these benefits to the person who

paid the expenses of the last illness and burial. We must

receive a claim for these benefits on VA Form 21-6898, copy

enclosed, within FIVE YEARS from the date of the veteran\'s death.

209175 We suspended payment of death pension because we PENSION WIDOW/ER

receivedinformation that the veteran\'s surviving spouse DECEASED

died. The child or children of the veteran may be entitled

to death pension. The enclosed VA Form 21-8919-1 may be

used to file a claim for them.

If a claim is filed for a child, and proof of death of the

surviving spouse was not submitted to VA, please send us a

copy of the public record of the surviving spouse\'s death.

This record must be certified by the custodian of the records.

You must return VA checks received after the payee\'s death

to the Division of Disbursement, Treasury Department, at the city

and state where the checks were issued. That address is shown

on the front of the check.

209200 We suspended your Dependency and Indemnity DIC WIDOW/ER

Compensation benefit because you remarried. However, the REMARRIED

child or children of the veteran may be entitled to benefits. Enclosure:
VAF 21-4183

You may use the enclosed application to file a claim for them.

You must return VA checks received after remarriage to the

Division of Disbursement, Treasury Department, at the city and

state where the checks were issued. That address is shown on

the front of the checks.

209115 Your appeal is being placed on the docket of the Board of
APPEAL\--ORIGINAL

Veterans Appeals for disposition. This means that your

records are being transferred to the Board in Washington D.C.

Appeals are considered by the Board as promptly as possible,

in docket order. Once the appeal has reached the Board of

Veterans Appeals, it takes several months to review it.

The time it takes to complete this appellate review process

will vary depending upon the current backlog at the Board.

If you have requested to appear personally at a hearing

before the Board of Veterans Appeals, you will receive further

information by separate letter.

As soon as a decision is made, the Board will notify you.

209120 We have completed our action on your remanded appeal and APPEAL:
REMAND

are returning the appeal to the Board of Veterans Appeals in

Washington, D.C. If you have requested a personal hearing

before the Board of Veterans Appeals, you will receive more

information by a separate letter from the Board. The Board

will notify you directly when they have made a decision.

209210 We stopped Dependency and Indemnity Compensation DIC WIDOW/ER

benefits because we learned that the veteran\'s surviving DECEASED

spouse died. Enclosure: VAF 21-4183

The child or children of the veteran may be entitled to

benefits. The enclosed application may be used to file a

claim for them.

If you file a claim and proof of death of the surviving spouse

has not been submitted to VA, please send us a copy of the

public record of the surviving spouse\'s death. This record

must be certified by the custodian of the records. Please

return VA checks received after the payee\'s death to the

Division of Disbursement, Treasury Department, at the city and

state where the checks were issued. That address is shown on

the front of the check.

**SUBCHAPTER IV. DISALLOWANCE LETTERS**

**23.09 GENERAL**

The BDC produces disallowance letters for all Compensation and Pension
disallowances authorized, provided the operator did not request
suppression of the letter. The letter is generated and printed during
batch processing after the close of the on-line day.

**23.10 LETTER SELECTION**

a\. The determination that a disallowance letter is to be generated is
made during the on-line processing as described in subchapter 1.
Selection of paragraphs for printing is determined during the end-of-day
batch processing.

b\. The selection of the disallowance reason paragraph is directly
related to the disallowance reason code selected on the 405 Screen.
Additionally, paragraph selection is also related to the benefit type
(CPL or CPD) and payee number. Some disallowance reason codes will not
result in a generated disallowance letter.

DISALLOWANCE CODE EXPLANATION

04 Claimant is required to forfeit entitlement to VA benefits.

16 Claimant has not responded to VA request for additional evidence.

19 Claimant is presently on active duty or receiving military retirement
pay.

21 Claimant cannot be located.

22 Claimant deceased.

29 Other reasons not listed.

30 Claimant elected a different benefit.

c\. There is no \"bridge\" between disallowance letters and development
letters even though the development screen and 405 Screen may be
completed on the same day. If the 405 is completed and GAP\'d along with
a development screen, the system will issue two letters.

d\. Generated disallowance letters will not be issued unless the 290
Screen is completed. The data entered on the 290 Screen will be printed
at the end of the paragraphs printed from 405 Screen entries.

**DISALLOWANCE LETTERS**

PARA RSN PARAGRAPH CONTENT SELECTION CRITERIA

NO. CODE

100 N/A We cannot grant your claim for All letters. Drop-in determined

by benefit. CPL = disability

benefits. CPD = Death benefits.

501 01 The evidence fails to show performance of any Benefit Type CPL

active military, naval, or air service as defined by law.

601 01 The evidence fails to show that the person on Benefit Type CPD

whom this claim is based had any active military,

naval or air service as defined by law.

502 02 Disability pension is payable only to veterans Payee 00, Benefit
Type CPL

of wartime service. Your service records show Drop-in 1: EOD

active service from to , which is not Drop-in 2: RAD

during a wartime period.

525 02 Disability pension is payable only to veterans of Payee 00,
Benefit Type CPL

wartime service. Your service records show active Drop-in 1: First EOD

service from to and from to , Drop-in 2: First RAD

which are not during a wartime period. Drop-in 3: Second EOD

Drop-in 4: Second RAD

602 02 Death pension is payable only if the veteran had Payee other than
00, Benefit

wartime service. The service records show active Type CPD

service from to which is not during a Drop-in 1: EOD

wartime period. Drop-in 2: RAD

625 02 Death pension is payable only if the veteran had Drop-in 1: First
EOD

wartime service. The service records show active Drop-in 2: First RAD

service from to and from to Drop-in 3: Second EOD

which are not during a wartime period. Drop-in 4: Second RAD.

503 02 Disability pension is payable only when the Payee 00, Benefit
Type CPL

veteran has served at least 90 days, part of which This paragraph is
generated

was during a wartime period;or was discharged for by entry of the second
02

a disability incurred in or aggravated by service. field

Basic eligibility is not shown by the evidence.

603 02 Death pension is payable only when the veteran Payee not 00,
Benefit Type

served at least 90 days, part of which was during a CPD This paragraph
is

wartime period; or was discharged for a disability generated by entry of
the

incurred or aggravated by service; or at the time of second 02 field

death was entitled to compensation or retirement

pay from the military for a service-connected

disability based on wartime service. Basic eligibility

is not shown by the evidence.

504 03 We have determined that your discharge from Benefit Type CPL

military serviceon was issued under Drop-in: Discharge Date

conditions which bar the payment of VA benefits. Enclosure: DD Form 293
and DD Form 149

For that reason, the period of service upon which that

discharge was based does not qualify you for the benefit you

applied for, or for any other non-contractual benefit under

laws administered by the VA. This decision also has the effect

of precluding entitlement to non-contractual VA benefits for

your dependents and survivors.

If you believe our decision is not correct, please see the

notice of procedural and appeal rights on the reverse side of

this letter.

You also have the right to file a request for revision of the

character of your discharge with the service department dis-

charge review board or to apply for correction of your military

records by the service department board for correction of mili-

tary records. To apply for revision of the character of dis-

charge or correction of service records, complete the enclosed

DD Form 293 or DD Form 149 as appropriate and send the form to

the board for the branch of service concerned at the address

shown on the form.

540 03 We have determined that your discharge from Benefit Type CPL

military service on was issued under Generated by entry of

conditions which bar the payment of VA benefits. Reason 03 PLUS
\'Entitled to For that reason, the period of service upon which SC
Treatment\'

that discharge was based does not qualify you for Enclosure: DD Form 149

other non-contractual benefit under laws and DD Form 293

administered by the VA, with the possible Drop-in: Discharge Date

exception of medical treatment for any disability or

disabilities you incurred or aggravated during active service.

If the need for medical treatment arises for such a service-

related condition, you should apply to your nearest VA health

care facility.

This decision also has the effect of precluding entitlement to

non-contractual VA benefits for your dependents and survivors.

If you believe our decision concerning your discharge from

military service is not correct, please see the notice of

procedural and appeal rights on the reverse side of this letter.

You also have the right to file a request for revision of the

character of your discharge with the service department dis-

charge review board or to apply for correction of your military

records by the service department board for correction of mili-

tary records. To apply for revision of the character of dis-

charge or correction of service records, complete the enclosed

DD Form 293 or DD Form 149 as appropriate and send the form to

the board for the branch of service concerned at the address shown on
the form.

541 03 We have determined that your discharge from Benefit Type CPL

military service on was issued under Generated by entry of

conditions which bar the payment of VA benefits. Reason 03 PLUS
\'Entitled to SC Treatment\' and 301 Screen For that reason, the period
of service upon which with at least one condition

that discharge was based does not qualify you for shown as Code 01.

the benefit you applied for, or for any other non- Drop-in 1: Discharge
Date

contractual benefit under laws administered by the Drop-in 2: All
disabilities

VA, with the exception of medical treatment for any listed on 301 Screen

disability or disabilities you incurred or aggravated with Code 01

during active service. Service connection has been

established for the following conditions:

542 If the need for medical treatment arises for such a Enclosure: DD
Form 293 service-related condition, you should apply to your and DD Form
149

nearest VA health care facility.

This decision also has the effect of precluding entitlement to

non-contractual VA benefits for your dependents and survivors.

If you believe our decision concerning your discharge from

military service is not correct, please see the notice of

procedural and appeal rights on the reverse side of this

letter.

You also have the right to file a request for revision of the

character of your discharge with the service department dis-

charge review board or to apply for correction of your military

records by the service department board for correction of mili-

tary records. To apply for revision of the character of dis-

charge or correction of service records, complete the enclosed

DD Form 293 or DD Form 149 as appropriate and send the form to

the board for the branch of service concerned at the address

shown on the form.

604 03 We have determined that the former service Benefit Type CPD;

person\'s discharge from military service on PAYEE not 00

was issued under conditions Drop-in: Discharge Date

which bar the payment of VA benefits. Enclosure: DD Form 293

and DD Form 149

For that reason, the period of service upon which that

discharge was based does not qualify you for the benefit

you applied for, or for any other non-contractual benefit

under laws administered by the VA.

If you believe our decision is not correct, please see the

notice of procedural and appeal rights on the reverse side of

this letter.

You also have the right to file a request for revision of the

character of the veteran\'s discharge with the service depart-

ment discharge review board or to apply for correction of the

former service person\'s military records by the service depart-

ment board for correction of military records. To apply for

revision of the character of discharge or correction of service

records, complete the enclosed DD Form 293 or DD Form 149 as

appropriate and send the form to the board for the branch of

service concerned at the address shown on the form.

506 05 The disability listed below is service-connected Benefit Type
CPL, PAYEE 00

but is less than 10% disabling and compensation is with only one
condition

not payable. shown as Code 01, 12 or 37

on 301 Screen

INSERT: Disabilities on 301

Screen with Code 01, 12 or 37

536 05 The disabilities listed below are service-connected Alternative
for 506 - used

but they are less than 10% disabling and compen- when more than one

sation is not payable. condition with Code 01, 12

or 37 is entered on 301

Screen

556 N/A There is entitlement to necessary treatment by the Printed
immediately

VA for any service-connected disability. following paragraph 506 or

Application for necessary treatment should be 536

made at the nearest VA office, ourpatient clinic

or hospital. Bring this letter if applying in person.

If applying by letter, please include the VA file number shown above.

507 06 The evidence does not establish service connection Benefit Type
CPL

for the following: INSERT: All disabilities

with Rating Code 08 entered

on 301 or 303 Screen

607 06 The evidence does not establish that the veteran\'s Benefit Type
CPD

death was due to a service-connected disability.

509 07 Your service records show treatment for your Benefit type CPL,
PAYEE 00

claimed condition(s), but no evidence of residual (No Rating entered)

disability was found during your last examination.

In order to reopen your claim, you must submit medical

evidence that shows continuity of treatment since

discharge from service and a current residual disability.

511 08 Service connection is not granted for your claimed Benefit Type
CPL, PAYEE 00

condition(s) because it is not shown by the Reason Code 08 - No Rating

evidence of record. We can take no further action

on your claim unless you submit evidence to show

the condition(s) was incurred in or aggravated by

military service and that it presently exists.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

512 08 Although there was a positive tuberculin reaction, Benefit Type
CPD, PAYEE 00

careful examination has disclosed no evidence of a Reason Code 08 - TB

disease associated with it. A positive tuberculin

reaction without evidence of any associated disease

is not considered to be a disability under the law.

513 09 The following conditions were incurred under Benefit Type CPL,
PAYEE 00

circumstances which prohibit payment of benefits. INSERT: All conditions

shown on the 303 Screen

with Code 14

553 09 Your disability was incurred under circumstances Benefit Type
CPL, PAYEE 00

which prohibit payment of benefits. Only one disability entered

with Code 14

613 09 The veteran\'s death resulted from circumstances Benefit Type
CPD, PAYEE

which prohibit the payment of death benefits. Not 00

514 10 The law requires that you must be both Benefit Type CPL, PAYEE 00

permanently and totally disabled to be entitled to Reason Code 10
(first)

disability pension. Your condition is totally

disabling now, but not established as permanent.

The medical evidence of record indicates that your

condition will improve and you will not be permanently

and totally disabled.

515 10 The evidence does not establish that your Benefit Type CPL, PAYEE
00

disabilities are severe enough to prevent sub- Reason Code 10 (second)

stantially gainful employment. If your disabilities Enclosure: VAF
21-527

increase in severity so that they prevent

your engaging in substantially gainful employment,

send in medical evidence and a completed VA

Form 21-527 at that time.

Please be certain to enter your name and VA file number

shown above on all evidence or forms submitted.

