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VA Simplifies Access to Health Care and Benefits for
Veterans with PTSD
WASHINGTON – Secretary of Veterans Affairs Eric K. Shinseki announced a
critical step forward in providing an easier process for Veterans seeking
health care and disability compensation for Post-Traumatic Stress Disorder (PTSD),
with the publication of a final regulation in the Federal Register.
“This nation has a solemn obligation to the men and women who have honorably
served this country and suffer from the often devastating emotional wounds
of war,” said Secretary of Veterans Affairs Eric K. Shinseki. “This final
regulation goes a long way to ensure that Veterans receive the benefits and
services they need.”
By publishing a final regulation today in the Federal Register to simplify
the process for a Veteran to claim service connection for PTSD, VA reduces
the evidence needed if the trauma claimed by a Veteran is related to fear of
hostile military or terrorist activity and is consistent with the places,
types, and circumstances of the Veteran’s service.
This science-based regulation relies on evidence that concluded that a
Veteran’s deployment to a war zone is linked to an increased risk of PTSD.
Under the new rule, VA would not require corroboration of a stressor related
to fear of hostile military or terrorist activity if a VA doctor confirms
that the stressful experience recalled by a Veteran adequately supports a
diagnosis of PTSD and the Veteran's symptoms are related to the claimed
stressor.
Previously, claims adjudicators were required to corroborate that a
non-combat Veteran actually experienced a stressor related to hostile
military activity. This final rule simplifies the development that is
required for these cases. VA expects this rulemaking to decrease the time it
takes VA to decide access to care and claims falling under the revised
criteria. More than 400,000 Veterans currently receiving compensation
benefits are service connected for PTSD. Combined with VA’s shorter claims
form, VA’s new streamlined, science-based regulation allows for faster and
more accurate decisions that also expedite access to medical care and other
benefits for Veterans.
PTSD is a medically recognized anxiety disorder that can develop from seeing
or experiencing an event that involves actual or threatened death or serious
injury to which a person responds with intense fear, helplessness or horror,
and is not uncommon among war Veterans. Disability compensation is a
tax-free benefit paid to a Veteran for disabilities that are a result of --
or made worse by -- injuries or diseases associated with active service.
To get benefits under the new policy, a
veteran with post-traumatic stress disorder must do four things to get
benefits:
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Be diagnosed by the Veterans Affairs
Department. The PTSD diagnosis must come from a psychiatrist or
psychologist either on VA’s staff or under contract with VA. Diagnosis
by a private doctor or by a military doctor is not enough.
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Indicate on their disability benefits
claim that their PTSD is related to a fear of hostile military or
terrorist activity because they experienced, witnessed or were
confronted with an event, injury or threat from an actual or potential
incident that involved being under attack.
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Indicate that their response to the real
or threatened event was a state of “fear, helplessness or horror.”
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Ensure the claimed event or threat is
consistent with places and circumstances of military service.
For
information on any veteran benefit, contact your County Veterans Service Officer whose phone number is in the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
Non-Service Connected Disability
Pension/Death Pension
Non-service connected (NSC) pensions are available to certain veterans who
are no longer able to work due to disability or age. These pensions are
intended to keep qualified veterans from living below the poverty level, and
as such are “needs-based” and not entitlements.
To qualify for an NSC pension, veterans must have been on active duty
during a recognized wartime period. It doesn’t matter where they actually
served (i.e. overseas or stateside), but they must have served at least one
(1) day during a wartime period. Veterans with service prior to 9/8/1980
are required to have served at least 90 days on active duty; veterans who
served after that date may have longer active duty requirements. Veterans
dishonorably discharged are not eligible for this benefit.
This benefit is only available to wartime veterans who are low income and no
longer able to work due to a permanent and total disability, or to those who
are over age 65. As a needs-based benefit, the pension availability is
based on family income and net worth, as adjusted by unreimbursed medical
expenses. If net worth and income are below a specified level, the veteran
may be eligible for a monthly tax-free stipend. If income or net worth is
above that level, the veteran is not eligible for the benefit. Benefit
levels also depend and vary according to family size and level of medical
care required by the veteran.
