Application for DIC, Death Pension, and/or Accrued Benefits
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Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable) (VA Form 21P-534) |
Application for Dependency and Indemnity Compensation by a
Surviving Spouse or Child – In-Service Death (VA Form
21P-534a)
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The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services, established by law, for veterans, service personnel, and their dependents and/or beneficiaries. Title 38 U.S.C. 5101(a) provides that a specific claim in the form provided by the Secretary must be filed in order for benefits to be paid to any individual under the laws administered by the Secretary. VA Forms 21P-534EZ and 21P-534 will be the prescribed forms for applications for Dependency and Indemnity Compensation (DIC), Death Pension, and/or Accrued benefits. VA Form 21P-534a will be the prescribed form for DIC when the Veteran died while in service.
Information is requested by these forms under the authority of 38 U.S.C. 1310 through 1314 and 1532 through 1543.
In RIN 2900-AO73, VA proposes to amend its pension regulations to maintain the integrity of its needs-based pension program. VA has authority under 38 U.S.C. 501(a) to prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by VA. VA would amend its information collections in conjunction with RIN 2900-AO73. This rulemaking is largely in response to a Government Accountability Office (GAO) report, GAO-12-50, Veterans’ Pension Benefits: Improvements Needed to Ensure Only Qualified Veterans and Survivors Receive Benefits.
VA Form 21P-534EZ is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. This form is used to by claimants to apply under the Fully Developed Claim program.
VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. This form is used to by claimants to apply under the Fully Developed Claim program.
VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active duty service.
The collection of information does not involve the use of automated, electronic, mechanical, or other technological collection techniques. VA does not currently have a technology solution in place to allow for the electronic submission of this form, though VA may develop this ability in the future.
The form is available in electronically-fillable format on the benefits.va.gov website. However, the form must be printed and physically submitted.
Program reviews were conducted to identify potential areas of duplication; however, none were found to exist. The necessary information is not available from other sources within VA.
Per 38 CFR §3.160(a)(5), a complete claim for Pension claims requires the submission of an application form prescribed by the Secretary that includes a statement of income, to the extent the form itself requires.
Per 38 CFR §3.277(a), As a condition of granting or continuing pension, the Department of Veterans Affairs may require from any person who is an applicant for, or a recipient of, Pension such information, proofs, and evidence as is necessary to determine the annual income and the value of the corpus of the estate of such person, and of any spouse or child for whom the person is receiving or is to receive increased pension (such child is hereinafter in this section referred to as a dependent child), and, in the case of a child applying for or in receipt of Pension in his or her own behalf (hereinafter in this section referred to as a surviving child), of any person with whom such child is residing who is legally responsible for such child's support (Authority: 38 U.S.C. 1506).
Per 38 CFR §3.277(b), Pension claimants and beneficiaries must promptly notify VA of any change affecting Pension entitlement, including changes to income, net worth, dependency status, and nursing home status (Authority: 38 U.S.C. 1506).
VA maintains active data sharing agreements with both the Internal Revenue Service and the Social Security Administration. These agreements allow VA to verify and reconcile claimant-reported income against government source data. However, the latest available data from these sources is the last year for which a Federal income tax return has been filed. Therefore, the data lags real-time by more than one year in some cases. The data also does not provide any information regarding the claimant’s assets which VA could use to determine the claimant’s entitlement to Pension.
Reviewing both claimant-reported and government-sourced data allows VA to make thorough decisions by identifying and resolving discrepancies. By requiring claimants to report current income, VA is also able to identify any changes to income that occur between the claimant’s last Federal tax filing and his/her application for Pension benefits.
The collection of information does not impact small business or other small entities.
If this collection is not conducted, VBA will not be able to adequately evaluate a surviving claimant’s eligibility to survivor’s benefits. The information is collected once, and cannot be collected less frequently.
There are no special circumstances which would cause this information collection to be conducted more often than quarterly, or require respondents to prepare written responses to a collection of information in fewer than 30 days after receipt of it; submit more than an original and two copies of any document; retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years; in connection with a statistical survey that is not designed to produce valid and reliable results that can be generalized to the universe of study and require the use of a statistical data classification that has not been reviewed and approved by OMB.
The Notice of Proposed Rulemaking was published at 80 FR 3839, on January 23, 2015. VBA received eighty-three (83) public comments in response to the notice. All comments received referenced VBA’s proposed revisions to the application forms.
Only one commenter mentioned one of the three forms included in this Information Collection Request. The commenter stated since the forms are used as one application for two benefits, Survivors Pension and Dependency and Indemnity Compensation (DIC), it could be interpreted by applicants to mean they must report the transfer of assets even if they only wish to apply for DIC and not Survivors Pension. The commenter further suggests that each type of benefit have its own separate application form. VA Notes that the evidence tables in the instructions of VA Form 21P-534EZ describes the evidence necessary to apply for the different benefits. In addition, VA will not consider the claim for DIC incomplete if the asset transfer information is not provided by the claimant. VA is bound to maintain a single application for multiple benefits by 38 CFR §3.152(b)(1), which states: “A claim by a surviving spouse or child for compensation or dependency and indemnity compensation will also be considered to be a claim for death pension and accrued benefits, and a claim by a surviving spouse or child for death pension will be considered to be a claim for death compensation or dependency and indemnity compensation and accrued benefits. (Authority: 38 U.S.C. 5101(b)(1))”
The other comments did not specifically address the instruments contained in this Information Collection Request. However, since these comments did address Paperwork Reduction Act issues and concerns, they are included here (this information can also be found in the supporting statement for 2900-0002).
