M21-1 Manual / Part IX, Subpart iii, Chapter 1, Section B

Social Security Administration (SSA) Benefits Program

M21-1, Part IX, Subpart iii, Chapter 1, Section B

Overview

In This Section

This section contains the following topics:

Topic	Topic Name
1	Overview of the SSA Benefits Program
2	Medicare
3	Computing Monthly SSA and Medicare Benefits
4	Sources for Accessing Social Security Information
5	Terminated Disability Social Security Benefits and Withdrawn Social Security Applications
6	Processing SSA Income that Began or Increased Before June 25, 2022

1. Overview of the SSA Benefits Program

Introduction

This topic provides an overview of the SSA benefits program, including

claims processor's familiarity with the SSA benefits program
Social Security benefits
Social Security eligibility
amount of Social Security benefits
Social Security disability benefits
Social Security benefits for a
- survivor with a child
- survivor without a child, and
- disabled surviving spouse
additional Social Security benefits
family maximum amount (FMAX)
Supplemental Security Income (SSI) program, and
lump-sum death benefit.

Change Date

April 12, 2018

IX.iii.1.B.1.a. Claims Processor's Familiarity With the SSA Benefits Program

Social Security is the type of income most often received by beneficiaries of the Department of Veterans Affairs (VA) income-based benefit programs. Therefore, claims processors should become familiar with the Social Security Administration (SSA) benefits program.

IX.iii.1.B.1.b. Social Security Benefits

Regular Social Security payments that are countable income for VA purposes are paid to workers and their dependents when the worker retires, becomes severely disabled, or dies. These benefits are paid under Title II of the Social Security Act.

IX.iii.1.B.1.c. Social Security Eligibility

To be eligible for Social Security benefits, the worker must have

been employed in an occupation that was covered by Social Security or self-employed under Social Security, and
had deductions taken from earnings and credited to their Social Security record.

IX.iii.1.B.1.d. Amount of Social Security Benefits

The amount of Social Security the beneficiary receives each month is determined by a number of factors, such as the

amount deducted from the individual’s earnings, and
age at which the beneficiary starts drawing Social Security.

Retirement payments can start as early as age 62. If the worker starts receiving retirement benefits before age 65, the monthly payment is permanently reduced.

IX.iii.1.B.1.e. Social Security Disability Benefits

Social Security disability benefits can be paid to a worker between ages 18 and 65. The worker must be so disabled as to be unemployable and the disabling condition must be expected to

last, or have lasted, for at least 12 months, or
result in death.

Social Security disability benefits cannot start before the sixth full month that the worker has been disabled. Disabled children, spouses, and survivors may also qualify for disability benefits on a worker’s Social Security record.

IX.iii.1.B.1.f. Social Security Benefits for a Survivor With a Child

A surviving spouse can get Social Security survivor’s benefits at any age if they have a child who is either

under age 16, or
disabled.

However, the benefits stop when the child reaches age 16 or is no longer disabled. Although this benefit is dependent on the existence of the child, it is a surviving spouse benefit and should be attributed to the surviving spouse for VA purposes.

IX.iii.1.B.1.g. Social Security Benefits for a Survivor Without a Child

A surviving spouse without a child can start receiving Social Security survivor’s benefits at age 60, but the monthly rate is permanently reduced if the surviving spouse starts drawing benefits before reaching age 65. The amount received ranges from
71.5 percent of the deceased worker’s benefit, if the surviving spouse starts drawing at age 60, to
100 percent of the deceased worker’s benefit if the surviving spouse waits until age 65 to start drawing Social Security.

IX.iii.1.B.1.h. Social Security Benefits for a Disabled Surviving Spouse

A disabled surviving spouse can start receiving Social Security survivor’s benefits at age 50. The disabled surviving spouse’s payment is 71.5 percent of the deceased worker’s benefit.

IX.iii.1.B.1.i. Additional Social Security Benefits

An individual receiving Social Security disability, retirement, or survivor’s benefits usually receives additional benefits for

unmarried children under age 18 (or under age 19 if the child is a full-time high school student), and
unmarried children age 18 or over who
- were severely disabled before age 22, and
- continue to be disabled.

IX.iii.1.B.1.j. FMAX

The total Social Security benefit payable does not always increase as additional dependents are added. The monthly benefit is limited by the family maximum amount (FMAX). The FMAX is the maximum benefit available for distribution within a family unit. It is based on a formula that is related to the worker’s average monthly earnings. If the FMAX applies, the removal of a dependent may not change the total Social Security benefit payable but may result in a reallocation of benefits. Reference: For more information on counting the income of dependents, see M21-1, Part IX, Subpart iii, 1.F.2.

