Class: PdfFill::Forms::Va21p530

Inherits:
FormBase
  • Object
show all
Includes:
FormHelper
Defined in:
lib/pdf_fill/forms/va21p530.rb

Constant Summary collapse

ITERATOR = 
PdfFill::HashConverter::ITERATOR
PLACE_OF_DEATH_KEY = 
{
  'vaMedicalCenter' => 'VA MEDICAL CENTER',
  'stateVeteransHome' => 'STATE VETERANS HOME',
  'nursingHome' => 'NURSING HOME UNDER VA CONTRACT'
}.freeze
KEY =

rubocop:disable Layout/LineLength

{
  'burialAllowanceRequested' => {
    'checkbox' => {
      'nonService' => {
        key: 'form1[0].#subform[37].Non-Service-ConnectedDeath[0]'
      },
      'service' => {
        key: 'form1[0].#subform[37].Service-ConnectedDeath[0]'
      },
      'vaMC' => {
        key: 'form1[0].#subform[37].UnclaimedRemains[0]'
      }
    }
  },
  'signature' => {
    key: 'form1[0].#subform[37].CLAIMANT_SIGNATURE[0]',
    limit: 45,
    question_num: 20,
    question_text: 'SIGNATURE OF CLAIMANT',
    question_suffix: 'A'
  },
  'amountIncurred' => {
    key: 'form1[0].#subform[37].COST_OF_BURIAL[0]',
    question_num: 19,
    dollar: true,
    question_text: "EXPENSES INCURED FOR THE TRANSPORTATION OF THE VETERAN'S REMAINS FROM THE PLACE OF DEATH TO THE FINAL RESTING PLACE",
    limit: 12
  },
  'amountGovtContribution' => {
    key: 'form1[0].#subform[37].AMOUNT[0]',
    question_num: 18,
    question_suffix: 'B',
    dollar: true,
    question_text: 'AMOUNT OF GOVERNMENT OR EMPLOYER CONTRIBUTION',
    limit: 10
  },
  'placeOfRemains' => {
    key: 'form1[0].#subform[37].PLACE_OF_DEATH[1]',
    limit: 80,
    question_num: 16,
    question_text: "PLACE OF BURIAL OR LOCATION OF DECEASED VETERAN'S REMAINS"
  },
  'hasGovtContributions' => {
    key: 'form1[0].#subform[37].YES5[0]'
  },
  'noGovtContributions' => {
    key: 'form1[0].#subform[37].NO5[0]'
  },
  'hasStateCemetery' => {
    key: 'form1[0].#subform[37].YES4[2]'
  },
  'noStateCemetery' => {
    key: 'form1[0].#subform[37].NO4[2]'
  },
  'hasFederalCemetery' => {
    key: 'form1[0].#subform[37].YES4[0]'
  },
  'noFederalCemetery' => {
    key: 'form1[0].#subform[37].NO4[0]'
  },
  'hasBenefitsUnclaimedRemains' => {
    key: 'form1[0].#subform[37].YES4[4]'
  },
  'noBenefitsUnclaimedRemains' => {
    key: 'form1[0].#subform[37].NO4[4]'
  },
  'hasPlotAllowance' => {
    key: 'form1[0].#subform[37].YES4[1]'
  },
  'noPlotAllowance' => {
    key: 'form1[0].#subform[37].NO4[1]'
  },
  'officialPosition' => {
    key: 'officialPosition',
    limit: 48,
    question_num: 20,
    question_suffix: 'B',
    question_text: 'OFFICIAL POSITION OF PERSON SIGNING ON BEHALF OF FIRM, CORPORATION OR STATE AGENCY'
  },
  'hasBurialAllowance' => {
    key: 'form1[0].#subform[37].YES4[3]'
  },
  'noBurialAllowance' => {
    key: 'form1[0].#subform[37].NO4[3]'
  },
  'hasPreviouslyReceivedAllowance' => {
    key: 'form1[0].#subform[37].YES2[0]'
  },
  'noPreviouslyReceivedAllowance' => {
    key: 'form1[0].#subform[37].NO2[0]'
  },
  'locationOfDeath' => {
    'checkbox' => {
      'vaMedicalCenter' => {
        key: 'form1[0].#subform[37].CheckBox1[1]'
      },
      'stateVeteransHome' => {
        key: 'form1[0].#subform[37].CheckBox2[1]'
      },
      'nursingHome' => {
        key: 'form1[0].#subform[37].CheckBox3[1]'
      },
      'other' => {
        key: 'form1[0].#subform[37].CheckBox4[1]'
      }
    },
    'other' => {
      key: 'form1[0].#subform[37].OTHER_SPECIFY[1]',
      question_num: 13,
      question_suffix: 'B',
      question_text: "WHERE DID THE VETERAN'S DEATH OCCUR?",