While this benefit is for wartime veterans, it also extends to the widows
and widowers of those veterans. Any low-income survivor of a wartime
veteran should apply for the benefit, including (and especially) those in
nursing homes.
For
information on any veteran benefit, contact your County Veterans Service Officer whose phone number is in the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
Service Connected Disability Claims
Veteran Affairs (VA) service-connected disabilities are those disabilities
(mental or physical) that were incurred or aggravated during active military
service, to include National Guard and Reserve service. Veterans who have
health problems today that started during their military service or
immediately after, may be entitled to benefits ranging from actual monthly
monetary compensation to guaranteed VA health care, vocational
rehabilitation and, in some cases, health insurance and education benefit
for their dependents.
Claims for
service-connected disability must satisfy three requirements: documentation
that a disability was incurred while on active duty, or that a pre-existing
disability worsened due to active duty service, medical proof of a current
disability, and a medical opinion or “nexus” that the current condition is
related to the in-service occurrence.
Disability
levels and their corresponding compensations are referred to in terms of
percentages, ranging from “0%” all the way up to 100% disabled.
Compensation starts at the 10% level and ranges from $123.00 per month to
$2673.00 or more, and it is a completely tax-free benefit. Additional
allowances are payable to those veterans rated 30% or higher that have
dependents.
Many veterans
often fail to file claims for disability either because they are not aware
that they can, or because they don’t think their disability would apply.
Disabilities need not be combat or even work related; they can be the result
of playing ball, falling out of bed, or car accidents on leave. Any veteran
with a current health problem that they believe started on or as a result of
their active duty should consider filing a claim with VA.
For those
veterans already receiving VA disability for service-connected conditions,
be aware that disabilities seldom improve over time; they normally worsen.
If a veteran who is service connected for a disability feels that their
disability has gotten worse, they should apply to VA for a reevaluation of
their disability level.
Veterans who
think they might have a disability caused by their service, or who feel that
their already service-connected disability has worsened, are strongly
encouraged to contact their County Veterans Service Officer (CVSO) to
inquire about this important benefit. The CVSO will be able to more fully
explain the claims process, and will complete all the necessary paperwork
for submission to Veteran Affairs.
For
information on any veteran benefit, contact your County Veterans Service Officer whose phone number is in the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
Wisconsin G.I. Bill/Post 9/11 G.I. Bill
(Chapter 33) WI CVSO Assoc. Position
The Wisconsin G.I. Bill is a state education benefit
for veterans, which was enacted in 2005 by the Wisconsin Legislature. The
benefit is available to veterans who joined the service from Wisconsin, and
who wished to obtain higher education following completion of their active
duty. It waives tuition and some fees for those veterans who attend
University of Wisconsin or Wisconsin Technical College system schools.
There is no delimiting date in the use of this benefit, and no restrictions
regarding level of education. Maximum benefit is 128 credits or 8
semesters of training, whichever is longer. Veterans were also able to use
this benefit in conjunction with the federal G.I. Bill.
The arrival of
the new federal G.I. Bill, known as Chapter 33 or the Post 9/11 G.I. Bill,
prompted a modification of the Wisconsin G.I. Bill as part of the 2009-2011
biennial budget bill. Under Chapter 33, the federal government pays all or
part of the tuition and fees for the veteran directly to the school, for
those veterans with active duty after 9/11/2001. This allowed the schools
to capture federal dollars for veterans attending their schools. Changes to
the Wisconsin G.I. Bill (Wisconsin Act 35) included a requirement that
veterans must use Chapter 33 if eligible, and a provision to protect the
veteran who might lose money by doing so if forced to change from another
entitlement to Chapter 33 (supplemental payment provision). A portion of
these modifications was interpreted by the education institutions as
requiring a month for month use of entitlement between Chapter 33 and the
Wisconsin G.I. Bill. Veterans eligible for Chapter 33 attending higher
education in Wisconsin would be charged a credit of Wisconsin G.I. Bill
entitlement for every Chapter 33 credit used, whether they were enrolled for
Wisconsin G.I. Bill or not. This interpretation of the change was not for
the benefit of our veterans, nor was it in their best interests.
