Beneficiary and/or Claimant the primary beneficiary, and/or the claimant for an apportionment of the primary beneficiary’s benefits. However, when the Privacy Act forbids a total disclosure of correspondence or other submissions from either party to the other, separately furnish the information that is vital to the decision to be made. Example: “Information that is vital to the decision” usually includes the income and expenses of each party. 2. Developing an Apportionment Claim Introduction This topic contains information on developing for evidence in order to make a decision as to whether an apportionment is appropriate, including determining whether a bar to apportionment exists actions to take when no bar to apportionment exists estimating the amount of benefits VA should withhold for an apportionment required evidence from the primary beneficiary and claimant time limits for responding to a VA request for evidence/information from the primary beneficiary and claimant establishing the estimated withholding, and handling a request for a hearing. Change Date July 5, 2015 a. Determining Whether a Bar to Apportionment Exists Upon receipt of a claim for apportionment, establish EP 130 under the claimant’s name, and determine whether there is a bar to the apportionment. Reference: Bars to apportionments are discussed in M21-1, Part III, Subpart v, 3.A.1.f, and M21-1, Part III, Subpart v, 3.A.4.a. b. Actions to Take When No Bar to Apportionment Exists If there is no bar to apportionment, establish EP 600 under the primary beneficiary’s name, with a suspense date that expires 65 days in the future follow the instructions in M21-1, Part III, Subpart v, 3.A.2.c, and send development letters that request the evidence/information described in
that the claimant made. Ask the beneficiary to explain any hardship he/she would suffer if VA granted an apportionment. Inform the beneficiary that if he/she is not contributing to the of the claimant, the beneficiary must explain why he/she is making no contributions. Notes: If the beneficiary is providing no support and fails to provide an explanation for not doing so, make a decision that is based on the other evidence of record. If a conflict arises regarding the amount of support the primary beneficiary provides to the claimant, ask the primary beneficiary to submit proof of his/her contributions, such as cancelled checks and/or receipts. claimant (or claimant’s custodian, if applicable) Ask the recipient to describe what hardships the claimant would suffer if VA denied the apportionment. Notes: Once completed, VA Form 21-0788 provides VA with information about the net worth and monthly income and expenses of the primary beneficiary claimant, and claimant’s custodian, if applicable. Consider individual household income and expenses when determining whether an apportionment would create a financial hardship on the primary beneficiary, and whether the claimant has a financial need for the apportionment and, if so, the amount of benefits VA should apportion. Reference: For more information about the evidence VA considers when deciding an apportionment claim, see . e. Time Limits for Responding to a VA Request for From the Primary Beneficiary and Claimant Concurrent with the actions described in M21-1, Part III, Subpart v, 3.A.2.d, notify the claimant that he or she must respond within 30 days the primary beneficiary that he or she must respond within 60 days, and both the claimant and primary beneficiary that a decision will be made after expiration of the specified time limit based on the evidence of record, unless an extension of the time limit is required for good cause.
3. Deciding an Apportionment Claim and Notification of a Decision on an Apportionment Claim Introduction This topic contains information on deciding an apportionment claim and notifying the primary beneficiary and the claimant of the decision, including actions to take upon expiration of the claimant’s 30-day response period considering evidence received after a decision determining the amount of an apportionment preparing VA Form 21-441, Special Apportionment Decision, for a favorable or unfavorable apportionment decision effect of deferred awards on pending apportionment claims determining the effective date of an apportionment and the appropriate award action to take after making an apportionment decision rounding the apportioned amount distributing the available amount for an institutionalized Veteran effect of rate changes on the primary award notifying the primary beneficiary and claimant of the apportionment decision, and responding to a notice of disagreement (NOD)with an apportionment decision. Change Date July 5, 2015 a. Actions to Take Upon Expiration of the Claimant’s 30-Day Response Period Follow the instructions in the table below after the claimant’s 30-day response period expires. If the claimant... Then make an administrative decision... responds within 30 days, but the evidence fails to demonstrate a hardship on the part of the claimant based on the claimant’s response and any other pertinent evidence of record deny the pending claim clear the pending EPs, and send notification of the decision to the claimant and beneficiary. does not respond within 30 days and/or the evidence of record fails to demonstrate a hardship on the part of the claimant based on the evidence of record deny the pending claim clear the pending EPs, and send notification of the decision to the
SUBJECT field under DOCUMENT PROPERTIES. Reference: For more information on handling a notice of disagreement (NOD) with an apportionment decision, see M21-1, Part III, Subpart v, 3.A.3.k. c. Determining the Amount of an Apportionment After making a decision to apportion benefits, determine the amount to apportion from an equitable assessment of any hardship or demonstrated need on the part of the primary beneficiary and the claimant. Consider such factors as the amount of VA benefits available other resources and income of the primary beneficiary and the claimant, and special needs of the primary beneficiary and the claimant. Consider the criteria in the table below when evaluating an apportionment claim under different benefit programs. Benefit Program Criteria compensation and Survivors Pension Authority: See and Veterans Pension , or Note: Court of Appeals for Veterans Claims (CAVC) decision in distinguishes adjudication under one regulation as being independent of the other regulation. This decision did not identify a need for hardship to apportion Veterans Pension. DIC , or Veterans Pension adjusted for a hospitalized or incompetent Veteran Important: When the primary beneficiary is receiving additional benefits for dependents, and the evidence shows he/she is not reasonably contributing to their support, hardship for the primary beneficiary would not normally result from apportionment of the additional amount payable for such dependents.