### Section D. Exhibits

#### Overview

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

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

  17           Exhibit 1: Examples of Retroactive Adjustments 6-D-2

  18           Exhibit 2: Examples of Future Adjustments      6-D-8
  ------------ ---------------------------------------------- ------------

#### 17. Exhibit 1: Examples of Retroactive Adjustments

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains five examples for completion of   |
| troduction | > the 304 (dependency) and 403 (disability/death award) |
|            | > screens while preparing retroactive adjustments. It   |
|            | > includes examples of a(n)                             |
|            |                                                         |
|            | -   example 1: increased award                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 2: continued award                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 3: separate DIC award to child previously   |
|            |     included on spouse's award                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen, and                                     |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 4: separate DIC award to child previously   |
|            |     receiving an apportioned award based on a spouse    |
|            |     also in receipt of benefits                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen, and                                     |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 5: separate DIC award, no surviving spouse  |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen.                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 26, 2007                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > On September 2, 2005, a veteran in receipt of         |
|  a. Exampl | > compensation at the 30 percent rate notifies the      |
| e 1: Incre | > regional office (RO) that his *only* dependent, Lynn, |
| ased Award | > born August 9, 1987, is attending high school through |
|            | > June 8, 2006.                                         |
+------------+---------------------------------------------------------+

Continued on next page

17\. Exhibit 1: Examples of Retroactive Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### b. 3 | > This is the 304 screen based on the information in    |
| 04 Screen  | > M21-1MR, Part III, Subpart iii, 6.D.17.a.             |
|            | >                                                       |
|            | > ![](media/image1.wmf)                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c.   | > This is the 403 screen based on the information in    |
| 403 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.a.             |
|            | >                                                       |
|            | > ![](media/image2.wmf)                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > On July 2, 2006, a veteran in receipt of improved     |
|  d. Exampl | > pension without income notifies the RO that his only  |
| e 2: Conti | > dependent, Arnie, born May 15, 1988, is attending     |
| nued Award | > school through June 8, 2007.                          |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e.   | > This is the 304 screen based on the information in    |
| 304 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.d.             |
|            | >                                                       |
|            | > ![](media/image3.wmf)                                 |
+------------+---------------------------------------------------------+

Continued on next page

17\. Exhibit 1: Examples of Retroactive Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### f.   | > This is the 403 screen based on the information in    |
| 403 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.d.             |
|            | >                                                       |
|            | > ![](media/image4.wmf)                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > On July 2, 2006, Bill, born May 15, 1988, notifies    |
|  g. Exampl | > the RO that he is attending school through June 8,    |
| e 3: Separ | > 2007.                                                 |
| ate DIC Aw |                                                         |
| ard to Chi |                                                         |
| ld Previou |                                                         |
| sly Includ |                                                         |
| ed on Spou |                                                         |
| se's Award |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### h.   | > This is the 304 screen based on the information in    |
| 304 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.g.             |
|            | >                                                       |
|            | > ![](media/image5.wmf)                                 |
+------------+---------------------------------------------------------+

Continued on next page

17\. Exhibit 1: Examples of Retroactive Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### i.   | > This is the 403 screen based on the information in    |
| 403 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.g.             |
|            | >                                                       |
|            | > ![](media/image6.wmf)                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > On July 2, 2006, Bill, born May 15, 1988, notifies    |
|  j. Exampl | > the RO that he is attending school through June 8,    |
| e 4: Separ | > 2007.                                                 |
| ate DIC Aw |                                                         |
| ard to Chi |                                                         |
| ld Previou |                                                         |
| sly Receiv |                                                         |
| ing an App |                                                         |
| ortioned A |                                                         |
| ward Based |                                                         |
|  on a Spou |                                                         |
| se Also in |                                                         |
|  Receipt o |                                                         |
| f Benefits |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### k.   | > This is the 304 screen based on the information above |
| 304 Screen | > in M21-1MR, Part III, Subpart iii, 6.D.17.j.          |
|            | >                                                       |
|            | > ![](media/image7.wmf)                                 |
+------------+---------------------------------------------------------+

