Arizona Department
of Veterans Services
Presents:
Overview of Veterans’ Benefits
Objective
• Provide an overview of veterans benefits
• Create awareness of veterans’ need for legal
assistance….
• Allow issue-spotting and referral to highest and best
resource for assistance; and ….
• Motivate you to answer the call for assistance from
our veterans.
INTRODUCTION
• Statistics on Veterans
• VA Benefits in General
– Who Is a “Veteran”: Basic Eligibility
Requirements
– Overview of Major Disability Benefits
Programs
• Service-Connected Disability
Compensation
• Non Service Connected Pension
– VA and SSA Interplay
– Benefits for Survivors
Statistics on Veterans
• 22.5 million veterans currently alive, nearly three
of every four served during a war or an official
period of hostility.
• 556,729 in Arizona – 2.5% of US Total
• About 1/4 of the nation's population -approximately 70 million people -- are potentially
eligible for VA benefits and services because they
are veterans, family members or survivors of
veterans.
What Defines a Veteran?
Basic Eligibility Requirements
• A veteran is defined as a “person who served in
the active military, naval, or air service, and who
was discharged or released under conditions
other than dishonorable”
• Or…
Veteran Continued
– Discharged due to a disease or injury incurred
or aggravated in line of duty while on active
duty for training, or
– Guard or Reserve - only if called to serve on
regular active duty
Veteran Continued
Character of discharge is important:
• A veteran must have been discharged or released under conditions other
than dishonorable
• Military services generally have 5 types of discharges:
1. Honorable discharge (HD)
2. Under Honorable Conditions (UHC) (General discharge)
3. Under Other than Honorable Conditions (OTH)
4. Bad Conduct discharge (BCD)
5. Dishonorable discharge (DD) or Dismissal (if officer),
*For VA purposes – a veterans discharge is either honorable or
dishonorable.
•
•
•
Certain administrative discharges by the Department of Defense are
classified as “Uncharacterized”.
personality disorder – pre-existing condition
Former service members can seek a discharge upgrade from a Military
Discharge Review Board or the Board for Correction of Military Records
Veteran Continued
•
•
Wartime versus peacetime service
The following are periods of wartime designated by Congress for purposes
of VA benefits:
•
•
•
•
•
•
Spanish-American War – April 21, 1898 – July 4, 1902
Mexican Border War – May 9, 1916 – April 5, 1917
World War I – April 6, 1917 – November 1, 1918
World War II – December 7, 1941 – December 31, 1946
Korean Conflict – June 27, 1950 – January 31, 1955
Vietnam Era - August 5, 1964 (February 28, 1961 if “in-country”) –
May 7, 1975
• Persian Gulf War – August 2, 1990 – date to be determined
• NOTE: Congress has not enacted legislation that would make other
“conflicts” as wartime.
•
Pensions are available only to veterans that served with at least 90 days
with one day wartime service. From September 8, 1980, criteria is two
years.
Overview of Major Disability
Benefits Programs
•
•
Service-Connected Disability Compensation
– Disability compensation is a monetary benefit paid to veterans who are
disabled by an injury or disease that was incurred or aggravated during
active service.
NSC Pension
– Pension is a monetary benefit paid to permanently and totally disabled
(not service-connected) veterans with low incomes.
– On occasion, a veteran may be entitled to both compensation and
pension. The VA is prohibited from paying both benefits concurrently.
A veteran entitled to both must elect to receive one benefit or the other.
Service-Connected Disability
Compensation
• Service-connected disability compensation is available where
disability claimed was either incurred or aggravated in the line of
duty, not the result of willful misconduct, and the veteran’s
discharge was other than dishonorable.
• The “in line of duty” requirement is very liberal:
• Example: A soldier that injures a knee while skiing on leave in
Lake Tahoe has just as much right to disability compensation
as a soldier who incurs a knee injury jumping from a
helicopter into combat in Baghdad.
Service-Connected Disability
Compensation
•
3 Requirements:
1. Medical diagnosis of current disability
2. Evidence of in-service occurrence or
aggravation of a disease or injury
3. Link or nexus (usually medical evidence)
between the in-service occurrence or
aggravation of a disease or injury.
Service-Connected Disability
Compensation
1. medical diagnosis of current disability
• Veterans can submit VA or private medical
records
• VA has a statutory “duty to assist” to obtain
medical evidence by making “reasonable
efforts,” which include ordering an examination
by a VA physician
Continued
2. in-service occurrence or aggravation
• VA places great weight on contents of military personnel and
medical records
– Unit histories
– Deck logs
• VA is required to consider lay evidence
– Veterans own statements describing in detail circumstances of
injury or event
– Private medical records
– Buddy statements
– Newspaper articles
– Letters to family/friends
Continued
3. Evidence of Link or Nexus
• 5 ways to establish service connection:
1. Direct service connection – medical evidence
2. Aggravation – medical evidence and presumption of
soundness
3. Statutory Presumption
4. Secondary service connected
5. 38 U.S.C.1151 and Federal Tort Claims Act (FTCA)
Continued
•
Medical Evidence in General
Competent medical evidence must establish that “it is as likely as not” that
current disability resulted from disease, injury, or precipitating event during
service.
