Page 8 - Desert Oracle November 2021

Examples of accrued benefits are:

1. A claim or appeal for a recurring benefit was pending at the time of
the beneficiary’s death and all of the evidence needed for a
favorable decision was in the file on the date of death. Evidence in
file means the evidence was in VA’s possession, in a VA facility,
even if it was not actually physically in the claims file.

2. A claim for a recurring benefit had not been allowed, but the
beneficiary died before award action could be taken.

3. At the time of the beneficiary’s death, no benefit checks had been
deposited or negotiated.

This applies to pending claims or appeals in which the original claimant
died and a request to be substituted is received within one year of the
claimant’s death. It does not apply to claims where a Rating Decision
denied the claim prior to death of the veteran and no appeal was filed prior
to death. In the case of an appeal the veteran must have filed a
Supplemental Claim, request for Higher Level Review, or to the Board of
Veterans Appeal (BVA) prior to death. An individual substituting for the
deceased veteran cannot appeal a previously denied claim. To initiate the
substitution, process an eligible survivor must submit their request on VA
Form 21P-0847, 21P-601, and 21P-534.

For purposes of substitution, the definitions of “pending claim” and
“pending appeal” are limited. A pending claim is one that was undecided at
the time of the initial claimant’s death. A pending appeal is one where a
Supplemental Claim, Higher Level Review, or an appeal to BVA was
submitted by the initial claimant on a decision made, but was not resolved
either by the agency of original jurisdiction (Regional Office) or the Board
of Veterans’ Appeals (BVA) at the time of death. However, a substitute
claimant steps into the shoes of the deceased claimant if was filed prior to
the original claimant’s death. A substitute claimant may not add issues or
expand the claim but is free to raise new theories of entitlement as to the
pending claim. Inferred or implied claims cannot be filed.