Post Service Officer Basics · Persian Gulf Radiation Exposure ... • Oral surgery • Osteopath, ... VA Form 21-2680 Exam for House bound/A&A

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Post Service Officer Basics

Cindy SmithOutreach Service Officer

6 June 2018

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Post Service Officer BasicsWhat you should know?

NVS Policy & Procedure Code of Conduct Knowledge on VA Benefits VA Forms to apply for VA Benefits Resources

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NVS Policy & ProceduresPost/District Service Officers

Will NOT retain any Personal Identifying Information. Act as recorders to assist in transcribing information on the

correct VA forms (cannot counsel or give guidance on VA claims).

Are under the general supervision of Department Service Officer (DSO).

Cannot make direct contact with VA. Cannot obtain status checks from DSO.

All Forms are to be returned to claimant for submittal to DSO

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NVS Policy & ProceduresCode of Conduct

Representation is Gratuitous Fraudulent Claims/false information Unlawful, unprofessional, or unethical practices (deceiving or

misleading claimant) Inappropriate jokes, slurs, innuendoes Sexual advances Discrimination

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Knowledge & Forms VA Benefits

A basic understanding of VA benefits is required in order to assist claimants with transcribing information on VA forms

Representation Effective Dates Compensation Pension Dependents Status Dependency and Indemnity Compensation Survivors Pension

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Knowledge & Forms VA BenefitsRepresentation: What?

A Veteran can appoint a Veteran Service Organization to represent him/her before the VA. The appointment of a representative is referred to as a Power of Attorney (POA). A Veteran may have only one representative.

The Veterans of Foreign Wars representation policy is that the acceptance or refusal of a Veteran’s POA is determined by an accredited representative.

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Knowledge & Forms VA BenefitsRepresentation: How?

Form Used VA Form 21-22 Appointment of Veterans Service Organization

ONLY an accredited representative can sign a VA form 21-22. Post Service Officers are NOT authorized to sign. Post Service Officers will NOT determine POA acceptance or

refusal.

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Knowledge & Forms VA BenefitsEffective Dates: What?

Effective dates are important because they determine the start or change in payments for Veteran and survivor benefits.

Effective dates are established by filing an intent to file or filing a formal claim. Exceptions are when a Veteran files within the first year of discharge or when a surviving spouse files within first year of the death of the Veteran.

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Knowledge & Forms VA BenefitsEffective Dates: How?

Forms Used VA Form 21-0966 Intent to file VA Form 21-526ez Application for Disability Compensation VA Form 21p-527ez Application for Veteran Pension VA Forms 21p-534ez Application for DIC/Pension/Accrued Benefits

Intent to file (ITF) An ITF is the best option when the Veteran or survivor is unsure what he/she

want to file or does not have all documents. It is NOT a formal claim but reserves the claim for one year from the date of

filing. A formal claim is required to be filed. The ONLY the disabilities filed on the first formal claim will be retroactive to

date of the ITF.

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Knowledge & Forms VA BenefitsEffective Dates: How?

What is the effective date for back pain?

What is the effective date for tinnitus?

VA Form 21-0966

Compensation

VA Form 21-526ezBack Pain

Hearing loss

VA Form 21-526ezTinnitus

12/12/2017 03/17/2018 07/10/2018

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Knowledge & Forms VA BenefitsDisability Compensation: What?

Disability Compensation is a monthly monetary benefit paid to Veterans because of a disability or disabilities that developed in military service or because of military service.

Each disability is rated individually according to VA regulations. Disabilities are divided by body systems and parts of the body. Disability can be granted at a 0% or in intervals of 10% to 100%. The disabilities are combined for pay purposes.

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Knowledge & Forms VA BenefitsDisability Compensation: What?

Service connection

NexusDisability has to have connection to service

DisabilityVeteran must prove the disability exists

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Knowledge & Forms VA BenefitsDisability Compensation: How?

There are four ways that Veterans can relate their disabilities to service:

Direct Secondary Presumptive Aggravation

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DirectAn injury or illness (disease) that occurred or was diagnosed while in service or in the line of duty (LOD).

Continuity and chronicity are VERY important.

Examples: An active duty Veteran injured his back in service and

required continuous medical care. A reservist fell and injured her hip while on drill. A LOD

determination was done. A Veteran was diagnosed with essential hypertension while

on active duty.

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SecondaryA secondary condition develops from a primary service connected condition.

A doctor will need to connect the two in writing (nexus statement).

Examples: Peripheral neuropathy (numbness in a limb) from type II

diabetes. Sciatica from a back condition. Sleep apnea from trauma to face (broken nose or injury to

sinus condition).

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PresumptiveAn illness that has developed either within a specified length of time following active service or because of environmental exposures or unique military service. Length of time 1 year: Chronic conditions such as arthritis and hypertension 7 years: Multiple Sclerosis Exception: ALS (Lou Gehrig’s disease) Environmental Exposures Agent Orange (Vietnam and areas in Korea and Thailand) Water Contamination in Camp LeJeune NC Persian Gulf Radiation Exposure Unique Military service POW or chemical testing

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Aggravation A condition that worsens during active service by a measurable degree according to the VA regulation.