516 11 The maximum annual rate of income for a Benefit Type CPL, PAYEE
00 veteran with to receive disability Drop-in 1: A child, children,

pension is . Your income is at a spouse, a spouse and

rate of per year after considerationof any a child or a spouse and

medical expenses, educational or vocational children as determined by

rehabilitation expenses, or last illness and burial entries

expenses you reported. For that reason, we cannot

pay you pension. You should complete and return

the enclosed VA Form 21- if your family income decreases.

If we receive evidence before the end of next year Drop-in 2: MAPR as
entered

that your income did not exceed the limit, you may Drop-in 3: IVAP as
entered

receive retroactive benefits from the earliest date Drop-in 4: 0517-1

entitlement is shown.

517 11 The maximum annual rate of income for a veteran Benefit Type CPL,
PAYEE 00

without dependents to receive disability pension without spouse or
child(ren)

is . Your income is at a rate of Drop-in 1: MAPR as entered

per year after consideration of any medical Drop-in 2: IVAP as entered

expenses, educational or vocational rehabil- Drop-in 3: 0515-1

itation expenses, or last illness and burial expenses

you reported. For that reason, we cannot pay you

pension. You should complete and return the

enclosed VA Form 21- if your income decreases.

If we receive evidence before the end of next year that your

income did not exceed the limit, you may receive retroactive

benefits from the earliest date entitlement is shown.

616 11 The maximum annual rate of income for a widow Benefit Type CPD,
PAYEE 10

with to receive death pension is Drop-in 1: a child or children,

. Your income is at a rate of as applicable

per year after consideration of any Drop-in 2: MAPR as entered

medical expenses, educational and vocational Drop-in 3: IVAP as entered

rehabilitation expenses, or last illness and burial Drop-in 4: 0519-1

expenses you reported. For that reason, we

cannot pay you pension. You should complete

and return the enclosed VA Form 21- if your

family income decreases. If we receive evidence

before the end of next year that your income did not

exceed the limit, you may receive retroactive

benefits from the earliest date entitlement is shown.

617 11 The maximum annual rate of income for a widow Benefit Type CPD,
PAYEE 10,

without dependents to receive death pension is no dependents

. Your income is at a rate of per Drop-in 1: MAPR as entered

year after consideration of any medical expenses, Drop-in 2: IVAP as
entered

educational or vocational rehabilitation expenses, Drop-in 3: 0519-1

or last illness and burial expenses you reported.

For that reason, we cannot pay you pension. You

should complete and return the enclosed VA

Form 21- if your income decreases. If we receive

evidence before the end of next year that your

income did not exceed the limit, you may receive retroactive

benefits from the earliest date entitlement is shown.

618 11 Your income exceeds the maximum annual income Benefit Type CPD,
PAYEE 50,

limit for the parent(s) of a veteran to receive 60 Drop-in: 0514-1

dependency and indemnity compensation (DIC).

For that reason, we cannot pay you DIC. Annual

income limits vary depending on your status; sole

surviving parent, two parents living together, etc.

You may contact the nearest VA regional office at the

toll-free number listed in the \"government\" section

of the telephone directory for information about the

income limit which applies to you. Complete and return

the enclosed VA Form 21- if your income should

fall below your annual income limit. If we receive evidence

before the end of next year that your income did not

exceed the limit, you may receive retroactive benefits from

the earliest date entitlement is shown.

620 11 The maximum annual rate of income for a child to Benefit Type
CPD, PAYEE

receive death pension is . Your income 11-19

is at a rate of per year without custodian or Drop-in 1: MAPR as entered

guardian after consideration of any medical Drop-in 2: IVAP as entered

expenses, educational or vocational rehabilitation Drop-in 3: 0519-1

expenses, or last illness and burial expenses you

reported. For that reason, we cannot pay you

pension. You should complete and return the enclosed

VA Form 21- if your income decreases.

If we receive evidence before the end of next year that your

income did not exceed the limit, you may receive retroactive

benefits from the earliest date entitlement is shown.

626 11 The maximum annual rate of income for a Benefit Type CPD, PAYEE

child with a custodian/guardian to receive death 11-19

pension is . The child\'s income with Drop-in 1: MAPR as entered

custodian or guardian including the custodian/ Drop-in 2: IVAP as
entered

guardian\'s income is at a rate of per year Drop-in 3: 0519-1

after consideration of any medical expenses,

educational or vocational rehabilitation expenses, or last

illness and burial expenses you reported. For that reason, we

cannot pay you pension. You should complete and return the

enclosed VA Form 21- if your income decreases.

If we receive evidence before the end of next year that the

combined income did not exceed the limit, you may receive

retroactive benefits from the earliest date entitlement is shown.

627 11 The maximum annual rate of income for Benefit Type CPD, PAYEE

child(ren) to receive death pension is . 31-39

The child(ren)\'s income is at a rate without Drop-in 1: MAPR as entered

custodian/guardianof per year after Drop-in 2: IVAP as entered

consideration of any medical expenses, Drop-in 3: 0519-1

educational or vocational rehabilitation expenses, or last

illness and burial expenses you reported. For that reason, we

cannot pay you pension. You should complete and return the

enclosed VA Form 21- if your income decreases.

If we receive evidence before the end of next year that the

child(ren)\'s income did not exceed the limit, you may receive

retroactive benefits from the earliest date entitlement is

shown.

628 11 The maximum annual rate of income for Benefit Type CPD, PAYEE

child(ren) with a custodian/guardian to receive 31-39

death pension is . The child(ren)\'s income, with custodian/guardian

including the custodian/guardian\'s income, Drop-in 1: MAPR as entered

is at a rate of per year after Drop-in 2: IVAP as entered

consideration of any medical expenses, Drop-in 3: 0519-1

educational or vocational rehabilitation expenses,

or last illness and burial expenses you reported. For

that reason, we cannot pay you pension. You should complete

and return the enclosed VA Form 21- if the child(ren)\'s

income decreases.

If we receive evidence before the end of next year that the

child(ren)\'s income did not exceed the limit, you may receive

retroactive benefits from the earliest date entitlement is shown.

560 11 We have also considered but cannot grant your Entry of \"D\" in
PAYEE

claim for special monthly pension. Special A&A, HSB

660 monthly pension is payable to a pension or both for payee 00 or 10

beneficiary who is in need of Aid and Attendance

or is Housebound.

561 11 In order to meet the requirements for the Aid and Payee 00 or 10
with entry of

Attendance benefit, the law requires a claimant \"D\" in PAYEE A&A

661 must be: Prints following paragraph

1\. So disabled that the person requires the regular 560 or 660 as
appropriate

attendance of another person to assist in eating, bathing, dressing and
undressing or taking care of the needs of

nature; or

2\. Blind or nearly blind as to have corrected visual acuity

of 5/200 or less in both eyes; or

3\. A patient in a nursing home because of mental or

physical incapacity.

562 11 To be eligible for the housebound benefit, the law Payee 00 or 10
with entry of

requires a claimant have one permanent disability \"D\" in PAYEE HSB

662 rated 100% disabling with an additional disability Prints after
paragraph 560/660

or disabilities ratable at 60% or more or, because when only HSB is
entered;

of permanent disability, be essentially confined to when both A&A and
HSB

the home. are entered, it follows

paragraph 561/661

563 11 The evidence shows your disabilities are severely Payee 00 or 10
with entry of

disabling and limit your activities, but they are not \"D\" in PAYEE
A&A,

663 sufficiently disabling to meet the requirements of PAYEE HB or both

the law, nor are you a patient in a nursing home. Prints after paragraph

If in the future, you feel you meet the requirements 561/661 when only
A&A

of the law for additional benefits, you may reopen is entered; when HSB
or

your claim. both is entered, prints

following paragraph 562/662

519 12 \"Corpus of estate\" and \"net worth\" mean the Benefit Type CPL,
PAYEE 00

market value, less mortgages and debts, of all real Benefit Type CPD,
PAYEE

619 and personal property owned by the claimant Not 00

except the claimant\'s residence, if the claimant Enclosures: VAF
21-8049

resides or will reside in this dwelling, and the and the appropriate EVR
form

personal effects suitable to an consistent with

the claimant\'s reasonable mode of living.

In determining whether some part of your estate should be

used for your maintenance, consideration is given to the

amount and type of asset together with the following factors:

whether the property can be readily converted to cash at no

substantial sacrifice; ability to dispose of property as

limited by community property laws; life expectancy; number

of dependents recognized for VA purposes; potential rate of

depletion, including unusual medical expenses for you and

your dependents; and family monthly income and expenses.

In evaluating the net worth, income and expense information

received from you, we have determined your net worth is of

such size that it is reasonable to expect that part of it

should be used for living expenses. Should circumstances

change, complete and return the enclosed VA Forms 21-8049 and

EVR VA Form 21- .

620 14 The evidence does not show that you stood in the Benefit Type
CPD, PAYEE

relationship of a parent to the veteran for the 50-60

one-year period prior to entry into service.

651 14 The evidence does not show that your marriage to Benefit Type
CPD, PAYEE 10

the veteran meets the requirements of law for basic

eligibility.

622 14 You did not live with the veteran continuously Benefit Type CPD,
PAYEE 10

until the veteran\'s death, and the evidence does not

show you were without fault in the separation.

623 15 The evidence does not establish your status as the Benefit Type
CPD, PAYEE 10

unremarried spouse of the veteran within the

meaning of the law.

624 15 To be eligible for benefits, a child must not be Benefit Type
CPD, PAYEE

married. The evidence shows that you are married. 11-19 or 31-39

526 17 Claimants must undergo an examination when Benefit Type CPL,
PAYEE 00,

requested, and you failed to report for a scheduled 10, 11-19 or 31-39

examination. No further action will be taken unless

we receive notification of willingness to report for

examination. If you do so, an examination will be

re-scheduled and the claim will be reconsidered when

the examination is completed.

528 20 We have discontinued action on your claim Benefit Type CPL or
CPD,

as requested. The claim can be reopened at PAYEE

any time. If reopened within one year of the 00, 10, 11-19, 31-39 or
50-60

date of this letter and entitlement is shown,

benefits will be based on this claim.

631 24 A child to be eligible for benefits, must be either Benefit Type
CPD, PAYEE

under 18 years of age, or under age 23 if attending 11-19

school, or must have become permanently incapable

of self support prior to attainment of age 18. The

evidence does not show that any of these conditions are met.

532 28 Due to imprisonment for more than 60 days, Benefit Type CPL,
PAYEE

payments of non-service-connected pension 00, 10, 11-19 or 31-39

cannot be made. Benefits may be paid effective

the day of release from prison, if the Veterans

Administration is notified within one year of that

date. If notice is not received within one year, the

earliest date of payment of benefits will be the date

a claim is received by the Veterans Administration.

Separate notification will be sent relative to benefits

payable to dependents, if any, during the period

of imprisonment.

**SUBCHAPTER V. COMPENSATION AND PENSION AWARD LETTERS**

**23.11 GENERAL**

The Benefits Delivery Center (BDC) produces award letters for all
compensation and pension awards authorized, provided the operator did
not request suppression of the letter. The generated award letters can
be categorized into four types, based on the benefit to be paid.

a\. Service-connected disability awards

b\. Nonservice-connected disability awards

c\. Service-connected death awards

d\. Nonservice-connected death awards

**23.12 LETTER AND PARAGRAPH SELECTION**

a\. The basic category of letter to be generated is determined during
0n-line processing, as described in subchapter I. The selection of
individual paragraphs to be printed is determined during end-of-day
batch processing, based on the category of letter and the information
stored in the PIF. Some of the factors considered in the selection of
paragraphs are:

\(1\) Entitlement code

\(2\) Payee number

\(3\) Reason code

\(4\) Dependency code

\(5\) Rating data

\(6\) Transaction code

b\. Within each category the paragraphs are identified and generated in
a specific order. Each paragraph has an alternate for use in the event
payment is to be made to a fiduciary. There are specific paragraphs for
each type of fiduciary.

c\. The following section of this chapter gives the specific paragraphs,
their alternate forms, the selection criteria for each paragraph and any
drop-in or enclosure data. The first three positions of the paragraph
number identify the type of letter. Paragraphs beginning with 350 appear
in original award letters to the claimant; those beginning with 351
appear in original award letters to a fiduciary; those beginning with
450 appear in supplemental award letters to the claimant; and those
beginning with 451 appear in supplemental award letters to a fiduciary.
The next three positions of the paragraph number indicate the actual
paragraph number.

d\. An enclosure providing general information pertaining to the
specific benefit payment is released with each award letter. For
example, a letter to a veteran concerning his or her compensation claim
will include a form providing information on compensation entitlement
and responsibilities.

PARAGRAPH PARAGRAPH CONTENT SELECTION CRITERIA

NUMBER

350001 We approved your claim for as Standard opening paragraph

follows: for transaction code 11

Drop-in is:

DISABILITY

COMPENSATION\--Payee

00, entitlement code X1

DISABILITY PENSION\--

Payee 00, entitlement codes

X4 and XL

DEATH PENSION - Payee

10, 11-19, 31-39, entitlement

codes X8 and XD

351001 We approved an award for disability compensation as Payee 00;
entitlement code

follows: X1; Standard opening

paragraph for transaction

code 11

450001 Your award has been amended as Standard opening paragraph

follows: for transaction code 13

Drop-in is:

DISABILITY

COMPENSATION\--Payee 00,

entitlement code X1

DISABILITY PENSION\-- Payee 00, entitlement codes

X4 and XL

DEATH PENSION\--Payee

10, 11-19, 31-39 with

entitlement codes X8 and XD

451001 An award for disability compensation has been amended Payee 00;
entitlement code X1

to provide for payment as follows:

Standard opening paragraph

for transaction 13

350002 We approved your claim for Dependency and Indemnity Payee 10, 50,
60, 11-19 or

Compensation as follows: 31-39; entitlement code X7

Standard opening paragraph

for transaction 11

351002 We approved an award for as follows: Standard opening paragraph

for transaction code 11 with

fiduciary Drop-in is:

DISABILITY PENSION\-- Payee 00, entitlement codes X4 and XL

DEATH PENSION\--Payee 10,

11-19, 31-39, entitlement

codes X8 and XD.

