What Veterans Must Know About VA Life Insurance Programs

Over the years the VA has offered a number of different life insurance plans.  Some of these plans are still open for enrollment while others are closed to new enrollees.

For details of the VA Life Insurance Program refer to VetsFirst Knowledge Book VA Life Insurance,.

As a general rule if you have questions regarding VA life insurance you should visit the VA’s insurance website at www.insurance.va.gov or call VA’s Insurance Center toll-free at 1-800-669-8477.  Specialists are usually available between the hours of 8:30 a.m. and 6 p.m., Eastern Time, to discuss premium payments, insurance dividends, address changes, policy loans, naming beneficiaries and reporting the death of the insured.

When contacting the VA regarding an insurance matter if the insurance policy number is not known, use whatever information is available, such as the veteran’s VA file number, date of birth, Social Security number, military serial number or military service branch and dates of service to:

Department of Veterans Affairs Regional Office and Insurance Center

Box 42954

Philadelphia, PA 19101

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

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Specially Adapted Housing and Special Home Adaptation Grants: Special VA Benefits for the Disabled Service Connected Vets

The VA offers 4 different grants for qualifying Veterans and Servicemembers to assist them with the building, remodeling, or purchasing an adapted home.   The four grants are:

  1. Specially adapted housing (SAH) grants, 
  2. Special housing adaptation (SHA) grants,
  3. Temporary Residence Adaptation (TRA) grants, and
  4. Home Improvements and Structural Alterations (HISA) grants.

1. Specially adapted housing (SAH) grants help veterans with certain service-connected disabilities live independently in a barrier-free environment.  SAH grants can be used to:

  • Construct a specially adapted home on land to be acquired
  • Build a home on land already owned if it is suitable for specially adapted housing
  • Remodel an existing home if it can be made suitable for specially adapted housing
  • Apply the grant against the unpaid principal mortgage balance of an adapted home already acquired without the assistance of a VA grant.

A SAH grant, which allows up to $81,080 (2018), can be used a maximum of three times up to the allowable dollar amount.  Veterans with certain permanent service-connected conditions qualify for an SAH grant if their service-connected conditions:

  • Are permanently and totally disabling,
  • Preclude locomotion without the aid of braces, canes, or a wheelchair due to the loss, or loss of use of
    • both lower extremities,
    • one lower extremity together with residuals of organic disease or injury, which so affects the functions of balance or propulsion, or
    • one lower extremity, together with one upper extremity, which so affects the functions of balance or propulsion
  • Result in the loss, or loss of use, of both upper extremities at or above the elbow, or
  • Cause blindness in both eyes, having light perception only, combined with the loss or loss of use of one lower extremity.
  • Include certain severe burn injuries

Veterans who served on or after September 11, 2001, and become permanently disabled on or after that date may also be eligible for SAH benefits if they have the loss or loss of use of one or more lower extremities which so affects the functions of balance or propulsion as to preclude ambulating without the aid of braces, crutches, canes, or a wheelchair.

To apply for a SAH grant, fill out and submit VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant.

2. Special housing adaptation (SHA) grants help veterans with certain service-connected disabilities adapt or purchase a home to accommodate their disability.  SHA grants can be used in the following ways:

  • Adapt an existing home the veteran or a family member already owns in which the veteran resides
  • Adapt a home the veteran or family member intends to purchase in which the veteran will live
  • Help a veteran purchase a home already adapted in which the veteran will live

SHA provides for a grant amount up to $116,217 (2018).  A SHA grant may also be used a maximum of up to three times until the maximum grant amount has been utilized.  A SHA grant will be awarded where the veteran has a service-connected disability for one of the following:

  • Blindness in both eyes with 5/200 visual acuity or less
  • Anatomical loss or loss of use of both hands
  • Certain severe burn injuries
  • Certain severe respiratory injuries

To apply for a SHA grant, fill out and submit VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant.

3. Temporary Residence Adaptation grants

May be available to SAH/SHA eligible veterans and Servicemembers who are or will be temporarily residing in a home owned by a family member.  This assistance, up to $35,593 (2018) for veterans eligible for a SAH grant or $6,355 (2018) for veterans eligible for the SHA grant, may be used to adapt the family member’s home to meet the veteran’s or Servicemember’s special needs at that time.

4. Home Improvements and Structural Alterations (HISA) grants

The VA Home Improvement and Structural Alteration (HISA) grant program helps veterans who are enrolled in the VA health care system and requires home improvements for the continuation of medical treatment or for basic access to the home and essential bathroom and sanitary facilities for veterans with certain disabilities.  Unlike most other benefits shown on this page, HISA grants are available for both service-connected and nonservice-connected veterans (with different maximum amounts).

  • Veterans with service-connected disabilities the home improvement benefit is $6,800 (2018)
  • Veterans with non-service-connected disabilities the home home improvement benefit is $2,000 (2018)

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

Clothing Allowance: Special VA Benefits for the Disabled Service Connected Vets

Clothing allowance is an annual lump-sum payment made when a Veteran’s service-connected disability causes the use of certain prosthetic or orthopedic appliances (including a wheelchair) that tend to wear or tear clothing, or when the Veteran’s service-connected skin condition requires the use of medication that stains the clothing. Eligible Veterans can receive a one-time or yearly allowance for reimbursement.

You may receive a clothing allowance as a Veteran who uses either of the following:

  • Prosthetic or orthopedic appliance, such as a wheelchair or crutches, because of a service-connected disability (Note: soft and flexible devices, such as an elastic stocking, are not included)
  • Medication prescribed by a physician for a service-connected skin condition that causes permanent stains or otherwise damages outer garments

Additional clothing allowances may be provided if more than one prosthetic or orthopedic appliance, or medication described above, is used and/or affects more than one type of clothing garment.

Note: An ancillary benefit is an additional benefit that is related to, or derived from entitlement to certain service-connected benefits.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What is Special VA Benefits for the Disabled Service Connected Vets: Automobiles, Conveyances, and Adaptive Equipment

Special VA Benefits for the Disabled Service Connected Vets: Automobiles, Conveyances, and Adaptive Equipment

Automobile Allowance

Servicemembers and Veterans may be eligible for a one-time payment of not more than $21,058.69 (10/1/2018) toward the purchase of an automobile or other conveyance if you have certain service-connected disabilities. The grant is paid directly to the seller of the automobile and the Servicemember or Veteran may only receive the automobile grant once in his/her lifetime.

Certain Servicemembers and Veterans may also be eligible for adaptive equipment. Adaptive equipment includes, but is not limited to, power steering, power brakes, power windows, power seats, and special equipment necessary to assist the eligible person into and out of the vehicle.

VA may provide financial assistance in purchasing adaptive equipment more than once. This benefit is payable to either the seller or the Veteran or Servicemember.

Important: You must have prior VA approval before purchasing an automobile or adaptive equipment.

