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@  babyray : (21 August 2014 - 07:15 AM) Dc
@  rootbeer22 : (20 August 2014 - 02:19 PM) Buddy Statements
@  IraqVet : (19 August 2014 - 07:02 PM) Anyone Recieveing Letters From Vfw To Applay For Tricare And Campava Supplimantal Insurance When You Do Not Have 100% Yet....mines Pending But I Wonder If They Know Something I Dont
@  Detonator : (19 August 2014 - 10:51 AM) Insomnia
@  jbasser : (18 August 2014 - 08:29 PM) Folks, Dont Miss The Hadit Radio Show Wed At 1Pm Eastern. The Basser Hour.
@  Thadine : (18 August 2014 - 12:23 PM) Nod
@  carlie : (18 August 2014 - 08:37 AM) Notapb1 - Might Get More Replies If You Post The Questions Into The Forums.
@  notapb1 : (18 August 2014 - 07:26 AM) Looking For Feedback. I Have Applied For Iu. Was Told To Come In For A Psych Eval And Diabetes Clinic. Received A Call From Va They Were Cancelling The Psych Eval As The Doc(?) Who Did It In March(Ptsd Increase) Was Asked For His Opinion And He Was Going To Submit That. This Is The Same Individual Who Told Me Off The Record About Iu And To Contact My Service Officer. Sounds Positive To Me, But I May Be A Little Bias. Thoughts?
@  waltbarb : (16 August 2014 - 08:35 PM) Appeal
@  MarkInTexas : (16 August 2014 - 04:49 PM) Just Testing This "shout" Thing....... Have A Great Weekend Everybody!
@  Notorious Kelly : (16 August 2014 - 04:40 PM) I Reset Firefox And Now Can Read- Probably Kok Issue (Kitties On The Keyboard)
@  Notorious Kelly : (16 August 2014 - 04:25 PM) I Couldn't Read Posts So I Changed Theme To Ipboard Mobile. Now I Can Read And It Says Hadit Custom
@  carlie : (16 August 2014 - 03:32 PM) Raymondb50 - Probably Better To Post Your Question To The Board.
@  carlie : (16 August 2014 - 03:15 PM) Raymondbb50 - What Is It That You Want ?
@  raymondb50 : (15 August 2014 - 09:47 PM) How Do I Change Member Title And Group Info In My Profile?
@  carlie : (15 August 2014 - 08:37 PM) Just Saying Hi To All
@  WoundedWarrior : (14 August 2014 - 08:50 AM) Got Unofficial Word From The Vso - Unofficially Approved For Tdiu, Effective Date 6/3/2014
@  mrmark1999 : (13 August 2014 - 06:23 PM) Ok When You Call The 1800 # You Feel Like They Allways Have Heavy Call Volume
@  Notorious Kelly : (13 August 2014 - 06:08 AM) Hi Autumn - Those Links Aren't Working Thru Shoutbox; Maybe In A Regular Post. Thanks!
@  autumn : (12 August 2014 - 05:46 PM) Http://bit.ly/1Ojvi2B : Why Would A Doctor With A Sense Of Integrity And Really Good Medical Quals Want To Work At This Thug Org? Central Office Ties Their Hands Too Boot.

Help Topic: Veterans Claims FAQ


FREQUENTLY ASKED QUESTIONS
& TOPICS OF DISCUSSION



VA HEALTH CARE AND ENROLLMENT—GENERAL INFORMATION


1. Who is eligible to receive health care through the VA system?

Any individual who served on active duty in the Army, Navy, Air Force, Marines or Coast Guard, and received honorable discharge or release under honorable conditions has basic eligibility for VA healthcare. Those who served after 1980 must have served 24 months active duty to be eligible.



2. How do I apply?

A quick and easy application form is available at any VA facility or by calling for an appointment. Applications are also available over the Internet by accessing the following web site: http://www.va.gov/1010ez.htm.

3. What services can I receive?

All necessary inpatient and outpatient health services, including preventive and primary care, diagnostic and treatment services as well as rehabilitation, mental health treatment, substance abuse treatment, home health, respite and hospice care, women’s clinic and prescribed drugs. In addition to medical care, the VA offers a variety of additional benefits to qualified veterans, including housing loan guaranties, educational benefits, burial plots and financial assistance to veterans and their dependents. Veterans Affairs has an annual booklet explaining these that you can purchase from any Government Printing Office outlet and which is available generally online.

4. What is compensation?

Compensation is Veterans Affairs monthly cash benefits payable to veterans for problems related to the time of life they were in active service. They are also available if you were injured in a Veterans Affairs hospital. If Veterans Affairs considers you are disabled by a condition that is service connected, it will then determine the percentage to which you are disabled and then base your monthly payments on the extent to which you are currently disabled.

5. What is a pension?

Pension is financial assistance to keep you above the waterline of poverty. It requires (1) honorable service at least 90 days during wartime; (2) health problems that are unrelated to service and other health problems serious enough to render you totally disabled; and (3) little or no income from any other source. Wartime service includes World War I, World War II, Korea, Vietnam, and the Persian Gulf era. Service in Panama or Grenada is not considered wartime service.

6. What is a service-connected disability?

A disability is service connected if you can prove that it resulted from injuries or an illness that you had in the military. It also includes conditions can be established are secondary to a service-connected illness or disease. It further can include a condition you had before the service that was aggravated by your service. The only conditions that are excluded are those that result from alcohol or drug usage.

7. Do I need to have incurred an illness or injury while wearing a uniform, on base or on a ship or at war?

No. You can be service connected for almost any illness or injury caused while you were in service or on leave from service.

8. How do I establish service connection?

You can establish service connection for a current disability five ways: (1) directly;

2) by using a presumption; (3) by showing that it is secondary to a disability that is

also service connected; (4) by showing that a pre-service condition was aggravated

during service; and (5) by showing that you were injured in a VA hospital or while

pursuing a course of VA vocational rehabilitation.



9. What is direct service connection?

This requires a showing of (1) an injury or illness in service; (2) a current medical condition; and (3) a medically established “nexus” between the injury/illness in service showing that the current condition is same as or related to the condition in service?



10. What is a presumptive service connection?

The VA will presume certain specific listed conditions to be service connected by

presumption, provided that they became manifest during a certain period of time after

service. These include certain “chronic “ diseases, including arthritis, gallstones,

psychoses, sarcoidosis, ulcers, and heart conditions (including hypertension). There

are also tropical conditions, conditions specific to POWs, diseases specific to

radiation, and Vietnam service conditions.