IX.iii.1.B.1.k. SSI Program

SSA and the States jointly administer the Supplemental Security Income (SSI) program. Eligibility criteria are different from those that apply to Title II Social Security. SSI assures a minimum monthly income to needy people with limited income and resources who are

65 or older
blind, or
determined disabled.

Under 38 CFR 3.3(a)(3)(vi), a Veteran meets the age or disability criterion for pension eligibility if the Veteran has attained age 65 or has been determined disabled by Social Security. Therefore, if the Veteran is shown to be in receipt of SSI benefits, presume the Veteran meets the age or disability criterion for pension eligibility. Note: Under 38 CFR 3.272(a), SSI is countable income for the Old-Law Pension program. It is not countable income for Section 306 Pension or Parents’ Dependency and Indemnity Compensation (DIC). For current-law pension purposes, SSI income is considered to be income from welfare and is not countable. Reference: For more information on exchanging information with SSA, see M21-1, Part XIII, Subpart ii, 1.

IX.iii.1.B.1.l. Lump-Sum Death Benefit

SSA pays a lump-sum Social Security Death Benefit (SSDB) on the death of an insured individual. The SSDB, usually $255, is countable income.When a VA pension claim is processed before the Veterans Benefits Management System (VBMS) contains the new Social Security rate information, assume that the claimant received the lump sum benefit if the

deceased spouse was in receipt of Social Security benefits during their lifetime, and
claimant was living in the same household as the deceased spouse.

Note: In the decision notice, inform the claimant of any assumptions VA made in processing the claim.

2. Medicare

Introduction

This topic contains information on Medicare, including

Medicare premiums
Part A coverage
Part B coverage
Part D coverage
standard and non-standard Supplementary Medical Insurance Benefit (SMIB)
private reimbursements for Medicare premiums
State’s purchase of Medicare coverage for SSI recipients
example of handling Medicare premiums paid by the State
example of handling Medicare premiums no longer paid by the State, and
prescription medication coverage under the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003.

Change Date

November 22, 2024

IX.iii.1.B.2.a. Medicare Premiums

Medicare is a Federal health insurance program for people 65 or older, or people of any age with permanent kidney failure, and certain disabled persons. Medicare is divided into the following three parts:

Part A-hospital insurance
Part B-medical insurance, and
Part D-prescription drug coverage.

Enrollment in the hospital insurance program is automatic if the eligibility criteria are met.

IX.iii.1.B.2.b. Part A Coverage

A qualified individual does not usually pay a premium for hospital insurance (Part A) coverage. Hospital insurance covers certain

inpatient hospital care
skilled nursing home care, and
hospice care.

IX.iii.1.B.2.c. Part B Coverage

Medical insurance (Part B) coverage is voluntary and requires payment of a monthly premium. Most people pay the monthly premium through a monthly deduction from their Social Security benefit. This is the Supplementary Medical Insurance Benefit (SMIB) also known as the SMIB premium, the SMI, or the Medicare premium or deduction. Part B coverage helps pay for doctor’s services and a variety of other medical services and supplies.

IX.iii.1.B.2.d. Part D Coverage

Medicare prescription drug coverage (Part D) is available to individuals who qualify for Medicare Part A or Part B. Enrollment under Part D is voluntary and requires payment of a monthly premium. Note: Part D monthly premiums are based, in part, on the income of the covered individual.

IX.iii.1.B.2.e. Standard and Non-Standard SMIB

The monthly Medicare premium paid by most beneficiaries is known as the standard SMIB. However, some beneficiaries have non-standard SMIBs, usually as a result of their not paying the Medicare premium when they first became eligible for Title II Social Security. They must now pay a higher premium to compensate. The actual SMIB rate amount will be determined by SSA based on individual income. If a VA beneficiary receives Social Security and has an amount deducted from the monthly Social Security payment to pay the Medicare medical insurance premium, add the amount of the deduction to the payment amount to determine countable Social Security income. Example: If the beneficiary receives a monthly payment of $650 and has a Medicare deduction of $78.20, monthly countable Social Security is $728.20.

IX.iii.1.B.2.f. Private Reimbursements for Medicare Premiums

Some private establishments reimburse their retired employees for premiums paid under Medicare.For current-law pension, count reimbursements as income and consider them as deductible medical expenses.For Old-Law or Section 306 Pension cases, do not count these reimbursements as income, but consider them as deductible medical expenses per 38 CFR 3.261(a)(22).

