Chapter Determining Veteran Status and Eligibility for Benefits


Benefit-Specific Eligibility Factors



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7. Benefit-Specific Eligibility Factors




Introduction

This topic contains information on benefit-specific eligibility factors, including


  • general guidelines for reviewing and processing an original application for VA benefits

  • Social Security numbers required for dependents, and

  • eligibility determinations for compensation

  • eligibility determinations for pension

  • eligibility determinations for death benefits

  • eligibility determinations for related benefits, and

  • eligibility for Chapter 18 benefits.



Change Date

September 30, 2010



a. General Guidelines for Reviewing and Processing an Original Application for VA Benefits

In reviewing and processing an original application for VA benefits, the Veterans Service Representative (VSR) must determine if the claimant meets the eligibility criteria for the specific benefits only after


  • Veteran status has been established

  • service has been verified, and

  • character of discharge has been found to be other than dishonorable.


Note: In order to verify service, review active duty dates and verify character of discharge by

  • reviewing the discharge document,

  • obtaining verification by the service department, or

  • obtaining a VA administrative decision, when necessary.



b. Social Security Numbers Required for Dependents

A claimant must provide the Social Security Number (SSN) assigned to any claimed dependent in order to receive additional benefits for that dependent. However, an SSN is not required for a dependent if an SSN has not been assigned. Generally, do not develop for an SSN if


  • the Social Security Administration indicates no SSN has been assigned, or

  • a child has not yet attained the age of two.


References: For more information about

  • the authority to request SSNs, see 38 CFR § 3.216, and

  • development procedures, see M21-1MR, Part V, Subpart i, 3.E.18.b.

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7. Benefit-Specific Eligibility Factors, Continued


c. Eligibility Determinations for Compensation

If a claim is submitted for SC disability and honorable active service is verified, compensation entitlement is determined by the rating activity.
When a rating decision is completed, the decision indicates whether a Veteran is entitled to compensation and, if so, to what degree. In addition, the rating decision may include entitlement to special monthly compensation and any related benefits.



d. Eligibility Determinations for Pension

Basic pension eligibility is established if a Veteran


  • served at least 90 days, part of which was during a wartime period, or

  • served any amount of time during a period of war and

  • was discharged for a disability incurred or aggravated in service, or

  • had an SC disability at the time of discharge that would have justified a discharge for disability, and

  • meets the minimum active duty requirement of 24 months of service or the full period to which the Veteran was called to active duty, as provided under 38 U.S.C. § 5303A.


Note: If these eligibility criteria are met, entitlement to pension payments based on disability and income must be determined as outlined in

  • M21-1MR, Part V, Subpart iii, 1.A.1

  • M21-1MR, Part V, Subpart i, 1.1, and

  • M21-1MR, Part V, Subpart ii, 1.A.1.


References: For information on

  • SC disabilities at the time of discharge, see 38 CFR § 3.3, and

  • the specific requirements concerning minimum active duty service requirements under 38 U.S.C. § 5303A, see M21-1MR, Part III, Subpart ii, 6.4.

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7. Benefit-Specific Eligibility Factors, Continued


e. Eligibility Determinations for Death Benefits

Based on the individual who files the claim for death benefits, consider the factors listed in the table below.




If…

Then…

the claimant is a surviving spouse or child who has filed for death pension

the Veteran’s service must meet the basic eligibility criteria of M21-1MR, Part III, Subpart ii, 6.7.c for pension.

the claimant is a surviving spouse, child, or parent who has filed for Dependency and Indemnity Compensation (DIC)

refer the claim to the Rating activity for a determination.
Note: If death occurred in service, see M21-1MR, Part IV, Subpart iii, 1.2 to determine if a rating is necessary.
Exception: If a parent(s) income is excessive for DIC, disallow the claim without referral to the Rating activity.

the claimant is a surviving spouse, child or parent who has filed for death pension or DIC

the claimant’s relationship to the Veteran must be established.
Reference: For information on relationship, see 38 CFR § 3.50 through 38 CFR § 3.60.

the claim is for a burial or plot allowance

the specific requirements of 38 CFR § 3.1600 must be met.


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7. Benefit-Specific Eligibility Factors, Continued

f. Eligibility Determinations for Related Benefits

Use the table below when making eligibility determinations regarding related benefits.




Type of Related Benefit

Eligibility Requirements

Automobile or other conveyance allowance (one-time payment)

Requires SC disability or a disability incurred due to treatment under 38 U.S.C. § 1151, which results in


  • loss, or permanent loss of use, of

  • one or both feet, or

  • one or both hands, or

  • permanent impairment of vision of both eyes to a prescribed degree.


References: For more information on payment and eligibility for automobile allowance, see

  • M21-1MR, Part IX, Subpart i, 2, and

  • 38 CFR § 3.808.

Specially adapted housing and special home adaptation grants

Requires SC disability or a disability incurred due to treatment under 38 U.S.C. § 1151, that results in prescribed limitations.
References: For information on eligibility factors, see

  • M21-1MR, Part IX, Subpart i, 3

  • 38 CFR § 3.809, and

  • 38 CFR § 3.809a.

Restored Entitlement Program for Survivors (REPS) (Special allowance under Public Law (PL) 97-377, Section 156)

Requires a formal determination concerning the Veteran’s death and disability.
References: For information on REPS, see

  • 38 CFR § 3.812, and

  • M21-1MR, Part IX, Subpart i, 6

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7. Benefit-Specific Eligibility Factors, Continued


f. Eligibility Determinations for Related Benefits (continued)




Type of Related Benefit

Eligibility Requirements

Vocational rehabilitation

38 U.S.C. Chapter 31 requires


  • a combined SC disability evaluation of at least 20 percent, and

  • an evaluation and determination of entitlement by the Vocational Rehabilitation and Employment (VR&E) Division, or

  • a combined SC disability evaluation of 10 percent with a VR&E finding of a serious employment handicap.


References: For information on VR&E benefits, see

  • M28-1, and

  • 38 CFR Part 21, Subpart A.

Dependents Educational Assistance (DEA)

38 U.S.C. Chapter 35 requires


  • permanent and total SC disability (This means either a combined evaluation of 100 percent or a total rating due to individual unemployability, both with no future examination.)

  • SC death, or

  • permanent and total SC disability at the time of death.


Note: Generally, a dependent must be established for benefit purposes and a child must have completed high school or be beyond the compulsory age for school attendance.
References: For more information on DEA, see

  • M22-4, Part VII, and

  • 38 CFR Part 21, Subpart C.

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7. Benefit-Specific Eligibility Factors, Continued

g. Eligibility for Chapter 18 Benefits

Benefits for children of Vietnam Veterans who are born with spina bifida (38 U.S.C., Chapter 18 benefits) are not dependent on the character of discharge. That is, regardless of the characterization of the service of the Veteran parent, individuals may receive Chapter 18 benefits if the necessary Vietnam service and relationship requirements are met.
Reference: For more information on eligibility and development for Chapter 18 benefits, see M21-1MR, Part VI, 2.B.




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