Eligibility Requirements (Automobile Grant)

  • You must be either a Servicemember who is still on active duty or a Veteran, AND
  • You must have one of the following disabilities that are either rated as service-connected or treated as if service-connected under 38 U.S.C 1151 or, for a Servicemember, the result of disease incurred or injury contracted in or aggravated by active duty:
    • Loss, or permanent loss of use, of one or both feet, OR
    • Loss, or permanent loss of use, of one or both hands, OR
    • Permanent impairment of vision in both eyes to a certain degree, OR
    • Severe burn injury, OR
    • Amyotrophic Lateral Sclerosis (ALS).

Evidence Requirements (Automobile Grant)

To support a claim for automobile allowance, the evidence must show that you are service-connected or are treated as if service-connected under 38 U.S.C 1151 or, for a Servicemember, the result of disease incurred or injury contracted in or aggravated by active duty, for a disability resulting in:

  • The loss, or permanent loss of use, of one or both feet, OR
  • The loss, or permanent loss of use, of one or both hands,OR
  • Permanent impairment of vision in both eyes, resulting in
    1. Central Visual acuity of 20/200 or less in the better eye with glasses, OR
    2. Central Visual acuity that is greater than 20/200, if there is a visual field defect in which your peripheral field has contracted to such an extent that the widest diameter of visual fields subtends an angular distance no greater than 20 degrees in the better eye, OR
  • Severe burn injury: Deep partial thickness or full thickness burns resulting in scar formation that cause contractures and limit motion of one or more extremities or the trunk and preclude the effective operation of an automobile, OR
  • Amyotrophic Lateral Sclerosis (ALS).

To support a claim for adaptive equipment, the evidence must show that you have a disability as shown above, OR you have ankylosis of at least one knee or one hip due to service-connected disability.

How to Apply (Automobile Grant)

  • Complete, VA Form 21-4502, “Application for Automobile or Other Conveyance and Adaptive Equipment” and mail to your regional office OR
  • Work with an accredited representative or agent OR
  • Go to a VA regional office and have a VA employee assist you. You can find your regional office on our Facility Locator page
  • If you are entitled to adaptive equipment only (i.e., service connected for ankylosis of knees or hips) you should complete VA Form 10-1394, “Application for Adaptive Equipment – Motor Vehicle” and submit it to your local VA medical center. You can find your local VA medical center on the health Facility Locator page.

Conveyances

You may purchase a new or used automobile, truck, station wagon, or certain other types of conveyance if approved by VA.

Adaptive Equipment

A veteran or servicemember who qualifies for the vehicle allowance also qualifies for adaptive equipment unless he or she is blind, requires a driver, or doesn’t have a valid State driver’s license or learner’s permit. See the attached list for more information about adaptive equipment. Important: VA will not pay for the purchase of add-on adaptive equipment (equipment furnished by someone other than the automobile manufacturer) that is not approved by VA. Contact the nearest VA health care facility for more information on add-on equipment. The adaptive equipment benefit may be paid more than once, and it may be paid to either the seller or the veteran or servicemember.

Special drivers training for disabled veterans should contact the nearest VA health care facility to request this training.

To Apply use VA form 21-4502, http://www.vba.va.gov/pubs/forms/VBA-21-4502-ARE.pdf.  There is no time limit for filing a claim; however, the claim must be authorized by VA before you purchase the automobile or conveyance.

Special Instructions to Veteran or Servicemember,

1. Complete all items of Section I in duplicate and submit both copies to VA. If you have previously applied for disability compensation, send the form to the VA regional office where your claims folder is located. If you have not applied for disability compensation or have not separated from military service, send the form to the nearest VA regional office.

2. VA will determine your eligibility and, if eligibility exists, VA will complete Section II and return the form to you.

3. Purchase a vehicle. When you receive the vehicle and the adaptive equipment from the seller, complete Section III.

4. Give the original VA Form 21-4502 to the seller.

5. Submit any invoices for adaptive equipment and/or installation not included on the seller’s invoice to the nearest VA health care facility. These invoices, identified with your full name and VA file number, must show the itemized net cost of any adaptive equipment and installation charges, any unpaid balance, and the make, year and model of the vehicle to which the equipment is added.

Special Instructions to Seller:

1. Make sure that Section II of VA Form 21-4502 is completed and signed by VA.

2. Deliver the vehicle, including VA-approved adaptive equipment provided and/or installed by the seller.

3. Obtain the original copy of VA Form 21-4502 from the veteran or servicemember after he or she has completed Section III.

4. Submit the original copy of VA Form 21-4502 and itemized invoice to the VA regional office shown in Section II, Attention: Financial Division, for payment.

The itemized invoice must include the following:

  • The net cost of any approved adaptive equipment and installation charges. If certain items of approved adaptive equipment (automatic transmission, power seats,     etc.) are included in the purchase price, also submit a copy of the window sticker.
  • A list of which adaptive equipment is standard on the vehicle or combined with other items.
  • The unpaid balance due on the vehicle which is to be paid by VA.
  • A certification that the amounts billed do not exceed the usual and customary cost for the purchase and installation of the adaptive equipment.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What is the Eligibility Verification Report for Non-Service Connected Pension

Pension recipients are required to file annual reports detailing their income status. The reports are called Eligibility Verification Reports (EVRs).

If the VA has requested an “EVR report” it must be completed, returned, and received by the VA within 60 days. Failure to return the EVR within the 60 days will result in the VA will suspending the pension benefit and denying the claim for the upcoming year.

It is important not to leave any blanks on the report. Instead of leaving a blank, enter either zero “0” or, the word “none” or, “N/A” on all answers that do not apply. If you leave a blank on the EVR report the VA will reject the report and suspend all benefits.

Another issue with the “EVR report” is with Social Security benefit reporting.   The SSI, (Supplemental Security Income), benefit is not considered “countable income”.   SSDI, (Social Security Disability Income), and Social Security Old Age Pension must be reported accurately to the VA. Any discrepancy in reporting SSDI or SS Old Age Pension can cause VA pension over payments and negative adjustments to the your pension benefit.

The Veteran’s EVR documented Social Security or Social Disability income amount must match the amount documented by Social Security. It is easy for Veterans to have a reporting error. Veterans mistakenly report the actual amount of their Social Security check instead of reporting their full Social Security benefit which includes the Medicare monthly deductibles for Part B Premium at $104.90 and other premiums, if the Veteran selected Premiums for Parts C and D.   Premium amounts for Part C and D vary by the plan. To avoid reporting errors, the Veteran and Spouse should refer to their annual report from the Social Security Administration and document the information correctly onto the EVR report.

If the Social Security Administration report is not available, the Veteran and/or Spouse can call and request the report from Social Security.   Social Security can be contacted at 1-800-772-1213. Social Security representatives are available between 7 a.m. and 7 p.m., Monday through Friday. If you have hearing problems you can call 1-800-325-0778, between 7 a.m. and 7 p.m., Monday through Friday.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

How VA Evaluates Income for Non-Service Connected Pension

Countable Income for Non-Service Connected Pension

To determine the income limit requirement for eligibility, the VA will require the Veteran to report all “countable income” for the Veteran’s household.

Countable income” refers to all household income:

  • the Veteran’s,
  • Veteran’s spouse (if living with the Veteran), and
  • Dependents.

The Veteran’s “countable income” must be below the maximum annual pension rate, MAPR, and the Veteran’s “net worth” must not provide adequate maintenance of the Veteran.