IX.iii.1.B.2.g. State’s Purchase of Medicare Coverage for SSI Recipients

Some States purchase Medicare coverage for certain residents who receive SSI. SSI is not countable income. Likewise, Medicare premiums paid by a State are not countable income. However, if a State pays an SSI beneficiary’s Medicare premium, do not allow the Medicare premium as a deductible medical expense.

IX.iii.1.B.2.h. Example: Handling Medicare Premiums Paid by the State

Situation: A Veteran receives a Social Security payment in the amount of
$850.70 per month, effective December 2023, paid January 2024, and
$850.00 per month, effective May 2024, paid June 2024.
The evidence in the SSA INQUIRY function in VBMS shows the Veteran has been paying SMIB premiums since February 2018. The SSA information now shows that the Veteran’s SMIB is paid by the State effective June 2024, indicated by the BUY-IN START DATE field.Result: The Veteran should be given credit for a total of five months of SMIB payments for 2024 (January through May) as a deductible medical expense. Typically, this is verified by the cents being removed from the Veteran’s Social Security rate effective the month the State started paying the SMIB payments, June 2024. May Social Security checks are paid in June, so June 2024 was the first month the Veteran did not pay the SMIB.

IX.iii.1.B.2.i. Example: Handling Medicare Premiums No Longer Paid by the State

Situation: A Veteran receives a Social Security payment in the amount of
$1,020.00 per month, effective November 2023, paid December 2023, and
$1,020.70 per month, effective May 2024, paid June 2024.
The evidence in the SSA INQUIRY function in VBMS shows the Veteran’s SMIB premiums have been paid by the State since March 2020, indicated by the BUY-IN START DATE field. Additionally, the SSA interface shows the State stopped paying SMIB premiums effective May 2024, indicated by the BUY-IN STOP DATE field.Result: The Veteran is now paying the SMIB premiums and should be given credit for a total of seven months of SMIB payments for 2024 (June through December) as a deductible medical expense. Typically, this is verified by the cents being added to the Veteran’s Social Security rate effective the month the State stopped paying SMIB premiums, May 2024. May Social Security checks are paid in June, so June 2024 was the first month the Veteran paid the SMIB.

IX.iii.1.B.2.j. Prescription Medication Coverage Under the MMA of 2003

Medicare beneficiaries at or below 135 percent of the Federal poverty level are eligible for subsidized discounts on prescription medications under the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. Assistance or savings received under the MMA is not countable income. However, it may be necessary to recalculate income for VA purposes (IVAP) if the beneficiary is subsequently reimbursed for the cost of prescription drugs that VA previously allowed as a deductible medical expense. Note: It is not necessary to recalculate IVAP if doing so would not change the beneficiary’s payment rate. Reference: For information on the federal poverty level, see the United States Census Bureau Poverty Thresholds.

3. Computing Monthly SSA and Medicare Benefits

Introduction

This topic contains information on computing monthly SSA and Medicare benefits, including

Social Security entitlement
determining the countable monthly Social Security when a portion of the Social Security is
- garnished, and
- withheld to recoup an overpayment
handling withheld and garnished Social Security benefits
example of handling
- withheld Social Security benefits, and
- garnished Social Security benefits
SSA Cost of Living Adjustment (COLA) calculations, and
entitlement changes to Social Security benefits in the months of November or December.

Change Date

January 15, 2026

IX.iii.1.B.3.a. Social Security Entitlement

Claims processors are required to use the SSA INQUIRY function in VBMS before awarding and adjusting income-based benefits. Therefore, it is generally unnecessary for claims processors to manually compute Social Security entitlement amounts. SSA computes a beneficiary’s monthly benefit or gross monthly entitlement based on a number of factors. The gross Social Security entitlement may be in dollars and cents, but Social Security monthly payments are always rounded down to even dollar amounts. References: For more information on
the SSA INQUIRY function in VBMS, see the VBMS Core User Guide, and
information provided through the SSA INQUIRY function, see M21-1, Part III, Subpart ii, 1.B.3.b and c.

IX.iii.1.B.3.b. Determining the Countable Monthly Social Security When a Portion of the Social Security Is Garnished

Follow the steps in the table below to determine countable monthly Social Security for VA purposes when a portion of the Social Security is garnished.

