There are thousands of
variations on many of those benefits. The period when you served, your
MOS, and dozens of other variables come into play for every benefit and
every veteran, dependent or survivor.
The benefits a veteran may receive are always based on eligibility. Eligibility is always the key.
friend may have a benefit that you aren't eligible for even though your
service was similar. Dates, disabling conditions, the type of discharge
and many other factors will affect your eligibility. Never try to
compare your benefit with another veterans benefit.
This guide is not complete. That would be impossible. Here we'll try to cover the most often used and questioned benefits.
this page develops over time, we're including some topics that may not
be "benefits" as such but will affect how benefits are delivered to you.
Arduous and lengthy? That’s an understatement. It was incredibly
time-consuming and required appointments with doctors and caregiving
agencies, finding documents (I still haven’t found the key to their
safety deposit box so I had to hunt down key documents) and a lot of
time on the computer and phone.
Problems with a Veterans Affairs benefit have created a scam industry
and left thousands of seniors ignorant of a pension they are entitled to
receive, veterans advocates and congressional investigators say.
Many families are unaware of the pension for ailing combat veterans and
their dependents, footing the bill for their care as up to $24,239 a
year for each veteran sits unused. Advocates blame poor outreach by the
Veterans Affairs Department, a massive federal agency that wields $127
billion each year.
Recipient Population Is Changing, and Awareness Could Be Improved...Report to the Ranking Member, Committee on Veterans’ Affairs
GAO-12-153 - United States Government Accountability Office
A VA study found that of pension recipients—who are mainly elderly
veterans—62 percent might be eligible for enhanced monthly benefits but
only 22 percent received them, which the study primarily attributed to
lack of awareness about the benefits. VA’s outreach efforts may not be
sufficient to inform elderly veterans about enhanced monthly benefits
because outreach activities do not typically focus on these benefits,
some printed material lacks information on eligibility and application
requirements for these benefits, and the extent to which regional
offices conduct elderly outreach varies, among other reasons.
Family Caregivers provide crucial support in caring for Veterans. VA
recognizes that Family Caregivers in a home environment can enhance the
health and well-being of Veterans under VA care.
Under the "Caregivers and Veterans Omnibus Health Services Act of 2010,"
additional VA services are now available to seriously injured post-9/11
Veterans and their Family Caregivers through a new program of
Comprehensive Assistance for Family Caregivers. VA is now accepting
applications for these services.
Who Is Eligible?
Veterans eligible for this program are those who sustained a serious
injury – including traumatic brain injury, psychological trauma or other
mental disorder – incurred or aggravated in the line of duty, on or
after September 11, 2001.
Veterans eligible for this program must also be in need of personal care
services because of an inability to perform one or more activities of
daily living and/or need supervision or protection based on symptoms or
residuals of neurological impairment or injury.
To be eligible for the Program of Comprehensive Assistance for Family
Caregivers, Veterans must first be enrolled for VA health services, if
not enrolled previously.
New Services Available to Family Caregivers through this Program
The new law will provide additional assistance to primary Family
Caregivers of eligible post-9/11 Veterans and Servicemembers. New
services for this group include:
* Monthly stipend
* Travel expenses (including lodging and per diem while accompanying Veterans undergoing care)
* Access to health care insurance (if the Caregiver is not already entitled to care or services under a health care plan)
* Mental health services and counseling
* Comprehensive VA Caregiver training provided by Easter Seals
* Respite care (not less than 30 days per year)
The VA Caregiver program didn't get off to a smooth start. This article gives you some background.
The clothing allowance reimburses you if, because of a service-connected
condition, your clothing gets permanently damaged by a prosthetic or
orthopedic appliance you wear or a prescribed medication you use on your
General Program Requirements
You must use the appliance or medication that has damaged your clothing because of a service-connected disability.
Generally, in order to receive VA benefits and services, your character
of discharge or service must be under conditions other than dishonorable
(e.g. honorable, under honorable conditions, general). However,
individuals receiving undesirable, bad conduct, and other types of
dishonorable discharges may qualify for VA benefits depending on a
determination made by VA.
