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Post by CDR Young, USVL on Sept 4, 2016 1:16:30 GMT
"Other than Honorable” Discharges – Special Health Care RuleTo be considered a “Veteran” eligible for Department of Veterans Affairs (VA) health care benefits, a former service-member must have been discharged “under conditions other than dishonorable.” Under VA regulations, administrative discharges characterized by the armed services as “Honorable” or “General Under Honorable Conditions” are qualifying, and punitive discharges (“Dishonorable” or “Bad Conduct”) issued by general courts-martial are disqualifying. The in-between categories, administrative “Other than Honorable” discharges, and punitive “Bad Conduct Discharges” issued by special courts-martial, may or may not be disqualifying for purposes of general VA benefit eligibility or VA health benefits eligibility specifically. In assessing whether such discharges were issued “under conditions other than dishonorable,” VA must apply the standards set forth in Title 38 Code of Federal Regulations (C.F.R.) §3.12. An individual with an “Other than Honorable” discharge that VA has determined to be disqualifying under application of title 38 C.F.R. §3.12 still retains eligibility for VA health care benefits for service-incurred or service-aggravated disabilities unless he or she is subject to one of the statutory bars to benefits set forth in Title 38 United States Code §5303(a). Authority: Section 2 of Public Law 95-126 (Oct. 8, 1977). VA health care benefits: If an individual presents or makes an application for VA health care benefits and has an “other than honorable” or “bad conduct” discharge, eligibility staff may register the individual and place in a Pending Verification Status. A request for an administrative decision regarding the character of service for VA health care purposes must be made to the local VA Regional Office (VARO). This request may be submitted using a VA Form 7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action. In making determinations of of 2IB 10-448 health care eligibility the same criteria will be used as are now applicable to determinations of service connection when there is no character of discharge bar. Reference: M21-1 Part IV, Chapter 11 “Special Determinations and Administrative Decisions.” When eligibility cannot be immediately established, the service (including transportation) may be authorized without any delay if it is determined that eligibility for care probably will be established. Tentative eligibility determinations can be made: (a) In emergencies. The applicant needs hospital care or other medical services in emergency circumstances, or (b) For persons discharged from service. The application for health care benefits was filed within 6 months after the date of an other than dishonorable discharge from active military, naval, or air service, and for a Veteran who seeks eligibility based on a period of service that began after September 7, 1980, and the Veteran meets the minimum service requirements in 38 USC 5303A. Note: Emergent treatment may be provided with a signed statement by the Veteran (may be on a VA Form 119, Report of Contact) that if s/he is subsequently found to be NOT Eligible for VA health care, they agree to pay the Humanitarian Rate for any emergent care or services provided while under this Pending Verification status. Note: A Veteran may request a review of his/her discharge from the Armed Forces, by submitting Form DD 293, “Application for the Review of Discharge from the Armed Forces of the United States” to the appropriate branch of service where the active duty was served. This request must be made within 15 years of discharge from active service. Form DD 293 can be found at the following link: www.dtic.mil/whs/directives/infomgt/forms/eforms/dd0293.pdfIf the discharge the Veteran wants reviewed was issued over 15 years ago, instead of applying on a DD Form 293, the Veteran must petition the appropriate Board for Correction of Military Record using DD Form 149, Application for Correction of Military Record Under the Provisions of Title 10, U.S. Code, Section 1552. Form DD 149 can be found at the following link: www.dtic.mil/whs/directives/infomgt/forms/forminfo/forminfopage2137.htmlNote: A Veteran may request copies of Military Records, by submitting Form SF 180, “Request Pertaining to Military Records” to the appropriate branch of service. The form can be found at www.archives.gov/research/order/standard-form-180.pdf, or it may be completed online at www.archives.gov/veterans/military-service-records. For Further Information: Contact your local VA health care facility’s Eligibility office or the Health Eligibility Center at 404-828-5257. This and other eligibility related fact sheets are available at www.va.gov/healthbenefits/resources/publications.asp. Authorities: Title 38, United States Code, §5303(a); Pub. L. No. 95-126,§2; and Title 38, Code of Federal Regulations, §§3.12 and 17.34. USVLA Facebook page: www.facebook.com/USVLA
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Post by CDR Young, USVL on Sept 4, 2016 1:21:25 GMT
No E.R. costs for OTH Vets awaiting VA application approval
VA document IB 10-448 "Other Than Honorable Discharges", states that Emergency Room treatment may be provided while awaiting an application determination to be made with a signed statement by the Veteran (VA Form 21-0820, "Report of General Information". VA Form 119, "Report of Contact" is no longer used.) that if he or she is subsequently found to be NOT Eligible for VA Health Care, they agree to pay the Humanitarian Rate for any emergent care or services provided while under this Pending Verification status.
