### Section B. SSA Requests for Information From VA

#### Overview

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

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

  10           General Information on SSA Requests to VA      3-B-3

  11           SSA Requests for Medical Information           3-B-4

  12           General Information on VA Responses to SSA     3-B-7
               Requests                                       

  13           Releasing Medical Information to the SSA       3-B-10

  14           When to Use VA Form 21-4184, Certification of  3-B-13
               Contents of Document(s) or Record(s)           

  15           General Information on Determining VA Benefits 3-B-16
               for SSA Purposes                               

  16           Exclusion of Aid and Attendance (A&A),         3-B-18
               Housebound or Special Monthly Compensation     
               (SMC) Entitlement for SSA Purposes             

  17           Exclusion of Deductions When Responding to SSA 3-B-22
               Inquiries                                      

  18           Exclusion of Amounts Payable Due to Medical    3-B-24
               Expenses                                       

  19           General Information on Calculating Award       3-B-26
               Amounts for Responses to the SSA               

  20           Calculating Old Law Pension Award Amounts for  3-B-27
               Responses to the SSA                           

  21           Calculating Section 306 Pension Award Amounts  3-B-30
               for Responses to the SSA                       

  22           Calculating DIC and Death Compensation Award   3-B-33
               Amounts for Responses to the SSA Concerning    
               Benefit Payments to Parents                    

  23           Calculating DIC and Death Compensation Award   3-B-34
               Amounts for Responses to the SSA Concerning    
               Benefit Payments to a Surviving Spouse or      
               Child(ren)                                     
  ------------ ---------------------------------------------- ------------

Continued on next page

Overview, Continued

  -----------------------------------------------------------------------
  In this Section (continued)

  -----------------------------------------------------------------------

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

  24           Calculating Disability Compensation Award      3-B-38
               Amounts for Responses to the SSA               

  25           Calculating Improved Pension Award Amounts for 3-B-40
               Responses to the SSA                           

  26           Calculating Service Pension Award Amounts for  3-B-45
               Responses to the SSA                           
  ------------ ---------------------------------------------- ------------

#### 10. General Information on SSA Requests to VA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains general information on Social     |
| troduction | > Security Administration (SSA) requests to the         |
|            | > Department of Veterans Affairs (VA), including        |
|            | > information on                                        |
|            |                                                         |
|            | -   the responsibilities of SSA field offices           |
|            |                                                         |
|            | -   the SSA/VA data exchange system                     |
|            |                                                         |
|            | -   when SSA uses *SSA Form L1103*, *SSI Request for    |
|            |     Information* to request additional information, and |
|            |                                                         |
|            | -   other VA benefits of interest to the SSA.           |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #####      | > In administering the Supplemental Security Income     |
| a. Respons | > (SSI) program, Social Security Administration (SSA)   |
| ibilities  | > field offices are charged with identifying all of an  |
| of SSA Fie | > SSI claimant's resources, including "income" in the   |
| ld Offices | > form of monetary benefits from the Department of      |
|            | > Veterans Affairs (VA).                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > The SSA/VA data exchange system is programmed to      |
| b. SSA/VA  | > "break down" VA payments to determine the amount to   |
| Data Excha | > which each beneficiary is entitled. It cannot,        |
| nge System | > however, calculate the additional amount VA pays for  |
|            | > individual dependents.                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c    | > The SSA uses *SSA Form L1103*, *SSI Request for       |
| . When SSA | > Information* to request pertinent information from VA |
|  Uses SSA  | > that is unavailable through the data exchange system. |
| Form L1103 |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > SSA may request information on other VA benefits, in  |
|  d. Other  | > addition to compensation and pension, such as         |
| VA Benefit |                                                         |
| s of Inter | -   educational benefits                                |
| est to SSA |                                                         |
|            | -   Medal of Honor benefits                             |
|            |                                                         |
|            | -   Naval pension                                       |
|            |                                                         |
|            | -   Restored Entitlement Program for Survivors (REPS),  |
|            |     and                                                 |
|            |                                                         |
|            | -   benefits under 38 U.S.C. 1312(a).                   |
+------------+---------------------------------------------------------+

#### 11. SSA Requests for Medical Information

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on SSA requests for   |
| troduction | > medical information, including information on         |
|            |                                                         |
|            | -   where SSA sends requests for medical information    |
|            |                                                         |
|            | -   the information that should be on *SSA Form         |
|            |     828-U4*, *Request for Medical Information From      |
|            |     Records of the Department of Veterans Affairs*      |
|            |                                                         |
|            | -   what to do with *SSA Form 828-U4*                   |
|            |                                                         |
|            | -   handling misdirected requests for hospital reports  |
|            |                                                         |
|            | -   handling requests with insurance numbers only, and  |
|            |                                                         |
|            | -   the appropriate action to take when the regional    |
|            |     office (RO) that receives the *SSA Form 828-U4*     |
|            |     does not have the claims folder.                    |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a    | > Requests from the SSA on *SSA Form 828-U4*, *Request  |
| . Where SS | > for Medical Information From Records of the           |
| A Sends Re | > Department of Veterans Affairs*, are sent to regional |
| quests for | > offices (ROs).                                        |
|  Medical I | >                                                       |
| nformation | > ***Exception***: SSA sends requests for hospital      |
|            | > reports on veterans who are currently hospitalized,   |
|            | > or who have been discharged within the last 30 days,  |
|            | > directly to the VA medical center (VAMC) involved.    |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > The *SSA Form 828-U4* should contain the              |
| # b. Infor |                                                         |
| mation Tha | -   veteran's                                           |
| t Should b |                                                         |
| e on SSA F | ```{=html}                                              |
| orm 828-U4 | <!-- -->                                                |
|            | ```                                                     |
|            | -   full name                                           |
|            |                                                         |
|            | -   file number                                         |
|            |                                                         |
|            | -   service number, and                                 |
|            |                                                         |
|            | -   Social Security number (SSN)                        |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   VARO of jurisdiction                                |
|            |                                                         |
|            | -   specific information required, and                  |
|            |                                                         |
|            | -   address of the requesting SSA office.               |
+------------+---------------------------------------------------------+

Continued on next page

11\. SSA Requests for Medical Information, Continued

+------------+---------------------------------------------------------+
| ##### c. W | > When records are provided to the SSA                  |
| hat to Do  |                                                         |
| With SSA F | -   annotate both copies of *SSA Form 828-U4* to show   |
| orm 828-U4 |     which records were furnished                        |
|            |                                                         |
|            | -   return the duplicate of *SSA Form 828-U4* with the  |
|            |     records furnished                                   |
|            |                                                         |
|            | -   file the original *SSA Form 828-U4* in the claims   |
|            |     folder.                                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### d.   | > If the veteran has been discharged from a VA medical  |
| Handling M | > center (VAMC) more than 30 days following a recent    |
| isdirected | > period of hospitalization, and a hospital summary is  |
|  Requests  | > not in the folder, acknowledge receipt of the *SSA    |
| for Hospit | > Form 828-U4* and refer the form to the hospital       |
| al Reports | > concerned.                                            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Use the table below to determine the appropriate      |
| # e. Handl | > action to take when the SSA request contains a VA     |
| ing Reques | > insurance number only.                                |
| ts With In |                                                         |
| surance Nu |                                                         |
| mbers Only |                                                         |
+------------+---------------------------------------------------------+

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 1     | Perform a Beneficiary Identification and Records Locator     |
|       | Subsystem (BIRLS) inquiry (BINQ) using the veteran's name,   |
|       | insurance number, and any other identifying information      |
|       | available.                                                   |
+-------+--------------------------------------------------------------+
| 2     | Does the BINQ screen show the existence of a claims folder   |
|       | or an insurance folder only?                                 |
|       |                                                              |
|       | -   If a ***claims folder exists***, go to Step 3.           |
|       |                                                              |
|       | -   If an ***insurance folder*** only exists, go to Step 4.  |
+-------+--------------------------------------------------------------+
| 3     | Take action to obtain the records as outlined in             |
|       |                                                              |
|       | -   M21-1MR, Part III, Subpart iii, 3.B.11.a through d, and  |
|       |                                                              |
|       | -   M21-1MR, Part III, Subpart iii, 3.B.11.f.                |
+-------+--------------------------------------------------------------+
| 4     | Acknowledge receipt of the *SSA Form 828-U4* and refer the   |
|       | form to the VA Insurance Center in Philadelphia for a reply. |
+-------+--------------------------------------------------------------+

Continued on next page

11\. SSA Requests for Medical Information, Continued

+------------+---------------------------------------------------------+
| ##### f.   | > Use the table below to determine the appropriate      |
| Appropriat | > action to take if the claims folder is not in the RO  |
| e Action t | > receiving *SSA Form 828-U4*.                          |
| o Take Whe |                                                         |
| n the RO D |                                                         |
| oes Not Ha |                                                         |
| ve the Cla |                                                         |
| ims Folder |                                                         |
+------------+---------------------------------------------------------+

+-----------------------------+----------------------------------------+
| If BIRLS shows that the     | Then ...                               |
| folder is ...               |                                        |
+-----------------------------+----------------------------------------+
| located in another RO       | -   enter the location of the folder   |
|                             |     under Item IIIA, "Remarks," of     |
|                             |     *SSA Form 828-U4*, and             |
|                             |                                        |
|                             | -   return both copies of the *SSA     |
|                             |     Form 828-U4* to the SSA office     |
|                             |     shown on the form.                 |
+-----------------------------+----------------------------------------+
| on temporary transfer to    | send the *SSA Form 828-U4* to the      |
| Central Office (CO)         | service within CO that has the folder. |
|                             |                                        |
|                             | ***Note***: The CO service having      |
|                             | possession of the folder will process  |
|                             | the *SSA-828-U4*.                      |
+-----------------------------+----------------------------------------+
| on temporary transfer to    | send the *SSA Form 828-U4* to CO       |
| the Board of Veterans       | Compensation and Pension Service (214) |
| Appeals (BVA)               | for                                    |
|                             |                                        |
|                             | -   review of the folder, and          |
|                             |                                        |
|                             | -   processing of the form.            |
+-----------------------------+----------------------------------------+

