[Federal Register Volume 60, Number 93 (Monday, May 15, 1995)]
[Proposed Rules]
[Pages 25877-25879]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-11880]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 3
RIN 2900-AH18
Eligibility Reporting Requirements
AGENCY: Department of Veterans Affairs.
ACTION: Proposed rule.
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SUMMARY: The Department of Veterans Affairs (VA) is proposing to amend
its adjudication regulations regarding eligibility verification reports
(EVRs) for income-based benefits. This amendment implements recent
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 is necessary to set forth the guidelines
that the Secretary will use in exercising this discretionary authority.
DATES: Comments must be received on or before July 14, 1995.
ADDRESSES: Mail written comments to: Director, Office of Regulations
Management (02D), Department of Veterans Affairs, 810 Vermont Avenue,
NW, Washington, DC 20420, or hand-deliver written comments to: Office
of Regulations Management, Room 1176, 801 Eye Street, NW, Washington,
DC 20001. Comments should indicate that they are in response to ``RIN
2900-AH18.'' All written comments received will be available for public
inspection in the Office of Regulations Management, Room 1176, 801 Eye
Street, NW, Washington, DC 20001, between the hours of 8:00 a.m. and
4:30 p.m., Monday through Friday (except holidays).
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). A series of forms, rather than one universal form, is
used because specific entitlement factors vary depending on the benefit
involved and the status of the beneficiary. However, all EVR forms
request income and marital status information and have a similar
format.
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. These implementing regulatory
amendments outline the manner in which the secretary will exercise this
discretionary authority each year to determine which claimants and
beneficiaries must complete an EVR.
The proposed rule would require an EVR in three instances. First,
VA will require submission of an EVR by any beneficiary whose Social
Security number, or whose spouse's Social Security number, has not been
verified by the Social Security Administration (SSA). VA conducts
periodic computer matches with SSA. These matches permit VA to verify
the information upon which payment of VA benefits is based. However,
these matches cannot be conducted unless VA records contain accurate
Social Security numbers for the beneficiary and, if applicable, his or
her spouse. A Social Security number is considered to be verified when
the identifying information associated with that number in VA records
(e.g., name, date of birth, sex) matches identifying information
associated with the number in SSA records. SSA verifies the Social
Security numbers of VA beneficiaries and spouses twice each year.
VA is required by 38 U.S.C. 5312 to increase current pension and
parents' DIC rates by the same percentage and on the same date as the
Social Security COLA, and for that reason we automatically update
Social Security income information in our records at the time of a
Social Security COLA. VA then receives a computer extract from SSA
showing the actual Social Security income which beneficiaries will
receive based upon the new COLA and reconciles any differences between
data in VA's records and data provided by SSA. Based on this review of
Social Security data, we are confident of the timeliness and accuracy
of the Social Security income match and, in our judgment, it is not
necessary to require beneficiaries with verified Social Security
numbers who have no income, or whose only income is Social Security, to
submit an annual EVR.
VA will also require beneficiaries who receive income other than
Social Security to submit an EVR. These beneficiaries must submit an
EVR because VA is unable to verify the receipt and amount of other
types of income with the same accuracy that it can verify Social
Security income.
Even if all relevant Social Security numbers have been verified and
neither the beneficiary nor the beneficiary's spouse received income
other than Social Security, VA will still require completion of an EVR
if it determines that submission of an EVR is necessary to preserve
program integrity. The phrase ``necessary to preserve program
integrity'' applies when it is necessary for VA, or an agency with
oversight authority over VA, to verify that EVR-exempt beneficiaries
are accurately reporting changes in entitlement factors.
38 U.S.C. 1315(e) establishes a statutory exemption from filing an
EVR for parents who have attained the age of 72 and who have been paid
Dependency and Indemnity Compensation for two consecutive years.
However, when Congress removed the mandatory requirement for annual
reporting by persons who have received old law or section 306 pension
or parents' DIC for two consecutive years and are at least 72 years
old, it indicated that removal of this reporting requirement did not
affect VA's authority to require clarification or [[Page 25878]] proof
of income, when indicated, for this group (see Pub. L. No. 91-588,
Secs. 2(d) and 6, 84 Stat. 1583, 1584 (1970)). Therefore, VA will apply
the same criteria for determining when persons who are 72 years or
older and have received the particular benefit for two consecutive
calendar years must submit an EVR.
Although beneficiaries will be required to file an EVR only if
requested to do so by VA, they have an affirmative obligation to advise
VA promptly of changes in factors such as income, marital status, etc.
which affect entitlement. This affirmative obligation appears at
Secs. 3.256(a) and 3.277(b) of the amendments.
