Department
Service Officer Newsletter
Volume
2, Issue 1
January 2007
Department
Service Office Business Hours:
The Department Service Office will be open each Monday through Friday from 8:00
AM until 4:00 PM. Appointments are not necessary for visits. You may
contact the Department Service Office by calling (603) 222-5784, faxing (603)
222-5787; or by using the following e-mail address:
§
New American Legion Heroes to
Hometowns (H2HT) Contact at the Pentagon:
By now, most Legion members
know about the Legion’s Heroes to Hometowns program in which local posts
organize community welcome home ceremonies and community assistance activities
to help recently discharged seriously disabled veterans reintegrate into
civilian life. Essentially, post officials are ask to arrange
events and community cooperation agreements long before receiving notice of a
returning seriously disabled veteran, then put the program into action whenever
the Pentagon Legion contact notifies the local post of a seriously disabled
veteran returning to the their community. The Legion’s new Pentagon contact
information is as follows: Scott Sundsvold; The American Legion, Heroes to
Hometowns Liaison, Military Severely Injured Center (Pentagon): legion.h2h@itc.dod.mil;
703-692-2054. Post should contact Mr. Sundsvold and let him know when
their H2HT program is ready.
§
Heroes to Hometowns (H2H)
Program:
We
have previously published several articles explaining how individual posts may
want to accept responsibility for setting up and organizing local H2H programs.
As noted before, the purpose of the H2H program is to help seriously injured
recently discharged servicemen and women reintegrate into the local community.
Post commanders are asked to register their H2H program with the Department
Service Office (603-222-5784) so we may help coordinate referrals from our
National Headquarters.
More information on the
Heroes to Hometowns program is available at:
http://www.legion.org/?content=heros2hometown.
§
VA Performance Standards vs.
Quality:
A
September 20, 2006 American Legion Bulletin brought out some interesting facts
about Department of Veterans Affairs (VA) Performance Standards. The Bulletin
states: “The emphasis on production continues to be a driving force in the VA
regional office, often taking priority over such things as training and quality
assurance. Performance standards of adjudicators and rating specialist are
centered on productivity as measured by work credits, known as ‘End
Products.’ Both veteran service representatives (VSRs) and rating veteran
service representatives (RVSRs) have minimum national productivity requirements
that must be met each day. Some stations also set their own standards, based on
their claims backlog and other station specific requirements that are over and
above the national requirement. Unfortunately, the end product work measurement
system essentially pits the interests of the claimant against the needs of VA
managers. The conflict is created because the regional offices have a vested
interest in adjudicating as many claims as possible in the shortest amount of
time. This creates a built-in incentive to take shortcuts so that the End
Product can be taken. The system, in effect, rewards regional offices for the
gross amount of work they report, not whether the work is done accurately or
correctly, often resulting in many claims being prematurely adjudicated…The
result has been a traditionally high remand rate by the Board of Veterans
Appeals’ (BVA) and the U.S. Court of Appeals for Veterans Claims (CAVC).
The BVA’s combined remand and reversal rate (59.4 percent) for Fiscal Year 2005
is arguably a direct reflection of the greater emphasis placed on production
over training and quality assurance.”
The
Bulletin recording The American Legion’s statement before Subcommittee on
Disability Assistance and Memorial Affairs Committee on Veterans’ Affairs
United States House of Representatives goes on to state: “It seems to The
American Legion VBA (VA’s Veterans Benefits Administration) management has been
reluctant to establish a rigorous quality assurance program to avoid exposing
the longstanding history of the manipulation of workload data and policies that
contribute to poor quality decision-making and the high volume of appeals.” Until
this problem is resolved, if ever, VA claimants are encouraged to appeal any VA
decision the claimant perceives unfair.
