Veterans

Medical Benefits

1. If I am enrolled with VA what medical benefits will I receive? ?

Veterans enrolled in the VA health care system are eligible to receive necessary hospital and outpatient services, including preventive and primary care. These services include: diagnostic and treatment services; rehabilitation; mental health; substance abuse treatment; home health, prosthetic equipment, respite and hospice care; and medications in conjunction with VA treatment. You are not required to use VA as your exclusive health care provider. If you have health insurance, or eligibility for other programs such as Medicare, Medicaid, or TRICARE, you may continue to use services under those programs. We recommend that, if you have other insurance or HMO coverage, you should keep that coverage to provide you with options and flexibility in the future.

2. If I am enrolled, what cost will there be for me?

Priority Group 8 and certain other veterans are responsible for VA's inpatient copay of $1,068 for the first 90 days of care during any 365-day period. For each additional 90 days, this charge is $534. In addition, there is a $10 per diem charge.

NOTE: VA's inpatient copay rate is based on the current Medicare deductible of $1,068.

A three-tiered copay system is used for all outpatient services. The copay is $15 for a primary care visit and $50 for some specialized care. Certain services are not charged copays.

3. Am I eligible for prescriptions from VA?

Yes, generally, to receive medications from a VA pharmacy, the prescriptions must be written by a VA health care provider. Most veterans are currently charged $8 for each 30-day or less supply of medication provided by VA for treatment of conditions that are not service- connected. For veterans enrolled in Priority Groups 2 through 6, the maximum copay for medications that will be charged in calendar year 2009 is $960.

4. I can't afford to make copays. What do I do?

There are three options. The first option is to request a Waiver from paying your current debt. If you request a waiver, you must submit sufficient proof that you cannot financially afford to make payment to VA. For assistance in applying for a waiver, contact the Revenue Coordinator at the VA health care facility where you receive care. The second option is to request a Hardship Determination to avoid future medical care copay charges. You will need to submit specific financial information about your current year income. If you are approved for a hardship determination, your copay status will change and your enrollment priority will improve. For further information on applying for a hardship determination, contact your Enrollment Coordinator. The third option is to request an Offer in Compromise, which is an offer for past debts only and acceptance of a partial payment in settlement and full satisfaction of the debt at the time the offer is made. If you request an offer in compromise, you must submit sufficient proof that you cannot financially afford to make payment to VA. For assistance in applying for an offer in compromise, contact the Revenue Coordinator at the VA health care facility where you receive care.

5. How do I request VA health care?

To schedule an appointment, contact your local VA health care facility.

6. If enrolled, can I get dental care?

In general, dental benefits are limited to dental conditions determined by VA to be service-connected, veterans who were Prisoners of War, and veterans who are receiving 100% SC disability compensation. For specifics, contact the VA health benefits advisor at your local VA health care facility.

7. Will VA take care of my nursing home care needs?

The following veterans will be offered nursing home care when appropriate:

  • Veterans requiring nursing home care for a SC disability
  • Veterans with service-connected disabilities rated 70% or greater
  • Veterans determined by VA to be unemployable or permanently and totally disabled from a service-connected condition.

 

Most other veterans are eligible for nursing home care as space and resources permit.

8. What is the coverage for emergency services?

VA provides urgent and limited emergency care in VA facilities. However, VA's ability to pay for emergency care in non-VA facilities is limited to veterans receiving care for a SC condition, or as payor of last resort for a NSC condition but only under the following conditions:

  • You do not have coverage under a health insurance plan, and the services are not eligible for payment under Medicare or Medicaid.
  • Emergency care was provided in a hospital emergency department or similar facility.
  • You are financially liable to the provider of care for payment of the emergency treatment.
  • You are enrolled in the VA health care system and receive care from VA within the 24 months preceding the non-VA emergency care.

 

9. Are there any restrictions on getting care in private facilities at VA expense?

Yes. Care in private facilities at VA expense is provided only under certain circumstances. To determine if you are eligible for private care at VA expense, contact your local VA health care facility.

10. What should I do if I was awarded the Purple Heart?

You should submit appropriate documentation to your local VA health care facility. Appropriate documentation includes a Department of Defense Form DD 214 or, for World War II veterans, a "WD" form, any military service records or orders that document your award of a Purple Heart. If you need to obtain a copy of your military records you may use a Standard Form 180 Request Pertaining to Military Records, available at http://www.archives.gov/veterans/military-service-records/ or at VA offices. Veterans who were awarded the Purple Heart are assigned to Priority 3.