Below you will find all the information you will need to know about non-VA facility Emergency Room care for Veterans with VA Healthcare or Veterans awaiting a Pending Verification status.
Emergency Care in Non-VA Facilities
In 2001, the U.S. Congress provided VA with authorization (called the Mill Bill) to pay for emergency care in non-VA facilities for veterans enrolled in the VA health care system. The benefit will pay for emergency care rendered for non-service-connected conditions for enrolled veterans who have no other source of payment for the care. However, VA will only pay to the point of medical stability. There are very strict guidelines concerning these types of claims. Veterans and their non-VA providers should be aware that these claims must be filed with the VA within 90 days from the last day of the emergent care. How do I qualify?
This benefit is a safety net for enrolled veterans who have no other means of paying a private facility emergency bill. If another health insurance provider pays all or part of a bill, VA cannot provide any reimbursement. Veterans who retired from the U.S. military are covered by TRICARE/CHAMPUS insurance and cannot file a Mill Bill claim. To qualify, you must meet all of these criteria: You were provided care in a hospital emergency department or similar facility providing emergency care. You are enrolled in the VA Health Care System. You have been provided care by a VA health care provider within the last 24 months (excludes C & P, Agent Orange, Ionized Radiation and Persian Gulf exams). You are financially liable to the provider of the emergency treatment for that treatment. You have no other form of health care insurance. You do not have coverage under Medicare, Medicaid, or a state program. You do not have coverage under any other VA programs. You have no other contractual or legal recourse against a third party (such as a Workman’s Comp Claim or a Motor Vehicle Accident) that will pay all or part of the bill. Department of Veterans Affairs or other federal facilities were not feasibly available at time of the emergency.
The care must have been rendered in a medical emergency of such nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health.
Should I cancel my current insurance to meet these requirements?
VA encourages you to keep all current health insurance coverage. If you cancel your current insurance, your spouse may not retain health insurance coverage and spouses of veterans generally do not qualify for VA health care. Cancellation of current insurance coverage could result in you being disqualified for reinstatement based upon any pre-existing illnesses. If you are covered by Medicare Part B and you cancel it, it cannot be reinstated until January of the next year. If you are covered by a program or plan that would pay for the emergency care received, you would not qualify for this benefit. What is the timeline to file?
Veterans have a responsibility to ensure that the VA Transfer Center is notified immediately upon any hospital admission. The MEDVAMC Transfer Center Coordinator can be reached during regular business hours at (813) 903-4221. If you are calling after hours, dial (813) 972-2000 and ask to speak to the Medical Administrative Assistant on duty. Claims must be filed with the nearest VA Medical facility to where the services were rendered within 90 days of the discharge date of medical service; otherwise, the claim will be denied because it was not filed in a timely manner. What type of emergency services will VA cover?
VA will reimburse health care providers for all medical services necessary to stabilize your condition up to the point you can be transferred to an approved VA health care facility or other federal facility. What about pharmacy items?
The VA’s authority for reimbursement of pharmacy items to veterans from non-VA providers follows a strict set of guidelines. The veteran must be actively enrolled in a Fee Basis Program; the pharmacy item must be considered as urgent or emergent by the initiating physician; the pharmacy item cannot be reimbursed past a 10 day supply; and the prescription and receipts must be turned in to the Fee Basis Unit. The reimbursement is based upon the U.S. Government’s Red Book cost and no taxes can be reimbursed.
