Do I Qualify for VA Care?
The benefits for which an individual is eligible depend on a number of criteria, including, but not limited to:
Eligibility for certain benefits may require a minimum of two years of documented service, while 30 days of documented service is enough to qualify for other benefits. In many cases, veterans with nearly identical records will not be eligible for the same benefits because of a few months difference in their discharge dates. There is no "One Size Fits All."
Gateways to Health Care
Veterans with honorable discharges have three possible "Gateways" to VA Health Care:
This is based on:
Threshold is adjusted every January.
Service Connected Disability:
A Service Connected Disability is any medical condition, physical or mental, related to your military service that negatively impacts your life today. A few examples are:
There is no minimum time in service requirement for Service Connected Disability.
*Agent Orange Exposure has a special Service Connected Disability list.
Limited or Special Programs:
There are several of these programs. Examples include, but are not limited to:
Compensation and Pension Exam
A veteran may request a Compensation & Pension exam from the Veterans Benefits branch of the VA to determine is he/she has a service connected disability. The Grand Junction VA Medical Center provides clinic space for these examinations, but its doctors do not perform them, as doctors who perform these evaluations are employed by Veterans Benefits, not the Veterans Health Administration. In some cases, existing medical records can be used to request compensation. Any disability rating of 10 percent or more qualifies a veteran for VA health care.
In addition to the traditional C&P exam, there is a new program in place for some military in which the Veteran's exit physical is also their C&P exam.
Registration, Enrollment, and Making a Service Connected Disability Claim
All Veterans are encouraged to register with a VA Medical Center even if they do not believe they are eligible for enrollment.
Veterans must fill out a VA Form 10-10EZ to register with a VA Medical Center. For some Veterans who qualify under income threshold or a special program, this may also enroll them for health care. For Veterans who are claiming a service connected disability, and who have not qualified under another program, can convert the registration to enrollment if the Service Connected Disability is granted.
A Veteran is enrolled when they are confirmed as eligible for care. Once an eligible Veteran has been seen, and maintains enrollment for a full tax year, they are vested in the system, but should continue to be seen at least once a year to ensure full eligibility.
Service Connected Disability Claim
VA Form 21-526 is used to make a Service Connected Disability Claim. It is also used to make a VA Pension Request. This form is used for a number of things, and may be up to 13 pages long. Most Veterans are not required to fill out the entire form, only the areas which apply to their situation. To avoid confusion, Veterans are encouraged to seek assistance with the 21-256 from a Veterans Service Officer/Organization in their area or another expert.
Qualifying for VA Health Care
Eligilibity does not equal enrollment. Even though a veteran is eligible for VA health care, if he/she does not take the steps to enroll, he/she cannot receive VA provided health care.
Veterans generally must have "Honorable" or "Under Honorable Conditions" noted on their discharge (DD 214) to be eligible for VA benefits.
Many Veterans believe that if they recieved a "General" discharge, it automatically converts to an "Honorable" discharge after six months. This is not true. For conversion, Veterans must file an appeal which may take from six to eighteen months to process. Approval is not guaranteed.
"Dishonorable" discharges may also be appealed.
Veterans with discharges which are not "Honorable," but who have service connected disabilities, may be eligible for treatment of that disability (no other care will be provided).
Proof of Military Service
Veterans who have lost their discharge papers can request a replacement:
Contact and Assistance Information
Because the Western Slope does not have a Veteran Benefits Office, veterans are encouraged to contact a certified veterans assistance officer, or an experience assistance representative with a Veteran's organization. Two such certified VSOs are Dave Dunnagan with the Disabled American Veterans office (located in the Grand Junction VA Medical Center) and "Doc" Ross with the Vietnam Veterans Association.
If a Veteran lives in Colorado, he/she can contact the county Veterans Service Officers in his/her area. Assistance is also available to veterans living in Utah and Wyoming through the state Veterans Affairs Offices and various veterans' organizations. Several Veterans' organizations also have representatives who can assist with the VA forms.
Most states have an Office or Department of Veterans Affairs. The Grand Junction VA Medical Center's area of responsibility covers three states, each of which has its own benefits for veterans. For details or assistance, contact:
(In order to facilitate more timely response, please have the Subject line of your email read: "Eligibility")