      limit: 50
    }
  },
  'burialCost' => {
    key: 'form1[0].#subform[37].COST_OF_BURIAL[1]',
    limit: 12,
    question_num: 13,
    question_suffix: 'A',
    question_text: 'If VA Medical Center Death is checked, provide actual burial cost'
  },
  'veteranFullName' => {
    'first' => {
      key: 'form1[0].#subform[36].VeteransFirstName[0]',
      limit: 12,
      question_num: 1,
      question_text: "DECEASED VETERAN'S FIRST NAME"
    },
    'middleInitial' => {
      key: 'form1[0].#subform[36].VeteransMiddleInitial1[0]'
    },
    'last' => {
      key: 'form1[0].#subform[36].VeteransLastName[0]',
      limit: 18,
      question_num: 1,
      question_text: "DECEASED VETERAN'S LAST NAME"
    }
  },
  'previousNames' => {
    key: 'form1[0].#subform[36].OTHER_NAME[0]',
    question_num: 12,
    question_text: 'IF VETERAN SERVED UNDER NAME OTHER THAN THAT SHOWN IN ITEM 1, GIVE FULL NAME AND SERVICE RENDERED UNDER THAT NAME',
    limit: 180
  },
  'burialDate' => {
    key: 'form1[0].#subform[36].DATE_OF_BURIAL[0]',
    format: 'date'
  },
  'vaFileNumber' => {
    key: 'form1[0].#subform[36].VAFileNumber[0]'
  },
  'placeOfDeath' => {
    key: 'form1[0].#subform[36].PLACE_OF_DEATH[0]',
    limit: 52,
    question_num: 10,
    question_suffix: 'B',
    question_text: 'PLACE OF DEATH'
  },
  'claimantEmail' => {
    key: 'form1[0].#subform[36].PreferredE_MailAddress[0]',
    limit: 31,
    question_num: 7,
    question_text: 'PREFERRED E-MAIL ADDRESS'
  },
  'claimantFullName' => {
    'first' => {
      key: 'form1[0].#subform[36].ClaimantsFirstName[0]',
      limit: 12,
      question_num: 4,
      question_text: "CLAIMANT'S FIRST NAME"
    },
    'middleInitial' => {
      key: 'form1[0].#subform[36].ClaimantsMiddleInitial1[0]'
    },
    'last' => {
      key: 'form1[0].#subform[36].ClaimantsLastName[0]',
      limit: 18,
      question_num: 4,
      question_text: "CLAIMANT'S LAST NAME"
    }
  },
  'claimantAddress' => {
    'street' => {
      key: 'form1[0].#subform[36].CurrentMailingAddress_NumberAndStreet[0]',
      limit: 30,
      question_num: 5,
      question_text: "CLAIMANT'S ADDRESS - STREET"
    },
    'street2' => {
      key: 'form1[0].#subform[36].CurrentMailingAddress_ApartmentOrUnitNumber[0]',
      limit: 5,
      question_num: 5,
      question_text: "CLAIMANT'S ADDRESS - APT/UNIT NO."
    },
    'city' => {
      key: 'form1[0].#subform[36].CurrentMailingAddress_City[0]',
      limit: 18,
      question_num: 5,
      question_text: "CLAIMANT'S ADDRESS - CITY"
    },
    'state' => {
      key: 'form1[0].#subform[36].CurrentMailingAddress_StateOrProvince[0]',
      limit: 2,
      question_num: 5,
      question_text: "CLAIMANT'S ADDRESS - STATE"
    },
    'country' => {
      key: 'form1[0].#subform[36].CurrentMailingAddress_Country[0]',
      limit: 2,
      question_num: 5,
      question_text: "CLAIMANT'S ADDRESS - COUNTRY"
    },
    'postalCode' => {
      'firstFive' => {
        key: 'form1[0].#subform[36].CurrentMailingAddress_ZIPOrPostalCode_FirstFiveNumbers[0]',
        limit: 5,
        question_num: 5,
        question_text: "CLAIMANT'S ADDRESS - POSTAL CODE - FIRST FIVE"
      },
      'lastFour' => {
        key: 'form1[0].#subform[36].CurrentMailingAddress_ZIPOrPostalCode_LastFourNumbers[0]',
        limit: 4,
        question: 5,
        question_text: "CLAIMANT's ADDRESS - POSTAL CODE - LAST FOUR"
      }
    }
  },
  'relationship' => {
    'checkbox' => {
      'spouse' => {