Do I need to get approval before going to the emergency room?
No. If you are an eligible veteran, and a VA facility is not feasibly available when you believe your health or life is in immediate danger, report directly to the closest emergency room. If hospitalization is required, you, your representative or the treating facility should contact the nearest VA within 24 hours to arrange a transfer to VA care by calling the VA Transfer Center at (813) 972-7614.
How long will I stay in the private hospital?
If you are hospitalized, and the VA is notified, the VA will be in regular contact with your physician at the private hospital. As soon as your condition stabilizes, the VA will assist the private facility with arrangements to transport you to a VA, or VA-designated facility.
What if I do not wish to leave the private facility?
VA will pay for your emergency care services only until your condition is stabilized. If you stay beyond that point, you will assume full responsibility for the payment of costs associated with treatment.
Will I have to pay for my ambulance bill to the non-VA facility?
If the VA accepts responsibility for the emergency room visit and/or admission, the ambulance will be paid from the scene of the incident to the first non-VA facility providing necessary care.
Will I have to pay for an ambulance from the non-VA facility to a VA facility?
Yes. The VA is only authorized to pay for an ambulance to go from the scene of the incident to the first non-VA facility providing necessary care. Ambulance bills are considered unauthorized claims, and must be submitted to the VA in a timely manner.
What if the private hospital bills me for services?
If you are billed for emergency care services, contact the James A. Haley Veterans’ Hospital Fee Unit at (813) 972-7009 and a representative will assist you in resolving the issue. Under the law, payment from the VA is considered as “payment in full” for the dates authorized. What documents are required by VA to process claims for emergency care in non-VA facilities? The following page contains a list of documents necessary for the VA to process claims for emergency care in non-VA facilities. Remember, there is a 90-day deadline to file a Mill Bill Claim once you have been discharged from the Emergency Room/Hospital. Please submit all of the documents as a packet to the James A. Haley Veterans’ Hospital Fee Basis Office. The mailing address is: James A. Haley Veterans’ Hospital, Attention Fee Basis, 13000 Bruce B. Downs Blvd, Tampa, FL 33612. What documents to I need to provide to VA to pay for my emergency care in a non-VA facility?
Here is a checklist of all the documents you will need to provide to the VA in order for your claim to be processed: NonVA Emergency Room Visit And/Or Hospitalization HCFA Form UB92 or other Approved Medicare Form (OCR) (pink and white Medicare Billing Form) from the Hospital Business Finance Office Itemized Billing Statement from the Hospital Business Office A complete copy of All Medical Records pertaining to the admission through the date of discharge for this ER Visit/Hospitalization
Ambulance Provider HCFA Form 1500 or other Approved Medicare Form (OCR) (pink and white Medicare billing form) Ambulance Trip Ticket/Run Report ALL OTHER Provider/Physician Medicare HCFA Form 1500 or other Approved Medicare Form (OCR) Remember, there is a 90day deadline to file a Mill Bill Claim once you have been discharged from the Emergency Room/Hospital. Please submit ALL OF THE ABOVE ITEMS as directed above in: What documents are required by VA to process claims for emergency care in non-VA facilities?
Who do I call for more information? For more information about emergency care in non-VA facilities, call the Fee Basis Mill Bill office at (813) 903-4275.