#### 12. General Information on VA Responses to SSA Requests

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains general information on VA         |
| troduction | > responses to SSA requests, including information on   |
|            |                                                         |
|            | -   the requirements of 38 U.S.C. 5105                  |
|            |                                                         |
|            | -   the definition of a ***VA payment***                |
|            |                                                         |
|            | -   what SSA usually requests                           |
|            |                                                         |
|            | -   handling requests for information on multiple       |
|            |     individuals                                         |
|            |                                                         |
|            | -   responding to                                       |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   follow-up requests, and                             |
|            |                                                         |
|            | -   supplemental requests, and                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   work credit for responding to SSA.                  |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a.   | > 38 U.S.C. 5105 requires that evidence filed with      |
| Requiremen | > either the SSA or VA must be made available to the    |
| ts of 38 U | > other agency if needed.                               |
| .S.C. 5105 | >                                                       |
|            | > ***Important***: A claimant is not precluded from     |
|            | > submitting a duplicate set of records/evidence to one |
|            | > or the other agency.                                  |
|            | >                                                       |
|            | > ***Reference***: For more information on making       |
|            | > evidence available to the SSA and VA, see 38 CFR      |
|            | > 3.201.                                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > For purposes of this chapter, ***VA payment*** means  |
| #### b. De | > the benefit amount after the round down required by   |
| finition:  | > 38 U.S.C. 5123.                                       |
| VA Payment |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

12\. General Information on VA Responses to SSA Requests, Continued

+------------+---------------------------------------------------------+
| #          | > An SSA inquiry typically requires only itemization of |
| #### c. In | > recurring benefit payments.                           |
| formation  | >                                                       |
| SSA Usuall | > ***Notes***:                                          |
| y Requests |                                                         |
|            | -   Use the information in M21-1MR, Part IX, Subpart    |
|            |     ii, 1.C.6 to reply to SSA requests for information  |
|            |     concerning benefits under 38 U.S.C. 1312(a).        |
|            |                                                         |
|            | -   When itemizing recurring benefit payments, show VA  |
|            |     payments made from the dates in question by the     |
|            |     SSA, which is not necessarily the payment in effect |
|            |     on that date.                                       |
|            |                                                         |
|            | -   SSA is specifically interested in                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   payment receipt dates, not effective dates, and     |
|            |                                                         |
|            | -   the distinction between retroactive payments and    |
|            |     recurring benefits.                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > SSA may simultaneously request payment information on |
| #### d. Ha | > multiple claimants, listing the names of individuals  |
| ndling Req | > (claimants for SSI purposes) for whom they desire     |
| uests for  | > information in Part I of *SSA Form L1103*.            |
| Multiple I | >                                                       |
| ndividuals | > VA should provide the requested information for each  |
|            | > individual.                                           |
|            | >                                                       |
|            | > If the response will not fit in the space provided on |
|            | > *SSA Form L1103*, attach a continuation sheet and     |
|            | > transfer the following identification information     |
|            | > from the top of *SSA Form L1103* to the top of the    |
|            | > continuation sheet:                                   |
|            |                                                         |
|            | -   the name of the claimant, and                       |
|            |                                                         |
|            | -   the claimant's SSN.                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Use the table below to determine how to respond to a  |
| #### e. Re | > follow-up request from SSA in the form of a copy of   |
| sponding t | > the original request marked "Second Request."         |
| o Follow-U |                                                         |
| p Requests |                                                         |
+------------+---------------------------------------------------------+

+--------------------------+-------------------------------------------+
| If ...                   | Then ...                                  |
+--------------------------+-------------------------------------------+
| A reply had already been | -   indicate in the "Remarks" section of  |
| forwarded to the same    |     the *SSA Form 828-U4*: "*VA reply     |
| SSA office               |     forwarded [(date) ]{.underline}* ,"   |
|                          |     and                                   |
|                          |                                           |
|                          | -   return the *SSA Form 828-U4* to the   |
|                          |     office that sent the follow-up.       |
+--------------------------+-------------------------------------------+

Continued on next page

12\. General Information on VA Responses to SSA Requests, Continued

  -----------------------------------------------------------------------
  e\. Responding to Follow-Up Requests (continued)

  -----------------------------------------------------------------------

+--------------------------+-------------------------------------------+
| If ...                   | Then ...                                  |
+--------------------------+-------------------------------------------+
| The RO is awaiting       | -   indicate in the "Remarks" section of  |
| information to complete  |     the *SSA Form 828-U4* that further    |
| the reply                |     action on the request is suspended    |
|                          |     pending the collection of additional  |
|                          |     information                           |
|                          |                                           |
|                          | -   explain briefly the reason for the    |
|                          |     delay, and                            |
|                          |                                           |
|                          | -   return the *SSA Form 828-U4* to the   |
|                          |     office that sent the follow-up.       |
+--------------------------+-------------------------------------------+
| the request was referred | -   acknowledge receipt of the request on |
| to a VAMC or clinic      |     a locally-generated letter or         |
|                          |     transmittal slip                      |
|                          |                                           |
|                          | -   indicate the medical center or clinic |
|                          |     to which the request was referred     |
|                          |                                           |
|                          | -   attach *SSA Form 828-U4* to the       |
|                          |     transmittal, and                      |
|                          |                                           |
|                          | -   return the forms to the requesting    |
|                          |     SSA office.                           |
+--------------------------+-------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > If the information VA previously furnished to the SSA |
| ## f. Resp | > is insufficient and more information is required, the |
| onding to  | > SSA will check Item 11E of a supplemental *SSA Form   |
| Supplement | > 828-U4* and describe the additional information       |
| al Request | > required.                                             |
| s From SSA | >                                                       |
|            | > ***Note***: The information VA previously furnished   |
|            | > is shown on the supplemental request to avoid         |
|            | > duplicate submission.                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Take work credit under end product (EP) 400 for       |
| ### g. Wor | > responses provided to SSA inquiries.                  |
| k Credit f |                                                         |
| or Respond |                                                         |
| ing to SSA |                                                         |
+------------+---------------------------------------------------------+

#### 13. Releasing Medical Information to the SSA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on releasing medical  |
| troduction | > information to the SSA, including information on      |
|            |                                                         |
|            | -   the action to take when requested medical           |
|            |     information is available                            |
|            |                                                         |
|            | -   who releases the records to the SSA                 |
|            |                                                         |
|            | -   handling a request involving a helpless child       |
|            |                                                         |
|            | -   types of records that are confidential              |
|            |                                                         |
|            | -   releasing medical records referring to treatment    |
|            |     for human immunodeficiency virus (HIV) or syndrome  |
|            |     (AIDS), alcohol abuse, drug abuse or sickle cell    |
|            |     anemia, and                                         |
|            |                                                         |
|            | -   the action to take if                               |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   only *VA Form 10-7131, Exchange of Beneficiary      |
|            |     Information and Request for Administrative and      |
|            |     Adjudicative Action*, is on file, and               |
|            |                                                         |
|            | -   reports are at both the RO and VA hospital.         |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ###        | > Furnish photocopies of *SF 502*, *VA Form 10-1000,    |
| ## a. Acti | > Hospital Summary*, and/or the *Compensation and       |
| on to Take | > Pension Exam Report*, (or its equivalent), covering   |
|  When Requ | > the period indicated on *SSA Form 828-U4*.            |
| ested Info |                                                         |
| rmation Is |                                                         |
|  Available |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. W | > Authorization activity personnel release the records  |
| ho Release | > requested by SSA on *SSA Form 828-U4*, unless the     |
| s the Reco | > records involved are located at a VA health care      |
| rds to SSA | > facility.                                             |
|            | >                                                       |
|            | > If the records are located at a VA health care        |
|            | > facility, refer both copies of the *SSA Form 828-U4*  |
|            | > to that medical facility for processing.              |
|            | >                                                       |
|            | > ***Note***: All records are furnished without charge  |
|            | > to SSA.                                               |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Provide SSA with evidence of helpless child status if |
| # c. Handl | > requested.                                            |
| ing a Requ |                                                         |
| est Involv |                                                         |
| ing a Help |                                                         |
| less Child |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

13\. Releasing Medical Information to the SSA, Continued

+------------+---------------------------------------------------------+
| ##### d    | > Medical records relating to human immunodeficiency    |
| . Types of | > virus (HIV) or syndrome (AIDS), alcohol abuse, drug   |
|  Records T | > abuse or sickle cell anemia are confidential,         |
| hat Are Co | > including records containing                          |
| nfidential |                                                         |
|            | -   the patient's identity                              |
|            |                                                         |
|            | -   diagnosis                                           |
|            |                                                         |
|            | -   prognosis, or                                       |
|            |                                                         |
|            | -   treatment in connection with any program of         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   education                                           |
|            |                                                         |
|            | -   training                                            |
|            |                                                         |
|            | -   treatment                                           |
|            |                                                         |
|            | -   rehabilitation, or                                  |
|            |                                                         |
|            | -   research.                                           |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Release these records *only*                          |
| ### e. Rel |                                                         |
| easing Med | -   for purposes and under circumstances expressed in   |
| ical Recor |     38 U.S.C. 7332(b), and                              |
| ds Referri |                                                         |
| ng to Trea | -   with the                                            |
| tment for  |                                                         |
| HIV or AID | ```{=html}                                              |
| S, Alcohol | <!-- -->                                                |
|  Abuse, Dr | ```                                                     |
| ug Abuse o | -   prior written consent of the patient or subject, or |
| r Sickle C |                                                         |
| ell Anemia | -   written consent from the next of kin, executor,     |
|            |     administrator or other personal representative, if  |
|            |     the patient or subject is deceased.                 |
|            |                                                         |
|            | > ***Reference***: For more information on the handling |
|            | > of records pertaining to treatment of HIV or AIDS,    |
|            | > alcohol abuse, drug abuse or sickle cell anemia, see  |
|            | > M21-1MR, Part III, Subpart ii, 4.A.5.                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### f.   | > If only a *VA Form 10-7131, Exchange of Beneficiary   |
|  Action to | > Information and Request for Administrative and        |
|  Take if O | > Adjudicative Action*, relating to the alleged         |
| nly VA For | > disability and date of onset, is in the claims        |
| m 10-7131  | > folder,                                               |
| Is on File |                                                         |
|            | -   indicate "*VA Form 10-7131 only on file*" on *SSA   |
|            |     Form 828-U4*, and                                   |
|            |                                                         |
|            | -   forward the request to the hospital or clinic that  |
|            |     executed the *VA Form 10-7131* for completion.      |
+------------+---------------------------------------------------------+