450002 Your Dependency and Indemnity Compensation award Payee 10, 50,
60, 11-19 or

has been amended as follows: 31-39; entitlement code X7

Standard opening paragraph

for transaction 11

451002 An award for has been amended to provide for Standard opening
paragraph

payment as follows: for transaction code 13

Drop-in is: DEATH

PENSION\--Payee 10, 11-19,

31-39; entitlement X8 and XD.

DISABILITY PENSION\--

Payee 00, entitlement codes

X4 and XL.

351003 We approved an award for Dependency and Indemnity Standard
opening paragraph

Compensation as follows: for transaction 11 with

Payee 10, 50, 60, 11-19 or

31-39 and entitlement code X7

451003 An award for Dependency and Indemnity Compensation Opening
paragraph for

has been amended to provide for payment as follows: transaction code 13
with

Payee 10, 50, 60, 11-19 or

31-39 and entitlement code X7

450004 Your election of improved pension is effective Generated when the
election

based on countable annual of , your indicator is entered on the award
has been amended as follows: 306 Screen

Drop-ins:

1\. Effective date of earliest

award line with entitlement

code XL or XD

2\. If dependency code is 00

or 10\--Income; for other

depend ency codes - Family

Income

3\. Income amount from

earliest award line with

entitlement code XL or XD

451004 The election of improved pension on behalf of the Generated when
the election

is effective based on countable annual indicator is entered on the of ,
the award has been amended as follows. 306 Screen

Drop-ins are:

1\. Veteran, veteran\'s spouse

veteran\'s child or veteran\'s

children as applicable

2\. Same as #1 above

3\. Same as #2 above

4\. Same as #3 above

450006 This adjustment results in an overpayment of benefits Generated
whenever the

which have been paid to you. You will be notified shortly of indicator
OVERPAYMENT

451006 exact amount of the overpayment and given information PARAGRAPH
is selected

about repayment. on the 501 Screen

350007 We computed your countable income considering your Generated
whenever

report of expenses paid as follows: expenses are entered on the

450007 306 Screen

351007 In computing the countable income, we considered Generated by
entry of

451007 your report of expenses paid as follows: expenses on the 306
Screen

Drop-ins:

Payee 00\--veteran\'s

Payee 10\--spouse\'s

Payee 50 or 60\--parent\'s

Payee 11-19\--child\'s

Payee 30-39\--children\'s

450008 This adjustment is based on our review of the eligibility Follows
opening paragraph

451008 verification report which you submitted. Transaction 13Q for
Parents\'

DIC and Improved Pension

cases

350009 **:** Earned **;** Social Security **;** Generates for
individuals

351009 Retirement **;** Interest **;** shown on 306 Screen

450009 Insurance **;** And other income **.**

451009 Drop-in 1:

Payee 00\--Self, Spouse

Payee 10\--Self

Payee 11-19, 31-39\--Guardian

Payee 50, 60\--Parent

Drop-in 2:

Amount of income by

category. If none is shown,

zeroes are printed.

Preceding retirement the

type is printed, e.g., Civil

Service, Railroad. If more

than one type was entered,

\"other\" is printed.

350010 Effective Date Annual Rate Countable Annual Maximum Annual
Entitlement code XL or XD and

351010 Income Rate monthly rate of more than \$00.00 but less than
\$19.00

450010

451010

350011 Monthly Rate Effective Date Entitlement code other than

XL or XD

351011

450011

451011

350012 We will notify you of additional scheduled changes in your
Generated for all payees, all

450012 award beyond the period shown above. benefits

351012 We will notify you of additional scheduled changes in this The
paragraph is automatically

451012 award beyond the period shown above. generated if a \"D\" future
is

present as a reason code for

the last line. In all cases,

after the current award line is

determined, the \"current

year\" is taken and three

years are added to it. The

program then counts the

total number of award lines

which come after the current

award line.

a\. If the number of award

lines following the

current line is three or less,

all of the award lines are

displayed on the award

letter.

b\. If there are more than 3

award lines after the current

award line, and if an award

line is found which is

greater than the current

award line plus three years,

and if it is the last award

line, all award lines are

shown on the award letter.

If, however, that award line

is not the last award line, it

and all subsequent award

lines are suppressed.

**NOTE:** If a \"D\" future is

used in the award, this same

logic is utilized to determine

if any of the award lines are

to be suppressed for the

letter.

350013 We granted service connection for: Generated when the

ORIGINAL indicator is

351013 entered on 301 Screen or

450013 when letter code A is

451013 entered. Prints only

conditions shown with

rating code of 01, 12 or 37.

The diagnostic legend for

each SC condition is printed

followed by the appropriate

bilateral indicator.

[301 BIL entry]{.underline} [Prints]{.underline}

L Left

LU Left Upper

LL Left Lower

R Right

RU Right Upper

RL Right Lower

B Both

BL Both Lower

In Improved Pension cases,

prints when at least one

diagnostic on the 301 Screen

has rating code 01, 12 or 37

and the combined evaluation

is at least 10 percent.

350014 You are entitled to receive either nonservice-connected Payee 00,
entitlement code X2,

disability pension or service-connected disability X4 or XL When an
award

compensation. We have awarded you pension because it of pension is made,
the

is the greater benefit. However, if you want to receive program
determines if

compensation instead of pension, let us know. the current service-

The law does not permit us to pay you both benefits connected combined

at the same time. evaluation is 10 percent or

greater. If so, the paragraph is generated.

351014 The veteran is entitled to receive either nonservice-connected

disability pension or service-connected disability

compensation. We awarded pension because it is the greater

benefit. However, if compensation is preferred instead of

pension, let us know. The law does not permit us to pay both

benefits at the same time.

450014 Based on our review of your eligibility verification report EVR
and NO CHG entered 451014 and our determination that your net countable
income is on the 306 Screen for Old

, your award of pension is being continued. Law or Section 306 payee

Drop-in: IVAP

350015 The veteran\'s death was not related to a service-connected
Entitlement code XD

disease or injury. Generated for all death

awards with a transaction

351015 We decided that the veteran\'s death was not related to a code of
11B

service-connected disease or injury.

350016 We will tell you later about your claim for service-connected
Generated whenever the

450016 death benefits. indicator SC DEATH

PENDING is selected on

351016 We will tell you later about the claim for service-connected the
501 Screen

451016 death benefits.

350017 **:** Earned **;** Social Security **;** and Generated for each
child whose

351017 other income **.** income is entered on the 336

450017 screen. The first fill-in is

451017 the name of the child. For

the income category fill-ins,

the amount of income

entered or zeros is printed as

applicable.

350018 **:** Medical **;** Last illness and burial **;** Generated to
detail the

351018 Education **;** Disability Social Security expense data discussed
in

450018 **;** and Disability Retirement **.** paragraph 007 or 008. The

451018 individual whose expenses

were considered is identified

as either self, spouse,

veteran or parent. The

expense included in the

income computation is then

filled in for the applicable

type specified. The type of

any disability retirement is

identified as either Civil

Service, railroad, military or

other based on the type

entered on the income screen.

350020 We based this award on countable annual income Generated for
Improved

of from . To determine your Pension awards whenever

450020 countable income, we included the following sources of income
data are entered on

income you reported: the 306/336 Screens, as

applicable, provided no more

351020 We based this award on countable annual income of than four 306
Screens were

451020 from . To determine the countable income, we entered. The
fill-ins for

included the following sources of income you reported: countable income
and

effective date are taken from

the income screen data.

350021 We consider a decrease or ending of recurring medical Generated
for Death Comp,

351021 expenses a change in income. You must report to VA Pension and
Death pension immediately any change in those expected recurring cases
with medical expenses 450021 expenses. Your failure to promptly notify
us can result in entered on the 306 or 336

451021 an overpayment which you may have to repay. Screen. Follows
paragraph

018 or 019, as applicable.

350022 Although the veteran\'s death was not service connected, we Payee
10, entitlement code X7

have awarded your benefit as if it were. You will receive Generated when
special law

Dependency and Indemnity Compensation under 38 U.S.C. code 19 is present

1318(b) because of the long period of time the veteran was

permanentlyand totally disabled due to service-connected causes.

351022 Although the veteran\'s death was not service connected, we have

awarded benefits as if it were. The beneficiary will receive

Dependency and Indemnity Compensation under 38 U.S.C. 1318(b)

because of the long period of time the veteran was permanently

and totally disabled due to service-connected causes.

350023 COMBINED XXXX Payee 00

We do not determine your combined evaluation by adding If two or more
evaluations in the percentages of your disabilities as shown. We
determine any combination of rating

it by using a combined rating table in the regulations. codes 01, 12 or
37 are

present, this paragraph is

generated.

351023 COMBINED XXXX Also generated for improved

We do not determine the combined evaluation by adding pension awards
when there are

the percentages of each disability as shown. We determine two or more
diagnostics with a

it by using a combined rating table in the regulations. rating code of
01, 12 or 37 and

the combined evaluation is

at least 10 percent.

450024 The combined evaluation for all service-connected Generated when
the 301

451024 disabilities is %. Screen contains conditions

with rating code 01, 12 or

37 AND paragraph

450013/451013,

450132/451132 or

450133/451133 is printed.

350025 From , we based your award on countable Generated for an Improved

450025 annual income of . We determined your countable Pension award
whenever

income by including the following sources of income: income screen is
completed

for a second period of

income. The fill-ins are the

351025 From , we based the award on countable same as for paragraph 020.

451025 annual income of . We determined the

countable income by including the following sources of income:

350030 Effective Date Monthly Rate Countable Annual Maximum Annual
Entitlement code XL or XD

351030 Income Rate and monthly rate more than

\$18.99

450030

451030

350032 We considered your reported family expenses of to Entitlement
code XL or XD

450032 determine the amount of your child\'s or children\'s income to
Generated when hardship

include as countable pension income. expenses are entered on the 336
Screen

351032 We considered reported family expenses of to Drop-in: Amount
entered in

determine the amount of the child\'s or children\'s income to HARDSHIP
EXPENSES

include as countable pension income. field of the 336 Screen

350034 VA pays a pension which is the difference between your
Entitlement code XL or XD

450034 countable annual income and a maximum annual rate. We Generated
whenever 010 is

computed your annual rate shown above, by subtracting printed and
payment is on

your countable annual income from your maximum annual an annual basis.
Prints

rate. immediately after paragraph 011

351034 VA pays a pension which is the difference between countable

451034 annual income and a maximum annual rate. We computed the

annual rate shown above, by subtracting countable annual

income from the maximum annual rate.

350035 VA pays a pension to make up the difference between your
Entitlement code XL or XD

450035 countable annual income and a maximum annual rate. You Generated
for all awards other

can determine your monthly payment rate as follows: than those paid
annually. Prints

immediately following 030.

\(1\) subtract your countable annual income from the maximum

annual rate;

\(2\) divide that answer by 12;

\(3\) round this answer down to the nearest whole dollar.

351035 VA pays a pension which is the difference between countable

451035 annual income and a maximum annual rate. You can determine

the monthly payment rate as follows:

\(1\) subtract countable annual income from the maximum annual

rate;

\(2\) divide that answer by 12,

\(3\) round this answer down to the nearest whole dollar.

350036 We use your reported medical expenses to reduce your Entitlement
codes XL and XD

450036 countable annual income. You can determine the amount of
Generated when 018 or 019 is

expenses to be deducted from your countable income as printed with
medical expenses

follows: greater than zero.

\(1\) multiply your basic maximum annual rate by .05;

\(2\) round this answer down to the nearest whole dollar amount;

\(3\) subtract that answer from the total amount of your

reported expenses.

That final answer is the amount of expenses we deduct. (If

you are entitled to a higher rate of pension because you are

Housebound or in need of Aid and Attendance, your basic annual

rate is less than the amount shown above. You can get your

basic rate from VA.)

351036 We use reported medical expenses to reduce countable annual

451036 income. You can determine the amount of expenses to be

deducted from the payee\'s countable income as follows:

\(1\) multiply the basic maximum annual rate by .05;

\(2\) round this answer down to the nearest whole dollar amount;

\(3\) subtract that answer from the total amount of reported expenses.

That final answer is the amount of expenses we deduct. (If

there is entitlement to a higher rate of pension because the

payee is Housebound or in need of Aid and Attendance, the

basic annual rate is less than the amount shown above. You

can get the basic rate from VA.)

350037 We may increase your pension based on your reported Entitlement
codes XL and XD

medical expenses which exceed 5% of the applicable basic Generated when
medical

maximum annual pension rate. As the medical expenses you expenses
entered on income

reported do not exceed this amount, they have not been screens do not
exceed 5% of

deducted from your income. the MAPR.

351037 We may increase pension based on reported medical expenses

which exceed 5% of the applicable basic maximum annual pension

rate. As the medical expenses you reported do not exceed this

amount, they have not been deducted from income.

450037 Pension may be increased based on reported medical expenses

451037 which exceed a specified amount (usually 5% of the applicable

maximum annual pension rate). Since the medical expenses you

reported do not exceed this amount, they have not been deducted

from your income.

350038 Your benefits may be increased based on medical expenses
Entitlement code X7, Payee

450038 which exceed 5% of your reported annual income. Since the 50/60
Medical expenses

451038 medical expenses you reported do not exceed this amount, entered
do not exceed 5%

they have not been deducted from your income. of income.

351038 Benefits may be increased based on reported medical expenses

which exceed 5% of reported annual income. As the medical

expenses you reported do not exceed this amount, they have not

been deducted from income.

