## Section B. Determining Disability, Unemployability, and Marginal Employment

#### Overview

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

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

  5            General Information on Determining             1-B-2
               Unemployability                                

  6            Factors to Consider When Determining           1-B-4
               Unemployability                                

  7            Determining Marginal Employment                1-B-6

  8            Determining Unemployability or Marginal        1-B-8
               Employment of Farmers                          

  9            Obtaining Evidence of Disability               1-B-10

  10           Determining Permanent and Total Disability     1-B-11

  11           Effective Dates for Disability Pension Awards  1-B-13

  12           Requirements for Retroactive Payment of        1-B-14
               Disability Pension                             
  ------------ ---------------------------------------------- ------------

#### 5. General Information on Determining Unemployability

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on determining        |
| troduction | > unemployability, including information on             |
|            |                                                         |
|            | -   the ability to retain employment                    |
|            |                                                         |
|            | -   when unemployability is established                 |
|            |                                                         |
|            | -   the definition of ***substantially gainful          |
|            |     employment***                                       |
|            |                                                         |
|            | -   the ability to secure employment                    |
|            |                                                         |
|            | -   the evidence required to establish unemployability, |
|            |     and                                                 |
|            |                                                         |
|            | -   making unemployability decisions.                   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a    | > The ability to retain employment once it is secured   |
| . Ability  | > is a necessary element of employability. This ability |
| to Retain  | > is reflected in sustained performance, as contrasted  |
| Employment | > with temporary or sporadic work.                      |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Unemployability is established for pension purposes   |
| # b. When  | > when the evidence shows an inability to secure and    |
| Unemployab | > retain substantially gainful employment by reason of  |
| ility Is E | > disability, as well as related factors.               |
| stablished |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > ***Substantially gainful employment*** is employment  |
| # c. Defin | > that is ordinarily followed by the nondisabled to     |
| ition: Sub | > earn their livelihood with earnings common to the     |
| stantially | > particular occupation in the community where the      |
|  Gainful E | > veteran resides.                                      |
| mployment  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### d    | > The "ability to secure employment" refers to the      |
| . Ability  | > veteran's success in obtaining work of the type the   |
| to Secure  | > veteran is capable of performing and that is          |
| Employment | > available in his/her community.                       |
|            | >                                                       |
|            | > ***Note***: The type and amount of evidence needed to |
|            | > establish that the veteran has made reasonable        |
|            | > efforts to secure employment will vary with the facts |
|            | > of the individual case.                               |
+------------+---------------------------------------------------------+

Continued on next page

5\. General Information on Determining Unemployability, Continued

+------------+---------------------------------------------------------+
| #####      | > In many instances, the veteran's unsupported          |
|  e. Eviden | > statement will be enough evidence to establish        |
| ce Require | > unemployability, if it is consistent with the other   |
| d to Estab | > facts of the case, such as a good work record.        |
| lish Unemp | >                                                       |
| loyability | > In other instances, evidence is required from past    |
|            | > and prospective employers. However, bear in mind that |
|            | > some employers may be reluctant to say they have      |
|            | > refused to hire an individual because of age, or age  |
|            | > and disability combined.                              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Both the degree of disability and the veteran's age   |
| #### f. Ma | > are determinative factors as to unemployability.      |
| king Unemp | > Consider age, education, occupational background, and |
| loyability | > other related factors when making a decision of       |
|  Decisions | > unemployability in pension claims.                    |
|            | >                                                       |
|            | > If basic eligibility is present, do not hesitate to   |
|            | > apply 38 CFR 3.321(b)(2) if disability percentage     |
|            | > requirements are not met.                             |
|            |                                                         |
|            | Exercise restraint in discontinuing eligibility to      |
|            | pension benefits for veterans already on the rolls      |
|            | merely because they have recently regained employment.  |
|            | Income limitations generally preclude both Improved     |
|            | Pension and Section 306 Pension recipients who are      |
|            | working and whose employability is in question from     |
|            | receiving benefits.                                     |
|            |                                                         |
|            | > If benefits have been discontinued for an extended    |
|            | > period based on excessive income from earnings, a     |
|            | > redetermination of unemployability on a factual basis |
|            | > is required.                                          |
+------------+---------------------------------------------------------+