11. What does VA care cost me?

While no monthly premium is required to use VA care, co-payments may be required depending on your eligibility and income level. (If you have insurance, it may cover the cost of the co-payments). Veterans who are Service Connected (SC), who require care for the SC condition, will receive healthcare at no cost for treatment required for that SC condition. For more information, visit our Enrollment Guide’s Co-Payment Information page.

12. Are there restrictions on getting care in private facilities at VA expense?
Yes. Care in private facilities at VA expense is provided only under certain circumstances, namely, when VA has a contract agreement for certain services or when a service disabled veterans lives too far from a VA facility to receive care and has obtained VA approval in advance.

13. What about emergency services?
VA provides urgent and emergency care in VA facilities. VA’s ability to pay for emergency care in non-VA facilities is very limited.

14. What if I get sick while traveling?
You may receive health care at any VA facility in the country. Familiarize yourself with where VA healthcare facilities are located in the area where you will be traveling. Reimbursement for care in non-VA facilities is very limited. (For a list of VA facilities nationwide, visit the VA’s Facilities Directory).

15. Will VA take care of my nursing home needs?
VA’s Community Nursing Home Care Program is designed to assist veterans and their families in making the transition from hospital to community. VA community contract nursing home care services are available for >0% SC to < 70% SC who need nursing home care for the specific SC condition for as long as nursing home care is needed for the specific SC condition. Veterans who are >= 70% SC are eligible for nursing home care for any condition for as long as nursing home care is needed.

16. Can I get free prescriptions from VA?
Medications are provided to veterans who are enrolled with the VA and receive healthcare provided by a VA primary care provider. Medications are prescribed for treatment of a condition for which they are receiving healthcare from the VA provider. Depending on service connected status, there may be a co-payment required for medications. For more information, visit our Enrollment Guide’s Prescription Drugs Information page.

17. Can I get dental care?
Generally, dental benefits are limited to service-connected dental conditions or to veterans who are permanently and totally disabled from service-connected causes.

18. Does VA provide hearing aids and eyeglasses?
Yes, if you are service-connected with a disability rating of 10% or more. Otherwise, hearing aids and eyeglasses will only be provided in special circumstances and not for generally occurring hearing or vision loss.

19. Does VA provide maternity services?
VA does provide maternity care, but cannot provide care to a newborn child, even

immediately after birth. The veteran mother must make other arrangements for care of the child.



20. I’ve heard that VA will now pay for treatment in the emergency rooms of private

hospitals. How do I get the VA to pick up the bill?
The new coverage for non-VA emergency care has a narrow scope. It is designed as a safety net for veterans who do not have any way to pay for emergency health care services. If you are treated at a civilian facility for a non-emergency, you will not be covered under this benefit. To be eligible for this coverage, veterans must have no other form of health coverage, including Medicare or Medicaid. They must be enrolled in VA’s health care system and have been seen by a VA health care professional with 24 months. The civilian facility typically files the paperwork to be reimbursed by VA. For information about VA’s emergency care benefits, contact the nearest VA medical facility or call 1-877-222-8387.



21. I was a POW during World War II. How do I get the new POW medal?
The military issues medals, not the VA. If you were in the Navy, Marine Corps or Coast

Guard, write to: U.S. Navy Liaison Office, National Personnel Records Center, Room 3475, 9700 Paige Blvd., St. Louis, MO 63132. If you were in the Army, write to Army Reserve Personnel Center, Attn: ARPC-VSE, National Personnel Records Center, 9700 Paige Blvd., St. Louis, MO, 63132. If you were in the Air Force, write to National Personnel Records Center (Military Personnel Records), 9700 Paige Blvd., St. Louis, MO 63132. If possible, include a copy of your discharge papers, dates of service, service number or Social Security number and other pertinent information. Survivors can receive the POW Medal on behalf of veterans who died before receiving it.



22. Is it true that veterans who fought in Afghanistan and the recent Gulf War can only

receive VA health care for two years?

No, that is not true. Since Nov. 11, 1998, VA has offered a special benefit to newly discharged combat veterans. Under the new program, these veterans can receive free VA health care for conditions that may be related to their military service for two years after discharge from the military. They may be charged co-payments for non-service-related care. This benefit waives VA’s customary requirement that veterans prove a connection between a current medical problem and their military service, or show that they fall below an income threshold. At the end of that two-year period, these veterans will be treated like combat veterans from earlier conflicts. They can apply for enrollment in VA’s health care system. There is no co-payment for veterans with medical care related to service-connected problems or for veterans with limited resources.



23. Besides health care, what other benefits do combat veterans receive?

The newest generation of combat veterans receives the same benefits traditionally associated with military service. That includes disability compensation for those with service-connected health problems, VA pensions for veterans with limited incomes, VA home loan guarantees and educational assistance for those who contributed to the Montgomery GI Bill while in the military. Other governmental agencies have their own benefits for veterans. The federal government and many state, territory and local governments have a hiring preference for veterans. Additional state benefits are available for veterans. For more information, see http://www.va.gov/partners/stateoffice.



24. Do military service members who die during Operation Iraqi Freedom or Operation

Enduring Freedom receive special treatment for burial?

Service members who die on active duty are eligible for burial at Arlington National Cemetery. They are also eligible for burial in any of the national cemeteries operated by VA. Regardless of burial location, VA will provide a headstone or marker for the deceased’s grave. If the remains of the deceased are cremated and placed in a niche in a stone wall called a columbarium, VA will furnish a niche marker. Veterans who die of any cause may receive military honors on request, with funeral directors generally contacting the Department of Defense on behalf of the family.



25. I’m a 20-year military retiree whose retirement pay is cut by the amount I receive

from VA for disability compensation. I read the military soon will begin making up

this offset. How can I make sure I receive this?

The military services will make case-by-case decisions if military retirees are eligible for the new program, which is called “Combat-Related Special Compensation.” It is for veterans rated at least 60 percent disabled because of armed conflict or certain other conditions, such as hazardous duty, training exercises, or mishaps involving military equipment. VA will provide the military information from veterans’ files that may help determine eligibility. Veterans may download DD Form 2860 and obtain more information at https://www.dmdc.osd.mil/crsc. They may also call their branch of service for more information: Army, 866-281-3254; Navy and Marine Corps., 877-366-2772; or Air Force, 866-229-7074.



26. We hear all the time that veterans are dying at an increasing rate and national

cemeteries are running out of burial space. What is VA doing about this?