Continued on next page

17\. Exhibit 1: Examples of Retroactive Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### l.   | > This is the 403 screen based on the information in    |
| 403 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.j.             |
|            | >                                                       |
|            | > ![](media/image8.wmf)                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### m.   | > On July 2, 2006, Bill, born May 15, 1988, notifies    |
| Example 5: | > the RO that he is attending school through June 8,    |
|  Separate  | > 2007.                                                 |
| DIC Award, |                                                         |
|  No Surviv |                                                         |
| ing Spouse |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### n.   | > This is the 304 screen based on the information in    |
| 304 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.m.             |
+------------+---------------------------------------------------------+

Continued on next page

17\. Exhibit 1: Examples of Retroactive Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### o.   | > This is the 403 screen based on the information in    |
| 403 Screen | > M21-1MR, Part III, Subpart iii, 6.D.17.m.             |
|            | >                                                       |
|            | > ![](media/image9.wmf)                                 |
+------------+---------------------------------------------------------+

#### 18. Exhibit 2: Examples of Future Adjustments

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains six exhibits of examples for      |
| troduction | > completing the 304 and 403 screens while preparing    |
|            | > future adjustments. It includes                       |
|            |                                                         |
|            | -   example 1: increased award                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 2: continued award                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 3: separate DIC award to a child previously |
|            |     included on the spouse's award                      |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 4A: when the child is the only payee        |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 4B: child is part of a consolidated award   |
|            |     with more than one child                            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 5: separate DIC award with no surviving     |
|            |     spouse                                              |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen, and                                     |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   example 6: a break in continuity                    |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   304 screen                                          |
|            |                                                         |
|            | -   403 screen.                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 26, 2007                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > In September 2006, a veteran in receipt of            |
|  a. Exampl | > compensation at the 30-percent rate notifies the RO   |
| e 1: Incre | > that his only dependent, Lynn, born May 15, 1988,     |
| ased Award | > would be attending high school through June 8, 2007.  |
|            | > (The topic is "Future" adjustments. If the child's    |
|            | > birth date is 1988, the 18^th^ birthday is May of     |
|            | > 2006. If we are making an adjustment in September of  |
|            | > 2006, to pay from the 18^th^ birthday to June of      |
|            | > 2007, it is not a future award. It is a retroactive   |
|            | > award from May of 2006. Need to change the date of    |
|            | > claim or the birth date so the claim for school child |
|            | > benefits is received prior to the child reaching 18.) |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### b. E | > This is the 304 screen based on the information in    |
| xample 1:  | > M21-1MR, Part III, Subpart iii, 6.D.18.a.             |
| 304 Screen | >                                                       |
|            | > ![](media/image10.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c. E | > This is the 403 screen based on the information in    |
| xample 1:  | > M21-1MR, Part III, Subpart iii, 6.D.18.a.             |
| 403 Screen | >                                                       |
|            | > ![](media/image11.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > In March 2006, a veteran in receipt of improved       |
|  d. Exampl | > pension without income notifies the RO that his only  |
| e 2: Conti | > dependent, Arnie, born May 15, 1988, is attending     |
| nued Award | > school through June 8, 2007.                          |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### e. E | > This is the 304 screen based on the information in    |
| xample 2:  | > M21-1MR, Part III, Subpart iii, 6.D.18.d.             |
| 304 Screen | >                                                       |
|            | > ![](media/image12.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### f. E | > This is the 403 screen based on the information in    |
| xample 2:  | > M21-1MR, Part III, Subpart iii, 6.D.18.d.             |
| 403 Screen | >                                                       |
|            | > ![](media/image13.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### g.   | > In March 2006, Bill, born May 15, 1988, notifies the  |
| Example 3: | > RO that he is attending school through June 8, 2007.  |
|  Separate  |                                                         |
| DIC Award  |                                                         |
| to Child P |                                                         |
