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Department Service Officer Newsletter

Volume 6, Issue 1

March 1, 2008

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:

COMBAT VETERANS ELIGIBILITY: On January 28, 2008, “Public Law 110- Enhanced Eligibility for Health Care Benefits 181” titled the “National Defense Authorization Act of 2008” was signed into law. Section 1707 amended Title 38, United States Code (U.S.C.), Section 1710(e)(3), extending the period of eligibility for health care for veterans who served in a theater of combat operations after November 11, 1998, (commonly referred to as combat veterans or OEF/OIF veterans).

Under the “Combat Veteran” authority, the Department of Veterans Affairs (VA) provides cost-free health care services and nursing home care for conditions possibly related to military service and enrollment in Priority Group 6, unless eligible for enrollment in a higher priority to:

• Currently enrolled veterans and new enrollees who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits, for 5 years post discharge.

• Veterans discharged from active duty before January 28, 2003, who apply for enrollment on or after January 28, 2008, are eligible for the enhanced benefit until January 27, 2011.

Combat veterans, while not required to disclose their income information, may do so to determine their eligibility for a higher priority status, beneficiary travel benefits and exemption of co-pays for care unrelated to their military service.

Who’s eligible: Veterans, including activated Reservists and members of the National Guard, are eligible if they served on active duty in a theater of combat operations after November 11, 1998, and have been discharged under other than dishonorable conditions.

• Military service documentation that reflects service in a combat theater, or

• Receipt of combat service medals and/or,• receipt of imminent danger or hostile fire pay or tax benefits.

• Cost-free care and medications provided for conditions potentially related to combat service.

• Enrollment in Priority Group 6 unless eligible for enrollment in a higher priority group.

What happens after the enhanced eligibility period expires: Veterans who enroll with VA under this authority will continue to be enrolled even after their enhanced eligibility period ends. At the end of their enhanced eligibility period, veterans enrolled in Priority Group 6 may be shifted to Priority Group 7 or 8, depending on their income level, and required to make applicable co-pays.

What about combat veterans who do not enroll during their enhanced authority period: For those veterans who do not enroll during their enhanced eligibility period, eligibility for enrollment and subsequent care is based on other factors such as: a compensable service-connected disability, VA pension status, catastrophic disability determination, or the veteran’s financial circumstances. For this reason, combat veterans are strongly encouraged to apply for enrollment within their enhanced eligibility period, even if no medical care is currently needed.

Co-pays: Veterans who qualify under this special eligibility are not subject to co-pays for conditions potentially related to their combat service. However, unless otherwise exempted, combat veterans must either disclose their prior year gross household income OR decline to provide their financial information and agree to make applicable co-pays for care or services VA determines are clearly unrelated to their military service.

Note: While income disclosure by a recently discharged combat veteran is not a requirement, this disclosure may provide additional benefits such as eligibility for travel reimbursement, cost-free medication and/or medical care for services unrelated to combat.

Dental Care: Eligibility for VA dental benefits is based on very specific guidelines and differs significantly from eligibility requirements for medical care. Combat veterans may be authorized dental treatment as reasonably necessary for the one-time correction of dental conditions if:

• They served on active duty and were discharged or released from active duty under conditions other than dishonorable from a period of service not less than 90 days and

• The certificate of discharge or release does not bear a certification that the veteran was provided, within the 90-day period immediately before the date of such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental service and treatment indicated by the examination to be needed and

• Application for VA dental treatment is made within 180 days of discharge or release Additional information: Additional information is available at the nearest VA medical facility. VA facilities listing and telephone numbers can be found on the internet at www.va.gov/directory, or in the local telephone directory under the “U.S. Government” listings. Veterans can also call the Health Benefit Service Center toll free at 1-877-222-VETS (8387) or visit the VA health eligibility Website at www.va.gov/healtheligibility.

VA Healthcare means test thresholds for 2008: Many veterans can qualify for VA healthcare services regardless of their income if they meet certain special category requirements, such as, having a service connected disability rating 10% or more disabling, having earned the Purple Heart award, being declared catastrophically disabled, having enrolled before January 16, 2003, etc.

