VA Benefits Briefing
Transition Tools for a Brighter Future
Compensation Disability
September
2014
VA Benefits Briefing
Tom Baird
Compensation Service
This document contains U.S. Department of Veterans Affairs proprietary
business information and may not be reproduced without permission.
VA Representative
Tom Baird
VA Military Service Coordinator
Ft Sill / Sheppard VA BDD / Altus AFB/IDES
580-442-2469
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VA on the Internet
www.va.gov
http://www.facebook.com/VeteransBenefits
http://twitter.com/VAVetBenefits
Or call us
1-800-827-1000
8:00 a.m. EST to 9:00 p.m. EST
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Objectives
• Define Disability Compensation
• Define Service Connected Disability
• Explain the Life Cycle of a Claim
• Describe Compensation Benefits directly
related to Disability Compensation
• Pension
• Veterans Service Organization
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Department of Veterans Affairs
• Veterans Benefits Administration
– All non-medical VA benefits: Compensation, Pension, Education, Home
Loan Guaranty, Vocational Rehabilitation and Employment, Life
Insurance
– Administered by VA Regional Offices
• Veterans Health Administration
– All VA health care services
– Administered by VA Medical Centers, Ambulatory Care & Community
Based Outpatient Clinics
• National Cemetery Administration
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National and State Veterans Cemeteries
Support to State Veterans Cemeteries
Headstones & Markers
Presidential Memorial Certificates
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Service-Connected Compensation
Compensation is paid for a disability resulting
from disease or injury incurred or aggravated
while on active service. The disability does not
have to be combat or wartime related.
Examples:
Torn knee ligament
Hearing loss
Back condition
Post traumatic stress (including the result of
sexual trauma)
Traumatic brain injury
Skin condition (psoriasis, eczema, scars)
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Service Connected Terms
• Acute disability – short duration, clear without residuals
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Common cold, Flu
• Chronic disability – long term duration, never goes away
– Hypertension, Arthritis, Migraines
• In the Line of Duty – injury or disease incurred while
serving on active duty
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Disability Compensation
• Disability Compensation is a tax free monetary benefit
paid for a service-connected disability
– A service-connected disability is a disability resulting from
injuries, illness, or disease that was incurred or aggravated
while on active duty
– Discharged under other than dishonorable conditions
– Compensation is paid for disability ratings from 10% to
100%
– Veterans may be eligible for additional compensation if
they are very seriously disabled; have qualified
dependents; have a seriously disabled spouse
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Disability Compensation (Con’t)
• A service-connected disability can be established:
– Directly
– Due to aggravation of a pre-Service disability
– Presumptively; and/or
– Secondary to a Service-connected condition
• No-time limit to apply
– Pre-Discharge – Programs designed for active duty
– Post-Discharge
• Paid retroactively to first of the month after separation/retirement if VA
receives the application within one year of separation/retirement.
• If after one year, generally effective no earlier than the date VA received the
application.
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Service Connected Claims Process
• Original Claims (38 CFR 3.160)
– Initial formal application on a form prescribed by VA
Secretary. For Veterans, it is the VA Form 21-526
• Formal Claims: Letters, Memorandums, and other Communication
from claimants or their representatives may be considered formal
claims if they:
– Request increased benefits
– Reopen previously denied claims
– Open a new claim
• Informal Claim: Any communication or action that shows an intent to
apply for benefits
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Life Cycle of a Claim
– Receive and review application
– Provide Veterans Claim Assistant Act (VCAA) Notice (Duty
to Assist)
– Schedule a VA examination, if necessary
– Gather evidence
– Prepare a decision using all evidence of record
– Prepare the award of benefits or disallowance document
– Notify the Veteran
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Combined Rating Calculation
Appeal Process
Combined Rating Table – 38 CFR 4.25
–
Constructed so that in no event will the combined
evaluation exceed 100%.