Step	Action
1	Determine the actual monthly payment amount.
2	Add in any amounts being withheld pursuant to garnishment orders, or other involuntary withholdings initiated by third parties.
3	Add in the amount of the SMIB (or Medicare deduction) and the Medicare Part D amount.Result: This is the countable monthly Social Security income.

IX.iii.1.B.3.c. Determining the Countable Monthly Social Security When a Portion of the Social Security Is Withheld to Recoup an Overpayment

Follow the steps in the table below to determine countable monthly Social Security for VA purposes when a portion of the Social Security is withheld to recoup an overpayment.

Step	Action
1	Subtract any amounts withheld to recoup a Social Security overpayment.
2	Subtract the SMIB (or Medicare deduction.)
3	Round down to an even dollar amount.
4	Add back the SMIB (or Medicare deduction.)*Result*: This is the countable monthly Social Security income.

IX.iii.1.B.3.d. Handling Withheld and Garnished Social Security Benefits

When Social Security is withheld to recoup an overpayment, the overpayment was probably counted as IVAP at the time it was received by the beneficiary. If there is garnishment of Social Security or involuntary withholding due to legal action initiated by a third party, it is as if the beneficiary had received the benefits and used the funds to pay a creditor.Use the table below to determine the difference in countable income based on either withheld or garnished Social Security benefits.
If a Social Security payee’s benefits are … Then count the …
withheld or reduced to recoup an overpayment of Social Security benefits amount actually received plus the Part B Medicare premium.
garnished or involuntarily withheld due to legal action initiated by a third party entire Social Security benefit.
Note: Do not count the amount withheld to recoup a Social Security overpayment, even if the beneficiary was not in receipt of VA pension at the time the Social Security overpayment was created.If notice is received that a claimant’s Social Security has been reduced to recoup an overpayment, initiate development to determine the exact rate while withholding is in effect and the date full benefits will be restored.

IX.iii.1.B.3.e. Example: Handling Withheld Social Security Benefits

Situation: A Veteran receives a Social Security payment in the amount of $520.00 per month. The payment would be larger except that
the Veteran has an $88.50 per month Medicare deduction, and
SSA is withholding $200.00 per month to recoup an overpayment.
Result: The countable Social Security is $608.50 per month ($520.00 + $88.50).

IX.iii.1.B.3.f. Example: Handling Garnished Social Security Benefits

Situation: A Veteran is entitled to Social Security of $1,010.50 per month. The Veteran has a $106.20 Part B Medicare deduction and $200 per month is being withheld for child support pursuant to a court order. The Veteran actually receives a monthly payment in the amount of $704. Result: The countable monthly Social Security for VA purposes is $1,010.20 ($904.00 + $106.20).

IX.iii.1.B.3.g. SSA COLA Calculations

The table below describes SSA Cost of living Adjustment (COLA) calculations.Note: In addition to this table, claims processors may also use the SSA Retro Calculator to determine earlier rates. The calculator is located on the Pension and Fiduciary Service Intranet page.
Stage Description
1 Identify the gross monthly SSA income for any year.
2 Multiply the gross monthly SSA income by the COLA factor for the next year. If the COLA factor is 3.5 percent, multiply the monthly SSA income by 1.035. Note: If calculating for a preceding year COLA, divide the gross monthly SSA income by the COLA factor.
3 Subtract the Medicare deduction.
4 Round down to an even dollar amount.
5 Add back the Medicare deduction. Result: This is the gross monthly Social Security income.
Examples:Situation 1:
The known SSA rate effective December 1, 2020, was $732.50
The December 1, 2021 COLA rate was 5.9 percent, and
the Medicare deduction was $170.10.
Calculation:
Multiply $732.50 by 1.059 = $775.71.
Subtract the Medicare deduction ($170.10) = $605.61.
Drop the cents = $605.
Add back in the Medicare deduction ($170.10) = $775.10.
Result: The December 1, 2021, monthly SSA rate was $775.10. Situation 2:
The known SSA rate effective December 1, 2021, was $532.10, and
the Medicare deduction for the individual was $148.50.
Calculation: To calculate the December 1, 2020 SSA rate, use the December 1, 2021, COLA rate, 5.9 percent and then the following calculations occur:
Divide $532.10 by 1.059 = $502.45.
Subtract the Medicare deduction ($148.50) = $353.95.
Drop the cents = $353.
Add back the Medicare deduction ($148.50) = $501.50.
Result: The December 1, 2020, monthly SSA rate was $501.50.