#### 6. Factors to Consider When Determining Unemployability

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on the factors to     |
| troduction | > consider when determining unemployability, including  |
|            |                                                         |
|            | -   determining unemployability                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   if the veteran is unable to perform household       |
|            |     duties                                              |
|            |                                                         |
|            | -   due to moderate progression of disability           |
|            |                                                         |
|            | -   when the veteran reaches retirement age, and        |
|            |                                                         |
|            | -   due to character or behavior disorders              |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   handling unemployment resulting from offenses       |
|            |     against society, and                                |
|            |                                                         |
|            | -   considering unemployability due to loss of industry |
|            |     in the community.                                   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > A veteran whose sole employment consists of           |
| a. Inabili | > performing household duties may qualify as            |
| ty to Perf | > unemployable, if the veteran is no longer able to     |
| orm Househ | > perform the principal household duties without        |
| old Duties | > substantial help.                                     |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | The fact that, prior to discontinuing employment, a     |
| ## b. Mode | veteran worked full-time with about the same degree of  |
| rate Progr | disability as presently exists is not, in itself, a     |
| ession of  | proper basis for holding the veteran employable.        |
| Disability |                                                         |
|            | > Even moderate progression of disabling conditions,    |
|            | > when considered with advancing age, may compel a      |
|            | > person who had been working despite disability to     |
|            | > terminate employment.                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Do not use the discontinuance of work upon reaching   |
| ### c. Rea | > mandatory or optional retirement age as the sole      |
| ching Reti | > reason for considering a veteran to be unemployable.  |
| rement Age | >                                                       |
|            | > The determinative factors of unemployability are      |
|            | > whether the veteran's disability and age prevent the  |
|            | > veteran from obtaining another position. Steady       |
|            | > employment over a long period is ordinarily an        |
|            | > indication of the veteran's desire to work.           |
|            | >                                                       |
|            | > ***Note***: Inability to compete in the labor market  |
|            | > because of age or disability is a valid basis for a   |
|            | > finding of unemployability, even though the veteran   |
|            | > did not actually become unemployed because of a       |
|            | > particular disability.                                |
+------------+---------------------------------------------------------+

Continued on next page

6\. Factors to Consider When Determining Unemployability, Continued

+------------+---------------------------------------------------------+
| #          | > A permanent and total disability pension rating may   |
| #### d. Ch | > be authorized for a congenital, developmental,        |
| aracter an | > hereditary, or familial condition.                    |
| d Behavior | >                                                       |
|  Disorders | > Even if a veteran with one of these conditions is     |
|            | > less than totally disabled, the veteran may still be  |
|            | > unemployable because of the nature of the disability, |
|            | > and a finding of unemployability would be in order.   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > If a personality disorder is manifested by behavior   |
| ## e. Offe | > offensive to society, and the offense against society |
| nses Again | > results in imprisonment or custodial care, it is this |
| st Society | > offense, rather than the individual's disability,     |
|            | > which removes the individual from the labor market.   |
|            | >                                                       |
|            | > In a case such as this, there is no basis for a       |
|            | > finding of unemployability.                           |
|            | >                                                       |
|            | > ***Example***: A veteran with an antisocial           |
|            | > personality disorder is imprisoned for assault with a |
|            | > deadly weapon. In this case, the veteran's            |
|            | > unemployment is due to removal from a work-possible   |
|            | > environment for an offense against society, rather    |
|            | > than his/her personality disorder.                    |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > The fact that an industry closes or is removed from   |
| ### f. Los | > the community where the veteran resides, resulting in |
| s of Indus | > the loss of the veteran's job, may have a bearing on  |
| try in the | > whether the veteran's disability prevents further     |
|  Community | > employment.                                           |
|            | >                                                       |
|            | > Do not use the loss of industry as the sole basis for |
|            | > a finding of either employability or unemployability. |
+------------+---------------------------------------------------------+