When VA sends a beneficiary an EVR to be completed, it advises the
beneficiary in writing that the completed form must be returned to VA
at the address shown within 60 days and that failure to return the
completed form will result in interruption of benefits. If the
completed form is not received within the specified period, VA will
suspend payment and send a letter to the beneficiary advising that
completion of the EVR form is required. The beneficiary's continued
failure to return the EVR will result in termination of the award under
the provisions of 38 CFR 3.661.
If a claimant with a pending claim fails to return an EVR when
requested to do so, VA will disallow the claim and notify the claimant
of the reason for the disallowance. The notification will furnish
notice of procedural and appellate rights and will advise the claimant
that no further action can be taken on the claim unless the EVR is
returned within 1 year of the date it was originally requested. VA will
consider the claim abandoned under 38 CFR 3.158 if the EVR is not
received within one year of the date it was originally requested.
We are proposing to change the heading of 38 CFR 3.256 from
``Annual income and net worth questionnaires'' to the more general
``Eligibility reporting requirements'' to better describe the content
of the section. The text of 38 CFR 3.256 is similarly changed to
reflect the new reporting requirements and set out the criteria for
determining which recipients are required to complete an EVR.
The heading of 38 CFR 3.277 is changed from ``Income and net worth
reports'' to ``Eligibility reporting requirements'' to better describe
the content of the section. Paragraph (b) emphasizes a pension claimant
or beneficiary's responsibility to notify VA of any material change in
entitlement factors. Paragraph (c) shows when VA will require
completion of an EVR.
These amendments do not change any substantive rules concerning
eligibility for VA benefits, alter the recipient's obligation to report
changes that may affect the rate of VA benefits payable, or limit VA's
authority to require evidence of entitlement factors in an individual
case. The amendments merely set out VA's policy on requiring completion
of an EVR.
Regulatory Flexibility Act
The Secretary hereby certifies that these regulatory amendments
will not have a significant economic impact on a substantial number of
small entities as they are defined in the Regulatory Flexibility Act
(RFA), 5 U.S.C. 601-612. The reason for this certification is that
these amendments would not directly affect any small entities. Only VA
beneficiaries could be directly affected. Therefore, pursuant to 5
U.S.C. 605(b), these amendments are exempt from the initial and final
regulatory flexibility analysis requirements of sections 603 and 604.
Paperwork Reduction Act of 1980
This proposed rule contains information collections which are
subject to review by the Office of Management and Budget (OMB) under
the Paperwork Reduction Act of 1980. The title, description of agency
need, and respondents of the information collections are shown below
with estimates of reporting burdens.
Title: Eligibility Verification Reports.
Description of Agency Need: These information collections are to be
used to verify entitlement to or continued eligibility for pension or
parents' DIC and to determine whether adjustments in the rate of
payment are necessary.
Respondents: Recipients of pension or parents' DIC who come within
the circumstances described in proposed Secs. 3.256(b) or 3.277(c) for
submitting an annual EVR or claimants or recipients who have a change
affecting entitlement as specified in proposed Secs. 3.256(a) or
3.277(b).
Estimates of Reporting Burdens: (1) Under current regulations all
of the 825,000 recipients of pension or parents' DIC are required to
submit an annual EVR. It is estimated that under proposed
Secs. 3.256(b) and 3.277(c) the number of persons required to submit an
EVR during a calendar year would be reduced from 825,000 to 325,000. It
is estimated that an EVR takes approximately 30 minutes to complete.
Accordingly, the estimated total annual reporting hours for annual EVRs
would be reduced from approximately 412,500 hours to approximately
162,500 hours. (2) Also, under current regulations approximately
190,000 individuals must independently report changes in factors
affecting entitlement. The proposed regulations (see proposed
Secs. 3.256(a) and 3.277(b)) would not cause a change in this reporting
requirement. It is estimated that such a report takes approximately 15
minutes to complete. Accordingly, the estimated total annual reporting
hours for independent reports because of changes in factors affecting
entitlement would be approximately 47,500 hours.
As required by section 3504(h) of the Paperwork Reduction Act of
1980, VA is submitting a copy of this proposed rule to OMB for its
review of these information collection requirements. Organizations and
individuals desiring to submit comments regarding these burden
estimates or any aspect of these information collection requirements,
including suggestions for reducing burdens, should direct them to VA's
Director, Office of Regulations Management (address above) and the
Office of Information and Regulatory Affairs, OMB, Room 10235, New
Executive Office Bldg., Washington, DC 20503, Attn: Desk Officer for
VA.
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, Reporting and recordkeeping
requirements, Veterans.
Approved: February 3, 1995.
Jesse Brown,
Secretary of Veterans Affairs.
For the reasons set forth in the preamble, 38 CFR part 3 is
proposed to be amended as follows:
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. 501(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 [[Page 25879]] 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 report. (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 Sec. 3.3 or 3.5
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) to read 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 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.
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[FR Doc. 95-11880 Filed 5-12-95; 8:45 am]
BILLING CODE 8320-01-P