IX.iii.1.B.3.h. Entitlement Changes to Social Security Benefits in the Months of November or December

For benefit entitlement that changed or began in November or December (not including COLA increases), the claims processor should not count new income until the first of the month after the date of receipt. When SSA changes are effective November (received in December), the claims processor should continue counting the rate the beneficiary was receiving prior to November for the month of December and count the new SSA rate for December effective January 1. Examples:Situation 1:Result: The monthly amount of $533.10 should be counted until January 1, 2023. Effective January 1, 2023, the monthly amount of $1,531.90 should be counted.Situation 2:Result: The monthly amount of $603.50 should be continued until February 1, 2020. Effective February 1, 2020, the monthly amount of $1,529.60 should be counted.

4. Sources for Accessing Social Security Information

Introduction

This topic contains information on sources for accessing Social Security information, including

sources of information about Social Security benefits, and
interpreting Social Security award letters.

Change Date

June 15, 2015

IX.iii.1.B.4.a. Sources of Information About Social Security Benefits

The most readily accessible and accurate sources of information concerning a beneficiary’s Social Security benefits are the

SSA INQUIRY function in VBMS, and
current Social Security award letters.

If a beneficiary alleges that information obtained from these sources is inaccurate, advise the beneficiary to furnish a statement from SSA with the specific information required to resolve the issue. Reference: For more information on the action to take when the Social Security rate reported by the beneficiary is different than the rate in VBMS, see M21-1, Part IX, Subpart iii, 1.A.2.d.

IX.iii.1.B.4.b. Interpreting Social Security Award Letters

Social Security award letters may indicate the date that the first payment will be sent to the beneficiary or may show a date of entitlement, for example, July 2024. If only a date of entitlement is shown, assume that the beneficiary will receive a full month’s payment for the entitlement month, for example, July 2024, and each month thereafter. However, if an offset or deduction is required for some reason, such as, payee employed, or overpayment to be recouped, then benefits may not be payable from the date of entitlement. If this is the case, the text of the letter should state the reason why benefits are not payable from the date of entitlement. The Social Security award letter shows the amount and date of any retroactive payment issued to the beneficiary. An R in the PAYMENT INDICATOR field of the VBMS screen indicates that an SSA action possibly affected payment. Note: With the exception of Social Security cost-of-living increases, VA counts income from the first day of the month following the date the beneficiary receives it. Unless Social Security retroactive payments are involved, a Social Security payee who first becomes entitled to Social Security as of July 2024 would generally receive the first Social Security payment in August 2024. VA would count this as income as of September 1, 2024.Reference: For more information on adjusting an award for a beneficiary who became entitled to new or increased Social Security disability, retirement, or survivor’s benefits in the months of November or December (not including COLA increases), see M21-1, Part IX, Subpart iii, 1.B.3.h.

5. Terminated Disability Social Security Benefits and Withdrawn Social Security Applications

Introduction

This topic contains information on terminated disability Social Security benefits and withdrawn Social Security applications, including

adjustments based on terminated disability Social Security, and
exception to benefit waiver rule: withdrawal of application for Social Security.

Change Date

May 20, 2011

IX.iii.1.B.5.a. Adjustments Based on Terminated Disability Social Security

For information about adjustments based on terminated disability Social Security benefits, see M21-1, Part IX, Subpart iii, 1.H.4.

IX.iii.1.B.5.b. Exception to Benefit Waiver Rule: Withdrawal of Application for Social Security

Under 38 CFR 3.271(i), a person may not waive entitlement to potential benefits from non-VA sources to receive or increase VA current-law pension. Potential income from such waived sources counts as income for current-law pension. However, if a claimant or beneficiary withdraws a Social Security application after a finding of entitlement so as to maintain eligibility for an unreduced Social Security benefit on attainment of age 65, do not regard the withdrawal as a waiver per 38 CFR 3.271(i).Note: Do not count as income the Social Security benefit that would have been received except for the withdrawal of the application.

6. Processing SSA Income that Began or Increased Before June 25, 2022

Introduction

This topic contains information on processing adverse actions related to SSA income that began or increased on or before June 24, 2022, including

Timeliness Instruction Memorandum
eligibility for non-collection of pension debt associated with the June 24, 2022, SSA income match
processing action related to the Secretary’s Timeliness Instruction when due process is required
processing EP 600 associated with the Secretary’s Timeliness Instruction
processing issues related to SSA income when due process is not required
processing concurrent EPs for issues related to SSA income
processing a subsequent claim that overlaps an SSA debt cancellation period
memo approval schedule for the Social Security Match Timeliness Memo, and
SSA Match Timeliness Memo.