        key: 'form1[0].#subform[36].CheckBox1[0]'
      },
      'child' => {
        key: 'form1[0].#subform[36].CheckBox2[0]'
      },
      'executor' => {
        key: 'form1[0].#subform[36].CheckBox4[0]'
      },
      'other' => {
        key: 'form1[0].#subform[36].CheckBox5[0]'
      },
      'parent' => {
        key: 'form1[0].#subform[36].CheckBox3[0]'
      }
    },
    'other' => {
      limit: 58,
      question_num: 8,
      question_text: 'RELATIONSHIP OF CLAIMANT TO DECEASED VETERAN',
      key: 'form1[0].#subform[36].OTHER_SPECIFY[0]'
    }
  },
  'toursOfDuty' => {
    limit: 3,
    first_key: 'rank',
    'dateRangeStart' => {
      key: "toursOfDuty.dateRangeStart[#{ITERATOR}]",
      question_num: 11,
      question_suffix: 'A',
      question_text: 'ENTERED SERVICE (date)',
      format: 'date'
    },
    'placeOfEntry' => {
      key: "toursOfDuty.placeOfEntry[#{ITERATOR}]",
      limit: 14,
      question_num: 11,
      question_suffix: 'A',
      question_text: 'ENTERED SERVICE (place)'
    },
    'serviceNumber' => {
      key: "toursOfDuty.serviceNumber[#{ITERATOR}]",
      limit: 12,
      question_num: 11,
      question_suffix: 'B',
      question_text: 'SERVICE NUMBER'
    },
    'dateRangeEnd' => {
      key: "toursOfDuty.dateRangeEnd[#{ITERATOR}]",
      question_num: 11,
      question_suffix: 'C',
      question_text: 'SEPARATED FROM SERVICE (date)',
      format: 'date'
    },
    'placeOfSeparation' => {
      key: "toursOfDuty.placeOfSeparation[#{ITERATOR}]",
      question_num: 11,
      question_suffix: 'C',
      question_text: 'SEPARATED FROM SERVICE (place)',
      limit: 15
    },
    'rank' => {
      key: "toursOfDuty.rank[#{ITERATOR}]",
      question_num: 11,
      question_suffix: 'D',
      question_text: 'GRADE, RANK OR RATING, ORGANIZATION AND BRANCH OF SERVICE',
      limit: 31
    }
  },
  'placeOfBirth' => {
    key: 'form1[0].#subform[36].PLACE_OF_BIRTH[0]',
    limit: 71,
    question_num: 9,
    question_suffix: 'B',
    question_text: 'PLACE OF BIRTH'
  },
  'veteranDateOfBirth' => {
    key: 'form1[0].#subform[36].DATE_OF_BIRTH[0]',
    format: 'date'
  },
  'deathDate' => {
    key: 'form1[0].#subform[36].DATE_OF_DEATH[0]',
    format: 'date'
  },
  'claimantPhone' => {
    'first' => {
      key: 'form1[0].#subform[36].PreferredTelephoneNumber_AreaCode[0]'
    },
    'second' => {
      key: 'form1[0].#subform[36].PreferredTelephoneNumber_FirstThreeNumbers[0]'
    },
    'third' => {
      key: 'form1[0].#subform[36].PreferredTelephoneNumber_LastFourNumbers[0]'
    }
  },
  'veteranSocialSecurityNumber2' => {
    'first' => {
      key: 'form1[0].#subform[37].VeteransSocialSecurityNumber_FirstThreeNumbers[1]'
    },
    'second' => {
      key: 'form1[0].#subform[37].VeteransSocialSecurityNumber_SecondTwoNumbers[1]'
    },
    'third' => {
      key: 'form1[0].#subform[37].VeteransSocialSecurityNumber_LastFourNumbers[1]'
    }
  },
  'firmNameAndAddr' => {
    key: 'form1[0].#subform[37].FULL_NAME[0]',
    limit: 90,
    question_num: 21,
    question_text: 'FULL NAME AND ADDRESS OF THE FIRM, CORPORATION, OR STATE AGENCY FILING AS CLAIMANT'
  },
  'veteranSocialSecurityNumber' => {
    'first' => {
      key: 'form1[0].#subform[36].VeteransSocialSecurityNumber_FirstThreeNumbers[0]'
    },
    'second' => {
      key: 'form1[0].#subform[36].VeteransSocialSecurityNumber_SecondTwoNumbers[0]'
    },
    'third' => {
      key: 'form1[0].#subform[36].VeteransSocialSecurityNumber_LastFourNumbers[0]'
    }
  }
}.freeze