If VA finds that a Veteran has multiple
disabilities, VA uses the Combined Ratings Table below to calculate a
combined disability rating. Disability ratings are not additive, meaning
that if a Veteran has one disability rated 60% and a second disability
20%, the combined rating is not 80%. This is because subsequent
disability ratings are applied to an already disabled Veteran, so the
20% disability is applied to a Veteran who is already 60% disabled.
Below you will find the steps VA takes to combine ratings for more than
one disability and examples using the Combined Ratings Table to
illustrate how combined ratings are calculated.
are first arranged in the exact order of their severity, beginning with
the greatest disability and then combined with use of Combined Ratings
The degree of one disability will be read in the left
column and the degree of the other in the top row, whichever is
The figures appearing in the space where the column and row intersect will represent the combined value of the two
This combined value is rounded to the nearest 10%
there are more than two disabilities, the combined value for the first
two will be found as previously described for two disabilities
The exact combined value (without rounding yet), is combined with the degree of the third disability
This process continues for subsequent disabilities and the final number is rounded to the nerest 10%
Examples of Combining Two Disabilities
a Veteran has a 50 percent disability and a 30 percent disability, the
combined value will be found to be 65 percent, but the 65 percent must
be converted to 70 percent to represent the final degree of disability.
with a disability of 40 percent, and another disability of 20 percent,
the combined value is found to be 52 percent, but the 52 percent must be
converted to the nearest degree divisible by 10, which is 50 percent.
Example of Combining Three Disabilities
there are three disabilities ratable at 60 percent, 40 percent, and 20
percent, respectively, the combined value for the first two will be
found opposite 60 and under 40 and is 76 percent. This 76 will be found
in the left column, then the 20 rating in the top row. The intersection
of these two ratings is 81. Thus, the final rating will be rounded to
This letter rescinds or clarifies prior guidance on the processing of
DIC claims to ensure timely delivery of benefits to vulnerable survivors
who have an immediate need for supplemental income following the death
of a Veteran.
Domiciliary Residential Rehabilitation Treatment Programs care for a
wide range of problems. A veteran's needs might be in any of the
Treatment and rehabilitation are provided by a team of professionals in
an environment where veterans support each other as they focus on
developing greater independence.
General Program Requirements
Eligibility for most Veterans' health care benefits is based solely on
active military service in one of the seven uniformed services. These
The Air Force
The Marine Corps
The Coast Guard
The Commissioned Corps of the Public Health Service
The Commissioned Officer Corps of the National Oceanic And Atmospheric Administration (NOAA)
Reservists and National Guard members who were called to active duty by a
Federal Executive Order ordinarily qualify for VA health care benefits.
Merchant Marines who served during World War II and former cadets of
the military Service Academies may be eligible as well.
You must have been discharged under conditions other than dishonorable.
If your separation papers indicate your service was other than
honorable, VA must study your service records to see if you qualify.
For reservists and Guard members who were called to federal active duty
by an executive order, the usual requirement is that you served the full
length of time you were ordered to serve.
For all others, the usual requirement is 24 months of continuous service.
There are a number of exceptions to these rules.
Returning service members,
including Reservists and National Guard members who served on active
duty in a theater of combat operations, have special eligibility for
hospital care, medical services, and nursing home care for five years
following discharge from active duty.
Because of budget requirements, VA cannot offer health care to every
Veteran who meets these basic requirements. The law contains a complex
system of priorities, mostly based on disability, income, and age.
VA **MAY** (Not "will") cover emergency treatment at non-VA medical
facilities. Having said that, it is rarely easy or simple to have VA
make the proper payment in a timely fashion.
The rules are complex. There are strict time restrictions to file.
Veterans must recognize that the system does not work in their favor
when they use this benefit. To avoid any problems, vets must take steps
as soon as they are able.
* Notify your VA Medical Center that you are in a civilian facility.
Telephone at the earliest opportunity. Make notes of who you speak to
and the time and date of your conversation.
* When you are released from the civilian facility, immediately begin to
follow up with your VA Medical Center regarding the payment to the
If you aren't diligent in pursuing this at your earliest convenience,
the civilian facility will not receive payment from VA and they will
look to you for payment. This can quickly lead to your hospital bill
being turned over to a collection agency or worse.