Change Date

January 15, 2026

IX.iii.1.B.6.a. Timeliness Instruction Memorandum

On December 22, 2023, the Secretary issued a Timeliness Instruction Memorandum for VA program offices to not collect pension overpayments associated with the June 24, 2022, SSA Income Match.VA experienced a data quality issue with the SSA Income Match beginning in 2011 and the match was paused between 2011 and 2022. The match was reestablished on June 24, 2022. Beneficiaries affected will have the entire SSA income debt removed for the period in question if they meet the eligibility requirements.

IX.iii.1.B.6.b. Eligibility for Non-Collection of Pension Debt Associated with the June 24, 2022, SSA Income Match

In order to qualify for non-collection of pension debt related to the June 24, 2022, SSA Income Match, the claimant

must have been in receipt of both pension and SSA income (including self-reported or discovered by SSA match) that began or increased on or before June 24, 2022, and
have an overpayment because of the SSA income.

Note: The initial or increased SSA payment date should be the date used when determining if the SSA discrepancy falls under the parameters of this guidance.Exception: The procedures in this topic do not apply to claims that were adjudicated prior to June 24, 2022, and had a debt established.

IX.iii.1.B.6.c. Processing Action Related to the Secretary’s Timeliness Instruction When Due Process Is Required

When the beneficiary meets the criteria described in M21-1, Part IX, Subpart iii, 1.B.6.b and there is a pending issue that leads to an EP 600 related to SSA income, the claims processor must follow the steps in the table below.

Step	Action
1	Clear the pending EP (150, 130, etc.,)
2	Establish EP 600 PMC-SSA Match for SSA Matches, or EP 600 PMC Social Security Reduction for other situations that lead to due process use the date of notice of proposed adverse action as the date of claim add the Upfront Verification special issue, and propose the most adverse action based on the evidence of record.
3	Include the paragraph shown below in the notice of proposed adverse action.A review of your record indicates there may have been a delay in VA’s ability to verify your Social Security income information, which was used to propose this adjustment to your benefits. As a result, you may not be required to repay any overpayment resulting from the delay in verification of your Social Security income. Any overpayment resulting from a concurrent issue (not related to Social Security income) may need to be repaid.

IX.iii.1.B.6.d. Processing EP 600 Associated With the Secretary’s Timeliness Instruction

Follow the steps in the table below after the notice of proposed adverse action has been issued to the beneficiary for a pension debt associated with the Secretary’s Timeliness Instruction Memorandum and either the required due process period has expired, or the beneficiary waived the due process period.

Step	Action
1	Did the claimant respond with evidence showing payment of SSA income that began after June 24, 2022, or any evidence that no overpayment would result from adjusting the SSA income? If yes, process EP 600, and disregard the rest of the steps in this table. If no, continue to next step.
2	Adjust the award under the EP 600 with the correct Social Security rates and any applicable medical expenses or other changes.Important: If there is a non-income concurrent issue pending, see M21-1, Part IX, Subpart iii, 1.B.6.f.
3	Determine the SSA overpayment timeframe and calculate the amount of the SSA overpayment that occurred using the paid/due calculator.
4	Use the Social Security Match Timeliness Memo template from M21-1, Part IX, Subpart iii, 1.B.6.i to document the SSA overpayment period and amount of the overpayment related to the SSA income that should not be established.
5	Submit the Social Security Match Timeliness Memo for approval following the guidance on M21-1, Part IX, Subpart iii, 1.B.6.h. Go to the next step following receipt of approval.
6	Adjudicate the award concurrently eliminate any resulting SSA overpayment in VBMS-A by following the steps in M21-1, Part VI, Subpart iii, 2.B.3.e, to add to gross rate using 5302B Debt Adjustment from the ADJUSTMENT REASON drop-down menu upload the approved Social Security Match Timeliness Memo* and paid/due calculator to VBMS electronic claims folder, and* add a VBMS note to the claim PENDEBTNC: [insert total debt amount]. Important: If the award terminates due to SSA income, terminate the award date last paid unless benefits can resume at some point due to medical expenses, compensation, etc., and add the following note to the award print PENDEBTNC case: If claimant reapplies update the SSA income [insert SSA rate] on [insert date] and do not create overpayment based on SSA income. *Note*: Prior to authorization, the authorizer must validate that the net effect of award generation is zero unless there is an additional debt due to a concurrent issue.
7	Upon promulgation of the EP 600, the authorizer will establish and clear an EP 960, PMC-Administrative Error Non-Rating, using the date of claim of the EP where the PMC discovered the SSA income discrepancy.
8	Prepare a decision notice with the reduced rates and corresponding dates previously provided in the notice of proposed adverse action (the rates/dates will not match what is shown in VBMS-A) and include the paragraphs shown below.We wrote to you on <insert month, day, and year> explaining that we received information from the Social Security Administration concerning your monthly payments. This information showed you received more money from the Social Security Administration than we previously thought. We asked you to send us a letter from the Social Security Administration showing the amount you received since <insert month, day, and year>. We <have/have not> received a response. What We Have Done Your VA pension depends on the amount of your Social Security payment. We <reduced/discontinued> your VA pension effective <insert month, day, and year>. Please note, we did not establish a debt due to your Social Security income because VA determined the overpayment is attributable to a delay in verification of your Social Security income and subsequent adjustment to your VA benefit payments.(The paragraph below should only be added if a concurrent issue creates an overpayment that is not related to SSA income.)What You Owe We’ve processed a concurrent issue and found that we’ve overpaid your benefits. This overpayment is separate from the one associated with your Social Security income. VA's Debt Management Center will send you a letter explaining how much you've been overpaid, and how to repay this debt. We know managing a new debt can be difficult, but we'd like to work with you on some options that can help. We encourage you to visit www.mymoney.gov and www.consumer.gov for helpful financial information.