•
Competent medical evidence can come from:
– Letter or statement of VA or private physician
– Evidence in veteran’s service medical records and treatment records
– Evidence in medical textbooks, treatises or journals
•
Medical evidence not required if nexus is presumed:
– Chronic disability diagnosed in service
– Disability presumed to be service-connected is diagnosed within
presumptive period following service
Continued
– Delayed Direct Service-Connection
• An event in-service caused the veteran to suffer a disability or
disease many years later
– Hearing loss due to noise exposure
– Arthritis due to trauma
– PTSD
– Chronicity
• If veteran was diagnosed with a chronic disability while in service and
currently suffers from the same chronic disability, then the VA may
assume the connection.
– Continuity of Symptomatology
• Shown through service medical records that condition diagnosed or
manifested during service, or demonstrating by medical opinion that
in-service event caused current condition
Continued
Aggravation
– Veteran shows worsening of pre-existing condition due to
military service
• Must be more than the natural progression of a condition
– Certain disabilities cannot be service-connected if the result of,
“congenital or developmental defects” or personality disorder.
• However, veterans are presumed to be in “sound condition”
at induction to military service, unless otherwise noted in
induction examination
– Presumption of “sound condition” can be rebutted only by
“clear and unmistakable evidence”
Continued
Statutory Presumption (38 CFR 3.309)
• Congress has determined that certain disabilities and conditions are
presumed to be related to military service
– Chronic diseases: manifested within defined period of time
– Tropical Diseases: manifested within defined period of time.
(malaria, cholera, yellow fever)
– Prisoners of War: manifested at any time,
– Persian Gulf Veterans: manifestation of “undiagnosed disability,”
– Radiation-Exposed Veterans
– Disabilities due to Agent Orange Exposure
• In other words, these presumptions relieve a veteran with a
qualifying condition from the obligation to show a nexus between
service and the condition.
Continued
Secondary service-connection
– If a service-connected condition causes or aggravates
a second condition, then that second condition is
treated as service-connected
– Compensated just like original service-connected
condition
• Examples: depression as a result of physical impairment or
pain, hip condition as a result of knee condition, etc.
Continued
Section 1151 and Tort Claims
– If a disability or disease was caused by VA medical
treatment, then that disability or disease is treated as
service connected: 38 U.S.C. § 1151
– Also potential for Federal Tort Claims Act (FTCA)
• Must file administrative claim with VA prior to filing suit in U.S.
district court
– administrative claim must be filed within 2 years after claim
accrues, and U.S. district court lawsuit must be filed within
– 6 months of determination on administrative claim
Continued
•
Once a condition is found to be service-connected, a percentage of disability is
assigned for compensation purposes. The evidence of symptomatology determine
the exact percentage assigned.
•
Description of Benefit
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–
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Disabilities are rated on a percentage scale and monthly awards determined
according to assigned percentage.
Percentages range from 10% to 100%, and monthly awards range from $127 to
$2769.00 per month effective December 1, 2008 cola increase basic rates.
• CONTRAST with Social Security Administration
Veterans may be entitled to a 100% rating where veteran is unable to engage in
substantially gainful occupation – termed total disability based on individual
em ployability (TDIU or IU)
May also apply for SS disability benefits.
Veterans may be entitled to special m onthly com pensation amounts for
certain severe disabilities.
• Examples:
– Aid and Attendance
– Housebound
NSC Pension
5 Basic Eligibility Criteria
–
Veteran must be discharged under other than dishonorable
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Veteran must have served during a “w ar-tim e period ”
Veteran must have lim ited incom e and net w orth
Veteran must be perm anently and totally disabled
Disability cannot be the result of the veteran’s “w illful
m isconduct ,” I.E. Substance abuse
conditions
•
However, exceptions exist if what would ordinarily be attributable
to willful misconduct is secondary or caused by another serviceconnected disability.
Continued
• Determining the Monthly Benefit
– Veteran’s “countable income” cannot exceed
the Maximum Annual Pension Rate (MAPR)
– Amount of MAPR varies depending on
number of dependents and need for services
• December 2011 MAPR for single veteran is
$12,256.00
VA and SSA Interplay
• A veteran can receive Service-Connected
Disability Compensation and SSI concurrently –
there is NO offset
• However, a veteran cannot receive Disability
Pension and SS concurrently – there is an offset
• Practice Pointer for Low Income Clients: VA
pension rates are much more generous than SS
rates
Benefits for Survivors
•
Main Benefits Programs for Survivors:
– Dependency and Indemnity Compensation
• Service-Connected
– Paid to dependents of veterans who died on active duty or whose
deaths w ere caused by service-connected conditions
– Paid to dependents of veterans
– Death Pension
• Non-service Connected
– Needs-based pension with eligibility criteria for survivors similar to
that of the eligibility criteria for veterans disability pension –
“wartime” service and low income
– However, the MAPR for survivors is much lower than the
maximum annual pension rate (MAPR) for veterans. The MAPR
for a surviving spouse with no dependents effective December
2011 is only $8219.00
Questions