#### 7. Determining Marginal Employment

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on determining        |
| troduction | > marginal employment, including                        |
|            |                                                         |
|            | -   the qualifying criteria for marginal employment     |
|            |                                                         |
|            | -   exceptions to the qualifying criteria for marginal  |
|            |     employment, and                                     |
|            |                                                         |
|            | -   factors pertinent to the issue of marginal          |
|            |     employment.                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### Ch   | > December 13, 2005                                     |
| ange Date  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Marginal employment exists if, by reason of age and   |
| ### a. Qua | > disability, the veteran                               |
| lifying Cr |                                                         |
| iteria for | -   works less than one-half the usual hours, or        |
|  Marginal  |                                                         |
| Employment | -   receives less than one-half the prevailing          |
|            |     community wage for the particular occupation.       |
|            |                                                         |
|            | > Either of the criteria listed above will suffice to   |
|            | > qualify as marginal employment under 38 CFR 4.17(a).  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > In many areas there are jobs available where the pay  |
| #### b. Ex | > is too low to attract the able-bodied and which,      |
| ceptions t | > therefore, must be filled by older or disabled        |
| o the Qual | > persons.                                              |
| ifying Cri | >                                                       |
| teria for  | > Such jobs are still considered marginal employment,   |
| Marginal O | > even though they                                      |
| ccupations |                                                         |
|            | -   require the employees to be present for a full work |
|            |     week, and                                           |
|            |                                                         |
|            | -   pay the same for the particular occupation          |
|            |     throughout the community.                           |
|            |                                                         |
|            | > Jobs such as these are generally sedentary and are    |
|            | > often of the type that qualify under 38 CFR           |
|            | > 3.342(b)(4), such as employment in a sheltered        |
|            | > workshop.                                             |
+------------+---------------------------------------------------------+

Continued on next page

7\. Determining Marginal Employment, Continued

+------------+---------------------------------------------------------+
| ##         | > Consider the following factors when determining       |
| ### c. Fac | > whether a veteran is marginally employed:             |
| tors Perti |                                                         |
| nent to th | -   the veteran's prior work history and earnings,      |
| e Issue of |     compared to the present, which may be related to    |
|  Marginal  |     and reflect the extent of the veteran's disability  |
| Employment |                                                         |
|            | -   whether there has been a marked reduction of        |
|            |     earnings, which may indicate a comparable decrease  |
|            |     in mental or physical capabilities                  |
|            |                                                         |
|            | -   the established wage for a particular type of job   |
|            |     in the community                                    |
|            |                                                         |
|            | -   the opportunity for employment in the community,    |
|            |     and                                                 |
|            |                                                         |
|            | -   the nature of the veteran's disabilities, in        |
|            |     relation to the work for which the veteran is       |
|            |     qualified by experience, education, or training.    |
|            |                                                         |
|            | > ***Note***: Do not regard any single factor, in       |
|            | > itself, as determinative.                             |
+------------+---------------------------------------------------------+

#### 8. Determining Unemployability or Marginal Employment of Farmers

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on determining the    |
| troduction | > unemployability or marginal employment of farmers,    |
|            | > including                                             |
|            |                                                         |
|            | -   computing the net return from a farm to determine   |
|            |     unemployability                                     |
|            |                                                         |
|            | -   considering farm size                               |
|            |                                                         |
|            | -   considering supplementation of farm income prior to |
|            |     disablement                                         |
|            |                                                         |
|            | -   considering the type of work                        |
|            |                                                         |
|            | -   considering past work history                       |
|            |                                                         |
|            | -   comparing the veteran's income and hours of work    |
|            |     with those of other farmers, and                    |
|            |                                                         |
|            | -   considering the veteran's supervision of a farm.    |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### Ch   | > December 13, 2005                                     |
| ange Date  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > In computing the net return from a farm operation     |
| a. Computi | > when members of a veteran's family work without pay,  |
| ng the Net | > deduct the reasonable value of such labor from the    |
|  Return Fr | > farm's total net return to determine how much of the  |
| om a Farm  | > income results from the veteran's own contribution of |
|            | > labor or supervision.                                 |
|            | >                                                       |
|            | > ***Important***: Use this procedure for               |
|            | > unemployability purposes *only*, and not to determine |
|            | > annual income.                                        |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. C | > Many farm operations are so small and the income so   |
| onsidering | > meager that, even though the disabled veteran is      |
|  Farm Size | > doing all of the work required, the veteran might be  |
|            | > considered as only marginally employed.               |
|            | >                                                       |
|            | > Do not base a denial solely on the fact that the      |
|            | > veteran never operated a farm on a large scale.       |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Consider whether the veteran supplemented farm income |
| ### c. Con | > by working as a hired laborer for others before       |
| sidering S | > becoming disabled and whether, because of physical    |
| upplementa | > impairment, this source of income is no longer        |
| tion of Fa | > available.                                            |
| rm Income  |                                                         |
| Prior to D |                                                         |
| isablement |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