The need for pension is determined by “countable income” minus allowable deductions. The calculated reduced income is then subtracted from MAPR limit and the result is the annualized pension divided by 12 months.

As an example:

  • The MAPR for a Veteran who needs aid and attendance with no dependents is $21,531 income per year.
  • The Veteran’s countable income is $32,000 per year.
  • After subtracting the allowable deductions, the countable income of the Veteran is reduced to $15,000/year.
  • The MAPR of $21,531 minus $15,000 of countable income equals $6,531 per year of VA Pension.
  • The $6,531 yearly VA Pension is divided by 12 months to determine the monthly amount.
  • The Veteran receives a VA pension for $544.25 monthly for this example.

Allowable Deductions from Countable Income for VA Pension

The Veterans “countable income” is reduced by specific expenses. However, often Veterans believe that they are not eligible for pension because they make too much or are denied because they do not know the complete list of income exclusions and deductible expenses that would reduce their “countable income”.

The complete list of income exclusions is provided in 3.272 of title 38, Code of Federal Regulations. This knowledge is important because most Veterans mistakenly think that the only income deduction is unreimbursed medical expenses over 5% of the Veteran’s household income. When in fact there are many deductions and when the Veteran uses all of the deductions that apply to their situation, the outcome is greater.

Another mistake that Veterans make is reporting income that is excluded from income reporting on the pension application.       Not knowing the rules or what information to supply can cause a VA denial!

All income received from the following exclusions are not considered countable income by the VA. Veterans should make sure that when applying for pension, all deductions are applied and only income not excluded is counted. The list includes 22 income sources that are excluded from reporting and are found in Title 38 CFR 3.272:

  1. Welfare,
  2. Maintenance in an institution or facility due to age or impaired health,
  3. VA pension benefits ( Payments under Chapter 15 of Title 38 and including accrued pension benefits payable under 38 U.S.C. 5121),
  4. Reimbursement for casualty loss,
  5. Profit from the sale of property,
  6. Joint accounts,
  7. Unreimbursed medical expenses that are 5% of the MARP,
  8. Veteran’s final expenses,
  9. Educational expenses for Veteran or Spouse,
  10. Domestic Volunteer Service Act Programs,
  11. Distribution of funds under 38. U.S.C 1718,
  12. DOD survivor benefit annuity,
  13. Agent Orange settlement payments,
  14. Restitution to individuals of Japanese ancestry,
  15. Cash surrender value of life insurance,
  16. Income received by American Indian beneficiaries from trust or restricted lands,
  17. Payments from the Radiation Exposure Compensation Act,
  18. Alaska Native Claims Settlement Act,
  19. Monetary allowance under 38 U.S.C. chapter 18, Victims of Crime Act,
  20. Healthcare premiums to include Medicare, (make sure to include all insurance premiums paid for all 4 Parts of Medicare-A,B,C,D and Supplemental plans),
  21. Medicare prescription drug discount card and transitional assistance program, and
  22. Lump-sum life insurance proceeds on a veteran.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

How Military Sexual Trauma is Handled During VA Disbailities Claims

Military Sexual Trauma

Military sexual trauma, or MST, is the term used by the Department of Veterans Affairs (VA) to refer to experiences of sexual assault or repeated, threatening sexual harassment that a Veteran experienced during his or her military service.

The definition used by the VA comes from Federal law (Title 38 U.S. Code 1720D) and is “psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is further defined as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.”

Fortunately, people can recover from experiences of trauma, and VA has effective services to help Veterans do this. VA is strongly committed to ensuring that Veterans have access to the help they need in order to recover from MST:

  • Every VA health care facility has a designated MST Coordinator who serves as a contact person for MST-related issues. This person can help Veterans find and access VA services and programs. He or she may also be aware of state and federal benefits and community resources that may be helpful.
  • Recognizing that many survivors of sexual trauma do not disclose their experiences unless asked directly, VA health care providers ask every Veteran whether he or she experienced MST. This is an important way of making sure Veterans know about the services available to them.
  • All treatment for physical and mental health conditions related to experiences of MST is provided free of charge. To receive free treatment for mental and physical health conditions related to MST, Veterans do not need to be service connected (or have a VA disability rating). Veterans may be able to receive this benefit even if they are not eligible for other VA care.
  • Veterans do not need to have reported the incident(s) when they happened or have other documentation that they occurred. MST-related services are available at every VA medical center and every facility has providers knowledgeable about treatment for the aftereffects of MST. MST-related counseling is also available through community-based Vet Centers.
  • Services are designed to meet Veterans where they are at in their recovery, whether that is focusing on strategies for coping with challenging emotions and memories or, for Veterans who are ready, actually talking about their MST experiences in depth.
  • Nationwide, there are programs that offer specialized sexual trauma treatment in residential or inpatient settings. These are programs for Veterans who need more intense treatment and support. To accommodate Veterans who do not feel comfortable in mixed-gender treatment settings, some facilities have separate programs for men and women. All residential and inpatient MST programs have separate sleeping areas for men and women.
  • In addition to its treatment programming, VA also provides training to staff on issues related to MST, including a mandatory training on MST for all mental health and primary care providers. VA also engages in a range of outreach activities to Veterans and conducts monitoring of MST-related screening and treatment, in order to ensure that adequate services are available.

Military Sexual Trauma Details

MST includes any sexual activity where a Service member is involved against his or her will – he or she may have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be sexually cooperative or with implied better treatment in exchange for sex), may have been unable to consent to sexual activities (for example, when intoxicated), or may have been physically forced into sexual activities. Other experiences that fall into the category of MST include:

Unwanted sexual touching or grabbing

Threatening, offensive remarks about a person’s body or sexual activities

Threatening and unwelcome sexual advances

The identity or characteristics of the perpetrator, whether the Service member was on or off duty at the time, and whether he or she was on or off base at the time do not matter. If these experiences occurred while an individual was on active duty or active duty for training, they are considered by VA to be MST.

MST is an experience, not a diagnosis or a mental health condition, and as with other forms of trauma, there are a variety of reactions that Veterans can have in response to MST. The type, severity, and duration of a Veteran’s difficulties will all vary based on factors like:

Whether he/she has a prior history of trauma

The types of responses from others he/she received at the time of the MST

Whether the MST happened once or was repeated over time

Although trauma can be a life-changing event, people are often remarkably resilient after experiencing trauma. Many individuals recover without professional help; others may generally function well in their life, but continue to experience some level of difficulties or have strong reactions in certain situations. For some Veterans, the experience of MST may continue to affect their mental and physical health in significant ways, even many years later.

