Medical Care & Leave

VA medical and pharmacy copayments cancelled through Sept. 30, 2021

Read here about the American Rescue Plan's debt relief and cancellation and refund of copayments made to VHA for medical and pharmacy care from April 6, 2020 through September 30, 2021.

BREAKING: The SAVE LIVES Act is signed into law!

The SAVE LIVES Act allows the VA to vaccinate ALL veterans, veteran spouses, caregivers, and CHAMPVA recipients against COVID-19.  
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Your Rights Under the Federal Family and Medical Leave Act (video)

View this video to learn the basics about how the federal law provides extra leave for some workers, including time to care for injured servicemembers.

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Frequently Asked Questions about the PACT Act

Answers to Frequently Asked Questions (FAQs) about the PACT Act. The Act provides eligibility and benefits to veterans exposed to burn pits and toxins during military service.

Tinnitus?

Question:

I have bad tinnutis, can't sleep but 4-5 hrs. I am 75 years old and served in Korea in 1967 & 1968. This problem continues to worsen. I am enrolled in VA health care but the co-pay cost me more than medicare. My retirement is $2500 per month and my wife has a teacher retirement, both incomes equal to less than 70k per year. What might I qualify for from veterans health services other than the Class 8 that I am now?

 

Jim's Reply:

When we are made eligible for VA health care services we are assigned to a priority group. Your tinnitus rating of 10% (the max for tinnitus) places you at 8 on the priority list and sets certain minimums for copays for health care other than that provided for the tinnitus. A vet with a disability rating of 100% is in priority group 1 with no copays for anything and the scale slides down from there.
 

From what you tell me I'd offer that you should consider filing a claim for the secondary conditions you associate with your tinnitus. Tinnitus is ringing in the ears and most people have a degree of tinnitus that they may or may not ever notice. In some people the ringing is distracting at times but not a real bother unless associated with profound hearing loss when the tinnitus may mask already dulled sounds. 
 

There are those folks who have such a loud tinnitus that they have serious issues with concentration, communication and sleep. VA doesn't compensate tinnitus at more than 10% disabling so to increase your benefits and get you into a better priority group so your copays don't cost as much, you need to file for a higher disability rating.
 

I'd first suggest that you have your hearing tested again and see if you don't suffer a degree of hearing loss. Then you'll need a medical record of the things that you believe are attributable to your tinnitus. Sleep loss is a condition as is depression, anxiety, mood swings, anger, etc. Again, these are secondary conditions to tinnitus that can be rated as such but you need a record of treatment to prove these are things bothering you.
 

As you are able to, take a while to get your records in order and file the claims.
 

Good luck!

 

Means Tested?

Question:

I am a 100% service connected veteran, my disabled stepson is in a residential program where he gets SSI and a portion of my wife's Social Security benefits. I am being billed $65 monthly because I get money from VA. Is this correct? They said the order came from the State or County's DFS. Is that accurate?


Jim's Reply:

I can't speak to rules and regs that are made up by a state or county when you don't tell me what state or county you refer to. Even if I could, it probably wouldn't make a lot of difference since most organizations that provide services to low income and disabled citizens do a means test to determine eligibility for their benefits.
 

Veterans often think their benefits are exempt from such things because our monetary benefits are exempt from taxes. That isn't true, our disability money is treated as income and I have to guess that's what happened here. It's likely that counting your VA income puts you in a position of paying a charge as you note.
 

Good luck.

 

Drug Testing?

Question:

Can I lose my VA benefits if I refuse drug testing? I am treated for mental health issues among other health issues. No prior history of usage, 20 years of service, and 16 years of VA documented medical treatment and drug testing... never one positive test.

 

Jim's Reply:

No. Benefits aren't associated with health care. Drug screens aren't meant to be to set you up for punishment, they're to detect a health care problem just like a kidney test or a liver test. VA is treating substance use and abuse as a health care issue, and that's very appropriate.


You can learn more here at the VAWatchdog site

 

 

Health Insurance?

Question:

Hello my question is my VA healthcare provider told me that I must not use any other medical and dental insurance other then then the VA. This was told to me in 2013 until present day and I have not used any other insurance since then. I have asked them why I can't use other insurance and they reply that I need to use the VA.
 

I have asked a couple of other veterans an they have never heard of this. I saw that you are a extremely knowledge with the VA policy's and am hoping you might give me some direction on this subject. I could have got a lot more dental work done and more medical issues taken care of if I could have used other insurance. It's gotten to the point that my health is now in bad shape because of I can't get anything done with the VA am having to repeat the process so many times. Any information on this is greatly appreciated an thank you for taking the time to read questions.

 

Jim's Reply:

I'm with all the other veterans you've asked, I've never heard of anything like this. To be honest, I'm not at all sure you understand what someone told you whenever that was. If a provider told you that there was no reason to seek care elsewhere, that's a lot different than telling you that you aren't allowed to get health care other places.
 

The first concern that comes to my mind is how you'll pay for health and dental care outside VA? Do you have civilian insurance or a pile of cash to spend? Civilian care costs a lot of money and if you don't have insurance the VA may not help you pay for civilian care.
 

You can get your care anywhere you'd like to but you'll have to foot any bills that arise. Good luck.

 

Drug Screens?

Question:

I know you can not refuse a drug test but can you to your family doctor?

 

Jim's Reply:

You have a right to refuse any test that you don't want to take at any time from any health care provider. But, why would you do that? If you refuse to take a drug test, that gives us a pretty good idea you are hiding something.
 

Drug screening isn't done to catch the user and punish them. Drug screens are a health indicator and your health provider needs to know. I'd say go for it.

 

Photo credit: whereslugo. Photo of a young person in a hoodie and baseball cap sits at a bus stop.

Are you unable to get to a VA facility?

Are you unable to get care from a VA hospital because the wait time is too long or the hospital is too far away? A law passed in 2014 may help you get the VA to pay for care in your local community.