M21-1 Manual / Part X, Subpart ii, Chapter 6, Section D
Processing Awards to Incompetent Beneficiaries
M21-1, Part X, Subpart ii, Chapter 6, Section D
Overview
In This Section | This section contains the following topics:
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1. General Authorization Issues in Incompetency Cases
Introduction | This topic contains information on general authorization issues in incompetency cases, including
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Change Date | May 24, 2018 |
X.ii.6.D.1.a. Indicating Incompetency When Scheduling a Physical Examination | When requesting an examination of an incompetent Veteran,
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X.ii.6.D.1.b. Actions to Take When an Incompetent Veteran Fails to Report for a Routine Future Examination | If an incompetent Veteran fails to report for a routine future examination, send
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X.ii.6.D.1.c. Admission of an Incompetent Veteran to an Institution for Medical Care | For information on handling cases in which an incompetent Veteran is admitted for medical care to a VA or non-VA institution, see M21-1, Part X, Subpart ii, 6.F. |
X.ii.6.D.1.d. Claims From Claimants Whom VA Has Determined Are Incompetent | VA must process claims it receives from a claimant whom VA has determined is incompetent, even if VA has appointed the claimant a fiduciary. A VA determination of incompetency under 38 CFR 3.353 constitutes a decision regarding the claimant’s ability to manage their own affairs, including disbursement of funds. It does not preclude such a claimant from prosecuting a claim for benefits.Reference: For more information on the process for determining whether a beneficiary is competent, see M21-1, Part X, Subpart ii, 6.A.3. |
2. Processing Incompetency Determinations and Authorizing Awards When a Beneficiary’s Competency Is at Issue
Introduction | This topic contains information on processing incompetency determinations and authorizing awards when a beneficiary’s competency is at issue, including
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Change Date | March 4, 2026 |
X.ii.6.D.2.a. Sources of Competency and Incompetency Determinations | Competency and incompetency determinations may be made by
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X.ii.6.D.2.b. Processing Medical Evidence of Incompetency That Does Not Involve a Judicial Determination | Follow the steps in the table below after receiving medical evidence that
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X.ii.6.D.2.c. Claimants Who Become Entitled to Benefits Before the Rating Activity Makes a Final Determination Regarding Competency | Use the table below to determine the actions to take if, at any point during the process described in M21-1, Part X, Subpart ii, 6.D.2.b, the rating activity determines a claimant is entitled to an original award of benefits, a reinstatement of benefits, or increased benefits. Exception: Under certain circumstances, which should be rare, not taking the action described in the table below might be in the beneficiary’s best interest. If, for example, the evidence of record shows the beneficiary has a history of giving away all income or spending it on frivolous activities on the same day it is received, it may be in the beneficiary’s best interest to withhold benefits until the
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X.ii.6.D.2.d. Actions the Authorization Activity Takes Following Receipt of a Recommendation for Payment From a Hub | When a hub makes a recommendation for payment, its own authorization activity typically processes the recommendation. When the hub’s authorization activity is unable to process such a recommendation, the hub refers the recommendation to a regional office (RO) for processing.Use the table below to determine the actions ROs must take after receiving a recommendation for payment from a hub.
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X.ii.6.D.2.e. Processing a Court Appointment of a Fiduciary Without a Judicial Determination of Incompetency | Do not consider a court appointment of a fiduciary as evidence of incompetence requiring rating action unless it is also accompanied by either
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X.ii.6.D.2.f. Processing a Court Decree of Incompetency or Court Appointment of a Fiduciary by Reason of Incompetency | If VA receives a court decree of incompetency or a court appointment of a fiduciary by reason of a beneficiary’s incompetency, it is unnecessary to
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X.ii.6.D.2.g. Processing a Judicial Determination of Incompetency | Judicial findings of a court with regard to the competency of a beneficiary are not binding on the rating activity. Follow the steps in the table below after receiving a judicial determination of incompetency regarding a beneficiary.