The new regulation extends VA’s authority to pay for emergency care
provided to eligible Veterans at non-VA facilities until the Veterans
can be safely transferred to a VA medical facility. More than 100,000
Veterans are estimated to be affected by the new rules, at a cost of
about $44 million annually.
38 USC 1725 - Reimbursement for emergency treatment
Sec. 1725. Reimbursement for emergency treatment
(1) Subject to subsections (c) and (d), the Secretary shall reimburse a
veteran described in subsection (b) for the reasonable value of
emergency treatment furnished the veteran in a non-Department facility.
(2) In any case in which reimbursement is authorized under subsection
(a)(1), the Secretary, in the Secretary’s discretion, may, in lieu of
reimbursing the veteran, make payment of the reasonable value of the
furnished emergency treatment directly—
(A) to a hospital or other health care provider that furnished the treatment; or
(B) to the person or organization that paid for such treatment on behalf of the veteran.
(1) A veteran referred to in subsection (a)(1) is an individual who is
an active Department health-care participant who is personally liable
for emergency treatment furnished the veteran in a non-Department
(2) A veteran is an active Department health-care participant if—
(A) the veteran is enrolled in the health care system established under section 1705 (a) of this title; and
(B) the veteran received care under this chapter within the 24-month
period preceding the furnishing of such emergency treatment.
(3) A veteran is personally liable for emergency treatment furnished the veteran in a non-Department facility if the veteran—
(A) is financially liable to the provider of emergency treatment for that treatment;
(B) has no entitlement to care or services under a health-plan contract
(determined, in the case of a health-plan contract as defined in
subsection (f)(2)(B) or (f)(2)(C), without regard to any requirement or
limitation relating to eligibility for care or services from any
department or agency of the United States);
(C) has no other contractual or legal recourse against a third party
that would, in whole, extinguish such liability to the provider; and
(D) is not eligible for reimbursement for medical care or services under section 1728 of this title.
Limitations on Reimbursement.—
(1) The Secretary, in accordance with regulations prescribed by the Secretary, shall—
(A) establish the maximum amount payable under subsection (a);
(B) delineate the circumstances under which such payments may be made,
to include such requirements on requesting reimbursement as the
Secretary shall establish; and
(C) provide that in no event may a payment under that subsection include
any amount for which the veteran is not personally liable.
(2) Subject to paragraph (1), the Secretary may provide reimbursement
under this section only after the veteran or the provider of emergency
treatment has exhausted without success all claims and remedies
reasonably available to the veteran or provider against a third party
for payment of such treatment.
(3) Payment by the Secretary under this section on behalf of a veteran
to a provider of emergency treatment shall, unless rejected and refunded
by the provider within 30 days of receipt, extinguish any liability on
the part of the veteran for that treatment. Neither the absence of a
contract or agreement between the Secretary and the provider nor any
provision of a contract, agreement, or assignment to the contrary shall
operate to modify, limit, or negate the requirement in the preceding
(A) If the veteran has contractual or legal recourse against a third
party that would only, in part, extinguish the veteran’s liability to
the provider of the emergency treatment, and payment for the treatment
may be made both under subsection (a) and by the third party, the amount
payable for such treatment under such subsection shall be the amount by
which the costs for the emergency treatment exceed the amount payable
or paid by the third party, except that the amount payable may not
exceed the maximum amount payable established under paragraph (1)(A).
(B) In any case in which a third party is financially responsible for
part of the veteran’s emergency treatment expenses, the Secretary shall
be the secondary payer.
(C) A payment in the amount payable under subparagraph (A) shall be
considered payment in full and shall extinguish the veteran’s liability
to the provider.
(D) The Secretary may not reimburse a veteran under this section for any
copayment or similar payment that the veteran owes the third party or
for which the veteran is responsible under a health-plan contract.
Independent Right of Recovery.—
(1) In accordance with regulations prescribed by the Secretary, the
United States shall have the independent right to recover any amount
paid under this section when, and to the extent that, a third party
subsequently makes a payment for the same emergency treatment.
(2) Any amount paid by the United States to the veteran (or the
veteran’s personal representative, successor, dependents, or survivors)
or to any other person or organization paying for such treatment shall
constitute a lien in favor of the United States against any recovery the
payee subsequently receives from a third party for the same treatment.