8\. Determining Unemployability or Marginal Employment of Farmers,
Continued

+------------+---------------------------------------------------------+
| ##### d.   | > Consider whether the veteran is performing light      |
|  Consideri | > chores, versus heavy farm labor, and seasonal labor,  |
| ng the Typ | > as compared to year-round work.                       |
| e of Work  | >                                                       |
|            | > Higher degrees of disability will limit the scope of  |
|            | > farm work that may be performed.                      |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e.   | > Consider whether the veteran was required by age or   |
|  Consideri | > disability to change from some other type of          |
| ng Past Wo | > full-time employment to a marginal farming operation. |
| rk History |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > If necessary, compare the veteran's income and hours  |
| f. Compari | > of work with those of other farmers in the area       |
| ng the Vet | > engaged in comparable operations.                     |
| eran's Inc | >                                                       |
| ome and Ho | > Contact the local county agricultural representative  |
| urs of Wor | > for this information, if necessary.                   |
| k With Tho |                                                         |
| se of Othe |                                                         |
| r Farmers  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Do not consider the fact that a veteran supervises a  |
| # g. Consi | > farm operation as evidence of employability, except   |
| dering a V | > when the farm operation is large enough to warrant a  |
| eteran's S | > full-time supervisor.                                 |
| upervision |                                                         |
|  of a Farm |                                                         |
+------------+---------------------------------------------------------+

#### 9. Obtaining Evidence of Disability

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on obtaining evidence |
| troduction | > of disability, including                              |
|            |                                                         |
|            | -   obtaining Social Security (SS) disability records,  |
|            |     and                                                 |
|            |                                                         |
|            | -   requesting evidence of unemployability concurrently |
|            |     with a request for examination.                     |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a. O | > Obtain and consider complete copies of Social         |
| btaining S | > Security Administration (SSA) records used in the SSA |
| S Disabili | > determination of disability if                        |
| ty Records |                                                         |
|            | -   the available evidence is insufficient to award     |
|            |     pension benefits, and                               |
|            |                                                         |
|            | -   the record shows that the veteran is receiving      |
|            |     Social Security (SS) benefits because of            |
|            |     disability.                                         |
|            |                                                         |
|            | > ***Reference***: For more information on requesting   |
|            | > SSA information, see M21-1MR, Part III, Subpart iii,  |
|            | > 3.A.                                                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > If evidence of unemployability is required, request   |
| #### b. Re | > it concurrently with a request for examination.       |
| questing E | >                                                       |
| vidence of | > To avoid unnecessary development, apply the rule "the |
|  Unemploya | > greater the disability, the less evidence of          |
| bility Con | > unemployability."                                     |
| currently  |                                                         |
| With a Req |                                                         |
| uest for E |                                                         |
| xamination |                                                         |
+------------+---------------------------------------------------------+

