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An Overview of Benefits for Veterans with Disabilities

An Overview of Benefits for Veterans with Disabilities. Lucy Miller Virginia Commonwealth University WIPA National Training Center. Why this topic is important…. A significant portion of veterans who are homeless do experience disability – some studies suggest as high as 60%!

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An Overview of Benefits for Veterans with Disabilities

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  1. An Overview of Benefits for Veterans with Disabilities Lucy Miller Virginia Commonwealth University WIPA National Training Center

  2. Why this topic is important…. • A significant portion of veterans who are homeless do experience disability – some studies suggest as high as 60%! • Veterans who receive VA/DoD benefits based on disability may also be eligible for disability benefits from the SSA. Many are not aware of this. • Cash benefits from VA/DoD and SSA represent a valuable resource for use in community reintegration of veterans who are homeless. • VA/DoD and SSA benefits may be affected by paid employment. It is important to understand these rules if veterans are pursuing paid employment

  3. What we will cover today: • Basic overview of Department of Defense (DoD) and Veterans Administration (VA) benefits available to veterans with disabilities • Basic overview of SSA benefits available to veterans with disabilities • Summary of how DoD/VA benefits interact with SSA disability benefits • Summary of how employment affects DoD/VA benefits and SSA disability benefits

  4. Types of Cash Benefits Available to Veterans with Disabilities • Military retirement due to disability provided by the US Department of Defense (DoD) • Veteran’s Administration (VA) benefits • VA Disability Compensation • VA Disability Pension • Disability benefits provided by the Social Security Administration (SSA) • Social Security Disability Insurance (SSDI) • Supplemental Security Income (SSI)

  5. Medical Benefits Available to Veterans with Disabilities • Military retirement comes with Tricare medical coverage • Veteran’s receiving VA benefits due to disability may access the VA health care system • Medicare coverage comes with Social Security Disability Insurance (SSDI) after a waiting period • Medicaid coverage is provided to all SSI recipients • Multiple forms of medical coverage may be accesses simultaneously

  6. Let’s start with the DoD and VA benefits… Veterans may get benefits from either DoD or the VA or from BOTH at the same time!

  7. Military Retirement Due to Disability • Military retirement benefits are administered by DoD • Military retirement is available to persons with 20+ years of active service in the military • Individuals may retire as disabled regardless of % level of disability if found unfit for service by reason of physical disability • Individuals with less than 20 years of active service at the time they are removed from the military by reason of physical disability may be either “separated” or retired, based on a variety of factors • Benefits may be dispensed as either a monthly check or as a lump-sum severance payment depending on the person’s circumstances

  8. Advantages of Military Retirement due to Disability • Recipients of these benefits are NEVER subject to a review of their disability rating • Retired veterans with disabilities get the same benefits as all other military retirees including use of commissaries, military hospitals, and Tricare coverage for themselves and family members • Military retirement is NOT affected by paid employment in any way!

  9. VA Disability Benefits – How to Apply • Most veterans apply for VA benefits when they are first separated from the military due to being “unfit for active duty” • Veterans’ may apply at any point after this by completing VA Form 21-526 – Veteran’s Application for Compensation or Pension • Veterans may also apply online at: http://vabenefits.vba.va.gov/vonapp/main.asp • Questions? Call toll free 1-800-827-1000

  10. Disability Evaluation under the VA System • Disability is assessed using a percentage system in intervals of ten from 0% - 100% • The higher the disability rating, the higher the monthly disability benefit payment • The rating was originally intended to represent the degree to which a veteran’s earnings capacity is diminished by the disability • Determinations are based on the VA Schedule for Rating Disabilities or VASRD

  11. More about the VA Rating System • The VA considers all service-connected disabilities and the totality of the changes in the person’s medical condition that occurred during military service • Unlike the DoD, the VA process permits reevaluation of service-connected disabilities if a condition worsens or improves over time • The DoD and VA use different rating systems – it is possible for a veterans two have two different ratings from the two agencies

  12. Rating Designations • Total disability based on 100% schedular rating • Total disability at less than 100% schedular rating based on “individual unemployability” • Permanent and total disability These designations are important because they allow higher benefits to be paid and may entitle veteran’s to additional benefits

  13. VA Disability Compensation • Disability must be “service connected” - incurred or aggravated during active military service • Separation or discharge from the military must be under conditions other than dishonorable • VA Compensation is an entitlement program and is not means-tested in any way! • VA compensation benefits may be reduced if certain DoD benefits such as military retirement or disability severance pay are received.