§
Additional Compensation Benefits
Available for Former Prisoners of War: For purposes of disability
compensation, Congress has recognized that certain diseases are associated with
Former POW's captivity. These are called presumptive medical
conditions, and if a former POW is diagnosed as having one or more of these
conditions to a degree of 10% disabling, VA presumes that it is associated with
the POW experience. The presumption of association is made for
seven conditions regardless of the length of captivity:
·
Psychosis
·
Dysthymic disorder, or depressive neurosis
·
Post-traumatic osteoarthritis
·
Any of the Anxiety States
·
Cold Injury
·
Stroke and complications
·
Heart Disease and complications
If
a former POW was interned for 30 days or more, the following additional
diseases are presumed to be service-connected:
·
Avitaminosis
·
Chronic Dysentery
·
Helminthiasis
·
Malnutrition, including
associated Optic Atrophy deficiency
·
Peptic Ulcer Disease
·
Beriberi
·
Cirrhosis of the Liver
·
Irritable Bowel Syndrome
·
Pellagra and any other
nutritional deficiency
·
Peripheral Neuropathy,
except where directly related to infectious causes
Extended Healthcare Eligibility
for Former Prisoners of War:
The VA health care system
affords priority treatment for former POWs. Former POWs who have a
service–connected disability are eligible for VA health care. This includes
hospital, nursing home, and outpatient treatment. Former POWs need not have a service-connected
disability to be eligible for VA hospital and nursing home care – without
regard to their ability to pay. They are also eligible for outpatient
care on a priority basis – second only to veterans with service-connected
disabilities. While former POWs are receiving treatment in an approved
outpatient treatment program, they are eligible for needed medicines, glasses,
hearing aids, or prostheses. Former POWs are also eligible for all needed
dental care. There is no co-payment requirement for former POWs at VA
pharmacies.
Extended Benefits for Survivors
of Former Prisoners of War:
The major benefit is Dependency and Indemnity Compensation (DIC) which is a
monthly benefit payable to the surviving spouse (and the former POW’s children
and parents in some cases) when the former POW:
·
Was a service member who
died on active duty; or
·
Died from service-related
disabilities; or
·
Died on or before September
30, 1999 and was continuously rated totally disabled for a service connected
condition (including individual unemployability) for at least 10 years
immediately preceding death; or
·
Died after
September 30, 1999, and was continuously rated totally disabled for a
service-connected condition (including individual unemployability) for at least
1 year immediately preceding death. .
DIC
is terminated for a surviving spouse who remarries, but can be resumed if the
remarriage ends in death, divorce, or annulment. However, a surviving
spouse who remarries on or after attaining age 57, and on or after December 16,
2003, can continue to receive DIC.
(The words in italics note the extended part of
DIC regulation concerning POWs.)
Former Prisoners of War Claims
Filing Contacts:
Indianapolis VA
Regional Office coordinator for former POWs, Bill Young, provided the Former
POW benefits information within this article. Bill can be reached at Bill Young
at (317) 916-3444. Each VA medical Center also has a POW coordinator. Former
POWs and their survivors may receive claims filing assistance and advised by
contacting their local county veterans service officer or The American Legion
Department Service Office.
§
Blue Water Navy Veterans Update:
On 16 AUG 06, the U.S.
Court of Appeals for Veterans' Claims (CAVC) in the case of Haas v.
VADC-Nicholson determined that Vietnam veterans who served in the waters off
Vietnam and did not set foot in Vietnam are entitled to a presumption of
exposure to herbicide agents, to include Agent Orange. This class of
veterans is generally known as blue water Navy veterans; but any claim,
regardless of branch of service, may be a Haas case. Prior to this
decision, VA’s interpretation of 38 CFR 3.307(a)(6)(iii) was that a service
member had to have actually set foot on Vietnamese soil or served on a craft in
its rivers (also known as brown water) in order to be entitled to the
presumption of exposure to herbicides. Specifically, the Court held the
following:
The
reference to service in
VA’s
regulation defining Vietnam service for purposes of granting the presumption of
exposure to herbicides is ambiguous when viewed together with 38 CFR 3.313,
which also defines service in Vietnam. The Court pointed to the use of
different conjunctions as well as the differing placement of a comma in each
regulation to prove the ambiguity and observed that VA had merely replaced
legislative ambiguity with regulatory ambiguity.
