By law, an application for survivor benefits filed with either the VA or the Social Security Administration (SSA) constitutes a common application for survivor benefits from both agencies. The agency taking the survivor's claim will have the applicant complete a “short-form” application for referral to the other agency. When a survivor of a veteran files a claim for:

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  VA survivor benefits--the VA shares its application information by sending us an SSA-24 (Application For Survivors Benefits (Payable under Title II of the Social Security Act)); or

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  Title II survivor benefits--we send a completed VA form 21-4182 (Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation Where Applicable) From the Department of Veterans Affairs) to the VA. (For more information on completing the VA form 21-4182, see RS 01702.442.)

NOTE: The automatic conversion of Title II life benefits to survivor benefits (no survivor application required) does not establish a protective filing for VA benefits. However, our notice of benefit conversion advises the survivor to contact the VA if the deceased wage earner was ever in the military service.

When a survivor files a claim for VA benefits and completes an SSA-24, the VA usually retains the SSA-24 for a month or more until it makes a determination on whether the veteran's death was service-connected. If the veteran’s death was:

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  service-connected – the VA sends us both the SSA-24 and the VA Form 21-4180 (Request for Certification by Social Security Administration). Our completion and return of the VA Form 21-4180 helps the VA determine the survivor’s potential eligibility for the special VA payment. (For more information on the special VA payment, see RS 01702.540.)

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  not service-connected – VA forwards the SSA-24 without a VA Form 21-4180.

VA faxes or mails the SSA-24 and VA Form 21-4180 to the:

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  program service center (PSC) servicing the Social Security number (SSN) entered on the SSA-24; or

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  field office (FO) nearest the VA office taking the claim if no SSN entered on the SSA-24. The receiving FO forwards the SSA-24 and VA Form 21-4180 to the servicing FO.

Before taking an application for Title II widow(er)’s benefits, determine whether the widow(er) is receiving a VA survivor’s pension. If so, it may not be advantageous for potential widow(er) beneficiaries to file for Title II benefits (e.g., when the widow(er) has other income and the family maximum is payable to the children without regard to his or her entitlement) because VA survivors’ pensions are reduced for countable income. Advise the widow(er) to get a full explanation of pension income limitations from the VA before filing for Title II benefits. The VA will not recognize a waiver of Title II benefits after we make a determination that widow(er)’s benefits are payable. For more information on waiver of benefits, see GN 02409.010.