Income and Net Worth Development Forms and Acceptable Statements

Overview

Introduction

This section contains the following topics:

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1. Original Applications for Pension and Parents’ DIC

Introduction

This topic contains information on the forms to be used for filing the original application for pension or Parents’ DIC, including

• application forms for pension and Parents’ DIC claims, and
• obtaining supplemental income and net worth information.

Change Date

September 10, 2025

IX.i.3.B.1.a. Application Forms for Pension and Parents' DIC

The table below shows the application forms that should be used to file an original claim for

• pension, and
• Parents’ Dependency and Indemnity Compensation (DIC).

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Note: Starting with the July 2022 version of the VA Form 21P-534EZ, there are no longer sections designated for Parents' DIC.

Reference: For more information on prescribed claim forms, see M21-1, Part II, Subpart iii, 1.A.1.a.

IX.i.3.B.1.b. Obtaining Supplemental Income and Net Worth Information

The applications described in M21-1, Part IX, Subpart i, 3.B.1.a request income and, if applicable, net worth information. However, it is often necessary to

• clarify or supplement income and net worth information furnished on the application, or
• request income or net worth information in connection with the original claim, any other new claim, or a supplemental claim.

Eligibility Verification Report (EVRs) and VA Form 21P-0969, Income and Asset Statement in Support of Claim for Pension or Parents' Dependency and Indemnity Compensation (DIC), are provided for this purpose.

Effective October 18, 2018, the Department of Veterans Affairs (VA) changed the net worth criteria for pension claims. As a result, applications for Veterans Pension and Survivors Pension were amended to incorporate a supplemental VA Form 21P-0969 when the assets indicated by the claimant are above a designated threshold.

Important: Claims processors must take into account the asset threshold provided on the application form. If the application indicates that assets are at or below the listed threshold on the form, and the subsequent asset value block is incomplete, then assume the threshold maximum value listed on the form for net worth calculation purposes. Further development is not required regarding net worth amount unless the implied assets plus the income for VA purposes is above the maximum net worth threshold or there is contradictory information of record.

2. Basic Income and Net Worth Development Forms

Introduction

This topic contains information on the basic income and net worth development forms, including

• EVR forms used to developing basic income/net worth information
• sending EVR forms
• determining if a pension claimant has dependents
• recording from/thru dates on pension EVR forms, and
• recording from/thru dates on pension EVR forms according to development period.

Change Date

June 17, 2026

IX.i.3.B.2.a. EVR Forms for Developing Basic Income/Net Worth Information

Use the information on the EVR forms listed below to develop basic income and net worth information after an initial application has been filed.

• VA Form 21P-0512s-1, Old Law and Section 306 Eligibility Verification Report (Surviving Spouse)
• VA Form 21P-0512V-1, Old Law and Section 306 Eligibility Verification Report (Veteran)
• VA Form 21P-0513-1, Old Law and Section 306 Eligibility Verification Report (Children Only)
• VA Form 21P-0514-1, DIC Parent’s Eligibility Verification Report
• VA Form 21P-0516-1, Improved Pension Eligibility Verification Report (Veteran With No Children)
• VA Form 21P-0517-1, Improved Pension Eligibility Verification Report (Veteran With Children)
• VA Form 21P-0518-1, Improved Pension Eligibility Verification Report (Surviving Spouse With No Children)
• VA Form 21P-0519s-1, Improved Pension Eligibility Verification Report (Surviving Spouse with Children), or
• VA Form 21P-0519C-1, Improved Pension Eligibility Verification Report (Child or Children).

IX.i.3.B.2.b. Sending EVR Forms

If an EVR form is sent to a beneficiary, enclose VA Form 21P-0510, Eligibility Verification Report Instructions.

Note: Veterans Benefits Management System (VBMS) should be used for development whenever possible.

References: For more information on generating letters with automated tools, see

• M21-1, Part III, Subpart i, 2.D.1.a, and
• the VBMS User Guide.

