MVC Veterans Service Officers App Professionals!

Transcription

1 MVC Veterans Service Officers App Professionals! Bonnie McNeill Boyt, y, Director Missouri Veterans Commission Workforce Development Don t Know One App from Another? There are APPs (applications) for Pension Comp Hospital Vocational Rehabilitation And More! Do you know one App from another? We Do! Our Professionally Trained Accredited Veterans Service Officers are who you should turn to when you have Apps that need completion! 1

2 So Who Am I? Bonnie McNeill Boyt, 30+ yrs w/missouri Veterans Commission, a State Agency working on behalf of all Missouri Veterans and Dependents 19 yrs working with Veterans, Dependents, care providers and VA to obtain all Veterans benefits legally possible 12 yrs training Veterans Service Officers how to properly file claims with VA Currently member of Missouri Benefits Task Force, working with VA to speed up claims process Getting Through the Application Nightmare App Professionals our VSOs will need to know What is YOUR ultimate destination as a medical service provider? To provide excellent healthcare for a client Assist the client in obtaining funding to help pay for the medical services you provide AT NO COST TO ANYONE! Which path would you like to take? A path that you ve never been down before OR A path someone else has already cleared that allows you time and resources to reach your goals of providing medical care! Warnings! Picking and choosing Apps without a knowledgeable professional can cause you to: Get lost and never arrive where you wanted to go Carry more of a load than necessary Waste time and energy on things that can be done by others rather than provide what you are trained and skilled to do provide excellent medical care Become so frustrated back tracking, you never want to try again. Unintentionally hurt the Veteran/Dependent with underpayments and overpayments. 2

3 The Team Effort for a Successful App Lead Guide Me! Provide benefits information to educate care providers of possible claims for clients they are caring for Care Providers Provide and Document Proper Medical Care Recognize a possible claim for VA benefits and Refer to a Veterans Service Officer (VSO) Provide necessary medical documentation when needed to enable a VSO to send a complete claims package to VA More Team Members The Veteran or Dependent Applying for VA Benefits With the assistance of a VSO, provide information to VSO to obtain documentation and complete forms necessary to properly justify a claim for VA benefits Keep the VSO appraised of any changes in medical conditions or payment of medical services (depending on which benefit is involved) VSO Duties Our App Professionals (Veterans Service Officers) will: Interview the Veteran/Dependent in a way that uncovers any and all benefits available to this client depending on the circumstances of service and his/her current life situation and needs. Work on behalf of the client to obtain all documentation necessary including military information, dependent information, medical documentation and any other information necessary to allow VA to accurately and quickly grant VA benefits due. 3

4 VSO Duties cont. Work WITH you on behalf of the Veteran/Dependent to obtain proper medical forms pertaining to the medical services you provide to support the claim package sent by the VSO to the VA Be at the client s and the caregiver s side as we go deeper into the VA Application i Process and help you get back on track if you get lost Make sure the effort we are taking together results in the Veteran or Dependent receiving all benefits legally entitled without undue hardship on the anyone! Be there for assistance when circumstances change to avoid unnecessary overpayments and underpayments. For Best Team Results We will not try to perform duties outside our own expertise as we go through the App Process! VSOs won t change bandages, provide physical therapy or manage prescriptions to ensure proper medical care. Care Providers, Veterans and family members will NOT provide information directly to the VA on behalf of the client without going through the Service Officer who is handling the claim to ensure proper input. Prepping for the App Process Upon completion of this training you will Understand the basics of VA pension and compensation benefits so they can REFER whenever possible to a VSO Have questions asked concerning VA paperwork Understand the value of using accredited Veterans Service Officers in obtaining benefits Know how to locate an accredited VSO 4

5 As the Apps Multiply.. Recognizing a possible claim for Veterans benefits based on service connected and non service connected conditions makes YOU a wonderful referral partner on behalf of the Veteran! Helps Veterans/claimants be aware of possible benefits Successful claims provide additional funding for the Veteran/claimant to pay for needed medical services, or if care is received through VA, allow the additional funding to pay for other family needs not now covered. The Ugly Side of the VA Paperwork Jungle Two vitally important benefits our military Veterans and qualified dependents have earned: Compensation Benefits (Live and Death) Pension Benefits (Live and Death) Compensation Payment for an illness or injury caused or aggravated by serving in the military 5

6 4 Types of Service Connected Disabilities Aggravated Direct Presumptive Secondary Aggravated Service Connection The Veteran had a condition that existed prior to entering the military that was worsened beyond the normal progression of the disease because of conditions in the military Pre existing iti knee condition Aggravation of climbing steep hills in combat boots, carrying excessive weight on unstable knee, etc Worsened Knee Condition beyond normal progression of disease $ Compensation payable based on level of disability on VA s Rating Schedule minus how severe it was upon entrance to the military Direct Service Connection The Veteran is either permanently disabled or develops a chronic condition between the periods of entering active duty and discharge. Service member suffers permanent injury to his back when he falls down a flight of steps. Back heals but has permanent damage that limits movement, causes pain and puts pressure on adjoining discs. Compensation is payable based on the level of disability according to the VA s Rating Schedule 6

7 Presumptive Service Connection A Veteran develops a chronic disability because of the unique circumstances of their military service. Veteran is exposed to herbicides while serving in Vietnam, then later develops Type II Diabetes Compensation is payable based on the level of disability according to the VA s Rating Schedule Secondary Service Connection The Veteran develops a chronic disability caused by another service connected condition. A Veteran is service connected for diabetes, then loses a foot due to diabetes complications. Vet could then be paid for the loss of the foot secondary to the diabetes. OR The Veteran s service connected back condition causes abnormal gait affecting his hip. Vet could then be paid for the hip condition secondary to the back condition depending on the level of severity of the hip condition. Compensation Claims Successful comp claims may result in Increased funding for the Veteran/Dependent Medical Insurance if the Vet s claim is rated 100% Adaptive equipment from VA Hospital dapt eequ p e t o osp ta Medical Supplies and Prescriptions Other ancillary benefits from VA 7

