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SERVICE OFFICER TRAINING SEPTEMBER 20-22, 2006 NON-SERVICE CONNECTED PENSION DON SMITH - INSTRUCTOR. BASIC PENSION. PURPOSE HISTORY CURRENT PENSION (PL 95-588) PENSION ELIGIBILITY WARTIME PERIODS
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SERVICE OFFICER TRAINING SEPTEMBER 20-22, 2006 NON-SERVICE CONNECTED PENSION DON SMITH - INSTRUCTOR
BASIC PENSION • PURPOSE • HISTORY • CURRENT PENSION (PL 95-588) • PENSION ELIGIBILITY • WARTIME PERIODS • DISABILITY REQUIREMENTS
BASIC PENSION CONT. • INCOME REQUIREMENTS • NET WORTH REQUIREMENTS • COMPUTATION OF PENSION RATE • MEDICAL EXPENSES • ANNUAL REPORTING (EVR’S) • UNDERSTANDING RATE CHART
PURPOSE OF VA PENSION • Pensions were intended to relieve distress from disability and destitution among the aging population of veterans and surviving spouses. Today VA’s pension has evolved into what is now know as improved pension to provide a level of financial support to wartime veterans or their widows.
HISTORY OF PENSION • OLD LAW PENSION • FEW, IF ANY LEFT • SECTION 306 PENSION -INCOME BASED -FIXED MONTHLY AMOUNT (DOES NOT HAVE COST OF LIVING INCREASE) -CAN ELECT TO CONVERT TO IMPROVED PENSION (CONVERSION IN IRREVOCABLE) • IMPROVED PENSION - PL 95-588 – JANUARY 1, 1979
BASIC ELIGIBILITY UNDER “IMPROVED PENSION” • To qualify, veteran must have 90 days or more of active duty, at least on day of which was during a period of war. 38 CFR 3.3(3) Generally, veterans who entered a/d on or after 9/18/1980, or officers who entered a/d on or after 10/16/1981, require a minimum of 24 months active duty. 38 CFR 3.12a(a-d) • 38 CFR 3.2 – Periods of War
DISABILITY REQUIREMENTS • Must be permanently and totally disabled (P&T) (38 CFR 4.17) • Exceptional cases allowed? (38 CFR 3.321 (b) (2) • PL 107-103, Sec. 206 & 207 – Authority for statutory presumption of P&T for pension at age 65. Effective 12/27/2001. • Plus P&T for veteran’s who are either a patient in a N/H getting long term care or Social Security disability.
INCOME REQUIREMENTS • Recognizing countable income – See 38 CFR 3.271 (Computation of Income) • Payments of any kind or source shall be counted as income during the 12 month annualization period. • Family income? • Recurring income? • Non-recurring income? • Irregular & short term income?
EXCLUSIONS FROM INCOME 38 CFR 3.272 • Welfare • Maintenance • Sale of Property • Medical expenses • Education expenses
NET WORTH38 CFR 3.274 • Relationship of Net Worth to Pension “reasonable that some part of the corpus of such estate be consumed for the veteran’s maintenance” • Evaluating Net Worth – 38 CFR 3.275 Whether property can be readily converted into cash at no substantial sacrifice Life expectancy of claimant
COMPUTATION OF INCOME • Income work sheet (PL 95-588) • Gross (family) Annual Income • Deductible Expenses (Minus 5% of MAPR) • IVAP (Income for VA purposes) • MAPR (Maximum annual pension rate) • Annual/Monthly Entitlement
DEDUCTIONS: Unreimbursed Medical Expenses(M21-1, Pt. IV, Ch. 16) • Para 16.30 Deductible Expenses – General • Para 16.31 Medical Expenses • Addendum A – Listing of possible medical expenses
DEDUCTIONS CONT. • Para 16.31 b. (2) – In-Home Attendants • - Disabled Person A&A or HB – Attendant does NOT have to be licensed. All fees paid are allowable “as long as the attendant provides some medical or nursing services” Includes fees paid for cleaning and food preparation, etc. • - Disabled Person NOT A&A or HB – Attendant must be licensed health professional, then all fees are allowable. • Para 16.31 b. (10) – Reference for Assisted Living Facilities • - Disabled Person A&A or HB – Full cost of Assisted Living is deductible as long “as the facility provides some medical or nursing services” • - Disabled Person NOT A&A or HB – “allow expenses paid to the facility only to the extent that they represent payment for medical treatment” • Additional Points of Interest
SPECIAL MONTHLY PENSION • Increased pension is payable to a veteran by reason of need for A&A or by being housebound (H/B). 38 CFR 3.351 and 3.352. • Describe A&A • Describe H/B
ANNUAL REPORTING • Eligibility Verification Reports - Who Receives Annually? - What form do they receive? 21-0516 vice 21-0516-1 Difference? Block 8, Medical Expenses Of Significance – Block 8. C. Projected Medical Expenses - Difference Between Recurring and Non-recurring Medical Expenses
ANNUAL PENSION ADJUSTMENT LETTER • Indicates amount claimant SHOULD have been paid for previous year, NOT the amount they were actually paid. Based on actual income and deductible expenses for that year. As determined by annual EVR and 21-8416. • Retro check or Overpayment letter to follow. • Retro check WILL NOT be equal to total of Medical Expenses reported on 21-8416.
CONDITIONS OF REDUCTION • Reduction because of hospitalization (38 CFR 3.551 (e)) • Adjustment of allowance for A&A (38 CFR 3.552)
APPROPRIATEREFERENCE MATERIALS • 38 CFR M21-1 - 3.1 (d), (e) (f) - Part III (l) & - 5.19 to 5.26 - 3.3 - 6.01 to 6.10 - 3.12a - 6.16 to 6.22 - 3.23 - Chapter 7 - 3.27 - 9.01 to 9.02 - 3.271 to 3.277 - M21-1, MR, - 3.342 PT III, Sub PT ii - 3.351 - M21-1, PT IV - 3.352 - 11.01 to 11.05 - 12.01 to 12.11 - 12.15 to 12.19 - Chapter 16 - Addenda A&B