350050 If the veteran died before January 1, 1993, the veteran\'s
Entitlement code X7, Payee 10,

351050 highest military pay grade determines the monthly benefit 11-19
or 31-39

450050 payable to you. VA shows that pay grade as: . Drop-in: Pay Grade
from 401

451050 Effective January 1, 1993, Public Law 102-568 changed the Screen
or BIRLS record

basis for payment. A basic rate is paid, without regard to Generated
when the

the veteran\'s military pay grade, for deaths occurring after minimum
pay grade

December 31, 1992. A surviving spouse of a veteran who indicator is not
selected

died prior to this change receives payment under the law on the 401
screen.

providing the greater benefit.

350051 We pay pension of less than \$72 per year in one payment
Entitlement code XL or XD

450051 around June 1st. Due to the round down provisions required Payee
00, 10, 11-19 or 31-39

by law, your payment may be slightly less than the annual

rate shown above. When the monthly rate

times 12 is less than \$72.00,

this paragraph is generated.

351051 We pay pension of less than \$72 per year in one payment

around June 1st. Due to the round down provisions required

by law, payment may be slightly less than the annual rate shown above.

350052 We pay pension of less than \$144 per year in two payments
Entitlement code XL or XD

450052 around June 1st and December 1st. Due to the round down Payees
00, 10, 11-19 or 31-39

provisions required by law, your payment may be slightly less

than the annual rate shown above. When the monthly rate

times 12 is less than \$144

351052 We pay pension of less than \$144 per year in two payments but
greater than \$71.99, this

451032 around June 1st and December 1st. Due to the round down paragraph
is generated.

provisions required by law, payment may be slightly less than

the annual rate shown above.

350053 We pay pension of less than \$228 per year in four payments
Entitlement code XL or XD

450053 around March 1st, June 1st, September 1st, and December .Payees
00, 10, 11-19 or 31-39

1st. Due to the round down provisions required by law, your When the
monthly rate

payments may be slightly less than the annual rate shown times 12 is
less than \$228 but

above. greater than \$143.99, this

351053 We pay pension of less than \$228 per year in four payments
paragraph is generated.

451053 around March 1st, June 1st, September 1st, and December 1st.

Due to the round down provisions required by law, payments may

be slightly less than the annual rate shown above.

350054 You may, if you prefer, receive monthly pension checks. If
Entitlement code XL or XD

351054 so, please send a written request to the address shown on Payees
00, 10, 11-19 or 31-39

450054 this letter. However, if you do elect to receive monthly Whenever
paragraph 051, 052

451054 checks, the total amount we pay over the course of the year 053
is generated, this

may be slightly lower than if payments were issued less often paragraph
will follow.

than monthly. This is because we are required by law to round

monthly payments down to even dollar amounts. Also, please

note that we do not issue checks in the amount of less than

\$1. Therefore, if the annual pension rate is less than \$12,

we cannot issue monthly checks. If you previously elected

monthly payments, you will continue to receive monthly

payments unless you elect a return to periodic payments.

350055 Benefits of less than \$21.40 per month are made in two
Entitlement code X7, Payee 50

351055 payments, on or about June 1 and December 1 each year. or 60

450055 However, if this method of payment adversely affects your

451055 entitlement to other benefits, you may request monthly Generated
when the first award

payments by submitting a written request to this office line\'s monthly
rate is less than

at the address shown on this letter. \$21.40.

351081 Payments made under this award are not for your personal Payee
00. This paragraph is

use. You are responsible to VA for the disposition of the generated
whenever the

funds based upon the fiduciary relationship between you fiduciary data
on the 601

and the person(s) in your care. If you are a court-appointed Screen
indicates a corporate

fiduciary, you may also have additional responsibilities or other
fiduciary.

imposed by the court approving your appointment. Payee 10, 11-19, 31-39,
50 or 60.

The program checks the

special condition data for a

death case. If so, and if the

fiduciary file location is

other than 099, the

paragraph is generated.

351082 We will make payment of this award to you in a fiduciary Payee 00
This paragraph

capacity as the veteran\'s spouse. You must use the is generated when
the

payments for the benefit of the veteran and the veteran\'s fiduciary
data indicate

dependents in your custody as well as for your own benefit. there is a
spouse-payee.

351083 We made this award to you as Chief Officer of the institution
Generated when payments

in which the veteran is a patient. The payments from this are authorized
to a

award are to be expended under your direction under the consolidated
payee.

agreement between your facility and VA. You will receive

the first payment soon.

351084 We made payment of this award to you in a fiduciary Payee 11-19
or 31-39

capacity for the veteran\'s children in your custody. You This paragraph
is generated

should sign checks as shown on the face of the check. if fiduciary file
location is 099.

The proceeds must be used only for the benefit of the Drop-in: If
dependency this

. If this award includes benefits for more ends in one, \"child\" is

than one child, each child is entitled to an equal share. inserted; if
it is more than

one, \"children\" is inserted

350102 The above evaluation is based on your service medical Payee 00;
entitlement code X1

records.

This evaluation is temporary and will continue for 12 301 Screen
indicates

months from the first of the month following the date of your ORIGINAL
(X) and at least

separation from service. We will schedule a VA one diagnostic code is

examination near the end of this period to reevaluate indicated with PAR
28.

your disability.

351102 The above evaluation is based on service medical records.

This evaluation is temporary and will continue for 12 months

from the first of the month following the date of the veteran\'s

separation from service. We will schedule a VA examination

near the end of this period to reevaluate the veteran\'s

disability.

350103 You are entitled to receive compensation at the 100% rate Payee
00; entitlement code X1

450103 because you are unemployable due to service-connected If the 301
Screen employable

disability. If you resume employment, you must tell VA indicator has an
entry of N,

as quickly as possible. the paragraph is generated.

351103 The veteran is entitled to receive compensation at the 100%

451103 rate because he/she is unemployable due to service-connected

disability. If the veteran resumes employment, you must

tell VA quickly.

350105 Unless we receive medical proof of recurrence, we will reduce
Payee 00, entitlement code X1

450105 our evaluation of your service-connected malaria to 0% When the
301 Screen contains

effective . diagnostic code 6304 with a

351105 Unless we receive medical proof of recurrence, we will reduce
letter A or I (blank for origi-

451105 our evaluation of the veteran\'s service-connected malaria to
nals), and degree of 10% or

0% effective . greater subsequently

reduced to 0%, this

paragraph is generated.

350106 We included in this award \$ special monthly Payee 00;
entitlement code X1

351106 compensation for:

450106 The program checks for

451106 special monthly

compensation code of 01,

02 or 14 and, if found, the

paragraph is generated.

Drop-in 1: The amount

payable for the SMC entered:

01 - Current rate for K

02 - Current rate for K times 2

14 - Current rate for K times 3

Drop-in 2: The appropriate

narrative that is present in

the table for the SMC code.

350107 We awarded you special monthly compensation because Payee 00,
entitlement code X1

450107 of the severity of your service-connected disability. If the COMP
AA field on 301

351107 We awarded special monthly compensation because of the Screen not
entered and basic

451107 severity of the veteran\'s service-connected disability. SMC is
3-13, 15-35 or 37, 48,

49 or 50, the paragraph is generated.

350108 When we receive additional evidence which we have Payee 00

351108 requested, we will consider service connection for: When rating
code 38 is

450108 entered, this paragraph is

451108 generated. The legend for

the diagnostic code

indicated as code 38 is

inserted.

350109 We included special monthly compensation in your award Payee 00,
entitlement code X1

because of the severity of your service-connected This paragraph is
generated

disabilities. This special monthly compensation is paid when SMC 43, 44
or 56-60

because you need constant medical care. is entered.

351109 We included special monthly compensation in this award because

of the severity of the veteran\'s service-connected

disabilities. This special monthly compensation is paid

because of the veteran\'s need for constant medical care.

350110 Because you are receiving service retired pay, we must Payee 00;
entitlement code X1

withhold VA compensation as follows:

450110 VA compensation is not taxable. However, service retired If the
401 screen for the

pay, based on age or length of service, is taxable. Under award shows
there is

current law, service retired pay equal to the amount of withholding for
retired pay, VA benefits payable is exempt from taxation. This the
paragraph is generated,

exemption applies only if VA received your waiver of retired using the
actual amounts

pay within one year of the date of your notification of VA entered in
the retired pay

entitlement. As we received your waiver with your claim for fields.

benefits, your exemption amount is the total amount of VA

compensation to which you are entitled from the earliest date

shown above. If you previously claimed a tax exemption, you are now

entitled to claim only the difference between the previous

amount withheld and the current amount withheld.

IMPORTANT: KEEP THIS AWARD LETTER AND INCLUDE A COPY OF IT

WHENEVER YOU FILE YOUR FEDERAL INCOME TAX RETURN.

351110 Because the veteran is receiving service retired pay, we must

451110 withhold VA compensation as follows:

VA compensation is not taxable. However, service retired

pay, based on age or length of service, is taxable. Under

current law, service retired pay equal to the amount of VA

benefits payable is exempt from taxation. This exemption

applies only if VA received the waiver of retired pay within

one year of the date of notification of VA entitlement. As

we received the veteran\'s waiver with the claim for benefits

the exemption amount is the total amount of VA compensation

to which the veteran is entitled from the earliest date

shown above. If you previously claimed a tax exemption

for the veteran, you are now entitled to claim only the

difference between the previous amount withheld and the

current amount withheld.

IMPORTANT: KEEP THIS AWARD LETTER AND INCLUDE A COPY OF IT

WHENEVER YOU FILE THE VETERAN\'S INCOME TAX RETURN.

350113 We are temporarily paying you compensation at the Payee 00,
entitlement code X1

100-percent rate. This is because you are (or were) This paragraph is
generated

hospitalized for observation or treatment of a service- when the 301
Screen contains

connected disability. rating data with paragraph

450013 If your hospital admission and discharge dates are during 29 and
no subsequent

the same month, we pay the 100-percent rate from the first evaluation
removing

day of the month of your admission to the hospital. If you the paragraph
29.

were hospitalized during two or more months, we pay the 100

percent rate from the first day of the month following your

admission to the hospital.

In either case, we will continue paying you the 100-percent

rate until the end of the month the hospital:

\(1\) discharges you; or

\(2\) places you on leave which continues for more than 30 days; or

\(3\) stops treating you as an inpatient for a service-connected
disability.

Unless we send you notice of a change in the evaluation of

your service-connected disability(ies), we will reduce your

award to the amount we paid you before you entered the

hospital.

351113 We are temporarily paying compensation at the 100-percent

451113 rate. This is because the veteran is (or was) hospitalized

for observation or treatment of a service-connected

disability. If the hospital admission and discharge dates

are during the same month, we pay the 100-percent rate from

the first day of the month of the hospital admission. If

the veteran was hospitalized during two or more months, we

pay the 100-percent rate from the first day of the month

following the admission to the hospital.

In either case, we will continue paying the 100-percent rate

until the end of the month the hospital:

\(1\) discharges the veteran; or

\(2\) places the veteran on leave which continues for more than 30 days;
or

\(3\) stops treating the veteran as an inpatient for a service-connected
disability.

Unless we send you notice of a change in the evaluation of

the veteran\'s service-connected disability(ies), we will

reduce the award to the amount we paid before the veteran

entered the hospital.

350114 We assigned you a temporary 100% disability rating. It Payee 00;
entitlement code X1

450114 starts from the first of the month after your hospital This
paragraph is generated

admission for treatment of a service-connected disability and for any
award where a

will continue until: paragraph 29 is shown with

\(1\) the end of the month of your hospital discharge; or a subsequent
evaluation

\(2\) start of leave of more than 30 days; or removing the paragraph 29.

\(3\) termination of treatment for your service-connected disability.

On your temporary 100% disability rating Drop-in: Effective date for

ends. The evidence we have establishes the percentage of removal of
paragraph 29.

disability shown.

351114 We assigned the veteran a temporary 100% disability rating.

451114 It starts from the first of the month after the veteran\'s

hospital admission for treatment of a service-connected

disability and will continue until:

\(1\) the end of the month of hospital discharge;

\(2\) start of leave of more than 30 days; or

\(3\) termination of treatment as an inpatient.

On , the veteran\'s temporary 100%

disability ends. The evidence we have establishes the

percentage of disability shown.

350115 We assigned you a temporary 100% disability rating for Payee 00;
entitlement code X1

450115 convalescence. It is effective from the first day of the This
paragraph is generated

month following your hospital admission for treatment of a when a
paragraph 30

service-connected disability. We will continue this evaluation is shown
on the

temporary rating for a period of convalescence until 301 Screen with a

.Then, your disability evaluation will be . subsequent scheduled

evaluation assigned. The

351115 We assigned the veteran a temporary 100% disability rating
drop-ins are the effective

451115 for convalescence. It is effective the first day of the month
date and combined degree

following the veteran\'s hospital admission for treatment of from the
latest combined

service-connected disability. We will continue this evaluation.

temporary rating for a period of convalescence until .

Then, the disability evaluation will be .

350116 We based your disability compensation benefits on your Payee 00;
entitlement code X1

450116 need for regular hemodialysis. You must tell the VA This
paragraph is generated

office immediately if you have kidney transplant surgery. when the 301
Screen indicates

Diagnostic code 7530 with

351116 We based the veteran\'s disability compensation benefits rating
code 1, 12 or 37 and a

on the need for regular hemodialysis. You must tell the percentage of
100.

451116 VA regional office immediately if the veteran undergoes

kidney transplant surgery.

350118 This award is subject to recoupment of . VA is When the Readjust
or

required to recoup the Separation Pay you received Separation field of
the 401

from your service department. When this amount is Screen is entered with

recouped, we will pay you compensation. award line withholding

under code 8.

