Post Service Officer Basics. Cindy Smith Outreach Service Officer June 2018

Transcription

1 Post Service Officer Basics Cindy Smith Outreach Service Officer June

2 Post Service Officer Basics What you should know? NVS Policy & Procedure Code of Conduct Knowledge on VA Benefits VA Forms to apply for VA Benefits Resources 2

3 NVS Policy & Procedures Post/District Service Officers Will NOT retain any Personal Identifying Information. Act as recorders to assist in transcribing information on the correct VA forms (cannot counsel or give guidance on VA claims). Are under the general supervision of Department Service Officer (DSO). Cannot make direct contact with VA. Cannot obtain status checks from DSO. All Forms are to be returned to claimant for submittal to DSO 3

4 NVS Policy & Procedures Code of Conduct Representation is Gratuitous Fraudulent Claims/false information Unlawful, unprofessional, or unethical practices (deceiving or misleading claimant) Inappropriate jokes, slurs, innuendoes Sexual advances Discrimination 4

5 A basic understanding of VA benefits is required in order to assist claimants with transcribing information on VA forms Representation Effective Dates Compensation Pension Dependents Status Dependency and Indemnity Compensation Survivors Pension 5

6 Representation: What? A Veteran can appoint a Veteran Service Organization to represent him/her before the VA. The appointment of a representative is referred to as a Power of Attorney (POA). A Veteran may have only one representative. The Veterans of Foreign Wars representation policy is that the acceptance or refusal of a Veteran s POA is determined by an accredited representative. 6

7 Representation: How? Form Used VA Form Appointment of Veterans Service Organization ONLY an accredited representative can sign a VA form Post Service Officers are NOT authorized to sign. Post Service Officers will NOT determine POA acceptance or refusal. 7

8 Effective Dates: What? Effective dates are important because they determine the start or change in payments for Veteran and survivor benefits. Effective dates are established by filing an intent to file or filing a formal claim. Exceptions are when a Veteran files within the first year of discharge or when a surviving spouse files within first year of the death of the Veteran. 8

9 Effective Dates: How? Forms Used VA Form Intent to file VA Form ez Application for Disability Compensation VA Form 21p-527ez Application for Veteran Pension VA Forms 21p-534ez Application for DIC/Pension/Accrued Benefits Intent to file (ITF) An ITF is the best option when the Veteran or survivor is unsure what he/she want to file or does not have all documents. It is NOT a formal claim but reserves the claim for one year from the date of filing. A formal claim is required to be filed. The ONLY the disabilities filed on the first formal claim will be retroactive to date of the ITF. 9

10 Effective Dates: How? ITF Formal Formal VA Form Compensation VA Form ez Back Pain Hearing loss VA Form ez Tinnitus 12/12/ /17/ /10/2018 What is the effective date for back pain? What is the effective date for tinnitus? 10

11 Disability Compensation: What? Disability Compensation is a monthly monetary benefit paid to Veterans because of a disability or disabilities that developed in military service or because of military service. Each disability is rated individually according to VA regulations. Disabilities are divided by body systems and parts of the body. Disability can be granted at a 0% or in intervals of 10% to 100%. The disabilities are combined for pay purposes. 11

12 Disability Compensation: What? Disability Veteran must prove the disability exists Nexus Disability has to have connection to service Service connection 12

13 Disability Compensation: How? There are four ways that Veterans can relate their disabilities to service: Direct Secondary Presumptive Aggravation 13

14 Disability Compensation: How? Direct An injury or illness (disease) that occurred or was diagnosed while in service or in the line of duty (LOD). Continuity and chronicity are VERY important. Examples: An active duty Veteran injured his back in service and required continuous medical care. A reservist fell and injured her hip while on drill. A LOD determination was done. A Veteran was diagnosed with essential hypertension while on active duty. 14

15 Disability Compensation: How? Secondary A secondary condition develops from a primary service connected condition. A doctor will need to connect the two in writing (nexus statement). Examples: Peripheral neuropathy (numbness in a limb) from type II diabetes. Sciatica from a back condition. Sleep apnea from trauma to face (broken nose or injury to sinus condition). 15