Continued on next page

13\. Releasing Medical Information to the SSA, Continued

+------------+---------------------------------------------------------+
| ####       | > If SSA requests both a report of hospitalization and  |
| # g. Actio | > a physical examination report, and the RO has only    |
| n to Take  | > the physical examination report                       |
| if Request |                                                         |
| ed Reports | -   attach a photocopy of the *Compensation and Pension |
|  Are at th |     Exam Report* (or its equivalent) to *SSA Form       |
| e RO and V |     828-U4*, and                                        |
| A Hospital |                                                         |
|            | -   forward *SSA Form 828-U4* to the VA hospital where  |
|            |     treatment is alleged for completion.                |
|            |                                                         |
|            | > ***Notes***:                                          |
|            |                                                         |
|            | -   The VA hospital will attach the report of           |
|            |     hospitalization and forward the completed request   |
|            |     to the SSA office concerned.                        |
|            |                                                         |
|            | -   Inform the requesting SSA office of the referral of |
|            |     *SSA Form 828-U4* to another RO using a             |
|            |     locally-generated letter or transmittal slip.       |
+------------+---------------------------------------------------------+

#### 14. When to Use VA Form 21-4184, Certification of Contents of Document(s) or Record(s)

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on when to use *VA    |
| troduction | > Form 21-4184*, *Certification of Contents of          |
|            | > Document(s) or Record(s)*, including information on   |
|            |                                                         |
|            | -   when to prepare *VA Form 21-4184*                   |
|            |                                                         |
|            | -   preparing the original *VA Form 21-4184*            |
|            |                                                         |
|            | -   when to use the "Remarks" section of *VA Form       |
|            |     21-4184*                                            |
|            |                                                         |
|            | -   action to take when a certification is              |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   complete, and                                       |
|            |                                                         |
|            | -   not possible.                                       |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a. W | > If SSA requests evidence, certify the requested       |
| hen to Pre | > document or record on *VA Form 21-4184*,              |
| pare VA Fo | > *Certification of Contents of Documents(s) or         |
| rm 21-4184 | > Record(s)*, unless                                    |
|            |                                                         |
|            | -   the evidence consists of a court record, or         |
|            |                                                         |
|            | -   certification is not feasible.                      |
|            |                                                         |
|            | > ***Reference***: For more information on handling a   |
|            | > situation when certification is not possible, see     |
|            | > M21-1MR, Part III, Subpart iii, 3.B.14.e.             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b    | > The original *VA Form 21-4184* should                 |
| . Preparin |                                                         |
| g the Orig | -   be prepared by a Veterans Service Representative    |
| inal VA Fo |     (VSR) and signed by a Senior VSR in his/her own     |
| rm 21-4184 |     name, and                                           |
|            |                                                         |
|            | -   contain the essential facts in the identical words  |
|            |     appearing on the document or record.                |
+------------+---------------------------------------------------------+

Continued on next page

14\. When to Use VA Form 21-4184, Certification of Contents of
Document(s) or Record(s), Continued

+------------+---------------------------------------------------------+
| #####      | > Use the "Remarks" section of *VA Form 21-4184* as     |
|  c. When t | > outlined below.                                       |
| o Use Rema |                                                         |
| rks Sectio | -   If the document or record is lengthy or has a       |
| n of VA Fo |     number of facts that may be pertinent, put the      |
| rm 21-4184 |     extra information in the "Remarks" section.         |
|            |                                                         |
|            | -   If certification is made from a record other than   |
|            |     an original document, make a statement in the       |
|            |     "Remarks" section that "the evidence consists of a  |
|            |     photocopy or a notarized copy," for example.        |
|            |                                                         |
|            | > ***Important***: Do not enter explanatory statements  |
|            | > anywhere on the *VA Form 21-4184* except under the    |
|            | > "Remarks" section.                                    |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Complete an authentication for every certification,   |
| # d. Actio | > and then                                              |
| n to Take  |                                                         |
| When Certi | -   forward the certification or copy of the evidence   |
| fication I |     to the requesting office of the SSA, and            |
| s Complete |                                                         |
|            | -   annotate the SSA request to show                    |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the date *VA Form 21-4184* was released, and        |
|            |                                                         |
|            | -   whether or not additional evidence relating to the  |
|            |     particular issue has been requested.                |
|            |                                                         |
|            | > ***Note***: If additional evidence relating to the    |
|            | > particular issue has been requested, indicate         |
|            |                                                         |
|            | -   the date of the request                             |
|            |                                                         |
|            | -   to whom the request was addressed, and              |
|            |                                                         |
|            | -   the nature of the additional information requested. |
|            |                                                         |
|            | > ***Important***: Take no further action unless a      |
|            | > request for the additional evidence is received from  |
|            | > the SSA.                                              |
+------------+---------------------------------------------------------+

Continued on next page

14\. When to Use VA Form 21-4184, Certification of Contents of
Document(s) or Record(s), Continued

+------------+---------------------------------------------------------+
| ##### e.   | > In the event certification is not possible, photocopy |
|  Action to | > the evidence. In the letter transmitting the          |
|  Take When | > photocopy to the SSA, include                         |
|  Certifica |                                                         |
| tion Is No | -   a certification that the record from which the      |
| t Possible |     photocopy was made is free from erasures,           |
|            |     insertions or other alterations, and that the       |
|            |     general appearance of the document or record        |
|            |     indicates that it is authentic, or                  |
|            |                                                         |
|            | -   an explanation as to why such a certification       |
|            |     cannot be made.                                     |
|            |                                                         |
|            | > ***Note***: If the record enclosed is a photocopy of  |
|            | > a photostat, state this fact.                         |
|            | >                                                       |
|            | > ***Exceptions***:                                     |
|            |                                                         |
|            | -   Do not photocopy an American passport, a            |
|            |     certificate of citizenship or naturalization, or    |
|            |     U.S. immigration papers. Furnish a copy of the      |
|            |     "memorandum to file" described in M21-1MR, Part     |
|            |     III, Subpart ii, 3.C.7.c                            |
|            |                                                         |
|            | -   If the request relates to an FBI report, see        |
|            |     M21-1MR, Part III, Subpart iii, 4.8.                |
+------------+---------------------------------------------------------+

#### 15. General Information on Determining VA Benefits for SSA Purposes

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains general information on            |
| troduction | > determining VA benefits for SSA purposes, including   |
|            | > information on                                        |
|            |                                                         |
|            | -   determining pay dates and amounts of nonrecurring   |
|            |     benefit payments                                    |
|            |                                                         |
|            | -   miscellaneous benefits that may be attributed to    |
|            |     the beneficiary, and                                |
|            |                                                         |
|            | -   handling inquiries involving nursing home patients. |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #####      | > Perform a Benefits Delivery Network (BDN) Treasury    |
|  a. Determ | > inquiry (TINQ) to determine the pay dates and amounts |
| ining Pay  | > of nonrecurring payments for any inquiry about        |
| Dates and  |                                                         |
| Amounts of | -   a period involving an original or reopened award,   |
|  Nonrecurr |     or                                                  |
| ing Benefi |                                                         |
| t Payments | -   an amended award that increased benefits            |
|            |     retroactively.                                      |
|            |                                                         |
|            | > ***Note***: Nonrecurring, one-time payments are shown |
|            | > as type *CP-ONE-T* on the BDN T01 PAYMENT HISTORY     |
|            | > INQUIRY screen.                                       |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > The Medal of Honor benefit                            |
| ## b. Misc |                                                         |
| ellaneous  | -   may be paid as a sole entitlement or with another   |
| Benefits T |     entitlement in a combined award, and                |
| hat May Be |                                                         |
|  Attribute | -   is attributed totally to the beneficiary, as are    |
| d to the B |     other benefits, such as                             |
| eneficiary |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   Naval pension                                       |
|            |                                                         |
|            | -   REPS, and                                           |
|            |                                                         |
|            | -   benefits under 38 U.S.C. 1312(a).                   |
|            |                                                         |
|            | > ***Note***: Only REPS and programs under 38 U.S.C.    |
|            | > 1312(a) recognize dependents, and each pays a         |
|            | > separate award to each entitled individual.           |
+------------+---------------------------------------------------------+

Continued on next page

15\. General Information on Determining VA Benefits for SSA Purposes,
Continued

+------------+---------------------------------------------------------+
| ##### c.   | > If the *SSA Form L1103* indicates that the claimant   |
| Handling I | > is a nursing home patient, and the claimant receives  |
| nquiries I | > Improved Pension in excess of \$90.00 per month,      |
| nvolving N | > determine if reduction is required under 38 U.S.C.    |
| ursing Hom | > 5503(f).                                              |
| e Patients | >                                                       |
|            | > Request that other divisions that process these       |
|            | > inquiries refer them to the Veterans Service Center   |
|            | > (VSC), when these circumstances exist.                |
+------------+---------------------------------------------------------+

#### 16. Exclusion of Aid and Attendance (A&A), Housebound or Special Monthly Compensation (SMC) Entitlement for SSA Purposes

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on the exclusion of   |
| troduction | > Aid and Attendance (A&A), Housebound or Special       |
|            | > Monthly Compensation (SMC) entitlement for SSA        |
|            | > purposes, including                                   |
|            |                                                         |
|            | -   special SSA considerations                          |
|            |                                                         |
|            | -   exclusions in disability compensation cases         |
|            |                                                         |
|            | -   handling Improved Pension cases                     |
|            |                                                         |
|            | -   what to do when the excludable amount is more than  |
|            |     the total award, and                                |
|            |                                                         |
|            | -   three examples of cases involving the receipt of    |
|            |     A&A or Housebound and SMC.                          |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #####      | > SSA                                                   |
|  a. Specia |                                                         |
| l SSA Cons | -   does not count the additional amount VA pays for    |
| iderations |     Aid and Attendance (A&A) or Housebound entitlement, |
|            |     and                                                 |
|            |                                                         |
|            | -   excludes certain "deductions" from VA benefits.     |
|            |                                                         |
|            | > ***Reference***: For more information on deductions   |
|            | > to exclude when responding to SSA inquiries, see      |
|            | > M21-1MR, Part III, Subpart iii, 3.B.17.               |
|            | >                                                       |
|            | > In response to an SSA inquiry about a specific award, |
|            | > always reduce the total VA benefit by these amounts.  |
|            | > Make this reduction before performing the             |
|            | > calculations shown in M21-1MR, Part III, Subpart iii, |
|            | > 3.B.19 through 26.                                    |
+------------+---------------------------------------------------------+