VA is developing five new cemeteries in metropolitan areas that now have neither national nor state cemeteries with burial space available. These new cemeteries, plus expansions planned for several existing cemeteries, will advance VA’s goal to have 85 percent of veterans living within 75 miles of casket and cremation burial space by 2007. Beyond that date, VA has identified other metropolitan areas that do not have veteran burial spaces or that will run out of space by 2020 in order to begin planning to fill that need.



27. What sort of benefits will VA provide to the veterans of Operation Iraqi Freedom?

The men and women who served in Iraq during combat are eligible for the same array of VA benefits that went to veterans of other conflicts. That includes GI Bill home-loan guarantees, educational assistance and disability compensation. Each of these programs has its own eligibility rules. Iraqi Freedom veterans are also covered by a new benefit. For two years after their discharge, veterans who served in the combat zone can receive VA health care for problems related to their military service without having to prove the connection. Details are available at the nearest VA health care facility.



28. I saw a news program on television that says veterans’ graves are going unmarked.

When did VA stop giving headstones to veterans?

Since the Civil War, the federal government has provided headstones or markers for the graves of veterans. There has always been a catch, which news organizations recently focused upon. VA gives the headstones or markers only if the veteran’s grave doesn’t already have a marker. In this case, a marker is defined as something with the veteran’s full name, date of birth and date of death. If a veteran’s grave already has a marker, federal law says, in effect, that VA cannot provide a headstone or marker. Some lawmakers and survivors of veterans are working to persuade Congress to change this law.

(**UPDATE: This policy has changed as set forth below.)



29. Has the government changed its position about not providing a VA headstone if a

veteran’s grave already has a headstone?

Yes. That rule has changed. Now, veterans who died since Sept. 11, 2001 can receive a VA headstone even if their graves already have a privately provided headstone. This change in the rules applies to everyone eligible for a VA headstone, including veterans, people who die on active duty and some reservists. The government will ship the headstone or marker free of charge, but it won’t pay for placement. VA will replace headstones and markers previously provided by the government if they are badly deteriorated, illegible, stolen or vandalized.



30. VA is reducing premiums for life insurance for the military. Are reductions planned

in premiums for veterans?

VA has reduced premiums for Veterans Group Life Insurance (VGLI) three times in the last four years. No further reductions are planned. Another VA-run program, Service members’ Group Life Insurance (SGLI), will have a major premium cut in July. Premiums are decreasing from 8 cents for each $1,000 of coverage to 6.5 cents. Information about VA’s insurance programs can be obtained on the Internet at http://www.insurance.va.gov by calling 1-800-419-1473, or by writing to the Office of Service members’ Group Life Insurance, 290 West Mt. Pleasant Ave., Livingston, NJ 07039.



31. What is meant by presumptive service-connection for VA disability compensation

benefits for former prisoners of war (POWs)?

The laws on former POW benefits recognize that military medical records do not cover periods of captivity. For many diseases, unless there is evidence of some other cause, VA disability compensation can be paid on the basis of a presumption that a disease present today is associated with the veteran’s captivity or internment.



32. What diseases are covered?

For POWs detained for 30 days or more, such eligibility covers any of the following illnesses that are found at a compensable level (at least 10 percent disabling): avitaminosis; beriberi; chronic dysentery; dysthymic disorder, or depressive neurosis; helminthiasis; irritable bowel syndrome and malnutrition, including associated optic atrophy. Also covered are: organic residuals of frostbite; pellagra and any other nutritional deficiency; peptic ulcer disease; peripheral neuropathy, except where directly related to infectious causes; post-traumatic osteoarthritis; psychosis and any of the anxiety states. For former POWs who suffered from swelling of the legs or feet during captivity, ischemic heart disease (sometimes known as “wet” beriberi) is also covered.



33. What exemptions from medical co-payments does VA provide for former POWs who

seek care in VA facilities?

Former POWs are exempt from making means test co-payments for inpatient and outpatient medical care and treatment received. Former POWs may be exempt from the medication co-payment if they are rated service-connected 50 per cent or more, are receiving medications for a service-connected condition, or their income is below the maximum annual pension level. If they do not meet one of these exemptions, they will be assessed a medication co-payment for each 30 day or less supply of medication dispensed on an outpatient basis. Former POWs may also be responsible for long-term care co-payments if the care is for a non-service connected condition and their income is above the single veteran pension level. Detailed financial information is also required to determine if the veteran may be exempt from long term care co-payments based upon their individual financial situation.



34. I’ve heard that VA will now pay for treatment in the emergency rooms of private

hospitals. How do I get VA to pick up the bill?

The new coverage for non-VA emergency care has a narrow scope. It is designed as a safety net for veterans who do not have any way to pay for emergency health care services. If you are treated at a civilian facility for a non-emergency, you will not be covered under this benefit. To be eligible for this coverage, veterans must have no other form of health coverage, including Medicare or Medicaid. They must be enrolled in VA’s health care system and have been seen by a VA health care professional with 24 months. The civilian facility typically files the paperwork to be reimbursed by VA. For information about VA’s emergency care benefits, contact the nearest VA medical facility or call 1-877-222-8387.



35. It used to be that widows and widowers lost their VA pensions if they remarried.

Hasn’t this changed?

A change in federal law that took effect Oct. 1, 1998 allows VA to resume Dependency and Indemnity Compensation (DIC) payments and related benefits to former recipients who lost their benefits because they remarried. The new law applies to people whether that later marriage ended in divorce, annulment or death of the spouse. The current rate is $911 for surviving spouses. In some cases, VA can pay more. Other rates are paid to eligible children. For information about restoring DIC, call toll-free, 1-800-827-1000.



36. I didn’t get government life insurance when I left the military. Is there any way to

get it now?

People leaving the military have 1 year plus 120 days to convert their Service members’ Group Life Insurance (SGLI) to Veterans Group Life Insurance (VGLI). After that period has expired, there are no provisions in federal law to convert one to the other. A couple fine points are important. First, if you didn’t have SGLI when you were in the military, you can’t get VGLI after you leave the military. Second, veterans who receive a disability rating can apply for a different kind of VA-supported life insurance, called Service-Connected Veterans Insurance (S-DVI). They must apply within two years after VA notifies them that a medical problem is being recognized as “service connected.”