Strong emotions: feeling depressed; having intense, sudden emotional responses to things; feeling angry or irritable all the time

Feelings of numbness: feeling emotionally “flat”; difficulty experiencing emotions like love or happiness

Trouble sleeping: trouble falling or staying asleep; disturbing nightmares

Difficulties with attention, concentration, and memory: trouble staying focused; frequently finding their mind wandering; having a hard time remembering things

Problems with alcohol or other drugs: drinking to excess or using drugs daily; getting intoxicated or “high” to cope with memories or emotional reactions; drinking to fall asleep

Difficulty with things that remind them of their experiences of sexual trauma: feeling on edge or “jumpy” all the time; difficulty feeling safe; going out of their way to avoid reminders of their experiences

Difficulties with relationships: feeling isolated or disconnected from others; abusive relationships; trouble with employers or authority figures; difficulty trusting others

Physical health problems: sexual difficulties; chronic pain; weight or eating problems; gastrointestinal problems

Although posttraumatic stress disorder (PTSD) is commonly associated with MST, it is not the only diagnosis that can result from MST. For example, VA medical record data indicate that in addition to PTSD, the diagnoses most frequently associated with MST among users of VA health care are depression and other mood disorders, and substance use disorders.

For more information, Veterans can:

Speak with their existing VA health care provider.

Contact the MST Coordinator at their nearest VA Medical Center.

Call Safe Helpline at 1-877-995-5247 to get confidential one-on-one help. Safe Helpline provides 24 hour a day, 7 day a week sexual assault support for the Department of Defense community.

Contact their local Vet Center.

Veterans should feel free to ask to meet with a provider of a particular gender if it would make them feel more comfortable.

DOWNLOAD MST BROCHURE: military-sexual-trauma-mst-brochure-for-veterans

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What Disabled Veterans Should Know About VA Changes About PTSD Claims

PTSD

Posttraumatic Stress Disorder (PTSD) is now included in a new chapter in DSM-5 on Trauma and Stressor Related Disorders.   In  the DSM-IV PTSD was addressed as an Anxiety disorder.

The diagnostic criteria for the manual’s next edition identify the trigger to PTSD as exposure to actual or threatened death, serious injury or sexual violation. The exposure must result from one or more of the following scenarios, in which the individual:

  • – directly experiences the traumatic event;
  • – witnesses the traumatic event in person;
  • – learns that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental); or
  • – experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related).

The disturbance, regardless of its trigger, causes clinically significant distress or impairment in the individual’s social interactions, capacity to work or other important areas of functioning. It is not the physiological result of another medical condition, medication, drugs or alcohol.

Changes

DSM-5 pays more attention to the behavioral symptoms that accompany PTSD and proposes 4 distinct diagnostic clusters instead of 3.  They are described as re-experiencing, avoidance, negative cognitions and mood and arousal.

Re-experiencing covers spontaneous memories of the traumatic event, recurrent dreams related to it, flashbacks or other intense or prolonged psychological distress. Avoidance refers to distressing memories, thoughts, feelings or external reminders of the event.

Negative cognitions and mood represents myriad feelings, from a persistent and distorted sense of blame of self or others, to estrangement from others or markedly diminished interest in activities, to an inability to remember key aspects of the event.

Finally, arousal is marked by aggressive, reckless or self-destructive behavior, sleep disturbances, hyper-vigilance or related problems. The current manual emphasizes the “flight” aspect associated with PTSD; the criteria of DSM-5 also account for the “fight” reaction often seen.

The number of symptoms that must be identified depends on the cluster. DSM-5 would only require that a disturbance continue for more than a month and would eliminate the distinction between acute and chronic phases of PTSD.

PTSD Debate within the Military

Certain military leaders, both active and retired, believe the word “disorder” makes many soldiers who are experiencing PTSD symptoms reluctant to ask for help. They have urged a change to rename the disorder posttraumatic stress injury, a description that they say is more in line with the language of troops and would reduce stigma.

But others believe it is the military environment that needs to change, not the name of the disorder, so that mental health care is more accessible and soldiers are encouraged to seek it in a timely fashion. Some attendees at the 2012 APA Annual Meeting, where this was discussed in a session, also questioned whether injury is too imprecise a word for a medical diagnosis.

In DSM-5, PTSD will continue to be identified as a disorder.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What Disabled Veteran Should Know About Special Rules For Certain Claims

Congress, and in some cases VA, has recognized that some conditions resulting from service are so widespread or unique that they require special procedures. Two of the most common of these conditions, herbicide exposure in Vietnam Era veterans and undiagnosed or multisymptom illnesses in Persian Gulf War veterans, are described below.

Herbicide-Exposed Veterans

Congress has established a “presumption” of exposure to herbicides, most infamously including “Agent Orange,” for veterans who served in the Republic of Vietnam during the period from January 9, 1962, to May 7, 1975. A presumption is a legal term that means that VA has to assume a fact unless there is evidence against the fact. For Vietnam veterans this means that evidence of actual exposure Agent Orange is not required – those veterans is presumed to have been exposed to Agent Orange – if they meet the requirements for the presumption.

For claimants, this means that if a veteran can show he or she was in Vietnam during the specific period and currently has a medical condition listed in VA regulations as being caused by Agent Orange which began within the listed time periods, VA must service connect that condition. Conditions that are presumptively service-connected for herbicide exposure include chloracne, Type 2 diabetes (also know as Type II diabetes mellitus or adult-onset diabetes), Hodgkin’s disease, Non-Hodgkin’s lymphoma, B cell leukemia, Parkinson’s disease, and ischemic heart disease. Other presumptive conditions are listed, so a Vietnam veteran with a health condition should review the entire list. [link to CFR]

Just who is eligible for the herbicide presumption has been the topic of extensive debate and litigation. As it currently stands, having earned a Vietnam Service Medal is not enough to obtain the presumption. A veteran must show that he or she put “boots on the ground” in Vietnam or have been a “brown water” (inland waters) sailor to qualify. A single layover or shore leave is enough to receive the presumption. In addition, some veterans with service in Korea are also eligible for the presumption. For veterans with service in Thailand the key to claims for exposure are military duties that took the veteran out to and alongside the perimeter of bases where defoliants were acknowledged to have been used. Such duties include dog handling, security, and some maintenance activities.

Many veterans have challenged this definition, especially “blue water” (open ocean) sailors and Air Force ground support personnel who believe that they were exposed to Agent Orange or other herbicides during service. VA, backed by the courts, will not apply the presumption unless they have evidence of “boots on the ground” from these veterans.  Air Force members and reservist who served

On June 19th, 2015 the Federal Register published that Air Force Servicemembers and Air Force Reservists who served during the period of 1969 through 1986 and whose service required that they regularly and repeatedly operate, maintain, or serve onboard C-123 aircraft that was exposed to Agent Orange are now eligible for VA disability compensation for presumptive conditions due to Agent Orange Exposure.

In addition, any veteran who believes that he or she was exposed to a herbicide can file a claim and attempt to show actual herbicide exposure. This can be done by providing evidence of actual exposure, such as photographs showing Agent Orange barrels. In addition, veterans who served in other locations, such as Guam, have occasionally been able to show actual exposure although the government does not officially acknowledge Agent Orange was stored or used in those locations.

A unique aspect of Agent Orange claims is the possible retroactive assignment of effective dates. A series of court orders in the class-action litigation in Nehmer v. United States Department of Veterans Affairs, requires VA in certain cases to make an award effective on the date of the claimant’s application or the date of a previously-denied application, even if such date is earlier than the effective date of the regulation establishing the presumption. In other words, the Nehmer case created an exception to the rules for calculating effective dates and requires VA to assign retroactive effective dates for certain awards of disability compensation and DIC.

