XI.i.2.C.2.b. Actions to Take When VA Is Paying Benefits to a Dependent Under 38 CFR 3.656 | | Follow the steps in the table below if the Department of Veterans Affairs (VA) is paying benefits to a dependent under 38 CFR 3.656 at least seven years after the Veteran’s disappearance.| Step | Action |
|---|
| 1 | Does an explanation exist for the Veteran’s absence?- If yes, go to the next step.
- If no, go to Step 6.
Note: Claims processors may conclude an explanation for a Veteran’s absence exists even though there is no evidence the Veteran is still alive.
| | 2 | Determine whether all of the following conditions are evident:- The Veteran failed to claim benefits to which they are likely entitled.
- The Veteran’s age, were they alive, exceeds average life expectancy (at birth, based on the Veteran’s sex) by at least 10 years.
- No evidence that the Veteran is still living exists.
| | 3 | Are all of the conditions described in Step 2 evident?- If yes, go to Step 16.
- If no, go to the next step.
| | 4 | - Prepare an administrative decision in accordance with instructions in M21-1, Part X, Subpart v, 1.C.
- Go to the next step following approval of the administrative decision.
| | 5 | Of the conditions described in Step 2, is the second one (the Veteran’s age, were they alive) the only condition that is not evident? - If yes,
- establish a diary that will expire when the Veteran’s age, were they alive, exceeds average life expectancy (at birth, based on the Veteran’s sex) by 10 years, and
- take no further action until the diary expires.
- If no, take no further action.
| | 6 | - Send three VA Forms 21P-1775, Statement of Disappearance, to the dependent for completion within 60 days by each of the following:
- the dependent
- the Veteran’s last employer, and
- a disinterested person who knew the Veteran and the facts surrounding their disappearance.
- Inform the dependent that
- completion of the forms is required to determine whether they remain entitled to VA benefits, and
- VA will discontinue the payment of benefits if it does not receive all three forms within 60 days.
| | 7 | Within the 60-day period referenced in the preceding step, did VA receive VA Form 21P-1775 from each of the three individuals to whom the form was sent for completion?- If yes, go to Step 12 after
- completing any additional development that is necessary to determine whether an explanation for the Veteran’s absence exists, and
- requesting and reviewing the results of a field examination, if a field examination is necessary and appropriate.
- If no, go to the next step.
Important: If VA received VA Form 21P-1775 from a dependent- prior to March 24, 2015, treat it as an informal claim for survivors benefits, or
- on or after March 24, 2015, treat it as a request for an application for survivors benefits.
References: For more information on | | 8 | Prepare and send a notice of proposed adverse action that contains the elements set forth in M21-1, Part X, Subpart ii, 3.A. | | 9 | Did the dependent submit all three of the forms referenced in Step 6 within 65 days of the notice referenced in Step 8?- If yes, go to Step 12 after
- completing any additional development that is necessary to determine whether an explanation for the Veteran’s absence exists, and
- requesting and reviewing the results of a field examination, if a field examination is necessary and appropriate.
- If no, go to the next step.
Note: Follow the instructions in M21-1, Part X, Subpart ii, 3.B, if the dependent requests a hearing. | | 10 | Discontinue the Veteran’s award (including the payment of insurance premiums and benefits under 38 CFR 3.656) effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in the Veterans Benefits Management System (VBMS). | | 11 | - Notify the dependent of the action taken.
- Disregard the remaining steps in this table.
| | 12 | Does an explanation for the Veteran’s absence now exist?- If yes, go to the next step.
- If no, go to Step 16.
Note: Claims processors may conclude an explanation for a Veteran’s absence exists even though there is no evidence the Veteran is still alive. | | 13 | Are all of the conditions described in Step 2 evident?- If yes, go to Step 16.
- If no, go to the next step.
| | 14 | - Prepare an administrative decision in accordance with instructions in M21-1, Part X, Subpart v, 1.C.
- Go to the next step following approval of the administrative decision.
| | 15 | - Notify the dependent that their benefits will remain unchanged.
- Go to Step 5.
| | 16 | | | 17 | - Prepare and send a notice of proposed adverse action that contains the elements set forth in M21-1, Part X, Subpart ii, 3.A.
- Go to the next step unless the dependent submits evidence within 65 days that shows VA should continue paying benefits to them under 38 CFR 3.656.
Note: Follow the instructions in M21-1, Part X, Subpart ii, 3.B, if the dependent requests a hearing. | | 18 | Discontinue the Veteran’s award (including the payment of insurance premiums and benefits to the dependent) effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS. | | 19 | Notify the dependent of the action taken. Note: In the decision notice, invite the dependent to submit a claim for survivors benefits by completing and returning VA Form 21P-534EZ, Application for DIC, Survivors Pension, and/or Accrued Benefits,unless the dependent has already submitted the form. | | 20 | Invite other eligible survivors to submit VA Form 21P-534EZ if their names and addresses are of record. | | 21 | E-mail a copy of the administrative decision to Director, Compensation Service (214D), for administrative review. | | 22 | Was VA deducting benefits from the Veteran’s award for the payment of insurance premiums? - If yes, send a copy of the administrative decision to Insurance Service.
- If no, take no further action.
| References: For more information on- field examinations, see M21-1, Part X, Subpart v, 1.E
- Field Examiner responsibilities, see FPM, Part I, 1.B.5, and
- preparing decision notices, see M21-1, Part VI, Subpart i, 1.B.
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