In the sponsor’s notice, the frequency of response was erroneously listed as “annually.” The actual frequency of response will be on an ad hoc (one time for most applicants) basis. Twenty-five (25) commenters took issue with VBA collecting this information on an annual basis, as the burden would be too great on all pension beneficiaries, and specifically too great for elderly or infirm beneficiaries. VBA agrees that requiring annual submission of this information would be too burdensome, however the information must only be submitted once, and will not be collected annually.
An additional thirteen (13) commenters noted that VA previously required Pension beneficiaries to verify their income annually by completing a form known as an Eligibility Verification Report (EVR). That program was suspended in 2012. The commenters stated that the annual reporting requirement for this Information Collection in effect re-establishes the EVR program. The annual reporting requirement in the Notice was inaccurate as described above, and VA is not re-establishing the EVR program.
Fifty-one (51) commenters stated VA’s application process is too complex, too many forms are required to complete the process, and forms are too long. We appreciate the commenters’ concerns regarding the complexity of the application process. We have designed the forms to minimize the burden imposed on the applicant and collect only the information necessary to properly administer the benefit.
Twenty-three (23) commenters took issue with the annual respondent burden hours of 84,000 hours (2900-0002). This number is calculated by multiplying the estimated number of respondents by the estimated number of hours required to complete the form. We have revised the estimated number of hours required to complete the 21P-534EZ from 50 minutes to 25 minutes. This change has reduced the burden hours to 62,857 hours. The previous approval of this Information Collection authorized 69,091 burden hours, so the revised forms do not present an increased respondent burden.
Four (4) commenters stated VA should receive the financial data requested in the forms from the Internal Revenue Service (IRS) and/or the Social Security Administration (SSA), based on a claimant’s federal tax return documents. VA exchanges data with various federal agencies, including both IRS and SSA, to improve the integrity of the Pension program. However, as stated above, per 38 CFR §3.277 (Authority: 38 U.S.C. 1506), VA may require a claimant to provide information and evidence necessary to determine the claimant’s annual income and the value of the corpus of the claimant’s estate. Additionally, per 38 CFR §3.160(a)(5), a complete claim for Pension claims requires the submission of an application form prescribed by the Secretary that includes a statement of income, to the extent the form itself requires.
Three (3) commenters expressed concern regarding a disabled individual’s ability to understand and complete the forms. We appreciate the difficulty disabled individuals face in completing the forms without assistance, but the information requested on the forms is required to properly administer the pension benefit.
The Veterans of Foreign Wars of the Unites States (VFW) submitted one comment which addressed several topics, some of which have been discussed above. VFW noted boxes 8 and 9 on the VA Form 21P-527 EZ are duplicated in Section III of the form. VA agrees the information requested is duplicative and we revised the form to remove the duplication.
VFW stated the instructions on the form create ambiguity about which sections are required to be completed and which sections are conditionally required. VA agrees with the comment and we revised various parts of the form to improve clarity.
VFW stated Section V of the 21P-527EZ has not been updated to comply with Obergefell v. Hodges. VA disagrees with this assessment, as all references to the Veteran’s sex and the spouse’s sex have been removed. VA has not published new regulations or policies which could provide an impetus to update the form to collect information regarding same-sex marriages covered by the Obergefell decision. If and when new regulations are published, the form may be updated to collect additional information.
VFW suggested that the form be compatible with optical-recognition scanning, and be made available electronically and to create the ability to submit the form via the eBenefits portal. The previous version of the 21P-527 was available for electronic submission via the vets.gov website, and VA will update vets.gov as soon as possible to reflect the revised form included in this Information Collection Request.
VA received thirteen (13) additional comments which did not contain specific areas of improvement or concern.
VA did not consult with those from whom the information is to be obtained. The information is submitted once, on an ad-hoc basis. It is impossible to identify potential claimants before they claim the benefit by submitting the application.
No payments or gifts to respondents will be made under this collection of information.
The records are maintained in the appropriate Privacy Act System of Records identified as “Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28),” published at 77 FR 42593 (July 19, 2012).
There are no questions of a sensitive nature (information that, with a reasonable degree of medical certainty, is likely to have a serious adverse effect on an individual's mental or physical health if revealed to him or her), such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.
VA will not disclose the information collected to any source other than what has been authorized under the Privacy Act of 1974 or Title 5, Code of Federal Regulations 1.526 for routine uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA benefits, verification of identity and status and personnel administration) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, published at 77 FR 42593 (July 19, 2012).