(3) Any amount paid by the United States to the provider that furnished
the veteran’s emergency treatment shall constitute a lien against any
subsequent amount the provider receives from a third party for the same
emergency treatment for which the United States made payment.
(4) The veteran (or the veteran’s personal representative, successor,
dependents, or survivors) shall ensure that the Secretary is promptly
notified of any payment received from any third party for emergency
treatment furnished to the veteran. The veteran (or the veteran’s
personal representative, successor, dependents, or survivors) shall
immediately forward all documents relating to such payment, cooperate
with the Secretary in the investigation of such payment, and assist the
Secretary in enforcing the United States right to recover any payment
made under subsection (c)(3).
The Secretary, in the Secretary’s discretion, may waive recovery of a
payment made to a veteran under this section that is otherwise required
by subsection (d)(1) when the Secretary determines that such waiver
would be in the best interest of the United States, as defined by
regulations prescribed by the Secretary.
For purposes of this section:
(1) The term "emergency treatment" means medical care or services furnished, in the judgment of the Secretary—
(A) when Department or other Federal facilities are not feasibly
available and an attempt to use them beforehand would not be reasonable;
(B) when such care or services are rendered in a medical emergency of
such nature that a prudent layperson reasonably expects that delay in
seeking immediate medical attention would be hazardous to life or
(i) such time as the veteran can be transferred safely to a Department
facility or other Federal facility and such facility is capable of
accepting such transfer; or
(ii) such time as a Department facility or other Federal facility accepts such transfer if—
(I) at the time the veteran could have been transferred safely to a
Department facility or other Federal facility, no Department facility or
other Federal facility agreed to accept such transfer; and
(II) the non-Department facility in which such medical care or services
was furnished made and documented reasonable attempts to transfer the
veteran to a Department facility or other Federal facility.
(2) The term "health-plan contract" includes any of the following:
(A) An insurance policy or contract, medical or hospital service
agreement, membership or subscription contract, or similar arrangement
under which health services for individuals are provided or the
expenses of such services are paid.
(B) An insurance program described in section 1811 of the Social
Security Act (42 U.S.C. 1395c) or established by section 1831 of that
Act (42 U.S.C. 1395j).
(C) A State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.).
(D) A workers’ compensation law or plan described in section 1729 (a)(2)(A) of this title.
(3) The term "third party" means any of the following:
(A) A Federal entity.
(B) A State or political subdivision of a State.
(C) An employer or an employer’s insurance carrier.
(D) An automobile accident reparations insurance carrier.
In order to speed up your claim processing, have your provider submit
the claim in English.
Claim information submitted in a language other
than English will require translation; your claim processing is then
TOLL FREE Phone Service
If you are traveling or reside in one of
the following countries: USA, Canada, Germany, Australia, Italy, UK,
Mexico, Japan, Costa Rica or Spain, use the following numbers to contact
the FMP Office in Denver, Colorado
USA and Canada (877) 345-8179
Australia 1 800 354 965
Italy 800 782-655
Costa Rica 0800-013-0759
You can call the FMP Office Monday through Friday, 8:05 AM to 6:45 PM Eastern.
The Foreign Medical Program is a program we have established to
provide health care benefits to U.S. veterans with VA-rated
service-connected conditions who are residing or traveling abroad
(Philippines excluded). Under FMP, we (the VA) assume payment
responsibility for certain necessary medical services associated with
the treatment of those service-connected conditions.
This information we have posted on this site, and to which we
have created links, like the fact sheets above, are designed for
veterans with VA-rated service-connected conditions who are planning to
move or travel abroad and addresses the procedures for obtaining health
care services for service-connected conditions while in a foreign
country and how to file a claim for VA payment or reimbursement.
With the exception of medical services received in Philippines,
all foreign provided services are under the jurisdiction our Foreign
Medical Program (FMP) Office in Denver, Colorado.
The FMP Office is responsible for all aspects of the program
including application processing, verification of eligibility,
authorization of benefits, and payment of claims. If you are a veteran
living or traveling outside the United States and have questions about
other VA benefits such as compensation and pension exams and disability
ratings you should direct those questions to your servicing VA regional
office (see Assistance with Other VA Issues at bottom for more information). Or you can access the VBA’s Foreign Services Web site here: http://www.vba.va.gov/bln/21/foreign/index.htm
Services provided in the Philippines are under separate jurisdictions as indicated below.
