VA benefits

VeteransBenefits
Objective:
• Provide information regarding 4 Department of Veterans Affairs programs.
• OEF/OIF/OND Case Management
• Peer Support
• VA Claims and Benefits
• Vocational Rehabilitation
StructureoftheDepartmentof
VeteransAffairs.
Department of
Veterans Affairs
(VA)
Veterans
Health
Administration
(VHA)
Veterans
Benefits
Administration
(VBA)
National
Cemetery
Administration
(NCA)
VAHealthCare(VHA)
• Manchester VA Medical Center in Manchester, NH
• Outpatient clinics in:
• Somersworth, NH
• Portsmouth, NH
• Conway, NH
• Tilton, NH
Other Clinics in the state are managed by White River Jct. VAMC. SomeManchesterVAPrograms
VA provides a number of health care services, including but, not limited to:
 Preventive Care Services, 24/7 Urgent Care services (at VA hospitals only)
 Hospital, outpatient medical, dental*, pharmacy, and prosthetic services
 Specialized health care for women Veterans
 Screening exams for: Depression, Substance Abuse, PTSD, Military Sexual Trauma, TBI
 Treatment related to Military Sexual Trauma (MST)
 Readjustment counseling, mental health services
 Couples/family counseling, Peer support services, supported employment
 Alcohol and drug dependency treatment
 Homeless Veteran programs
 Veterans Justice Outreach  Polytrauma/ TBI
 Caregiver Support Program
 Therapeutic and Supported Employment. OEF/OIF/ONDProgram
Mission
• To honor Americas OEF/OIF/OND Service Members by ensuring access to exceptional care to improve their health and wellbeing. Howwemeetourmission
• Promote healthy transition from active duty to VA care. • Provide a safe and friendly entry point into the VA system.
• Ensure patient centered, comprehensive integrated care. • Coordinate across service lines and with community partners. Assist with arranging timely and Veteran negotiated appointments
• Outreach to service members in the community. • Provide same day access (where and when available)
• Diminish the stigma of mental health services
• Provide comprehensive female preventative & Primary Care.
OEF/OIF/ONDVeteran
EligibilityforVACare
• Who is considered an OEF/OIF/OND Veteran?
• Served 24 continuous months or the full period for which they were called to active duty by Federal order. With a discharge status of anything other than dishonorable. • Eligible for co‐pay free care for five years post discharge date for any injuries and illnesses related to their military service during deployment
• Eligible for one full dental exam/evaluation within 180 days of discharge
OEF/OIF/ONDCaseManagementServices.
(CaseManagementisthefocusofthe
OEF/OIF/ONDteam).
• Explore readjustment Concerns after military separation
• Establish VA health care services – medical appointment; meds; mental health appointment/need; substance abuse appointment/need; prosthetic equipment
• Explore resources and discuss issues related to financial hardship ,VA benefits, relationship concerns , legal issues , housing/homelessness issues, employment and unemployment issues……..
• Connecting to appropriate medical provider regarding physical health concerns
ManchesterVAMedicalCenter
•Peer Support Services VACLAIMSAND
BENEFITS
TUESDAY SEPTEMBER 23, 2014
BASICELIGIBILITYFORVA
CLAIMS
• Has to be a Veteran with a discharge that is considered Honorable for VA purposes (38 CFR 3.12)
• A discharge that is Honorable, General or Under Honorable Conditions is good to go
• Anyone else is considered to have been naughty, but if there is an application for benefits we have to provide Due Process
BASICELIGIBILITYFORVA
CLAIMSANDMORE
• Minimum active Duty requirements are 24 months of more of continuous active service
• Or, the full period the Veteran was called to service (National Guard, Reserves)
• However, a Veteran that was injured in an Active Duty for Training status (ACDUTRA) may apply for benefits related to the injury or event.