Another result of the Nehmer case is that if an individual was entitled to retroactive benefits as a result of the court orders but died prior to receiving such payment, VA must pay the entire amount of the retroactive payments to the veteran’s estate, regardless of any statutory limits on payment of benefits following a veteran’s death. Veterans and surviving spouses, dependent children, and dependent parents of veterans with service in Vietnam who previously filed claims for conditions associated with herbicide exposure should carefully review current VA regulations to determine if they are eligible for retroactive benefits.

Polytraumatic Injuries Requiring Specialized Rehab

Recent combat has resulted in new patterns of polytraumatic injuries and disability requiring specialized intensive rehabilitation processes and coordination of care throughout the course of recovery and rehabilitation. While serving in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), military service members are sustaining multiple severe injuries as a result of explosions and blasts. Improvised explosive devices, blasts, landmines, and fragments account for 65 percent of combat injuries (see subpar. 17a). Congress recognized this newly emerging pattern of military injuries with the passage of Public Law 108-422, Section 302, and Public Law 108-447.

Combat injuries are often the result of a blast. Blasts cause injuries through multiple mechanisms. Severe blasts can result in total body disruptions and death to those closest to the blast site or they can result in burns and inhalation injuries. Blast injuries typically are divided into four categories: primary, secondary, tertiary, and quaternary or miscellaneous injuries.

1. Primary Blast Injuries. Primary blast injuries are caused by overpressure to gas- containing organ systems, with most frequent injury to the lung, bowel, and inner ear (tympanic membrane rupture). These exposures may result in traumatic limb or partial limb amputation.

2. Secondary Blast Injuries. Secondary blast injuries occur via fragments and other missiles, which can cause head injuries and soft tissue trauma.

3. Tertiary Blast injuries. Tertiary Blast injuries result from displacement of the whole body by combinedpressure loads (shock wave and dynamic overpressure).

4. Miscellaneous Blast-related Injuries. These are miscellaneous blast-related injuries such as burns and crush injuries from collapsed structures and displaced heavy objects. Soft tissue injuries, fractures, and amputations are common.

Animal models of blast injury have demonstrated damaged brain tissue and consequent cognitive deficits. Indeed, the limited data available suggests that brain injuries are a common occurrence fromblast injuries and often go undiagnosed and untreated as attention is focused on more “visible” injuries. A significant number of casualties sustain emotional shock and may develop PTSD. Individuals may sustain multiple injuries from one or more of these mechanisms. Explosions can produce unique patterns of injury seldom seen outside combat.

Center for Disease Control and Prevention (CDC) Classification of Blast Injuries

Auditory or Vestibular
Tympanic membrane rupture, ossicular disruption, cochlear damage, foreign body, hearing loss, distorted hearing, tinnitus, earache, dizziness, sensitivity to noise.

Eye, Orbit or Face
Perforated globe, foreign body, air embolism, fractures.

Respiratory
Blast lung, hemothorax, pneumothorax, pulmonary contusion and hemorrhage, atrioventricular fistula (source of air embolism), airway epithelial damage, aspiration pneumonitis, sepsis.

Digestive
Bowel perforation, hemorrhage, ruptured liver or spleen, mesenteric ischemia from air embolism, sepsis, peritoneal irritation, rectal bleeding.

Circulatory
Cardiac contusion, myocardial infarction from air embolism, shock, vasovagal hypotension, peripheral vascular injury, air embolism-induced injury.

Central Nervous System
Concussion, closed or open brain injury, petechial hemorrhage, edema, stroke, small blood vessel rupture, spinal cord injury, air embolism- induced injury, hypoxia or anoxia, diffuse axonal injury.

Renal and/or Urinary Tract
Renal contusion, laceration, acute renal failure due to rhabdomyolysis, hypotension, hypovolemia.

Extremity
Traumatic amputation, fractures, crush injuries, burns, cuts, lacerations, infections, acute arterial occlusion, air embolism-induced injury.

Soft Tissue
Crush injuries, burns, infections, slow healing wounds.

Emotional or Psychological
Acute stress reactions, PTSD, survivor guilt, post-concussion syndrome, depression, generalized anxiety disorder.

Pain
Acute pain from wounds, crush injuries, or traumatic amputations; chronic pain syndromes.

Recognizing the specialized clinical care needs of individuals sustaining multiple severe injuries, VA has established four PRCs. The PRC mission is to provide comprehensive inpatient rehabilitation services for individuals with complex physical, cognitive and mental health sequelae of severe and disabling trauma, to provide medical and surgical support for ongoing and/or new conditions, and to provide support to their families. Intensive clinical and social work case management services are essential to coordinate the complex components of care for polytrauma patients and their families. Coordination of rehabilitation services must occur seamlessly as the patient moves from acute hospitalization through acute rehabilitation and ultimately back to the patient’s home community. Transition to the home community may include a transfer from a PRC to a less acute facility.

The Secretary of Veterans Affairs designated five PRCs, co-located with TBI Lead Centers, at VA Medical Centers in Richmond, VA; Tampa, FL; Minneapolis, MN; San Antonio, TX, and Palo Alto, CA (see App. A). It is VHA policy that the PRCs provide a full-range of care for all patients eligible for VA care, who have sustained varied patterns of severe and disabling injuries including, but not limited to: TBI, amputation, visual and hearing impairment, spinal cord injury (SCI), musculoskeletal injuries, wounds, and psychological trauma. Due to the medical complexity of these patients, PRCs must be prepared to admit individuals who may have a higher level of medical acuity and require interdisciplinary management by various medical specialists. The general admission criteria to the PRC include:

1.The individual with polytrauma is an eligible veteran or an active duty military service member; and
2.The individual has sustained multiple physical, cognitive, and/or emotional impairments secondary to trauma; and
3.The individual has the potential to benefit from inpatient rehabilitation; or
4.The individual has the potential to benefit from a transitional community re-entry program; or
5.The individual requires an initial comprehensive rehabilitation evaluation and care plan.

It is recommended that all patients experiencing a polytraumatic injury be referred to a VA PRC. The PRC team has specialized expertise to determine the most appropriate setting for care. If the patient does not require admission to a PRC, the team can assist with coordination of care at the most appropriate facility. Referral to a PRC also ensures that the patient and family are integrated into the VA system of care with the appropriate rehabilitation services. NOTE: The SCI Chief for the applicable region needs to be contacted by the PRC admissions clinical case manager to consult on the transfer of patients with a diagnosis of TBI and SCI.

Referrals to the PRC must be given the highest priority and the screening process needs to be expedited to ensure that there are no delays in transferring a patient to the Center. The PRC must accept admissions on a 24/7 basis. To establish the medical needs and acuity of the patient, there is a need to review medical documentation, consult with the referring treatment provider, and coordinate a plan for transfer.

Referral of service members with polytrauma to a PRC is initiated by DOD, typically by the MTF social worker or case manager, or other DOD representative. Where assigned, the VA- DOD liaison social worker is actively involved in the referral process, facilitating communications, information exchange, transition of care, and family support. The PRC’s admissions clinical case manager coordinates the referral and screening process for the accepting VA PRC. NOTE: For those referral sources that do not have VA-DOD liaisons, admission screening is to be coordinated between the PRC admission clinical case manager and the MTF.