37. If I am enrolled with VA, what benefits will I receive?

Veterans in the VA health care system will be eligible to receive necessary inpatient and outpatient services, including preventive and primary care. These include: diagnostic and treatment services; rehabilitation; mental health and substance abuse treatment; home health, respite and hospice care; and drugs in conjunction with VA treatment.



38. If I am enrolled, what cost will there be for me?

There is not a monthly premium required to use VA care. However, you may have to agree to pay some co-payments. If you have insurance, it may cover the cost of the co-payments. There is also a small co-payment for each 30-day supply of prescription drugs.



39. Is it true that money can be deducted from Social Security checks if a veteran owes

money to the VA?

When veterans receive overpayments of their VA benefits or they’re responsible for co-payments for medical care and they do not make the required payments, VA is legally obligated to turn the debts over to the Treasury Department, which then withholds the money from other federal payments. Among the sources from which money can be withheld are income tax refunds and federal retired pay. Social Security withholdings began this year. Veterans will always receive the first $750 of each month’s Social Security payment. Veterans will be notified several times before any withholdings are made. People can avoid the withholding by voluntarily settling their debts.



40. Does VA provide health care for veterans with AIDS?

Veterans with HIV (the Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome) are treated like veterans with any other health problem. All are eligible to enroll in VA’s health-care system. They may have to make co-payments for treatments and medication unless they qualify for VA disability compensation or their income falls below a certain level known as the “means-test threshold.”



41. My father got a medical discharge from the military after World War II. He never applied for any VA benefits. Is there anything that can be done for him now?

There are no time limits to apply for disability compensation, VA pension or VA health care. It’s routine for VA to see World War II veterans for the first time. VA health care facilities will treat any veteran. There may be an out-of-pocket payment, call a “a co-pay,” unless your father holds the Purple Heart Medal, qualifies for VA disability compensation or receives VA pension. Disability compensation is for people with medical problems they can trace back to their military service. They must prove that the problem was caused or aggravated by something that happened while they were in the military. VA’s pensions are for wartime veterans in poor health with few financial resources. Qualifying for VA pensions or disability compensation may take several months. To find out more details and to begin the application process, call 1-800-827-1000.



42. I got a “certificate of eligibility” from VA to buy a home using my GI Bill benefits. Then the deal fell through. Do I have to get another certificate when I try to buy another home? Is there an expiration date?

The “certificate of eligibility” is the form that VA provides to show a veteran is eligible for the home loan benefit. Veterans can obtain the application for a certificate and information about where to send it by calling the VA at 1-800-827-1000. Generally, the certificates are valid until used. However, a certificate issued to a person while on active duty is only valid while the person remains on active duty. For persons qualifying based on service in the reserves or National Guard, eligibility expires Sept. 30, 2007.



43. I plan to use my GI Bill benefits to buy my first house. I got the “Certificate of Eligibility” from VA. Then the bank said I wasn’t eligible. What gives?

All veterans using their GI Bill benefits to purchase homes must obtain a “Certificate of Eligibility” from VA. The certificate is their proof that they are eligible for the program. But the certificate doesn’t prove that they’re able to repay a loan of a certain size. The mortgage company or bank offering the mortgage has considerable discretion to decide how large a mortgage a particular veteran can afford to repay.



44. I’ve heard we can file for benefits on the Internet. How does that work?

VA has put four standard forms on the Internet. They are Form 21-526 (used when first filing for disability compensation or a VA pension), Form 28-1900 (used by disabled veterans applying for vocational rehabilitation), Form 10-10EZ (used to enroll in VA health care) and Form 22-8979 (used to verify enrollment in school under Montgomery GI Bill). VA formally launched its on-line application program in November. Other forms will be added in the future. All can be found at www.va.gov.



45. Does VA offer any assistance to veterans who own their own businesses?

VA has had programs for veteran-owned businesses for a long time. Recently, Congress passed a law that expands VA’s involvement in veteran-owned businesses. Under the new law, VA created a Center for Veterans Enterprise in Washington. It will be a clearinghouse of information for veterans who are entrepreneurs or who plan to start their own businesses. The new legislation includes goals for federal contractors to subcontract work with veteran-owned businesses. It also requires federal agencies to award a percentage of their contracts to firms owned by service-disabled veterans. To be eligible, a veteran or a group of veterans must control at least 51 percent of the business. Information about the new VA business center can be obtained from its Internet site, www.vetbiz.gov or by calling 1-866-584-2344.



46. I heard that VA is creating special centers for Parkinson’s disease. When will one

open up here?

Between 20,000 and 40,000 veterans with Parkinson’s disease are treated each year at VA medical centers, including local facilities. Veterans don’t have to go to a national Parkinson’s center to receive quality care. The new centers do many things besides care for patients. Their mission includes research and the education of health-care workers. VA has no plans to create additional Parkinson’s disease centers. The special centers for Parkinson’s disease are in Houston, Philadelphia, Portland (Ore.), Richmond (Va.), San Francisco and Los Angeles. Veterans with Parkinson’s disease - in fact, all veterans - can enroll in VA’s health-care system. Those who don’t have a medical problem that is officially ruled “service connected” may have to pay a co-payment.



47. I’ve heard several times that World War II veterans are dying at the rate of about 1,000 a day. Is this true?

VA projects about 414,000 deaths among our World War II veterans this year, for a daily rate of about 1,135. At the start of the year, VA estimated the number of World War II veterans at 5,032,591. The number of deaths per year among World War II veterans is projected to decline slightly for at least the next five years, although it will stay above the 1,000-per-day mark.



48. I am an active-duty veteran eligible for benefits under the Montgomery GI Bill. Why did the amount VA is paying monthly toward my tuition go up in October?

Cost-of-living increases for the payment rates take effect each Oct. 1 with the beginning of each new federal fiscal year. A federal law bases the amount of increase for the full-time student rate on a consumer price index calculation. Certain other rates such as payments for part-time studies or for veterans who converted benefits from an earlier Vietnam-era education program are based at least in part on this full-time rate. The new monthly payment rates for those eligible at the maximum levels under VA’s major Montgomery GI Bill education programs for full-time students are: for veterans of active-duty, $672; for members of the reserves or National Guard, $272; and for those covered under a program for surviving spouses and dependents of deceased veterans, $608. Detailed rates for persons taking a class load that is less than full time or who are covered under other provisions based on their type of training or lengths of military service are available at http://gibill.va.gov



49. Where can I get help determining which category I fall under with my class load?

Veterans with questions about their status or their personal eligibility for education benefits may call VA toll-free at 888-442-4551.