The Persian Gulf War is legally defined in title 38 U.S.C. § 101(33) as
beginning on August 2, 1990, and ending on the date thereafter
prescribed by Presidential proclamation or by law. While the term "Gulf
War Veterans" could refer to all Veterans of conflicts during this
period, including Veterans of Operation Iraqi Freedom, and subsequent
conflicts, the term Gulf War Syndrome is usually used to define veterans
who were deployed on the Operation Desert Shield and/or Operation
Desert Storm components of the 1990 - 1991 Gulf War.
Gulf War Veterans have been exposed to numerous potential toxins that
are not often encountered. These include pyridostigmine, depleted
uranium, and petrochemical by-products, among numerous others. Exposure
to these potential toxins and resultant clinical implications are
described in the 2008 Institute of Medicine comprehensive Gulf War
Many disability patterns experienced by returning Gulf War Veterans
remain ill-defined. We read of terms like “undiagnosed illness” and
“medically unexplained chronic multisymptom illness”. A service
connection to establish disability compensation may be granted for other
diagnosed chronic, multisymptom illness in addition to chronic fatigue
syndrome, fibromyalgia, and irritable bowel syndrome.
Researchers say they have found physical proof that Gulf War illness is
caused by damage to the brain — and that proof may ultimately help
civilians who suffer from chronic fatigue syndrome and fibromyalgia.
Using fMRI machines, the Georgetown University researchers were able to
see anomalies in the bundle of nerve fibers that interpret pain signals
in the brain in 31 Gulf War veterans.
The findings are "huge," because an fMRI allows doctors to diagnose a
person with Gulf War illness quickly, said James Baraniuk, senior author
and professor of medicine at Georgetown University Medical Center. The
research, he said, also shows that Gulf War illness is not
Over 25% of the 697,000 veterans deployed
to the 1990–1991 Persian Gulf War and 15% of nondeployed veterans have
developed a symptom complex of widespread pain, fatigue, headache,
gastrointestinal, bladder, and other “functional” nociceptive and
interoceptive complaints. Gulf War veterans were exposed to a wide
variety of exposures that include binary nerve agents,
acetylcholinesterase inhibitors, organophosphates, other pesticides and
herbicides that may have initiated their symptom complex.
This syndrome has been termed Gulf War Illness (GWI). An initial
analysis defined these subjects as Chronic Multisymptom Illness (CMI)
based on ≥2 complaints of (i) fatigue, (ii) musculoskeletal or (iii)
mood and cognitive dysfunction for ≥6 months. Deployed Gulf War veterans
met criteria for Chronic Fatigue Syndrome (CFS) (odds ratio = 40.6) and
Fibromyalgia (FM) (odds ratio = 2.32) indicating extensive symptom
overlap. All of the veterans who met CMI criteria in this study also met
CFS criteria, and 52% met FM criteria.
Internal Revenue Service is committed to providing assistance to
veterans and veterans with disabilities. We work with community and
government partners to provide timely federal tax-related information to
veterans about tax credits and benefits, free tax preparation, and
asset-building opportunities available to them.
VA Disability Benefits
not include disability benefits you receive from the U.S. Department of
Veterans Affairs (VA) in your gross income. In particular some of the
payments which are considered disability benefits include:
* Disability compensation and pension payments for disabilities paid either to veterans or their families,
* Grants for homes designed for wheelchair living,
* Grants for motor vehicles for veterans who lost their sight or the use of their limbs, or
* Benefits under a dependent-care assistance program.
The Department of Veterans Affairs (VA) receives information on a
regular basis from several Federal agencies and compares it to
information used to determine the status of VA beneficiaries.
The matches identify cases where there are apparent contradictions
between information contained in VA records and information furnished by
other Federal agencies that affect entitlement.
are nearly 25 million veterans living in the United States today.
