Section A. Rating Dependency and Indemnity Compensation (dic)




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Section A. Rating Dependency and Indemnity Compensation (DIC)

Overview



In This Section

This section contains the following topics:




Topic

Topic Name

1

    DIC Benefits Under 38 U.S.C. 1310 & 1318

2

    DIC Benefits Under 38 U.S.C. 1151




1. DIC Benefits Under 38 U.S.C. 1310 & 1318



Introduction

This topic contains information on DIC benefits under 38 U.S.C. 1310 & 1318, including


  • considering the reasonable probability of service-connected (SC) Death

  • when DIC is payable under 38 U.S.C. 1310

  • when DIC is payable under 38 U.S.C. 1318

  • evaluations that provide entitlement to benefits under 38 U.S.C. 1318

  • when DIC is not payable under 38 U.S.C. 1318

  • Dependents’ Education Assistance (DEA) under 38 U.S.C. Chapter 35

  • when a death claim does not require a rating decision

  • review of service treatment records (STRs), and

  • evidence to support a claim for DIC.



Change Date

July 30, 2015




a. Considering the Reasonable Probability of SC Death

A reasonable probability of service-connected (SC) death exists if, based on a rating decision made during the Veteran’s lifetime, one or more of the following exists:


  • service connection was granted for any chronic disease under 38 CFR 3.309

  • service connection was granted for a condition affecting any vital organ

  • the death certificate lists at least one of the Veteran’s SC disabilities as a principal or contributory cause of death, or

  • the Veteran

  • had at least one SC disease or disability evaluated at 50 percent or more disabling

  • was rated 100 percent for an SC disease or disability, or

  • was entitled to individual unemployability (IU).




b. When DIC is Payable Under 38 U.S.C. 1310

The rating activity must determine if, based on the evidence of record, it is at least as likely as not that the Veteran’s death was related to service. Grant Dependency and Indemnity Compensation (DIC) when:


  • the principal or contributory cause of death shown on the death certificate matches one or more of the deceased Veteran’s service-connected disabilities or

  • the cause of death is a presumptive disability and the evidence shows the Veteran meets the particular presumptive criteria.



    Reference: For more information on the types of evidence required to confirm the cause of death, see 38 CFR 3.211.



c. When DIC is Payable Under 38 U.S.C. 1318

Pay DIC to a surviving spouse or children in the same manner as if death were SC, if a Veteran was in receipt of, or entitled to receive, disability compensation for an SC disability totally disabling for


  • 10 or more years immediately preceding death, or

  • a continuous period of not less than five years from the time of separation from service until death or

  • 1 or more years immediately preceding death if the Veteran was a former prisoner of war



Notes:

  • The starting point for calculating the 10-year period is the effective date of the total evaluation.

  • The fact that the Veteran may never have actually received compensation (as in retired pay cases) does not preclude a grant under 38 U.S.C. 1318.

d. Evaluations That Provide Entitlement to Benefits Under 38 U.S.C. 1318

Evaluations that provide entitlement to benefits under 38 U.S.C. 1318 include total evaluations based on


  • IU under 38 CFR 4.16

  • paired organs or extremities under 38 U.S.C. 1160, and

  • disability awarded for persons disabled by treatment or vocational rehabilitation under 38 U.S.C. 1151.



Reference: For more information on granting under 38 U.S.C. 1151, see VAOPGCPREC 80-90, July 18, 1990.


e. When DIC is Not Payable Under 38 U.S.C. 1318

Benefits under 38 U.S.C. 1318 are not payable if


  • the cause of death is found to have been the result of a Veteran’s own willful misconduct, or

  • the Veteran’s death was wrongfully and intentionally caused by the claimant.


Note: Absent evidence to the contrary in Department of Veterans Affairs (VA) records or on the death certificate, presume that the cause of death was not due to the Veteran's willful misconduct.
References: For more information on

  • willful misconduct, see M21-1, Part III, Subpart v, 1.D, and

  • development action when the Veteran’s death is a homicide, see M21-1, Part III, Subpart v, 1.F.2.


f. DEA under 38 U.S.C. Chapter 35

Whenever DIC is granted under 38 U.S.C. 1310 or 38 U.S.C. 1318, the rating must address Dependents’ Education Assistance (DEA) under 38 U.S.C. Chapter 35.
Reference: For more information on when to address ancillary benefits, see M21-1, Part III, Subpart iv, 6.B.2.b.




g. When a Survivor Claim Does Not Require a Rating Decision

When survivor claims are referred to the rating activity for review, a formal rating decision is not required if


  • service connection for cause of death was not claimed, and

  • the rating activity finds no basis for pursuing the matter further.


Note: When a rating decision is not required, the Rating Veterans Service Representative (RVSR) annotates VA Form 21-6789–E, Deferred Rating Decision, to show they


  • reviewed the claims folder, and

  • identified no evidence suggesting service connection for the cause of death.




h. Review of STRs

A review of STRs is required only when DIC cannot be granted based on the evidence of record.




i. Evidence to Support a Claim for DIC

Evidence to support a claim for DIC may be obtained from


  • the claims folder

  • corporate record

  • VA medical center treatment reports or VA outpatient clinic records

  • service treatment records, or

  • private doctor or hospital treatment records.




    Important: If the rating activity can grant DIC, and there is sufficient evidence in the Veteran’s corporate record, then the claims folder is not needed for review.





j. Consideration for Payment Under 38 U.S.C. 1318 if SC Death Is Denied

The rating activity must consider entitlement to payment under 38 U.S.C. 1318 if


  • service connection for cause of death is denied, and

  • the veteran had a totally disabling SC condition at the time of death.

Use the table below to determine the appropriate action to take if the rating activity determines that the cause of death is not SC.








If the rating activity …

Then …







  • prepare an award using SL code 19, and

  • annotate the award to read “DIC awarded per 38 U.S.C. 1318 based on rating dated [date].”







denies

  • service connection for the cause of death, and

  • payment under 38 U.S.C. 1318

include a remark that these issues were considered in any denial or pension award prepared.








2. DIC Benefits Under 38 U.S.C. 1151


Introduction

This topic contains information on DIC benefits under 38 U.S.C. 1151, including


  • benefits under 38 U.S.C. 1151, and

  • rating guidance under 38 U.S.C. 1151.


Change Date

June 15, 2015


a. Benefits Under 38 U.S.C. 1151

38 U.S.C. 1151 provides for the payment of compensation for death that is


  • not the result of the Veteran’s willful misconduct, and

  • attributable to

  • hospital care, medical or surgical treatment, or examination furnished the Veteran under any law administered by the Secretary, either by a VA employee or in a VA facility as defined in 38 U.S.C. 1701(3)(A)

  • participation in vocational rehabilitation training under 38 U.S.C. Chapter 31, or

  • participation in Compensated Work Therapy (CWT).

Award benefits for death under 38 U.S.C. 1151 in the same manner as if the disability or death were SC.




b. Rating Guidance Under 38 U.S.C. 1151

  • 38 CFR 3.361

  • M21-1, Part IV, Subpart ii, 2.G, and

  • VAOPGCPREC 80-90, July 18, 1990.




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