16 Disability Compensation: How? Presumptive An illness that has developed either within a specified length of time following active service or because of environmental exposures or unique military service. Length of time 1 year: Chronic conditions such as arthritis and hypertension 7 years: Multiple Sclerosis Exception: ALS (Lou Gehrig s disease) Environmental Exposures Agent Orange (Vietnam and areas in Korea and Thailand) Water Contamination in Camp LeJeune NC Persian Gulf Radiation Exposure Unique Military service POW or chemical testing 16

17 Disability Compensation: How? Aggravation A condition that worsens during active service by a measurable degree according to the VA regulation. Examples A reservist has controlled hypertension before mobilization and while on active duty his blood pressure readings become elevated. A Veteran had surgery in high school for her right ankle. While on active duty, the ankle began to swell and she loses some range of motion in the ankle. 17

18 Disability Compensation: How? Evidence Timeline dictates the burden of evidence for direct injuries Less than a year from discharge Greater than a year from discharge Evidence of the disability is required Treatment within the VA medical system must be reported in the claims process. Private medical records have to be provided or consent given for the VA to obtain the records. Disability Benefit Questionnaires (DBQ) are available for most disabilities. 18

19 Disability Compensation: How? Forms Used VA Form ez Application for Compensation VA Form (a) Release for private medical treatment Supporting Documents Discharge Documents/DD214 Service Medical Records (if initial and if available) Private Medical Records 19

20 Veterans Pension: What? Veterans Pension is a tax-free monetary benefit payable to lowincome wartime Veterans. There are multiple levels that effects the amount paid and medical expenses considered. Housebound. This increased monthly pension amount the if the Veteran is substantially confined to his/her immediate premises because of permanent disability Aid & Attendance (A&A). The A&A increased monthly pension amount may be added to monthly pension amount if the Veteran meets one of the following conditions: Require aid of another person in order to perform personal functions required in everyday living; bedridden; a patient in a nursing home due to mental or physical incapacity; eyesight is limited. 20

21 Veterans Pension: What? Minimum Service Requirements Veteran must have at least 90 days of active duty service, with at least one day during a wartime period. If the active duty occurred after September 7, 1980, the Veteran is required to have served at least 24 months or the period called up. Wartime Periods Mexican Border Period (May 9, 1916 April 5, 1917) World War I (April 6, 1917 November 11, 1918) World War II (December 7, 1941 December 31, 1946) Korean conflict (June 27, 1950 January 31, 1955) Vietnam era (February 28, 1961 May 7, 1975 for Veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964 May 7, 1975) Gulf War (August 2, 1990 through a future date to be set by law or Presidential Proclamation) 21

22 Veterans Pension: What? Age or Disability Requirements In addition to meeting minimum service requirements, the Veteran must be: Age 65 or older, OR Totally and permanently disabled, OR A patient in a nursing home receiving skilled nursing care, OR Receiving Social Security Disability Insurance, OR Receiving Supplemental Security Income 22

23 Veterans Pension: What? Income limits Maximum Annual Pension Rate (MAPR) Category Amount If you are a veteran... Your yearly income must be less than... Without Spouse or Child $13,166 To be deducted, medical expenses must exceed 5% of MAPR, or, $ 659 With One Dependent $17, 241 To be deducted, medical expenses must exceed 5% of MAPR, or, $ 863 Housebound Without Dependents $16,089 Housebound With One Dependent $20,166 A&A Without Dependents $21,962 A&A With One Dependent $26,036 23

24 Veterans Pension: What? Deductible Medical Expenses Unreimbursed expenses directly related to medical care, including transportation to and from medical appointments. Common allowable medical expenses Medical insurance premiums Nursing services for medical care Drugs, prescription and nonprescription Home health services Copays for medical and dental appointments Hospital expenses Medical devices such as braces, hearing aids, splints, and eye glasses. 24

25 Veteran Pension: How? Forms Used VA Form 21p-527ez Application for Pension VA Form 21p-8416 Medical Expense Report VA Form Exam for House bound/a&a Supporting Documents Military Discharge/DD214 25

26 Dependency: What? Veterans can receive additional money for dependents. Must have 30% or higher service connected disability. Dependents of Veterans are: Current spouse ONLY Children Biological, step, or adopted Under the age of 18 Ages 18 to 23 in school Helpless child-no age limit Grandchildren-Adopted only Parents of Veteran-must provide at least 50% support 26