50. Will the recent activation of reservists for Operation Enduring Freedom entitle them to the higher Montgomery GI Bill education benefit rates enjoyed by active-duty members?

A Reservist would not ordinarily qualify on the basis of activation alone. However, a service member can qualify at the active-duty rate with as little as two continuous years on active duty if that tour is followed within a year by four years in the Reserves. Congress is continuing to look at the issue of benefits for activated Reservists.



51. Is this an insurance policy or an HMO?

It is neither. VA health benefits are established by Federal law and regulations and funded through appropriations. They are not the same as an insurance contract. Also, veterans do not pay monthly premiums to receive VA health care. In addition, you are not required to use VA as your exclusive health care provider. If you have health insurance, or eligibility for other programs such as Medicare, Medicaid, or CHAMPUS, you may continue to use services under those programs. We recommend that, if you have other insurance or HMO coverage, you should keep that coverage to provide you with options and flexibility in the future.



52. Do enrolled veterans have to pay the deductibles that their insurance carrier requires when treated at VA?

No. VA does not require veterans to pay those charges. In addition, many insurance companies will apply VA co-payment charges toward satisfaction of their annual deductible.



53. Are there any restrictions on getting care in private facilities at VA expense?

Yes. Care in private facilities at VA expense is provided only under certain circumstances, namely, when VA has a contract arrangement for certain services or when a veteran who is service disabled is too far from a VA facility to receive care.



54. Will the VA pay for care in private facilities?

Usually not. VA provides care in private facilities at VA expense when VA has a contract arrangement for certain services or, under very limited circumstances, when VA approves the care in advance.



55. What is the coverage for emergency services?

VA provides urgent and limited emergency care services in VA facilities. Emergency care may be provided in non-VA facilities with which VA has entered into a contract to provide such services. However, VA’s ability to pay for emergency care in non-VA facilities is very limited.



56. What If I get sick while on travel?

You may receive health care at any VA health care facility in the country. To minimize any “out of pocket” expenses while traveling, you should familiarize yourself with the location of any VA health care facilities in the area. VA’s authority to reimburse you for care in non-VA facilities is very limited.



57. If enrolled, can I get dental care?

In general, dental benefits are limited to service-connected dental conditions or to veterans who are permanently and totally disabled from service-connected causes. For specifics, contact the VA health benefits advisor at your local VA health care facility.



58. Are there any limits on days of care or outpatient visits VA will provide?

No, your treating physician will determine what is considered appropriate and necessary hospital care or outpatient services and must provide such care consistent with current medical care practices.



59. My town has something called a “Vet Center” in a shopping center. Is that a VA program? What’s it for?

Vet Centers are places where combat veterans receive counseling for the psychological effects of war. Although they were created in the aftermath of the Vietnam War, they are now open to combat veterans of all conflicts. VA psychologists, nurses and social workers staff the facilities, along with volunteers. The centers have a distinctive non-medical, non-government atmosphere that many veterans find appealing. Last year, VA operated 206 Vet Centers through its Readjustment Counseling Service. The centers saw more than 130,000 veterans. For more information, call 1-877-222-8387. Or, pay a visit to a Vet Center.



60. I’ve finally bought a home computer, and I’m teaching myself to use the Internet. How do I reach VA on the Web?

VA’s Internet address is www.va.gov. Once there, you’ll notice that information is arranged by broad topics - health care, compensation and pensions, insurance, and education. The best way to learn what’s there is to see for yourself. Don’t overlook the Public Affairs section. That area has the latest announcements, plus information about benefits that are still taking shape. You can also download the latest edition of “Federal Benefits for Veterans and Dependents.”



61. I saw a story recently about coverage increasing for veterans insurance. How do I go about getting the new, higher coverage?

The federal law governing VA’s life insurance program says that the maximum coverage veterans can receive under the Veterans Group Life Insurance (VGLI) program is the maximum amount of coverage they purchased during their military days under Service members’ Group Life Insurance (SGLI). In other words, if you purchased $100,000 in life insurance during your active-duty days, VGLI limits you to a maximum of $100,000. These limits, of course, don’t apply to non-VA insurance that veterans might purchase. Under a change that took effect April 1, $250,000 is the maximum coverage with SGLI. Veterans who had $250,000 under SGLI when they discharged after April 1 can purchase $250,000 in coverage under VGLI.



62. I’ve heard about disabled veterans getting extra money for their families. I have two children at home. Can I get an increase in my disability pay?

Disabled veterans can receive extra money from the Department of Veterans Affairs (VA) for family members. There are several rules that must be followed. First, the veteran’s disability must be officially recognized by VA as “service connected.” Second, VA must determine the disability is at least 30 percent. Third, the family member must meet certain requirements. Among the requirements for children are that the child must be under 18 years of age, or under 23 years if still in school, or of any age if the child became disabled before reaching the 18th birthday.



63. I read recently that the separated spouse of a veteran may be able to receive a portion of the veteran’s VA disability compensation. Can I get part of my divorced husband’s VA disability payment if the divorce decree says I am entitled to a portion of his income? We have no children.

No. Once your divorce was final, VA was no longer able to consider apportioning any of your former husband’s disability compensation to you.



64. I last served in Vietnam 1966 and was diagnosed with lung cancer in December 2001. Am I eligible for service-connected disability benefits based on exposure to Agent Orange?

Yes. The law recently changed, eliminating the previous requirement that respiratory cancer become evident within 30 years of a veteran’s departure from Vietnam to qualify for the presumption for service connection based on exposure to herbicides.



65. I received an honorable discharge from the Army after two years of service during the Korean War. I am now age 67. Do I need a medical examination to qualify for VA pension benefits?

No. Since you are over age 65 and a wartime veteran, you are presumed to be permanently and totally disabled for VA non-service-connected pension purposes. You must still meet certain income and net worth requirements, however.



66. How long does a former prisoner of war have to be continually rated totally disabled in order for his surviving spouse to be eligible for Dependency and Indemnity Compensation (DIC) even if his death is not service-connected?

A former prisoner of war who dies after Sept. 30, 1999 needs to have been continually rated totally disabled for one year prior to death in order for his surviving spouse to qualify for DIC benefits.

NATIONAL GUARD AND RESERVISTS

67. Are Reservists and National Guard Members called to active duty eligible for VA

Benefits?