IX.iii.1.B.6.e. Processing Issues Related to SSA Income When Due Process Is Not Required

When the claimant meets the criteria described in M21-1, Part IX, Subpart iii, 1.B.6.b and there is a pending issue related to SSA income reported by the beneficiary, the claims processor must follow the steps in the table below.

Step	Action
1	Adjust the award under the pending EP with the correct SSA rates and any applicable medical expenses or other changesImportant: If there is a concurrent issue pending see M21-1, Part IX, Subpart iii, 1.B.6.f.
2	Follow Steps 3-6 in the table in M21-1, Part IX, Subpart iii, 1.B.6.d to calculate the overpayment amount using the paid/due calculator submit the Social Security Match Timeliness Memo, and add to gross rate to eliminate any resulting overpayment, and go to next step.
3	Authorize the EP and add a VBMS note to the claim PENDEBTNC. Prepare a decision notice with the reduced rates and corresponding dates (this will not match the rates/dates shown in VBMS-A) and include the paragraph shown below. We adjusted your award based on the changes in Social Security income you reported. Any increase owed to you for medical expenses or other changes for the same period were used to offset the overpayment caused by your Social Security income. The remaining balance of the debt after the adjustments were made will not be subject to collection because VA has determined the overpayment was based solely upon VA’s untimely processing of your Social Security income information. If you receive a retroactive payment, it is because the money due to you exceeded the overpayment balance.

IX.iii.1.B.6.f. Processing Concurrent EPs for Issues Related to the SSA Income

When there is a concurrent issue pending with the SSA income and they both result in an overpayment, the concurrent issue should typically be processed simultaneously as instructed in M21-1, Part VI, Subpart iii, 2.A.2.a. For these cases only eliminate the portion of the debt related to the SSA income.If the concurrent issue

is also an income issue, such as a medical expenses adjustment, and the concurrent issue will result in a retroactive increase, process the issues together and use the medical expenses to reduce the overpayment.
is not an income issue, and the concurrent issue will result in a retroactive increase, process the SSA income issue first and follow the guidance in M21-1, Part IX, Subpart iii, 1.B.6.g to process the other issue as a subsequent claim after completion of the SSA income adjustment.
will also result in a retroactive decrease and it requires processing under 5302B due to untimely processing, process the SSA income adjustment first, and process the concurrent issue upon completion of the SSA income adjustment.

Reference: For more information on 5302B processing, see 38 U.S.C. 5302B – Prevention of Debt Due to Processing Delays SOP.

IX.iii.1.B.6.g. Processing a Subsequent Claim That Overlaps an SSA Debt Cancellation Period

If VA retroactively increases benefits over a range of dates that includes a cancelled or waived SSA debt, the claimant may not be entitled to the full amount of the lump-sum retroactive payment. To avoid making improper duplicate payments, VA may only pay above what was previously overpaid during the SSA debt cancellation period.Retroactive increased benefits over an SSA debt cancellation period may represent a duplicate payment of benefits. In such cases, claims processors must follow the instructions in the table below for withholding any benefits VA already paid a beneficiary.

