|
Thomas R. Kennedy, Esq. - Office of Regional Counsel - U.S. Department of Veterans Affairs
Paul Dean Tayloe, Jr. - Denver Regional Office - U.S. Department of Veterans Affairs
2-1. Disability Compensation
2-2. Pension Benefits
2-3. Survivor Benefits
2-4. Health Care Benefits
2-5. Services and Aids for Blind Veterans
2-6. Home Improvements
2-7. Outpatient Dental Treatment
2-8. Outpatient Pharmacy Services
2-9. Nursing Home Care
2-10. Domiciliary Care
2-11. Medical Care for Dependents and Survivors
2-12. Burial Benefits
2-13. Resources
A variety of benefits provided by the U.S. Department of Veterans Affairs (VA) are
available to eligible veterans and their families. This chapter focuses on those benefits that
are most likely to be of interest to older veterans and their families.
2-1. Disability Compensation
Disability compensation is a monetary benefit paid to veterans who are disabled by
injury or disease incurred or aggravated during active military service. The service of the
veteran must have been terminated through separation or discharge under conditions other
than dishonorable. Disability compensation varies with the degree of disability and the
number of dependents, and is paid monthly. The benefits are not subject to federal or state
income tax. The payment of military retirement pay, disability severance pay, and separation
incentive payments known as SSB (Special Separation Benefits) and Voluntary
Separation Incentives (VSI) also affects the amount of VA compensation paid.
Former prisoners of war (POWs) are eligible for disability compensation if they are
rated at least 10 percent disabled from certain conditions presumed by federal law to be
related to the POW experience. Former POWs who were imprisoned for at least 30 days are
also eligible by federal law for certain presumptive conditions.
The Specially Adapted Housing Grant is available to severely disabled veterans or
servicemembers who are entitled to a home especially adapted to their needs due to loss of
mobility. Under this entitlement, a temporary grant (TRA) may be available to veterans who
are/will be temporarily residing in a home owned by a family member. Any veteran who is
entitled to receive compensation for a service-connected disability for which he or she uses
prosthetic or orthopedic appliances may receive an annual clothing allowance. The
allowance also is available to any veteran whose service-connected skin condition requires
prescribed medication that irreparably damages the veteran’s outer garments.
Veterans whose service-connected disabilities are rated at 30 percent or more are
entitled to additional allowances for dependents. The number of dependents and the
degree of disability determines the additional amount.
A veteran who is determined by VA to be in need of the regular aid and attendance
of another person, or a veteran who is permanently housebound, may be entitled to additional
disability compensation or pension benefits. A veteran evaluated at 30 percent or
more disabled is entitled to receive a special allowance for a spouse who is in need of the
aid and attendance of another person.
2-2. Pension Benefits
Veterans with low incomes who are permanently and totally disabled, or are age 65
and older, may be eligible for monetary support if they have 90 days or more of active military
service, at least one day of which was during a period of war. Generally, veterans who
entered active duty on or after September 8, 1980, or officers who entered active duty on or
after October 16, 1981, may have to meet a longer minimum period of active duty.
Requirements for eligibility to receive pension benefits include the discharge from
active duty under conditions other than dishonorable. Permanent and total disability cannot
be as a result of the veteran’s own willful misconduct. Payments are made to qualified veterans
to bring their total income, including other retirement or Social Security income, to a
level set by Congress. Unreimbursed medical expenses may reduce countable income.
2-3. Survivor Benefits
Dependency and Indemnity Compensation (DIC) is a monthly tax-free benefit that
may be available to a veteran’s survivor. For survivors to be eligible, the deceased veteran
must have died from (1) a disease or injury incurred or aggravated while on active duty or
active duty for training; (2) an injury incurred or aggravated in line of duty while on inactive
duty training; or (3) a disability compensable by VA. Death cannot be the result of the
veteran’s willful misconduct. If a spouse remarries, eligibility for benefits may be restored if
the marriage is terminated later by death, annulment, or divorce.