If this
interpretation of the law in fact does require a credit for credit offset,
then this change effectively negates the value of the benefit in terms of
unlimited use and delimiting date. Veterans will in most cases be limited
to undergraduate degrees. There will be no more ability to use the benefit
for advanced degrees. In border areas, veterans would garner a greater
benefit by seeking undergraduate education out of state to avoid the loss of
credit hours, and many of these may choose not to return for employment
purposes. This is not consistent with the original intent of the Wisconsin
G.I. The current interpretation effectively eliminates most if not all of
the benefit that was originally intended to provide the active duty veterans
of Wisconsin with a reason to return to Wisconsin post-active duty.
The change
which allowed federal payment of tuition to state institutions under the new
Chapter 33 should have been sufficient to offset a significant portion of
the “lost revenue” reported by the schools without further interpretation.
The County
Veterans Service Officer’s Association of Wisconsin seeks assistance from
the Wisconsin Department of Veterans Affairs, Board of Veterans Affairs and
all Veterans Service Organizations with the State of Wisconsin in obtaining
either a more favorable interpretation of the law, or a change to the law
itself, which would be in the best interests of our state’s veterans.
For
information on any veteran benefit, contact your County Veterans Service Officer whose phone number is in the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
UNIQUE BENEFITS FOR VIETNAM VETERANS
Ailments ADDED - Parkinson’s Disease, Two Other Illnesses Recognized
Relying on an
independent study by the Institute of Medicine (IOM), Secretary of Veterans
Affairs Eric K. Shinseki decided to establish a service-connection for
Vietnam Veterans with three specific illnesses based on the latest evidence
of an association with the herbicides referred to Agent Orange.
The illnesses
affected by the recent decision are B cell leukemias, such as hairy cell
leukemia; Parkinson’s disease; and ischemic heart disease.
Used in
Vietnam to defoliate trees and remove
concealment for the enemy, Agent Orange left a legacy of suffering and
disability that continues to the present. Between January 1965 and April
1970, an estimated 2.6 million military personnel who served in
Vietnam were potentially exposed to sprayed
Agent Orange.
In practical terms,
Veterans who served in
Vietnam during the war and who have a
“presumed” illness don’t have to prove an association between their
illnesses and their military service. This “presumption” simplifies and
speeds up the application process for benefits.
Current law dictates
that three conditions must manifest within one year of leaving Vietnam in
order to be considered as related to Agent Orange exposure: chloracne,
porphyria cutanea tarda
acute or subacute peripheral neuropathy
Other illnesses
previously recognized under VA’s “presumption” rule as being caused by
exposure to herbicides during the Vietnam War are:
·Acute
and Subacute Transient Peripheral Neuropathy
·Chloracne
·Chronic
Lymphocytic Leukemia
·Diabetes
Mellitus (Type 2)
·Hodgkin’s
Disease
·Multiple
Myeloma
·Non-Hodgkin’s
Lymphoma
·Porphyria
Cutanea Tarda
· Prostate
Cancer
·Respiratory
Cancers,
and
·Soft
Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposi’s sarcoma,
or Mesothelioma)
Additional
information about Agent Orange and VA’s services and programs for Veterans
exposed to the chemical are available at
www.publichealth.va.gov/exposures/agentorange.
Presumptive service
connection means that compensation is automatically granted without having
to prove exposure, the extent of the exposure or that the illness is
absolutely caused by that exposure. V.A. payments are also made to the
surviving spouse and dependent children of the veteran if one of these
illnesses contributed to the cause of death.
