Part XII, Subpart i, Chapter 4, Section ADependency and Indemnity Compensation (DIC) Benefits Based on Social Security Administration (SSA) Application

1

Stamp the date of receipt on both forms.

2

Enter the correct Department of Veterans Affairs (VA) file number in Block 12 of Form SSA-24.

3

Fax or mail Form SSA-24 to the appropriate Social Security Administration (SSA) office, according to the instructions in the table below. Note: There is no need to prepare a cover letter for the form or complete Blocks 20 and 21 of the form. If the applicant ... Then ...

entered a Social Security number (SSN) in Block 3 of Form SSA-24

fax the form to the SSA program service center of jurisdiction, using information from the table in M21-1, Part III, Subpart ii, 1.B.6.c. Important: The first three-digits of the SSN in Block 3 of Form SSA-24 represent the “account number” referenced in the column heading of the table.

did not enter an SSN in Block 3 of Form SSA-24

mail the form to the nearest SSA field office. Note: Use the SSA Office Locator to identify the nearest SSA field office and its address.

Has the claimant already submitted a completed and signed VA Form 21P-534EZ or VA Form 21P-535?

• If yes , proceed to Step 3.
• If no , send to the claimant
  • VA Form
  • 21P-534EZ(if the claimant is a surviving spouse or child), or
  • 21P-535 (if the claimant is a surviving parent), and
  • proceed to Step 2.

When the claimant returns VA Form 21P-534EZor VA Form 21P-535, establish the claim with the date of claim that SSA received the VA Form 21-4182.

Is a claim for survivors benefits from the claimant already pending?

• If yes , proceed to the next step.
• If no , proceed to Step 5.

Is the date SSA received the VA Form 21-4182 prior to the date VA received the pending claim for survivors benefits?

• If yes ,
  • change the date of claim of the pending end product (EP) to the date SSA received the form, and
  • continue to process the claim normally.
• If no , continue to process the claim normally.

Was the prior claim for entitlement to survivors benefits granted?

• If yes , proceed to the next step.
• If no , proceed no further.

Is an earlier effective date warranted based on the date SSA received the VA Form 21-4182?

• If yes , proceed to Step 7.
• If no , proceed no further.

Establish the appropriate EP, using the date SSA received the form as the date of claim.References: For more information about

• choosing the appropriate EP, see M21-4, Appendix B, and
• establishing an EP in
  • Share, see the Share User Guide, or
  • the Veterans Benefits Management System (VBMS), see the VBMS User Guide.

Is development action required?

• If yes , refer the claim for development action.
• If no , refer the claim to the appropriate decision maker (rating activity if a rating decision is required; authorization activity if no rating decision is required).

Consider entitlement to benefits from an earlier effective date when

• benefits are awarded from the date of receipt of claim which was filed more than one year after the date of the Veteran’s death, and
• there is no indication in the claims folder as to whether or not a claim for survivors’ benefits was filed with SSA.

If a claim for SSA benefits was filed prior to the claim for VA benefits and the date the application was filed is unknown,

• develop to the claimant to inform him/her of the possibility of assignment of an earlier effective date, and
• ask the claimant to complete SSA Form 3288, Consent for Release of Information, and return the form to VA. The form should be completed by the claims processor except for the signature, date, and contact information of the signer.

If the claimant returns SSA Form 3288, with consent and signature, send the form via fax or with a development letter to the appropriate Social Security payment center to verify in writing the date the application was filed with that agency. When SSA responds, proceed to Step 5. Reference: For more information on where to fax or mail the form, see M21-1, Part III, Subpart ii, 1.B.6.c.

If the claimant does not return SSA Form 3288, does not grant consent, or failed to provide a signature, contact the Social Security payment center to obtain the information without forwarding the _SSA Form 3288. _ If SSA

• provides the information, proceed to Step 5, or
• is unable to provide the information without the claimant’s authority to release information to VA
  • take award action to grant benefits from the earliest date VA received the application for survivor’s benefit, and
  • notify the claimant in the decision notice, VA was unable to confirm the date the application was filed with SSA to grant an earlier effective date. Advise the claimant to submit SSA Form 3288, and VA Form 20-0995, Decision Review Request: Supplemental Claim, for reconsideration of the earlier effective date.

Adjust the effective date of the award, if otherwise in order, upon receipt of information from SSA establishing the date the SSA application/claim was received.