351118 This award is subject to recoupment of . VA is Drop-in: Amount of

required to recoup the Separation Pay the veteran received Readjust or
Separation Pay

from the service department. When this amount is

recouped, we will pay VA compensation.

350119 Your spouse may be entitled to educational assistance. Payee 00

450119 The benefit is explained in the enclosed VA Form 22-73-3. Printed
whenever the

To claim this benefit, complete the enclosed application chapter 35
indicator is

(VA Form 22-5490) and return it to this office. selected for spouse on
the

501 Screen (Authorization)

351119 The veteran\'s spouse may be entitled to educational assistance.

451119 The benefit is explained in the enclosed VA Form 22-73-3.

To claim this benefit, complete the enclosed application

(VA Form 22-5490) and return it to this office.

350120 Your between 18 and 26 may be entitled to Payee 00

450120 educational assistance. The benefit is explained in the

enclosed VA Form 22-73-3. To claim this benefit, an Printed whenever the

application for each (VA Form 22-5490) should be chapter 35 child
indicator

completed and returned to this office. is entered on the 501 Screen

(Authorization).

351120 The veteran\'s between 18 and 26 may be Drop-in: When dependency

entitled to educational assistance. The benefit is total/dependency this
is X1=

451120 explained in the enclosed VA Form 22-73-3. To claim this Child.
When dependency

benefit, an application for each child (VA Form 22-5490)
total/dependency this is X2-

should be completed and returned to this office. X9 = children

350121 Your award is subject to recoupment of . VA is Payee 00;
entitlement code X1

450121 required to recoup the Severance Pay you received from If the
support data entered

your service department. Each month we will withhold from BIRLS or the
401

until we have recouped the full amount of your Screen indicate severance

Severance Pay. pay, this paragraph

is generated.

In *St. Clair v. United States*, 778 F.Supp, 894 (E.D. Va. 1991),

the United States District Court for the Eastern District of

Virginia decided that disability severance payments are Drop-in 1:
Severance Pay

excluded from taxable income. If you received disability amount Drop-in
2: Amount

severance pay and paid income taxes on that amount, you shown under Type
9

may be entitled to a tax refund. Direct any questions withholding

regarding this issue to your local Internal Revenue Service

office as VA cannot answer any questions on income tax liability.

351121 This award is subject to recoupment of . VA is

451121 required to recoup the Severance Pay the veteran received

from the service department. Each month we will withhold

until we have recouped the full amount of Severance Pay.

In *St. Clair v. United States*, 778 F.Supp, 894 (E.D. Va. 1991),

the United States District Court for the Eastern District of

Virginia decided that disability severance payments are

excluded from taxable income. If the veteran received

disability severance pay and paid income taxes on that amount,

the veteran may be entitled to a tax refund. Direct any

questions regarding this issue to the local Internal Revenue

Service office as VA cannot answer any questions on income

tax liability.

350123 The veteran\'s service-connected disabilities were rated Payee
10, Entitlement Code X7

100% disabling for 8 years immediately preceding death. Generated when
award

450123 You were married to the veteran for those same 8 years. contains
Special Law Code 23.

Your monthly benefit, therefore, includes an additional

allowance.

351123 The veteran\'s service-connected disabilities were rated 100%

451123 disabling for 8 years immediately preceding death. The

surviving spouse was married to the veteran for those same 8

years. The monthly benefit, therefore, includes an additional

allowance.

350127 We awarded special monthly compensation because of the Payee 00;
entitlement code X1

450127 severity of your service-connected disabilities including
Generated when Y is entered

your need for Aid and Attendance. in the 301 Screen COMP

A&A field.

351127 We awarded special monthly compensation because of the

451127 severity of the veteran\'s service-connected disabilities

including the need for Aid and Attendance.

350128 We found that the disability listed below is service Payee 00;
entitlement codes X2,

connected but is less than 10% disabling. Therefore, we X4 and XL

cannot pay you compensation. For a pension award, the

program determines if any

351128 We found that the disability listed below is service
service-connected

connected but is less than 10% disabling. Therefore, we evaluations have
been

cannot pay compensation. entered on the 301 Screen. If

the combined evaluation is 0

percent, the paragraph is

generated.

350129 You are entitled to treatment by VA for any service- Payee 00;
entitlement codes X2,

connected disability. You should apply for treatment at the X4 or XL

nearest VA office, outpatient clinic or medical center. Take Prints
whenever paragraph

this letter if you apply in person. If you apply by letter, 350128 or
351128 is

please include your VA file number shown above. printed

351129 The veteran is entitled to treatment by VA for any

service-connected disability. Apply for treatment at the

nearest VA office, outpatient clinic or medical center. Take

this letter if applying in person. If applying by letter,

please include the VA file number shown above.

350131 We denied service connection for: Payee 00

351131

451131 This paragraph is generated

451131 for rating codes 08, 13, 14,

35 or 36 as entered on the

301 or 303 Screens. For

conditions entered on

the 301 Screen the condition

will be shown as the

appropriate legend for

the diagnostic code; for

conditions entered on the

303 Screen the condition

will be shown as entered.

450132 Based on an increase in the severity of your service- Payee 00;
entitlement code X1

connected disability, your evaluation is increased:

Condition New % This paragraph is generated

for rating codes 01, 02 or 37 when the letter code is I.

451132 Based on an increase in the severity of the veteran\'s The
diagnostic legend is

service-connected disability, the evaluation is increased: generated
with

Condition New % appropriate modifiers.

Percentages are determined

as in paragraph 013.

450133 Because your service-connected disability has improved, the Payee
00; entitlement code X1

evaluation will be reduced:

Condition New % Generated for diagnostic

entered on the 301 Screen

with a letter code of R.

451133 Because the veteran\'s service-connected disability has For each
diagnostic

improved the evaluation will be reduced: with letter code R an appro-

Condition New % priate legend is printed

under the heading

\"condition\" along with the

latest disability percent

entered.

450134 You may submit evidence to show that the reduction Generated
whenever the

should not be made. A statement from a physician who letter code R is
used on the

has recently examined you would be the best type to 301 Screen and
diagnostic

submit. It should include detailed findings relating to your code for
that condition is not

service connected conditions. If additional evidence is one of the
following: 9200-

not received within 60 days from the date of this letter, your
9210,9312- 9326, 9400-9405,

award will be reduced as indicated. 9407-9411, 9500-9502 or

9505-9511.

451134 You may submit evidence on behalf of the veteran to show that

the reduction should not be made. A statement from a physician

who has recently examined the veteran would be the best type to

submit. It should include detailed findings relating to the

veteran\'s service connected conditions. If additional evidence

is not received within 60 days from the date of this letter,

the veteran\'s award will be reduced as indicated.

450135 You may submit evidence to show that your nervous Generated
whenever letter

condition has not improved. The best type to submit would codeR is
entered for a

be medical or lay statements regarding your inability to diagnostic code
on the 301

make an adequate social and industrial adjustment. If Screen. All
diagnostic codes

additional evidence is not received within 60 days from the with an R
must fall within the

date of this letter, your award will be reduced as indicated. following
range: 9200-9210,

9312-9326, 9400-9405, 9407-

9411, 9500-9502 or 9505-9511.

451135 Evidence may be submitted to show that the veteran\'s nervous

condition has not improved. The best type to submit would be

medical or lay statements regarding the veteran\'s inability to

make an adequate, social and industrial adjustment. If addi-

tional evidence is not received within 60 days from the date of

this letter, the veteran\'s award will be reduced as indicated.

450136 You may submit evidence to show that the reduction should
Generated whenever letter

not be made. A statement from a physician who has code R is entered on
the 301

recently examined you would be the best type to submit. It Screen for
two or more

should include detailed findings relating to your service- conditions.
At least one of

connected conditions. For your nervous condition the diagnostic codes
shown

best type of evidence to submit would be medical or lay with the R must
be in

statements regarding your inability to make an adequate the following
range and at

social and industrial adjustment. If additional evidence least one must
not be in the

is not received within 60 days from the date of this following range:
9200-9210,

letter, your award will be reduced as indicated. 9312-9326, 9400-9405,

9407-9411, 9500- 9502 or

9505-9511.

451136 You may submit evidence on behalf of the veteran to show that

the reduction should not be made. A statement from a physician

who has recently examined the veteran would be the best type to

submit. It should include detailed findings relating to the

veteran\'s service connected conditions. For the veteran\'s ner-

vous condition the best type of evidence to submit would be

medical or lay statements regarding the veteran\'s inability to

make an adequate social and industrial adjustment. If addi-

tional evidence is not received within 60 days from the date of

this letter the veteran\'s award will be reduced as indicated.

450137 The evidence does not warrant any change in our previous Payee
00; entitlement code X1

determination about the following condition(s): This paragraph is
generated

if a rating code of 01, 12 or

37 is found, and the letter

code is C. The diagnostic

legend is then generated for

each such condition with

modifiers as appropriate.

350202 We based this DIC payment on the veteran\'s service pay Payee 10,
entitlement code X7

grade of . We have asked the service department If minimum pay grade

351202 if the veteran served at a higher pay grade for 6 months or
indicator on Screen 401

more. If so, we will increase the DIC payment retroactively is entered
and minimum

to the beginning of this award. pay grade is indicated

as being paid, the paragraph

is generated.

350203 You may be entitled to educational assistance. The benefit
Printed when the CH35

450203 is explained in the enclosed VA Form 22-73-3. If you wish Spouse
indicator is selected

to make a claim, complete the enclosed application (VA Form on the 501
Screen for

22-5490) and return it to this office. If you filed for payee\'s other
than 00.

this benefit, you need not file the enclosed form.

Please be certain to enter the veteran\'s name and VA file

number shown above, on all evidence or forms submitted.

351203 Your ward may be entitled to educational assistance. The bene-

451203 fit is explained in the enclosed VA Form 22-73-3. If you

wish to make a claim, complete the enclosed application (VA

Form 22-5490) and return it to this office. If you filed

for this benefit, you need not file the enclosed form.

Please be certain to enter the veteran\'s name and VA file

number shown above, on all evidence or forms submitted.

350204 Children between 18 and 26 may be entitled to educational
Generated if the CH35 child

351204 assistance. The benefits are described in the enclosed indicator
is entered on the

450204 VA Form 22-73-3. To apply, complete and return VA Form 501 Screen
and Payee is

451204 22-5490 for each child. If you filed for this benefit, you need
not 00.

not file the enclosed form. Please be certain to enter the

veteran\'s name and VA file number shown above, on all

evidence or forms submitted.

350225 No additional pension can be paid for a child whose Payee 00,
entitlement code

351225 net worth is so large that part of it should be used for his XL
and Payees 10, 11-19

450225 or her living expenses. For that reason, we cannot pay or 31-39,
Entitlement code XD

451225 additional pension for . This paragraph is generated

when any child, but not

more than 4 children, has a

net worth of XS.

350226 If conditions change, fill out and return the enclosed VA Payee
00, entitlement code

450226 Form . Please be certain to enter the veteran\'s full Payees 10,
11-19 or 31-39,

name and VA file number shown above on all evidence entitlement code XD

or forms you submit. This paragraph is printed

351226 Should conditions change, fill out and return the enclosed
immediately after 225 or 227.

451226 VA Form . Please be sure to enter the veteran\'s

full name and VA file number shown above on all evidence or

forms you submit. Drop-in: For Payee 00 when:

Dep This = 00 21-0515-1

Dep This = 10 21-0516-1

Dep This = Other 21-0517-1

For Payee 10 when:

Dep This = 10 21-0518-1

Dep This = Other 21-0519-1

For All other Payees:

21-0519-1

351227 When the income of a child exceeds the limit provided Generated
when any child,

by law, we cannot pay Improved Pension on behalf of but not more than 4
children

that child. Therefore, we determined that benefits are not are shown
with Net Worth =

payable for . XI on the 336 Screen.

451227 When the income of a child exceeds the limit provided Drop-in:
Child(ren)\'s name(s)

Improved Pension may not be paid on behalf of that child.

Therefore, we have determined that benefits are not payable

for .

350232 Payments have been discontinued as shown, because Payee 00,
entitlement code

351232 countableannual income from that date exceeds . If XL and Payees
10, 11-19 or

450232 there is a reduction in income and you reopen your claim, 31-39,
entitlement code XD

451232 please complete the enclosed VA Form showing Reason Code on
Current

income received and expected for 12 months following Award Line = 11,
24, 25, 54

termination and for the following 12-month period. We or 56
[AND]{.underline} Amount = Zero.

have enclosed VA Form 21-0510 which contains instructions Fill-in 1:
Maximum pension

to help you in completing this form. Please be certain to Fill-in 2:
E-21-0515-1,0516-1

enter the veteran\'s name and VA file number, shown above, 0517-1,
0518-1 or 0519-1 as

on all evidence or forms submitted. You should reopen your determined by
payee number

claim 12 months from the date of discontinuance if your and dependency
code

payments were stopped because of one-time receipt of income.

350233 We stopped your payments as shown because countable Payee 00,
entitlement code

450233 annual from that date exceeds the limit of . If X2 or X4 Payee
10, 11-19,

your income is reduced, fill out and return the enclosed VA 31-39,
entitlement codes X6

Form . Instructions to help you fill out this form or X8 Payee 50 or 60,

are contained in the enclosed VA Form 21-0510. Please entitlement code
X5 or X7.

enter the veteran\'s full name and VA file number shown

above on all evidence or forms submitted.

