[Federal Register Volume 60, Number 192 (Wednesday, October 4, 1995)]
[Rules and Regulations]
[Pages 51921-51922]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-24673]



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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 3

RIN 2900-AH18


Eligibility Reporting Requirements

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: This document amends the Department of Veterans Affairs (VA) 
adjudication regulations regarding eligibility verification reports 
(EVRs) for income-based benefits. This amendment implements legislation 
which eliminated the mandatory requirement for submission of EVRs on an 
annual basis from recipients of pension or parents' dependency and 
indemnity compensation (DIC) and gives VA discretionary authority to 
require such reports where necessary to determine eligibility. This 
amendment sets forth the guidelines that the Secretary will use in 
exercising this discretionary authority.

EFFECTIVE DATE: This amendment is effective October 4, 1995.

FOR FURTHER INFORMATION CONTACT:
Paul Trowbridge, Consultant, Regulations Staff, Compensation and 
Pension Service, Veterans Benefits Administration, 810 Vermont Avenue 
NW., Washington, DC 20420, telephone (202) 273-7210.

SUPPLEMENTARY INFORMATION: The term ``eligibility verification report'' 
means a VA form which requests information needed to determine or 
verify eligibility for VA's income-based benefit programs (pension and 
parents' DIC). Until recently VA was required by law (38 U.S.C. 1315(e) 
and 38 U.S.C. 1506(2)) to secure a completed EVR at least once a year 
from every pension beneficiary and every parents' DIC beneficiary under 
the age of 72. Public Law 103-271, the Board of Veterans' Appeals 
Administrative Procedures Improvement Act of 1994, amended 38 U.S.C. 
1315 and 1506 to give the Secretary of Veterans Affairs discretionary 
authority to require submission of income and resource reports by 
recipients of income-based benefits.
    On May 15, 1995, we published a document in the Federal Register 
(60 FR 25877) proposing criteria for determining which claimants and 
beneficiaries must complete an EVR. Interested parties were invited to 
submit written comments on or before July 14, 1995, and we appreciate 
the one comment that was received.
    The commenter, noting that in the past workload backlogs developed 
when all EVRs fell due at the same time, expressed concern over the 
possibility of similar backlogs developing if all EVRs are sent at the 
same time.
    While we appreciate the commenter's concern, any potential negative 
impact from concentrating the EVR workload at one time will be 
ameliorated by the vast reduction in the total number of EVRs we 
request. We project that with implementation of this final rule the 
number of annual EVRs will drop from approximately 850,000 to around 
350,000.
    The commenter also expressed concern that some beneficiaries who 
are not required to complete an annual EVR will not advise VA of 
unreimbursed medical expenses that could reduce countable income for VA 
purposes, and thereby lose potential entitlement to increased benefits.
    Each year VA will remind beneficiaries who are not required to 
submit EVRs that they might be due an adjustment because of 
unreimbursed medical expenses paid from their own funds during the 
previous calendar year. Beneficiaries will therefore be reminded of the 
opportunity to advise VA of medical expenses as they have been in the 
past, but the ultimate responsibility for doing so lies with the 
beneficiary.
    Based on the rationale set forth in this document and in the 
proposed rule, the provisions of the proposed rule are adopted as a 
final rule without change.
    The Secretary certifies that this final rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. This amendment will directly affect VA beneficiaries but will not 
affect small businesses. Therefore, pursuant to 5 U.S.C. 606(b), this 
final rule is exempt from the initial and final regulatory flexibility 
analysis requirements of sections 603 and 604.
    The Catalog of Federal Domestic Assistance program numbers are 
64.104, 64.105, and 64.110.

List of Subjects in 38 CFR Part 3

    Administrative practice and procedure, Claims, Health care, 
Individuals with disabilities, Pensions, Veterans.

    Approved: September 7, 1995.
Jesse Brown,
Secretary of Veterans Affairs.

