The VA's Disability Rule
"...(for purposes of a pension and 100% compensation)...HIV-related Illness...(is)...AIDS with recurrent opportunistic infection or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss, without remission, or few or brief remissions.
-- 38 Code of Federal Regulations, Part 4, Subpart B, Section 4.88a, # 6351.
Many fans of movie musicals can recall Joan Blondell belting out "Remember My Forgotten Man" against a moving tableau of World War I doughboys in Busby Berkeley's "Goldiggers of 1933." In one of Hollywood's rare early forays into social issues, the song-and-dance number called for better treatment of the veterans who had just been spurned by President Hoover, the lame-duck GOP Congress, and even future World War II hero, General Douglas MacArthur. (MacArthur has used tanks to disperse crowds of peaceably demonstrating veterans in Washington the previous year.)
But in 1997, more than 60 years later, Blondell's torchy lament still rings true: most veterans aren't aware of benefits available to them -- especially disabled veterans like people with AIDS. Veterans (and the benefits due them) remain "forgotten." In an effort to remember them, here's a brief survey of income and health coverage programs for veterans of active duty with general or honorable discharges.
VA Disability Pension
Veterans who have served at least 90 days, active duty, including at least one day during "wartime" (even if they never actually entered the war zone), can receive pensions for non-service-connected disabilities; that is, disabilities not arising from the time in service, if their incomes and assets are below certain levels. In 1997, the pension level for a single veteran without dependents is $707.17 monthly. (See accompanying charts for more details about pension income levels and for the wartime dates.)
Income and Asset Rules for VA Pensions
In spite of its name, the VA (Veterans Administration) pension is, in fact, a welfare program: those with low enough assets and income below the pension amount receive payments to bring them up to the pension level. Other income -- except welfare payments like Supplemental Security Income (SSI) or Aid To Families with Dependent Children (AFDC) -- reduces the pension payment dollar-for-dollar; and if the other income is high enough, it prevents pension eligibility at all. Allowable assets include a vehicle and a lived-in home of any value, and $30,000 in savings or investments.
Disability Standards for VA Pension
To qualify for a pension, the veteran need not show that his or her disability arose from time spent in the service. A veteran must be 100% disabled under the VA's disability schedule. VA rules are similar to, but somewhat more liberal than, Social Security's. Unlike Social Security, though, the VA will consider such purely social factors as chronic unemployability. By law, it must resolve all borderline or doubtful questions in favor of the veteran. (See the accompanying quote from the VA's disability regulations on HIV disease on page 35.)
Pensions for Surviving Spouses and Disabled Grown Children
Surviving spouses of wartime veterans can also collect VA pensions if they are poor enough. Unlike veterans themselves, they need not show that they're disabled, nor do the deceased veterans they survive have to have been disabled when they were still alive. Even grown children of wartime veterans (if they are poor enough) can receive VA pensions, although in these cases the grown child (called a "helpless adult child" in VA bureaucratic language) must satisfy VA disability standards and show that the disability arose before age 18. (See the chart below for pension levels for surviving spouses and "helpless adult children.")
Higher Pensions for Those Needing "Aid and Attendance"
Pension levels of veterans, surviving spouses, and helpless adult children are increased if the VA finds that they need "Aid and Attendance:" This broad class covers almost anyone with limited mobility (physical por mental) to meet their living needs. A similar increment is added to pensions of those whom the VA determines are "housebound." This category defines itself, but is far less widely used than the Aid and Attendance add-on. (Pensioners can not receive both at the same time.)
VA Pensions, SSI and Medicaid
VA pensions count all income to reduce (and, if the other income is high enough, to eliminate) the pension payment: wages, private pensions, Social Security Disability Insurance (SSDI) benefits, bank interest, investments income, whatever. Welfare payments (including Supplemental Security Income/SSI, Aid to Families with Dependent Children/AFDC, General Assistance, food stamps, the value of medical care Medicaid purchases for you, and housing aid) don't count as income for VA pension purposes.
But the reverse isn't true. SSI, AFDC, General Assistance, food stamps, Medicaid, and housing programs do count VA pensions (even though they are welfare-type payments) as income! Mercifully, the other need programs don't count the Aid and Attendance add-on to pensions as income, recognizing it to be a medical care-related item; but where this issue comes up, it almost always requires painstaking proof of the Aid and Attendance payment and its purpose -- to get SSI, Medicaid, and other welfare programs to exempt it.
Where someone is on SSI, Medicaid or welfare, the VA won't consider the simultaneous receipt of these benefits as overpayment (or, what's worse, fraud), but SSI, welfare, and Medicaid will! The situation is even more complex where more than one person is in a family and both VA pension and SSI and/or Medicaid are being received or applied for: in these cases, expert advise from legal aid attorneys or other experienced advocates is a must.
VA Pension's "UME" Medical Expenses Allowance
In counting income, the VA disregards (i.e., it doesn't count in determining eligibility and how much a pension payment will be) all income in the name of minor children in the family. In addition, income above five percent of the veteran's basic pension amount (i.e., not including add-ons to the pension level for Aid and Attendance or Housebound status) gets disregarded if it is to be spent on any medical care and related expenses.