#### 10. Determining Permanent and Total Disability

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on determining        |
| troduction | > permanent and total disability, including information |
|            | > on                                                    |
|            |                                                         |
|            | -   establishing the permanence of total disability     |
|            |                                                         |
|            | -   the actions on anticipated permanent residuals, and |
|            |                                                         |
|            | -   rating Day Hospital program cases.                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Under 38 CFR 3.342(b)(2)                              |
| a. Establi |                                                         |
| shing the  | -   establish the permanence of total disability as of  |
| Permanence |     the earliest date consistent with the evidence in   |
|  of Total  |     the claim, and                                      |
| Disability |                                                         |
|            | -   establish permanence after six months               |
|            |     hospitalization without improvement in tuberculosis |
|            |     and other disabilities requiring hospitalization    |
|            |     for indefinite periods.                             |
|            |                                                         |
|            | > ***Note***: Consider the six-month period a maximum,  |
|            | > rather than a minimum, waiting period.                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Take the following actions if a veteran suffers a     |
| #### b. Ac | > heart attack, stroke, accident, and so forth:         |
| tions on A |                                                         |
| nticipated | -   Evaluate the anticipated permanent residuals from   |
|  Permanent |     the degree of recovery shown within a comparatively |
|  Residuals |     short time after the occurrence.                    |
|            |                                                         |
|            | -   Consider the impact of the veteran's age,           |
|            |     educational level, occupational background, and     |
|            |     prior physical condition on the anticipated level   |
|            |     of functional impairment.                           |
|            |                                                         |
|            | -   Do not defer rating action until the residual       |
|            |     disability can be established with absolute         |
|            |     certainty.                                          |
|            |                                                         |
|            | -   If a permanent, total disability is anticipated,    |
|            |     but not definitely established, prepare a favorable |
|            |     rating decision and schedule a future review        |
|            |     examination.                                        |
+------------+---------------------------------------------------------+

Continued on next page

10\. Determining Permanent and Total Disability, Continued

+------------+---------------------------------------------------------+
| ##         | > The Veterans Health Administration Day Hospital       |
| ### c. Rat | > program is a post-hospital care or outpatient program |
| ing Day Ho | > which provides veterans with a brief, but very        |
| spital Pro | > intensive, psychiatric regimen.                       |
| gram Cases | >                                                       |
|            | > Since there is the potential for recovery under       |
|            | > intensive treatment, exercise care in establishing    |
|            | > permanent and total disability for pension            |
|            | > entitlement based solely on records showing           |
|            | > participation in the Day Hospital program.            |
+------------+---------------------------------------------------------+

#### 11. Effective Dates for Disability Pension Awards

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on the effective      |
| troduction | > dates for disability pension awards, including the    |
|            |                                                         |
|            | -   effective date of an original or reopened award,    |
|            |     and                                                 |
|            |                                                         |
|            | -   conditions for awarding pension retroactively.      |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > For claims received after September 30, 1984, the     |
| a. Effecti | > effective date of an original or reopened award of    |
| ve Date of | > disability pension is the date the Department of      |
|  an Origin | > Veterans Affairs (VA) received the claim.             |
| al or Reop |                                                         |
| ened Award |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > VA may award the disability pension retroactively for |
| # b. Condi | > up to a period of one year before the date of claim,  |
| tions for  | > but not earlier than the date of permanent and total  |
| Awarding P | > disability, if *all* the following conditions are     |
| ension Ret | > met:                                                  |
| roactively |                                                         |
|            | -   The veteran files a claim for a retroactive award   |
|            |     within one year from the date the veteran became    |
|            |     permanently and totally disabled.                   |
|            |                                                         |
|            | -   The veteran was prevented from applying for pension |
|            |     by a disability, not of misconduct origin, and not  |
|            |     necessarily the disability upon which the permanent |
|            |     and total disability status is based.               |
|            |                                                         |
|            | -   The disability prevented the veteran from filing    |
|            |     the pension claim for a period of at least 30       |
|            |     consecutive days following the beginning date of    |
|            |     permanent and total disability.                     |
|            |                                                         |
|            | > ***Reference***: For more information on retroactive  |
|            | > payment of disability pension, see                    |
|            |                                                         |
|            | -   38 CFR 3.400(b)(1)(ii)(B), and                      |
|            |                                                         |
|            | -   M21-1MR, Part V, Subpart ii, 1.B.12.                |
+------------+---------------------------------------------------------+