IX.i.3.B.2.c. Determining if an Pension Claimant Has Dependents

If there is uncertainty as to whether or not an pension claimant has dependents, use the most inclusive form, which would be

• VA Form 21P-0517-1, in a Veterans Pension case, or
• VA Form 21-0519S-1, in a Survivors Pension case.

IX.i.3.B.2.d. Recording From/Thru Dates on Pension EVR Forms

Claims processors must complete the from/thru spaces on an EVR when the development period is anything other than the calendar year. Generally, when filling out these spaces on the EVR forms, write the date

• of pension entitlement in the from date space, and
• that is 12 months from the end of the month of the from date in the thru date space.

Example: If a surviving spouse’s entitlement is based on the date of claim, which is October 28, 2023, write

• 10/28/23 as the from date, and
• 10/31/24 as the thru date.

IX.i.3.B.2.e. Recording From/Thru Dates on Pension EVR Forms According to Development Period

Two sets of spaces for from/thru dates are provided on pension EVR forms.

If the development period covers

• less than six months
• write the from/thru dates in just one of the spaces, and
• draw a line through the other space, or
• more than six months, write the from/thru dates in both spaces, with the from/thru dates on the right-hand side of the form being used for the calendar year following the first date on the left-hand side of the form.

Example: If the date of entitlement is October 28, 2023, and the form is being dispatched on August 7, 2024 (more than six months later), write

• 10/28/23 and 10/31/24 as the from/thru dates on the left-hand side of the form, and
• 01/01/24 and 12/31/24 as the from/thru dates on the right-hand side of the form.

3. Specialized Income Development Forms

Change Date

April 18, 2023

IX.i.3.B.3.a. Forms for Developing Specific Types of Income

Use the table below to determine the appropriate form to use to develop for specific types of income.

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References: For more information on

• development procedures, see M21-1, Part III, Subpart i, 2.D.1.a, and
• handling outdated forms, see M21-1, Part II, Subpart i, 2.B.4.a and b.

4. Developing for Income and Net Worth Information by Telephone, E-Mail, or Electronic Claims Submission Service

Introduction

This topic contains information on developing for income and net worth information by telephone, e-mail or electronic claims submission service, including

• claimant requirements for submitting information
• procedures for oral communications, and
• retroactive restoration of benefits.

Change Date

January 12, 2026

IX.i.3.B.4.a. Claimant Requirements for Submitting Information

Effective March 24, 2015, VA only recognizes compensation, pension, survivors, and related claims if they are submitted on the required standard forms.

Once a standard form is received, VA can accept further information by written correspondence, phone, etc., to clarify what was reported on the standard form.

Note: VA does not require a standard form to report a change that will result in a decrease in benefits. A beneficiary may report such changes

Reference: For more information on QuickSubmit, see M21-1, Part II, Subpart i, 1.A.3.

• in writing, or
• by telephone, e-mail, or to be uploaded directly into the Centralized Mail portal using an approved VA claims submission service such as QuickSubmit.

IX.i.3.B.4.b. Procedures for Oral Communications

Follow the specific telephone contact procedures outlined in

M21-1, Part III, Subpart i, 2.D.1.f and M21-1, Part X, Subpart ii, 3.C.2, on all oral communications in order to

• use the information furnished to reduce or terminate benefits, and
• furnish the beneficiary contemporaneous notice of the adverse action.

Reference: For more information on the submission of statements or information affecting entitlement to benefits, see 38 CFR 3.217(b).

IX.i.3.B.4.c. Retroactive Restoration of Benefits

Per 38 CFR 3.103(b)(4), VA must retroactively restore benefits that were adversely affected based on oral communication, if, within 30 days of the date that the notice of adverse action is issued, the beneficiary or their fiduciary asserts that the adverse action was based upon

• information or statements that were inaccurate, or
• information that was not provided by the beneficiary or their fiduciary.