  14. More About VA Disability Compensation • Vets with ratings or 30% or more are eligible for additional allowances for dependents • Vets with certain types of disabilities (loss of limb or use of organs) may be eligible for “Special Monthly Compensation” (SMC) in addition to regular VA compensation • Vets with 100% ratings who are “housebound or bedridden” may get an additional SMC payments known as “Aid and Attendance and Housebound Allowance”

  15. VA Disability Pension • Available to veterans with non-service connected disabilities • Must have at least 90 days of active military service, with at least one day during a period of war (in some cases, more service required) • Disability must be assessed as being permanent and total • Separation or discharge must have been under conditions other than dishonorable and disability must not be due to willful misconduct

  16. More about VA Disability Pension • VA pension is intended to bring the veteran’s total income up to a minimum level set by Congress • Eligibility is based on strict income and asset guidelines • Payments are reduced by the amount of countable income of the veteran, the spouse, or dependent children • Pension calculations are complicated – leave this to the VA to determine!

  17. Other VA Benefits for Veterans with Disabilities • Veteran’s Medical Benefits Package • Vocational Rehabilitation and Employment Services (VR&E) • Specially adapted housing grants • Service-disabled veteran’s insurance • Assistance with adapting an automobile to meet disability needs • Annual clothing allowance

  18. Where to Get More Information about VA Benefits • VCU CWIC Training Manual – Module 3 at www.vcu-ntc.org • A Handbook for Injured Service Members & Their Families http://www.fallenheroesfund.org/common/page.php?ref=familyinfo • Federal Benefits for Veterans and their Dependents http://www1.va.gov/opa/vadocs/current_benefits.asp • Veterans Benefits Explained http://www.military.com/benefits/veteran-benefits/veterans-benefits

  19. How Employment Affects DoD and VA Disability Benefits • Military retirement is never affected by earned income in any way! • VA Disability Compensation is not affected by earned income EXCEPT that in some cases, substantially gainful employment may cause a reduction in disability rating • VA Disability Pension is reduced dollar-for dollar by earned income and gross income is what counts

  20. Employment and VA Disability Ratings Disability ratings are NOT reviewed for individuals who are: • Elderly (age 69 or older) • Designated as being totally disabled (100% schedular rating or designated as having permanent & total disability) • Designated as being totally disabled due to “individual unemployability” for a period of 20 or more continuous years

  21. Employment and VA Disability Rating Persons at potential risk of reduced disability rating due to employment include: • Veterans under age 69 with schedular ratings under 100% • Veterans who are rated as being totally disabled based on individual unemployability, who have been on benefits for less than 20 consecutive years, and who are working in a “substantially gainful occupation”

  22. What is a Substantially Gainful Employment? “Substantially Gainful Employment is defined as employment at which non-disabled individuals earn their livelihood with earnings comparable to the particular occupation in the community where the veteran resides.” (M21-1MR, Part IV, Subpart ii, Chapter 2, Section f)

  23. Substantially Gainful Employment is NOT…… • Marginal employment. Marginal employment exists when a veterans’ earned income does not exceed the current Federal Poverty Guidelines for a household of one. • Earnings can go over the FPG and still not be considered substantial if the work occurred in a protected environment such as a family business, a sheltered workshop, or when supported employment services are provided.

  24. Now lets’ look at SSA disability benefits Many veterans are eligible to receive disability benefits from both DoD/VA and the Social Security Administration. Veterans should be encouraged to apply!