– “Whole person concept”: Presumption that upon entering
service, a person is 100% efficient
Appeal Process
– VA Form 4107, Your Rights to Appeal our Decision
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Related Benefits
• Free VA health care for all rated service-connected
conditions
• Vocational rehabilitation & employment services
• VA life insurance - $10,000
• Veterans preference in Federal hiring
• VA home loan guaranty funding fee waived
• Possible state and local benefits
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Automobile Grants (38 CFR 3.808)
• Financial assistance is available to purchase a vehicle or adapt a
vehicle to certain Servicemembers and Veterans
• The Automobile Grant can be issued once in a lifetime and requires:
– Loss, or permanent loss of use, of one or both feet, OR
- Loss, or permanent loss of use, of both hands, OR
- Permanent impairment of vision in both eyes to a certain degree
• Automobile Adaptive Equipment can be used more than once and
requires:
– Those qualified for Auto Grant as above, OR
– Akylosis of one or both knees or hips
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Housing GrantsLife Cycle of a Claim
• Special Adaptive Housing (SAH) Grants
– $64,960
• Special Home Adaptation (SHA) Grant
– $12,992
• Temporary Residence Adaptation
– Up to $28,515 (if eligible for $64,960)
– Up to $5,092 (if eligible for $12,992)
• Rates vary annually in accordance with the cost
of living
index
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Clothing Allowance (38 CFR 3.810)
• Veterans may be eligible for a clothing allowance if they
have:
– Service-connected condition that requires the Veteran to
wear or use a prosthetic or orthopedic appliance (including
wheel chairs)
– Service connected skin condition that requires prescribed
medications that cause irreparable damage to outer
garments
• Veteran Health Administration Prosthetics and Sensory
Aids Service administers the program
* Clothing allowance can be paid as a one time benefit, or an
annual allowance
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Special Monthly Compensation (38 CFR 3.350)
• Additional compensation for the loss or loss of use of
specific organs or extremities.
• Loss, or loss of use, is either an amputation or having no
effective remaining function
• Special Monthly Compensation may be granted for:
Loss, or Loss of use, of a hand or foot
Complete loss, or loss of use, of both buttocks
Immobility of a joint or paralysis
Loss, or loss of use, of a reproductive organ
Inability to communicate by speech
Loss of sight of an eye (only light perception)
Deafness of both ears (absence of air and bone conduction)
Loss of a percentage of tissue from a single breast, or both breasts, from Mastectomy or
Radiation Treatment
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Pension
• Benefit paid to wartime Veterans with limited income, and who are
permanently and totally disabled or age 65 or older
- Disability must not be due to own willful misconduct and need not be
related to service
• Who is eligible? A Veteran may be eligible if:
- Discharged from service under conditions other than dishonorable, AND
- Served at least 90 days of AD and at least one day during wartime, AND
- Countable family income is below a yearly limit set by law, AND
- Permanently and totally disabled, OR
- Age 65 or older
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Servicemembers’ Group Life Insurance (SGLI)
• $400,000 automatic maximum coverage
• Free coverage for 120 days after
Servicemember’s separation from service
• Convertible to Veterans’ Group Life Insurance
(VGLI) or commercial policy after separation
from service (can split coverage)
• Insures active duty members, Ready Reservists,
cadets at service academies, National Oceanic
and Atmospheric Administration (NOAA), and
Public Health Service (PHS)
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Traumatic Servicemembers’ Group Life Insurance (TSGLI)
• Rapid financial assistance payable to members who
suffer a qualifying loss due to traumatic injury
• Benefit of $25K—$100K depending on injury
• Automatic for members with SGLI coverage
• Traumatic injury need not be combat related
• Traumatic injury must occur prior to separation from
service
• Qualifying loss must occur within two years of date of
traumatic injury.
• TSGLI coverage ends at separation from service.
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Veterans’ Group Life Insurance (VGLI)
• Lifetime renewable term insurance
• Premiums increase with age
• 240 time period to convert to VGLI without proof
of good health
• 1 year 120 day time period to convert
• Maximum coverage=amount of SGLI at time of
separation from service
• Available in increments of $10,000
• Convertible to a commercial policy at any time
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Veteran Service Organizations
M21-1MR, Part I, Chap 3, Sect A
Accredited Veterans Service Organization Representatives:
· Are recognized by the VA as advocates for Servicemembers, Veterans and
Survivors
· Can assist claimants in filing for VA benefits and services
· Must be appointed in accordance with VA Procedures
Examples: Disabled American Veterans (DAV), Veterans of Foreign War
(VFW), State VA, American Veterans (AMVETS), Military Order of the Purple
Heart (MOPH), American Legion (AL)
Once appointed, VSO Representatives are authorized to prepare, present,
and prosecute a claimant’s claim, review their records, present evidence,
sign an informal claim, withdraw an appeal, etc (38 CFR 14.626 – 14.636)
VA Benefits Briefing
• www.ebenefits.va.gov
• One-stop shop for benefits-related online tools
and information.
– Apply for benefits
– View your claim status and benefits and
payments online
– Download your DD 214
– Print your VA home loan guaranty Certificate
of Eligibility (CoE)
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Questions?
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