DIC also may be authorized for survivors of veterans who at the time of death were
determined to be totally disabled as a result of military service, even though their serviceconnected
disabilities did not cause their deaths. The veteran must have been discharged
under conditions other than dishonorable. The survivor qualifies if (1) the veteran was continuously
rated totally disabled for a period of 10 or more years immediately preceding
death; (2) the veteran was so rated for a period of at least five years from the date of military
discharge; or (3) the veteran was a former prisoner of war who died after September
30, 1999, and who was continuously rated totally disabled for a period of at least one year
immediately preceding death. Payments are subject to offset by any amount received from
judicial proceedings brought on account of the veteran’s death.
2-4. Health Care Benefits
VA operates the nation’s largest integrated health care system, with more than 1,400
sites of care, including hospitals, community clinics, nursing homes, domiciliaries, readjustment
counseling centers, and various other facilities. For additional information on VA
health care, visit www1.va.gov/health/index.asp.
Veterans will be assigned the highest priority group for which they qualify. VA uses
the priority group system to balance demand with available resources. Changes in VA’s
available resources may reduce the number of priority groups VA can enroll. If this occurs,
VA will publicize the changes and notify affected enrollees. Veterans will be enrolled to the
extent Congressional appropriations allow. If appropriations are limited, enrollment will
occur based on the following priorities:
Priority Group 1: Veterans with service-connected disabilities rated 50 percent or
more and veterans determined by VA to be unemployable due to serviceconnected
conditions;
Priority Group 2: Veterans with service-connected disabilities rated 30 or 40 percent;
Priority Group 3: Veterans with service-connected disabilities rated 10 and 20 percent,
veterans who are former POWs or were awarded a Purple Heart, veterans
awarded special eligibility for disabilities incurred in treatment or participation
in a VA vocational rehabilitation program, and veterans whose discharge
was for a disability incurred or aggravated in the line of duty;
Priority Group 4: Veterans receiving aid and attendance or house benefits and veterans
determined by VA to be catastrophically disabled. Some veterans in this
group may be responsible for co-payments;
Priority Group 5: Veterans receiving VA pension benefits or eligible for Medicaid
programs, veterans with nonservice-connected disabilities, and veterans with
noncompensable zero percent service-connected disabilities whose annual
income and net worth are below the established VA means test thresholds;
Priority Group 6: Veterans of the Mexican border period or World War I; veterans
seeking care solely for certain conditions associated with exposure to radiation,
for any illness associated with combat service in a war after the Gulf
War or during a period of hostility after Nov. 11, 1998, for any illness associated
with participation in tests conducted by the Defense Department as part
of Project 112/Project SHAD; and veterans with zero percent service-connected
disabilities who are receiving disability compensation benefits;
Priority Group 7: Veterans with nonservice-connected disabilities and veterans with
noncompensable zero percent service-connected disabilities with income
above VA’s national means test threshold and below VA’s geographic means
test threshold, or with income below both the VA national threshold and the
VA geographically based threshold, but whose net worth exceeds VA’s ceiling
(currently $80,000), who agree to pay co-payments; or
Priority Group 8: All other veterans with nonservice-connected disabilities and zero
percent noncompensable service-connected disabilities who agree to pay copayments.
(Note: Effective January 17, 2003, VA no longer enrolls new veterans
in Priority Group 8.)
Veterans enrolling in priority group 5 based on their inability to defray the cost of
care must provide information on their annual household income and net worth to determine
whether they are below the annually adjusted “means test” financial threshold.
Veterans completing a financial assessment must report their annual gross household
income plus net worth, which includes Social Security; U.S. Civil Service retirement; U.S.
Railroad retirement; military retirement; unemployment insurance; any other retirement
income; total wages from all employers, interest, and dividends; workers’ compensation;
black lung benefits; and any other gross income for the calendar year prior to application
for care. Also considered are assets such as the market value of property that is not the primary residence, stocks, bonds, notes, individual retirement accounts, bank deposits, savings
accounts, and cash. VA also is required to compare veterans’ financial assessment information
with a geographically based income threshold. If the veteran’s income is below the
threshold where the veteran lives, he or she is eligible for an 80 percent reduction in the
inpatient co-payment rates.
Services requiring co-payments include the following. Veterans with nonservice-connected
disabilities and veterans with noncompensable zero percent service-connected disabilities
whose income is above the national “means test” threshold must agree to pay
appropriate co-payments for care. If they do not agree to make co-payments, they are ineligible
for VA care. Veterans whose income is determined to be above the means test threshold
and below VA’s geographically based income threshold are responsible for paying 20
percent of the Medicare deductible for the first 90 days of inpatient hospital care during any
365-day period.
With certain exceptions, a veteran must agree to pay co-payments for extended care.
A veteran’s application for extended care services (VAF 10-10EC) requires financial information
used to determine the monthly co-payment amount, based on each veteran’s financial
situation.
Prosthetic and Sensory Aid Services
VA will furnish needed prosthetic appliances, equipment, and devices, such as artificial
limbs, orthopedic braces, and shoes; wheelchairs; crutches and canes; and other durable
medical equipment and supplies to veterans receiving VA care for any condition. VA will
provide hearing aids and eyeglasses to veterans who receive increased pension based on
the need for regular aid and attendance or being permanently housebound, receive compensation
for a service-connected disability, or are former prisoners of war. Otherwise, hearing
aids and eyeglasses will be provided only in special circumstances, and not for normally
occurring hearing or vision loss.
2-5. Services and Aids for Blind Veterans
Blind veterans may be eligible for services at a VA medical center or for admission to
a VA blind rehabilitation center. Services are available at all VA medical facilities through the
Visual Impairment Services coordinator. In addition, blind veterans enrolled in the VA
health care system may receive VA aids for the blind, including:
- A total health and benefits review;
- Adjustment to blindness training;
- Home improvements and structural alterations to homes;
- Specially adapted housing and adaptations;
- Automobile grants;
- Low-vision aids and training in their use;
- Electronic and mechanical aids for the blind, including adaptive computers and
computer-assisted devices such as reading machines and electronic travel aids;
- Guide dogs, including the expense of training the veteran to use the dog; and
- Talking books, tapes, and Braille literature.
2-6. Home Improvements
VA provides funding for eligible veterans to make home improvements necessary
for the continuation of treatment or for disability access to the home and essential lavatory
and sanitary facilities provided.
2-7. Outpatient Dental Treatment
Outpatient dental treatment provided by VA includes examinations and the full
spectrum of diagnostic, surgical, restorative, and preventive procedures. Veterans eligible to
receive dental care include the following:
- Veterans having service-connected and compensable dental disabilities or conditions;
- Former prisoners of war;
- Veterans with service-connected, noncompensable dental conditions as a result of
combat wounds or service injuries;
- Veterans with nonservice-connected dental conditions determined by VA to be
aggravating a service-connected medical problem;
- Veterans having service-connected conditions rated as permanently and totally
disabling or rated 100 percent by reason of individual unemployability;
- Veterans participating in a vocational rehabilitation program under Chapter 31 of
Title 38;
- Certain enrolled homeless veterans participating in specific health-care programs;
- Veterans with nonservice-connected dental conditions for which treatment was
begun while the veteran was an inpatient in a VA facility when it is necessary to
complete such treatment on an outpatient basis; and
- Veterans requiring treatment for dental conditions clinically determined to be
complicating a medical condition currently under treatment.
Recently discharged veterans who served on active duty 90 days or more and who
apply for VA dental care within 90 days of separation from active duty may receive one
time treatment for dental conditions if the veteran’s certificate of discharge does not indicate
that the veteran received necessary dental care within a 90-day period prior to discharge
or release.
2-8. Outpatient Pharmacy Services
Outpatient pharmacy services are provided free to:
- Veterans with a service-connected disability of 50 percent or more;
- Veterans receiving medication for treatment of service-connected conditions;
- Veterans whose annual income does not exceed the maximum VA annual rate of
the VA pension;
- Veterans receiving medication for conditions related to exposure to ionizing radiation;
- Veterans receiving medication for conditions related to combat service in a war
after the Gulf War or against a hostile force in a period of hostilities beginning
after November 11, 1998;
- Veterans receiving medication for conditions related to participation in U.S.
Department of Defense tests conducted as part of Project 112/Project SHAD;
- Veterans receiving medication for conditions related to sexual trauma experienced
while serving on active duty;
- Certain veterans receiving medication for treatment of cancer of the head or
neck;
- Veterans receiving medication as part of a VA-approved research project; and
- Former prisoners of war.
Other veterans will be charged a co-payment for each 30-day or less supply of medication.
To eliminate a financial hardship for veterans who require an unusually large
amount of medications, there is a maximum co-payment amount that veterans enrolled in
Priority Groups 2 through 6 pay in any single year. The medication co-payment applies to
prescription and over-the-counter medications, such as aspirin, cough syrup, or vitamins,
dispensed by a VA pharmacy.
Medication co-payments are not charged for medications injected during the
course of treatment or for medical supplies, such as syringes or alcohol wipes. In the
event over-the-counter drugs are ordered, the veteran can choose to purchase them at a
local pharmacy.
2-9. Nursing Home Care
VA provides nursing home services through three national programs: VA owned and operated nursing homes, state veterans homes owned and operated by the state, and contract community nursing homes. Each program has its own admission and eligibility criteria. VA owned and operated homes typically admit residents requiring short-term skilled care, or who have a 70 percent or more service-connected disability, or who require nursing home care because of a service-connected disability. The state veterans home program is a cooperative venture between VA and the states whereby VA provides funds to help build the home and pays a portion of the costs for veterans eligible for VA health care. The states, however, set eligibility criteria for admission. The contract nursing home program is designed to meet the long-term nursing home care needs of veterans who may not be eligible and/or qualify for placement in a VA or state veterans home or if there is no VA or state home available.
To be placed in a nursing home, veterans generally must be medically stable, have a
condition that requires inpatient nursing home care, and be assessed by an appropriate
medical provider to be in need of institutional nursing home care. They also must meet the
eligibility requirements for the home to which they are applying. For VA nursing homes,
they may have to pay a co-payment depending on their financial status. VA social workers
can help interpret eligibility and co-payment requirements.
In addition to nursing home care, VA offers other extended care services either
directly or by contract with community agencies, including adult day care, respite care, geriatric
evaluation and management, hospice and palliative care, and home-based primary
care. These services may require a co-payment.
2-10. Domiciliary Care
Domiciliary care provides rehabilitative and long-term, health-maintenance care for
veterans who require minimal medical care but do not need the skilled nursing services
provided in nursing homes. VA may provide domiciliary care to veterans whose annual
income does not exceed the maximum annual rate of VA pension or to veterans the
Secretary of Veterans Affairs determines have no adequate means of support. The co-payments
for extended care services apply to domiciliary care.
2-11. Medical Care for Dependents and Survivors
The Civilian Health and Medical Program of the Department of Veterans Affairs
(CHAMPVA) provides reimbursement for most medical expenses: inpatient, outpatient,
mental health, prescription medication, skilled nursing care, and durable medical equipment.
To be eligible for CHAMPVA, an individual cannot be eligible for TRICARE (the medical
program for civilian dependents provided by the U.S. Department of Defense) and
must be one of the following:
- The spouse or child of a veteran who VA has rated permanently and totally disabled
for a service-connected disability;
- The surviving spouse or child of a veteran who died from a VA-rated service-connected
disability or who, at the time of death, was rated permanently and totally
disabled; or
- The surviving spouse or child of a military member who died in the line of duty,
not due to misconduct. However, in most cases, these family members are eligible
for TRICARE, not CHAMPVA.
A surviving spouse under age 55 who remarries loses CHAMPVA eligibility on midnight
of the date of remarriage. However, eligibility may be re-established if the remarriage
is terminated by death, divorce, or annulment effective the first day of the month after the
termination of the remarriage or December 1, 1999, whichever date is later. A CHAMPVAeligible
surviving spouse who is 55 or older does not lose eligibility upon remarriage.
Individuals who have Medicare entitlement may also have CHAMPVA eligibility secondary
to Medicare. Eligibility limitations apply.
2-12. Burial Benefits
Veterans discharged from active duty under conditions other than dishonorable discharge
and service members who die while on active duty, as well as spouses and dependent
children of veterans and active duty service members, may be eligible for VA burial and
memorial benefits. The veteran does not have to predecease a spouse or dependent child
for them to be eligible.
With certain exceptions, active duty service beginning after September 7, 1980, as an
enlisted person, and after October 16, 1981, as an officer, must be for a minimum of 24 consecutive
months or the full period of active duty (as in the case of reservists or National
Guard members called to active duty for a limited duration). Eligibility is not established by
active duty for training in the reserves or National Guard.
Reservists and National Guard members, as well as their spouses and dependent
children, are eligible if they were entitled to retired pay at the time of death, or would have
been if they were over age 60.
Burial in a VA national cemetery is available for eligible veterans and their spouses
and dependents at no cost to the family and includes the gravesite, grave liner, opening and
closing of the grave, a headstone or marker, and perpetual care as part of a national shrine.
For veterans, benefits also include a burial flag (with case for active duty) and military
funeral honors. Family members and other loved ones of deceased veterans may request
Presidential Memorial Certificates.
VA operates 124 national cemeteries, of which 84 are open for new interments and
20 of these accept only cremated remains. Burial options are limited to those available at a
specific cemetery but may include in-ground casket or interment of cremated remains in a
columbarium, in ground, or in a scatter garden. Surviving spouses of veterans who died on
or after January 1, 2000, do not lose eligibility for burial in a national cemetery if they remarry.
Burial of dependent children is limited to unmarried children under 21 years of age, or
under 23 years of age if a full-time student at an approved educational institution.
Unmarried adult children who become physically or mentally disabled and incapable of
self-support before age 21, or age 23 if a full-time student, also are eligible for burial.
2-13. Resources
Phone Numbers
Education: (888) 442-4551
Headstones and markers: (800) 697-6947
Health care: (877) 222-8387
Life insurance: (800) 669-8477
Special health issues: (800) 749-8387
TTD: (800) 829-4833
VA benefits: (800) 827-1000
Websites
Burial and memorial benefits: www.cem.va.gov/
Department of Defense: www.defenselink.mil/
Education benefits: www.gibill.va.gov/
Federal jobs: www.usajobs.opm.gov/
Health care eligibility: www.va.gov/healtheligibility/
Home loan guaranty: www.homeloans.va.gov/
Life insurance: www.insurance.va.gov/
Records: www.archives.gov/st-louis/military-personnel/
Returning veterans: www.seamlesstransition.va.gov/
Veterans Employment and Training Service: www.dol.gov/vets/
Vets Employment Info: www.opm.gov/veterans/index.asp
Vocational rehabilitation: www.vba.va.gov/bln/vre/index.htm
VA benefit payment rates: www.vba.va.gov/bln/21/Rates/
VA facilities: www.va.gov/directory/guide/home.asp
VA forms: www.va.gov/vaforms/
VA home page: www.va.gov/
Written Materials
Federal Benefits for Veterans and Dependents (2007 edition):
Department of Veterans Affairs
Office of Public Affairs
810 Vermont Ave. N.W.
Washington, D.C. 20420
|