Continued on next page

16\. Exclusion of Aid and Attendance (A&A), Housebound or Special
Monthly Compensation (SMC) Entitlement for SSA Purposes, Continued

+------------+---------------------------------------------------------+
| ##         | > If A&A or the Housebound benefit is being paid,       |
| ### b. Exc | > exclude the "maximum" amount of the benefit from the  |
| lusions in | > primary payee's total award.                          |
|  Disabilit | >                                                       |
| y Compensa | > For a compensation case that                          |
| tion Cases |                                                         |
|            | -   involves A&A or housebound entitlement, consider    |
|            |     the 100-percent rate, exclusive of any SMC, the     |
|            |     adjusted "total" award, and                         |
|            |                                                         |
|            | -   includes benefits for a spouse in need of A&A,      |
|            |     exclude                                             |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the spouse "add-on" from the total award unless the |
|            |     spouse is being paid an apportionment, and          |
|            |                                                         |
|            | -   the amount of the add-on from the spouse's award.   |
|            |                                                         |
|            | > ***Note***: If this exclusion is greater than the     |
|            | > spouse's apportionment, the attributable benefit for  |
|            | > the spouse is "none" and nothing is excluded from the |
|            | > primary award.                                        |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c. H | > For Improved Pension cases, exclude the amount of the |
| andling Im | > A&A or housebound entitlement from the primary        |
| proved Pen | > payee's award to arrive at an adjusted total award.   |
| sion Cases | >                                                       |
|            | > For pension cases other than Improved Pension,        |
|            | > exclude the amount from the payable rate outlined in  |
|            | > M21-1, Part I, Appendix B.                            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > If the amount of benefits excludable because of the   |
| # d. When  | > primary payee's entitlement to Special Monthly        |
| the Exclud | > Pension (SMP) is more than the total award, the       |
| able Amoun | > attributable amounts for all individuals included on  |
| t Is More  | > the primary award, excluding apportionees, is "none." |
| Than the T | >                                                       |
| otal Award | > If an apportionment is authorized representing some   |
|            | > part of the maximum SMP, it must be attributable to   |
|            | > the apportionees as indicated in M21-1MR, Part III,   |
|            | > Subpart iii, 3.B.19 through 26, subject to the        |
|            | > exclusion of deductions as stated in M21-1MR, Part    |
|            | > III, Subpart iii, 3.B.17.                             |
+------------+---------------------------------------------------------+

Continued on next page

16\. Exclusion of Aid and Attendance (A&A), Housebound or Special
Monthly Compensation (SMC) Entitlement for SSA Purposes, Continued

+------------+---------------------------------------------------------+
| ###        | > ***Situation***:                                      |
| ## e. Exam |                                                         |
| ple 1: Cas | -   A veteran is receiving compensation under SMC code  |
| e Involvin |     03 (L), based on the need for A&A.                  |
| g A&A for  |                                                         |
| a Spouse a | -   The veteran receives additional compensation for a  |
| nd SMC for |     spouse who is rated as in need of A&A. The spouse   |
|  a Veteran |     receives an apportionment of \$50.00 monthly.       |
|            |                                                         |
|            | > ***Result***: Because the veteran is entitled to A&A, |
|            | > consider the 100-percent rate for veteran and spouse, |
|            | > \$2,336.00 (including the spouse A&A add on), the     |
|            | > adjusted total rate.                                  |
|            | >                                                       |
|            | > As outlined in M21-1MR, Part III, Subpart iii, 3.B.19 |
|            | > through 26, the \$50.00 apportionment will later be   |
|            | > excluded from the veteran's award. The spouse's A&A   |
|            | > add-on, \$108.00, will be excluded from her           |
|            | > apportionment of \$50.00, developing a negative value |
|            | > or "none" attributable to the spouse.                 |
|            | >                                                       |
|            | > ***Action***: Attribute \$2,286.00 to the veteran in  |
|            | > this case.                                            |
|            | >                                                       |
|            | > ***Note***: This example is based on rates in effect  |
|            | > on December 1, 2000.                                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > ***Situation***:                                      |
| ### f. Exa |                                                         |
| mple 2: Ca | -   A veteran with a spouse is receiving Section 306    |
| se Involvi |     Pension.                                            |
| ng A&A and |                                                         |
|  Section 3 | -   The veteran is entitled to A&A and, in 1978, was    |
| 06 Pension |     paid based on income over the limit but less than   |
|            |     the special limit for A&A cases                     |
|            |                                                         |
|            | > ***Result***: The special A&A allowance is \$110.22.  |
|            | > The amount attributable is "none."                    |
|            | >                                                       |
|            | > ***Note***: If any part of the allowance was          |
|            | > apportioned, consider the amount of the apportionment |
|            | > as outlined in M21-1MR, Part III, Subpart iii, 3.B.19 |
|            | > through 26.                                           |
+------------+---------------------------------------------------------+

Continued on next page

16\. Exclusion of Aid and Attendance (A&A), Housebound or Special
Monthly Compensation (SMC) Entitlement for SSA Purposes, Continued

+------------+---------------------------------------------------------+
| ##### g.   | > ***Situation***:                                      |
| Example 3: |                                                         |
|  Case Invo | -   A veteran is receiving Improved Pension with only a |
| lving A&A  |     spouse as a dependent.                              |
| and Improv |                                                         |
| ed Pension | -   The veteran is entitled to the A&A allowance.       |
|            |                                                         |
|            | > ***Result***: The maximum pension rate                |
|            |                                                         |
|            | -   without consideration of A&A is \$12,186.00, and    |
|            |                                                         |
|            | -   with A&A is \$18,405.00.                            |
|            |                                                         |
|            | > Based on countable income of \$14,000.00, the amount  |
|            | > attributable is "none," since pension would not be    |
|            | > payable but for entitlement to the A&A allowance.     |
|            | >                                                       |
|            | > ***Note***: This example is based on rates in effect  |
|            | > on December 1, 2000.                                  |
+------------+---------------------------------------------------------+

#### 17. Exclusion of Deductions When Responding to SSA Inquiries

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on the deductions VA  |
| troduction | > allows but must exclude when responding to an SSA     |
|            | > inquiry, including information on                     |
|            |                                                         |
|            | -   SSA's consideration of deductions allowed by VA     |
|            |                                                         |
|            | -   deductions, by type and codes, that must be         |
|            |     included                                            |
|            |                                                         |
|            | -   obtaining deduction information                     |
|            |                                                         |
|            | -   the action to take when                             |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   an excludable deduction is a factor, and            |
|            |                                                         |
|            | -   A&A, Housebound has been considered, and            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   when to complete Part III, Block G of *SSA Form     |
|            |     L1103*.                                             |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #####      | > SSA excludes certain deductions that VA allows in     |
| a. SSA's C | > determining entitlement to VA benefits.               |
| onsiderati | >                                                       |
| on of Dedu | > In responding to an SSA inquiry, exclude the amount   |
| ctions All | > of deductions for deduction types *other than* the    |
| owed by VA | > codes listed below in M21-1MR, Part III, Subpart iii, |
|            | > 3.B.17.b.                                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. D | > For SSA purposes, include the amount of the deduction |
| eductions, | > if the BDN M01 DEDUCTION/RECEIVABLE/BALANCE DATA      |
|  by Type a | > screen shows one of the following deduction type      |
| nd Code, T | > codes:                                                |
| hat Must B |                                                         |
| e Included | -   31 for attorney fees                                |
|            |                                                         |
|            | -   66 for debt from REPS benefits                      |
|            |                                                         |
|            | -   67 for debt from Chapter 1606 education benefits,   |
|            |     or                                                  |
|            |                                                         |
|            | -   68 for debt from an education loan.                 |
+------------+---------------------------------------------------------+

Continued on next page

17\. Exclusion of Deductions When Responding to SSA Inquiries, Continued

+------------+---------------------------------------------------------+
| ##### c. O | > Use the table below to determine when to request      |
| btaining D | > deduction information from the finance activity.      |
| eduction I |                                                         |
| nformation |                                                         |
+------------+---------------------------------------------------------+

  ----------------------------------- -----------------------------------
  If ...                              Then ...

  there is no indication that         do not request deduction
  excludable deductions apply         information from the finance
                                      activity.

  the BDN M01 deducTion/              request a complete summary of
  receivable/balance data screen      pertinent deductions from the
  shows current excludable            finance activity *only* for the
  deductions, or the folder contains  period(s) identified in the SSA
  evidence of prior pertinent         inquiry.
  excludable deductions,              
  ----------------------------------- -----------------------------------

+------------+---------------------------------------------------------+
| ####       | > When an excludable deduction is a factor, subtract    |
| # d. Actio | > the total amount of the excludable deduction from the |
| n to Take  | > primary or apportioned award that contains the        |
| When an Ex | > excludable deduction.                                 |
| cludable D |                                                         |
| eduction I |                                                         |
| s a Factor |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e. A | > Exclude the deductions after A&A or Housebound        |
| ction to T | > entitlement has been considered, since the deductions |
| ake When A | > may be irrelevant after the exclusion of SMP (but not |
| &A or Hous | > SMC), as described in M21-1MR Part III, Subpart iii,  |
| ebound Ent | > 3.B.16.                                               |
| itlement i |                                                         |
| s Involved |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Complete Part III, block G of *SSA Form L1103* only   |
| #### f. Wh | > if the code for the deduction type is 30.             |
| en to Comp |                                                         |
| lete Part  |                                                         |
| III, Block |                                                         |
|  G of SSA  |                                                         |
| Form L1103 |                                                         |
+------------+---------------------------------------------------------+