Reservists called to active duty might be eligible for VA benefits, such as health care, educational, home loan guaranty and vocational rehabilitation benefits. Compensation for injuries sustained while on active duty might also be available to them, if their injuries are deemed service connected by VA. To determine eligibility for benefits, Reservists must file VA Form 21-526, Application for Compensation and/or Pension, VA Form 22-1990, Application for Education Benefits, and/or VA Form 28-1900, Disabled Veteran’s Application for Vocational Rehabilitation, once their active duty has ended. National Guard members might be eligible for VA benefits only if the President activated them for federal duty, in which case they might be entitled to the benefits mentioned above. Both Reservists and National Guard members on federal duty only need to serve for the period of time they were activated for in order to be eligible for VA benefits. For specific information about eligibility call VA at 1-800-827-1000.



68. What benefits are available to Reservists and National Guard Members who are not called to active duty?

Even if not called to active duty, Reservists and National Guard members might be entitled to benefits from VA such as educational benefits under the Montgomery GI Bill - Selected Reserve and Home Loan Guaranty. The Montgomery GI Bill - Selected Reserve provides up to 36 months of education benefits to members of the Selected Reserve and the National Guard enrolled in a program approved for VA training. A Reservist or National Guard member is eligible for this benefit if: After June 30, 1985 the Reservist or National Guard member signed a six-year obligation to serve in the Selected Reserve; and he/she completed Initial Active Duty for Training (IADT); and he/she received a high school diploma or GED prior to completing IADT; and he/she is in good standing in a drilling Selected Reserve unit. For more information about the Montgomery GI Bill - Selected Reserve call VA at 1-888-442-4551 or visit our http://www.gibill.va.gov VA’s Home loan guaranty are loans often made without any down-payment. A Reservist or National Guard member can apply for a VA loan with any mortgage lender that participates in the VA home loan program. To apply, the Reservist or National Guard member will need a Certificate of Eligibility from VA, which can be requested by completing VA Form 26-1880. Reservist and National Guard members must include an original statement of service showing the length of time that they have been members of the Selected Reserves. At least 6 years of honorable service must be documented. Visit http://www.homeloans.va.gov for more information.

DEPENDENCY AND INDEMNITY COMPENSATION (DIC)

69. My veteran husband died. Am I entitled to any benefits?

Yes. The most important is called Dependency & Indemnity Compensation (DIC), which is for spouses and dependents of veterans who died of service-connected deaths. The VA also has a pension program for veterans who did not die of a service-connected condition, and various burial benefits are available, depending on the cause and circumstances of death.



70. How can I establish eligibility for DIC?

This is relatively simple if the death certificate shows that a service-connected disability was the primary or secondary cause of death. If death occurred after the veteran was totally and permanently disabled for 10 years and did not die from willful misconduct, the Veterans Affairs will presume that the death was service connected. If the veteran did not die of a condition that was already service connected, this is more difficult. There must be evidence that death was either a primary cause of a service-connected condition that was not obvious to the Veterans Affairs or the veteran, or substantially contributed to his death.


71. Dependency and Indemnity Compensation is a monthly payment for surviving

spouses.

A. This monthly payment has to be applied for on VA form 21-534.

B. The widow or widower of a spouse who died from direct service connected disability or from contributing causes due to that disability is eligible for DIC. See 38 CFR 3.312 (2004)

C. If a veteran was entitled to receive or in receipt of service connected compensation for a period of ten years prior to death, survivors can receive DIC “as if” service connected. See 38 U.S.C.1318.
D. If a veteran was in receipt of 100% SC compensation or entitled to receive 100% compensation within a period of not less than five years after discharge from service, eligible survivors may receive DIC “as if” the death was service connected.
E. If a veteran dies due to VA medical error, negligence or substandard care, the survivor can receive DIC under Section 1151 38 U.S.C. The application for DIC must be made as well as a formal claim for death under Section 1151 38 U.S.C..

A death pension can be awarded for non-service connected deaths if the spouse claimant has low income and the veteran had wartime service. All income, such as social security and any other wages, etc, are deducted from the death pension, however.





CHILDREN’S HEALTH ISSUES



71. Are any VA benefits available for children of Vietnam veterans born with spina bifida?

Congress authorized the benefits because of evidence linking the illness to a parent’s exposure to the herbicide Agent Orange. VA recently created a toll-free number where people can receive information about the spina bifida program. The number is 1-888-820-1756. Children of Vietnam veterans born with spina bifida are eligible a monthly disability allowance and for vocational training. A monthly allowance is set at three levels, depending upon the degree of disability suffered by the child. The monthly rate for Level I is $221, Level II is $770 and Level III is $1,317. VA’s Vocational Rehabilitation and Employment program administers a vocational training program to enable a qualified child to prepare for and attain suitable employment. Services may include counseling and rehabilitative services, education, training and employment services. VA pays for the costs of the services up to 24 months depending on need. For more information on spina bifida, please contact VA’s web site at http://www.va.gov/hac/spina/faq.htm.



72. What is the first step in establishing eligibility for VA spina bifida healthcare benefits?

Since VA spina bifida healthcare benefits are based upon eligibility determinations made by VA regional offices, prospective beneficiaries must first contact a regional office to obtain an Application for Spina Bifida Benefits (VA Form 21-0304). The local VA regional office can be contacted toll-free at 1-800-827-1000. Upon return of a completed application, the regional office will determine eligibility and notify the applicant of the determination.



73. Upon establishing eligibility through a VA regional office, what is the next step in obtaining VA spina bifida healthcare benefits?

Beneficiaries in receipt of a VA regional office spina bifida award should immediately contact VA’s Health Administration Center (HAC) in Denver, CO to register for health care benefits. The following information is required: name, address, and telephone number of both the beneficiary and veteran sponsor (and legal guardian when applicable); Social Security number of both the beneficiary and veteran sponsor; and VA claim number of the veteran sponsor. Registration with HAC can be accomplished by telephone, fax, or mail. The telephone number for Spina Bifida Healthcare Benefits Information/Registration is 1-888-820-1756. The fax number is 1-303-331-7807. The address is VA Health Administration Center, Spina Bifida Healthcare Benefits, P O Box 65025, Denver, CO 80206-9025.



74. VA recently said it would give benefits to the children of Vietnam veterans with leukemia. What kind of benefits? How do I apply?

