Va Form 21p-534ez - Notice To Survivor Of Evidence Necessary To Substantiate A Claim For Dependency And Indemnity Compensation, Death Pension, And/or Accrued Benefits Page 3
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10WHAT THE EVIDENCE MUST SHOW TO SUPPORT YOUR CLAIM
If you are claiming...
See the evidence table titled...
Needs-based benefits based on the veterans wartime service.
Death Pension
• The veteran's death was related to his or her service (DIC), OR
• DIC benefits because the veteran was receiving or entitled to
Dependency and Indemnity Compensation (DIC)
receive benefits for a service-connected disability rated totally
disabling.
The veteran's death was a result of VA medical treatment,
DIC under 38 U.S.C. 1151
vocational rehabilitation, or compensated work therapy.
DIC and it was previously denied by VA.
Reopened DIC
Increased death pension or DIC benefits because your disabilities
Increased Survivor Benefits Based on Need for Aid and
cause you to be in need of aid and attendance or to be confined
Attendance or Being Housebound
to your residence.
You are eligible to the benefits that were due to the veteran at
Accrued Benefits
the time of the veteran's death.
You are eligible to the benefits because a child of the veteran is
Helpless Child
severely disabled.
EVIDENCE TABLES
Death Pension
To support your claim for death pension benefits, the evidence must show:
1. The veteran met certain minimum requirements regarding active service during a period of war.
Generally, those requirements involve:
• 90 days of consecutive service, at least one day of which was during a period of war; OR
• 90 days of combined service during at least one period of war;
(Note : If the veteran's service began after September 7, 1980, additional length-of-service requirements may apply, typically
requiring two years of continuous service or completion of active-duty obligations.)
OR any length of active service during a period of war when:
• At the time of death, the veteran was receiving (or entitled to receive) VA disability compensation or
retirement pay for a service-connected disability; OR
• The veteran was discharged from active service due to a service-connected disability.
2. Your net worth and income do not exceed certain requirements.
Dependency and Indemnity Compensation (DIC)
To support a claim for Dependency and Indemnity Compensation (DIC) benefits based on a service-connected disability
established during the veteran's lifetime, the evidence must show:
• The veteran died while on active service; OR
• The veteran had a service-connected disability(ies) that was either the principal or contributory cause of
the veteran's death; OR
• The veteran died from non service-connected injury or disease AND was receiving, or entitled to receive VA
compensation for a service-connected disability rated totally disabling:
• For at least 10 years immediately before death; OR
• For at least 5 years after the veteran's release from active duty preceding death; OR
• For at least 1 year before death, if the veteran was a former prisoner of war who died after September 30, 1999
To support a claim for DIC benefits based on a disability that was not service-connected or for which the veteran did not file
a claim during his or her lifetime, the evidence must show:
• An injury or disease that was incurred or aggravated during active service, or an event in service that caused an injury
or disease; AND
• A physical or mental disability that was either the principle or contributory cause of death. This may be shown by
medical evidence or by lay evidence of persistent and recurrent symptoms of disability that were visible or observable; AND
• A relationship between the disability associated with the cause of death and an injury, disease, or event in service. This may
be shown by medical records or medical opinion or, in certain cases, by lay evidence
Page 3
VA FORM 21P-534EZ, JUL 2015
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