The VA system

The U.S. Department of Veteran Affairs (VA) is a much-maligned (both fairly and unfairly) but critical organization. It is the second-largest federal agency. The Department of Defense is the largest, so this shouldn’t be a surprise. It employs a little under 350,000 people to serve 5,124,168 enrolled veterans as of 2014.

There are essentially three parts of VA and they have very little interaction: VHA(health services), VBA(benefits) and National Cemetery Administration. To get benefits from the VA, you need to contact one or more of them depending on what you are trying to get. Signing up with one agency will not get you signed up with the others. Annoyingly, you need to contact both VHA and VBA if you move, so you don’t miss important correspondence. All benefits and eligibility for them are authorized by various laws, and VA is bound to them. All eligibility decisions can be formally appealed. Everything is based on what can be proven through military records along with civilian medical records if they exist. It is a maze of bureaucracy. The best way to deal with it is to start with a Veteran Service Officer (VSO).

A VSO is a person hired by veteran organizations such as VFW. You do not need to be a member of the organization, nor do they ever charge for their services. There are links to several organizations that provide VSO’s in the helpful links section at the top, but it is not a complete list. Shop around and find one that seems to really understand the system. What is needed to get started is your DD-214 (They can help begin the process while still on active duty). If applicable, give the VSO access to your medical records, so they can decide how to proceed on any disability claims. Whether or not you can qualify for educational or health benefits, disability, and even burial benefits depends on your records.

I don’t think I can overstate this. Make sure that everything is documented correctly and that you have official copies of everything. Many Vets end up with little to no help because documents were lost or burned in fires. What services and compensation that you eventually qualify for depends on your documentation.

To get the most help, you will need to sign a limited power of attorney so they can work on your behalf on issues related to the VA. Otherwise, you will be left to fill out forms and submit them on your own. You will also not be able to get information as quickly as a VSO can.

When I was moving through my medical retirement proceedings, I was sent to a VFW VSO. He let me know everything I would likely qualify for and got the ball rolling before my retirement was completed. He got the application for disability put in and also enrolled me in the nearest VA hospital. He also started me in the vocational rehab program, which is a phenomenal program, especially stacked up against the GI Bill as it existed in 1996. It also covers things that the GI Bill does not, such as vocational evaluations.

Within 12 months of retirement, I had disability compensation and vocational rehab set up. I didn’t really have to do anything except show up to a few appointments.

I had always assumed that a service member would need a medical discharge or retirement to qualify for these benefits. That is not true! Congress expanded the range of vets that qualify for health care. Of course, they did not properly fund that expansion, but that is a different topic.

You also do not need to be a boots-on-the-ground combat vet injured in the line of duty to qualify for benefits. If you are on active duty, you are considered to be on duty 24/7.

If you are on active duty, and develop epilepsy, as in my case, and it is a chronic disability, you can get rated for it. Even if the condition existed before enlistment, and you still passed the initial medical exam (assuming you disclosed it - never lie to the military or VA, it can bite you hard), and it got worse, you can get compensation for what got worse. In my case, my service did not cause it, at least as far as I can tell, but it happened on active duty, so it is service-connected. You could be walking off base and get run over by a drunk driver, and if there are any disabling conditions, it could be considered as service-connected. As long as your disability wasn’t caused by your misconduct, you can likely get it service-connected. If your disabilities happened while driving drunk, for example, it will not likely lead to a service-connected disability. It does have to be chronic and disabling. An acute incident that caused no problems once addressed will not qualify. Reservists and National Guard members do not have the 24/7 on-duty presumption since they typically spend so little time each month drilling.

Disabilities are rated from 0%-100%, some are capped lower than that, and are combined (not added together) using what is often called the whole-man system. It is a system that is used around the world in both private and public disability insurance systems. The max combined disability is 100%. I will write more specifically about the system, obtaining disability benefits, and pitfalls to avoid in another post.

Other than a dishonorable discharge, less than honorable discharges might qualify you for some services and benefits. A VSO can help here.

VHA has rules mandated to them for health care that can be a little tricky. It is not as simple as “I served one enlistment give me free health care for life”. Again, a VSO can help you know what sorts of services you qualify for. The simplest is if you have any service-connected disability. You can always get seen for service-connected issues and any related treatment that your VA doctor thinks is appropriate for free. Your dependents(unless your spouse or child is a veteran or otherwise qualifies) do not get typically get medical care from VA, but there are some cases where they do qualify for CHAMPVA which is free insurance they can use in the private sector.

Retirees and their families qualify for medical care through the DoD. That is outside the scope and control of VA. They are separate cabinet-level agencies, despite seemingly being linked.

There are 8 categories of vets that qualify for VA care called priority groups. Priority groups have nothing to do with scheduling. Everyone is scheduled the same from my experience. If you fit into multiple priority groups, which many do, you will be placed in the highest group. Some vets will have co-pays, but they are very low, and only applies to some eligible vets, and are means-tested. If you have co-pays and private insurance, you can use that to pay for it. I have read reports from vets on VBN that their private insurance assumes that you paid your insurance deductible to the VA even though you did not. It is a cheap way to meet your deductible.

This was a quick and dirty introduction to the VA system. I will write more in other articles as there is much more to add.

The most important thing here is if you are a vet, take your DD214 - or a separating active duty member - see a VSO and see what you might be eligible for.