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Post by CDR Young, USVL on Sept 4, 2016 1:35:03 GMT
Important VA benefit links (Updated)Department of Veterans Affairs (VA) The US Department of Veterans Affairs provides patient care and federal benefits to Veterans and their dependents. (You can access all divisions of the VA through this site.) www.benefits.va.gov/benefits/ VA E-benefits site (Manage all your benefits and applications electronically) *** It is essential to apply for an E-benefits account once you are approved for any VA benefit, so that you can view and manage your medical records, make appointments online, e-mail your doctors, and check the status of your claims or loan information. Once you get an account you will then need to verify your identity at a local Tri-Care office. Tri-Care is the health care program that all active duty service members are covered under. This is a very quick process. They are usually done in less than ten minutes once they put your information into the system. www.ebenefits.va.gov/ebenefits-portal/ebenefits.portalMyHealtheVet My HealtheVet is VA’s online personal health record. It was designed for Veterans, active duty Servicemembers, their dependents and caregivers. My HealtheVet helps you partner with your health care team. It provides you opportunities and tools to make informed decisions and manage your health care www.myhealth.va.gov/index.htmlVA Healthcare application For more information and assistance call 1-877-222-VETS (8387) between the hours of 8 AM and 8 PM EST Monday - Friday. www.va.gov/healthbenefits/apply/For Further Information: Contact your local VA health care facility’s Eligibility Office or the Health Eligibility Center at 404-828-5257. This and other eligibility related fact sheets are available at www.va.gov/healthbenefits/resources/publications.asp. VA Compensation pay Disability Compensation is a tax free monetary benefit paid to Veterans with disabilities that are the result of a disease or injury incurred or aggravated during active military service. Compensation may also be paid for post-service disabilities that are considered related or secondary to disabilities occurring in service and for disabilities presumed to be related to circumstances of military service, even though they may arise after service. Generally, the degrees of disability specified are also designed to compensate for considerable loss of working time from exacerbations or illnesses. www.benefits.va.gov/compensation/index.asp VA Spouse and Dependant benefits The Veterans Benefits Administration offers a variety of benefits and services to spouses, children, and parents of Servicemembers and Veterans who are deceased or totally and permanently disabled by a service-connected disability www.va.gov/opa/persona/dependent_survivor.asp Caregivers of Veterans If you’re taking care of a Veteran, you can call the toll free Caregiver Support Line at 1-855-260-3274 to receive the help you need and deserve. VA Benefits for Elderly Veterans Geriatrics is health care for elderly Veterans with complex needs. Extended care – also known as long term care – is a program for Veterans of all ages who need the daily support and assistance of another individual. Elderly Veterans can receive geriatric and long term care programs at home, at VA medical centers, or in the community. www.benefits.va.gov/persona/veteran-elderly.asp Women Veterans Women served in the United States Military as early as the Revolutionary War. Since then, women of all ages, ranks, and levels of authority have entered every branch of service, made significant contributions, and suffered the same sacrifices as men. As a woman with military service, you may qualify for a wide range of benefits offered by the Department of Veterans Affairs. www.benefits.va.gov/persona/veteran-women.aspBurial Benefits/National Cemetery Administration The National Cemetery Scheduling Office has the primary responsibility for verifying eligibility for burial in VA national cemeteries. A determination of eligibility is made in response to a request for burial in a VA national cemetery. To schedule a burial you will need to fax all discharge documentation to 1-866-900-6417 and follow-up with a phone call to 1-800-535-1117. www.cem.va.govVA Small Business Loans OSDBU seeks to enable Service-Disabled Veteran-Owned Small Businesses (SDVOSBs) Veteran-Owned Small Businesses (VOSBs), Small Disadvantaged Businesses, HUBZone Businesses, and Woman-Owned Small Businesses. Verification Assistance Program also available including Verification Self-Assessment Tool and Verification Briefs. www.va.gov/osdbu/Homeless Veterans Many Veterans face challenges throughout their lives that may lead them to lose their home, eventually becoming homeless. VA recognizes that every homeless Veteran's story is different, including their specific needs to help them get back into permanent and stable housing. There are many VA benefits that may support your specific needs, so it is important you know what benefits you may be eligible for. www.benefits.va.gov/persona/veteran-homeless.aspMinority Veterans As a minority Servicemember or Veteran, you may qualify for a wide range of benefits offered by the Department of Veterans Affairs. We encourage you to learn about available resources and programs and to apply for the benefits you may have earned. www.benefits.va.gov/persona/veteran-minority.aspVFW