• In this scenario the evidence of record should indicate no negligence on the part of the Veteran‐commonly referred to as a Line of Duty (LOD) Determination. SERVICECONNECTEDCLAIMS
• A claim that is based upon an event, or injury in military service
• The there elements of service connection are:
• Event or injury in service
• Current condition (diagnosis; lay testimony)
• Nexus, or the link/connection (in almost all cases the VA exam will take care of this)
• Reference: 38 CFR 3.303
DIAGNOSISvsLAY
TESTIMONY
• Some conditions have to be diagnosed in order to obtain a VA exam
• Examples are heart conditions, diabetes or specific mental conditions (i.e. bipolar)
• Some conditions the Veteran is considered competent to claim without a current diagnosis such as musculoskeletal issues or depression (the Veteran is competent and can tell us his back hurts or that he is depressed)
CLAIMSBASEDUPON
PRESUMPTIVECONDITIONS
• Per 38 CFR 3.309 there are diseases that are considered service‐connectable based upon verified exposure
• Examples are Agent Orange, Gulf War Environmental Hazards and Camp LeJeune
(drinking water)
• Former Prisoners of War (FPOW)
PTSDCLAIMS
• 38 CFR 3.304(f)
• Relates to a traumatic event or experience in military service‐Combat, Personal Trauma and Military Sexual Trauma (MST)
• The Veteran provides a stressor statement
• The evidence of record needs to place the Veteran in the described situation or circumstance
• In a sense, in certain situations PTSD is in a way presumptive (but not exactly)
OTHERMENTALHEALTH
CLAIMS
• The elements of service connection apply
• The Veteran’s in service medical records need to show complaints or mental health treatment in service
• Certain conditions need a diagnosis such as Bipolar or schizophrenia
• Conditions such as Anxiety or Depression can be claimed by the Veteran as lay testimony
OTHERTYPESOFCLAIMS
• Secondary: The claimed condition is caused by a service connected condition
• Aggravation: The claimed condition existed prior to service and the condition was worsened by service
• Reopen: The claimed condition was previously denied; The Veteran submits New and Material evidence (not just new but addresses the reason for the denial)
• 38 USC 1151: condition is caused by injury or illness as a result of VA healthcare or occurred in training such as Compensated Work Therapy (CWT) or Vocational Rehabilitation
NONSERVICECONNECTED
PENSION
• May be claimed based on injuries or illness not related to military service
• Specific requirements to be eligible:
• Service in a recognized wartime period (can be as little as 1 day)
• 24 months or more of active duty; prior to 1980 this can be the full term of active duty service if less than 24 months of active duty (ACDUTRA Does not apply)
• A discharge that is Honorable for VA purposes
• Low income: based upon an income threshold established by Congress
• If over age 65 a lack of medical records is not an issue
AIDANDATTENDANCE
• This is an additional benefit which may be awarded based upon either service connected compensation or non service connected pension
• This is to help a Veteran or a spouse of a service connected Veteran that needs help from others to perform daily life tasks
• Conditions such as loss of use of extremities and blindness are the most common CLAIMFORMS
VA Form 21‐526EZ Fully Developed Claim (FDC)for Service Connection
VA Form 21‐527 EZ Fully Developed Claim (FDC) for Non Service Connected Pension
VA Form 21‐2680 Aid and Attendance Application VA Form 21‐0781 Statement in Support of Claim for PTSD
VA Form 21‐0781a Statement in Support of Claim for PTSD Secondary to Personal Trauma (most often used for MST)
VA Form 21‐4142 Release for VA to request private medical records (This form is HIPPA compliant if filled out correctly by the Veteran)
VA Form 21‐4138 Statement in Support of Claim (think of this as VA notepaper)
WHATHAPPENSIFACLAIMIS
SUCCESSFUL?
• If the Veteran is granted benefits, they are paid based upon percentage (determined by severity of condition(s)) • Reference: 38 CFR part 4
• If more than one condition is granted, the combined evaluation is determined based upon the most to the least severe disabling
• Conditions granted at 0% are still service connected; these do not pay monetary benefits but the Veteran is entitled to VA healthcare for any condition that is service connected at 0%
• If a Veteran is service connected at 30% or more disabling they may request additional benefits for dependency
• Spouse, minor children and even school age children 18 and over if enrolled in school
• School age child benefits are paid until the child is age 23 if still enrolled in school
HOWTOGETVAFORMS
• Any VA regional Office; Manchster is open 8:30 to 4:00 Monday through Friday
• Located at 275 Chestnut Street in Manchester
• Online via eBenefits
• Online via VONAPP
• You may also call 1‐800‐827‐1000 for assistance
• Also at:
http://www.va.gov/vaforms/search_action.asp
*These are fillable pdf’s
VARegionalOffice
•Vocational Rehabilitation
Questions?
HowtoReachus
• Kristin Maxwell, OEF/OIF/OND Program Manager 603‐624‐4366 ext. 6483
• Shannan Brown, Peer Support Specialist
603‐624‐4366 ext. 6041
• Veterans Benefit Administration
1‐800‐827‐1000

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