#### 12. Requirements for Retroactive Payment of Disability Pension

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on the requirements   |
| troduction | > for retroactive payment of disability pension,        |
|            | > including information on                              |
|            |                                                         |
|            | -   granting retroactive awards of disability pension   |
|            |                                                         |
|            | -   the action when it is determined that retroactive   |
|            |     benefits may be payable                             |
|            |                                                         |
|            | -   what constitutes a qualifying disability for a      |
|            |     retroactive pension award, and                      |
|            |                                                         |
|            | -   rating decisions to dispose of the issue of a       |
|            |     retroactive effective date.                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > Generally, VA does not invite a claim to establish    |
| ## a. Gene | > entitlement to a retroactive payment of disability    |
| ral Inform | > pension.                                              |
| ation on R | >                                                       |
| etroactive | > The instructions for *VA Form 21-526*, *Veteran's     |
|  Payment o | > Application for Compensation and/or Pension* advise   |
| f Disabili | > the veteran that a claim for disability pension is    |
| ty Pension | > considered a claim for retroactive payment *only* if  |
|            | > so indicated on the application.                      |
|            | >                                                       |
|            | > ***Reference***: For more information on retroactive  |
|            | > payment of disability pension, see 38 CFR             |
|            | > 3.400(b)(1)(ii)(B).                                   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > If the veteran has not requested consideration for    |
| b. Action  | > retroactive payment on *VA Form 21-526,* but the RVSR |
| When Retro | > determines that a qualifying disability may exist,    |
| active Ben | > the RVSR requests the authorization activity to       |
| efits May  | > advise the claimant that retroactive benefits may be  |
| Be Payable | > payable.                                              |
|            | >                                                       |
|            | > ***Important***: Do *not* establish a pending control |
|            | > in this event.                                        |
+------------+---------------------------------------------------------+

Continued on next page

12\. Requirements for Retroactive Payment of Disability Pension,
Continued

+------------+---------------------------------------------------------+
| #          | > To qualify for a retroactive pension award, the       |
| #### c. Wh | > claimed disability must be so incapacitating that it  |
| at Constit | > reasonably could have prevented the veteran from      |
| utes a Qua | > filing an application for pension. A disability will  |
| lifying Di | > meet this requirement when it                         |
| sability f |                                                         |
| or a Retro | -   is so severe as to normally require hospitalization |
| active Pen |     and intensive treatment                             |
| sion Award |                                                         |
|            | -   prevents the veteran from filing an application     |
|            |     from the date he/she first became permanently and   |
|            |     totally disabled, and                               |
|            |                                                         |
|            | -   continues for a period of at least 30 consecutive   |
|            |     days.                                               |
|            |                                                         |
|            | > ***Note***: Although the qualifying disability must   |
|            | > have continued for a period of at least 30            |
|            | > consecutive days, it is not necessary for it to have  |
|            | > continued for the entire retroactive period.          |
|            | >                                                       |
|            | > ***Example***: Examples of this type of disability    |
|            | > are a                                                 |
|            |                                                         |
|            | -   severe heart attack                                 |
|            |                                                         |
|            | -   cardiovascular accident, or                         |
|            |                                                         |
|            | -   critical, incapacitating injury requiring intensive |
|            |     care and/or treatment.                              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### d. R | > In disability pension claims, dispose of the issue of |
| ating Deci | > a retroactive effective date in a rating decision.    |
| sion to Di | >                                                       |
| spose of t | > If retroactive benefits under 38 CFR                  |
| he Issue o | > 3.400(b)(1)(ii)(B) are claimed                        |
| f a Retroa |                                                         |
| ctive Effe | -   with the application for pension, and the evidence  |
| ctive Date |     is sufficient to determine whether the claimed      |
|            |     disability qualifies, dispose of the issue with a   |
|            |     rating decision granting or denying permanent and   |
|            |     total disability, or                                |
|            |                                                         |
|            | -   after commencement of pension payments, prepare a   |
|            |     separate disability rating decision disposing of    |
|            |     the issue.                                          |
|            |                                                         |
|            | > ***Note***: Do not delay granting pension benefits    |
|            | > from the date of receipt of the claim when the        |
|            | > evidence shows the veteran is permanently and totally |
|            | > disabled, but the issue of retroactive payment cannot |
|            | > be immediately resolved.                              |
+------------+---------------------------------------------------------+