In addition to
compensation payments, the V.A. provides free medical care for Vietnam
veterans who have illnesses presumed to be related to Agent Orange. They
also offer a special protocol physical exam on a one-time basis to those who
served in Vietnam whether or not they have any current health concerns.
Children of any Vietnam
veteran born with spina bifida (other than spina bifids occulta) are
eligible for monthly allowances, health care and education benefits.
Children of female Vietnam veterans both with certain other birth defects
are also eligible for these benefits.
A newsletter called the
AGENT ORANGE REVIEW is mailed to all Vietnam veterans upon request. Call
1-800-749-8387 to subscribe. All issues and additional information is also
available at a V.A. website:
http://www.va.gov/agentorange/
Many of you reading
this article may not have served in Vietnam, but you know someone who did.
Please make this information available to them so that as many Vietnam
veterans as possible receive this vital information. County Veterans
Service Officers (CVSO) are able to assist all veterans with their
disability claims, requests for medical care, etc.
You can locate your CVSO
under the county government listings in your local phone directory or the
website of the County Veterans Service Officers Association of Wisconsin at
www.wicvso.org
Vietnam Veterans - Enroll in
VA Healthcare Before the Rules Change!
As most of you may know, enrollment in the VA
Healthcare system has undergone a number of changes since 1998, not always
in the best interest of veterans as a whole.
In 1998, the VA “threw open the doors” to any
veteran who wanted to enroll in the healthcare system. This resulted in
“waiting lists” that often exceeded one year, just to get assigned to a
primary care physician. The VA’s response was the current system of “means
testing” veterans who apply to enroll. This means testing, which started in
January of 2003, is indexed by the county of residence of the veteran.
There is some talk that these caps may be increased in the coming year(s) to
allow more Priority Group 8 veterans to enroll. We’ll have to wait and see
on that issue.
One fact, that was not very widely
publicized, was that veterans with service in-country in Vietnam we eligible
based solely on their service in Vietnam, no matter their incomes or lack of
a service connected disability. The act that authorized this enrollment
technically expired in 2002, however, most VA facilities have continued to
enroll Vietnam veterans anyway.
There is some talk, refuted by some in the VA
Healthcare System, that the VA Central Office has been asked by some VA
Healthcare networks to suspend any further enrollment of Vietnam veterans,
if they do not meet the means test criteria, or have a service connected
disability.
As veterans advocates, we encourage ALL
veterans of Vietnam (remember, you MUST have served in-country in Vietnam)
to enroll in the VA Healthcare system NOW!
The VA has a habit of changing the rules, but
one thing they have been consistent about, is when they change the rules,
they “Grandfather” all of those who got in under the old rules, to remain in
the system. Hence, if you are eligible to enroll now, do so, before they
change the rules again!
For information on any veteran
benefit, contact your County Veterans Service Officer whose phone number is in
the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
Non-Service Connected Pension
and Aid and Attendance Benefit Alert
There are companies that are distributing misleading
information to places such as Assisted Living facilities and Nursing Homes
soliciting to assist veterans in obtaining Veterans Administration (VA)
benefits for a fee. The fee can vary from around four hundred dollars ($400)
to seven hundred dollars ($700) or more. This is a huge disservice to our
veterans and barely within the law.
Each county in Wisconsin has a County Veterans Service Officer (CVSO).
The job of the CVSO is to assist military veterans to apply for benefits
from the Veterans Administration (VA).
The assistance provided by the local CVSO is without cost to the veteran or
the veteran's family, guardian, POA, or other persons representing
the veteran's interests.
There are several different companies around the country participating in
this type of activity. As an example, two companies currently known to be
sending misleading information are: Kneifel and Associates in Avoca, WI and
Alliant Associates, LLC based in Kearney Nebraska, with affiliations in
Madison, WI.