Because
of its determination that ambiguity was present, the Court looked to a
procedural manual (M21-1) provision from 1991 that stated that possession of a
Vietnam Service Medal (VSM) would be conceded as proof of Vietnam service in
the absence of contradictory evidence. The Court held this to be a
substantive rule establishing entitlement to the presumption of exposure to
herbicides. It held that VA’s attempted rescissions of that M21-1
provision were void because they failed to comply with the notice and comment
requirements of the Administrative Procedures Act (APA). The Court also
held that within the meaning of VA’s manual provisions: (1) proof that a veteran
had blue water service without setting foot on mainland
VA
has appealed the Haas decision to the U.S. Court of Appeals for the Federal
Circuit. The VA director subsequently issued a letter that provides
interim procedures for controlling claims affected by the CAVC decision. Regional
offices have been directed that claims with Haas issues will not be adjudicated
until this litigation is resolved but will be acknowledged upon receipt with
specific language approved by the Office of General Counsel and controlled as
indicated in this letter. Among other things it provides general answers
to typical questions VA employees may receive during interviews or when
answering telephones. The primary one is, “We have received your claim
for (insert the disability) based upon claimed herbicide exposure. Your
claim may be affected by recent judicial action by the Court of Appeals for
Veterans Claims in Haas v. Nicholson. VA has appealed that action to the
Federal Circuit. We must await the outcome of that appeal and receive
guidance from the Department of Veterans Affairs General Counsel prior to
taking further action on your claim. We will advise you further when we
receive guidance.”
The
Secretary’s brief is due to be filed in the Haas appeal on 8 JAN 07. The
National Veterans Legal Services (who are representing Hass) brief will be due
to be filed 40 days after the Secretary’s brief is served on NVLSP. The
Secretary then may file a reply brief 14 days after that. Thus, the briefing
will likely be completed by early March, but there is a small possibility that
either party may ask for, and be granted, extensions for those filings. The
Court will then likely schedule oral argument and, after it hears the argument,
issue a decision. The decision will likely be issued several months after the
oral argument and will be posted on the NVLSP website www.nvlsp.org.
Questions should be submitted to Richard V. Spataro, Staff Attorney, National
Veterans Legal Services Program, 1600 K Street, NW, Suite 500, Washington, DC
20006-2833 [Source: www.vawatchdog.org
14 Dec 06 ++]
§
VA PRESCRIPTION POLICY UPDATE:
The Department of Veterans Affairs is helping some veterans get generic
prescriptions for half the VA price. Veterans in health care priority
categories 4 through 8 normally must make an $8 co-pay for drugs from the VA
that might be available at the $4 rate being offered by Wal-Mart Stores Inc.,
and Target Corp. VA deputy undersecretary William Feeley has told VA providers
they can write prescriptions that can be filled at any private-sector pharmacy.
They cannot transfer the veterans’ prescriptions directly to a private-sector
pharmacy, but they can write new prescriptions if they meet state requirements
and cancel existing VA prescriptions.
§
VA Extends Presumptive Period
for Compensation for Gulf War Undiagnosed Illness:
VA issued an interim final rule, effective December 18, 2006, extending the
current presumptive period, which was set to expire at the end of year 2006, to
December 31, 2011, for compensation for disabilities resulting from undiagnosed
illnesses suffered by veterans who served in the Persian Gulf War. More than 16
years have passed since the 1991 Gulf War and major questions regarding the
etiology of the chronic unexplained multi-symptom illnesses suffered by
thousands of Gulf War veterans remain unanswered; research is ongoing.
Moreover; neither Congress nor the President have established an end date for
the Gulf War, and Southwest Asia Theater of operations continue. (Resource,
American Legion bulletin, 32-06, December 19, 2006)
§
VA Reaches out to Veterans and Spouse’s
“Aid and Attendance” an Under-Used Benefit:
The
Department of Veterans Affairs (VA) is reaching out to inform wartime veterans
and surviving spouses of deceased wartime veterans about an under-used, special
monthly pension benefit called Aid and Attendance.
“Veterans
have earned this benefit by their service to our nation,” said Secretary of
Veterans Affairs Jim Nicholson. “We want to ensure that every veteran or
surviving spouse who qualifies has the chance to apply.”
Although
this is not a new program, not everyone is aware of his or her potential
eligibility. The Aid and Attendance pension benefit may be available to
wartime veterans and surviving spouses who have in-home care or who live in
nursing-homes or assisted-living facilities.
Many
elderly veterans and surviving spouses whose incomes are above the
congressionally mandated legal limit for a VA pension may still be eligible for
the special monthly Aid and Attendance benefit if they have large medical
expenses, including nursing home expenses, for which they do not receive
reimbursement.