Examples A reservist has controlled hypertension before mobilization and

while on active duty his blood pressure readings become elevated.

A Veteran had surgery in high school for her right ankle. While on active duty, the ankle began to swell and she loses some range of motion in the ankle.

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EvidenceTimeline dictates the burden of evidence for direct injuries Less than a year from dischargeGreater than a year from discharge

Evidence of the disability is requiredTreatment within the VA medical system must be reported in the claims process.Private medical records have to be provided or consent given for the VA to obtain the records.Disability Benefit Questionnaires (DBQ) are available for most disabilities.

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Forms Used VA Form 21-526ez Application for Compensation VA Form 21-4142(a) Release for private medical treatment

Supporting Documents Discharge Documents/DD214 Service Medical Records (if initial and if available) Private Medical Records

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Knowledge & Forms VA BenefitsVeterans Pension: What?

Veterans Pension is a tax-free monetary benefit payable to low-income wartime Veterans. There are multiple levels that effects the amount paid and medical expenses considered. Housebound. This increased monthly pension amount the if the Veteran is substantially confined to his/her immediate premises because of permanent disability

Aid & Attendance (A&A). The A&A increased monthly pension amount may be added to monthly pension amount if the Veteran meets one of the following conditions: Require aid of another person in order to perform personal functions required in everyday living; bedridden; a patient in a nursing home due to mental or physical incapacity; eyesight is limited.

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Minimum Service RequirementsVeteran must have at least 90 days of active duty service, with at least one day during a wartime period. If the active duty occurred after September 7, 1980, the Veteran is required to have served at least 24 months or the period called up.

Wartime Periods Mexican Border Period (May 9, 1916 – April 5, 1917) World War I (April 6, 1917 – November 11, 1918) World War II (December 7, 1941 – December 31, 1946) Korean conflict (June 27, 1950 – January 31, 1955) Vietnam era (February 28, 1961 – May 7, 1975 for Veterans who served in the

Republic of Vietnam during that period; otherwise August 5, 1964 – May 7, 1975) Gulf War (August 2, 1990 – through a future date to be set by law or Presidential

Proclamation)

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Age or Disability RequirementsIn addition to meeting minimum service requirements, the Veteran must be:

Age 65 or older, OR Totally and permanently disabled, OR A patient in a nursing home receiving skilled nursing care, OR Receiving Social Security Disability Insurance, OR Receiving Supplemental Security Income

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Income limitsMaximum Annual Pension Rate (MAPR) Category Amount

If you are a veteran... Your yearly income must be less than...

Without Spouse or Child $13,166

To be deducted, medical expenses must exceed 5% of MAPR, or, $ 659

With One Dependent $17, 241


Housebound Without Dependents $16,089

Housebound With One Dependent $20,166

A&A Without Dependents $21,962

A&A With One Dependent $26,036

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Medical Expenses• Abdominal supports• Acupuncture service• Ambulance hire• Anesthetist• Arch supports• Artificial limbs and teeth• Back supports• Braces• Cardiographs• Chiropodist• Chiropractor• Convalescent home (for medical treatment

only)• Crutches• Dental service, for example, cleaning, x-

ray, filling teeth• Dentures• Dermatologist• Drugs, prescription and nonprescription• Gynecologist• Hearing aids and batteries• Home health services• Hospital expenses

• Lab tests• Lip reading lessons designed to overcome a

disability• Lodging incurred in conjunction with out-of-

town travel for treatment (to be determined on a facts-found basis)

• Long-term care insurance• Medical insurance premiums• Medicare premiums• Neurologist• Nursing services for medical care, including

nurse’s board paid by claimant• Occupational therapist• Ophthalmologist• Optician• Optometrist• Oral surgery• Osteopath, licensed• Pediatrician examinations• Physical examinations• Insulin treatment• Insurance premiums, for medical insurance

only• Invalid chair

• Physician• Physical therapy Podiatrist• Psychiatrist• Psychoanalyst• Psychologist• Psychotherapy• Radium therapy• Sacroiliac belt• Service animals and maintenance• Speech therapist• Splints• Surgeon• Telephone/teletype special

communications equipment for the deaf• Transportation expenses for medical

purposes (plus parking and tolls or actual fares for taxi, buses)

• Vaccines• Wheelchairs• Whirlpool baths for medical purposes• X-rays

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Knowledge & Forms VA BenefitsVeteran Pension: How?

Forms Used VA Form 21p-527ez Application for Pension VA Form 21p-8416 Medical Expense Report VA Form 21-2680 Exam for House bound/A&A

Supporting Documents Military Discharge/DD214

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Knowledge & Forms VA BenefitsSurvivor Benefits: What?