Points of Contact
VA Polytrauma Points of Contact are available at 39 VAMCs without specialized rehabilitation teams. These Points of Contact, established in 2007, are knowledgeable about the VA Polytrauma/TBI System of care and coordinate case management and referrals throughout the system and may provide a more limited range of rehabilitation services.

Polytrauma Points of Contact (PPOC)
VISN Facility/Health Care System Contact Information
1. Louis A. Johnson VAMC- Clarksburg, WV (304) 623-3461
2. Beckley VA Medical Center, WV (304) 255-2121
3. Asheville VA Medical Center- Asheville NC (828) 298-7911
4. Fayetteville VA Medical Center- Fayetteville, NC (910) 488-2120
5. Carl Vinson VA Medical Center- Dublin, GA (334) 727-0550
6. Central Alabama Veterans Health Care System: East Campus- Tuskegee, AL (478) 272-1210
7. Columbus Outpatient Clinic- Columbus, OH (614) 257-5327
8. Chillicothe VA Medical Center- Chillicothe, OH (740) 773-1141
9. VA Northern Indiana Health Care System- Marion, IN (989) 497-2500
10. Aleda E. Lutz VA Medical Center- Saginaw, MI (260) 426-5431
11. Battle Creek VA Medical Center- Battle Creek, MI (269) 966-5600
12. Iron Mountain, MI VAMC (906) 774-3300
13. Marion VA Health Care System- Marion, IL (618) 997-5311
14. VA Eastern Kansas Health Care System: Colmery-O’Neill VA Medical Center Topeka, KS (785) 350-3111
15. Harry S. Truman Memorial Veterans’ Hospital- Columbia, MO (573) 814-6638
16. John J. Pershing VA Medical Center- Poplar Bluff, MO (573) 778-4359
17. Southeast Louisiana Veterans Health Care System- New Orleans, LA (504) 556-7245
18. Kerville VA Medical Center- Kerville, TX (830) 896-2020
19. Waco VA Medical Center- Waco, TX (254) 0743-0711
20. VA Texas Valley Coastal Bend Health Care System (956) 291-9000
21. Amarillo VA Health Care System- Amarillo, TX (806) 355-9703
22. West Texas VA Health Care System- Big Spring, TX (432) 263-7361
23. El Paso VA Health Care System- El Paso, TX (915) 564-6159
24. Northern Arizona VA Health Care System- Prescott, AZ (505) 265-1711
25. VA Montana Health Care System- Ft. Harrison, MT (406) 442-6410
26. Cheyenne VA Medical Center- Cheyenne, WY (307) 778-7550
27. Sheridan VA Medical Center- Sheridan, WY (307) 672-1677
28. Alaska VA Healthcare System- Anchorage, AK (907) 257-4854/6911
29. VA Roseburg Healthcare System- Roseburg, OR (541) 440-1000
30. VA Puget Sound Health Care System-American Lake (206) 277-3693
31. VA Southern Oregon Rehabilitation Center and Clinics- White City, OR (541) 826-2111
32. Spokane VA Medical Center- Spokane, WA (509) 434-7018
33. Jonathan M. Wainwright Memorial VA Medical Center- Walla Walla, WA (509) 525-5200
34. Sierra Nevada Health Care System- Reno, NV (775) 786-7700
35. VA Central California Health Care System- Fresno, CA (559) 225-6100
36. VA Pacific Islands Health Care System- Honolulu, HI (808) 433-0605
37. Manila Outpatient Clinic-Manila, Philippines (632)-318-8387 or (632)-833-4566
38. VA Southern Nevada Healthcare System- Las Vegas, NV (702) 636-3000
39. Fargo VA Medical Center- Fargo, ND (701) 239-3700

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What Veterans Should Know About VA Pension Non-Service Connected Disability

Pension-Legal References

VA “shall pay to each veteran of a period of war who meets the service requirements of this section . . . and who is permanently and totally disabled from non-service-connected disability not the result of the veteran’s willful misconduct, pension at the rate prescribed by [statute].”   38 U.S.C. § 1521(a).  The maximum annual rates for improved pension must be reduced by the amount of the veteran’s countable annual income.  38 U.S.C. § 1521; 38 C.F.R. § 3.23(b); Springer v. West, 11 Vet. App. 38, 40 (1998).  “Payments of any kind from any source shall be counted as income during the 12-month annualization period in which received unless specifically excluded under [section] 3.272.”  38 C.F.R. § 3.271(a); 38 U.S.C. § 1503; see Martin v. Brown, 7 Vet. App. 196, 199 (1994) (stating “statute and VA regulations provide that ‘annual income,’ as defined by statute and applicable regulation, includes payments of any kind from any source, unless explicitly exempted by statute or regulation”); but see 38 C.F.R. § 3.272 (enumerating categories to “be excluded from countable income for the purpose of determining entitlement to improved pension”).

Certain countable income is specifically excluded from this rule and as a result, a veteran’s pension will not be reduced.  38 C.F.R. § 3.272.  Social Security Administration (SSA) old age and survivor’s insurance and disability insurance payments are considered income and must, therefore, be included.  38 C.F.R. §§ 3.262; 3.271(g); Burch v. Brown, 6 Vet. App. 512, 513 (1994).  Benefits under noncontributory programs, such as old age assistance, aid to dependent children, and supplemental security income are treated as charitable donations.  See 38 C.F.R. §§ 3.262(d), (f).  Unreimbursed medical expenses paid within the 12-month annualization period are excluded from income to the extent that they are in excess of 5% of the maximum annual pension rate.  38 C.F.R. § 3.272(g)(1)(iii).  Whether a claimant is entitled to VA pension benefits is a question of fact.

Pursuant to 38 U.S.C. § 1505, pension benefits administered by the Secretary shall not be paid to or for an individual who has been imprisoned in a Federal, State, or local penal institution as a result of conviction of a felony or misdemeanor for any part of the period beginning 61 days after such individual’s imprisonment begins and ending when such individual’s imprisonment ends.  38 U.S.C. § 1505(a); 38 C.F.R. § 3.666; see also Latham v. Brown, 4 Vet. App. 265 (1993).

VA Non-Service Connected Pension or Wartime Pension

Many people confuse VA Pension with VA disability compensation. The two are different.

  • VA pension is based on wartime service, having a non-service connected disability and the Veteran must be of low income.
  • VA disability compensation is based on a service connected disability rating for the Veteran. The focus of this article is to provide the facts on the VA Pension since recently there has been misleading TV and internet advertisements promoting Veteran’s and Spouses to apply for the Pension.

Over the years the VA improved pension has been known as a Non-service connected Pension, a VA low-income Pension, live VA pension and most recently on TV and the internet advertised as a VA Wartime Pension for Veterans or Surviving Widows of Wartime Veterans.   The current improved pension became effective January 1, 1979 and was preceded by Section 306 Pension and Old-Law Pension Program.   All three non-service connected programs are disability and needs based. Today, the only available program for applicants is the improved pension program or non-service connected pension.

Eligibility for Non-Service Connected Pension

The improved pension program is for Veterans who served during wartime and meet specific requirements. It is for the requirement reason that TV advertisements refer to this pension as a wartime pension. The following program qualifying requirements must apply for the Veteran to receive this pension:

The Veteran must have an have a discharge “under other than dishonorable conditions” also known as a “honorable discharge”,

  1. actively served a minimum of one day during wartime,
  2. meet specific service time requirements,
    1. 90 days or more of active duty
    2. Veterans with active duty enlistment after September 7, 1980 must serve at least 24 months of active duty or complete the full period for which they were called to active duty.
  3. be of limited income (determined by the Maximum Annual Pension Rate or MARP) and net-worth, which are discussed later in this article and
  4. the Veteran must have one or more of the following :
    1. age 65 or older, or
    2. have a permanent and total non-service connected disability that will continue throughout the Veteran’s lifetime and prevents the Veteran from sustaining employment, or
    3. be a reside in a nursing home for long-term care , or
    4. be a recipient of Social Security disability benefits.

 Maximum Annual Pension Rate for VA NSC Pension

Date of Cost-of-Living Increase: 12-01-2017
Increase Factor:  2.0%
Standard Medicare Deduction: Actual amount will be determined by SSA based on individual income.


Maximum Annual Pension Rate (MAPR) Category

Amount

If you are a veteran… Your yearly income must be less than…
Without Spouse or Child $13,166
To be deducted, medical expenses must exceed 5% of MAPR,  or,  $ 659
With One Dependent $17,241
To be deducted, medical expenses must exceed 5% of MAPR,  or,  $ 863
Housebound Without Dependents $16,089
Housebound With One Dependent $20,166
A&A Without Dependents $21,962
A&A With One Dependent $26,036
Two Vets Married to Each Other $17,241
Two Vets Married to Each Other One H/B $20,166
Two Vets Married to Each Other Both H/B $23,087
Two Vets Married to Each Other One A/A $26,036
Two Vets Married to Each Other One A/A One H/B $28,953
Two Vets Married to Each Other Both A/A $34,837
Add for Early War Veteran (Mexican Border Period or WW1) to any category above $2,991
Add for Each Additional Child to any category above $2,250
Child Earned Income Exclusion effective: 01-01-2000 $7,200
(38 CFR §3.272 (j)(1))
This link takes you to the full regulation;
scroll down to get the specific citation.
01-01-2001 $7,450
01-01-2002 $7,700
01-01-2003 $7,800
01-01-2004 $7,950
01-01-2005 $8,200
01-01-2006 $8,450
01-01-2007 $8,750
01-01-2008 $8,950
01-01-2009 $9,350
01-01-2012 $9,750
01-01-2013 $10,000
01-01-2014 $10,150
01-01-2015 $10,300
01-01-2016 $10,350
01-01-2017 $10,400
01-01-2018 $10,650

*Child dependents are: (1) under the age of 18, (2) between the ages of 18 and 23 who are attending college, or (3) declared a “helpless child” due to an infirmity before the age of 18. Veterans with additional dependent children should add $2,205 to the MAPR limit for each child.

Countable Income for Non-Service Connected Pension

To determine the income limit requirement for eligibility, the VA will require the Veteran to report all “countable income” for the Veteran’s household.

Countable income” refers to all household income:

  • the Veteran’s,
  • Veteran’s spouse (if living with the Veteran), and
  • Dependents.

The Veteran’s “countable income” must be below the maximum annual pension rate, MAPR, and the Veteran’s “net worth” must not provide adequate maintenance of the Veteran.

The need for pension is determined by “countable income” minus allowable deductions. The calculated reduced income is then subtracted from MAPR limit and the result is the annualized pension divided by 12 months.

As an example:

  • The MAPR for a Veteran who needs aid and attendance with no dependents is $21,531 income per year.
  • The Veteran’s countable income is $32,000 per year.
  • After subtracting the allowable deductions, the countable income of the Veteran is reduced to $15,000/year.
  • The MAPR of $21,531 minus $15,000 of countable income equals $6,531 per year of VA Pension.
  • The $6,531 yearly VA Pension is divided by 12 months to determine the monthly amount.
  • The Veteran receives a VA pension for $544.25 monthly for this example.

Allowable Deductions from Countable Income for VA Pension

The Veterans “countable income” is reduced by specific expenses. However, often Veterans believe that they are not eligible for pension because they make too much or are denied because they do not know the complete list of income exclusions and deductible expenses that would reduce their “countable income”.

The complete list of income exclusions is provided in 3.272 of title 38, Code of Federal Regulations. This knowledge is important because most Veterans mistakenly think that the only income deduction is unreimbursed medical expenses over 5% of the Veteran’s household income. When in fact there are many deductions and when the Veteran uses all of the deductions that apply to their situation, the outcome is greater.

Another mistake that Veterans make is reporting income that is excluded from income reporting on the pension application.       Not knowing the rules or what information to supply can cause a VA denial!

All income received from the following exclusions are not considered countable income by the VA. Veterans should make sure that when applying for pension, all deductions are applied and only income not excluded is counted. The list includes 22 income sources that are excluded from reporting and are found in Title 38 CFR 3.272:

  1. Welfare,
  2. Maintenance in an institution or facility due to age or impaired health,
  3. VA pension benefits ( Payments under Chapter 15 of Title 38 and including accrued pension benefits payable under 38 U.S.C. 5121),
  4. Reimbursement for casualty loss,
  5. Profit from the sale of property,
  6. Joint accounts,
  7. Unreimbursed medical expenses that are 5% of the MARP,
  8. Veteran’s final expenses,
  9. Educational expenses for Veteran or Spouse,
  10. Domestic Volunteer Service Act Programs,
  11. Distribution of funds under 38. U.S.C 1718,
  12. DOD survivor benefit annuity,
  13. Agent Orange settlement payments,
  14. Restitution to individuals of Japanese ancestry,
  15. Cash surrender value of life insurance,
  16. Income received by American Indian beneficiaries from trust or restricted lands,
  17. Payments from the Radiation Exposure Compensation Act,
  18. Alaska Native Claims Settlement Act,
  19. Monetary allowance under 38 U.S.C. chapter 18, Victims of Crime Act,
  20. Healthcare premiums to include Medicare, (make sure to include all insurance premiums paid for all 4 Parts of Medicare-A,B,C,D and Supplemental plans),
  21. Medicare prescription drug discount card and transitional assistance program, and
  22. Lump-sum life insurance proceeds on a veteran.

Net Worth requirement for Non-Service Connected Pension

The other financial consideration for pension is “net worth.” “Net Worth” limitations are based on the net worth of a Veteran.   The test is whether or not the Veteran’s “net worth” is able to provide adequate maintenance of the Veteran.

“Net worth” determination is also sometimes referred to as the “needs test”.   “Net worth or Needs test” is determined on a case-by-case basis.   The VA uses the Veteran’s and the Spouse’s Social Security numbers to verify income and net worth information from all government sources. The VA’s main source for financial information on Veterans is the IRS Income Tax Return(s).

The VA defines “net worth” or “corpus of estate” as the market value of the Veteran’s home minus the mortgages or other legal liabilities on the property or personal property owned by the Veteran and/or Spouse.

The Veteran’s single-family dwelling and reasonable personal effects are excluded. Unsecured debts are not a factor in determining VA “net worth”.

It is to the advantage of the Veteran to be prepared to document the market value of their home by submitting to the VA either: a real estate broker statement, appraisal, or bank loan officer statement.   The Veterans should also be able to document their mortgage balance and any encumbrances on the property.

The following example will illustrate how the VA determines “net worth.”

  • The Veteran owns a home with a market value of $200,000. The mortgage on the property is $150,000 and there is a $5,000 lien on the property.
  • The Veteran’s personal effects values are: Clothing $2,000, car worth $10,000, furniture $2,000 and other belongings $800.
  • The VA reduces the Real Property value to $45,000 ($200,000 market value reduced by the outstanding mortgage balance of $150,000 and the $5,000 property lien).
  • The values of the personal effects are excluded.
  • Thus, the Veteran’s net worth is $45,000 (Real Property Value) for this illustration.

The VA is known not deny “net worth” under $80,000.   If the Veterans “net worth” is over $80,000, due to the high cost of living where the Veteran resides, the Veteran and/or Spouse should explain:

  • why their claim “should be approved by the VA” despite a net worth over $80,000
  • They should also detail the cost of living for the area,
  • They should document that if their net-worth assets were liquidated, given the area cost of living, the liquidated resources would be rapidly exhausted and the proceeds of the liquidated assets would be unable to sustain the Veteran for any period of time.

NSC Pension Reporting: Eligibility Verification Report for Non-Service Connected Pension

Pension recipients are required to file annual reports detailing their income status. The reports are called Eligibility Verification Reports (EVRs).

If the VA has requested an “EVR report” it must be completed, returned, and received by the VA within 60 days. Failure to return the EVR within the 60 days will result in the VA will suspending the pension benefit and denying the claim for the upcoming year.

It is important not to leave any blanks on the report. Instead of leaving a blank, enter either zero “0” or, the word “none” or, “N/A” on all answers that do not apply. If you leave a blank on the EVR report the VA will reject the report and suspend all benefits.

Another issue with the “EVR report” is with Social Security benefit reporting.   The SSI, (Supplemental Security Income), benefit is not considered “countable income”.   SSDI, (Social Security Disability Income), and Social Security Old Age Pension must be reported accurately to the VA. Any discrepancy in reporting SSDI or SS Old Age Pension can cause VA pension over payments and negative adjustments to the your pension benefit.

The Veteran’s EVR documented Social Security or Social Disability income amount must match the amount documented by Social Security. It is easy for Veterans to have a reporting error. Veterans mistakenly report the actual amount of their Social Security check instead of reporting their full Social Security benefit which includes the Medicare monthly deductibles for Part B Premium at $104.90 and other premiums, if the Veteran selected Premiums for Parts C and D.   Premium amounts for Part C and D vary by the plan. To avoid reporting errors, the Veteran and Spouse should refer to their annual report from the Social Security Administration and document the information correctly onto the EVR report.

If the Social Security Administration report is not available, the Veteran and/or Spouse can call and request the report from Social Security.   Social Security can be contacted at 1-800-772-1213. Social Security representatives are available between 7 a.m. and 7 p.m., Monday through Friday. If you have hearing problems you can call 1-800-325-0778, between 7 a.m. and 7 p.m., Monday through Friday.

Extra Benefits to add to the Non-Service Connected Pension

There are two extra benefits that can be claimed along with this pension. The two benefits are Aid and Attendance or Housebound Benefits. A Veteran can only receive one of the benefits. The Veteran’s housebound benefit is usually less than the Aid and Attendance benefit. Comparing the benefits, per the 12/01/2016 Table to determine pension of a Veteran with no dependents who might need either the housebound benefit or the aid and attendance benefit, the housebound benefit is about $238 per month and the Aid and Attendance benefits is about $716 per month.

To qualify for Aid and Attendance a Veteran must document one or more of the following:

  • The Veteran requires the aid of another person for assistance with activities of daily living. (Activities of daily living include: bathing, feeding, dressing needs, toileting, adjusting prosthetic devices, or protecting yourself from the hazards of your daily environment.
  • The Veteran is bedridden and the disability requires that the Veteran remain in bed apart from any prescribed course of convalescence or treatment. )
  • The Veteran is in a nursing home due to mental or physical incapacitating conditions.
  • The Veteran is blind or so nearly blind as to have corrected visual acuity of 5/200 or less in both eyes and has contraction of the concentric visual field to 5 degrees or less.

Submitting a Claim for Non-Service Connected Pension

To submit a claim for the wartime or non-service connected pension, you will need:

  1. The proper VA application Form
    1. If the Veteran believes that he or she may qualify for both service connected disability compensation and/or a non-service connected pension, the Veteran should apply for both benefits.  They should apply for compensation by submitting VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits.  The fillable form can be obtained by going to: https://www.vba.va.gov/pubs/forms/VBA-21-526EZ-ARE.pdf
    2. If the Veteran believes that he or she is only eligible for non-service connected pension, then the Veteran should apply using VA Form 21-527EZ Application for pension. This fillable form can be obtained by going to: http://www.vba.va.gov/pubs/forms/VBA-21-527EZ-ARE.pdf
  2. All income and net worth information and supporting documents.
  3. Medical Evidence of the Claim: To support your claim, submit all medical treatment records and documents from private Practitioners, private facilities, testing centers and VA medical centers. For each source of medical information, complete VA Form 21-4142, Authorization to Disclose Information to the Department of Veteran Affairs, http://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf. VA medical centers do not need a VA Form 21-4142.
  4. Extra Benefit applications
    1. Application for Aid and Attendance or housebound benefits will require:
      1. If the Veteran resides at home, complete VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance,   http://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf or
      2. If the Veteran is in a Nursing Home, complete VA Form 21-0779 Request for Nursing Home Information in Connection with Claim for Aid and Attendance, http://www.vba.va.gov/pubs/forms/VBA-21-0779-ARE.pdf
    2. Claim application for a dependent child in school between 18 and 23 with the pension requires completing VA Form 21-674, Request for Approval of School Attendance http://www.vba.va.gov/pubs/forms/VBA-21-674-ARE.pdf
    3. Claim application for helpless (disabled) child benefits, will require you to declare the child a dependent, using VA Form 21-686c, Declaration of Status of Dependents, http://www.vba.va.gov/pubs/forms/VBA-21-686c-ARE.pdf and submission of all relevant medical treatment records for the child’s disabilities using VA Form 21-4138, Statement in Support of Claim, http://www.vba.va.gov/pubs/forms/VBA-21-4138-ARE.pdf.

For a brief overview of the pension, go to the VA Fact Sheet on Live Pension: http://benefits.va.gov/BENEFITS/factsheets/limitedincome/livepension.pdf.

Or, the VA Fact Sheet on Survivors Pension: http://www.benefits.va.gov/BENEFITS/factsheets/survivors/Survivorspension.pdf