Veterans not meeting any of the special category requirements can still enroll for VA healthcare services if their 2007 income was no more than the following:

Dependent threshold amounts increases above two dependents at $1,909 per dependent. Also, VA’s healthcare income thresholds can be replaced with higher HUD income thresholds in high cost of living areas.

To enroll, veterans should contact the enrollment office at their nearest VA Medical Center.

OUTPATIENT DENTAL TREATMENT: Outpatient dental benefits are provided by the Department of Veterans Affairs according to law. In some instances, VA may provide extensive dental care , while in other cases treatment may be limited. This Fact Sheet describes the outpatient dental eligibility criteria and contains information veterans should know in order to understand eligibility for VA dental care.

ELIGIBILITY: Veterans are eligible for outpatient dental treatment if they are determined by VA to meet one of the following criteria:

• Those having a service-connected compensable dental disability or condition are eligible for any needed dental care.

• Those who were prisoners of war (POWs) and those whose service-connected disabilities have been rated at 100 percent or who are receiving the 100 percent rate by reason of individual unemployability are eligible for any needed dental care.

• Those who are participating in a VA vocational rehabilitation program under 38 U.S.C. chapter 31 are eligible for dental care necessary to: enter into a rehabilitation program, achieve the goals of the veteran’s vocational rehabilitation program; or prevent interruption of a rehabilitation program; or hasten the return to a rehabilitation program of a veteran in interrupted or leave status; or hasten the return to a rehabilitation program of a veteran placed in discontinued status because of illness, injury or a dental condition; or secure and adjust to employment during the period of employment assistance; or to achieve maximum independence in daily living.

• Effective January 28, 2008, recently discharged veterans with a service-connected non-compensable dental condition or disability who served on active duty 90 days or more and who apply for VA dental care within 180 days of separation from active duty, may receive one time treatment for dental conditions if the dental condition is shown to have existed at the time of discharge or release and the veteran’s certificate of discharge does not indicate that the veteran received necessary dental care within a 90-day period prior to discharge or release. This includes veterans who reentered active military, naval, or air service within 90 days after the date of a prior discharge and; veterans whose disqualifying discharge or release has been corrected by competent authority.

Note: Veterans discharged between August 1, 2007, and January 27, 2008, are eligible for the dental benefit by making application within 180 days of their discharge. Veterans previously denied this one time dental benefit because application was made outside of the previously mandated 90 day period after separation will be contacted to review and correct, as appropriate, your application denial. Affected veterans may also contact their local medical center to review and correct, as appropriate, their denied application.

• Those having a service-connected non-compensable dental condition or disability resulting from combat wounds or service trauma are eligible for repeat care for the service-connected condition(s).

• Those having a dental condition clinically determined by VA to be currently aggravating a service-connected medical condition are eligible for dental care to resolve the problem.

• Those with nonservice-connected dental conditions or disabilities for which treatment was begun while the veteran was in an inpatient status in a VA medical center, when it is clinically determined to be necessary to complete such dental treatment on an outpatient basis.

• Those receiving outpatient care or scheduled for inpatient care may receive dental care if the dental condition is clinically determined to be complicating a medical condition currently under treatment.

• Certain veterans enrolled in a VA Homeless Program for 60 consecutive days or more may receive certain medically necessary outpatient dental services.

For more information about eligibility for VA medical and dental benefits, contact the Health Benefits Service Center at 1-877-222-8387 or www.va.gov/healtheligibility.

Separation Program Numbers (SPN) Codes: Even on an Honorable discharge, an unfavorable "Spin Code" (SPN - Separation Program Number) could hurt a veteran's chance of being hired by a prospective employer.

These spin codes were put on DD Forms 214 (discharge papers) from the 1940's through the early 1970's.

SPN 463 - Paranoid personality

a complete listing of spin codes can be found at http://www.landscaper.net/discharg.htm. Veterans can request a new DD 214 with the spin codes removed.

If you were in the US Army, written requests for having a SPN code removed from your DD 214 (Report of Separation from Active Duty) or earlier discharge papers, should be sent to:

Additional info on this subject is available at: http://veterancourtcodes.com containing a 90 minute video on the subject.

