Va Form 21 601

An Application for Accrued Amounts Due a Deceased Beneficiary document is formally known as Form 21P-601 to the Department of Veterans Affairs. This is a document that a veteran will fill out and submit if one of their beneficiaries passes away. This document consists of four pages and collects information of both the veteran and the deceased beneficiary. The veteran will have to include debts and expenses in relation to the death of this beneficiary in order to determine the need for benefits.

What is a VA Form 21 601?

This form will be used by the Department of Veterans Affairs in the United States. A VA Form 21P-601 is known as an Application for Accrued Amounts Due a Deceased Beneficiary. This form will be filled out by a veteran if one of their designated beneficiaries passes away. This is a four-page form that requires information about both parties.
The form will require a lot of information in order to determine if the applicant is eligible to receive the accrued VA benefits. The veteran will need to list their own personal information as well as that of the deceased beneficiary. Debts and expenses related to the death of this beneficiary are also needed to determine the need for benefits from the VA. Before this form can be submitted, it must be signed by the claimant. Witnesses may be required as well.

Most Common Uses

Use VA Form 21P-601 to apply for accrued benefits that were due to beneficiary but not paid prior to the beneficiary’s death.  Each person who is claiming a share of the accrued benefits must complete a separate VA Form 21P-601.  If you are a deceased veteran's surviving spouse, one of the veteran's children, or dependent parent applying for benefits after the veteran's death, you should use VA Form 21P-534EZ Application for DIC, Death Pension and/or Accrued Benefits instead.

Who may file a claim for reimbursement for last illness and burial expenses?

If there are no living persons who are entitled to accrued benefits on the basis of relationship, the money may be used to reimburse the person who paid for or is responsible for paying for the health care expenses of last illness and burial of the beneficiary.  The claim can be filed the person or persons whose funds were or will be used to pay the expenses or the executor or administrator of the estate if the expenses were paid out of the estate.

Components of a VA Form 21 601

A VA Form 21P-601 contains the following sections:

  • Information About Deceased Beneficiary
  • Information About Deceased Beneficiary’s Surviving Relatives
  • Debts and Expenses of the Last Sickness and Burial of Deceased Beneficiary
  • Waiver of Reimbursement from All Unpaid Creditors
  • Signature
  • Remarks

What evidence should I submit

You should submit the following items with your claim for accrued benefits:

  • Copy of death certificate if beneficiary did not die in a VA medical facility
  • Certified copy of letters of administration or letters testamentary with signature and seal of appointing court if an executor has been assigned
  • Bills and statements of account covering the services and supplies that were provided in connection with these expenses if you are claiming reimbursement

Other Considerations

What are accrued benefits?

Accrued benefits are benefits that were due to the beneficiary at the time of death but not paid prior to death.

Time limits to apply for accrued benefits

A claim for accrued benefits must be filed within one year from the date of death of the deceased beneficiary.

How does the VA decide what I will or will not receive?

The VA decides who will receive accrued benefits according to the line of succession that is established by law.  A person who is eligible for accrued benefits may request to substitute for a deceased claimant who had a pending claim or appeal at the time of his or her death.  Substitution allows a person to submit evidence in support of the pending claim or appeal.

What do I do when I have completed my application?

When your application is complete, you should mail it or take it to a regional VA office.  You should be sure to attach any materials that support your claim.  Make a photocopy of all your materials before you submit them.

How can I contact VA if I have questions?

If you have questions for the VA, you can call 1-800-827-1000.  If you are hearing impaired, you can call TDD line 711.  You can also contact our nearest VA office that you can locate in your telephone book blue pages under “United States Government, Veterans” or online at https://iris.custhelp.va.gov/. 

Privacy Act Notice

VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 5, Code of Federal Regulations 1.576 for routine uses (example: the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA benefits, verification of identity and status) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, and published in the Federal Register.  Information submitted is subject to verification through computer matching programs with other agencies. You are required to provide the Social Security number requested under 38 U.S.C. 5101(c)(1). 

Respondent Burden

The VA needs this information to determine eligibility for payment of accrued benefits under 38 U.S.C. 5121. Title 38, United States Code, allows the VA to ask for this information. It should take an average of 30 minutes to complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at http:www.reginfo.gov/public/do/PRAMain.

Sample Va Form 21 601

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Sample Va Form 21 601

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