To
qualify, claimants must be incapable of self support and in need of regular
personal assistance.
The
basic criteria for the Aid and Attendance benefit include the inability to feed
oneself, to dress and undress without assistance, or to take care of one’s own
bodily needs. People who are bedridden or need help to adjust special
prosthetic or orthopedic devices may also be eligible, as well as those who
have a physical or mental injury or illness that requires regular assistance to
protect them from hazards or dangers in their daily environment.
For
a wartime veteran or surviving spouse to qualify for this special monthly
pension, the veteran must have served at least 90 days of active military
service, one day of which was during a period of war, and be discharged under
conditions other than dishonorable.
Wartime
veterans who entered active duty on or after September 8, 1980, (October 16,
1981, for officers) must have completed at least 24 continuous months of
military service or the period for which they were ordered to active duty.
If
all requirements are met, VA determines eligibility for the Aid and Attendance
benefit by adjusting for un-reimbursed medical expenses from the veteran’s or
surviving spouse’s total household income. If the remaining income amount
falls below the annual income threshold for the Aid and Attendance benefit, VA
pays the difference between the claimant’s household income and the Aid and
Attendance threshold.
The
Aid and Attendance income threshold for a veteran without dependents is now
$18,234 annually. The threshold increases to $21,615 if a veteran has one
dependent, and by $1,866 for each additional dependent. The annual Aid
and Attendance threshold for a surviving spouse alone is $11,715. This
threshold increases to $13,976 if there is one dependent child, and by $1,866
for each additional child.
Additional
information and assistance in applying for the Aid and Attendance benefit may
be obtained by calling 1-800-827-1000. Applications may be submitted
on-line at:
www.vabenefits.vba.va.gov/vonapp/main.asp/
Information
is also available on the Internet at http://www.va.gov/ or from any local veterans
service organization.
§
Global War on Terrorism Bonus:
Bonus of $100 for those with active service of 90 days or more between August
5, 1964, and August 15, 1973, or those who served in Vietnam between July 1,
1958, and August 5, 1964, and earned the Vietnam Service Medal or the Armed
Forces Expeditionary Medal. Must have been a bona fide resident of
Persian
Gulf War Bonus of $100. Each person who actively served as a member of the
armed forces of the United States between August 2, 1990, and November 30,
1995, and who earned the Southwest Asia Service Medal, and who was discharged,
released or has a certificate of service there from, under honorable
conditions, and who at the time of entry on such service, and at the time of
such service was a bona fide resident of this state shall be entitled to a $100
bonus. However, no individual who has received a Persian Gulf War Bonus payment
from another state shall be qualified to receive the NH bonus. Program expires
August 31, 2002, but there are provisions that allow for acceptance of
applications after that date. (See RSA 115-A:9).
Global
War on Terrorism Operations Service Bonus of $100. Each person who actively
served in any capacity as a member of the uniformed services of the United
States on or after September 11, 2001 and on or before a date to be determined
by the Secretary of Defense, and who earned the Global War on Terrorism
Expeditionary Medal or Afghanistan Campaign, or Iraq Campaign Medal; and who
was discharged, released or has a certificate of service there from, with an
honorable discharge, or who is missing in action or who was killed in action;
and who at the time of entry on such active service, and at the time of such
service was a bona fide resident of this state shall be entitled to the
benefits provided under this subdivision. Program ends on June 11, 2009, but
there are provisions that allow for acceptance of applications after that date.
(See RSA
115-A:16). For questions concerning these benefits, please contact the
Department Service Officer or State Veterans Council at 275 Chestnut Street
Room 517, Manchester, NH 03103-2411 or telephone (603) 624-9230 or
1-800-622-9230 (in state only).
§
National Registry of Veterans
with Amyotrophic Lateral Sclerosis (ALS):
The Department of Veterans Affairs (VA)
is developing a nationwide registry of veterans who have ALS, or Lou Gehrig's
disease. The goal of this registry is to collect important information for
studies on the causes of ALS in veterans. In addition, the registry will provide
a way for the VA to inform veterans with ALS about clinical trials and other
studies for which they may be eligible.
The ALS registry is also developing a DNA bank. The DNA Bank will
involve the collection and storage of DNA and plasma from blood samples
provided by registry participants. The samples will be available for studies
that examine genetic factors associated with ALS. ALS researchers will be able
to request access to the DNA samples in this bank, as well as the clinical data
that have been collected from participants.