These expenses could include costs not covered by one's health coverage, co-payments and deductibles, transportation to medical care, treatments and drugs considered "experimental" by other health plans, premiums for Medicare and any other health insurance, HIV-related drugs not available through the VA, ADAP or Medicaid, and even medical expenses of non-veteran family members.
For a single veteran, this means that other income over $35.36 monthly (if it is to be spent on medical care) won't be deducted from his pension amount. This feature is called the "unreimbursed medical expenses," or "UME" deduction, and is a way of shielding income meant for medical care from being counted as income in the VA pension eligibility budgeting process. To adjust one's pension to take account of income to be spent on medical care, ask the VA for Form 21-8416. (See example)
VA Medical Care Eligibility
All veterans with honorable or general discharges who have served at least 180 days, active duty, can receive care at VA medical centers. All veterens are eligible to receive medical care at veteran administratration facilites even if they aren't disabled under VA or Social Security rules and whether or not they served in a war zone or during wartime. Care available at the VA (please be certain to make a note or the fact that the VA does not pay for care at non-VA facilities except with rare exceptions) includes inpatient hospital stays, outpatient hospital services, clinic and physician services, and outpatient prescription drugs. Some, but not all, VA centers offer home health services, and in many areas there are free-standing VA outpatient clinics.
Medical Care Rules for Income, Assets and Co-Payments
Single veterans with annual incomes below $21,610 are eligible for free care (except for a $2 co-payment per prescription) after those with service-connected disabilities, former prisoners of war, and certain other priority classes are served. Allowable assets per family include a vehicle and lived in home of any value, and $50,000 in savings or investments. If a veteran has private health insurance, the VA will bill the plan for what it can, but it will not bill the veteran directly if he or she has income below this level (except for the $2 prescription co-payment). (See the accompanying chart below for details on the VA medical care eligibility levels.)
"Space Available" Care for Richer Veterans
After high priority cases like service-connected disabled veterans, former prisoners of war, and poor veterans are served, VA Medical Centers may at their option also give care to veterans who served at least 180 days, active service, with honorable or general discharges even if their incomes or assets exceed the regular eligibility levels. In these cases, co-payments are charged, but care is still far cheaper than it would be for those who would otherwise have to pay cash or do without. If these higher income veterans happen to have some private health insurance (or in rare instances, even Medicaid), the payments from the health plan to the VA for the care are counted off the amount the veteran has to pay in co-payments.
Compensation for Veterans with Service-Connected Disability
The VA pays "compensation" to veterans whose disabilities arose from their time in the service -- even if off-base, off-duty, or on leave. These service-connected disabilities could include HIV infection which a veteran proves was contracted during service, even if symptoms only showed after discharge. Military medical records, but also evidence from non-military sources, can be used to demonstrate this; it's usually a long, legalistic process. However, veterans who do demonstrate a 100% service-connected disability are entitled to lifetime, tax-free monthly payments of $1,924 (1997).
Dependents, Survivors and Their Medical Coverage
The payments go up for those dependents and include not only priority medical care, but also medical coverage for dependents and survivors in the VA's CHAMPVA medical insurance plan. The CHAMPVA medical plan is free for those who are eligible and it offers coverage similar to major medical plans of large employers (dependents and survivors of pensioners, unlike those of compensationers -- can not get CHAMPVA). Survivors of deceased service-connected disabled veterans get payments called Dependency and Indemnity Compensation (DIC). For a single surviving spouse, the monthly payment is $833 (1997). It is more in cases where the disabled veteran lived for over eight years with the disability, or if the death occurred before 1993.
Compensation and DIC are Tax-Free, Non-Welfare Benefits
Compensation and DIC benefits are tax-free and are not based on need as are pensions. One can have additional income without affecting the payment. But even though compensation and DIC are tax-free and are not welfare-type payments, need-based programs like SSI, Medicaid, welfare, ADAP and housing aid count them as income.
Life Insurance for Service-Connected Disabled Veterans
Veterans being discharged have the right to retain $200,000 life insurance policies issued under the Servicemember's Group Life Insurance (SGLI) plan by converting them into the Veterans Group Life Insurance (VGLI) through the Office of Servicemen's Group Life Insurance, 213 Washington Street, Newark, NJ 07102, within 120 days of separation. (Those totally disabled at discharge have up to one year to convert.) VGLI policies may then be converted, at any time through participating insurers, into individual whole life insurance policies suitable for acceleration or viatication.
Those found to be disabled (not necessarily at the 100% level, either) may apply for $30,000 additional Service Disabled Veterans Insurance. Unlike SGLI and VGLI, this insurance can not be converted, accelerated, or viaticated. But the rates are very, very low (for example, only about $20 monthly for a male of 35 years of age) and the first $10,000 is free for those rated 100% disabled! The SGLI office in Newark has further details.
Vocational Rehabilitation, Education and Job Placement
The VA offers vocational rehabilitation and related job training, education, and placement services to those who receive compensation for service-connected disabilities. Only those pensioners whose pensions started before December 31, 1995 are eligible for these services. Vocational rehabilitation services can include job readiness counseling, career evaluation, job placement, career training, on-the-job training and, in some instances, even college courses.
Those in a full-time program can receive benefits of nearly $400 monthly, and in addition, the VA can also cover books, fees, transportation, tutoring, and other miscellaneous costs. Generally, VA vocational rehabilitation programs must be completed within 48 months; in exceptional cases, an additional 18 months are allowed. In some instances, living allowances over and above compensation and pension levels may be authorized.
Once a veteran successfully completes a vocational rehabilitation program and is at work for one-to-twelve months, compensation and pension benefits can be ended; priority medical eligibility continues, however.
VA benefits need not be forgotten for those who inform and educate themselves about them. The benefits are there for your use. Don't let them just sit around gathering dust. In these times of dwindling HIV/AIDS funds, veterans need all the help they can get. Help yourself to the benefits to which you are entitled.
|How To Get Help With VA Benefits|
|VA Benefit Information||800-827-1000|
|VA Life Insurance Information||800-669-8477|
|VA Burial Benefits||800-697-6947|
|Persian Gulf Helpline||800-PGW-VETS|
Call the VA Benefits Information Line for the location of the VA Medical center and regional office closest to you.
Applications for VA Pensions, Compensation, and DIC are filed with VA Regional Offices; applications for medical care are made at VA Medical Centers and Clinics.
Most VA Medical Centers and Regional Offices have skilled volunteers, known as "service representatives" from the American Legion, the Veterans of Foreign Wars, AmVets and similar veterans groups to help with applications.
To get copies of your DD 214 (discharge papers) or other medical records write to the Army, Navy, Air Force, or Coast Guard Liaison Office at the National Personnel Records Center, 9700 Page Boulevard, St. Louis, MO 63132, giving full name, date of birth, dates served, service number, and social security number.
What Counts As WartimeWorld War I
World War II
Korean War (6/27/50-1/31/55)
Vietnam War (8/5/64-5/7/75)
Gulf War (9/2/90-present)
Note that the Bay of Pigs, Grenada, Lebanon, Panama, Central America, and Libya don't qualify as wartime; conversely, Bosnia, Somalia, Haiti, and Rwanda do qualify (because they're in the Gulf War period). Congress hasn't yet ended the Gulf War period.
Remember, even one day of active duty service out of an active duty total of at least 90 days, an honorable or general discharge, and a non-service-connected present disability can qualify a veteran for a pension if he or she is poor.
1997 Amounts: Needy Wartime Veterans' Pension
|Single veteran:||$707.17 monthly|
|Veteran + 1 dependent:||$219.08 more monthly|
|Each add'l dependent:||$120.42 more monthly|
|Aid & Attendance:||$423.92 more monthly|
|Housebound:||$157.25 more monthly|
|Surviving spouse:||$474 monthly|
|Surviving spouse + dependent:||$143.83 more monthly|
|Each add'l dependent:||$120.42 more monthly|
|Aid & Attendance:||$284 more monthly|
|Housebound:||$105.50 more monthly|
Family assets cannot exceed a vehicle and lived-in home of any value and $30,000 in savings and investments.
Pension and Unreimbursed Medical Expenses (UME):
Martin a disabled HIV patient with severe mobility problems, receives $943.80 in SSDI and Medicare. His wife, Audrey, who has no health insurance, earns $1,000 but needs $300 worth of anti-depressants monthly. Their son Herbie needs $200 worth of insulin and syringes per month. They spend $200 on transportation to medical care per month.
Their regular VA pension level would be $1046.67, plus a $423.92 Aid and Attendance allowance because of Martin's immobility, for a total pension level of $1470.59 applicable to this family. But the family's income is $1,943.80 (Martin's social security plus Audrey's salary) and therefore they'd be "too rich."
But under the UME rule, all income over $52.33 (that is five percent of the regular family pension level of $1046.67, not counting the $423.92 for Aid Attendance) that gets spent on medical care isn't counted in figuring the family's pension payment... Since the family is spending $743.80 on medical care, including Martin's $43.80 Medicare Part B Premium, they are allowed to deduct $691.47 ($743.80 minus $52.33) from their income of $1,943.80 before it is compared to the pension level.
This level is countable income of $1252.33. This is less than the total pension level of $1470.59 applicable to this family by $218.20. This $218.20 therefore becomes the VA Pension payment in this case - a pension payment the family wouldn't qualify for at all without disregarding the funds spent on reinbursed medical expenses (UME).
Back to the October 1997 Issue of Body Positive Magazine.
|VA Medical Care Income Levels (1997)|
|One veteran:||$21,610 per year||($1,800.83 monthly)|
|Veteran + 1 dependent:||$4,325 more||($360.42 more monthly)|
|Each add'l dependent:||$1,445 more||($120.42 more monthly)|
The only co-payment charged to these veterans is $2.00 per 30 days' supply of prescription drugs. Family assets cannot exceed a vehice and lived-in home of any value and $50,000 in savings and investments.