Instance Attribute Summary

Attributes inherited from FormBase

#form_data

Instance Method Summary collapse

Methods included from FormHelper

#address_block, #combine_date_ranges, #expand_checkbox_as_hash, #extract_country, #extract_middle_i, #format_boolean, #select_checkbox, #select_radio_button, #split_date, #split_ssn, #validate_date

Methods inherited from FormBase

#combine_both_addr, #combine_full_address, #combine_full_address_extras, #combine_full_name, #combine_hash, #combine_name_addr, #combine_name_addr_extras, #combine_postal_code, #combine_previous_names, date_strftime, #expand_checkbox, #expand_date_range, #expand_signature, #initialize

Constructor Details

This class inherits a constructor from PdfFill::Forms::FormBase

Instance Method Details

#expand_burial_allowance ⇒ Object 



441
442
443
444
445
446
447
448
449
450
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 441

def expand_burial_allowance
  burial_allowance = @form_data['burialAllowanceRequested']
  return if burial_allowance.blank?

  @form_data['burialAllowanceRequested'] = {
    'value' => burial_allowance
  }

  expand_checkbox_as_hash(@form_data['burialAllowanceRequested'], 'value')
end

#expand_checkbox_in_place(hash, key) ⇒ Object 



399
400
401
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 399

def expand_checkbox_in_place(hash, key)
  hash.merge!(expand_checkbox(hash[key], StringHelpers.capitalize_only(key)))
end

#expand_firm ⇒ Object 



430
431
432
433
434
435
436
437
438
439
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 430

def expand_firm
  if @form_data['relationship'].try(:[], 'isEntity')
    combine_name_addr(
      @form_data,
      name_key: 'firmName',
      address_key: 'claimantAddress',
      combined_key: 'firmNameAndAddr'
    )
  end
end