The companies remain marginally within the law by taking advantage of a
loophole that does not allow them to charge the veteran directly but does
allow them to charge what is referred to as "Disinterested Third Parties",
such as family members, guardians, POAs or other persons representing the
veteran's interests.
Once these companies have contact with the veteran or persons representing
the interests of the veteran, they are leading them to believe that they can
work more effectively in the veteran's behalf by getting the VA claims
through the system faster and with a higher rate of success than the local
CVSO. They are also intimating that they will give more hands on assistance.
However, no matter who files the VA claim or how quickly the claim is
submitted, once it reaches the VA it is subject to VA's processing time
frame, current back logs, etc.
CVSOs are trained and accredited to assist veterans with all aspects of
State and Federal VA benefits. In addition, they receive many hours of
continuing education each year to maintain the ability to assist veterans
with a high degree of efficiency, accuracy and success.
Veterans should never have to pay to apply for VA benefits to which they may
be entitled.
Nursing Homes, Community Based Residential Facilities (CBRF's) and other
service related providers, as well as the general public can help to keep
veterans from being taken advantage of by these unscrupulous companies and
do them a great service in the future by referring veterans, their families,
guardians, POAs or other persons representing the interests of the veteran
to the County Veterans Service Officer (CVSO) in their county. In that way,
veterans will receive accurate and efficient hands on service that does not
come with a fee.
For information on any veteran
benefit, contact your County Veterans Service Officer whose phone number is in
the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
WISCONSIN G.I. BILL
The Wisconsin G.I. Bill is a State
of Wisconsin education program that is separate from and not to be confused
with the Federal Montgomery G.I. Bill program.
The
Wisconsin G.I Bill provides a full waiver (remission) of tuition and fees
for eligible veterans and their dependents for up to eight full-time
semesters or 128 credits at any University of Wisconsin system (UW) or
Wisconsin Technical College System (WTCS) School.
There are
no income limits or ending periods following military service during which
the benefit must be used. In addition, there are currently no limits on the
level of study. The benefit may be used for under graduate as well as
graduate level studies.
WHO
IS ELIGIBLE?
Veterans: Wisconsin veterans who
entered active military duty as a Wisconsin resident and reside in Wisconsin
at the time of enrollment.
Dependents: Spouses, surviving
spouses (who have not remarried) of deceased veterans and children of
Wisconsin veterans who have a 30% or higher service connected disability
rating with the VA. Dependents must also be Wisconsin residents to
qualify.
Spouses/surviving spouses eligibility is limited to 10 years after the
youngest child attains the age of 18.
The spouse
or surviving spouse may attend school full-time or part-time.
Children of
the eligible veteran must be between the ages of 17 and 26 years old. The
child may attend part-time or full-time.
All
eligibility determinations are made by the Wisconsin Department of Veterans
Affairs (WDVA).
In addition
to the Wisconsin G.I. Bill, you may be eligible for other benefits.
The best
way to find out what benefits you are eligible for is to contact your County
Veterans Service Officer (CVSO).
For information on any veteran
benefit, contact your County Veterans Service Officer whose phone number is in
the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
Individual Unemployability
Benefit (IU)
There is a
benefit administered by the U.S. Department of Veterans Affairs (VA) that is
payable under certain conditions when a veteran has one or more service
connected disabilities rated less than 100% that interfere with his or her
ability to secure or retain employment. This benefit is known as Individual
Unemployability (I.U.), also referred to as Total Disability Based on
Individual Unemployability (T.D.I.U.). I.U. or T.D.I.U. must be established
on a factual basis.
I.U.
establishes entitlement to compensation at the 100% disability rate even
though a veteran’s combined disabilities are less than a scheduler 100%
rating.
To apply
for I.U. benefits VA form 21-8940, Application for Increased Compensation
Based on Unemployability, must be submitted to the VA with current medical
evidence on the extent of the service connected disabilities. Veterans who
may qualify, should contact their local County
Veterans
Service Officer (CVSO) to begin the process.