The respondent is required to provide his or her Social Security number when requested under 38 U.S.C. 5101 (c)(1). VA May disclose Social Security numbers as authorized under the Privacy Act, and specifically may disclose them for the purposes stated above. Information furnished on the information collection may be utilized in computer matching programs with other Federal or state agencies for the purpose of determining the respondent’s eligibility to receive VA benefits, as well as to collect any amount owed to the United States by virtue of the respondent’s participation in any benefit program administered by the Department of Veterans Affairs.
Number of Respondents: 101,426
VA Form 21P-534a 1,426
VA Form 21P-534EZ 75,000
VA Form 21P-534 25,000
These totals were derived from a query of our claims database and represent the actual number of each form received on in an average year.
Frequency of Response: Once
Annual Burden Hours: 62,857 hours
VA Form 21P-534a 357 hours
VA Form 21P-534EZ 31,250 hours
VA Form 21P-534 31,250 hours
Estimated Completion Time: 37.18 minutes (0.62 hours; average of three forms)
VA Form 21P-534a 0.25 hours (15 Minutes)
VA Form 21P-534EZ 0.41667 hours (25 Minutes)
VA Form 21P-534 1.25 hours (75 Minutes)
The
population of respondents includes school children, working age
adults, disabled adults, and elderly adults. Therefore, it is not
possible to make assumptions regarding the population of applicants,
such as the average age of applicants or their average earnings. In
order to estimate the costs to respondents, VBA used general wage
information for the population as a whole.
The Bureau of
Labor Statistics (BLS) gathers information on full-time wage and
salary workers. According to the latest available BLS data,
the mean hourly earnings of full-time wage and salary workers is
$24.34 based on the BLS wage code – “00-0000 All
Occupations.” This information was taken from the
following website: (https://www.bls.gov/oes/current/oes_nat.htm,
May 2017).
Legally, respondents may not pay a person or
business for assistance in completing the information collection,
and a person or business may not accept payment for assisting a
respondent in completing the information collection. Therefore,
there are no expected overhead costs for completing the information
collection. VBA estimates the total cost of all respondents to be
$1,530,599.48 (62,857 burden hours x $24.34 per hour).
Mean
Wage = $24.34/hour
Burden Hours per Response = 0.62 hrs.
Cost
per Response = $24.34/hr. x 0.62 hrs. = $15.0908
Total Burden
Estimate = $15.0908/Response x 101,426 Responses = $1,530,599.48
The submission does not involve any record-keeping costs.
Estimated Costs to the Federal Government:
Grade |
Step |
Burden Time |
Fraction of Hour |
Hourly Rate |
Cost Per Response |
Total Responses |
Total |
5 |
3 |
15 Min. |
0.2500 |
$14.79 |
$3.6975 |
101,426 |
$375,022.64 |
Overhead at 100% Salary |
$375,022.64 |
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9 |
3 |
60 Min. |
1.0000 |
$22.42 |
$22.420 |
101,426 |
$2,273,970.92 |
|
$2,273,970.92 |
||||||
11 |
3 |
15 Min. |
0.2500 |
$27.12 |
$6.780 |
101,426 |
$687,668.28 |
Overhead at 100% Salary |
$687,668.28 |
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|
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Processing / Analyzing Costs |
$6,673,323.67 |
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Printing and Production Cost |
$0.00 |
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Total Cost to Government |
$6,673,323.67 |
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Overhead costs are 100% of salary and are same as the wage listed above and the amounts are included in the total.
Note: The hourly wage information above is based on the hourly 2018 General Schedule (Base) Pay (https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2018/GS_h.pdf ). This rate does not include any locality adjustment as applicable.
The processing time estimates above are based on the actual amount of time employees of each grade level spend to process to completion a claim received on this form. The within-grade step (3) of each employee represents the average experience of employees within each grade.
To account for overhead costs and benefits, we factored in additional costs of 100% of employee salary. This is necessarily a rough adjustment, because methods of estimating these costs vary widely from study to study. One such study, from the Boston Business Journal (http://web.mit.edu/e-club/hadzima/pdf/how-much-does-an-employee-cost.pdf), references an estimate of overhead costs and benefits as high of 170% of employee salary. Since there is no industry standard for estimating overhead costs and benefits costs based on employee salary, we feel our estimate of 100% of employee salary is reasonable.
VA reviewed the actual number of claims received using this collection and determined we receive fewer than previously requested. This number was derived from a query of our claims database. The reduction in the number of estimated annual respondents and burden hours was published in the Notice of Proposed Rulemaking 2900-AO73 (80 FR 3839 through 386, on January 23, 2015).
The information collected is not for tabulation.
We are not seeking to omit the expiration date.
This submission does not include any exceptions to the certification statement.
No statistical methods are used in this data collection.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | SUPPORTING STATEMENT FOR VA FORM 10-2065, FUNERAL ARRANGEMENTS; VA FORM 10-10, APPLICATION FOR MEDICAL BENEFITS; VA FORM 10-10I, |
| Author | Preferred Customer |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |