developed by bonnie mcneill-boyt september, 2007 · developed by bonnie mcneill-boyt ... questions...

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For those who care enough to take those extra steps

Developed by Bonnie McNeill-BoytMissouri Veterans CommissionWorkforce Development Office

September, 2007

For those who care enough to take those extra stepsto make sure all Missouri Veterans and their Dependentspursue the Federal and State Veterans benefits for which

they are legally entitled because of the Veteran’s Brave and Faithful Service in the United States Military

Class ObjectivesUpon conclusion of this seminar, participants will:

1. Understand the basics of what benefits are available to Veterans and their

qualified dependents from the Dept. of Veterans Affairs and the State of

Missouri.

2. Understand the importance of using Accredited Veterans Service Officers

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when filing for claim through the Department of Veterans Affairs to ensure

accuracy and timeliness in obtaining benefits.

3. Understand how health care providers can work in partnership with

Veterans Service Officers to obtain funding to pay for needed in-home

health care and care in nursing homes.

4. Feel comfortable that their questions have been answered, or follow-up will

occur, or they have received a referral to the proper authority when needed.

References

38 Code of Federal Regulations

Department of Veterans Affairs

* Website: www.va.gov

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Missouri Veterans Commission

* Workforce Development Office

* Website: www.mvc.dps.mo.gov

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What We’ll Cover Today

Missouri Veterans Commission Programs

Compensation

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Compensation

Live and Death Pension

Hospital

What to Expect?

Cover the Basics of the Topics

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Questions & Answers At the End of the Briefing

Missouri Veterans Commission (MVC)

MVC is a state agency which provides

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professional veterans’ advocacy for Missouri

Veterans and their Dependents

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MVC Program OverviewVeterans Services Program

Provides 50 highly trained Accredited Veterans Service Officers, Assistants and staff who explain VA and State veterans benefits to all MO Veterans and their dependents, apply for benefits on behalf of those with potential eligibility, and provide follow-up services to ensure clients received the maximum amount of benefits for which they are legally entitled

Missouri Veterans Homes Program

Operates seven (7) Highly Skilled Professional Award Winning Veterans Nursing Homes located strategically throughout the state

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Missouri Veterans Cemetery Program

Operates Four (4) (soon to be five (5)) State Veterans Cemeteries located statewide

Minority Veterans Benefits Program

Provides Advocacy and outreach awareness for Minority Veterans in Kansas City area

Women’s Veterans

Provides Advocacy and outreach awareness for Missouri’s Women Veterans

Incarcerated Veterans Re-Entry Program

Provides Referrals to Incarcerated and Newly Released Veterans to our accredited Veterans Service Officers/Assistants for the purposes of advocacy, Veterans benefits assistance and professional referrals to other Missouri Re-entry Programs

Veterans Services Program

Veteran’s Life Cycle & Beyond

Provides Assistance in Obtaining all VA Benefits and Assistance in Using all MVC Programs th h t th t ’ lif ti ll th h t th t ’ lifi d d d t ’ lif ti

MVC’s goal is to provide veterans benefits assistance and care for all Missouri’s Veterans from prior to discharge throughout his/her lifetime and beyond.

Minority Veterans Program Women’s Veterans Program

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Entry intoMilitary

Discharge

Live Vet’s Benefits:Comp, Education, Pension, Loan, Hospital, etc

Dependent’s Live & Death Benefits:Burial, Marker, Death Pension/DIC Education, Loan, etc

Nursing Care

needed

Dependent Private Nursing

Care needed

Cemetery Perpetual Care

throughout the veteran’s lifetime as well as throughout the veteran’s qualified dependents’ lifetime.

MO VeteransCemeteries

Cemetery Pre-Certification

DependentDeath

MO VeteransNursing Homes

Vet’s Death

About Department of Veterans Affairs Programs

Veterans Health Administration (VHA)

V t B fit Ad i i t ti (VBA)

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Veterans Benefits Administration (VBA)

National Cemetery Administration (NCA)

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Service Connected Claimscommonly referred to as “Compensation”

Objectives

* To learn the basic ways a veteran can be

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service connected for their disabilities which

were caused by military service

* To learn some basic terminology pertaining to

Comp claims

Topics

Service Connection Definition

Types of Service-Connection

* Direct service-connection

* Aggravated service-connection

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Aggravated service-connection

* Presumptive service-connection

* Secondary service-connection

Special Category

* 38 USC 1151 (compensated as if service connected)

What is a Service-Connected Condition?

Service-Connected Condition: any injury or

disease that is caused by or aggravated by

active military service, or treatment of service-

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active military service, or treatment of service

connected disabilities. It can also be a

condition that is associated secondarily to a

condition that is service-connected.

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What are the eligibility requirements for service connection?

Service of the veteran must have been terminated by discharge

or separation under conditions other than dishonorable.

There is no minimum length of service.

S i C ti t b t bli h d f t it

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Service Connection may not be established for transitory

illnesses or superficial injuries with no ascertainable chronic or

permanent residuals.

The injury itself must not have been due to the service

member’s own willful misconduct, i.e. due to drugs, alcohol,

breaking the law

What are the commonly used termswhich apply to Compensation?

“Service Connected Injury or Illness”* The term “service connected injury or illness” refers to the veteran’s disability

itself and the fact that it was caused or aggravated by military service• Example: A service member is shot in the hand and has lost the use of that hand. The hand injury

is considered “service connected”.

“Service connected veteran”* The term “service connected veteran” refers to a veteran who the VA has

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The term service connected veteran refers to a veteran who the VA has recognized as having a service connected injury or illness.

“Compensation”* The term “compensation” refers to the monthly payment a veteran receives due

to a service connected injury or illness that is at least 10% disabling.

“Non-compensable service connection”* The term “Non-compensable service connection” refers to a service connected

injury or illness that has been recognized by the VA, but is not disabling enough to the veteran to rate at least 10%. The veteran can receive treatment for this type of injury or illness, but does not draw any payment.

Simplistic Timeline for a Veteran’s Life

Active Duty Time Period

Prior to

EntryInto Balance of Veteran’s Lifetime

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Time PeriodMilitary

Date of Entryinto

Military

Date of Military

Discharge

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Veteran’s Life Timeline as it Pertains to Service Connected Benefits

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The specific time when an injury occurs or illness is diagnosed will determine what type of Service Connected Claim it is.

Aggravated Service Connection Timeline

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Aggravated Service Connection Time Period

Aggravated Service-ConnectionDefinition

Aggravated Service Connection:

* the injury/disease existed prior to military service but is now worse because of participation in service

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* In order to be considered for aggravation of a pre-existing condition, the veteran must provide medical evidence that the condition has progressed beyond the normal course of the condition due to his/her participation in active military service.

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Aggravated SC ConditionExamples

Examples* Prior to enlisting, the service member injured his/her right knee playing

basketball. The injury was not so bad that it prevented entry into service. During a military exercise involving climbing steep hills, the service member re-injured the same knee. The result of that injury was that the right knee was in worse physical condition that it was when the service member entered the military.

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* Another example might be asthma which existed prior to entry, but was made worse because of military service.

*Note: The VA must determine how bad the injury was upon enlistment. If no degree of disability can be found, the veteran is presumed to have been 100% able (meaning 0% disabled). The VA then pays that veteran for the full amount of current disability. If the entrance records show a 10% disability, the VA would reduce the current disability by the 10% shown upon entry.

Direct Service ConnectionTimeline

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Direct Service Connection Time Period

Direct Service-ConnectionDefinition

Direct: the injury/disease was incurred

in/began during a qualifying period of service

and was not due to misconduct

* I d f diti t b id d d

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* In order for a condition to be considered under

Direct, the veteran must show there is a current

condition and an incident or treatment in service for

that condition or symptoms associated to that

condition.

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Examples

* While on active duty for training, the service member

injured his/her right shoulder while lifting heavy

equipment. Treatment was performed on the right

h ld hi h ll d hi /h t t t d t

Direct SC ConditionExamples

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shoulder which allowed him/her to return to duty.

* A service member who was exposed to radiation during

an anatomic test suffered a severe skin condition which

has become chronic.

* A service member is diagnosed with diabetes while on

active duty, and must take insulin to keep blood sugar

levels normal.

Presumptive Service ConnectionTimeline

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Presumptive Time Line

Presumptive Service-Connection

Presumptive: diseases that are known to be caused by specific exposures while on active military service or

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active military service, or injuries and diseases that manifest to the 10% level within a specific time frame

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Presumptive Service-ConnectionExamples

Examples:* Many years after a veteran served “in country” during the

Vietnam War, the veteran is diagnosed with diabetes and lung cancer due to Agent Orange exposure

* Within a year of the discharge date, a peacetime veteran is diagnosed with diabetes with a compensable

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diagnosed with diabetes with a compensable rating(minimum10%)

* Within 3 years of the discharge date, a veteran is diagnosed with TB with a compensable rating

* Within 7 years of the discharge date, a veteran is diagnosed with MS with a compensable rating

* Many years after exposure to nuclear radiation, a veteran is diagnosed with bone cancer.

Secondary Service Connection

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Aggravated Direct Presumptive

Secondary

Secondary Service-Connection

Secondary: a disease or injury that is directly attributed to a condition for which the veteran is already service-connected.* In order for a condition to be listed as secondary,

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there must be medical evidence linking the secondary condition to the primary service-connected condition in a cause and effect nature.

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Secondary Service ConnectionExamples

A Veteran is service connected for his hip. Because of the pain in that hip, his gait is uneven which causes extra wear and tear on his back. His back could be secondary to his service connected hip.

A Veteran must take large amounts of ibuprofen to control the pain of his service connected knee condition. The ibuprofen has done damage to his stomach. His stomach condition could be secondary to his knee.

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A Veteran is service connected for PTSD (Post Traumatic Stress Disorder). Because of the anxiety suffered because of the PTSD, the veteran develops high blood pressure, ulcers, and a heart attack. All of those conditions could be secondary to the PTSD.

A Veteran is service connected for seizures. While driving, the veteran suffers a seizure which results in the veteran wrecking. The veteran suffers permanent damage to the jaw. The jaw could be secondary to the seizure condition.

1151 Service-Connected Claims

38 USC 1151: These claims involve a veteran who has been injured by a VA Medical Facility. This injury can result from services provided for service-connected disabilities or it may result

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from some other treatment procedure.

Disabilities are considered under 1151 are compensated as if they were service-connected in nature.

Service-Connection - 1151 cont’dThe difference between aggravated, direct,

presumptive and secondary service connected conditions and 1151 Claims is that 1151 Claims do not involve anything that pertains to military service itself.

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Basically, 1151 claims are malpractice claims and the resulting money drawn from the claim is routed through the VA the same as a regular comp claim.

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Service Connected Claims that Worsen A veteran can, at any time, open his/her claim for service-connected

disabilities based on an increase in severity of a condition that is currently

service-connected, or may open to add a condition that they failed to raise

during the initial claim for service connection.

Example: A Veteran is drawing a 20% service connected rating for a right

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knee condition and has been drawing this benefit for 10 years. The condition

has worsened to the point that the knee can only bend ½ as far as it did 10

years ago and the veteran is now taking increasing amounts of pain

medicine.

Example: A Veteran is drawing 10% for diabetes. Even though the veteran is

taking insulin, activities such as exercising and other physical activity have

become severely limited.

Briefing Topics

* Compensation

* DIC

* Pension

* Death Pension

* C

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* VA Medical Care

* Burial Benefits

* Special VA Benefits

Dependency & Indemnity Compensation - DICp

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Class Objectives

To learn the basic ways a dependent can be eligible for benefits based on veterans who died because of service connected disabilities

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To learn some basic terminology

DICPaid to surviving spouses, dependent

children, and dependent parents when* service member dies on active duty

* when death occurs after military service if a service connected disability either directly

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service-connected disability either directly caused or contributed substantially and materially to the death of the veteran.

* The veteran dies from medical treatment received through DVA medical system or from Voc Rehab training.

Service-Connected DeathExamples:A veteran is service connected for a heart condition,

then dies from a heart attack.

A veteran is service connected for Multiple Sclerosis. He has a bad fall, and ends up in the hospital While in the hospital he ends p ith

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hospital. While in the hospital, he ends up with pneumonia and dies. The MS was what led up to the fall and then the pneumonia, so this death could be considered service connected, thus allowing for DIC.

A veteran dies from taking prescription drugs which were clearly marked in VA hospital records as being toxic to the veteran, but were accidentally given anyway by hospital staff.

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Non Service Connected Deaths & DIC

When vet had been rated 100% service connected for ten or more years at time of death and dies from non-service connected (NSC) causes other than willful misconduct

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For vets who pass away within ten years from discharge date and die from NSC causes, DIC is payable when vet was rated 100% SC for at least 5 years prior to death.

Parent’s DIC

Death must be service connected

Income based benefit

Different income limits based on whether one or

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both parents survive, if they are married to each

other, have or have not remarried, whether one

or both parents needs A&A.

Net Worth NOT a factor

Requirements of DIC for Dependents

Not required that dependent be recognized prior to death of vet

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Surviving spouse must have been married to vet for at least one year prior to vet’s death or any length of time if a child was born of the marriage or before the marriage

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Briefing Topics

* Compensation

* DIC

* Pension

* Death Pension

* C

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* VA Medical Care

* Burial Benefits


Non-Service Connected Pension Benefits

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Non-Service Connected Pension Benefits

Objectives

* To learn the basic requirements for a veteran to be

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qeligible for non-service connected pension

* To learn some basic terminology

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What is Pension?

Eligibility

War Periods

Income Determination & Net Worth

Topics for Coverage

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Disability

Housebound

Aid & Attendance

Pension

What is Pension?* The VA’s Pension program is an income

based program to ensure a basic standard of living for eligible veterans and their

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dependents.

EligibilityWartime Service (at least one day)

Character of discharge under honorable conditions

A certain length of service

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Veteran is permanently & totally disabled

Family Income under a certain limit

Net worth is not excessive

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War PeriodsMexican Border Period: 5/9/16 - 4/5/17

WWI: 4/6/17 - 11/11/18

WWII: 7/7/4112/31/46

Korea: 6/27/50 -1/31/55

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Vietnam: 8/5/64-5/7/75* a beginning date of 2/28/61 for “in-country”

service as a forward observer

Gulf War: 8/2/90 to ???* Date to be determined by law or

Presidential proclamation

Eligibility (enlistment prior to 9/7/80)

90 days or more with at least one (1) day during a wartime period

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Certain exceptions apply* Discharge for sc disability or hardship

* Serving the entire period for which called up (National Guard and Reserves)

Eligibility (enlistment after 9/7/80)

24 consecutive months or more with at least one (1) day during a wartime period

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period

Certain exceptions apply* Discharge for sc disability or hardship

* Serving the entire period for which called up (National Guard and Reserves)

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Disability Requirements

The veteran must be permanently and totally disabled (100% P&T)* Unemployability

• a single disability rated at 60% or more or multiple disabilities combining to 70% with at least one 40%

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disabilities combining to 70% with at least one 40%

• Veterans must be considered based on determinations of Individual Unemployability.

*NOTE: Disabilities which were caused by the veteran’s own willful misconduct (drugs, alcohol, while breaking the law) are NOT considered.

Exceptions to Proving Disability for the Basic Pension Rate

Currently, the VA presumes permanent and total disability if a veteran is:* a patient in a nursing home for long-term

care due to disability, or

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* receives Social Security Benefits for disability, or

* is age 65 or older when the VA application is received (no need to list medical problems)

Disability Measuring More than What is Required for the Basic Pension Amount

Housebound * A veteran or widow(er) will qualify for the

housebound rate if he/she has a single

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gdisability rated at 100% and a second disability rated at 60%, or where the claimant has a disability that substantially confines them to their home or immediate premises and which is reasonably certain to remain throughout his/her lifetime.

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Aid & Attendance

A veteran will be considered to be in need of regular Aid & Attendance (A&A) if he/she is a patient in a nursing home, is helpless, is blind, or is so nearly

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is helpless, is blind, or is so nearly helpless or blind as to need the assistance of another person.

A&A may only be authorized when the claimant is in receipt of Improved Pension

Aid & Attendance

In determining the need for Aid & Attendance the claimant must be deficient in 3 of the 5 following

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categories:* Dress unassisted

* Bathe unassisted

* Toilet unassisted

* Eat unassisted

* Walk in and out of home unassisted

Aid & Attendance

A person may qualify for Aid & Attendance where they have been determined as bedridden or “totally blind” by the VA.* Total blindness is determined as visual acuity of

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5/200 or less in both eyes.

* Or standing 5 feet from a 16 foot tall “E” and not seeing it.

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A&A and HouseboundThe Housebound and A&A rates are

determined by the Veteran’s health only.

If the veteran has a dependent who is severely disabled the VA will not pay the vet the

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disabled, the VA will not pay the vet the housebound rate or the A&A rate based on the dependent’s health. But, the VA will allow medical expenses associated with the care required for that dependent to be used to offset income which could potentially increase the veteran’s benefit.

Net Worth Requirements

Family net worth is the value of assets owned by the veteran and his/her dependents.

Assets such as the home the veteran is living in and personal property such as a car, furniture, jewelry,

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p p p y j yetc are not counted.

If the family net worth is less than $80,000, the net worth is not usually a problem. The VA may at any time request living expense information to determine if net worth is too high based on the veteran’s estimated life expectancy, but this does not mean the veteran won’t qualify.

Income Requirements

Since pension is an income based benefit, the VA must obtain all veteran’s and dependents’ income information in order to determine how much the

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veteran will be paid.

Basically all income most people receive (including dependent’s income) will be used when calculating the benefit.

One exception is SSI (Supplemental Security Income) from Social Security.

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Maximum Annual Pension Rate

$10,929 yr/ $910 mo

Housebound

$13,356 yr/ $1113 mo

Aid & Attendance

$18,234 yr/ $1519 mo

MaximumVA Payment

(Veteran with zero income)

$10,929 yr/ $910 mo

$10,929 yr/ $910 mo

$

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Zero Income

(Veteran with zero income)

Although Veterans may have paid medical expenses, thereis no reason to submit them as there is no “other income” to offset.

Maximum Annual Pension Rate

$10,929 yr/ $910 mo

Housebound

$13,356 yr/ $1113 mo

Aid & Attendance

$18,234 yr/ $1519 mo

OtherIncome

Out of PocketFamilyMedical ExpensesVet w/no

C t bl

MaximumVA Payment

$10,929 yr/ $910 mo

(Veteran with other income)Social Security

$10,929 yr/ $910 mo

$

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Zero Income

VA PaymentLess income

CountableIncome

Social SecurityRailroad RetirementInterestDividendsOther Income

Veterans with income other than VA should always submit their medical expenses to reduce the other income so they can receive maximum VA benefits!

Family Out-of-Pocket Medical Expenses That Lower Income

Medical expenses* Prescription and over the counter medicine

* Non prescription medicine

* Doctor, dentist, hospital payments

* Glasses, dental work, mileage to and from doctors,

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Glasses, dental work, mileage to and from doctors, dentists, etc

Medical insurance premiums

Medicare premiums

Nursing Home costs

*If the claimant receives reimbursement for expenses, a deduction is not allowable.

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Net worth is the market value of all real

estate and personal property owned by

claimant (not including primary

residence furnishings and automobile)

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residence, furnishings, and automobile)

minus his/her expenses.

* Primary residence is considered as main

residence and reasonable adjoining land as

determined by housing market in the area.


The purpose of evaluating net worth is to determine whether or not the veterans financial resources are sufficient to meet his/her basic needs without assistance from VA

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If a claimant’s assets are sufficiently large, the claimant is expected to use these assets to pay for living expenses.

Net Worth Includes:

Stocks, Bonds, Bank Deposits

Real Estate (other than the veteran’s primary

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residence)

Investment property such as an antique car or

coin collection

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Briefing Topics

* Compensation

* DIC

* Pension

* Death Pension

* C

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* VA Medical Care

* Burial Benefits


Death Pension

Non-Service Connected Death Pension Benefits

Objectives

* To learn the basic requirements for a dependent to

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q pbe eligible for non-service connected death pension

* To learn some basic terminology

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What is Death Pension?

Eligibility


Topics for Coverage

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Disability Factors

What is Death Pension?

Death pension is an income based monthly

benefit paid to the surviving spouse and

children of eligible veterans who died of

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nonservice connected causes.

Eligibility Requirements

Conditions necessary for death pension eligibility include:* Deceased veteran had qualifying military service

* Claimant’s income is under applicable limit (uses

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the same process as for live pension, although the benefit is less than for live pension

* Claimant’s net worth is within VA limits

* Claimant can prove dependency

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Wartime Eligibility Requirements

The wartime eligibility requirements are the same as those for live pension

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Dependent Eligibility Requirements

3 Requirements for dependents:* Ability to establish death of veteran

• death certificate

* Ability to establish dependency

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• Married one year or had a child with the vet

• Marriage info must have month, year, city, state

* Income for VA Purposes is within applicable limits and net worth is not a bar.

Income factors

The items which can be used to deduct from the veteran’s income for live pension purposes can be used for death pension.A commonly used deduction that is a

tremendous help for reducing income for death

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tremendous help for reducing income for death pension is the use of the paid last illness and death expenses. As with live pension, paid death expenses reduces the surviving spouse’s income, thus allowing for a higher death pension benefit for the first 12 months after the payment of death expenses.

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Disability for Death Pension

The surviving spouse and/or children do not need to be disabled to be eligible for this benefit as long as they meet all other criteria.

But……………

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* There are higher rates for those dependents are either Housebound or in need of Aid and Attendance. The requirements needed to meet these disability ratings are the same as for live pension.

Briefing Topics

* Compensation

* DIC

* Pension

* Death Pension

* C

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* VA Medical Care

* Burial Benefits


Veterans Health Administration

(VHA)(VHA)

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VHA Vision

VHA Vision Statement

Healthcare Value begins with VA. The new Veterans Healthcare System supports innovation, empowerment, productivity, accountability and

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continuous improvement. Working together, we provide a continuum of high qualify health care in a convenient, responsive, caring manner - and at a reasonable cost.

Office of Academic Affiliations

Medical Education and Health Professions training:VA manages the largest program in U.S.

VA facilities are affiliated with:• 107 medical schools

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107 medical schools

• 55 dental schools

• more than 1200 other schools

*Each year approximately 81,000 health

professionals are trained in VA medical centers.

*More than half of the physicians practicing in US received part of their education in the VA Healthcare System.

Office of Readjustment Counseling

Psychological counseling for war related trauma

Community outreach

Since 1979, the VA Readjustment counseling Service has operated 206 Vet Centers who provide:

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Case management and referral activities

Supportive social services to veterans and family members

Since Vet Center Program began 1.6 million veterans have been helped:•126,000 veterans served each year with over 900,000 visits to Vet Centers across the country.

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Office of Readjustment Counseling (cont’d)

Eligibility for Services at Vet Centers

Any veteran with service in combat theater d i ti ti d i i d f

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during wartime or anytime during a period of armed hostilities

Any veteran who was sexually assaulted or harassed while on active duty

Family members of eligible veterans

Veterans Integrated Service Networks (VISNs)

The VA medical system consists of 22 Integrated networks of care that are focused on pooling and aligning resources to better meet

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p g g glocal health needs and provide greater access to care.

VISNs

VISN 1: VA New England Healthcare System

VISN 3: VA (NY/N) Veterans Healthcare

VISN 5: VA Capitol Healthcare Network

VISN 2: VA Healthcare Upstate NY VISN 4: VA Stars & Stripes Healthcare VISN 6: The Mid-Atlantic Network VISN 8: VA Sunshine Network VISN 10: VA Ohio Healthcare Systems

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Network VISN 7: The Atlanta Network VISN 9: Mid South Veterans

Healthcare VISN 11: Veterans Integrated

Healthcare VISN 13: VA Upper Midwest

Healthcare VISN 15: VA Heartland Network VISN 17: VA Heart of Texas Health

Care VISN 19: Rocky Mountain Network VISN 21: Sierra Pacific Network

VISN 12: The Great Lakes Health Care VISN 14: Central Plains Health

Network VISN 16: Veterans Integrated

Service VISN 18: VA Southwest Healthcare

Network VISN 20: Northwest Network VISN 22: Desert Pacific Healthcare

Network

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PRIORITIES

VA Hospitals current have 8 Eligibility Status Groups

Which are divided into 2 Categories

*Non-Discretionary

*Discretionary

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PRIORITIES

Non-Discretionary

VA shall provide any needed hospital and outpatient care to the extent and in the amount that Congress appropriates funds.

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Discretionary

VA may furnish any hospital and outpatient care to the extent resources and facilities are available if the veteran makes a co-payment.

Non-Discretionary Priority Groups

Priority Group 1•Veterans rated 50% or more service connected

Priority Group 2•Veterans rated 30% or 40% serviced connected

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Veterans rated 30% or 40% serviced connected

Priority Group 3•Veterans who are former POWs•Veterans discharged for service connected disability•Veterans rated 10% or 20% service connected•Veterans awarded eligibility under 38 USC 1151•Veterans awarded the Purple Heart

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Non-Discretionary Priority Groups (cont’d)

Priority Group 4•Veterans in receipt of A&A or Housebound benefits•Veterans the VA has determined to be catastrophically disabled(some may be responsible for co-payments

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Priority Group 5•Non service-connected veterans•Veterans rated 0% service connected disabled•Veterans in receipt of VA pension•Veterans eligible for Medicaid

•(annual incomes and net worth are below income level)

Priority Group 6This group includes all other eligible veterans who are not required to make co-payments for their care, including:

•WW I and Mexican Border War Veterans

Veterans receiving care solely for disabilities resultingfrom exposure to toxic substances, radiation or for disorders

Non-Discretionary Priority Groups (cont’d)

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from exposure to toxic substances, radiation or for disordersassociated with service in the Gulf War; or for any illness associated with service in combat in any war after the Gulf War or during a period of hostility after Nov. 11, 1998.-For other treatment these vets are required to make co-payments based on Geographic Means Test co-payment levels or the full medical care co-payment rate.

•Compensable 0% service connected veterans(4 separate conditions each rated 0% SC)

Discretionary Priority GroupPriority Group 7

Veterans whose income is above the VA Means Test threshold but below the applicable Geographic Means Test threshold who agree to co-payments (inpatient co-payments reduced by 80%)7a. Noncompensable 0% service connected veterans7c. Non Service connected veteransFollowing veterans are not eligible for enrollment if an enrollment

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Following veterans are not eligible for enrollment if an enrollment decision to restrict enrollment of new Priority group 7 veterans has been made7e. Zero percent noncompensable service connected veterans who applied for enrollment after the date of an enrollment decision to restrict enrollment of new priority group 7 veterans7g. Nonservice connected veterans who applied for enrollment after the date of an enrollment decision to restrict enrollment of new priority group7 veterans agree to make copayments

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Discretionary Priority GroupPriority Group 8

Veterans not included in priority group 4, 6, or 7 who are eligible for care only if they agree to pay the medical care co-payment.

8a. Zero percent noncompensable service connected veterans8b Non service connected veterans

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8b. Non service connected veterans

Veterans who are not eligible for enrollment.These veterans are eligible for care of NSC conditions on a humanitarian emergency basis and for care of SC conditions•Zero percent noncompensable service connected veterans who applied for enrollment after Jan. 16, 2003•Non service connected veterans who applied for enrollment after Jan. 16, 2003.

VA Healthcare EligibilityPriority Categories 1-8

•All Veterans honorably discharged prior to 9/7/80

•All Veterans honorably discharged after 9/7/80 who completed at least 24 months of active duty unless:

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*release was for convenience of the government, OR

*for disability

Eligibility for FREE VA Healthcare

Any service-connected condition

A former prisoner of war

A veteran of the Mexican Border Period

A veteran of World War I

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A veteran of World War I

A veteran eligible for Medicaid

A veteran receiving VA NSC pension benefits

A Purple Heart Award veteran

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Additional Eligibility for FREE VA Healthcare - Protocol Exams

A veteran fitting the following classifications, can

receive free VA medical care for that or a related

condition:

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* Conditions resulting from exposure to herbicides (Agent

Orange) in Vietnam, or to ionizing radiation in WW II

* Conditions resulting from military service in the Persian Gulf

* Conditions resulting from sexual trauma while in military

service

The MEANS TESTCompletion of 10-10 EZ

Is a measure of a veteran’s family income/assets and is based on income/assets from the previous calendar year.

Is used to determine eligibility for free VA

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healthcare (no co-payments)

Most non-service connected veterans and non-compensable 0% service connected veterans are required to complete the means test.

If Family income/assets of veterans for previous calendar year fall below means test threshold, veteran pays no co-payment.

*Current Means Test Threshold

Based on geographical area

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FREE Medications from VA Pharmacy

Veterans rated 50% or more service connected (any condition)

Medications for treatment of service connected conditions

V t i i t f NSC VA i

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Veteran in receipt of NSC VA pension

Veteran’s annual income is below established Geographical thresholds.

CO-PAYMENTSOUTPATIENT MEDICAL CARE at Primary Care Clinics

$15 per visit

Specialty Clinics

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$50 per visit

(Multiple appointments $50 NOT $65)

CO-PAYMENTSINPATIENT CARE for veterans whose income is above the means threshold but below the geographically based threshold:Veteran is responsible for paying 20% of the Medicare deductible for first 90 days of inpatient hospital care during any 365 day period For each additional 90 days of in

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any 365 day period. For each additional 90 days of in patient hospital care, they are charged 10 percent of the Medicare deductible. In addition, the patient is charged a $2 a day for hospital care.NSC veterans and noncompensable zero percent SC veterans with incomes above the geographical income threshold will be charged the full Medicare deductible for the first 90 days of care during any 365 day period. For each additional 90 days, they are charged one half of the Medicare deductible and $10 per day.

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Prescription DrugsPRESCRIPTION DRUGS

$8 per 30 day or less supply (including OTC drugs)

*There is a maximum cap of $960 for veterans in

Categories 2 through 6 on what the veteran must pay to

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Categories 2 through 6 on what the veteran must pay to

VA in one year.

On Categories 7 and 8, there are no caps

on out of pocket expenses to the VA.

THIRD PARTY BILLING

VA is authorized to bill insurance companiesfor the cost of medical care furnished to allveterans for non-service connected conditions covered by health insurance policies

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Veterans are NOT responsible and WILL NOT be charged for ANY co-payment or co-insurance required by THEIR health insurance policies.

The veteran IS responsible for any co-payments

due the VA!

DentalDental services are provided by the VA to veterans on an outpatient basis under the following conditions:

1. Vets are considered eligible and may apply at any time if:a. Vet receives SC comp for a dental condition or disabilityb. Vet is rated at 0% for SC dental conditions as result of

combat wounds or service injuriesc. Vet was POW with no distinctions based on length of

captivity

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captivityd. Vet receives, or is entitled to receive but for military retired

pay, disability comp at the 100% rate for one or more SC conditions, or is rated SC and totally disabled because of individual unemployability

e. Veteran’s dental condition is NSC and is determined by the VA to be associated with and aggravating a SC condition.

f. Vet is participating in a VA Voc Rehab programg. Certain enrolled homeless veterans participating in specific

health care programs.

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Dental cont.

2. Veteran must apply within 90 days of separation from active

duty if his/her dental conditions or disabilities are shown to

have been in existence at the time of his/her discharge or

release from active service of at least 180 days. (DD 214 must

state Dental Care Not Provided

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state Dental Care Not Provided.

Dental treatment claimed is for a NSC condition and dental

treatment was begun while receiving hospital care at VA

expense, and it is professionally determined to be reasonably

necessary to complete the remainder of this dental care on an

outpatient basis. Dental condition must be considered by the

VA Physician to be detrimental to the veteran’s current

condition to qualify

Sensory-Neural Aids(eyeglasses, contact lenses

and hearing aids)Are provided by VA to:

•Veterans who are service connected for vision or hearing loss

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•VA will furnish needed hearing aids to veterans who haveservice connected hearing disabilities rated 0% if there isorganic conductive, mixed or sensory hearing impairmentand loss of pure tone hearing sensitivity which contributeto a loss of communication ability.

•Veterans 10% or more service connected for any condition

Sensory-Neural Aids

The following veterans are eligible if they are receiving VA care or service:

•Former Prisoners of War•Who are in receipt of 38 USC 1151 benefits

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•Who are in receipt of 38 USC 1151 benefits•Who have a visual or hearing impairment secondary toanother medical condition being treated by the VA•Who have a significant functional or cognitive impairment NOT including normally occurring visual or hearing impairments•Whose visual or hearing impairment is so severe that the provision of sensory-neural aids are necessary to permit activeparticipation in their own medical treatment.

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Fee Basis Card EligibilityService connected veterans

Veterans in receipt of SMP

WW I Veterans

Requires recurrent outpatient medical

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q p

treatment

No Dept. of VA facilities available or the VA

facility cannot treat the medical condition

Using the Fee-Basis CardVet should locate the doctor of their choice who is

willing to participate in Fee basis program

Payment is limited to $125 per month for the

conditions listed on Fee Basis card

Procedures costing more than $125 must be pre-

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Procedures costing more than $125 must be pre

approved by Medical Center where enrolled

Doctor must accept Fee Schedule payments as

Paid in Full

Vet should not be billed for excesses above

schedule unless services were for unapproved

conditions

Fee Basis Special Notes

Fee Basis ID Cards are for outpatient treatment

only (no dental, hospital, prosthetic or any other

purposes)

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All vets are re-evaluated periodically to

determine continued eligibility for Fee basis

care (not permanent status for any vet)

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Insurance Info

VA will bill insurance companies for treatment

of all non-service connected conditions

Veterans with 50% SC or more will still get

bill d f t t t f i t d

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billed for treatment for non-service-connected

conditions

VA will not bill the veteran if the insurance

carrier does not pay

VA Authorization of Emergency-Outpatient Treatment

Service connected 50% - 100%

* Any Emergent condition

Service-connected less than 50%

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* Emergent treatment for SC conditions only

A&A, Housebound, or WWI veterans

* Any Emergent condition

VA facilities are not feasibly available

VA Authorization of EmergencyOutpatient Treatment (cont’d)

Must be reported within 15 days from date of

Emergent condition

Notification of such Emergency may be made by

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telephone, telegram or letter

Vet must submit all invoices, medical reports and

substantiation for treatment of medical emergency

Notification must be made to VAMC where vet is

enrolled

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NSC Emergency Care Benefits

only if funds are available from VA Enrolled in VA Health Care System

Provided care by VA within last 24 months

Provided hospital emergency department

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No other form of health insurance

NO Medicare, Medicaid, or a state program

No coverage under any other VA program

No DVA or Federal Facility feasibly available at time

of emergency

Reasonable person would judge a delay would

endanger vet’s life

NSC Emergency Care Benefits (cont’d)

Vet is financially liable to emergency care provider for that

treatment

Vet has no other contractual or legal recourse against a third

party that will pay all or part of the bill

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party that will pay all or part of the bill

VA Medical Center should be contacted ASAP

VA will only pay the private facility until your condition stabilizes

Eligibility and Procedures to File a Claim for Unauthorized

Emergent OP Medical Services

Emergent treatment for a SC disability

Emergent treatment for any condition for vets with

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A&A or 100% SC

No VA facilities feasibly available

Emergent Medical Conditions only

Payment request within 2 years of date of treatment

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How to File

All bills, vouchers, invoices, or receipts or other evidence establishing that such amount was paid

Emergency room reports

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g y p

An explanation of circumstances necessitating the use of private emergent care

Submit to Medical Center where enrolled

Briefing Topics

* Compensation

* DIC

* Pension

* Death Pension

* C

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* VA Medical Care

* Burial Benefits


Burial Benefits

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Class Objectives

To learn about Missouri Veterans Commission Veterans Cemeteries

To learn what benefits are available for the funeral, transportation, and interment of a deceased veteran, and what requirements are for eligibility of such

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and what requirements are for eligibility of such benefits.

To learn the requirements for burial in a National Cemetery

Burial in MO State Veterans Cemeteries

All services at no charge

Military Honors Program

Services available upon

request to Funeral Director

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Predetermination of

eligibility forms available

and encouraged

Any deceased veteran discharged from US Armed Forces under conditions other than dishonorable

Military Service after 9/7/80 requires a minimum of 24 months of service except under special

Missouri Veterans CemeteryEligibility Requirements

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p pcircumstances..

Individuals with 20 or more years of service in the NG or Reserves, entitled to retired pay are eligible for burial.

Spouses, surviving spouses, dependent children and adult, handicapped children are also eligible.

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Veteran’s Death Benefits

Burial benefits* for veterans who die of a SC disability

• burial allowance for the total cost of the funeral, burial and transportation from place of death to fi l i t t $2000 hi h i l

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final interment, or $2000, whichever is less

• An additional amount is payable for transportation if the veteran is buried in a National Cemetery. Amount is based on the place of death of vet to nearest National Cemetery

• No Time Limit for filing for burial or transportation

Veterans Death Benefits

Burial benefits* for veterans who die of a Non-SC disability

• May be entitled to burial benefit of $300 with an additional $300 for plot or interment allowance.

• Additional amount payable for transportation costs

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Additional amount payable for transportation costs to a National Cemetery or from place of death if death occurred in DVA Medical Center, non-DVA Medical Center if under DVA authorization, while travelling under DVA authorization. If in an approved state nursing home, and no other entitlement, $300 is payable.

• Time limit for filing: 2 years from date of final interment or burial.

Burial BenefitEntitlement Requirements

Must be in receipt of comp or pension, or was entitled to

either benefit but for waiver of military retired pay or

If veteran, at time of death, had a claim pending for

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comp or pension that would have entitled the vet to

payment or

If vet has wartime era service and the body is unclaimed

or

» Continued on next page

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Entitlement Requirements (cont’d)

Vet died hospitalized at DVA Medical Center or while receiving

care at a non-DVA Medical Center under contract or

Veteran died while traveling under DVA authorization and

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expense was to or from a specified place for examination,

treatment, or care.

vet died while a patient in an approved state nursing home

Vet was indigent or the body is unclaimed (documentation from

responsible officials required)

Order of Precedence of Claimant for Payment of Benefits

Funeral Director if any portion of funeral bill is unpaid

The person or entity from whom the plot was

purchased or who provided interment services (other

than the FD) if any portion of the bill is unpaid

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t a t e ) a y po t o o t e b s u pa d

The person whose personal funds were used to pay

the expenses of the funeral, transportation and burial

The executor of the veteran’s estate or estate of the

person who paid the expenses of the veteran’s burial

or provided such services

Headstone or MarkerProvided upon request to mark the gravesite of

an eligible veteran in any cemetery around the world

No time limit for ordering the marker

Headstones provided for eligible spouses and

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Headstones provided for eligible spouses and dependents of veterans when buried in National, Military, or State Veterans Cemetery.

Note: Dependents buried in private cemeteries are NOT eligible for a headstone.

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Headstone or MarkerEligibility

Any deceased veteran discharged from US Armed

Forces under conditions other than dishonorable

Military Service after 9/7/80 requires a minimum of 24

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months service except under special circumstances.

Individuals with 20 or more years of service in National

Guard or Reserves, entitled to retired pay subsequent

to October 27, 1992 are entitled to a marker

Headstone or MarkerEligibility

For veterans who died after 12/27/01,

entitlement exists even though the grave is

already marked.

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Prior to 12/27/01, marked graves did not qualify

for government markers.

United States Flag

VA furnishes flags to drape the caskets of

veterans, National Guardsmen, and Reservists

discharged or released from military service

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discharged or released from military service

under conditions other than dishonorable.

The flag is presented to the next of kin or close

friend following interment.

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Presidential Memorial Certificate

Program initiated March 1962 by President Kennedy to honor the memory of honorably discharged, deceased veterans.

Certificate bears the current President’s

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signature and expresses the country’s grateful recognition of vet’s service.

One application can suffice for multiple requests for same veteran - must have complete names and addresses referenced.

DVA National Cemetery System

Burial includes gravesite, headstone, opening

and closing of grave, and perpetual care.

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National Cemetery Eligibility Requirements

Any deceased veteran discharged from US Armed Forces under conditions other than dishonorable

Military Service after 9/7/80 requires a minimum of 24 months of service except under special

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circumstances..

Individuals with 20 or more years of service in the NG or Reserves, entitled to retired pay are eligible for burial.

Spouses, surviving spouses, dependent children and adult, handicapped children are also eligible.

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National Cemetery System (cont’d)

Only one gravesite is authorized for the

interment of all eligible members of a family.

Gravesites are not reserved before it is needed

f b i l

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for burial.

Burial in Arlington National Cemetery

Any active duty member of Armed Forces (except

those on active duty for training only)

Any veteran retired from the active military

A t ti d f th R hi

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Any veteran retired from the Reserves upon reaching

age 60 and drawing retired pay; and who served a

period of active duty (other than for training)

Burial in Arlington National Cemetery Any former member of the Armed Forces separated

honorably prior to Oct. 1, 1949 for medical reasons and

who was rated at 30% or greater disabled effective on the

day of discharge

Any former member of the Armed Forces who has been

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awarded one of the following decorations:

* Medal of Honor

* Distinguished Service Cross (Navy Cross or Air Force Cross)

* Distinguished Service Medal

* Silver Star

* Purple Heart

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Burial in Arlington National CemeteryThe President of the United States or any

former President of the United States

Former members of Armed Forces who served on active duty (other than for training) who held any of the following positions:

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* An elective office of the U.S. Govt

* Office of the Chief Justice of the US or of an Assoc. Justice of the Supreme Court of the US

* An office listed, at the time the person held the position, in 5 USC 5312 or 5313 (Levels I and II of the Executive Schedule)

Briefing Topics

* Compensation

* DIC

* Pension

* Death Pension

* C

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* VA Medical Care

* Burial Benefits


Special Benefits

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Special BenefitsObjectives

To learn about many of the specialized benefits that can enhance the lives of veterans

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Special Benefits Prosthetic devices, medical accessories etc

Automobile and Special Adaptive Equipment

Home Assistance & Structural Alterations

CHAMPVA

Minority Veterans Outreach

W V t S i

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Women Veterans Services

Military Sexual Trauma Counseling

Spina Bifida & Children of Women Vets Benefits

Special Benefits Rates Table

Bereavement Counseling

Blind Veterans Services

Combat Veteran Eligibility

Homeless Programs

Prosthetic (Medical Equipment and Sensory Aids) Enrolled veterans receiving VA care for any condition may

receive medically necessary VA prosthetic appliances, equipment and devices, such as artificial limbs, orthopedic braces and shoes, wheelchairs, crutches and canes, and other durable medical equipment and supplies. Certain veterans who are not enrolled are also eligible for prosthetic items: veterans needing prosthetic items for a service-connected disability and veterans rated service-connected 50% or more.

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VA will provide hearing aids and eyeglasses to veterans who receive increased pension based on the need for regular aid and attendance or being permanently housebound, receive compensation for a service-connected disability or are former prisoners of war. Otherwise, hearing aids and eyeglasses are provided only in special circumstances, and not for normally occurring hearing or vision loss.