Veterans of Foreign Wars of the US is the official nonprofit service organization for USA military veterans benefits and VFW programs and services. www.vfw.orgGI Rights Hotline Hotline for military personnel wanting information about military discharges, grievance and complaint procedures, and other civil rights. Call 1-877-447-4487. girightshotline.org/en/Veterans Crisis Line The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. Veterans and their loved ones can call 1-800-273-8255 and Press 1, chat online, or send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. Support for deaf and hard of hearing individuals is available. Confidential Homeless Veteran chat and self check quiz also available. www.veteranscrisisline.netVA Mental Health Home Authoritative mental health information and resources for Veterans and their families. www.mentalhealth.va.govVA Health Benefits Reference Library Type, Publication Number, Title/Description, Date. Flyer, This document requires Adobe Reader to be installed. www.va.gov/healthbenefits/resources/publications.aspVA E-publications These publications have the latest information available regarding your benefits through the Veterans Health Administration. The VA is currently offering publications in PDF, ePub, and Mobi formats. www.va.gov/healthbenefits/resources/epublications.asp
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Post by CDR Young, USVL on Sept 4, 2016 1:36:02 GMT
VA Disability Pension for OTH Vets
Disability Pension is a benefit paid to wartime veterans with limited income who are no longer able to work. You may be eligible if: you were discharged from service under other than dishonorable conditions, AND you served 90 days or more of active duty with at least 1 day during a period of war time. However, 38 CFR 3.12a requires that anyone who enlists after 9/7/80 generally has to serve at least 24 months or the full period for which a person was called or ordered to active duty in order to receive any benefits based on that period of service. AND you are permanently and totally disabled, or are age 65 or older, AND your countable family income is below a yearly limit set by law
*Other than dishonorable means that for all discharges OTH, BCD, or General, the VA will make an individual determination as to whether or not the conditions of the discharge are considered to be "dishonorable''. Most OTH Vets meet the requirements.
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Post by CDR Young, USVL on Sept 4, 2016 1:36:54 GMT
VA Disability Compensation for OTH VetsDisability Compensation is a benefit paid to a veteran because of injuries or diseases that happened while on active duty, or were made worse by active military service. It is also paid to certain veterans disabled from VA health care. While there is no required minimum active duty service to qualify as a "veteran" for this benefit, one must have a disability that the VA determines happened while on active duty, or was made worse by active military service. One must also have a discharge that the VA determines was under other than dishonorable conditions. The amount of basic benefit paid ranges from $112 to $2,393 per month, depending on how disabled you are. Note: You may be paid additional amounts, in certain instances, if: you have very severe disabilities or loss of limb(s) you have a spouse, child(ren), or dependent parent(s) you have a seriously disabled spouse For complete information, see the VA's Disability Compensation Web site. www.benefits.va.gov/compensation/
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Post by CDR Young, USVL on Sept 4, 2016 1:37:40 GMT
Burial in a VA National Cemetery for OTH VetsTo qualify as a "veteran" for the purposes of burial in a VA National Cemetery, also depends on the conditions and period of service: (1) Any member of the Armed Forces of the United States who dies on active duty. (2) Any veteran who was discharged under conditions other than dishonorable. With certain exceptions, service beginning after September 7, 1980, as an enlisted person, and service after October 16, 1981, as an officer, must be for a minimum of 24 continuous months or the full period for which the person was called to active duty (as in the case of a Reservist called to active duty for a limited duration). Undesirable, bad conduct, and any other type of discharge other than honorable may or may not qualify the individual for veterans benefits, depending upon a determination made by a VA Regional Office. Cases presenting multiple discharges of varying character are also referred for adjudication to a VA Regional Office. (3) Any citizen of the United States who, during any war in which the United States has or may be engaged, served in the Armed Forces of any Government allied with the United States during that war, whose last active service was terminated honorably by death or otherwise, and who was a citizen of the United States at the time of entry into such service and at the time of death. (4) Reservists and National Guard members who, at time of death, were entitled to retired pay under Chapter 1223, title 10, United States Code, or would have been entitled, but for being under the age of 60. Specific categories of individuals eligible for retired pay are delineated in section 12731 of Chapter 1223, title 10, United States Code. (5) Members of reserve components, and