8 Non Service Connected Pension Benefits Income based monetary benefit based on the Veteran s Wartime Service (Minimum One Day) Length of Service (Prior to 9/7/80 90 days with one day wartime OR after 24 continuous months with one day wartime with exceptions to length of service) Discharge other than dishonorable 100% permanently and totally disabled (Not due to military service) or based on age (65 yrs old), Disability Social Security or Living as Patient in Nursing Home Family Income and Net Worth within limits Pension Definition Wartime means a period of time, not a location Permanent and Total means the medical condition is not expected to improve, and total means it falls in the 100% category on VA s rating schedule Non service connected disability means the disability itself was not connected to the military in any way Definitions Cont. Family income and net worth relates to the total of all the Veteran and his/her dependents income and net worth. Income sources can be Social Security, Retirement benefits, wages, interest earned, profits from businesses, etc. Net Worth is the value of family assets other than the home they reside in, 5 surrounding acres and personal property such as cars, jewelry, etc. Most net worth comes from Bank accounts, CD s, stocks, bonds, property other than the home, etc. 8

9 How Pension Works When all requirements are met, VA calculates the monetary award using the following: MAPR means the Maximum Annual Pension Rate allowed by law IVAP means Income for VA Purposes IVAP amount is determined by reducing the family income with out of pocket family medical expenses after a certain deductible has been met MAPR IVAP = VA Annual Benefit 12 months = VA Monthly Benefit Allowable Medical Expenses used to Reduce Income for VA Purposes Medical insurance premiums including Medicare Prescription and Non prescription medicine Doctors, Hospitals, Dentists, Glasses, Dentures, Medical Equipment, Medical Equipment cleaning products, etc Mileage for medical purposes In home medical care Residential care Nursing Home care *Must be paid out of the Veteran/Family s pocket and not reimburseable in any way. *Expenses can be for Vet, qualified dependent or relative living in the Vet s household and Vet pays expenses. Pension Calculator MAPR Aid and Attendance Rate MAPR Housebound Rate MAPR Basic Rate Zero Income Veteran Zero Income Veteran with Countable Income Veteran with Countable Income reduced by medical expenses Typical Benefit for a Veteran with A&A Due to High Cost of Out of Pocket Medical Care 9

10 Navigating the Pension Paperwork Jungle As with compensation claims, please allow a Veterans Service Officer to assist the Veteran/Family by completing the necessary paperwork. When asked, complete necessary paperwork to account for medical expenses being paid by the Veteran/Family and provide to the VSO to include with the fully completed claim package the VSO will send to the VA. Known Dangers of the Application Nightmare Failure to educate the Veteran/Dependent on the benefit being applied for Failure to accurate or completely report all income and asset information when first applying or when providing yearly updates (EVRs) to VA Failure to report accurate out of pocket expenses to VA Failure to report changes in dependency Failure to provide updated information when Veteran/Dependent changes medical care providers and costs involved The Best App to Use In the best interests of the Veteran/Dependent, the path to follow is the one that causes the least disruption to the medical care you are providing and the least chances that the Veteran/Dependent is either underpaid or overpaid. 10

11 Allowing the VSO to do His/Her Job Allow your VSOguide: To find out from the Veteran/Dependent exactly what benefit(s) will help them the most (Comp or Pension?) and to carry the paperwork burden for the Veteran and the care provider To advise the care provider when certain information is necessary and how it needs to be written To submit the claim package from beginning to end to VA avoid conflicting information being submitted To clear any obstacles before they become obstacles Provide reliable follow up should circumstances change so the Veteran/Dependent doesn t get lost in the application nightmare! The Team Commitment for a Successful Journey We will not try to perform duties outside our own expertise as we go through the App Nightmare VSOs won t change bandages, provide physical therapy or manage prescriptions to ensure proper medical care Care Providers, Veterans and family members will NOT provide information to the VA on behalf of the client without going through the Service Officer who is handling the claim to ensure proper input. Where to Locate a Veterans Service Officer Our MVC Website: OR You may call our Missouri Veterans Commission CentralOffice * Remember, as State Employees, these Veterans Service Officers are trained professionals, accredited by the Dept. of Veterans Affairs and provide benefits assistance at no cost to you or the Veteran or family members! 11

12 Know Anyone Who Might Need Benefit Assistance? Please allow our Missouri Veterans Service Officers to be YOUR best guide through the VA Application Nightmare! Your referrals will be quite appreciated and THANK YOU for the medical expertise you are providing our great Missouri Veterans and families! Home Health Care from the Veterans Hospital Perspective What type of Home Health Services are available? Home health services are any medically indicated supportive medical services prescribed by and under the direction of a VA physician or a physician contracted by the VA for providing treatment to veterans. These services are skilled treatment services as performed by professional health care providers and professional health care technicians. The best source for determining what assistance is available for these VA services, is the Social Work department at the nearest VA facility. Social Work Social workers are members of all primary care teams and the behavioral health care team at the hospital. They assist veterans and their families in finding ways to manage psychosocial, emotional and economic problems. Assistance is provided in making the best possible transition from hospital to home or other community settings. Social workers also provide information about VA and community resources. Social workers are available at the hospital during normal business hours, Monday through Friday from 8:00 am to 4:30 pm except on holidays. 12

13 Contact Info 13