Emergency Medical Care at VA Expense: VA may pay non-VA emergency medical care expenses for veterans under the following circumstance(s):

Ø The veteran has been provided care by A VA clinician or provider within the last 24 months,

Ø The veteran was provided care in a hospital emergency department or similar facility providing emergency care,

Ø The veteran does not have coverage under Medicare, Medicaid, or a state program,

Ø Department of Veterans Affairs or other Federal facilities were not feasibly available at the time of the emergency,

Ø A reasonable lay person would judge that any delay in medical attention would endanger the veteran’s health or life,

Ø The veteran has no other contractual or legal recourse against a third party that will pay all “or part” of the bill.

VA is obligated to pay for the cost of emergency medical care when required for service-connected disabilities, or for non-service connected medical conditions if the veteran has a 100% service connected disability rating.

The veteran or someone on the veteran’s behalf should notify the VA Medical Center within 72 hours of the emergency medical care that the veteran is willing to transfer to the VA when his or her condition stabilizes.

Veteran Travel Reimbursement Increase: Benefit Description: If you meet the criteria below, you may be eligible for VA beneficiary travel benefits associated with obtaining VA health care services. In most cases, travel benefits are subject to a deductible. Deductibles apply for compensation and do not pension examinations and for travel by an ambulance or a specially equipped van.

You Qualify for Special Mode Transportation (Ambulance, wheelchair van etc.) If:

1. Your medical condition requires an ambulance or a specially equipped van, and

3. The travel is pre-authorized (authorization is not required for emergencies if a delay would be hazardous to life or health)

Note: OEF/OIF Combat Veterans must meet one of the qualifying eligibilities or conditions noted above.

General Travel .............................................................$ 0.285 (28.5 cents) per mile

Scheduled appointments qualify for round-trip mileage. Unscheduled visits may be limited to return mileage only.

Deductible: …………………………………………$7.77 one-way ($15.54 round trip).

• Deductible requirement is subject to a monthly cap of $46.62. Upon reaching $46.62 in deductibles, travel payments made for the balance of that particular month will be free of deductible charges.

• Veterans whose projected income in the year of application will not exceed the applicable VA pension rate may request a waiver from the deductible requirement.

NOTE: Mileage reimbursement claims for travel prior to February 1, 2008 will be processed at the previous rates of 11 cents per mile for travel in relation to health care and 17 cents per mile for recalls due to an insufficient lab, EKG, x-ray, etc. in relation to a Compensation and Pension examination (“Convenience of the Government”) with deductibles of $3 per one-way trip; $6 for a round-trip; with a maximum of $18 per calendar month.

Basic Care Services—services provided by a primary care clinician $15/visit

Specialty Care Services—services provided by a clinical specialist such as surgeon, radiologist, audiologist, optometrist, cardiologist, and specialty tests such as magnetic resonance imagery (MRI), computerized axial tomography (CAT) scan, and nuclear medicine studies $50/visit

* Co-pay amount is limited to a single charge per visit regardless of the number of health care providers seen in a single day. The co-pay amount is based on the highest level of service received. There is no co-pay requirement for preventive care services such as screenings and immunizations.

For each 30-day or less supply of medication for treatment of nonservice-connected condition $8 (Veterans in Priority Groups 2 through 6 are limited to $960 annual cap)

Inpatient Co-pay for each additional 90 days of care during a 365-day period $512

** Based on geographically-based means testing, lower income veterans who live in high-cost areas may qualify for a reduction of 80% of inpatient co-pay charges.

Nursing Home Care/Inpatient Respite Care/Geriatric Evaluation maximum of $97/day

Adult Day Health Care/Outpatient Geriatric Evaluation Outpatient Respite Care .............maximum of $15/day

*** Co-pays for Long-Term Care services start on the 22nd day of care during any 12-month period—there is no co-pay requirement for the first 21 days. Actual co-pay charges will vary from veteran to veteran depending upon financial information submitted on VA Form 10-10EC.

Guard and reserve update: The total number of Guard and Reserve on active duty as of February 20, 2008 has increased by 2,555 from the last report to 95,228.

The totals for each service are Army National Guard and Army Reserve, 73,808; Navy Reserve, 5,225; Air National Guard and Air Force Reserve, 7,128; Marine Corps Reserve, 8,724; and the Coast Guard Reserve, 343.