#### 18. Exclusion of Amounts Payable Due to Medical Expenses

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on SSA's exclusion of |
| troduction | > additional benefits that VA pays based on a           |
|            | > beneficiary's unreimbursed medical expenses,          |
|            | > including information on                              |
|            |                                                         |
|            | -   SSA regulations concerning unreimbursed medical     |
|            |     expenses                                            |
|            |                                                         |
|            | -   how SSA categorizes the additional benefits VA pays |
|            |     for unreimbursed medical expenses                   |
|            |                                                         |
|            | -   the effect of unreimbursed medical expenses on a    |
|            |     pension award, and                                  |
|            |                                                         |
|            | -   when to provide information on payment amounts      |
|            |     attributable to unreimbursed medical expenses.      |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #####      | > Under SSA regulations, the SSA *cannot* count as      |
|  a. SSA Re | > income the increased amount of VA pension or parent's |
| gulations  | > Dependency and Indemnity Compensation (DIC) payable   |
| Concerning | > because of unreimbursed medical expenses.             |
|  Unreimbur |                                                         |
| sed Medica |                                                         |
| l Expenses |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Reimbursement by VA for medical expenses incurred by  |
| # b. How S | > pensioners qualifies as a third-party payment for     |
| SA Categor | > medical care or services.                             |
| izes the A | >                                                       |
| dditional  | > As such, it is not available for meeting basic needs  |
| Benefits V | > and is not "income" for the purpose of determining    |
| A Pays for | > SSI eligibility and payment amount.                   |
|  Unreimbur |                                                         |
| sed Medica |                                                         |
| l Expenses |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > ***Situation***:                                      |
| ## c. Exam |                                                         |
| ple of the | -   A veteran with no dependents is receiving a monthly |
|  Effect of |     pension of \$200.00, effective December 1, 2000,    |
|  Reimburse |     based on countable annual income of \$6,904.00.     |
| ment by VA |                                                         |
|  for Medic | -   The veteran submits a claim for deductions for      |
| al Expense |     unreimbursed medical expenses of \$1,000.00.        |
| s on a Pen |                                                         |
| sion Award | > ***Result***: This entitles the veteran to an         |
|            | > adjustment payment of \$535.00. The entire \$535.00   |
|            | > does not count as "income" for determining SSI        |
|            | > eligibility and payment amount.                       |
+------------+---------------------------------------------------------+

Continued on next page

18\. Exclusion of Amounts Payable Due to Medical Expenses, Continued

+------------+---------------------------------------------------------+
| ##### d.   | > Provide information on the payment amounts            |
|  When to P | > attributable to medical expenses *only* if the        |
| rovide Inf | > information is requested in Part II, Block F of the   |
| ormation o | > *SSA Form L1103*.                                     |
| n Payment  | >                                                       |
| Amounts At | > The amount attributable to reported unreimbursed      |
| tributable | > medical expenses is the difference between the rate   |
|  to Medica | > payable with the allowed medical expenses and the     |
| l Expenses | > rate that would be payable without the medical        |
|            | > expenses.                                             |
|            | >                                                       |
|            | > ***Notes***:                                          |
|            |                                                         |
|            | -   Do not attempt to show "shares" of medical expenses |
|            |     for the primary beneficiary and dependents.         |
|            |                                                         |
|            | -   Report the amount of the gross benefit attributable |
|            |     to medical expenses.                                |
+------------+---------------------------------------------------------+

#### 19. General Information on Calculating Award Amounts for Responses to the SSA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains general information on            |
| troduction | > calculating award amounts for responses to the SSA,   |
|            | > including information on                              |
|            |                                                         |
|            | -   responding to Part I of *SSA Form L1103*            |
|            |                                                         |
|            | -   considering apportionees, and                       |
|            |                                                         |
|            | -   handling apportionment awards involving multiple    |
|            |     apportionees.                                       |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a    | > In responding to Part I of *SSA Form L1103,*          |
| . Respondi | > determine the SSI claimant's share of benefits as     |
| ng to Part | > discussed in M21-1MR, Part III, Subpart iii, 3.B.19   |
|  I of SSA  | > through 26.                                           |
| Form L1103 | >                                                       |
|            | > Indicate whether the SSI claimant is a VA beneficiary |
|            | > or a dependent of a VA beneficiary.                   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > *Always* consider an apportionee as a beneficiary and |
| ## b. Cons | > not a dependent.                                      |
| idering Ap |                                                         |
| portionees |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c.   | > If an apportionment award includes benefits for       |
| Handling A | > multiple individuals, divide the award total by the   |
| pportionme | > number of apportionees on the award and attribute the |
| nt Awards  | > result to each apportionee on the award.              |
| Involving  | >                                                       |
| Multiple A | > If the apportionment does not divide evenly,          |
| portionees | > attribute the extra pennies to the spouse or to the   |
|            | > oldest child apportionee.                             |
+------------+---------------------------------------------------------+

#### 20. Calculating Old Law Pension Award Amounts for Responses to the SSA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating Old    |
| troduction | > Law Pension award amounts for responses to the SSA,   |
|            | > including information on                              |
|            |                                                         |
|            | -   Old Law Pension disability rates                    |
|            |                                                         |
|            | -   allowances for dependents, and                      |
|            |                                                         |
|            | -   attributing Old Law Pension                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   disability benefits, and                            |
|            |                                                         |
|            | -   death benefits.                                     |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #          | > The Old Law Disability Pension rates are as follows:  |
| #### a. Ol |                                                         |
| d Law Pens | -   the statutory rate is \$78.75, and                  |
| ion Disabi |                                                         |
| lity Rates | -   the rate with                                       |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   Housebound is \$100.00, and                         |
|            |                                                         |
|            | -   the A&A allowance is \$135.35.                      |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > The Old Law Pension program includes no allowance for |
| # b. Allow | > dependents but does recognize dependency without an   |
| ances for  | > increase in payment rates.                            |
| Dependents | >                                                       |
|            | > The existence of a dependent may be the entitling     |
|            | > basis for payment. For example, a veteran may be over |
|            | > the income limit applicable for a veteran without a   |
|            | > dependent.                                            |
+------------+---------------------------------------------------------+

Continued on next page

20\. Calculating Old Law Pension Award Amounts for Responses to the SSA,
Continued

+------------+---------------------------------------------------------+
| #####      | > Use the table below to determine how to attribute Old |
| c. Attribu | > Law Disability Pension benefits.                      |
| ting Old L |                                                         |
| aw Disabil |                                                         |
| ity Pensio |                                                         |
| n Benefits |                                                         |
+------------+---------------------------------------------------------+

  ----------------------------------- -----------------------------------
  If ...                              Then ...

  the veteran's protected 1960 income attribute the entire amount to the
  for VA purposes is \$1,400.00 or    veteran after any allowable
  less                                exclusions as outlined in M21-1MR.
                                      Part III, Subpart iii, 3.B.16
                                      through 18.

  the veteran's protected 1960 income attribute the entire benefit, less
  for VA purposes exceeds \$1,400.00  any allowable exclusions, to the
                                      dependents.

  there are multiple dependents       divide the benefit equally among
                                      the dependents.

  the shares do not divide evenly     attribute the extra pennies to the
                                      spouse or the oldest child.
  ----------------------------------- -----------------------------------

+------------+---------------------------------------------------------+
| #          | > Use the table below to determine how to attribute Old |
| #### d. At | > Law Death Pension benefits.                           |
| tributing  |                                                         |
| Old Law De |                                                         |
| ath Pensio |                                                         |
| n Benefits |                                                         |
+------------+---------------------------------------------------------+

+----------------------------------+-----------------------------------+
| If ...                           | Then ...                          |
+----------------------------------+-----------------------------------+
| the surviving spouse's protected | -   attribute \$50.40 to the      |
| 1960 income for VA purposes is   |     surviving spouse, and         |
| \$1,400.00 or less               |                                   |
|                                  | -   divide the difference between |
|                                  |     the rate payable and \$50.40  |
|                                  |     among the children.           |
+----------------------------------+-----------------------------------+
| the surviving spouse's protected | attribute the entire benefit,     |
| 1960 income for VA purposes      | less any exclusions, to the       |
| exceeds \$1,400.00               | children in equal shares.         |
+----------------------------------+-----------------------------------+

Continued on next page

20\. Calculating Old Law Pension Award Amounts for Responses to the SSA,
Continued

  -----------------------------------------------------------------------
  d\. Attributing Old Law Death Pension Benefits (continued)

  -----------------------------------------------------------------------

+----------------------------------+-----------------------------------+
| If ...                           | Then ...                          |
+----------------------------------+-----------------------------------+
| there is an excludable deduction | reduce the amount attributed to   |
| under M21-1MR, Part III, Subpart | the                               |
| iii, 3.B.17                      |                                   |
|                                  | -   surviving spouse by half of   |
|                                  |     the amount of the deduction,  |
|                                  |     and                           |
|                                  |                                   |
|                                  | -   child or children by half of  |
|                                  |     the deduction.                |
+----------------------------------+-----------------------------------+
| the shares do not divide evenly  | attribute the extra pennies to    |
|                                  | the surviving spouse or the       |
|                                  | oldest child.                     |
+----------------------------------+-----------------------------------+

#### 21. Calculating Section 306 Pension Award Amounts for Responses to the SSA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating        |
| troduction | > Section 306 Pension award amounts for responses to    |
|            | > the SSA, including information on                     |
|            |                                                         |
|            | -   the basis for Section 306 Pension rates             |
|            |                                                         |
|            | -   computing the                                       |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   1978 income for VA purposes, and                    |
|            |                                                         |
|            | -   augmented rate (rate increased because of           |
|            |     dependent(s)) for Section 306 Pension.              |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ####       | > For Section 306 Pension, rates are based on income    |
| # a. Basis | > levels. A veteran may be paid for a maximum of three  |
|  for Secti | > dependents. A surviving spouse may be paid for        |
| on 306 Pen | > unlimited dependent children.                         |
| sion Rates |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > To compute the veteran's or surviving spouse's 1978   |
| b. Computi | > income for VA purposes, first determine whether the   |
| ng 1978 In | > dependents' income or expenses were a factor in       |
| come for V | > arriving at the beneficiary's protected 1978 income   |
| A Purposes | > for VA purposes.                                      |
|            | >                                                       |
|            | > ***Note***: A child's income was not countable in     |
|            | > determining Section 306 Pension rates in 1978.        |
|            | >                                                       |
|            | > Use the table below to compute the veteran's or       |
|            | > surviving spouse's 1978 income for VA purposes.       |
+------------+---------------------------------------------------------+

  ----------------------------------- -----------------------------------
  If ...                              Then ...

  dependents' income or expenses were use the protected income for VA
  not a factor                        purposes.

  dependents' income or expenses were recompute the 1978 income for VA
  a factor in arriving at the         purposes based on the beneficiary's
  beneficiary's protected 1978 income income and expenses.
  for VA purposes                     
  ----------------------------------- -----------------------------------

Continued on next page

21\. Calculating Section 306 Pension Award Amounts for Responses to the
SSA, Continued

  -----------------------------------------------------------------------
  b\. Computing 1978 Income for VA Purposes (continued)