The Department of Veterans Affairs (VA) is in the early stages of putting together a package of benefits for victims of a rare form of leukemia whose parents served in Vietnam. No one knows what those benefits will be. It will take several months before veterans can begin applying for the new benefits. But two things are clear: First, the parent must have been physically present in Vietnam during the war. Second, the child must have a certain kind of leukemia, acute myelogenous leukemia (AML). This is not the most common form of leukemia. The Institute of Medicine reported April 19 it has evidence that AML is more common in the families of Vietnam veterans than among their peers who served elsewhere during the war years. Researchers believe the disease in children was caused by a parent’s exposure to Agent Orange and other toxins in the combat zone.

COMMON TOPICS OF DISCUSSION AT HADIT—NOTE: The following answers, discussions and explanations of the VA claims process should be neither construed nor relied upon by the reader as legal advice or recommendation, but rather as the informal, individual opinions of various Hadit member veterans and advocates. This section does not purport to be a full and accurate explanation of VA regulations, federal regulations, U.S. Code or case law, but exists merely to provide personal opinions in lay terms, giving an overview of various aspects of how the VA claims system may work. Remember, laws and regulations change frequently. In the past, the VA has changed (and continues to change) how disabilities are rated and currently has in the works a complete overhaul of Part 3. Accordingly, you should always consult someone knowledgeable about these changes and seek counsel from a licensed attorney with training, knowledge and expertise in veterans’ claims for any legal advice.

CUE
75. What is a CUE claim?
CUE stands for “Clear and Unmistakable Error” in a past VA decision. It is a collateral attack. CUE claims involve three specific facets:

1. A final decision from VARO or the BVA that was never appealed.
2. It involves an error as to the application of the fact or law that existed when the CUE was made.
3. It manifestly would change the outcome of the past claim if successful.

Often a CUE is the only way to recover lost retroactive monies in a decision that was never appealed. CUE claims are not appropriate for medical decisions, a failure of the VA’s duty to assist, or a disagreement as to how an adjudicator weighed the facts.

Before attempting to file a CUE claim, a claimant should thoroughly read Section 20.1403 of 38 C.F.R. and also search in the BVA website by putting “CUE granted” into the search button, as these cases will be good examples of what a CUE claims needs in order to succeed.

Example: The VA fails to adjudicate whether a veteran was entitled to SMC in 1997. The veteran accepted the service-connected award for 100% for Diabetes Mellitus and also the veteran had lost a leg due to amputation directly due to the circulation problems of the diabetes in 1995. But, although the loss of leg was stated within the claim, the veteran did not question VA’s failure to mention or adjudicate his entitlement to SMC. In 2005, the veteran files a CUE claim stating that SMC is an inferred issue and should have been granted on the medical evidence showing his leg was lost to the service connected diabetes. VA’s failure to apply regulations at that time (1997) caused the veteran to lose retroactive monies as well as an additional current SMC award. The outcome of this CUE involves retroactive money, so a proper award under CUE has manifestly changed the outcome of the past 1997 decision.


AGENT ORANGE (AO)

75. Can I be service connected for Agent Orange?
Agent Orange is not a disease itself, but the VA will presume that certain conditions were incurred in Vietnam. These include certain specifically listed soft-tissue cancers including, but not limited to, prostate cancer, respiratory tract cancers and diabetes mellitus (DM II). You can also be service connected for other conditions you believe are due to exposure to Agent Orange, but for these you will need a physician’s opinion stating that these conditions were due to Agent Orange, and you can expect the VA to initially deny service connection.



76. I served in the blue-water Navy. Can I be service connected for Agent Orange

diseases?

Yes, if your duty involved your physical presence in Vietnam, such as even stepping

ashore during leave. The VA generally records helicopter crewmen to have served in

Vietnam, even if they were not stationed in country but flew there, but not long-range

bombers.


77. What is the Nehmer case?
Nehmer altered significantly the way the VA adjudicates Agent Orange (AO) claims.

Unlike all other types of claims, a retroactive payment to a Nehmer class member (all AO

vets and their spouses) can be much higher than normal EED (earlier effective date) retro

awards.

If the claimant applies for an AO disability AFTER the regulations for that disability were published, the claimant will usually receive retroactive pay only back to the date they filed their claim. Other claimants who had any AO disability denied for service connection in the past or had the AO disability listed as non-service connected and rated on their past rating decision can often successfully re-open their claim and state that they believe their retroactive award should go back to the date that the disability was put on the regulation lists (or that their EED should be the date that medical evidence in their C-file showed they had a ratable service connected condition due to Agent Orange exposure).

Widows or widowers with claims denied in the past whose spouse’s death was contributed to (or caused by) what is now a presumptive Agent Orange illness can re-open their DIC claims requesting that either they be awarded DIC—if denied in the past—and be awarded retro DIC back to the date of the veteran’s death.

Each Nehmer claim is unique and the best information on these claims is found at http://www.nvlsp.org .


Any Agent Orange veteran who has a presumptive AO disability and had a past claim, whether it was denied or not, should get a service officer (SO) well versed in Nehmer to see if the veteran was, in fact, awarded the proper retroactive amount, including SMC if entitled to it also due to the AO disability.

The NVLSP web site has the retroactive order published. VAROs failed many times to address this order properly and many vets almost lost thousands of dollars because of that. These awards are only specific to claims filed before the regulations were published -adding the condition to the presumptive list.





PTSD



78. What are the requirements for PTSD claims?
Service connection for PTSD requires (1) a psychiatric diagnosis of post traumatic stress

disorder; (2) medical evidence that the PTSD symptomology relates to the claimed stressor (nightmares, intrusive thoughts, flashbacks, etc.); and (3) credible evidence that the stressor actually occurred. PTSD is usually associated with wartime events but can also be diagnosed as a result of a sexual assault, being in an automobile accident, or being a participant in (or witness to) in-service deaths, life-threatening injuries or other psychologically traumatizing events.



79. How can I show that a stressor occurred?

Most PTSD claims fail due to lack of proof of stressor occurrence. The VA eases the rules for veterans who served in combat with the enemy who can establish the occurrence of stressors by their own testimony, provided it is consistent with their service and not rebutted. The VA may look for proof of combat service by the award of certain medals, including the Combat Infantryman Badge, Combat Medics Badge, Combat Action Ribbon or Purple Heart. In the absence of such awards, the VA also looks to MOS and the nature of the unit to which the veteran was assigned.



80. What if I did not serve in combat?

For veterans who did not serve in combat, the VA requires independent credible proof that a stressor actually occurred. It will give you a questionnaire to describe stressors to which you were exposed, and you should spend some time making this as complete as possible, including dates wherever available. It will go to military historians to search for unit histories, which are rarely helpful unless you can narrow the stressor down to ten days or so. Other types of independent proof could include “buddy” statements, contemporary letters home and newspaper accounts.