351233 We stopped payments as shown because countable annual Current
Award line Reason

451233 .Total from that date exceeds the limit . Code is 11, 24, 25, 54
or 56 AND

If from that date exceeds the limit of . If Award Amount is Zero.

there is a reduction in income, fill out and return the enclosed

VA Form . Instructions to help you fill out this form are Drop-in 1:
FAMILY

contained in the enclosed VA Form 21-0510. INCOME for payee 00

Please enter the veteran\'s full name and VA file number dependency not
00 and

shown above on all evidence or forms submitted. payee 10 dependency not
00;

Otherwise, INCOME

Drop-in 2: Maximum

allowable pension

Drop-in 3: E-21-0512V-1,

0511S-1, 0512S-1,

0514-1 or 0513-1 as

applicable

350303 Although you have entitlement to the Aid and Payee 00,
entitlement code XL

450303 Attendance allowance, we are paying you at a lower Reason code 30
or 33 with

rate. This is because of your admission to a health care DISAB STATUS of
PT-A/H

facility at VA expense. We will pay you your full benefit

when you are discharged if the evidence we have shows

your continued entitlement.

351303 Although the veteran has entitlement to the Aid and Attendance

451303 allowance, the veteran is being paid a lower rate. This is

because of his/her admission to a health care facility at VA

expense. We will pay the full benefit upon the veteran\'s

discharge if the evidence we have shows continued entitlement.

350304 We included in this award an additional monthly amount Payee 00,
Entitlement XL

based on your need for the Housebound benefit. \--The 301 Screen shows

Special Monthly Pension of HB or the Award line shows

HB.

351304 We included in this award an additional monthly amount Payee 10 -
The 401 Screen

based on the need for the Housebound benefit. or 403 Screen indicates HB

entitlement.

450304 This award includes an additional monthly amount based on Payee
00, entitlement code XL

451304 confinement to the home or immediate premises. with reason code
30 or 33 and

DISAB STATUS of PT-HB

Payee 10, Entitlement XD

or X7 with DISAB STAT of

HB as shown on 401 or 403

Screen.

350305 As a veteran, having neither spouse nor child, and Payee 00,
entitlement code XL

450305 receiving nursing home or domiciliary care at government with
reason code 35, and

expense, the law limits your monthly payments to \$90. Type 4
withholding.

This reduction is effective the first day of the fourth month

following your date of admission.

351305 Because the veteran has neither spouse nor child and is receiving

451305 nursing home or domiciliary care at government expense, the law

limits monthly payment to \$90. This reduction is effective the first

day of the fourth month following the date of admission.

450306 The full rate of pension to which you are entitled has been Payee
00, entitlement code

restored effective the date of release from the health care X4 or XL,
reason code 36

facility. and no type 4 withholding

451306 The full rate of pay to which the veteran is entitled has been

restored effective the date of release from the health care

facility.

450307 As a veteran, having neither spouse nor child, and having Payee
00, entitlement code

451307 been furnished hospital, domiciliary, or nursing home care X2,
reason code 35 with

by the Veterans Administration, payments are limited to type 5
withholding

one half the monthly benefit, effective the first of the seventh

month following the date of admission. The amount by which

payments are reduced will be paid upon approved discharge by the

institution authorities.

450308 Due to discharge from care at VA expense the full rate of Payee
00, entitlement code X2,

pension to which you are entitled has been restored as of reason code
36, no type 5

the date of prior reduction. withholding and DISAB

STAT not PT-A/A

451308 Due to discharge from care at VA expense the full rate of

pension to which the veteran is entitled has been restored as

of the date of prior reduction.

450309 Due to discharge from care at VA expense the full rate of Payee
00, entitlement code X2,

pension to which you are entitled, excluding the Aid and reason code 36,
DISAB

Attendance benefit, has been restored as of the date of prior STAT of
PT-A/A and no

reduction. type 5 withholding

451309 Due to discharge from care at VA expense the full rate of

pension to which the veteran is entitled, excluding the Aid and

Attendance benefit, has been restored as of the date of prior

reduction.

350320 You are a patient in a Medicaid-approved nursing home and Entry
of MEDICAID NHC

450320 covered by a Medicaid plan. Therefore, your monthly on 401 Screen

pension is limited to \$90.00 while you are receiving this type

of care. The \$90 monthly payment is for your incidental needs,

such as toilet articles, snacks, etc., and no part of this payment

should be used by Medicaid to cover your medical expenses.

You should notify your state Medicaid office that the benefits

you receive under the Improved Pension Program are being reduced.

Generally, nursing home expenses that are in excess of your

non-VA income should now be paid by Medicaid. Individual

states, however, have considerable latitude in determining the

amount, duration, and scope of nursing home services paid by

the Medicaid program.

351320 The payee is a patient in a Medicaid-approved nursing home and

451320 covered by a Medicaid plan. Therefore, monthly pension is

limited to \$90 while receiving this type of care.

The \$90 monthly is for incidental needs, such as toilet articles

snacks, etc., and no part of this payment should be used by

Medicaid to cover medical expenses. You should notify the

state Medicaid office that the benefits the payee receives

under the Improved Pension Program are being reduced.

Generally, nursing home expenses that are in excess of non-VA

income should now be paid by Medicaid. Individual states,

however, have considerable latitude in determining the amount,

duration, and scope of nursing home services paid by the

Medicaid program.

350341 Your monthly payments are limited to \$50. This is because Payee
00, Dependency Code 00

450341 you are receiving hospital, nursing home or domiciliary care
Entitlement Code X4, Reason

at government expense and do not have a spouse or child. Code = 35,
Withholding

This reduction is effective the first day of the third month Type = 4
AND VA HOSPITAL,

following the date of admission. NURSING HOME or

DOMICILIARY was

entered on the 401 Screen.

351341 The veteran\'s monthly benefit is limited to \$50. This is

451341 because the veteran is receiving hospital, nursing home or

domiciliary care at government expense and does not have a

spouse or child. This reduction is effective the first day

of the third month following the date of admission.

350342 Your monthly payments are limited to \$50. This is because Same
as for the above

450342 you are receiving hospital, nursing home or domiciliary care
paragraph except that

at government expense and do not have a spouse or child. IMMED is also
entered

This reduction is effective the date of readmission, since on the 401
Screen.

readmission is within six months of a period of treatment or

care of at least two full months.

351342 The veteran\'s monthly benefit is limited to \$50. This is

451342 because the veteran is receiving hospital, nursing home or

domiciliary care at government expense and does not have a

spouse or child. This reduction is effective the date of

readmission, since readmission is within six months of a

period of treatment or care of at least two full months.

350401 We included a cost-of-living increase in this award effective
Payees 00, 10, 11-19, 31-39,

351401 . 50 or 60 with reason code 37

450401

451401 Drop-in: Effective date

shown on the award line

with reason Code 37

350403 We cannot pay you benefits for the year in which the Payee 10,
entitlement code XD

veteran died because your income exceeds . We Drop-in 1: Maximum

authorized payment for your for that year. allowable pension rate.

351403 We cannot pay benefits for the year in which the veteran died

because the reported income exceeds . We authorized Drop-in 2:
Dependency

payment for the veteran\'s . code = 81 \"Child\"

Dependency code greater

than 81 \"Children\"

350501 To pay you a higher rate, we did not include the income Payee 50
or 60, entitlement

you received before you become entitled. We based your code X7

award on net countable income from the date of entitlement to

the end of the year. We computed annual income as

using a proportional computation method. We based your

entitlement for next year on expected annual income of .

351501 To pay a higher rate, we did not include the income received

before the date of entitlement. We based this award on net

countable income from the date of entitlement to the end of

the year. We computed annual income as using a

proportional computation method. We based entitlement for

next year on expected annual income of .

350504 We cannot pay you pension during because your Entitlement codes
X2, X4

income exceeds the legal limit. We based benefits from

January 1, , on your expected income for that year.

351504 We cannot pay pension during because income exceeds

the legal limit. We based benefits from January 1, on

expected income for that year.

350505 We stopped payments from the date shown above because Award line
contains reason

450505 your expected income for exceeds the legal limit. If code 11 and
zero rate

your income is reduced, you may use the enclosed form to tell us.

Please enter the veteran\'s full name and VA file number shown

above on all evidence or forms submitted.

351505 We stopped payments from the date shown because expected

451505 income for exceeds the legal limit. If income is

reduced, please use the enclosed form to tell us. Please

enter the veteran\'s full name and VA file number shown

above on all evidence or forms submitted.

350506 We stopped payments from the date shown above because Payee 00,
entitlement code

450506 you no longer have an eligible dependent or dependents. X4 orXL;
Payee 10,

Your income is too great to pay you without a dependent entitlement code

or dependents. XD or X8

351506 We stopped benefits from the above date because the Generated
when last award

451506 beneficiary no longer has an eligible dependent or line has a
zero rate with

dependents. reason code 24, 25, 54or 56.

Income is too great to pay him/her without a dependent

or dependents.

350515 You will receive information later regarding continued benefits

351515 for the veteran\'s children.

450515

451515

350581 You are only entitled to 1/2 of the dollar rate shown, Generated
when Station No

450581 payable in equivalent pesos, since military service was = 58 and
Entitlement Code

performed with the Commonwealth Army of the Philippines, = 91 and 95
(all Payees) or

recognized guerrillas and/or the New Philippine Scouts. 97 and 99 (all
Payees except 50 and 60).

351581 The payee is only entitled to 1/2 of the dollar rate shown,
Printed immediately following

451581 payable in equivalent pesos, since military service was rates and
effective dates.

performed with the Commonwealth Army of the Philippines,

recognized guerrillas and/or the New Philippine Scouts.

350582 If you have reported any of your income in pesos, the Generated
for all pension

450582 income information shown reflects that it has been letters when
Station No is

converted into dollars based on the prevailing quarterly rate 58 and
Entit lement Code =

of exchange used by the United States Department of the X2, X4, X6, X8,
XL

Treasury. The total amount of income determines your or XD (all Payees).

monthly rate of entitlement. Printed immediately

following reported income

paragraphs.

351582 If you have reported any of the payee\'s income in

451582 pesos, the income information shown reflects that it has been

converted into dollars based on the prevailing quarterly rate

of exchange used by the United States Department of the

Treasury. The total amount of income determines the veteran\'s

monthly rate of entitlement.

350601 You may be eligible for up to 24 months or more of Payee 00,
Entitlement Code

vocational training to help you prepare for and get a job. X4 or XL,
Transaction Code

During this training, VA will pay for your tuition, books, 11B or 11D
and DOB plus 45

tools and other training supplies. You may also receive up is less than
date

to 18 months of job counseling, employment search and of authorization.

work adjustment. If you want to apply for this training and

assistance, you should contact the nearest VA office to

obtain VA Form 28-8966, Vocational Training Application

for VA Pensioners, and VA Form 28-1902, Counseling

Record\--Personal Information. If the information you give us

on these forms and the other information contained in VA

records show you have good potential for employment, we

will schedule you for a personal appointment to complete the

evaluation of your ability to benefit from vocational training

and assistance. To qualify for consideration for this program,

you must apply before January 1, 1996, or 60 days from the

date of this letter, whichever is the later date.

351601 The veteran may be eligible for up to 24 months or more of

vocational training to help him or her prepare for and get a

job. During this training, VA will pay for the veteran\'s

tuition, books, tools and other training supplies. The veteran

may also receive up to 18 months of job counseling, employment

search and work adjustment. If you want to apply for this

training and assistance for the veteran, you should contact the

nearest VA office to obtain VA Form 28-8966, Vocational Train-

ing Application for VA Pensioners, and VA Form 28-1902,

Counseling Record - Personal Information. If the information

you give us on these forms and the other information contained

in VA records show that the veteran has good potential for

employment, we will schedule the veteran for a personal

appointment to complete the evaluation of his/her ability to

benefit from vocational training and assistance. To qualify

for consideration for this program, you must apply before

January 1, 1996, or 60 days from the date of this letter,

whichever is the later date.

350700 We included benefits for your . You Payee 00, entitlement code
X1,

450700 must tell us immediately if there is any change in the number X4,
XL: Payee 10, entitlement

or status of your dependents. Your failure to quickly tell code X7; all
Death Pension

VA of a dependency change will result in an overpayment cases

which must be repaid. Drop-in 1: Additional

351700 We included benefits for the veteran\'s . Drop-in 2: Spouse,
Child, or

451700 You must notify us immediately if there is any change in the
Children. When more

number or status of dependents. Your failure to quickly tell than one
type of

VA of a dependency change will result in an overpayment dependent is
found

in the veteran\'s account which must be repaid. paragraph 701 is used

350701 We included benefits for your . Payee 00 and Payee 10

450701 You must tell us immediately if there is any change in the

number or status of your dependents. Failure to tell VA Drop-in 1:
Additional

immediately of a dependency change will result in an

overpayment which must be repaid. Drop-in 2: For payee 00

will be spouse and children

or spouse and

dependent parents For

payee 10 will be child or

children (Also, will not be

printed when 707 is printed)

350702 We your award effective due to Payee 00, entitlement codes

the loss of a dependent . X1, X4 and XL Payee 10,

entitlement codes X7,

351702 We this award effective due to the X8 and XD

loss of a dependent . Generated when award is

reduced prior to the current

450702 Your award is effective due to the award line for loss of

loss of a dependent . dependent and the

304 Screen has remove

451702 This award is effective due to the reason 11, 14, 12, 28, 41,

loss of a dependent . 54, 56, 15, 16, 22, 24, 25 or 30.

Drop-in 1: For entitlement

code XL or XD \"adjusted\",

otherwise, \"reduced\"

Drop-in 2: Date of removal

Drop-in 3: Spouse, mother,

father or child

350703 We included in your award benefits based on Payee 00, entitlement
codes X1,

450703 permanent incapacity for self-support . You must tell us X4 and
XL Payee 10 and

immediately if this child marries, becomes employed, or 31-39,
entitlement

undergoes an improvement in physical or mental condition. codes X8 and
XD

Your failure to tell us promptly can result in an overpayment

which must be repaid. Generated when the 403

Screen indicates a helpless child.

