VA Form 21P-0519S-1
Improved Pension Eligibility Verification Report - Surviving Spouse With Dependent Children
VA sent you this annual EVR as a surviving spouse receiving Survivors Pension with dependent children listed on your award.
- Who fills it
- survivor
- Journey phase
- Keeping Your Award Current
- Estimated time
- 25-40 minutes.
- When to file
- By the deadline printed on the form.
Official VA form page: https://www.va.gov/find-forms/
Walk it box by box
Fill it out with your information
Open the official VA form, then work down the boxes below. Each one is pre-filled from what you have already entered in Claim Recon and explained in plain language with the wording a VA rater expects. Review and edit every answer, then export your worksheet and copy it onto the official form. We never fill out or submit anything for you.
Gather before you start
- ▸Current income and net worth
- ▸Children's current ages and status
- ▸School enrollment documentation for children 18-23
- ▸Any marital status changes
Attach with the form
- ▸Income documentation if amounts changed
- ▸21P-8416 Medical Expense Report if claiming deductions
- ▸21-674 if child 18-23 is still in school
Section I - Surviving Spouse Identification (pre-printed)
Blocks 1-5Name, SSN, VA File Number, address (pre-printed)PII
Pre-printed by VA. Verify accuracy. Report any address change.
(pre-printed; verify)
Common mistakes
- ×Not correcting an outdated address.
Section II - Marital Status
Block 6Confirm you have not remarried
Remarriage terminates Survivors Pension immediately. Report any remarriage. If a second marriage ended, contact VA about benefit restoration.
e.g., Have not remarried since veteran's death.
Common mistakes
- ×Not reporting a remarriage - creates large overpayment debt.
Authority
- 38 USC 1541 - Death pension for surviving spouse of wartime veteran.
Section III - Income and Children Status
Blocks 7-28All income sources and current status of each dependent child
Report your income and children's income. For each child: confirm they are still living, their current age, and whether they remain eligible (under 18, or 18-23 in school, or permanently disabled). Any child who has turned 18 and is not in school, or reached 23, or married, must be removed.
e.g., SSA: $14,400/yr; Child SSA survivors: $3,840/yr Emily Smith (age 14) - at home, no change. Timothy Smith (age 20) - enrolled full time ASU.
Common mistakes
- ×Not reporting that a child graduated or left school - dependency ends, pension adjusted.
- ×Not filing 21-674 for school approval for a child who is 18-23.
Authority
- 38 CFR 3.52 - Defines dependent children including biological, adopted, stepchildren, and helpless adult children.
- 38 CFR 3.667 - Continued benefits for dependent children in school.
Section IV - Certification
Blocks 29-30Surviving spouse signature and datePII
Sign and return by the deadline. Missing the deadline suspends your pension.
(signature/date)
Common mistakes
- ×Missing the deadline.
Statutory and regulatory authority
- 38 CFR 3.3 - Eligibility criteria for veterans pension: wartime service, discharge character, income below MAPR, and net worth below threshold.
- 38 CFR 3.52 - Defines dependent children including biological, adopted, stepchildren, and helpless adult children.
- 38 CFR 3.667 - Continued benefits for dependent children in school.
- 38 USC 1541 - Death pension for surviving spouse of wartime veteran.