All veterans who have been diagnosed with ALS, or their friends or
family members, are encouraged call 1-877-DIAL-ALS (1-877-342-5257) or email ALS@med.va.gov for more information. Additional
information about the registry can also be found at the following website:
http://www.va.gov/durham/alsregistry.asp.
§
Money for Child Care for Reserve
Families:
Army Reserve families will receive a minimum of $100 per child per
month towards their child care costs when they begin participating in the Child
& Youth Services child care programs. Some families may qualify for more
money based on their individual situation. To apply, visit the National
Association of Child Care Resource and Referral Agencies (NCCRRA) website at
http://www.naccrra.org. NCCRRA and DOD also offer child care services to severely
injured service members in locations across the
§
Some Families due Retroactive
Payments:
The
National Defense Authorization Act 2006 increased the amount of death benefits
paid to beneficiaries of all deceased active duty Service-members. The amount
has been increased for the Service-members Life Insurance (SGLI) from $250,000
to $400,000 and the death Gratuity from $12,000 to $100,000. If you suffered
the loss of a loved one between October 7 2001 and December 31, 2006, you may
be eligible for a retroactive death payment. For additional information contact
the
§
TRICARE Expands Healthcare
Benefit:
The
expansion of TRICARE Reserve Select by Congress earlier this year allows all
qualified members of the selected Reserve to purchase health care coverage.
Tier 2 and Tier 3 coverage began Oct. 1, 2006 for members whose request form
and premium is postmarked or submitted to a
TRICARE Prime Portability:
When you move to a new TRICARE region where Prime is available, you do not have
to change your TRICARE Prime coverage. However, you must transfer your
enrollment to the new regional contractor and select a new primary care manager
to avoid expensive point-of-service charges and interruption of coverage.
In addition, when you move, you must update your address in the Defense Eligibility
Enrollment Reporting System (DEERS) as soon as possible. You can update
DEERS online at http://www.dmdc.osd.mil/rsl/owa/home.
TRICARE Eligibility for
Newborns, Adoptee's:
It
is important to register newborns and adoptee's in DEERS to establish TRICARE
eligibility and avoid potential claims problems. It is important for you to
apply for your child’s social security number at the Social Security
Administration Website at http://www.ssa.gov
or by calling (800) 772-1213. Once you receive your child’s social
security number, visit your nearest identification (ID) card-issuing facility
to update their DEERS information. For more information on newborn or adoptee
DEERS registration, contact your military personnel office, uniformed service
ID card-issuing facility, or call (800) 538-9552. A list of ID card
facilities is available at http://www.dmdc.osd.mil/rsl/owa/home.
DEERS eligibility information is also available on the TRICARE website at http://www.tricare.osd.mil/deers/default.cfm
New TRICARE Standard Handbook
Released:
TRICARE officials are making a handbook available to all beneficiaries covered
under TRICARE Standard. This new manual goes into much greater detail than the
old booklet. Although the handbook is full of useful data from what's covered
to how to file a claim, it does not include cost information. Beneficiaries may
ask for copies of the TRICARE Standard handbook or the summary of beneficiary
costs flyer from their regional contractors or from a local
Basic
information on TRICARE Standard is available at http://www.tricare.osd.mil/Factsheets/viewfactsheet.cfm?id=318.
Reactivated? Don’t Lose Your
TRICARE Prime Coverage: The families of National
Guardsmen and Reservists enrolled in TRICARE Prime under the Transitional
Assistance Management Program (TAMP) are automatically switched to TRICARE
Standard when their sponsors are recalled to active duty. But new rules allow
them to keep their Prime coverage when they re-enroll up to 30 days after the
sponsor’s activation. The new policy authorizes a 30-day retroactive TRICARE
Prime enrollment period for transitioning family members. As long as the family
gets reenrolled in TRICARE Prime within 30 days of the member’s reactivation,
Prime coverage remains unchanged, with coverage back to the date the sponsor
was recalled to active duty.
A
TAMP fact sheet explains details of this policy, at http://www.tricare.osd.mil/Factsheets/viewfactsheet.cfm?id=317.
