Handling Claims for Restored Entitlement Program for Survivors (REPS) Benefits

Overview

In This Section

This section contains the following topics:

Scroll sideways to see the full table.

1. Handling Claims for REPS Benefits When the Deceased Veteran’s Claim Folder Exists

Introduction

This topic contains information on handling claims for REPS benefits when the deceased Veteran’s claim folder exists, including

• actions following receipt of a REPS claim, and
• end products (EPs) for controlling REPS claims.

Change Date

May 8, 2019

XII.ii.3.B.1.a. Actions Following Receipt of a REPS Claim

Following receipt of a claim for Restored Entitlement Program for Survivors (REPS) benefits, the St. Louis Regional Office (RO) takes the following actions when the deceased Veteran’s claims folder exists:

• establishes one of the end products (EPs) discussed in M21-1, Part XII, Subpart ii, 3.B.1.b, and
• clears the EP after it resolves the claim.

Note: ROs other than the St. Louis RO that receive REPS-related correspondence or a claim for benefits under REPS must forward them to the St. Louis RO according to the instructions in M21-1, Part XII, Subpart ii, 3.A.5.a.

XII.ii.3.B.1.b. EPs for Controlling REPS Claims

The St. Louis RO uses the EPs referenced in the table below to control claims for REPS benefits.

Scroll sideways to see the full table.

2. Authorization Activity Determinations of Basic Eligibility

Introduction

This topic contains information on authorization activity determinations of basic eligibility, including

• memorandum decision holding that there is no basic eligibility
• approving REPS authorization determinations, and
• making line-of-duty (LOD) determinations for REPS claims.

Change Date

May 8, 2019

XII.ii.3.B.2.a. Memorandum Decision Holding That There Is No Basic Eligibility

The St. Louis RO’s authorization activity prepares a memorandum decision holding that there is no basic eligibility for REPS benefits if any of the following conditions exist:

• the earliest entry-on-duty date of the person on whose service the claim is based is after August 12, 1981, or
• DIC entitlement was established
• under 38 U.S.C. 1318, or
• as if death was service-connected (SC) under the provisions of
• 38 U.S.C. 1151 (disability due to treatment or training), or
• 38 U.S.C. 1160 (paired organs or extremities).

Reference: For more information on DIC entitlement as if death was SC, see 38 CFR 3.812(c).

XII.ii.3.B.2.b. Approving REPS Authorization Determinations

After preparing a memorandum decision indicating whether or not REPS entitlement exists, the St. Louis RO’s authorization activity

• obtains second-signature approval by following the procedures in M21-1, Part X, Subpart v, 1.C.3.e, and
• uploads the memorandum and VA Form 21-0961, Rating Decision/Administrative Decision/Formal Finding/Statement of the Case/Supplemental Statement of the Case (Electronic Signatures), to the deceased Veteran’s electronic claims folder.

XII.ii.3.B.2.c. Making LOD Determinations for REPS claims

If death occurred in service, line of duty (LOD) is not a factor.

An LOD determination is required when death occurs after active service and character of discharge (COD) is a bar to Department of Veterans Affairs (VA) noncontractual benefits.

If LOD for the in-service disability that caused or contributed to the Veteran’s post-service death is established, the St. Louis RO refers the claim to its rating activity.

Reference: For more information on death after separation from service, see M21-1, Part XII, Subpart ii, 3.A.2.f.

3. Rating Claims for REPS Benefits

Introduction

This topic contains information on rating claims for REPS benefits, including information on determining basic REPS eligibility

• by a formal death rating, and
• when death occurred in service after August 12, 1981.

Change Date

May 8, 2019

XII.ii.3.B.3.a. Determining Basic REPS Eligibility by a Formal Death Rating

The St. Louis RO’s rating activity determines basic REPS eligibility by a formal death rating if no previous claim for survivors benefits has been filed and one of the following applies:

• a previous rating was not made because
• COD was a bar, and
• the authorization activity has established the disability was incurred in the LOD
• the Veteran was released from active duty after August 12, 1981, or
• death occurred in service after August 12, 1981.

Note: If the rating activity determines that the disability that resulted in SC death had its onset before August 13, 1981, basic REPS eligibility exists.

Reference: For more information on making LOD determinations for REPS claims, see M21-1, Part XII, Subpart ii, 3.B.2.

XII.ii.3.B.3.b. Determining Basic REPS Eligibility When Death Occurred in Service After August 12, 1981

If death occurred in service after August 12, 1981, the St. Louis RO’s rating activity must review the service treatment records to determine if the disease or injury that resulted in or contributed to death had its onset before August 13, 1981.

Basic REPS eligibility exists if the condition that caused death had its onset before August 13, 1981.

4. Actions to Take After Determining Basic Eligibility

Introduction

This topic contains information on the actions to take after determining basic eligibility, including

• notifying claimants of REPS disallowance, and
• handling disagreements with decisions involving REPS.

Change Date

May 8, 2019

XII.ii.3.B.4.a. Notifying Claimants of REPS Disallowance

If the Veteran’s death is nonqualifying, the St. Louis RO

• disallows the claim, and
• notifies the claimant of the specific reason for the administrative denial.

Note: Existing VA review rights will apply for these cases.

XII.ii.3.B.4.b. Handling Disagreements With Decisions Involving REPS

The St. Louis RO’s REPS Unit handles all disagreements with denials of eligibility to REPS benefits.

References: For more information on

• legacy appellate procedures, see M21-5, Chapter 7
• higher-level reviews, see M21-5, Chapter 5, and
• supplemental claims, see M21-1, Part II, Subpart iii, 2.B.