  25. Overview of Disability Benefit Programs Administered by SSA Title II Social Security Disability Benefits Entitlement program based upon insured status Assumes 3 different forms – SSDI, CDB and DWB Comes with Medicare coverage Title XVI Supplemental Security Income (SSI) Funded by federal tax dollars, not SSA trust fund Welfare program based upon financial eligibility Comes with Medicaid coverage

  26. Applying for SSA Disability Benefits Applications for benefits are generally completed in local SSA Field Office. The process can be started online or over the phone One application for both Title II and Title XVI benefits State contracted Disability Determination Service (DDS) makes disability decision Local SSA office handles all other initial determinations

  27. SSA’s Definition of Disability “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

  28. Important Concepts in SSA’s Disability Definition Individual must have a disability which can be documented by a qualified medical examiner — meet a certain level of disability The disability must be expected to last 12 or more months or result in death Individuals must either not be working at time of application, or if working must have countable earnings of less than SGA level ($940/$1,570 per month in 2008. If blind, meet SSA’s definition of statutory blindness – the SGA test is waived for blind individuals in the SSI program

  29. Eligibility for Social Security Disability Benefits (Title II) • Be medically disabled as defined by the SSA. • Not be working or earnings are under SGA limit ($940/$1,570 GROSS per month for 2008). • Have earned sufficient “credits” by paying into the system yourself,have a deceased, retired or disabled parent who paid in on your behalf (CDB), or be eligible for Disabled Widow(er)s Benefits (DWB).

  30. Eligibility for Title II Disability Benefits continued • Resources and other forms of unearned income are irrelevant and are not considered in SSD eligibility determination. • OTHER DETAILS: There is a 5-month waiting period of initial eligibility before the SSD check begins. There is also a 24-month Medicare Qualifying Period. In the meantime, SSI and Medicaid may be received by persons meeting applicable eligibility standards.

  31. Eligibility for SSDI Must have insured status on own work record At least 20 credits in the 10 years prior to onset of disability Those disabled prior to age 31 need fewer credits to qualify Possible to earn up to four credits per year -one credit = $1,050 in 2008 Benefits may be paid retro-actively back to date of disability onset or 12 months prior to application – whichever is less

  32. Some Things to Remember about SSA Title II Disability Benefits Title II disability benefits are a form of insurance - not welfare These benefits are NOT means-tested. There are no limits on resources or unearned income The amount of disability benefits payable under title II is determined by the number holder’s work record. The maximum monthly payment for 2008 is $2,185 The SGA limit on countable earned income applies at initial application and forever onwards. The SGA Limits for 2008 are $940/$1570 per month in countable earned income

  33. Employment and Title II Disability Benefits • There is no gradual reduction of payments in this program – all or nothing deal • Work incentives consist of a series of “phases” – each successive phase provides less protection than the one before • The phases include Trial Work Period (TWP), Extended Period of Eligibility (EPE) and Extended Period of Medicare Coverage (EPMC)

  34. Employment and Title II Disability Benefits • The work incentive phases are complex and difficult to understand – get help! • Worst case scenario, beneficiaries who have not used any of their TWP will keep their full payment for a minimum of 12 months after going to work – no matter how much they earn. • As long as the beneficiary does not consistently earn over the current SGA amount ($940/$1,570 per month in 2008), full cash benefits can be retained indefinitely

  35. Extended Medicare Coverage • Even if title II disability cash benefits are lost due to work, Medicare coverage (Parts A & B) can be retained for a minimum of 93 months after the end of the Trial Work Period • SSA will bill the individual for Part B premiums each quarter • In 2008, the Part B premium is $96.40 per month • Medicare Part D pays for prescription drug coverage. Part D can be retained as long as either Part A and/or Part B are retained.

  36. Special Work Incentives for Title II Disability Beneficiaries • Work incentives in this program are used to reduce countable earnings during SGA determinations • Impairment Related Work Expenses (IRWE) • Subsidy and Special Conditions • Employer Subsidies • Special conditions provided by third parties • Subsidy for self-employed persons

  37. Eligibility for SSI • Be medically disabled as defined by the SSA • Not be working or earnings under SGA limit ($940/$1,570 GROSS for 2008) at time of application ONLY! Parental income counts for children under 18. Spousal income counts for married persons. • Have unearned income of less than the current FBR. For 2008 the FBR is $637 for an individual and $956 for an eligible couple.