For additional information, veterans can contact the prosthetic representative at the nearest VA Health Care Facility.

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Automobile Assistance

You may qualify for automobile assistance for this VA benefit if you have:

A service connected loss or permanent loss of use of one or both hands or feet; or

A permanent impairment of vision of both eyes to a certain

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A permanent impairment of vision of both eyes to a certain degree; or

Entitlement to compensation for ankylosis (immobility) of one or both knees or one of both hips.

VA provides a one time payment of not more than $11,000 toward the purchase of an automobile or other vehicle. VA pays for adaptive equipment and for repair, replacement or reinstallation required because of disability.

Home Improvement and Structural Alterations (HISA)

VA provides grants to assist in making certain home improvements or structural alterations that are medically necessary.

For more information use the following website: http://www.homeloans.va.gov/sah.htm

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New! Circular 26-06-7 - November 8, 2006Implementation of Public Law 109-233, Section 101 - Specially Adapted HousingPURPOSE: On June 15, 2006, the President signed P. L. 109-233, the Veterans Housing Opportunity and Benefits Act of 2006. This circular explains provisions for implementing Specially Adapted Housing (SAH) grant use, which is a portion of the new law.

CHAMPVA Eligibility To be eligible for CHAMPVA, you cannot be eligible for

TRICARE/CHAMPUS and you must be in one of these categories:

the spouse or child of a veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office, or

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the surviving spouse or child of a veteran who died from a VA-rated service connected disability, or

the surviving spouse or child of a veteran who was at the time death rated permanently and totally disabled from a service connected disability, or

the surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).

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Women Veterans Services Women veterans are eligible for the

same Medical Benefit Package as all veterans. In addition to the Medical Benefits Package, the Women’s Program provides women’s gender-specific health care; such as

hormone replacement therapy

breast care

gynecological care

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maternity care

limited infertility treatment (excludes in-vitro fertilization)

The Sexual Trauma Treatment Center is also affiliated with the Women's Clinic, providing treatment for the psychological effects of sexual trauma.

For addition information regarding these services contact the Women Veterans Coordinator at your local VA health care facility.

Military Sexual Trauma Counseling

VA provides counseling and treatment to help male and female

veterans overcome psychological trauma resulting from sexual

trauma while serving on active duty. In addition to counseling,

related services are available at VA medical facilities

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related services are available at VA medical facilities.

Veterans will receive care at no charge for conditions related to

Military Sexual Trauma.

For information regarding sexual trauma services, contact the

Military Sexual Trauma Coordinator or Women Veterans

Program Manager at your local VA facility.

Spina Bifida

Natural children born to veterans who served in Vietnam during the Vietnam Wartime period and who live with Spina Bifida may draw benefits from the VA. Since 2003, his law states that Spina Bifida benefits have been extended to the natural child of a service

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have been extended to the natural child of a service member if the service member served in Korea during the period September 1, 1967 - August 31, 1971. The veteran must have served in the active military, naval or air service and have been exposed to an herbicide agent during such service in or near the Korean demilitarized zone.

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Children of Women Vietnam Veterans (CWVV) Information

Contact Method Detail Monday-Friday 8:05 AM - 6:45 PMEastern Time Fax:303-331-7807

Mailing Address:

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VA Health Administration CenterCWVVV Healthcare BenefitsPO Box 469027Denver, CO 80206-9027

Children of Women Vietnam Veterans Program

Biological children of women veterans who served in Vietnam during the period beginning February 28, 1961 and ending May 7, 1975

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may be eligible for monetary allowances if their birth defects are associated with the mother’s service in Vietnam and resulted in permanent physical or mental disability.

Special Benefit Allowances Rate Table

Automobile Allowance $11,000 once

Clothing Allowance $662 per year effective 12/06

Medal of Honor Pension $1104 per month12-01-2006

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* The clothing allowance increase, while effective the date of the law, is not payable until the following August 1st. (Example: PL 97-306 effective October 1, 1982, increased the clothing allowance to $327.00. This rate was payable August 1, 1983.)

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Bereavement Counseling

VA health care facilities offer bereavement counseling to veterans and their family members who are receiving VA health care benefits. Bereavement counseling is also provided parents, spouses and children of Armed Forces personnel who died in the

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children of Armed Forces personnel who died in the service of their country. Also eligible are family members of reservists and National Guardsmen who die while on duty. Counseling is provided at Vet Centers. The nearest Vet Center locations can be found by calling 800-827-1000 or by going to http://www.va.gov/rcs/.

Blind Veterans Services Blind veterans may be eligible for services at a VA Medical Center or for

admission to a VA blind rehabilitation center or clinic. Services are available at all VA medical facilities through the Visual Impairment Services (VIST) Coordinator. Aids and services for blind veterans include:

A total health and benefits review by a VA Visual Impairment services team

Adjustment to blindness training

Home improvements and structural alterations to homes

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Specially adapted housing and adaptations

Low vision aids and training in their use

Electronic and mechanical aids for the blind, including adaptive computers and computer-assisted devices such as reading machines and electronic travel aids

Guide dogs, including the expense of training the veteran to use the dog and the cost of the dog's medical care

Talking books, tapes and Braille literature

Homeless ProgramsVA offers special programs and initiatives specifically designed to help homeless veterans live as independently as possible. VA's treatment programs offer:

VA's specialized homeless veterans treatment programs have grown and developed since they were first authorized in 1987. The programs strive to offer a continuum of services that include:

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aggressive outreach to those veterans living on streets and in shelters who otherwise would not seek assistance;

clinical assessment and referral to needed medical treatment for physical and psychiatric disorders, including substance abuse;

long-term sheltered transitional assistance, case management, and rehabilitation;

employment assistance and linkage with available income supports; and

supported permanent housing.

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Referring VeteransIf you come across a veteran who you believe

might be eligible for any VA benefit, please refer him as quickly to possible to a Veterans Service Office in his/her area. The veteran will

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be interviewed to help determine what benefits should be applied for. Applications will be sent when appropriate by the Veterans Service Officer to the VA AT NO CHARGE. Service Officers also provide follow up assistance with claimwork at no charge to the veteran or dependent.

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developed by bonnie mcneill-boyt september, 2007 · developed by bonnie mcneill-boyt ... questions...

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