351703 We included in this award benefits based on Drop-in: Name of the
child as

451703 permanent incapacity for self-support. You must tell us shown on
the 304 Screen

immediately if this child marries, becomes employed, or as status 3.
Unless the

undergoes an improvement in physical or mental condition. name ends in x
or s,

Your failure to tell us promptly can result in an overpayment it is
followed by an

which must be repaid. apostrophe and an s

350704 Your award is based on your permanent incapacity for self Payee
11-19, entitlement

450704 support. You must tell us immediately if you marry, become code
X7

employed, or undergo an improvement in your physical Generated when 403
Screen

condition. Your failure to tell us promptly can result in an shows a
helpless child and

overpayment which must be repaid. dependency this = 81.

350705 We will continue payments based on your school Payee 11-19,
entitlement

450705 attendance until . code X7, X8 or XD

351705 We will continue payments based on school attendance When the
award contains a

451705 until . line with reason code 25,

this paragraph is generated.

Drop-in: Effective date

shown on the award line

with reason code 25.

350706 We will continue payments for based on school Payee 00,
entitlement code

351706 attendance until . X1, X4 or XL Payee 31-39,

450706 entitlement code X7

451706 Payee 10 or 31-39, entitlement

code X8 or XD

Generated when the 403

Screen contains an award

line with reason code 25.

For each child on the 304

Screen with a status code 2,

a paragraph is generated.

On supplemental awards if

the change status reason is

15 or 22 and the remove

reason is 25, this paragraph

is not generated. Paragraph

702 will be generated instead.

Drop-in 1: Name of child

Drop-in 2: Date of removal

350707 We are paying you for the in your custody. Payee 10, entitlement
codes

450707 We are making a separate award for any child not in X7, X8 and XD

your custody.

351707 We are paying you for the veteran\'s in your . Dependency codes
on all

custody award lines are checked

451707 We are making a separate award for any child not in your and
Dependency Total is

custody. compared to Dependency

This. If Total for any line is

greater than This of the same

award line, the paragraph is

generated.

Drop-in: If the highest

dependency this indicates a

single child, then \"child\" is

inserted; if more than one child

is indicated, \"children\" is

inserted.

**NOTE:** Generation of this

paragraph will result in

suppression of paragraph

701 or 702.

350708 We are paying you for the in your custody. Payee 00, entitlement
code X1,

351708 We are making a separate award to the custodian of the X4 or XL
This paragraph is

450708 not in your custody. generated when any award

451708 line has a dependency

total greater than dependency

This.

Drop-in: Both drop-ins will

be child or children

depending on the

dependency code

Generation of this paragraph

will cause suppression of

paragraph 701.

350709 The following in dependency status of a child Payee 00,
entitlement codes

351709 or children paid by separate award your payments: X1, X4 and XL

450709 Payee 10, 11-19 or 31-39,

451709 entitlement code X8 or XD

This paragraph is generated

when any award line

contains reason code 43, 44

or 45.

Drop-in: If only one line

contains the above reasons

the drop-ins will be \"change\"

and \"affects.\" When more

than one line contains these

reasons, \"changes\" and

\"affect\" will be inserted.

350719 VA payments based on school attendance begin . For every reason
code 43,

351719 this paragraph is generated

450719 and the date for that award 451719 line is inserted as the
drop-in.

350729 VA payments based on school attendance end . For every reason
code 44, 351729 this paragraph is generated

450729 and the date for that award

451729 line is inserted as the drop-in.

350739 Child reaches age 18 on . For every reason code 45, this

351739 paragraph is generated and

450739 the date for that award line is

451739 inserted as the drop-in.

350771 We are paying you benefits for your . Payee 00, entitlement codes
X4

450771 We are making a separate award to your . and XL

Generated whenever the

351771 This award includes benefits only for the veteran\'s . award
indicates that payments

451771 A separate award is being made to the veteran\'s . are not being
made to the

veteran for all dependents.

The drop-ins advise exactly

which dependents are being

paid on the veteran\'s

award (spouse, mother,

father or children) and

which are not included

based on the difference

between the dependency

Total and dependency This

entered.

350781 We established your spouse as a permanently and totally Payee 00,
entitlement code XL

450781 disabled veteran.

Generated when two

351781 We established the veteran\'s spouse as a permanently and
permanently totally disabled

451781 totally disabled veteran. veterans are married to one

another. The 304 Screen

must contain VET MARRIED

TO VET indicator or 1 or 2.

350783 We determined that your spouse needs Aid and Attendance. Payee
00, entitlement code XL

450783

This paragraph is generated

351783 We determined that the veteran\'s spouse needs Aid and when
Reason code 33 is

451783 Attendance. used with a helpless spouse

indicator A (304 Screen).

350785 We determined that your spouse is Housebound. Payee 00,
entitlement code XL

450785

This paragraph is generated

351785 We determined that the veteran\'s spouse is Housebound. when
reason code 33 is used

451785 with the helpless spouse

indicator H (on the 304 Screen).

350786 We determined that your spouse is Housebound. We Payee 00,
entitlement code XL

450786 stopped pension entitlement due to your spouse\'s need This
paragraph is generated

for Aid and Attendance. when reason code 34 is used with the spouse
helpless

351786 We determined that the veteran\'s spouse is Housebound. indicator
H (on the 304

We stopped pension entitlement due to the veteran\'s Screen).

spouse\'s need for Aid and Attendance.

451786 The veteran\'s spouse is determined to be Housebound; need

for regular Aid and Attendance is no longer shown and that

benefit is discontinued.

350791 Your spouse is no longer considered Housebound or on Payee 00,
entitlement code

450791 need of Aid and Attendance. XL This paragraph is

351791 The veteran\'s spouse is no longer considered Housebound
generated when reason code

451791 or in need of Aid and Attendance. 34 is used with spouse

helpless indicator of N (on

304 Screen).

350793 We are stopping the Aid and Attendance allowance Payee 00,
entitlement code XL

for your spouse. This is effective the first day of the This paragraph
is generated

second calendar month after the date of your spouse\'s when reason code
35 is

admission to the health care facility at VA expense. used with spouse
helpless

When your spouse is discharged, we will resume the indicator H (on the
304 Screen)

allowance if the evidence shows continued entitlement.

351793 We are stopping the Aid and Attendance allowance for the

veteran\'s spouse. This is effective the first day of the

second calendar month after the date of the veteran\'s spouse\'s

admission to a health care facility at VA expense. We will

resume the allowance upon discharge if the evidence shows

continued entitlement.

450793 Aid and Attendance for your spouse is discontinued effective

the first day of the second calendar month after the date of

admission to hospital or nursing home care at VA expense. The

benefit will be resumed upon discharge if the evidence shows

continued entitlement.

451793 Aid and Attendance for the veteran\'s spouse is discontinued

effective the first day of the second calendar month after the

date of admission to hospital or nursing home care at VA

expense. The benefit will be resumed upon discharge if the

evidence shows continued entitlement.

350795 We are restoring the Aid and Attendance allowance for Payee 00,
entitlement code XL

your spouse. It is effective the date of release from the Reason code 36
is used with

health care facility. spouse helpless indicator of

A (on the 304 Screen).

351795 We are restoring the veteran\'s spouse\'s Aid and Attendance

benefit. It is effective the date of the spouse\'s release from the

health care facility.

450795 Aid and Attendance for your spouse is being restored effective

the date of release from hospital or nursing home care.

451795 Aid and Attendance for the veteran\'s spouse is being restored

effective the date of the spouse\'s release from hospital or

nursing home care.

350800 Due to your discharge from care at VA expense, we are Payee 00,
entitlement code X1

450800 restoring the full rate of compensation to which you are This
paragraph is generated

entitled. This is effective the date of your discharge from when reason
code 36 is used,

the health care facility. DISAB combined degree is

100% and SMC is not zero

351800 Due to discharge from care at VA expense, we are restoring or
spaces.

451800 the full rate of compensation to which the veteran is entitled.

This is effective the date of the veteran\'s discharge from the

health care facility.

450850 We have restored your VA benefit as shown above Generated when an
award line

because of your release from imprisonment. contains Reason Code 28

[AND]{.underline} there is no Type 1

451850 We have restored the payee\'s award as shown above Withholding on
the same

because of his/her release from imprisonment. line.

350901 We are stopping the additional allowance you receive This
paragraph is generated

450901 for Aid and Attendance. This is effective the first day when one
of the following

of the second calendar month after the date of your exists: 1. Reason
code 35;

admission to a health care facility at VA expense. We will DISAB of
spaces; Payee 10;

resume this benefit upon your discharge if the evidence we Ent Code XD.

have shows your continued entitlement.

351901 We are stopping the additional allowance for Aid and 2. Reason
code 35; DISAB of

451901 Attendance. This is effective the first day of the second spaces;
Payee 50/60; Ent

calendar month after the date of the veteran\'s admission to Code X7.

a health care facility at VA expense. We will resume this

benefit upon discharge if the evidence we have shows 3. Reason code 35;
DISAB

continued entitlement. Payee 10, ent Code X7 or XD.

4\. DISAB A/H; Payee 10;

Ent code of X7 or XD

350902 We resumed the additional allowance for Aid and Payee 10,
entitlement code

351902 Attendance effective the date of release from the hospital. X7 or
XD

450902 Payee 50 or 60, entitlement

451902 code X7 This paragraph is

generated when reason

code 36 is entered with

DISAB of A/A.

350903 This award includes an additional monthly amount based Payee 00,
entitlement code

351903 on need for Aid and Attendance. X2, X4 or XL

Payee 10, entitlement code

450903 This award includes an additional monthly amount from X7, X6, X8
or XD

451903 based on need for regular Aid and Payee 50 or 60, entitlement

Attendance. code X7

This paragraph is generated

when the 403 DISAB is A/A

and Special Monthly

Pension (on 301 Screen) is

A/A OR the A/A HB FROM

DATE on the 401 Screen

is greater than zero for

original awards.

For supplemental awards the

paragraph is generated when

reason code 30 or 33 is used

with a DISAB of PT-A/A

for Payee 00 or A/A for

other payees.

350904 The rate for the first month of entitlement is the rate Payee 10,
entitlement code

351904 we would have paid the veteran. X7, X8 or XD If the first

award line has an

entitlement code of X1, X2,

X4 or XL and the VET

RATE MO DEATH was

entered on the 401 Screen,

the paragraph is generated.

350905 We may pay additional benefits if you give us the This paragraph
is generated

351905 following evidence or information. when the 203 or 204 Screen

450905 was completed on the same

451905 day the award was GAP\'d.

350906 We included additional compensation due to your spouse\'s Payee
00, entitlement code X1

450906 need for Aid and Attendance. This paragraph is generated

351906 We included additional compensation due to the veteran\'s when
reason code 50 is used

451906 spouse\'s need for Aid and Attendance. with the entry of A in the

helpless spouse indicator of

the 304 Screen.

450907 The additional compensation you receive due to your Payee 00,
entitlement code X1

spouse\'s need for Aid and Attendance is discontinued as This paragraph
is generated

entitlement is no longer established. when reason code 51 is used

and the 304 Screen shows

451907 The additional compensation you receive for the veteran\'s the
spouse is no longer

spouse\'s need for Aid and Attendance is discontinued as helpless.
(Helpless spouse

entitlement is no longer established. indicator on 304 Screen is N).

350914 The amount we awarded you for the first month is the rate Payee
10, entitlement code X7

we would have paid the veteran. After that month, we

based payments on the veteran\'s service pay grade of . This paragraph
is generated

when the entitlement code

351914 The amount we awarded for the first month is the rate on the
first award line is X1,

which we would have paid the veteran. After that month, X2, X4 or XL,
the 401

we based payments on the veteran\'s service pay grade Screen VET\'S RATE

of . MONTH OF DEATH and

PAY GR are entered and the

MIN RATE is blank.

350923 This award includes additional special monthly Payee 00,
Entitlement X1

compensation because of service-connected

of your and the additional nonservice-

connected loss or loss of use of your other . This paragraph is
generated

when the 301 Screen shows

basic SMC of 45, 46 or 47.

351923 This award includes additional special monthly compensation

because of service-connected of the veteran\'s Drop-in 1: \"loss\" when
loss

and the additional nonservice-connected loss or loss of anat (2nd LOSS
CODE on

use of the veteran\'s other . 301) is 12, 13, 26 or 27 \"loss

of use\" when loss of use (1st LOSS CODE on 301) is 12,

26, 27, 13, 72, 73, 74, 75, or 82-85

Drop-in 2 and drop-in 3:

\"hand\" when loss anat

or loss of use is 12,

26, 72, 74, 82 or 84

\"foot\" when loss anat

or loss of use is 13,

27, 73, 75, 83 or 85

350924 We adjusted your award to show your waiver of Payee 00,
entitlement code X1

450924 compensation to receive Drill Pay for days. This paragraph is
generated

when the 401 Screen contains

a positive entry in DRILL

PAY DAYS.

Drop-in: Days entered on

401 Screen.

350925 We have stopped your award effective as Payee 00, entitlement
code X1,

450925 required bylaw. The law says that we cannot pay VA X2, X4 or XL

benefits to a veteran who:

This paragraph is generated

\(1\) is rated incompetent by VA, and when an award line contains

\(2\) has no spouse or dependent child, and reason code 18 and a rate of

\(3\) whose estate, from any source, equals or exceeds zero.

\$1500, and Drop-in: The effective date

\(4\) is hospitalized, institutionalized or domiciled by the of award
line described above.

United States or any political subdivision, with or without

charge.

We cannot restart your payments until your estate is reduced

to \$500 or less, or you are released from treatment or care.

We may continue payments for not more than 60 days during a

calendar year while you receive care at government expense if

we determine that continuing benefits is necessary to avoid a

hardship.