#expand_place_of_death ⇒ Object 



416
417
418
419
420
421
422
423
424
425
426
427
428
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 416

def expand_place_of_death
  location_of_death = @form_data['locationOfDeath']
  return if location_of_death.blank?

  location = location_of_death['location']

  @form_data['placeOfDeath'] =
    if location == 'other'
      location_of_death['other']
    else
      PLACE_OF_DEATH_KEY[location]
    end
end

#expand_relationship(hash, key) ⇒ Object 



403
404
405
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 403

def expand_relationship(hash, key)
  expand_checkbox_as_hash(hash[key], 'type')
end

#expand_tours_of_duty(tours_of_duty) ⇒ Object 



407
408
409
410
411
412
413
414
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 407

def expand_tours_of_duty(tours_of_duty)
  return if tours_of_duty.blank?

  tours_of_duty.each do |tour_of_duty|
    expand_date_range(tour_of_duty, 'dateRange')
    tour_of_duty['rank'] = combine_hash(tour_of_duty, %w[serviceBranch rank], ', ')
  end
end

#extract_va_file_number(va_file_number) ⇒ Object

VA file number can be up to 10 digits long; An optional leading ‘c’ or ‘C’ followed by 7-9 digits. The file number field on the 4142 form has space for 9 characters so trim the potential leading ‘c’ to ensure the file number will fit into the form without overflow.



455
456
457
458
459
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 455

def extract_va_file_number(va_file_number)
  return va_file_number if va_file_number.blank? || va_file_number.length < 10

  va_file_number.sub(/^[Cc]/, '')
end

#merge_fields(_options = {}) ⇒ Object

rubocop:disable Metrics/MethodLength



462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 462

def merge_fields(_options = {})
  expand_signature(@form_data['claimantFullName'])

  %w[veteranFullName claimantFullName].each do |attr|
    extract_middle_i(@form_data, attr)
  end

  ssn = @form_data['veteranSocialSecurityNumber']
  ['', '2'].each do |suffix|
    @form_data["veteranSocialSecurityNumber#{suffix}"] = split_ssn(ssn)
  end

  split_phone(@form_data, 'claimantPhone')

  split_postal_code(@form_data)

  expand_relationship(@form_data, 'relationship')

  expand_place_of_death

  expand_tours_of_duty(@form_data['toursOfDuty'])

  @form_data['previousNames'] = combine_previous_names(@form_data['previousNames'])

  @form_data['vaFileNumber'] = extract_va_file_number(@form_data['vaFileNumber'])

  expand_burial_allowance

  expand_firm

  expand_checkbox_as_hash(@form_data['locationOfDeath'], 'location')

  %w[
    previouslyReceivedAllowance
    burialAllowance
    plotAllowance
    benefitsUnclaimedRemains
    federalCemetery
    stateCemetery
    govtContributions
  ].each do |attr|
    expand_checkbox_in_place(@form_data, attr)
  end

  @form_data
end

#split_phone(hash, key) ⇒ Object

rubocop:enable Layout/LineLength



378
379
380
381
382
383
384
385
386
387
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 378

def split_phone(hash, key)
  phone = hash[key]
  return if phone.blank?

  hash[key] = {
    'first' => phone[0..2],
    'second' => phone[3..5],
    'third' => phone[6..9]
  }
end

#split_postal_code(hash) ⇒ Object 



389
390
391
392
393
394
395
396
397
 
# File 'lib/pdf_fill/forms/va21p530.rb', line 389

def split_postal_code(hash)
  postal_code = hash['claimantAddress']['postalCode']
  return if postal_code.blank?

  hash['claimantAddress']['postalCode'] = {
    'firstFive' => postal_code[0..4],
    'lastFour' => postal_code[6..10]
  }
end