  -----------------------------------------------------------------------

  ----------------------------------- -----------------------------------
  If ...                              Then ...

  the income can be attributed to a   exclude the income.
  dependent                           

  the actual attribution of benefits  assume the income or expenses
  cannot be determined (it cannot be  belong to the beneficiary.
  determined whether certain income   
  or expenses belong to the           
  beneficiary or to the dependents)   
  ----------------------------------- -----------------------------------

+------------+---------------------------------------------------------+
| #          | > Use the table below to compute the veteran or         |
| #### c. Co | > surviving spouse beneficiary's augmented rate for     |
| mputing th | > Section 306 Pension.                                  |
| e Augmente |                                                         |
| d Rate for |                                                         |
|  Section 3 |                                                         |
| 06 Pension |                                                         |
+------------+---------------------------------------------------------+

+--------------------------------+-------------------------------------+
| If ...                         | Then ...                            |
+--------------------------------+-------------------------------------+
| the beneficiary's 1978 income  | -   compute the beneficiary's rate  |
| for VA purposes, as computed   |     using the 1978 rate chart in    |
| in M21-1MR, Part III, Subpart  |                                     |
| iii, 3.B.21.b, is \$3,770.00   | ```{=html}                          |
| or less                        | <!-- -->                            |
|                                | ```                                 |
|                                | -   M21-1, Part I, Appendix B, page |
|                                |     VI(1978) for a veteran alone,   |
|                                |     or                              |
|                                |                                     |
|                                | -   M21-1, Part I, Appendix B, page |
|                                |     I(1978)-1 for a surviving       |
|                                |     spouse alone                    |
|                                |                                     |
|                                | ```{=html}                          |
|                                | <!-- -->                            |
|                                | ```                                 |
|                                | -   round down to the next even     |
|                                |     dollar, and                     |
|                                |                                     |
|                                | -   attribute the rounded amount,   |
|                                |     after any allowable exclusions  |
|                                |     under M21-1MR. Part III,        |
|                                |     Subpart iii, 3.B.16 through 19, |
|                                |     to the veteran or surviving     |
|                                |     spouse.                         |
+--------------------------------+-------------------------------------+

Continued on next page

21\. Calculating Section 306 Pension Award Amounts for Responses to the
SSA, Continued

  -----------------------------------------------------------------------
  c\. Computing the Augmented Rate for Section 306 Pension (continued)

  -----------------------------------------------------------------------

+--------------------------------+-------------------------------------+
| If ...                         | Then ...                            |
+--------------------------------+-------------------------------------+
| the veteran's or surviving     | -   attribute \$0.00 to the veteran |
| spouse's 1978 income for VA    |     or surviving spouse             |
| purposes, as computed in       |                                     |
| M21-1MR, Part III, Subpart     | -   subtract the amount attributed  |
| iii, 3.B.21.b, is greater than |     to the veteran or surviving     |
| \$3,770.00                     |     spouse from the current         |
|                                |     benefit, after deduction of any |
|                                |     allowable exclusions, and       |
|                                |                                     |
|                                | -   attribute to the dependents the |
|                                |     difference between the current  |
|                                |     benefit and the amount          |
|                                |     attributed to the veteran or    |
|                                |     surviving spouse, in equal      |
|                                |     shares.                         |
+--------------------------------+-------------------------------------+
| the shares do not divide       | attribute the extra pennies to the  |
| evenly                         |                                     |
|                                | -   surviving spouse, or            |
|                                |                                     |
|                                | -   oldest child.                   |
+--------------------------------+-------------------------------------+

#### 22. Calculating DIC and Death Compensation Award Amounts for Responses to the SSA Concerning Benefit Payments to Parents

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating DIC    |
| troduction | > and death compensation award amounts for responses to |
|            | > the SSA concerning parents' payments, including       |
|            | > information on                                        |
|            |                                                         |
|            | -   attributing DIC and death compensation payments to  |
|            |     parents, and                                        |
|            |                                                         |
|            | -   an example of how DIC payments are attributed to a  |
|            |     parent.                                             |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a    | > Attribute the full award amount to the payee.         |
| . Attribut |                                                         |
| ing DIC an |                                                         |
| d Death Co |                                                         |
| mpensation |                                                         |
|  Payments  |                                                         |
| to Parents |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > ***Situation***: A remarried father of a veteran is   |
| ## b. Exam | > receiving \$186.12 in monthly benefits.               |
| ple of How | >                                                       |
|  DIC Payme | > ***Explanation***: In every case, attribute the total |
| nts Are At | > award amount to the father, the beneficiary.          |
| tributed t | >                                                       |
| o a Parent | > ***Response:*** If SSA inquires about benefits        |
|            | > payable to the father and a spouse, respond as        |
|            | > follows:                                              |
|            |                                                         |
|            | -   father, "name given"-\$186.12, and                  |
|            |                                                         |
|            | -   spouse, "name given"-\$0.00.                        |
+------------+---------------------------------------------------------+

#### 23. Calculating DIC and Death Compensation Award Amounts for Responses to the SSA Concerning Benefit Payments to a Surviving Spouse or Child(ren)

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating DIC    |
| troduction | > and death compensation award amounts for responses to |
|            | > the SSA concerning payments made to a surviving       |
|            | > spouse or child(ren), including                       |
|            |                                                         |
|            | -   information on attributing DIC benefits for         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   a surviving spouse and children, and                |
|            |                                                         |
|            | -   children with no surviving spouse                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   examples of attributing DIC benefits for            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   a surviving spouse and children, and                |
|            |                                                         |
|            | -   children with no surviving spouse                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   information on attributing a surviving spouse's     |
|            |     death compensation, when an apportionment is        |
|            |     involved.                                           |
|            |                                                         |
|            | -   an example of attributing a surviving spouse's      |
|            |     death compensation, and                             |
|            |                                                         |
|            | -   information on attributing children's payments when |
|            |     the surviving spouse is not entitled.               |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a.   | > If the benefits are apportioned, attribute the        |
| Attributin | > apportioned amount(s) to the apportionee(s).          |
| g DIC Bene | > Attribute the                                         |
| fits for a |                                                         |
|  Surviving | -   amount of DIC added to the payment because of a     |
|  Spouse an |     child to each child in the custody of the surviving |
| d Children |     spouse, and                                         |
|            |                                                         |
|            | -   balance of the award to the spouse.                 |
|            |                                                         |
|            | > ***Note***: The amount of DIC added to the payment    |
|            | > because of a child is specified in the DIC rate       |
|            | > tables in M21-1, Part I, Appendix B.                  |
+------------+---------------------------------------------------------+

Continued on next page

23\. Calculating DIC and Death Compensation Award Amounts for Responses
to the SSA Concerning Benefit Payments to a Surviving Spouse or
Child(ren), Continued

+------------+---------------------------------------------------------+
| ##### b. E | > ***Situation***:                                      |
| xample 1:  |                                                         |
| Attributin | -   A surviving spouse receives DIC benefits for        |
| g DIC Bene |     herself and three children based on the death of    |
| fits for a |     the veteran in March 1998.                          |
|  Surviving |                                                         |
|  Spouse an | -   In addition, two children receive apportionments.   |
| d Children |     The apportionment for one child is the additional   |
|            |     amount received for the child, but the other child  |
|            |     is receiving a special apportionment of \$300.00.   |
|            |                                                         |
|            | -   The total monthly benefit is based on five children |
|            |     and is \$2,056.00.                                  |
|            |                                                         |
|            | -   The amount of DIC added for each child is \$229.00. |
|            |                                                         |
|            | > ***Response***: If SSA inquires about benefits        |
|            | > payable to the six individuals, indicate a breakdown  |
|            | > as follows:                                           |
|            |                                                         |
|            | -   surviving spouse "name given"-\$840.00              |
|            |                                                         |
|            | -   child 1, "name given"-\$229.00                      |
|            |                                                         |
|            | -   child 2, "name given"-\$229.00                      |
|            |                                                         |
|            | -   child 3, "name given"-\$229.00                      |
|            |                                                         |
|            | -   child 4, apportionee "name given"-\$229.00, and     |
|            |                                                         |
|            | -   child 5, apportionee "name given"-\$300.00.         |
|            |                                                         |
|            | > ***Note***: This example is based on rates in effect  |
|            | > on December 1, 2000.                                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c. E | > ***Situation***:                                      |
| xample 2:  |                                                         |
| Attributin | -   A surviving spouse was awarded benefits based on    |
| g DIC Bene |     pay grade 0-5, effective December 1, 1989.          |
| fits for a |                                                         |
|  Surviving | -   In addition, two children over age 18 are being     |
|  Spouse an |     paid by separate awards and one child is helpless.  |
| d Children |                                                         |
|            | > ***Response***: If SSA inquires about benefits        |
|            | > payable to the three individuals, indicate a          |
|            | > breakdown as follows:                                 |
|            |                                                         |
|            | -   surviving spouse "name given"-\$1,239.00            |
|            |                                                         |
|            | -   child 1, schoolchild "name given"-\$194.00, and     |
|            |                                                         |
|            | -   child 2, helpless child "name given"-\$386.00.      |
|            |                                                         |
|            | > ***Note***: This example is based on rates in effect  |
|            | > on December 1, 2000.                                  |
+------------+---------------------------------------------------------+

Continued on next page

23\. Calculating DIC and Death Compensation Award Amounts for Responses
to the SSA Concerning Benefit Payments to a Surviving Spouse or
Child(ren), Continued