27 Dependency: How? Forms Used VA Form c Declaration of Dependents VA Form 21P-509 Statement of Dependency of Parents Supporting Documents Marriage Certificates Divorce Decrees Proof of helpless child status (if need) 27

28 Survivor Benefits: What? Dependency and Indemnity Compensation (DIC) VA Benefit for eligible dependents of veterans who died as a result of conditions caused by military service. Survivors Pension Incomed based VA Benefit for eligible dependents of deceased veterans with wartime service (see wartime service requirement in earlier slide). 28

29 Survivor Pension: What? Income limits Maximum Annual Pension Rate (MAPR) Category Amount If you are a Surviving Spouse... Your yearly income must be less than... Without Dependent Child $8,830 To be deducted, medical expenses must exceed 5% of MAPR, or, $ 442 With One Dependent Child $11,557 To be deducted, medical expenses must exceed 5% of MAPR, or, $ 863 Housebound Without Dependents $10,792 Housebound With One Dependent $13,514 A&A Without Dependents $14,113 A&A With One Dependent $16,837 29

30 Survivors Benefit: How? Forms Required VA Form 21p-534ez Application for DIC/Pension/Accrued Benefits VA Form 21p-8416 Medical Expense Report VA Form Exam for House bound/a&a Supporting Documents Death certificate Veteran s Discharge papers/dd214 30

31 Burial Benefits: What? Burial allowance is a flat rate one time payment to cover the cost of a Veteran s burial and funeral costs. Service Connected Death Up to $2,000 if the Veteran died after 9/11/2001 Up to $1,500 if the Veteran died before 9/11/2001 Non Service Connected Death $300 burial and $762 for plot if Veteran died after 10/1/2017 $300 burial and $749 for plot if Veteran died after 10/1/2016 but before 10/1/2017 $300 burial and $747 for plot if Veteran died after 10/1/2015 but before 10/1/

32 Burial Benefits: How? Forms Required VA Form 21p-530ez Supporting Documents Death certificate Veteran s Discharge papers/dd214 (if Veteran had not filed a claim) Itemized, paid-in-full funeral bill, if claiming transportation 32

33 How to get a Military Discharge? National Personnel Records Center The best option is on line at Emergency request can be processed Form Used Standard Form 180 Fax Number Mailing address: National Personnel Records Center Military Personnel Records 1 Archives Drive St. Louis, MO

34 VA Health Care: What? VA provides a number of health care services, including: Hospital, outpatient medical, dental, pharmacy, and prosthetic services Domiciliary, nursing home, and community-based residential care Treatment related to Military Sexual Trauma (MST) Readjustment counseling Homeless Veteran programs Alcohol and drug dependency treatment Medical evaluation for disorders related to Gulf War service or environmental hazards Specialized health care for women Veterans 34

35 VA Health Care: What? Eligibility Veterans with service connected disabilities Veterans who were discharged for a disability incurred or aggravated in the line of duty, or a hardship or early out. Former Prisoner of War (POW) Purple Heart Medal recipient Medal of Honor recipient Veterans in receipt of a VA Pension Veteran who served in the Republic of Vietnam from January 9, 1962 to May 7, Veteran who served in the Persian Gulf from August 2, 1990 to November 11, Veterans who were stationed or resided at Camp Lejeune for 30 days or more between August 1, 1953 and December 31,

36 VA Health Care: What? 36

37 VA Health Care: How? By Phone Call VETS (8387) Monday - Friday between 8 a.m. and 8 p.m. ET. Online Go to By Mail The application form (10-10ez) can be downloaded from Mail the completed form to: Health Eligibility Center Enrollment Eligibility Division 2957 Clairmont Road Suite 200 Atlanta, GA In Person You can apply at any VA health care facility. 37

38 Resources Online Benefits Information ebenefits: VA Forms: General: Technical: Maryland State Benefits: Help Maryland 211: VFW Unmet Needs: 38

39 Service Program Contact Information Baltimore DCO: Mary Walters 31 Hopkins Plaza, Room 1226 Baltimore, MD Phone: Fax: Outreach Service Officer Cindy Smith mdvfwoutreach.org 39