These brave men and women who defended our nation deserve compassion
and care. The U.S. Department of Veterans Affairs is responsible for
providing health care and other benefits to these veterans and their
dependents; however, in recent years a number of veterans
associations and regulatory groups have drawn attention to
substandard care and conditions at many VA hospitals.
epidemic of substandard care can have a detrimental effect on the
victim’s quality of life, and may even result in permanent injury
or even death. If you believe that you or someone you love may have a
VA hospital medical malpractice claim, the lawyers at Hodes
Milman Liebeck Mosier can help.
Our experienced team has
the knowledge and resources to assist you in taking legal action
against the Veterans Administration under the Federal Tort Claims
Act, a process that can be unduly confusing and complex without the
guidance of an attorney with particular experience in filing
malpractice claims on behalf of veterans.
VA malpractice is
medical malpractice, and victims are entitled to appropriate
compensation for their hardship and suffering.
Mental Health Services
Department of Veterans Affairs (VA)
provides general inpatient psychiatric services as well as mental health
outpatient services. Many of these services are being integrated into
primary care clinics, VA nursing homes, and residential care facilities
where veterans receive mental health care.
Veterans with serious mental illness are seen at all facilities and
clinics where specialized programs, such as mental health intensive case
management, day centers, work programs and psychosocial rehabilitation
Despite being one of the most common forensic mental health evaluations,
no article has ever appeared in a peer-reviewed journal describing how
to conduct US Department of Veterans Affairs (VA) mental health
compensation and pension examinations. This article rectifies that
paucity of information. We outline the legal framework, ethical
considerations, and administrative challenges inherent in these
evaluations. We provide separate guidelines for private practice
clinicians and VA staff or contractors. We pay special attention to the
multiple sources of collateral information available for these exams and
how to access relevant records. The article alerts examiners to the
possibility that they might face resistance from VA officials if they
screen for and assess symptom exaggeration or feigning and that they
could encounter VA-imposed restrictions on time allotted for exams.
Personality disorders are a group of psychiatric conditions in which a
person's long-term (chronic) behaviors, emotions, and thoughts are very
different from their culture's expectations and cause serious problems
with relationships and work.
“A VA Pension claim is one of the most complicated claims there is.” Senior VA employee
The VA Pension program has its origins in the Civil War. The intent of
the program was to provide for US veterans and eligible spouses of that
conflict. It was then expanded to include veterans of the Indian Wars
and the Spanish-American War.
The program was modified in the early 1900s to lessen abuse. It was then
revamped to another form, known as 306 pension—there are still some 306
pension recipients to which VA pays this older form of benefit.
The current pension benefit is known as Improved Pension. Anyone making
a claim for pension today is filing under improved Pension rules. The
purpose of the benefit is to ensure that eligible veterans and their
spouses receive at least a minimum standard of living and one which
exceeds the low-income pension provided by Supplemental Security Income
(SSI); the standard is dictated by the Congress.
The benefit has three separate eligibility criteria: medical
impairment(s), income, and assets and is only available to veterans or
surviving spouses of a veteran who: served in a wartime period, have an
honorable discharge, served at least 90 days on active duty, and have
medical and financial need.
This is a tiered benefit with increasing levels of pension provided for on the basis of a medical condition. The base level, Improved Pension,
is for eligible veterans or spouses aged 65 years of age or older.
Improved Pension pays up to $1,021/month for a single veteran if the
veteran has no income for VA purposes (IVAP). Housebound
is the next higher level and potentially pays out more, up to
$1,226/month for a single veteran. Housebound fundamentally means a
veteran who’s medical condition confines him or her to the home and they
do not drive. The most well-known tier is the highest level of the
benefit, known as Aid and Attendance and pays out up to $1,703/month for a single veteran.
Aid and Attendance is for someone in need of assistance with at least
two of the activities of daily living (ADLs); this benefit is typically
used to defray assisted living to caregiver expenses. All the benefit
levels pay out more if there are dependents; the surviving spouse rates
are lower than for a veteran.
The benefit pays out up to the maximum of each level, as determined by
medical condition. The exact amount paid is determined by available
income—VA allows unreimbursed medical expenses to be deducted from
actual income when determining available income. As an example, a
veteran has $2,000 a month in income from retirement and Social Security
and is confined to his home (he is housebound). The Housebound benefit
pays up to $1,226 but the veteran already has more than that coming in,
so he is not eligible, from an income perspective, for the benefit.