+------------+---------------------------------------------------------+
| #          | > For DIC benefits for children, including direct       |
| #### d. At | > payment to children when there is no surviving        |
| tributing  | > spouse, and payments for children over 18, attribute  |
| DIC Benefi | > the full amount payable to the children.              |
| ts for Chi | >                                                       |
| ldren With | > For consolidated awards to multiple children,         |
|  No Surviv | > attribute the share for each child to each child plus |
| ing Spouse | > the additional allowance payable to each helpless     |
|            | > child.                                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e. E | > ***Situation***:                                      |
| xample: At |                                                         |
| tributing  | -   Two children under 18 and a helpless child are      |
| DIC Benefi |     receiving benefits based on the veteran's death on  |
| ts for Chi |     June 8, 1999.                                       |
| ldren With |                                                         |
|  No Surviv | -   There is no surviving spouse.                       |
| ing Spouse |                                                         |
|            | -   The two minor children are paid on a consolidated   |
|            |     award.                                              |
|            |                                                         |
|            | > ***Response***: If SSA inquires about benefits        |
|            | > payable to the three individuals, indicate a          |
|            | > breakdown as follows:                                 |
|            |                                                         |
|            | -   child 1, "name given"-\$241.00                      |
|            |                                                         |
|            | -   child 2, "name given"-\$241.00, and                 |
|            |                                                         |
|            | -   child 3, (name given)-\$470.00.                     |
|            |                                                         |
|            | > ***Note***: This example is based on rates in effect  |
|            | > on December 1, 2000.                                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > For a surviving spouse in receipt of death            |
|  f. Attrib | > compensation whose benefits are apportioned,          |
| uting a Su | > attribute the                                         |
| rviving Sp |                                                         |
| ouse's Dea | -   apportioned amount to the apportionee               |
| th Compens |                                                         |
| ation, Whe | -   balance to the spouse and any children in custody,  |
| n an Appor |     and                                                 |
| tionment i |                                                         |
| s Involved | -   the amount from the rate chart specified in M21-1,  |
|            |     Part I, Appendix B as the "child's share," based on |
|            |     the total number of children shown to be in         |
|            |     custody.                                            |
+------------+---------------------------------------------------------+

Continued on next page

23\. Calculating DIC and Death Compensation Award Amounts for Responses
to the SSA Concerning Benefit Payments to a Surviving Spouse or
Child(ren), Continued

+------------+---------------------------------------------------------+
| ##### g.   | > ***Situation***:                                      |
| Example: A |                                                         |
| ttributing | -   A surviving spouse is receiving death compensation  |
|  a Survivi |     for herself and a helpless child.                   |
| ng Spouse' |                                                         |
| s Death Co | -   A second helpless child is receiving an             |
| mpensation |     apportionment of \$42.50.                           |
|            |                                                         |
|            | > ***Response***: If SSA inquires about benefits        |
|            | > payable to the three individuals, indicate a          |
|            | > breakdown as follows:                                 |
|            |                                                         |
|            | -   surviving spouse, "name given"-\$65.00              |
|            |                                                         |
|            | -   child in custody, "name given"-\$42.50, and         |
|            |                                                         |
|            | > child not in custody, "name given"-\$42.50.           |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > For children's payments, when the surviving spouse is |
| # h. Attri | > not entitled, attribute to each child the amount      |
| buting Chi | > specified in the rate chart in M21-1, Part I,         |
| ldren's Pa | > Appendix B, Section V as each child's share.          |
| yments Whe |                                                         |
| n the Surv |                                                         |
| iving Spou |                                                         |
| se Is Not  |                                                         |
| Entitled t |                                                         |
| o Death Co |                                                         |
| mpensation |                                                         |
+------------+---------------------------------------------------------+

#### 24. Calculating Disability Compensation Award Amounts for Responses to the SSA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating        |
| troduction | > disability compensation award amounts for responses   |
|            | > to the SSA, including                                 |
|            |                                                         |
|            | -   information on attributing disability compensation, |
|            |     and                                                 |
|            |                                                         |
|            | -   an example of attributing disability compensation.  |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ####       | > Use the table below to determine how to attribute     |
| # a. Attri | > disability compensation.                              |
| buting Dis |                                                         |
| ability Co |                                                         |
| mpensation |                                                         |
+------------+---------------------------------------------------------+

+---------------------------+------------------------------------------+
| If ...                    | Then ...                                 |
+---------------------------+------------------------------------------+
| benefits are apportioned  | attribute the                            |
|                           |                                          |
|                           | -   apportioned amounts to the           |
|                           |     apportionees, and                    |
|                           |                                          |
|                           | -   benefits payable for non-apportioned |
|                           |     dependents to the dependents in an   |
|                           |     amount equal to the amount paid for  |
|                           |     the dependent, as determined from    |
|                           |     the applicable rate table.           |
+---------------------------+------------------------------------------+
| minor children are a      | -   the amount for each child varies     |
| factor                    |     based on the actual amounts shown in |
|                           |     the rate table, and                  |
|                           |                                          |
|                           | -   attribute the                        |
|                           |                                          |
|                           | ```{=html}                               |
|                           | <!-- -->                                 |
|                           | ```                                      |
|                           | -   amounts to such children, in         |
|                           |     sequence, oldest to youngest, and    |
|                           |                                          |
|                           | -   balance to the veteran, including    |
|                           |     any amount payable because of an     |
|                           |     apportionee dependent but not paid   |
|                           |     to the apportionee.                  |
+---------------------------+------------------------------------------+

Continued on next page

24\. Calculating Disability Compensation Award Amounts for Responses to
the SSA, Continued

+------------+---------------------------------------------------------+
| ###        | > ***Situation***:                                      |
| ## b. Exam |                                                         |
| ple: Attri | -   A veteran is rated 90 percent disabled and receives |
| buting Dis |     compensation for a spouse, a mother, two minor      |
| ability Co |     children and three schoolchildren.                  |
| mpensation |                                                         |
|            | -   The mother and one schoolchild receive separate     |
|            |     apportionments of less than the additional amount   |
|            |     of compensation payable to the veteran for them as  |
|            |     dependents (\$88.00 and \$172.00, respectively).    |
|            |                                                         |
|            | -   The mother receives \$75.00 per month and the       |
|            |     schoolchild receives \$120.00.                      |
|            |                                                         |
|            | > ***Explanation***: Attribute the "difference" of      |
|            | > \$65.00 to the veteran.                               |
|            | >                                                       |
|            | > ***Response***: If SSA inquires about benefits        |
|            | > attributable to the veteran and each of his           |
|            | > dependents, respond as follows:                       |
|            |                                                         |
|            | -   veteran, "name given"-\$1,331.00                    |
|            |                                                         |
|            | -   spouse, "name given"-\$108.00                       |
|            |                                                         |
|            | -   mother, apportionee "name given"-\$75.00            |
|            |                                                         |
|            | -   child 1, apportionee, schoolchild "name             |
|            |     given"-\$120.00                                     |
|            |                                                         |
|            | -   child 2, schoolchild "name given"-\$172.00          |
|            |                                                         |
|            | -   child 3, schoolchild "name given"-\$172.00          |
|            |                                                         |
|            | -   child 4, "name given"-\$79.00, and                  |
|            |                                                         |
|            | -   child 5, "name given"-\$56.00.                      |
|            |                                                         |
|            | > ***Note***: The amounts shown in this example are     |
|            | > based on rates in effect on December 1, 2000.         |
+------------+---------------------------------------------------------+

#### 25. Calculating Improved Pension Award Amounts for Responses to the SSA

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating        |
| troduction | > Improved Pension award amounts for responses to the   |
|            | > SSA, including                                        |
|            |                                                         |
|            | -   determining the amount of attributable benefits     |
|            |                                                         |
|            | -   computing apportionee amounts                       |
|            |                                                         |
|            | -   an example of computing apportionee amounts         |
|            |                                                         |
|            | -   attributing a primary disability or death pension   |
|            |     award                                               |
|            |                                                         |
|            | -   computing the percentage for each dependent on a    |
|            |     primary disability or death pension award           |
|            |                                                         |
|            | -   examples of computing the factors and share         |
|            |                                                         |
|            | -   computing the veteran's amount when two veterans    |
|            |     are married to each other                           |
|            |                                                         |
|            | -   considering separate awards when two veterans are   |
|            |     married to each other, and                          |
|            |                                                         |
|            | -   considering SMP when two veterans are married to    |
|            |     each other.                                         |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| #####      | > Because of the nature of *Public Law (PL) 95-588*,    |
| a. Determi | > benefits that are intended to supplement family       |
| ning the A | > income based on the number of dependents, a different |
| mount of A | > procedure is required to determine the amount of      |
| ttributabl | > benefits attributable to the respective family        |
| e Benefits | > members. The benefits paid by VA are distributed      |
|            | > "proportionately."                                    |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b.   | > To compute apportionee amounts, attribute the amount  |
|  Computing | > apportioned, if any, to the apportionees.             |
|  Apportion | >                                                       |
| ee Amounts | > If the apportionment is for multiple individuals,     |
|            | > divide the total amount of the apportionment by the   |
|            | > number of apportionees to determine the individual    |
|            | > shares.                                               |
|            | >                                                       |
|            | > ***Reference***: For more information on calculating  |
|            | > award amounts for responses to SSA, see M21-1MR, Part |
|            | > III, Subpart iii, 3.B.19 through 26.                  |
+------------+---------------------------------------------------------+

Continued on next page

25\. Calculating Improved Pension Award Amounts for Responses to the
SSA, Continued

+------------+---------------------------------------------------------+
| ##### c    | > ***Situation***:                                      |
| . Example: |                                                         |
|  Computing | -   \$100.00 is apportioned for a spouse and five       |
|  Apportion |     children.                                           |
| ee Amounts |                                                         |
|            | -   The \$100.00 divided by six results in \$16.6666    |
|            |     dollars for each individual.                        |
|            |                                                         |
|            | > ***Explanation***: Attribute                          |
|            |                                                         |
|            | -   \$16.66 for each child, a total of \$83.30, and     |
|            |                                                         |
|            | -   \$16.70 (the difference between the total           |
|            |     apportionment (\$100.00) and the children's shares  |
|            |     (\$83.30)) to the spouse.                           |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Attribute the balance or available amount of a        |
| # d. Attri | > primary disability or death award to all individuals  |
| buting a P | > included on the award (the primary beneficiary and    |
| rimary Dis | > all dependents), on a proportionate basis, after      |
| ability or |                                                         |
|  Death Pen | -   exclusion of                                        |
| sion Award |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the A&A allowance, if applicable, and               |
|            |                                                         |
|            | -   any pertinent deductions in M21-1MR. Part III,      |
|            |     Subpart iii, 3.B.17, and                            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   subtraction of the total apportioned amount, if     |
|            |     applicable.                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e.   | > Compute the portion for each dependent included on a  |
| Computing  | > primary award based on his or her percentage of the   |
| the Percen | > maximum pension payable.                              |
| tage for E | >                                                       |
| ach Depend | > To determine the percentage or "factor" for each      |
| ent on a P | > dependent,                                            |
| rimary Dis |                                                         |
| ability or | -   determine the maximum pension payable, excluding    |
|  Death Pen |     any SMP allowance                                   |
| sion Award |                                                         |
|            | -   determine the amount of additional pension payable  |
|            |     because of dependents                               |
|            |                                                         |
|            | -   identify the first dependent for a                  |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   disability award by considering the spouse (or      |
|            |     oldest child if there is no spouse) the first       |
|            |     dependent, or                                       |
|            |                                                         |
|            | -   death award by considering the oldest child the     |
|            |     first dependent, and                                |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   divide the amount of additional pension payable by  |
|            |     the maximum pension payable.                        |
|            |                                                         |
|            | > ***Notes***:                                          |
|            |                                                         |
|            | -   More pension is always payable for the "first"      |
|            |     dependent than any additional dependents.           |
|            |                                                         |
|            | -   If a child is the first dependent, and is a twin or |
|            |     triplet, for example, randomly designate one of the |
|            |     multiple siblings as the oldest child.              |
+------------+---------------------------------------------------------+