11. What If I’m Catastrophically Disabled?

To be considered Catastrophically Disabled, you must have a severely disabling injury, disorder, or disease which permanently compromises your ability to carry out activities of daily living, and:

  • requires you to have personal or mechanical assistance to leave home or bed, OR
  • requires you to have constant supervision to avoid physical harm to yourself or others.

 

To request a catastrophic disability evaluation, contact the Enrollment Coordinator at your local VA health care facility. VA will make every effort to schedule your evaluation within 35 days of request. There is no charge for the Catastrophic Disability evaluation.

If it is determined by a VA health care provider that you are Catastrophically Disabled, your priority group assignment will be upgraded to Priority Group 4.

12. Will VA provide hearing aids and eyeglasses?

VA will ensure access to audiology and eye care services including preventive health (care) services and routine vision testing for all enrolled veterans and those veterans exempt from enrollment. Eyeglasses and hearing aids will be provided to the following veterans:

  • Those with any compensable service-connected disability.
  • Those who are former Prisoners of War (POWs).
  • Those who were awarded a Purple Heart.
  • Those in receipt of benefits under Title 38 United States Code (U.S.C.) 1151.
  • Those in receipt of an increased pension based on being permanently housebound and in need of regular aid and attendance.
  • Those with vision or hearing impairment resulting from diseases or the existence of another medical condition for which the veteran is receiving care or services from VHA, or which resulted from treatment of that medical condition, e.g., stroke, polytrauma, traumatic brain injury, diabetes, multiple sclerosis, vascular disease, geriatric chronic illnesses, toxicity from drugs, ocular photosensitivity from drugs, cataract surgery, and/or other surgeries performed on the eye, ear, or brain resulting in vision or hearing impairment.
  • Those with significant functional or cognitive impairment evidenced by deficiencies in the ability to perform activities of daily living.
  • Those who have vision and/or hearing impairment severe enough that it interferes with their ability to participate actively in their own medical treatment and to reduce the impact of dual sensory impairment (combined hearing and vision loss).
    • NOTE: The term “severe” is to be interpreted as a vision and/or hearing loss that interferes with or restricts access to, involvement in, or active participation in health care services (e.g., communication or reading medication labels). The term is not to be interpreted to mean that a severe hearing or vision loss must exist to be eligible for hearing aids or eyeglasses.
  • Those veterans who have service-connected vision disabilities rated zero percent or service-connected hearing disabilities rated zero percent if there is organic conductive, mixed, or sensory hearing impairment, and loss of pure tone hearing sensitivity in the low, mid, or high- frequency range or a combination of frequency ranges which contribute to a loss of communication ability; however, hearing aids are to be provided only as needed for the service-connected hearing disability.

 

Veterans meeting the eligibility requirements to receive health care are eligible for diagnostic audiology services and eye & vision care services. Eligibility rules are the same for both inpatient and outpatient medical services. Veterans will not be denied access to audiology services and/or eye & vision care services covered by the Medical Benefits Package (38 CFR §17.38) because they do not meet the eligibility criteria for hearing aids and/or eye glasses.

For additional information, veterans can contact the prosthetic representative at the nearest VA health care facility.

13. Are there any special benefits for combat veterans?

On January 28, 2008, the "National Defense Authorization Act of 2008" was signed into law. This law extends the period of eligibility for health care for veterans who served in a theater of combat operations after November 11, 1998. Under this authority, the Department of Veterans Affairs (VA) provides cost-free health care services and nursing home care for conditions possibly related to military service and enrollment in Priority Group 6 unless eligible for enrollment in a higher priority to:

  • Currently enrolled veterans and new enrollees who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits, for 5 years post discharge. Veterans discharged from active duty before January 28, 2003, who apply for enrollment on or after January 28, 2008, are eligible for the enhanced benefit until January 27, 2011.

Combat veterans, while not required to disclose their income information, may do so to determine their eligibility for a higher priority, beneficiary travel benefits and exemption of copays for care unrelated to their military service.

For those veterans who do not enroll with VA during their enhanced eligibility period, eligibility for enrollment and subsequent care is based on other factors such as a compensable service connection rating, VA pension status, catastrophic disability determination or the veteran's financial circumstances. For this reason, combat veterans are strongly encouraged to apply for enrollment within their enhanced eligibility period, even if no medical care is currently needed.

 

14. What if I Want to Cancel my Enrollment?

There are many reasons to remain with VA for your health care needs. However, the decision as to whether it is more beneficial for you to find a doctor outside VA system is yours to make.

15. What Should I Consider Before Deciding to Cancel My Enrollment?

On January 17, 2003, the Secretary of Veterans Affairs made the difficult decision to suspend enrollment of veterans applying for enrollment who are determined to be in Priority Group 8. Veterans in Priority Group 8 who enrolled prior to January 17, 2003, are not affected by the Secretary’s decision. If you cancel your enrollment and later decide to re-apply, you may not be eligible for enrollment if VA is not enrolling all priority groups.

16. How to Cancel or Decline Enrollment?

If you no longer wish to be enrolled, you need to submit a signed statement requesting disenrollment to your local VA health care facility or to:

  • VA Health Eligibility Center (742/006)
  • 2957 Clairmont Road, Suite 200
  • Atlanta, GA 30329-1647

 

17. How Do I Reapply for Enrollment?

If you wish to obtain VA health care in the future, you may reapply at any time by completing VA form 10-10EZR, “Health Benefits Renewal Form.” However, you may not be eligible for re-enrollment if VA continues to implement enrollment restrictions such as the restriction on enrolling new Priority Group 8 veterans.

You may obtain VA Form 10-10EZR by downloading the form, visiting, calling or writing any VA health care facility or veterans’ benefits office. You may also call toll-free 877-222-VETS (877-222-8387).

Disability Benefits

1. What is service connected disability compensation?

The VA compensation program provides monthly benefits if a veteran is disabled because of an injury or disease incurred in or aggravated during military service, and for certain conditions which may develop after release from active duty if you were released from active military duty with an other than dishonorable discharge. There is no time limit to apply for VA disability compensation. However, you are encouraged to apply within one year of your release from active duty as entitlement is established retroactively to the date of separation if your claim is filed within this period. The effective date of eligibility for benefits will be based upon the date of your claim if you apply beyond the one-year period. A claim for compensation may be established by evidence showing that an injury or illness arose or became worse during service and that the veteran currently suffers from that difficulty.

2. How is the amount of disability compensation determined?

The amount of compensation paid depends on how severe the medical problem is. Severity can vary from 10 percent to 100 percent disability. Benefits range up to a certain amount each month, with additional payments for certain severe disabilities. The rate of compensation may change as the severity of injury or illness changes. If you have dependents, an additional allowance may be added id your disability is over 30%. An allowance for clothing or transportation is available if certain requirements are met.

3. I receive military retired pay. Should I file for disability compensation and will my retire pay be affected?

It is important to file a claim if you are disabled because of an injury or disease incurred in or aggravated during your military service. Service connected disabled veterans are afforded some benefits not offered to military retirees. By law, the payment of VA compensation benefits is affected by the receipt of military retired pay. If you receive military retirement, you may initiate a waiver of your retired pay to receive the full amount of VA compensation. Until the waiver takes effect, your compensation will be adjusted or withheld depending on the amount of military retired pay you are entitled to.

The advantage of waiving military retired pay for VA compensation is that VA benefits are not taxable. As of 2004, this law changed so that qualified disabled military retirees will now get paid both their full military retirement pay and their VA compensation. This law phases out (over 9 years) the VA Disability Offset, which means that military retirees with 20 years or more of service and a 50% or higher VA rated disability will no longer have their military retirement pay reduced by the amount of their VA compensation. Under this program, full restoration will occur in 2014.

4. I received disability severance pay when I left the military. Will this affect my VA compensation?

Law prohibits payment of VA compensation and military disability severance pay for the same medical condition or disability. VA compensation will be withheld on a monthly basis until the total amount of military severance pay has been recovered. Special Separation Benefit (SSB) - VA compensation will be withheld in full until the amount of the SSB has been recovered.

5. I plan to join the Selected Reserve or the National Guard when I leave active duty. Can I file a claim for service connected disability?

Yes. You may file a claim if you are disabled because of an injury or disease incurred in or aggravated during your military service. Of course if your condition is severe, you may not meet the requirements of the Guard or Reserves. If you are an active member of the Selected Reserve or National Guard, your VA compensation will be withheld at the rate of one day of pay for each drill period served. Also, VA compensation is not payable while serving full-time on active duty.

6. How do I file a claim for service connected disability?

The VA claims process can be very confusing and frustrating. We suggest you contact a veteran service organization or County Director of Veterans' Affairs for professional assistance and representation.

7. What supporting evidence and/or documents should I take with me when I visit my representative?

The following supporting evidence and/or documents should be submitted with your application:

  • Service Medical Records - Those applicants who have their service medical records are encouraged to submit them with their application to expedite processing. Otherwise, VA will contact the service department to obtain them.
  • Other Medical Records - Medical records to substantiate any and all treatment by private doctors and hospitals.
  • Dependency Documents - Original or copies of birth and marriage certificates and copies of divorce/death record terminating all of your prior marriages and those of your spouse.
  • Military Discharge/DD Form 214 - (Copy 4 - Member Copy) Those applicants who have a copy of their DD-214 are encouraged to provide a copy with their claim to expedite processing. Otherwise, VA will attempt to obtain verification from the service department.

General FAQS

1. Who is eligible for Veteran Benefits??

People who fall under old GI Bills as well as new GI Bills, and those who fall under Veterans Educational Assistance Program (VEAP) are eligible for receiving veteran benefits.

2. What documents do I require to receive veteran benefits?

 

  • Discharge A (WDAGO or DD214).
  • Marriage certificate
  • Death certificate (For immediate family member of veteran receiving benefits on behalf of the late veteran)
  • Divorce Decree
  • Veteran and widow’s Social Security Number
  • Details of previous marriages
  • Current monthly income
  • Financial Institution information

 

3. What do I do if I do not have my DD 214?

Request for a copy of the form from Military Service records from this website -
http://www.archives.gov/veterans/military-service-records/

You need to provide information about your service to the military. For instance, the date you joined the military, home address at the time you joined, your social security number etc. to get the discharge form.

4. What do I do if I do not have my SSN card?

You need to request for a replacement card from social security number office website –
http://www.ssa.gov/online/ss-5.html

Fill the SS–5 form. Again you are required to provide several documents like passport, license, military records school identity cards etc.

5. Where will I get a copy of my birth certificate, marriage certificate, death certificate, if I do not have one?

You will have to go to the following website an order to get those certificates. Generally you can get your certificate within 2-3 working days. http://www.usbirthcertificate.net/site/othercert.html

6. How do I apply for veteran benefits?

You could go to one of the following four veteran affairs offices –

  • Hanover Red Cross Red Lion Senior Center
  • York Veteran Affairs Outpatient Clinic
  • York County Department of Veteran Affairs

And fill the form manually. You could also go online and fill a form, print it sign it and give it at one of the offices mentioned above.

7. What is a Presidential Memorial Certificate?

A Presidential Memorial Certificate (PMC) is an engraved paper certificate, signed by the current President, to honor the memory of honorably discharged deceased veterans. This program was initiated in March 1962 by President John F. Kennedy and has been continued by all subsequent Presidents. Statutory authority for the program is Section 112, Title 38, of the United States Code. The U.S. Department of Veterans Affairs (VA) administers the PMC program by preparing the certificates that bear the President’s signature expressing the country’s grateful recognition of the veteran’s service in the United States Armed Forces. Eligible recipients include the deceased veteran’s next of kin and loved ones. More than one certificate may be provided. Eligible recipients, or someone acting on their behalf, may apply for a PMC in person at any VA regional office or by U.S. mail only. Requests cannot be sent via email. There is no form to use when requesting a PMC. Include a return mailing address with your request and a copy of the veteran’s discharge documents. Please send your PMC request to:

  • U.S. Department of Veterans Affairs National Cemetery Administration (403A)
    810 Vermont Ave.
    NW Washington, DC 20420

 

8. If my service-connected condition becomes worse, will the VA automatically increase my rating?

No. You must reopen your claim if your condition has worsened. The best way to do this is to contact a veteran service organization or your County Director of Veterans' Affairs. To request an increase in your percent of disability file a VA Form 21-4138 "Statement in Support of Claim." You may also use a blank sheet of paper to provide the pertinent information. The first paragraph should read "I am requesting reevaluation of my service-connected disability".

You need not submit conclusive evidence that a compensable condition has increased in severity. To persuade the VA to authorize a VA examination to assess the severity of the condition, you need only to submit evidence that leads the VA to conclude there is the "reasonable probability of a valid claim". The VA may accept a private medical statement, a lay statement, and even your own statement that the service-connected disability has increased in severity. Even a sketchy medical statement that you are being treated for the service-connected condition will almost always result in a VA examination.

9. Over the past several years, my service-connected conditions have gotten so severe; I can no longer make a living wage. Should I inform the VA?

Yes, there is a benefit called individual employability (IU). IU exists as a concept to cover the situation in which a service-connected disability makes the veteran unemployable, even though an average person with a similar impairment could secure and retain substantial gainful employment. Since the rating schedule focuses on the average person, the concept of IU is necessary to take into account circumstances such as education and past employment history that are peculiar to the claimant and to implement "the established policy of the Department of Veterans' Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled." If IU is granted your total rating will be 100%. Basically, you must be currently rated 70% disabled overall or 60% for a single issue to be eligible for this benefit.

10. What is VA pension?

Permanently and totally disabled veterans with low income may qualify for a non-service connected disability pension if they served at least 90 days on active duty with one day during a period of war. The amount paid by the VA's Improved Pension Program varies depending on whether a veteran has dependents; and/or has other sources of income, including other retirement or Social Security income. Unreimbursed medical and health insurance expenses may reduce countable income.

11. I asked about this pension a few years ago. I was told my income was too high. Now I need the assistance of others to care for me. Is there any help available?

These are two separate types of VA allowances that can be added to non-service related pensions. To qualify, veterans must be permanently housebound because of health reasons or need assistance with care from another person (Aid and Attendance). These allowances are intended to keep the veteran as independent as possible in a community setting. They are available to veterans who live at home or in a licensed long-term care setting (e.g., a personal care or assisted living facility, an adult foster care home or a nursing home).

Burial Benefits

1. I am a veteran. Will the Department of Veterans Affairs pay for my funeral services?

VA does not provide any payment for funeral services, but does provide the following:

  • VA Cash Benefits For Reimbursement of Burial Expenses - $300 is available for an honorably discharged veteran, IF: they were receiving a pension or disability benefits from the VA at the time of death; or the death occurred in a VA hospital, or VA contracted health care facility.
  • Active Duty or Service Connected Death - $2,000 is available IF: the veteran died during active duty; or an honorably discharged veteran died of a service-connected injury.
  • Burial Plot Allowance - $300 is available for an honorably discharged veteran not interred in a cemetery that is under the jurisdiction of the US government, IF: the veteran was receiving a pension or disability benefits from the VA at the time of death; the death occurred in a VA hospital, or VA contracted health care facility.
  • Transportation Allowance - Transportation allowance will be reimbursed by the VA for transportation expenses from the place of death to the funeral home and to the cemetery for a veteran who died in a VA hospital, or VA contracted health care facility.
  • US flag - An honorably discharged veteran is entitled to a US flag provided by the Veterans Administration. The American flag is used to drape casket of veteran, after which it may be given to next of kin, close friend or associate of the deceased.
  • Headstone or Marker - A headstone or grave marker is provided without charge and shipped at Government expense to the consignee designated to mark the burial site of eligible veterans. The cost of placing the marker in a private cemetery must be borne by the applicant. Applicants are cautioned to ensure the correctness of all information. In a National Cemetery, a veteran, spouse and dependent children receive a free headstone. We suggest that if burial will be in a private cemetery and a Government headstone or marker will be requested for the veteran’s grave, that the family complete VA Form 40-1330, Application for Standard Government Headstone or Marker in advance and place it with the veterans military discharge papers for use at the time of need.
  • Burial in a National Cemetery - Burial is available at all VA national cemeteries to any deceased veteran of wartime or peacetime service (other than for training) who was discharged under conditions other than dishonorable. Members of the Reserve and the Army and Air National Guard who die while performing or as a result of performing active duty for training may also be eligible. A deceased veteran who had entered active duty as an enlisted person after September 7, 1980. Also, any deceased veteran who has entered active duty after October 16, 1981. Said veteran must have had minimum active duty of 24 months, or the period for which he/she was called to active duty, or have had a hardship discharge, or a service-connected disability. Burial is also available to an eligible veteran's spouse minor child(ren) and, under certain conditions, to unmarried adult children. Headstones and markers are provided for the gravesites of those interred in national cemeteries. No application is required. Gravesites in (VA) national cemeteries cannot be reserved in advance. Families are encouraged to prepare in advance by discussing cemetery options, collecting the veteran’s military information including discharge papers, and by contacting the cemetery where burial is desired.

2. What if I want burial at sea?

The Department of Veterans Affairs National Cemetery Administration cannot provide burial at sea. You should contact the U.S. Department of the Navy for information.

U.S. Department of the Navy Bureau of Medicine and Surgery Naval Office of Medical/Dental Affairs (MEDDEN AFFAIRS) Mortuary Affairs
Building 38H
Great Lakes, Illinois 60085-5200
1-800-876-1131, ext. 629

3. How can I find out the status of a headstone order?

The Applicant Assistance Line is available from 8:00 a.m. to 5:00 p.m. EST to check the status of a Government headstone or marker order for placement in a private cemetery.

Applicant Assistance Line: 1-800-697-6947