| Filling out VA Claims |
| When you are going to fill out a VA Claim form you will need the following documents: Non-Medical Benefits A copy of your discharge certificate, or DD Form 214, Certificate of Release or Discharge from Active Duty, if available Your VA claim number or Social Security number if receiving benefits under prior service A copy of all marriage certificates and divorce decrees (if any) A copy of each child's birth certificate (or adoption order) A copy of your birth certificate if there are living parents dependent on you for support A copy of any service medical records for disabilities you intend to claim The most typical claim for benefits is for compensation for military service related injuries. Complete VA Form 21-526, Veterans Application for Compensation or Pension, you may obtain a copy of the form from any VA Regional Office . Medical Benefits A copy of your discharge certificate, or DD Form 214, Certificate of Release or Discharge from Active Duty, if available In order to document your service in a theater of combat operations, it would be helpful if you brought any of the following: A copy of your Leave and Earnings Statement showing receipt of Hostile Fire or Imminent Danger Pay Receipt of the Armed Forces Expeditionary Medal Kosovo Campaign Medal Global War on Terrorism Expeditionary Medal Southwest Asia Campaign Medal Proof of exemption of federal tax status for Hostile Fire or Imminent Danger Pay Orders to a theater of combat operations Complete VA Form 10-10EZ, Application for Health Benefits, online. Or, you may obtain the form by: Calling VA's Health Benefits Service Center toll free number, 1-877-222-VETS(8387), Monday through Friday between 8:00 AM and 8:00 PM (Eastern Time) Calling or visiting any VA health care facility or VA regional office. To find the facility nearest you, visit the VA Facilities web page. Determining Your Eligibility Eligibility for health care through VA is a two-step process: 1) VA must determine your eligibility status as a veteran by reviewing your Character of Discharge from active military service, and your Length of active military service 2) VA must determine whether you qualify for one of the eight enrollment priority groups. Step 1. Determine your qualifying military service The character of discharge you received from the military can be a factor. It is not an issue if you received: *An honorable discharge A general discharge A discharge under honorable conditions *The length of your service may also matter. It depends on when you served. There’ s no length of service requirement for: Former enlisted persons who started active duty before September 8, 1980, or Former officers who first entered active duty before October 17, 1981 All other veterans must have 24 months of continuous active duty military service or meet one of the exceptions described below. If you have a different character of discharge, you may still be eligible for care. Contact your Enrollment Coordinator at your local VA health care facility to see if you qualify. Minimum Service Requirement You do not have to meet the 24 continuous months of active duty service requirement if you: Were a reservist who was called to Active Duty and who completed the term for which you were called, and who was granted an other than dishonorable discharge, or Were a National Guard member who was called to Active Duty by federal executive order, and who completed the term for which you were called, and who was granted an other than dishonorable discharge, or Only request a benefit for or in connection with: a service-connected condition or disability; or treatment and/or counseling of sexual trauma that occurred while on active military service; or treatment of conditions related to ionizing radiation; or head or neck cancer related to nose or throat radium treatment while in the military. Were discharged or released from active duty for a hardship , or Were discharged with an “early out”; or Were discharged or released from active duty for a disability that began in the service or got worse because of the service; or Have been determined by VA to have compensable service-connected conditions; or Were discharged for a reason other than disability, but you had a medical condition at the time that Was disabling, and In the opinion of a doctor, would have justified a discharge for disability (in this last case, the disability must be documented in service records) Step 2. Enrollment in VA Health Care System Generally, you must be enrolled in VA health care system to receive benefits offered in the Medical Benefits Package. Certain veterans do not need to be enrolled to receive medical care benefits. You do not have to be enrolled if you: Have been determined by VA to be 50% or more disabled from service-connected (SC) conditions Are seeking care for a VA rated service-connected disability only It is less than one year since you were discharged for a disability that the military determined was incurred or aggravated by your service, but that VA has not yet rated However, enrolling will assist VA in planning and budgeting resources. Information About Enrollment To apply for VA health care benefits, including enrollment you must fill out an application. We use the application to determine: Whether you have qualifying service as a veteran What your veteran status is so that you can be placed into one of the priority groups I want more information about applying for care. Once enrolled, most veterans remain enrolled from year to year without further action on their part. However, Some veterans need to provide updated financial information to continue their enrollment in a certain priority group You may cancel your enrollment anytime Changes in VA’s available resources may reduce the number of priority groups VA can enroll in a given year. If that occurs, VA will publicize the enrollment changes and notify affected enrollees. Enrollment Priority Groups The number of veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up priority groups to make sure that certain groups of veterans are able to be enrolled before others. Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a priority group. The priority groups range from 1-8 with 1 being the highest priority for enrollment. Some veterans may have to agree to pay copayments to be placed in certain priority groups. You may be eligible for more than one Enrollment Priority Group. In that case, VA will always place you in the highest priority group that you are eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled veterans. The priority groups are complicated and some reference financial thresholds. For more information about the thresholds go to the Copayments and Charges page. We have provided a couple of different ways to view priority groups. What if I am Catastrophically Disabled? To be considered Catastrophically Disabled, you must have a severely disabling injury, disorder, or disease which permanently compromises your ability to carry out activities of daily living, and: requires you to have personal or mechanical assistance to leave home or bed, OR requires you to have constant supervision to avoid physical harm to yourself or others. To request a catastrophic disability evaluation, contact the Enrollment Coordinator at your local VA health care facility. VA will make every effort to schedule your evaluation within 35 days of request. There is no charge for the Catastrophic Disability evaluation. If it is determined by a VA health care provider that you are Catastrophically Disabled, your priority group assignment will be upgraded to Priority Group 4. Why Choose a Preferred Facility? VA asks you to identify the health care facility where you would like to receive your primary care. A preferred facility may be any VA health care location, for example, VA health care facility, independent clinic, or community based outpatient clinic. If VA is unable to provide your needed health care, that facility will make arrangements to refer you to another VA health care facility or to one of VA’s private sector affiliates to provide the required care. What if I Want to Cancel my Enrollment? There are many reasons to remain with VA for your health care needs. However, the decision as to whether it is more beneficial for you to find a doctor outside VA system is yours to make. |
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