Now, same veteran, who has $1500 a month in caregiver expenses—VA then
says his available income is $500/month (subtracting out the
unreimbursed caregiver expense) and VA would supplement his income by
an additional $726/month in order for the veteran to be receiving at
least the $1,226 housebound benefit.
In practice, the benefit is usually paid out in full, either at the
Improved Pension Rate or at the Aid and Attendance rate. It is often
used to supplement finds for Assisted Living; VA considers Assisted
Living as a valid unreimbursed medical expense.
Medical condition is one eligibility component. Income is another and
too much income, even after deducting unreimbursed medical expense, will
prevent eligibility for the benefit if the available income exceeds
benefit levels. The third component is assets. VA figures that if a
veteran or a surviving spouse has too many assets, the claimant should
not need this benefit. Asset posture is determined by what the veteran
(and spouse) both own and the cap on assets varies as a function of
age. A rough rule of thumb used to be $80,000 as an asset cap, but that
is simply a planning figure.
Making the claim requires sound and complete documentation, to include
proof of current infirmity(ies) and unreimbursed medical expenses.
After award, yearly verification of this same information is required.
As many seniors suffer from dementia or Alzheimer’s, any indication of
these conditions will further require the appointment of a fiduciary to
receive VA funds on behalf of the claimant. Naturally, nominations for a
fiduciary should only be made for someone considered trustworthy by the
As you can see, this is a complicated benefit. It becomes more so when
eligibility work may be required to assist a claimant in seeking the
benefit. Often, this eligibility work consists of a combination of
measures to validly reduce income (normally through documentation of
caregiver costs) and/or assets.
Such work is the proper province of skilled and experienced elder law
attorneys. There are others out there that describe what they do as “VA
eligibility” work, but it often means they are simply annuity
salespeople and if selling an aging veteran an annuity is impractical
for the circumstances, then they won’t do anything else to assist.
Utilizing trusts, particularized annuities, considering gifting or
transfers are all legitimate tools to provide for pension eligibility.
Elder law attorneys who are VA accredited can assist veterans and their
families in a greater understanding of this little-understood benefit.
The Department of Veterans Affairs
announced today it is cutting red tape for Veterans by eliminating the
need for them to complete an annual Eligibility Verification Report
(EVR). VA will implement a new process for confirming eligibility for
benefits, and staff that had been responsible for processing the old
form will instead focus on eliminating the compensation claims backlog.
Atlanta based veterans attorney Drew Early
commented to VAWatchdog; "This is a good thing—eliminates the annual
financial filing requirements for those veterans or spouses drawing VA Improved Pension. The program supports the aged community and getting rid of this annual paperwork drill is a positive step."
Copays and Pharmacy Charges
Many veterans will find that they are required to pay a "copay" amount
for their prescribed medications. This usually depends on the Priority Group that the veteran is assigned to.
A rating of total disability or permanent total disability which has
been made for compensation, pension, or insurance purposes under laws
administered by the Secretary, and which has been continuously in force
for twenty or more years, shall not be reduced thereafter, except upon a
showing that such rating was based on fraud. A disability which has
been continuously rated at or above evaluation for twenty or more years
for compensation purposes under laws administered by the Secretary shall
not thereafter be rated at less than such evaluation, except upon a
showing that such rating was based on fraud. The mentioned period shall
be computed from the date determined by the Secretary as the date on
which the status commenced for rating purposes.
are often puzzled when VA distinguishes levels of ratings by referring
to conditions or symptoms as mild or moderate or severe. In this case, a
veteran challenged a determination that her condition was moderate and
she (with the help of her able advocate, Todd Wesche) argued that her
condition was more appropriately considered as severe.
success was, in part, tied to linking her condition by analogy to
another rating code. The initial rating did not fully give reasons for
the level of award, but just listed symptoms. The Court found VA had to
do more than that and provide a rationale to the veteran that explained
what would be necessary to achieve a higher subjective rating.
is a good example of the Court laying out for VA what should occur in
a rating decision, rather than simply allowing a recitation of symptoms
and then saying "that's not enough for a higher award."