  38. Eligibility for SSI Continued • Resources under $2,000 or $3,000 for an eligible couple • Countable resources do NOT include: home you live in, one car (some restrictions), life insurance policy, burial plot, burial funds or pre-paid funeral expenses up to $1,500, personal effects and household goods, and property essential to person's self-support.

  39. Amount of SSI Payment Affected by Many Things • Earned Income – wages, net earnings from self-employment, in-kind items in lieu of pay • Unearned income • In-kind support & maintenance (ISM). Full ISM results in a 1/3 reduction of SSA base rate ($424.67) • Overpayment recovery

  40. Employment and SSI 1.Start with the GROSS monthly earnings and subtract a $20.00 general exclusion. 2.Next, subtract a $65.00 earned income exclusion. 3.Take the remaining amount and divide it by two. You are left with what is called countable earned income. 4.Subtract the countable earned income from the base SSI rate for the person. The remaining amount is the adjusted SSI check.

  41. A simple way to explain this … The first $85.00 that you earn each month does not count against you. For anything above $85.00, the SSA will take away one dollar from your SSI check for every two dollars that you earn. SSI recipients ALWAYS come out ahead by working!

  42. 1619(b) Extended Medicaid • Even after earnings cause the loss of SSI cash payments, Medicaid can be continued indefinitely - • Must still be disabled • Must meet the Medicaid “needs” or “use” test • Must have annual earnings under the current threshold amount for your state • Must meet ALL other SSI income and resource rules

  43. Special Work Incentives for SSI Recipients • Student Earned Income Exclusion (SEIE) • Impairment related Work Expenses (IRWE) • Blind Work Expenses (BWE) • Plans for Achieving Self-Support (PASS)

  44. Where to get more information about SSA disability benefits • Social Security’s Website http://www.socialsecurity.gov/work/index.html • VCU’s WIPA National Training Center Website: www.vcu-ntc.org • SSA’s Redbook on Work Incentives http://www.socialsecurity.gov/redbook/eng/main.htm

  45. How VA and SSA Disability Benefits Interact • VA Disability Compensation is not affected by receipt of SSA disability benefits in any way! Many veterans would be eligible for SSDI and are encouraged to apply • VA Disability Pension would count SSA title II benefits (SSDI) as income. This income could cause ineligibility for VA Pension benefits, or would cause a dollar-for-dollar reduction in VA Pension payments. SSI payments do NOT count against VA Pension!

  46. How VA and SSA Disability Benefits Interact • Receipt of DoD/VA benefits would not impact a veteran’s eligibility for SSA title II disability benefits • SSDI is not reduced by VA disability benefits, but may be reduced when military retirement payments based on disability are received • SSI is means-tested and would count DoD/VA cash benefits as unearned income

  47. Special VA Programs Disregarded by the SSI Program • Aid and Attendance or Housebound allowance • Disability compensation payments resulting from unusual medical expenses • Benefits paid on the basis of a Medal of Honor or special act of Congress • Payments made as part of the VA Vocational Rehabilitation and Employment program • VA clothing allowance

  48. State Veterans Benefits • Many states offer additional benefits to veterans- what is offered varies by state • Benefits may include educational assistance, discounts on taxes and/or fees, home loans, free hunting or fishing privileges, and more • A Directory of State Veterans benefits can be found at: http://www.military.com/benefits/veteran-benefits/state-veterans-benefits-directory

  49. Getting Help with VA and SSA Benefits • Every state has SSA funded WIPA projects that can help beneficiaries understand how DoD/VA and SSA benefits are affected by employment • To be eligible for WIPA services, persons must be age14-65 and be receiving SSA benefits based on disability • To locate your local WIPA project go to: https://secure.ssa.gov/apps10/oesp/providers.nsf/bystate

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