    For the reasons set forth in the preamble, 38 CFR part 3 is amended 
as follows:

[[Page 51922]]


PART 3--ADJUDICATION

Subpart A--Pension, Compensation, and Dependency and Indemnity 
Compensation

    1. The authority citation for part 3, subpart A continues to read 
as follows:

    Authority: 38 U.S.C. 510(a), unless otherwise noted.

    2. Section 3.256 is revised to read as follows:


Sec. 3.256  Eligibility reporting requirements.

    (a) Obligation to report changes in factors affecting entitlement. 
Any individual who has applied for or receives pension or parents' 
dependency and indemnity compensation must promptly notify the 
Secretary in writing of any change affecting entitlement in any of the 
following:
    (1) Income;
    (2) Net worth or corpus of estate;
    (3) Marital status;
    (4) Nursing home patient status;
    (5) School enrollment status of a child 18 years of age or older; 
or
    (6) Any other factor that affects entitlement to benefits under the 
provisions of this Part.
    (b) Eligibility verification reports. (1) For purposes of this 
section the term eligibility verification report means a form 
prescribed by the Secretary that is used to request income, net worth 
(if applicable), dependency status, and any other information necessary 
to determine or verify entitlement to pension or parents' dependency 
and indemnity compensation.
    (2) The Secretary shall require an eligibility verification report 
under the following circumstances:
    (i) If the Social Security Administration has not verified the 
beneficiary's Social Security number and, if the beneficiary is 
married, his or her spouse's Social Security number;
    (ii) If there is reason to believe that the beneficiary or, if the 
spouse's income could affect entitlement, his or her spouse may have 
received income other than Social Security during the current or 
previous calendar year; or
    (iii) If the Secretary determines that an eligibility verification 
report is necessary to preserve program integrity.
    (3) An individual who applies for or receives pension or parents' 
dependency and indemnity compensation as defined in Secs. 3.3 or 3.5 of 
this part shall, as a condition of receipt or continued receipt of 
benefits, furnish the Department of Veterans Affairs an eligibility 
verification report upon request.
    (c) If VA requests that a claimant or beneficiary submit an 
eligibility verification report but he or she fails to do so within 60 
days of the date of the VA request, the Secretary shall suspend the 
award or disallow the claim.

(Authority: 38 U.S.C. 1315(e) and 1506)

    3. Section 3.277 is amended by revising the heading and paragraphs 
(b) and (c); and by adding paragraph (d) as follows:


Sec. 3.277  Eligibility reporting requirements.

* * * * *
    (b) Obligation to report changes in factors affecting entitlement. 
Any individual who has applied for or receives pension must promptly 
notify the Secretary in writing of any change affecting entitlement in 
any of the following:
    (1) Income;
    (2) Net worth or corpus of estate;
    (3) Marital status;
    (4) Nursing home patient status;
    (5) School enrollment status of a child 18 years of age or older; 
or
    (6) Any other factor that affects entitlement to benefits under the 
provisions of this Part.
    (c) Eligibility verification reports. (1) For purposes of this 
section the term eligibility verification report means a form 
prescribed by the Secretary that is used to request income, net worth, 
dependency status, and any other information necessary to determine or 
verify entitlement to pension.
    (2) The Secretary shall require an eligibility verification report 
under the following circumstances:
    (i) If the Social Security Administration has not verified the 
beneficiary's Social Security number and, if the beneficiary is 
married, his or her spouse's Social Security number;
    (ii) If there is reason to believe that the beneficiary or his or 
her spouse may have received income other than Social Security during 
the current or previous calendar year; or
    (iii) If the Secretary determines that an eligibility verification 
report is necessary to preserve program integrity.
    (3) An individual who applies for or receives pension as defined in 
Sec. 3.3 of this part shall, as a condition of receipt or continued 
receipt of benefits, furnish the Department of Veterans Affairs an 
eligibility verification report upon request.
    (d) If VA requests that a claimant or beneficiary submit an 
eligibility verification report but he or she fails to do so within 60 
days of the date of the VA request, the Secretary shall suspend the 
award or disallow the claim.
* * * * *
[FR Doc. 95-24673 Filed 10-3-95; 8:45 am]
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