Continued on next page

25\. Calculating Improved Pension Award Amounts for Responses to the
SSA, Continued

+------------+---------------------------------------------------------+
| ##         | > ***Situation***: A veteran with five dependents (a    |
| ### f. Exa | > spouse and four children) is receiving the maximum    |
| mple 1: Co | > pension rate of \$18,530.00, effective December 1,    |
| mputing th | > 2000. This is the maximum rate payable not including  |
| e Factors  | > SMP entitlement.                                      |
| and Shares | >                                                       |
|            | > ***Computing the Dependents' Factors:***              |
|            | >                                                       |
|            | > Compute                                               |
|            |                                                         |
|            | -   the first dependent's factor by                     |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   taking the difference between the maximum pension   |
|            |     payable for a veteran without dependents (\$9,304), |
|            |     and for a veteran with a dependent (\$12,186.00),   |
|            |     and                                                 |
|            |                                                         |
|            | -   dividing the difference (\$2,882.00) by the maximum |
|            |     pension payable (\$18,530.00), for a factor of      |
|            |     0.1555, and                                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the factor for each additional dependent by         |
|            |     dividing the pension payable for each additional    |
|            |     dependent (\$1,586.00) by the maximum pension rate  |
|            |     (\$18,530.00), for a factor of 0.0855.              |
|            |                                                         |
|            | > ***Computing the Dependents' Shares***:               |
|            |                                                         |
|            | -   Compute each dependent's                            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   factor to four decimal positions, and               |
|            |                                                         |
|            | -   share by multiplying the available primary award    |
|            |     amount by the factor                                |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   subtract the total of the shares of all dependents  |
|            |     from the "available" primary award amount, and      |
|            |                                                         |
|            | -   attribute the remaining amount to the payee.        |
|            |                                                         |
|            | > ***Note***: Drop fractions of a cent. For example,    |
|            | > \$44.1269 rounds down to \$44.12.                     |
+------------+---------------------------------------------------------+

Continued on next page

25\. Calculating Improved Pension Award Amounts for Responses to the
SSA, Continued

+------------+---------------------------------------------------------+
| > **g.     | > ***Situation***:                                      |
| > Example  |                                                         |
| > 2:       | -   A veteran with \$2,400.00 countable annual income   |
| >          |     is receiving pension, including the A&A allowance.  |
|  Computing |                                                         |
| > the      | -   A spouse and three children have been recognized as |
| > Factors  |     dependents.                                         |
| > and      |                                                         |
| > Shares** | -   The spouse is receiving an apportionment of         |
|            |     \$100.00 monthly, and all the children are in the   |
|            |     veteran's custody.                                  |
|            |                                                         |
|            | -   The total monthly pension payment is \$1,212.00,    |
|            |     excluding the A&A allowance.                        |
|            |                                                         |
|            | > ***Computing the Available Primary Award Amount***:   |
|            | > Subtract the \$100.00 apportionment from \$1,212.00   |
|            | > to obtain the difference (\$1,112.00), which is the   |
|            | > available primary award amount.                       |
|            | >                                                       |
|            | > ***Computing the Dependents' Shares***:               |
|            | >                                                       |
|            | > Compute the dependent's shares as explained in        |
|            | > M21-1MR, Part III, Subpart iii, 3.B.25.f.             |
|            | >                                                       |
|            | > ***Computing the Spouse's Share***: Because the       |
|            | > spouse is an apportionee, it is not necessary to      |
|            | > compute the spouse's share.                           |
|            | >                                                       |
|            | > ***Computing the Veteran's Share***:                  |
|            |                                                         |
|            | -   The factors for the children's shares are the same, |
|            |     since the spouse is considered the "first"          |
|            |     dependent.                                          |
|            |                                                         |
|            | -   Each child's factor is 1586/16994 or .0936.         |
|            |                                                         |
|            | -   Attribute to each child \$104.48 of the available   |
|            |     amount (.0936 x 1,112.00 = 104.0832 rounded down).  |
|            |                                                         |
|            | -   Subtract the total of the children's shares         |
|            |     (\$312.24) from the available amount (\$1,112.00)   |
|            |     to determine the veteran's share of \$799.76.       |
|            |                                                         |
|            | > ***Response***: If SSA inquires about benefits for    |
|            | > all family members, respond as follows:               |
|            |                                                         |
|            | -   veteran, "name given"-\$799.76                      |
|            |                                                         |
|            | -   spouse, "name given"-\$100.00                       |
|            |                                                         |
|            | -   child 1, "name given"-\$104.08                      |
|            |                                                         |
|            | -   child 2, "name given"-\$104.08, and                 |
|            |                                                         |
|            | -   child 3, "name given"-\$104.08.                     |
|            |                                                         |
|            | > ***Note***: The amounts shown in this example are     |
|            | > based on rates in effect on December 1, 2000.         |
+------------+---------------------------------------------------------+

Continued on next page

25\. Calculating Improved Pension Award Amounts for Responses to the
SSA, Continued

+------------+---------------------------------------------------------+
| #####      | > If a disability award is based on two veterans        |
| h. Computi | > married to each other, a special procedure is         |
| ng the Att | > required to compute the amount attributable to each   |
| ributable  | > payee-veteran.                                        |
| Amount Whe | >                                                       |
| n Two Vete | > The amount attributable to ach veteran will be half   |
| rans Are M | > of the amount available after subtraction of the      |
| arried to  | > amounts for dependent children.                       |
| Each Other | >                                                       |
|            | > ***Example***: In the example in M21-1MR. Part III,   |
|            | > Subpart iii, 3.B.25.g, this would result in each      |
|            | > veteran being attributed half of \$899.76, or         |
|            | > \$449.88.                                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### i. C | > If separate awards are authorized, divide benefits    |
| onsidering | > equally between the veterans, according to M21-1MR,   |
|  Separate  | > Part V, Subpart iii, 4.3 (TBD) or M21-1, Part IV,     |
| Awards Whe | > 25.20. For purposes of responding to a SSA inquiry,   |
| n Two Vete | > consider the awards a "combined" award, subject to a  |
| rans Are M | > single breakdown.                                     |
| arried to  | >                                                       |
| Each Other | > ***Note***: SSA may not be aware that the case        |
|            | > involves married veterans paid separately. Regardless |
|            | > of whether the SSA request is under one or both file  |
|            | > numbers, process the case as if it were a combined    |
|            | > award.                                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### j.   | > If both veterans are entitled to SMP, exclude the     |
|  Consideri | > appropriate total SMP allowance.                      |
| ng SMP Whe | >                                                       |
| n Two Vete | > If the "early war bonus" under 38 U.S.C. 1521(g) is a |
| rans Are M | > factor, do not exclude the amount of the bonus.       |
| arried to  | > Rather, divide the amount of the bonus equally        |
| Each Other | > between the spouses, even if only one spouse has such |
|            | > entitlement.                                          |
|            | >                                                       |
|            | > ***Important***: Only one such "bonus" may be paid.   |
+------------+---------------------------------------------------------+

#### 26. Calculating Service Pension Award Amounts for Responses to the SSA 

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on calculating        |
| troduction | > service pension award amounts for responses to the    |
|            | > SSA, including information on                         |
|            |                                                         |
|            | -   disability benefits                                 |
|            |                                                         |
|            | -   available death benefits for surviving spouses      |
|            |                                                         |
|            | -   attributing death benefits                          |
|            |                                                         |
|            | -   available death benefits for children, and          |
|            |                                                         |
|            | -   attributing death benefits for children.            |
+------------+---------------------------------------------------------+

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

+------------+---------------------------------------------------------+
| ##### a.   | > At this time, no known claimants are paid under the   |
| Disability | > various provisions authorizing service pensions for   |
|  Benefits  | > veterans.                                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > A surviving spouse may be entitled to the following   |
| b. Availab | > death benefits:                                       |
| le Death B |                                                         |
| enefits fo | -   for the Indian Wars and Civil War, the statutory    |
| r a Surviv |     rate is                                             |
| ing Spouse |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   \$40.64 if the claimant is less than 70 years of    |
|            |     age                                                 |
|            |                                                         |
|            | -   \$70.00 if the claimant is 70 or older, or          |
|            |                                                         |
|            | -   \$75.00 if the claimant was married to the veteran  |
|            |     during service in the war, and                      |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   for the Spanish-American War                        |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the statutory rate is \$70.00, regardless of age,   |
|            |     or \$75.00 if the claimant was married to the       |
|            |     veteran during service in the war, and              |
|            |                                                         |
|            | -   an A&A allowance of \$79.00 may be added.           |
|            |                                                         |
|            | > ***Note***: An additional \$8.13 is payable for each  |
|            | > eligible child of a veteran of any of these three     |
|            | > wars.                                                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Attribute rates for a case involving a spouse, to the |
|  c. Attrib | > spouse, after any allowable exclusions, such as A&A,  |
| uting Deat | > apportionments, and certain deductions, minus \$8.13  |
| h Benefits | > per child in the spouse's custody.                    |
+------------+---------------------------------------------------------+

Continued on next page

26\. Calculating Service Pension Award Amounts for Responses to the SSA,
Continued

+------------+---------------------------------------------------------+
| #####      | > For children *only*, the statutory rate is \$73.13    |
| d. Availab | > for the first child, and an additional \$8.13 for     |
| le Death B | > each additional child.                                |
| enefits fo |                                                         |
| r Children |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e.   | > Attribute rates for a case involving only children,   |
|  Attributi | > to the children, on an equal-share basis.             |
| ng Death B |                                                         |
| enefits fo |                                                         |
| r Children |                                                         |
+------------+---------------------------------------------------------+