If you believe that our action to discontinue benefits will

cause a hardship for you, you may request that we consider a

waiver.

351925 We have stopped this award effective as required by

451925 law. The law says that we cannot pay VA benefits to a veteran
who:

\(1\) is rated incompetent by VA, and

\(2\) has no spouse or dependent child, and

\(3\) whose estate, from any source, equals or exceeds \$1500, and

\(4\) is hospitalized, institutionalized or domiciled by the

United States or any political subdivision, with or without charge.

We cannot restart payments until the estate is reduced to \$500

or less, or the veteran is released from treatment or care.

We may continue payments for not more than 60 days during a

calendar year while the veteran receives care at government

expense if we determine that continuing benefits is necessary

to avoid a hardship for the veteran.

If you believe that our action to discontinue benefits will

cause a hardship for the veteran, you may request that we

consider a waiver.

350926 We have resumed your award from . This is Generated when reason
code

450926 the date your estate was reduced to \$500 or less. If you 18
occurs on any award line,

stay hospitalized in a government facility, and if your estate the net
rate payable for that

should again equal or exceed \$1500, we would stop your award line is
other than zero

benefits on the date your estate again equaled or exceeded and the
\$1500 ESTATE

\$1500. LIMIT TO date is entered

on 401 Screen.

351926 We have resumed this award from . This is the Fill-in: Effective
date of

451926 date the veteran\'s estate was reduced to \$500 or less. If the
award line described above

veteran stays hospitalized in a government facility, and if

the estate should again equal or exceed \$1500, we would stop

the veteran\'s benefits on the date the estate again equaled or

exceeded \$1500.

450927 Your award has been changed to provide for payment of Generated
when reason code

as follows: 30 appears on any award line.

451927 The veteran\'s award has been changed to provide for Drop-in:
Type of benefit

payment of as follows: elected

450940 You have elected to receive dependency and indemnity Entitlement
code X7 with

compensation (DIC). After you have received and cashed reason code 30

the first check under this award, your election to receive

DIC is final and you cannot re-elect any other death benefit.

If you decide you do not wish to receive DIC, return the first

check with a signed statement that you do not elect DIC.

451940 You have elected to receive dependency and indemnity compensa-

tion (DIC) on behalf of the payee. After you have received and

cashed the first check under this award, the election on the

payee\'s behalf to receive DIC is final and you cannot re-elect

any other death benefit. If you decide that it would not be in

the payee\'s best interest to receive DIC, return the first

check with a signed statement that you do not elect DIC.

350950 You owe money to VA. As we previously notified you, we will

450950 withhold all or part of your benefits until the amounts

withheld equal the full amount of the debt, or the balance of

the debt is otherwise paid.

351950 The claimant owes money to VA. As we previously notified you,

451950 we will withhold all or part of the benefits until the amounts

withheld equal the full amount of the debt, or the balance of

the debt is otherwise paid.

350955 Your rate of VA pension depends on total family income
Entitlement code XL or XD

which includes your income and that of any dependents. This paragraph is
generated

We must adjust your payments whenever this income for Improved Pension
cases

notify us immediately if income is received from any source where the
Total Award

other than that shown above. You must also report any is greater than
zero.

changes in the income shown above. Your failure to promptly

tell VA about income changes may create an overpayment

which will have to be repaid.

351955 The rate of VA pension depends on total family income which

includes the payee\'s income and that of any dependents. We

must adjust the payments whenever this income changes. You

must notify us immediately if income is received from any

source other than that shown above. You must also report any

changes in the income shown above. Your failure to promptly

tell VA about income changes may create an overpayment which

will have to be repaid.

450955 Your rate of VA pension is directly related to your/your

451955 family\'s income. Adjustment to your payments must be made

whenever your/your family\'s income changes. Therefore, you

must notify us immediately if you/your family receive(s) any

income from a source other than that shown above. You must also

report any changes in the income shown above. Failure to inform

the VA promptly of income changes may result in the creation of

an overpayment in your account.

350990 Please read the enclosed VA Form 21-876 . It contains Generated
on all original

351990 important information about rights to receive this benefit. award
letters.

450990

451990 Drop-in: Entitlement code X2,

X4 or XL: \"8\"

Entitlement code X1: \"4\"

Entitlement code X5 or

X7: \"5\"

Entitlement code X6, X8

or XD: \"7\"

350993 ENCL:

351993

450993

451993

350994 Your monthly payments are limited to \$90. This is because Payee
00, entitlement code XL

450994 you are receiving nursing home or domiciliary care at Generated
when reason code

government expense and do not have a spouse or child. 35 is used with
withholding

This reduction is effective the first day of the month type 4 and the
401 Screen

following the date you were readmitted to the nursing shows IMMED.

home or domiciliary.

351994 The veteran\'s monthly payment is limited to \$90. This is

451994 because the veteran is receiving nursing home or domiciliary

care at government expense and does not have a spouse or child.

This reduction is effective the first day of the month

following the date the veteran was readmitted to the nursing

home or domiciliary.

350995 We awarded you the Aid and Attendance allowance Generated when
the 401 Screen

because of your nursing home admission. You must contains X in A&A
and/or

immediately tell VA the date you leave the nursing home in N/H.

which you are now a patient.

351995 We awarded the Aid and Attendance allowance because of the

veteran\'s nursing home admission. You must immediately tell

VA the date the veteran leaves the nursing home in which

he/she is now a patient.

350020 We based this award on countable annual income Generated for
Improved

of from . Pension awards whenever

450020 To determine your countable income, we income data are entered

included the following sources of income you reported: on the 306/336
Screens,

as applicable, provided no

351020 We based this award on countable annual income of more than four
306 Screens

451020 from . To determine the countable income, we were entered. The
fill-ins for

included the following sources of income you reported: countable income
and

effective date are taken from

the income screen data.

**SUBCHAPTER VI. BURIAL LETTERS**

**23.13 GENERAL**

The BDC produces award and disallowance letters for all burial actions
authorized, provided the operator did not request suppression of the
letter.

**23.14 LETTER AND PARAGRAPH SELECTION**

a\. The basic category of the letter to be generated is determined
during on-line processing as described in subchapter 1. The selection of
individual paragraphs to be printed is determined during end-of-day
batch processing, based on the category of letter and the information
stored in the PIF.

b\. The following section of this chapter gives the specific paragraphs,
the selection criteria for each paragraph and any drop-in or enclosure
data.

[BURIAL LETTERS]{.underline}

Paragraph Paragraph Content Selection Criteria

Number

375100 We have authorized payment of the following benefit(s) Opening
paragraph when

to you: money is being paid

375102 for plot or interment allowance. STANDARD PLOT

AMOUNT OR

Drop-in: \$150 or amount

entered

375103 for transportation expenses. TRANSPORTATION

AMOUNT

Drop-in: amount entered

375104 for burial allowance. STANDARD BURIAL

AMOUNT OR

Drop-in: \$1500 when

Service Connected = Y, or

\$300 when Service

Connected = N, or

Amount Entered

375107 You will be informed at a later date about your claim for the
DEFER SC

service-connected burial allowance.

375108 There may be an additional amount payable for DEVELOP

transportation of the body to the place of burial. If there
TRANSPORTATION

were specific chargesfor transportation, please furnish an

itemized statement of such charges and indicate whether

they were included in the original claim.

375114 This payment represents an allowance for plot or interment STATE
PLOT PYMT = Y

expense, payable when burial is in a state cemetery.

375115 We have authorized payment of to you as STD HEADSTONE/

whole or partial reimbursement for the purchase or MARKER OR

engraving of the deceased\'s headstone or marker. Drop-in: \$85 or
amount

entered

375116 (1) The veteran was not in receipt of nor entitled to NOT IN
RECEIPT OF

disability compensation or pension on the date of death; or COMP OR
PENSION = Y

\(2\) The veteran did not have a claim pending on the date of Prints
after 375300 for

death which would have resulted in entitlement to disability claimant
Prints after

compensation or pension; or 375212 for third party.

\(3\) At the time of death, the veteran was not hospitalized by

VA nor traveling under proper authority and at VA expense for

the purpose of examination, treatment or care.

375120 This is the maximum amount payable for this benefit. STD
HEADSTONE/

MARKER

375130 This payment is based on nonservice-connected death. SERVICE
CONNECTED = N

375150 The burial allowance is based on service-connected death. SERVICE
CONNECTED =

Y and STANDARD

BURIAL AMOUNT OR is

entered

375160 You will receive a check in the near future. Printed whenever
paragraph

375102, 375103, 375104,

375130 or 375150 is printed

375209 Because you authorized the burial services for the veteran,
Opening paragraph for third

we want to tell you that we are making payment to party letters when
payment

in the amount of . is made. Drop-in: First line

of claimant\'s address

segment, Total of amounts

paid this award

375210 We have denied the claim for burial benefits. Third party letter
when any

disallowance reason (except

HEADSTONE NOT

PAYABLE) is entered

375212 We must deny the claim for the plot or interment allowance NO SCD
EST-PTE SVC,

because NATL CEM, DOD AFTER

10-31-90, EMPLOYER or

NO COSTS

375213 A decision is pending as to whether the increased Third party
letter only

allowance for service-connected death is payable. We DEFER SC = Y

will advise you when the decision is made. Printed after 375209

375214 The evidence does not show that the veteran\'s Third party letter
only

death resulted from a service-connected disease or injury. SERVICE
CONNECTED = N

and DEFER SC not entered

375216 We cannot pay the claim for the nonservice-connected Third party
letter only

burial allowance because DISALLOWANCE

REASON (other than

HEADSTONE NOT

PAYABLE) = Y

375300 We cannot pay your claim for the nonservice-connected
DISALLOWANCE

burial allowance because REASON (except

HEADSTONE NOT

PAYABLE) = Y

375310 We regret that we must deny your claim for the headstone
HEADSTONE NOT

allowance or reimbursement of the cost of engraving PAYABLE = Y

added to an existing headstone. Claimant and third party

letters

The law no longer permits payment of this benefit for Drop-in: Date of
death

veteranswho died after October 31, 1990. Because the

veteran died on , we must deny your claim.

375336 The allowance is payable only if the deceased veteran NO SCD
EST-PTE SVC = Y

served during a period of war; or was discharged for Claimant\'s
letter - Prints

(or could have been discharged for) a disability incurred after 375345

in or aggravated in line of duty; and when burial is not in Third party
letter - Prints

a national cemetery. after 375212

375337 The deceased did not serve in the active military, NO ACTIVE
MILITARY

naval or air service. SERVICE = Y

See Note 1.

375338 The veteran\'s discharge from military service on was CHARACTER
OF

issued under conditions which are a bar to VA benefits. DISCHARGE IS BAR
= Y

See Note 1.

375339 The deceased died in Service. DEATH IN SERVICE = Y

See Note 1.

375340 A claim for the burial allowance was not filed within two CLAIM
FILED BEYOND

years after permanent burial or cremation. STATUTORY PERIOD = Y

See Note 1.

375341 The addition evidence we requested was not received within NOT
PROSECUTED IN

one year from the date of our request. STATUTORY PERIOD

See Note 1.

375342 Total burial expenses were paid or will be paid by a public or
PAYMENT BY OUTSIDE

private organization(s). SOURCE = Y See Note 1.

375343 Total burial expenses were paid or will be paid by another
PAYMENT BY OTHER

agency of the federal government. GOVERNMENT AGENCY

See Note 1.

375344 The funeral director is the proper claimant because our FUNERAL
DIRECTOR

records show the burial expenses are unpaid. PROPER CLAIMANT= Y

If you pay these expenses, use the enclosed form to Enclosure: VA Form
21-530

reapply for the allowance at any time within two years from See Note 1.

the date of permanent burial or cremation.

The form must be accompanied by a receipted funeral bill

showing the name of the person for whom the services were

performed and the name of the person who paid the funeral bill.

The bill should also state whether it is paid in full or the

amount of the remaining balance.

375345 We must deny your claim for the plot or interment NO SCD EST-PTE
SVC,

allowance because DOD AFTER 10-31-90,

EMPLOYER or NO COSTS

375346 Burial was in a National cemetery or a cemetery under the NATL
CEM = Y

jurisdiction of the United States government. See Note 2.

375347 The veteran\'s employer assumed responsibility for the EMPLOYER =
Y

deceased veteran\'s plot and interment cost. See Note 2.

375348 No plot or interment costs were incurred which exceed costs NO
COST = Y

covered by the statutory burial allowance. See Note 2.

375349 (1) The veteran died on or after November 1, 1990, the DOD AFTER
10-31-90 = Y

effective date of PL 101-508, the Budget Reconciliation See Note 2.

Act; and

\(2\) The veteran is not entitled to the burial allowance; or

\(3\) The veteran was not discharged from service due to

line-of-duty disabilities.

The plot allowance can also be paid on behalf of a wartime

veteran buried in a cemetery owned by a state or an agency or

political subdivision of a state. To qualify, burial must be

in a section of the cemetery used only for interment of persons

otherwise eligible for burial in a national cemetery. Payment

in these cases would be made directly to the state, state

agency or political subdivision, such as a county or city. The

available evidence does not show that the veteran was buried

under these circumstances.

**NOTE 1**: Claimant\'s letter: Prints after paragraph 375300.

Third party letter: Prints after paragraphs 210 and 216.

**NOTE 2**: Claimant\'s letter: Prints after paragraph 375345.

Third party letter: Prints after paragraph 375212.

375400 Due to the provisions of the Balanced Budget and Used when
Graham-

Emergency Deficit Control Act of 1985, the amount of this Rudman
reductions are in

award is less than the payment authorized by statute. effect

This reduced rate is the maximum amount payable under the

above act.

375993 ENCL: When VA Form 21-530 is

enclosed