| reviously  |                                                         |
| Included o |                                                         |
| n the Spou |                                                         |
| se's Award |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### h. E | > This is the 304 screen based on the information in    |
| xample 3:  | > M21-1MR, Part III, Subpart iii, 6.D.18.g.             |
| 304 Screen | >                                                       |
|            | > ![](media/image14.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### i. E | > This is the 403 screen based on the information in    |
| xample 3:  | > M21-1MR, Part III, Subpart iii, 6.D.18.g.             |
| 403 Screen | >                                                       |
|            | > ![](media/image15.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > ***Situation***: This situation involves a separate   |
| ## j. Exam | > DIC award to a child previously receiving an          |
| ple 4A: Wh | > apportioned award based upon a surviving spouse also  |
| en the Chi | > in receipt of benefits.                               |
| ld Is the  | >                                                       |
| Only Payee | > ***Notification***: In March 2006, Bill, born May 15, |
|            | > 1988, notifies the RO that he is attending school     |
|            | > through June 8, 2007.                                 |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| #          | > This is the 304 screen based on the information in    |
| #### k. Ex | > M21-1MR, Part III, Subpart iii, 6.D.18.j.             |
| ample 4A:  | >                                                       |
| 304 Screen | > ![](media/image16.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > This is the 403 screen based on the information in    |
| #### l. Ex | > M21-1MR, Part III, Subpart iii, 6.D.18.j              |
| ample 4A:  | >                                                       |
| 403 Screen | > ![](media/image17.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > ***Situation***: This situation involves a separate   |
| ## m. Exam | > DIC award to a child previously receiving an          |
| ple 4B: Ch | > apportioned award based upon a surviving spouse also  |
| ild is Par | > in receipt of benefits.                               |
| t of a Con | >                                                       |
| solidated  | > ***Notification***: In March 2006, Bill, born May 15, |
| Award With | > 1988, notifies the RO he is attending school through  |
|  More Than | > June 8, 2007.                                         |
|  One Child |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| #          | > This is the 304 screen based on the information in    |
| #### n. Ex | > M21-1MR, Part III, Subpart iii, 6.D.18.m.             |
| ample 4B:  | >                                                       |
| 304 Screen | > ![](media/image18.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > This is the 403 screen based on the information in    |
| #### o. Ex | > M21-1MR, Part III, Subpart iii, 6.D.18.m.             |
| ample 4B:  | >                                                       |
| 403 Screen | > ![](media/image19.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### p.   | > In March 1996, Bill, born May 15, 1988, notifies the  |
| Example 5: | > RO that he is attending school through June 8, 2007.  |
|  Separate  |                                                         |
| DIC Award, |                                                         |
|  No Surviv |                                                         |
| ing Spouse |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### q. E | > This is the 304 screen based on the information in    |
| xample 5:  | > M21-1MR, Part III, Subpart iii, 6.D.18.p.             |
| 304 Screen | >                                                       |
|            | > ![](media/image20.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### r. E | > This is the 403 screen based on the information in    |
| xample 5:  | > M21-1MR, Part III, Subpart iii, 6.D.18.p.             |
| 403 Screen | >                                                       |
|            | > ![](media/image21.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### s.   | > On July 1, 2006, a veteran, in receipt of pension     |
| Example 6: | > without income, reports that his son, Arnold, will    |
|  Break in  | > attend college August 15, 2006, through May 29, 2007. |
| Continuity | > He has countable income of \$145 per year.            |
|            | >                                                       |
|            | > ***Important***: If there has been a break in the     |
|            | > continuity, Improved Pension cases must show the      |
|            | > current award line using special law (SL) code 18     |
|            | > zeroed out effective the date the child is added      |
|            | > whenever there is a future change in income for VA    |
|            | > purposes (IVAP) due to the child's income.            |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exhibit 2: Examples of Future Adjustments, Continued

+------------+---------------------------------------------------------+
| ##### t. E | > This is the 304 screen based on the information in    |
| xample 6:  | > M21-1MR, Part III, Subpart iii, 6.D.18.s.             |
| 304 Screen | >                                                       |
|            | > ![](media/image22.wmf)                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### u. E | > This is the 403 screen based on the information in    |
| xample 6:  | > M21-1MR, Part III, Subpart iii, 6.D.18.s.             |
| 403 Screen | >                                                       |
|            | > ![](media/image23.wmf)                                |
+------------+---------------------------------------------------------+