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 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 



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# 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 



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# 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 



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# 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 



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# 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 



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# 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 



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# 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.



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# 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



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# 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



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# 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 



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# 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