Step	Action
1	On the OTHER ADJUSTMENTS tab in the awards-processing system select Debt Waiver in the ADJUSTMENT REASON field enter the amount that must be withheld each month in the ADJUSTMENT AMOUNT field, and enter the time period for the withholding in the FROM DATE and TO DATE fields.
2	Make any other necessary adjustments to the beneficiary’s award.
3	Follow the instructions in M21-1, Part VI, Subpart i, 1.B for notifying the beneficiary of the actions taken.

IX.iii.1.B.6.h. Memo Approval Schedule for the Social Security Match Timeliness Memo

The table below outlines the approval levels for the Social Security Match Timeliness Memo. This guidance supersedes the guidance provided in M21-1, Part VI, Subpart i, 2.B.3.h.

If the total overpayment not subject to recoupment is ...	Then the decision must be approved by ...
less than $25,000	an authorizer.
between $25,000 to $49,999	a specified designee of the Pension Management Center Manager (PMCM) no lower than a coach.
between $50,000 to $149,999	A PMCM or specified designee no lower than a coach.
$150,000 or more	P&F no lower than an Assistant Director.

Follow the steps below when submitting SSA debt memos over $150K to P&F Service.

Step	Action
1	PMC VSR sends the memo for 2nd signature.
2	Once the memo is second signed, PMC VSR should make the award adjustment(s) under the pending EP (used to make the SSA adjustment) *without* taking the final authorization action. Save the draft award print as a PDF to send to P&F Service with the memo.
3	PMC VSR will update the suspense for 14 days add Administrative Decision Review special issue to the pending EP add a tracked item to place the claim in “development” status, and hold both EPs on station. *Note*: Stations may use the following suspense reason/tracked item: Requested/Awaiting other evidence: PF Signature for SSA debt memo, or Administrative Review: PF Signature for SSA Debt Memo” (if available).
4	VSR will submit a request through the SSA Debt Memo Tracking Power Apps for approval using either the “open” or “resubmitted” status. Include the VA Form 0961 and any additional required documentation to initiate sign off (e.g., copy of Pension Debt memorandum, VBMS-A draft award print, and paid/due calculations). *Important: Do not upload documents into VBMS until the decision is finalized. The third signature space on the VA Form 0961* should be reserved for P&F approval.
5	P&F will review and respond to the originating PMC via the SSA Debt Memo Tracking Power Apps, with the signed VA Form 0961.

IX.iii.1.B.6.i. SSA Income Match Timeliness Memo

The following is a sample of the memo that must be completed when the beneficiary meets the eligibility requirements for non-collection of an overpayment related to the Secretary’s Timeliness Instruction Memorandum.

				PENSION OVERPAYMENTS RELATED TO SOCIAL SECURITY INCOME MATCHING IMPACTFUL AS OF JUNE 24, 2022ISSUE: Due to a data quality issue in identifying and matching Social Security income with the Social Security Administration (SSA), VA delayed processing income information on behalf of Veterans and beneficiaries which led to VA pension benefit overpayments.DECISION:VA overpaid [NAME] [insert amount of overpayment determined]. This amount represents the amount of pension paid from [DATE] to [DATE]. VA has determined that this overpayment amount is no fault of [NAME] and was based solely upon VA’s untimely processing of SSA income information on [NAME’S] behalf. Pursuant to 38 U.S.C. § 5302B(a)(1), VA will negate any debt associated with this overpayment and will not pursue debt collection with respect to this overpayment now or in the future.[NAME] is not responsible for the overpayment listed above.REASONS AND BASES:VA experienced a data quality issue with the SSA income match system beginning in 2011. VA paused the SSA income match between 2011 and 2022 because of data discrepancies. The match was reestablished on June 24, 2022. VA then matched [NAME’S] SSA income in July 2022 and determined the resulting overpayment amount listed above. Applying the Secretary’s Temporary Timeliness Instruction of December 22, 2023, VA determined that this overpayment amount was due to a failure to process income information on [NAME’S] behalf within applicable timeliness standards, and that to collect this overpayment would violate 38 U.S.C. § 5302B(a)(1) and be inconsistent with VA’s mission and core values.

Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part IX, Subpart iii, Chapter 1, Section B (U.S. government work, reproduced for reference). Browse all sections →