§
VA Services for Veterans of
Operation Iraqi Freedom and Operation Enduring Freedom:
The
Department of Veterans Affairs (VA) and the Department of Defense (DOD)
continue their partnership to meet the needs of our newest veterans – the men
and women who served in Operation Iraqi Freedom and Operation Enduring Freedom
(OIF/OEF) – by assisting them with a smooth transition from active duty to
civilian life.
VA’s
goal is to ensure that every seriously injured or ill serviceman and woman
returning from combat receives priority consideration and world-class
service. Together VA and DOD are finding ways to move records more
efficiently between the two agencies; share critical medical information
electronically; protect the health of troops stationed in areas where environmental
hazards pose a threat; process benefits claims quickly and efficiently; and, in
every way possible, hold open the doors to an uncomplicated passage from
soldier to citizen.
Benefits and Services:
Active-duty personnel, and Reservist or National Guard members who serve in a
theater of combat operations are eligible for hospital care, medical services,
and nursing home care for injuries or illnesses they believe are related to
combat service for a period up to two years beginning on the date of discharge or
release from service. This two-year eligibility for medical care is
available even if there is insufficient medical evidence to conclude that the
veteran’s illness is the result of combat service. At the end of the
two-year period, these veterans can continue to receive free health care for
injuries and illnesses officially connected to military service.
In
addition to health care, VA offers a spectrum of programs for veterans,
including disability compensation, vocational rehabilitation, prosthetic services,
life insurance, pension, education benefits, specially adapted housing and
automobile grants, and survivor and burial benefits. Many VA services are
provided at a higher priority or on an expedited basis for this newest
generation of combat-disabled veterans. VA programs for veterans with a
service-connected injury or illness apply equally to those who served in the
regular active duty forces and to National Guard members or reservists
returning from federal activation.
Seamless Transition – 2/2/2/2
VA Outreach:
In an effort to assist wounded military members and their families, VA placed
benefits counselors and social workers at key military hospitals where severely
wounded service members from
Currently,
six staff members are assigned
full-time to work with patients at both the
Similar
teams work with patients, discharge planners, and other military staff at six
other key DOD medical centers caring for seriously injured troops:
Eisenhower Army Medical Center, Ft. Gordon (Ga.); Brooke Army Medical Center,
Ft. Sam Houston (Texas); Madigan Army Medical Center at Western Regional
Medical Command, Tacoma (Wash.), Darnall Army Medical Center at Ft. Hood
(Texas); Evans Army Hospital at Ft. Carson (Colorado); and Camp Pendleton Naval
Medical Center in San Diego, (Calif.).
Throughout
the nation, VA officials identify service members from
Military Services Briefings:
Military Services Briefings
are designed to ensure that service-members are aware of their VA benefits and
to provide assistance as needed. Briefings include separation and
retirement seminars, pre- and post-deployment briefings as well as the formal
Transition Assistance Program. For those leaving active duty due to medical
problems, the outreach effort is intensified to ensure a full understanding of
the VA compensation process and vocational rehabilitation and employment
programs.
Generally
briefings range from one to three hours; however, the formal TAP workshop is a
three-day seminar conducted by VA, DOD and the Department of Labor at military
installations for personnel within 90 days of separation. It provides a
number of services to assist military personnel in making a smooth transition
to civilian life. All military services briefings cover the full range of
benefits administered by VA including compensation, education, vocational
rehabilitation and employment, health care, insurance and more.
Seamless Transition
– 3/3/3/3
Benefits Delivery at Discharge:
A joint VA-DoD initiative
is helping personnel file for and receive service-connected disability
compensation benefits more quickly than in the past. The goal is to
adjudicate claims within 30 days of discharge by examining service members as
part of the discharge process. By comparison, VA's national average
processing time is 163 days for claims requiring a disability rating.
In the Benefits Delivery at
Discharge program, the medical information needed to begin the VA claims
process carries over from DOD to VA seamlessly. In addition, if a service
member is found to be disabled,
additional applicable
vocational and employment services may be quickly initiated.
Additional Resources:
VA
has brochures and other information for veterans of Operation Iraqi Freedom and
Operation Enduring Freedom available on the Web:
Veterans
Benefits
Information
http://www.vba.va.gov/
Information for Iraqi Freedom Veterans &nb