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VB 00901.001 Adjudicating Claims for Special Veterans Benefits Overview

A. Introduction

This subchapter explains the adjudicative process which results in the initial qualification/entitlement determination for a new benefit program, Special Benefits for Certain World War (WW) II Veterans, in a new title VIII of the Social Security Act. The determination of entitlement for a title VIII benefit is a two-step claims process which may involve a collaborative effort between both domestic and foreign components. This subchapter includes the specific responsibilities of the servicing field office (FO), the designated central processing site (CPS), and the Foreign Service Post (FSP) in the jurisdiction and routing of the claims file and evidence.

B. Definitions

1. Servicing Field Office (FO)

The district office (DO) or branch office (BO) that takes the SVB claim.

2. Central Processing Site (CPS)

The term CPS, as used in this subchapter, includes seven designated FOs (six in the San Francisco region and one in the New York region) that will handle and maintain the SVB case file once the claimant has proved foreign residency.

3. Foreign Service Posts (FSP)

FSPs are United States Embassies and consulates which assist in the development of claims and the evaluation of evidence overseas.

4. Adjudication

Adjudication is the application of the law to the facts and an authoritative declaration (i.e., signature) of the result.

5. Adjudicator

An adjudicator is an employee who is delegated authority for the Commissioner to approve or disapprove applications for Social Security benefits; usually title II and title XVI claims representatives (CR), title II claims authorizers (CA) and other personnel with specifically designated authority. For purposes of title VIII, these are CRs or other personnel with specifically delegated authority, e.g., the SSA Technical Advisor has the authority to issue formal denials of SVB claims.

6. Adjudicative Signature

An adjudicative signature is the signature of the employee who adjudicates or authorizes the claim. The Personal Identification Number (PIN) serves as the signature for electronic claims and for direct input screens used to adjudicate a claim.

7. Adjudication Date

The adjudication date is the date that all qualification/entitlement evidence has been considered and the adjudicator applies his/her signature to the form authorizing the determination/decision.

8. Decision

A decision is a written notice of a formal action at or above the administrative law judge (ALJ) level.

9. Determination

A determination is a judgment on a fact or group of facts supporting a conclusion. Determinations are steps in the adjudicative process and are made below the ALJ level.

10. Develop

To develop means to gather information and evidence. (Unless specifically stated, development does not require documentation).

11. Document

To document means to place in SSA's files information used to support findings of fact and determinations.

12. Evidence

Evidence is information used to establish a fact.

13. Filing Date

The filing date is the date on which SSA receives a valid application or a protective writing.

14. Protective Filing Date

The protective filing date is the date of an oral inquiry or written statement.

15. Alpha Claim

A claim filed by an individual without a social security number.

C. Policy

When all development, verification, and documentation requirements are met, the adjudicator must make a determination of entitlement and a determination of qualification for SVB. Establishing entitlement to SVB is generally a two-step process (see VB 00101.005A.).

D. References

Adjudicative Policy and Standards, GN 01010.001 ff.

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VB 00901.001 - Adjudicating Claims for Special Veterans Benefits Overview - 06/30/2014
Batch run: 06/30/2014