C&P EXAMINATIONS and SUPPORTIVE MEDICAL EVIDENCE
81. What is a C&P Examination?

A Compensation and Pension Examination is a VA medical examination routinely given to veterans who seek service connection or increases in the percentage of disability assigned to an already service-connected disability. In the first instance, a C&P examiner will determine if you have a disability that the Veterans Affairs can rate and assess its severity in medical terms. C&P examiners are also supposed to state a medical estimation of the origin of the disease, and specifically whether it was incurred or aggravated by service. For an increase, service connection having already been established, the C&P examination will be limited to determining whether it has in fact worsened.



82. Do I have to attend an examination?

The penalties for not attending a C&P examination are severe. If you are applying for service connection, failure to attend an examination will cause the VA to rate the condition on your claims file. If you are applying for an increase, failure to show up will cause the VA to dismiss your application, and failure to show up for a routine examination may jeopardize your existing stream of benefits.



83. How can I get a copy of my C&P examination?

Go to the Release Of Information (ROI) office at the VAMC where your C&P exam was conducted and fill out the necessary form.


84. Can I use private medical opinions to support a claim?

Yes, definitely. In many instances, a medical opinion from a supportive doctor can mean the difference between winning and losing a claim. In a great variety of medical specialties, a private physician may have more extensive training, credentials, knowledge and experience than a VA physician. Private physicians can be more direct in their written opinions regarding a veteran’s claim if they understand that the VA will not challenge their opinions and, unlike in civilian (civil) lawsuits, they do not risk depositions and cross-examination for their opinions.


85. Should I rely on a Veterans Affairs doctor to provide such opinions?

Definitely not. If you are not being treated outside the VA system, find a doctor in private practice who will provide an independent medical opinion (IMO) as evidence for you. This will not be free but will usually be worth every penny.


86. When is private medical evidence particularly important?
Private medical opinions are vital if you receive an unfavorable C&P examination or if the

VA sends your claim off for review. The opinion of a private physician with superior

medical credentials may help discredit unfavorable VA findings.



87. What are re-examinations?
Routine C&P re-examinations are given at the VA’s request for disabilities that are expected

to improve, but not for disabilities that are static in nature. If you are 100% service-

connected or drawing Individual Unemployability (IU) as explained below, the VA will rate

your disability as “Permanent and Total,” which will mean no further examinations are

scheduled plus additional benefits, including health care for your family, eligibility for travel

on military planes, commissary privileges, educational benefits for minor children, and

often reduction of state property taxes.


88. What is the standard of proof for medical evidence?

The VA standard of proof for medical evidence is whether, after review of the veteran’s

complete medical records, the evidence (at a minimum) shows that “it is as least as likely

as not” that a current condition originated from an in-service injury or disease. Therefore,

if a private physician cannot attest to the fact as a matter of medical certainty, he may be

amenable to saying that it is “at least as likely as not” that a condition occurred during, or

as a result of, military service. His opinion must be based upon his own examination AND

a review of the veteran’s complete medical record.



89. How does the VA assign disability ratings?
A disability rating is the percentage of impairment that results as nearly as practicable as

the average impairment in civilian earning capacity resulting from specific diseases and

injuries listed in the VA rating schedule. The VA refers to a table and, depending on the

level of severity of the injury or disease, assigns a percentage to that disability. The

percentage of disability determines the amount of your monthly disability payment.


90. I am already rated at 100%. Can I get additional financial benefits?

Additional benefits are payable if a veteran is housebound, needs the aid and attendance

of another person, or suffers profound injuries. These benefits are called “Special Monthly

Compensation”.


91. What is the rule on the effective date of a claim?

When the Veterans Affairs finds that a veteran is entitled to cash benefits, it will assign an

effective date for when these begin. Pursuant to 38 C.F.R. 3.400 (2), the effective date of VA disability compensation benefits for direct service connection is the “[d] ay following separation from active service OR date entitlement arose if claim is received within 1 year after separation from service; otherwise, date of receipt of claim, or date entitlement arose, whichever is later.” See 38 U.S.C. 5110(a).



VA MATH

92. I have three injuries rated at 10, 30 and 50 percent. Why aren’t I paid a for 90%

disability?
In VA math, your total disability is calculated as follows:

10% of 100% = 10% (100% - 10% = 90%)

30% of 90% = 27%; (90% - 27% = 63%)

50% of 63% = 31.5%; now, add together 10% + 27% + 31.5% = 68.5%, rounded UP to 70%.

(*Note, .5 and above rounds UP; .4 and below rounds DOWN.)





Try calculating total disability ratings using the following 2 examples:



Veteran #1 has:

Bronchial Asthma: 30 %
Hep C: 20%
Seborrheic Dermatitis: 10 %
Hypertension: 10%
Mild Ulnar Nerve Entrapment: 10%
Lower Back Pain: 10%
Retention Cyst Maxillary Sinus: 0%

ANSWER: 60%



Veteran #2 has:

70% PTSD
30% Muscle injury
20% Shoulder muscle injury
20% Chest muscle impairment
0% Facial scars
0% Scars
0% Bilateral hearing loss

ANSWER: 90%



Here is a third example: A veteran has 50% SC disability. He expects to get another 30% secondary SC. Does that equal 70% in VA math? Answer: It depends. 38 CFR 4.25 requires that you need to know the highest level award, since that is the starting point in VA math. If the 30% is the highest award, then it counts for the full thirty percent. However, if the 50% is the highest award, then you get 50+15=65 rounded up to 70%. HOWEVER:
If 40% was the highest award then it would be 40+18+4=62 (rounded to 60%).
If 30% was the highest award, and he had another 30% already then it would be 30+21+15=66% (rounded to 70%).

As you can see, it really matters WHAT the value of the other awards are. VA Math is a matter of ‘combining’ percentages under 38 CFR para 4.25-26. You can find the regulation here:
http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=5b7f286b27c46f81eab27a1964db11e4&rgn=div5&view=text&node=38:1.0.1.1.5&idno=38




93. My disabilities, although not so severe as to be rated at 100%, still prevent me from

working. Can I get additional benefits for this?
Yes. Veterans Affairs has a special policy called “Individual Unemployability” (IU),

sometimes referred to a TDIU (Total Disability due to Individual Unemployability. This

pays a veteran as if he/she received a 100% rating on the schedule. This is a benefit

always to be considered when filing a claim, since the money dramatica

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