When an
application for I.U. benefits is received by the VA, VA must first decide
whether the veteran meets the requirements for a scheduler 100% rating
before considering I.U.
The
scheduler requirements for I.U. benefits are provided in the Code of Federal
Regulations (38 CFR 4.16), which states in essence, that total disability
ratings for compensation may be assigned when there is one disability rated
at 60% or more, or two or more disabilities combined at 70% or more, with at
least one of the combined disabilities rated at least 40%.
In
addition, for the purpose of one 60% disability, or one 40% disability in
the case of combined disabilities, the following will be considered one
disability:
1)
Disabilities of one or both upper or lower extremities, including the
bilateral factor if applicable.
2)
Disabilities resulting from common etiology or a single accident
3)
Disabilities affecting a single body system, such as, orthopedic,
digestive, respiratory, cardiovascular-renal, neuropsychiatric
4)
Multiple injuries incurred in action
5)
Multiple disabilities incurred as a Prisoner of War (POW)
When
considering I.U., the VA looks at the following evidence:
1)
Current degree of service connected disability
2)
Employment status
3)
Results of VA examination(s)
4)
Hospital reports and/or outpatient treatment records
5)
Current physical and mental status
6)
Nature of employment
7)
Reason employment was terminated
8)
Whether disabilities meet scheduler consideration (38 CFR 4.16)
9)
Whether Extra Scheduler consideration is warranted (38 CFR
3.321(b)(1)
In
addition, VA will take in to consideration the veteran’s previous type of
occupation (such as physical or non physical) and his or her level of formal
education.
Factors that may not be
taken in to account when considering I.U. are:
1) Age
2) Non
service connected (NSC) disabilities
3) Injuries
occurring after military service
4)
Availability of work
5) Voluntary
withdrawal from the labor market
In certain
situations where a veteran does not meet the percentage standards under 38
CFR 4.16 for scheduler consideration of I.U but the evidence supports that
the veteran is unemployable due to his or her service connected conditions,
VA rating boards may submit to the Director of Compensation and Pension
Service for an Extra Scheduler consideration.
When
deciding Extra Scheduler consideration, the following evidence is taken into
account:
1) A clear
statement of the facts including medical and lay evidence of symptoms
2) Relevant
laws and regulations
3) A
statement of the issues to be resolved and recommended evaluation
Once an
I.U. rating is granted, VA will pay service connected compensation at the
100% rate.
Receipt of
I.U. benefits does not mean that a veteran is never allowed to work again;
however, if a veteran receiving I.U. benefits obtains substantially gainful
employment, I.U. benefits can be terminated.
VA’s
definition of substantial gainful employment is basically any amount earned
above the annual poverty limit for one person set by the U.S. Census
Bureau. In 2007 the poverty limit for one person was $10,210.
Amounts
earned below the Census Bureau annual poverty limit are considered marginal
employment and do not affect receipt of I.U. benefits.
Each year
after the U.S. Census Bureau sets the new poverty limit, VA publishes notice
in the Federal Register.
For
information on the U.S. Census Bureau poverty limit go to the following
website:
http://www.census.gov.
Veterans
receiving I.U. benefits are required to complete a VA form 21-4140,
Employment Questionnaire, each year to maintain entitlement to the benefit.
VA also does an Income Verification Match (IVM) with the Internal Revenue
Service (IRS).
VA does
not monitor changes in employability when the following conditions exist:
1) Age 69 or
older
2) Has been
rated I.U. for 20 years
3) Is
assigned a scheduler 100% rating
After
twenty continuous years, the I.U. evaluation is protected from future
reduction under 38 CFR 3.91(b).
For information on any veteran
benefit, contact your County Veterans Service Officer whose phone number is in
the blue or white pages of your phone directory or available on the website:
www.wicvso.org.
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