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X.ii.6.D.2.h. Processing Evidence That a Child Beneficiary Is Permanently Incapable of Self-Support | Following receipt of evidence indicating a child beneficiary is permanently incapable of self-support, refer the case to the rating activity for a decision as to whether or not the child
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X.ii.6.D.2.i. Authorizing an Award for a Beneficiary Found Competent by Court Decree | If a beneficiary previously held incompetent
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3. Due Process Requirements for Incompetency Determinations
Introduction | This topic contains information on due process requirements for incompetency determinations, including
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Change Date | March 4, 2026 |
X.ii.6.D.3.a. Elements of a Notice of a Proposed Rating of Incompetency | Notice of a proposed rating of incompetency must include
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X.ii.6.D.3.b. Notifying a Beneficiary Who Is Under the Age of Majority | If VA is making payments to the custodian of a beneficiary who is under the age of majority, and a decision regarding the child’s competency is needed when the child reaches the age of majority, send notice of a proposed rating of incompetency to
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X.ii.6.D.3.c. Handling Evidence VA Receives During the Due Process Period | The hub will review the evidence VA receives within 60 days of the date of the notice referenced in M21-1, Part X, Subpart ii, 6.D.3.a, and complete the final rating decision, unless one of the exceptions in FPM, Part I, 1.A.2.b applies. Exception: Follow the process outlined in M21-1, Part X, Subpart ii, 6.D.3.e, if VA receives evidence regarding a beneficiary’s competency in connection with a hearing the beneficiary requested. |
X.ii.6.D.3.d. Responding to a Beneficiary’s Request for a Hearing | If a beneficiary requests a personal hearing, advise the beneficiary that
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X.ii.6.D.3.e. Processing a Beneficiary’s Request for a Hearing | The hub will process hearing requests VA receives between the date of the notice referenced in M21-1, Part X, Subpart ii, 6.D.3.a, and the date VA makes a final decision regarding the beneficiary’s competency, unless one of the exceptions in FPM, Part I, 1.A.2.b applies. The table below describes the RO of jurisdiction's (ROJ’s) process for handling a beneficiary’s request for a hearing when one of the exceptions in FPM, Part I, 1.A.2.b applies.
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X.ii.6.D.3.f. Conducting a Hearing Prior to a Final Determination | Designated hearing officials conduct hearings in accordance with the instructions in M21-1, Part X, Subpart v, 1.D.4.Due to the nature of the hearings referenced in this section, hearing officials must be flexible in allowing a beneficiary’s next of kin (or any other person of the beneficiary’s choosing) to participate in the hearing on the beneficiary’s behalf or to assist the beneficiary during the hearing. |
X.ii.6.D.3.g. Processing a Waiver of Due Process Concerning a Proposed Rating of Incompetency | If VA receives a waiver of due process concerning a proposed rating of incompetency
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X.ii.6.D.3.h. Proposals on Which a Beneficiary Takes No Action | If a beneficiary does not respond to notice of a proposed rating of incompetency within 65 days of the date of the notice, the hub of jurisdiction makes a final decision regarding the beneficiary’s competency based on the evidence of record. |
X.ii.6.D.3.i. Processing a Legacy NOD That VA Receives After Issuing Notice of a Final Rating of Incompetency | The ROJ handles all legacy appeals of incompetency determinations. If VA receives a legacy NOD after issuing notice of a final rating of incompetency, the ROJ must
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4. SDP
Introduction | This topic contains information on SDP, including
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Change Date | May 10, 2019 |
X.ii.6.D.4.a. Authorization of SDP by a Hub | Under 38 CFR 13.110, a hub may authorize SDP to
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X.ii.6.D.4.b. Confirmation of SDP Status Following a Loss of Entitlement | If an incompetent beneficiary loses entitlement to benefits that VA had been paying directly to them based on a hub’s authorization of SDP, and VA later restores entitlement, do not resume the payment of benefits directly to the beneficiary without concurrence from a hub.If necessary, request a current VA Form 21P-555 by
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X.ii.6.D.4.c. Hub Responsibilities Following the Authorization of SDP | After a hub authorizes SDP, it is responsible for
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X.ii.6.D.4.d. Processing and Controlling an SDP Award | Follow the steps in the table below to process and control an SDP award.
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5. Processing Rating Decisions That Conclude a Beneficiary VA Previously Rated as Incompetent Is Now Competent
Change Date | March 4, 2026 |
X.ii.6.D.5.a. Processing Rating Decisions That Conclude a Beneficiary VA Previously Rated Incompetent Is Now Competent | Follow the steps in the table below to process rating decisions that conclude a beneficiary VA previously rated incompetent is now competent.
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Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part X, Subpart ii, Chapter 6, Section D (U.S. government work, reproduced for reference). Browse all sections →