Compensation Disability

1. Compensation Disability Tom Baird Compensation Service September 2014

2. VA Representative Tom Baird VA Military Service Coordinator Ft Sill / Sheppard VA BDD / Altus AFB/IDES 580-442-2469

3. VA on the Internet www.va.gov http://www.facebook.com/VeteransBenefits http://twitter.com/VAVetBenefits Or call us 1-800-827-10008:00 a.m. EST to 9:00 p.m. EST

4. 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

5. 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 • National and State Veterans Cemeteries • Support to State Veterans Cemeteries • Headstones & Markers • Presidential Memorial Certificates

6. 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)

7. Service Connected Terms • Acute disability – short duration, clear without residuals • 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

8. 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

9. 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.

10. 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

11. 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

12. Combined Rating CalculationAppeal 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 12

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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)

20. 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.

21. 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

22. 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)

23. 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)

24. Questions?