members of the Army National Guard or the Air National Guard, who die while hospitalized or undergoing treatment at the expense of the United States for injury or disease contracted or incurred under honorable conditions while performing active duty for training or inactive duty training, or undergoing such hospitalization or treatment. (6) Members of the Reserve Officers' Training Corps of the Army, Navy, or Air Force who die under honorable conditions while attending an authorized training camp or on an authorized cruise, while performing authorized travel to or from that camp or cruise, or while hospitalized or undergoing treatment at the expense of the United States for injury or disease contracted or incurred under honorable conditions while engaged in one of those activities. (7) Members of reserve components who, during a period of active duty for training, were disabled or died from a disease or injury incurred or aggravated in line of duty or, during a period of inactive duty training, were disabled or died from an injury or certain cardiovascular disorders incurred or aggravated in line of duty. Further information can be viewed on the VA's National Cemetery's Web Site at: www.cem.va.gov/
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Post by CDR Young, USVL on Sept 4, 2016 1:40:04 GMT
OTH Vets qualify for Home Loan GuaranteeMilitary veterans are entitled to a home loan guarantee of up to $359,650, when they purchase a home. While this is commonly referred to as a "VA Home Loan," the money is not actually loaned by the government. Instead, the government acts as a sort of co-signer on the loan, and guarantees the lending institution that they will cover the loan if the veteran defaults. This can result in a substantial reduction in interest rates, and a lower down payment requirement. However, whether or not the Veteran's Administration (VA) defines someone as a "veteran" under this program also depends on (1) when they served, (2) how long they served, and (3) what kind of discharge they received. First of all, the law requires that the veteran's discharge be under "other than dishonorable conditions." This is not the same as a "dishonorable discharge." What this means is that for all discharges other than honorable or general, the VA will make an individual determination as to whether or not the conditions of the discharge are considered to be "dishonorable." Required periods of service are:At least 90 days of active duty service during WWI, WWII, Korean War, or the Vietnam War (09/16/40 to 07/25/47, 06/27/50 to 01/31/55, and 08/05/64 to 05/07/75). The 90 days does not have to be continuous. If you served less than 90 days, you may be eligible if discharged for a service connected disability. For active duty service prior to 09/07/80 (enlisted) and 10/16/81 (officer) -- other than the dates listed above, you must have served 181 days of continuous active duty to qualify for a home loan guarantee. For active duty service from 09/07/80 (enlisted) or 10/16/81 (officer) to 08/01/90: (a) Completed 24 months of continuous active duty or the full period (at least 181 days) for which you were ordered or called to active duty and been discharged under conditions other than dishonorable, or (b) Completed at least 181 days of active duty and been discharged under the specific authority of 10 USC 1173 (Hardship), or 10 USC 1171 (Early out), or have been determined to have a compensable service-connected disability; (c) Been discharged with less than 181 days of service for a service-connected disability. Individuals may also be eligible if they were released from active duty due to an involuntary reduction in force, certain medical conditions, or, in some instances for the convenience of the Government. For active duty service after 08/02/90: (a) completed 24 months of continuous active duty or the full period (at least 90 days) for which you were called or ordered to active duty, and been discharged under conditions other than dishonorable; or (b) completed at least 90 days of active duty and been discharged under the specific authority of 10 USC 1173 (Hardship), or 10 USC 1173 (Early out), or have been determined to have a compensable service-connected disability, or (c) been discharged with less than 90 days of service for a service-connected disability. Individuals may also be eligible if they were released from active duty due to an involuntary reduction in force, certain medical conditions, or, in some instances, for the convenience of the Government. Members of the Reserves and National Guard who don't have enough active duty service to qualify under the above requirements can also qualify for the VA Home Loan Guarantee program, if they have completed a total of 6 years in the Selected Reserves or National Guard (member of an active unit, attended required weekend drills and 2-week active duty for training) and: Were discharged with an honorable discharge, or Were placed on the retired list, or Were transferred to the Standby Reserve or an element of the Ready Reserve other than the Selected Reserve after service characterized as honorable service, or Continue to serve in the Selected Reserves Note: Individuals who completed less than 6 years may be eligible if discharged for a service-connected disability.VA HOME LOAN WEBSITE: www.benefits.va.gov/homeloans/
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