Dependency and Indemnity Compensation (DIC) VA Benefit for eligible dependents of veterans who died as a result of conditions caused by military service.

Survivors PensionIncomed based VA Benefit for eligible dependents of deceased veterans with wartime service (see wartime service requirement in earlier slide).

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Knowledge & Forms VA BenefitsSurvivor Pension: What?

Income limitsMaximum Annual Pension Rate (MAPR) Category Amount

If you are a Surviving Spouse... Your yearly income must be less than...

Without Dependent Child $8,830


With One Dependent Child $11,557


Housebound Without Dependents $10,792

Housebound With One Dependent $13,514

A&A Without Dependents $14,113

A&A With One Dependent $16,837

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Knowledge & Forms VA BenefitsSurvivors Benefit: How?

Forms Required VA Form 21p-534ez Application for DIC/Pension/Accrued

Benefits VA Form 21p-8416 Medical Expense Report VA Form 21-2680 Exam for House bound/A&A

Supporting Documents Death certificate Veteran’s Discharge papers/DD214

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Knowledge & Forms VA BenefitsBurial Benefits: What?

Burial allowance is a flat rate one time payment to cover the cost of a Veteran’s burial and funeral costs.

Service Connected Death Up to $2,000 if the Veteran died after 9/11/2001 Up to $1,500 if the Veteran died before 9/11/2001

Non Service Connected Death $300 burial and $762 for plot if Veteran died after 10/1/2017 $300 burial and $749 for plot if Veteran died after 10/1/2016 but before

10/1/2017 $300 burial and $747 for plot if Veteran died after 10/1/2015 but before

10/1/2016

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Knowledge & Forms VA BenefitsBurial Benefits: How?

Forms Required VA Form 21p-530ez

Supporting Documents Death certificate Veteran’s Discharge papers/DD214 (if Veteran had not filed a

claim) Itemized, paid-in-full funeral bill, if claiming transportation

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Knowledge & Forms VA BenefitsHow to get a Military Discharge?

National Personnel Records Center The best option is on line at www.archives.gov Emergency request can be processed

Form Used Standard Form 180 Fax Number 314-801-9195 Mailing address:

National Personnel Records Center Military Personnel Records1 Archives DriveSt. Louis, MO 63138

http://www.archives.gov/

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Knowledge & Forms VA BenefitsVA Health Care: What?

VA provides a number of health care services, including:

Hospital, outpatient medical, dental, pharmacy, and prosthetic services Domiciliary, nursing home, and community-based residential care Treatment related to Military Sexual Trauma (MST) Readjustment counseling Homeless Veteran programs Alcohol and drug dependency treatment Medical evaluation for disorders related to Gulf War service or

environmental hazards Specialized health care for women Veterans

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Knowledge & Forms VA BenefitsVA Health Care: What?

Eligibility Veterans with service connected disabilities Veterans who were discharged for a disability incurred or aggravated in the

line of duty, or a hardship or “early out.” Former Prisoner of War (POW) Purple Heart Medal recipient Medal of Honor recipient Veterans in receipt of a VA Pension Veteran who served in the Republic of Vietnam from January 9, 1962 to May

7, 1975. Veteran who served in the Persian Gulf from August 2, 1990 to November 11,

1998. Veterans who were stationed or resided at Camp Lejeune for 30 days or more

between August 1, 1953 and December 31, 1987

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Knowledge & Forms VA BenefitsVA Health Care: How?

By Phone Call 1-877- 222-VETS (8387) Monday - Friday between 8 a.m. and 8 p.m. ET.

OnlineGo to www.1010ez.med.VA.gov/

By Mail The application form (10-10ez) can be downloaded from www.va.gov/healthbenefits/enroll. Mail the completed form to: Health Eligibility Center EnrollmentEligibility Division 2957 Clairmont Road Suite 200 Atlanta, GA 30329-1647

In Person You can apply at any VA health care facility. www.va.gov/directory

http://www.1010ez.med.va.gov/

http://www.va.gov/directory

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ResourcesOnline

Benefits Information eBenefits: www.ebenefit.va.gov VA Forms: www.va.gov/vaforms General: www.va.gov Technical: www.knowva.ebenefits.va.gov Maryland State Benefits: http://veterans.maryland.gov

Help Maryland 211: https://211md.org VFW Unmet Needs: www.vfw.org/assistance/financial-grants

http://www.ebenefit.va.gov/

http://www.va.gov/vaforms

http://www.va.gov/

http://www.knowva.ebenefits.va.gov/

http://veterans.maryland.gov/

https://211md.org/

http://www.vfw.org/assistance/financial-grants

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Service Program Contact Information

BaltimoreDCO: Mary Walters31 Hopkins Plaza, Room 1226Baltimore, MD 21201Phone: 410-230-4480Fax: 410-230-4481

OutreachService Officer Cindy [email protected]

mailto:[email protected]