An Overview of Benefits for Veterans with Disabilities

Lucy Miller

Virginia Commonwealth University

WIPA National Training Center

Why this topic is important….

A significant portion of veterans who are homeless do experience disability – some studies suggest as high as 60%!

Veterans who receive VA/DoD benefits based on disability may also be eligible for disability benefits from the SSA. Many are not aware of this.

Cash benefits from VA/DoD and SSA represent a valuable resource for use in community reintegration of veterans who are homeless.

VA/DoD and SSA benefits may be affected by paid employment. It is important to understand these rules if veterans are pursuing paid employment

What we will cover today:

Basic overview of Department of Defense (DoD) and Veterans Administration (VA) benefits available to veterans with disabilities

Basic overview of SSA benefits available to veterans with disabilities

Summary of how DoD/VA benefits interact with SSA disability benefits

Summary of how employment affects DoD/VA benefits and SSA disability benefits

Types of Cash Benefits Available to Veterans with Disabilities Military retirement due to disability provided

by the US Department of Defense (DoD) Veteran’s Administration (VA) benefits

VA Disability Compensation VA Disability Pension

Disability benefits provided by the Social Security Administration (SSA) Social Security Disability Insurance (SSDI) Supplemental Security Income (SSI)

Medical Benefits Available to Veterans with Disabilities Military retirement comes with Tricare medical

coverage Veteran’s receiving VA benefits due to

disability may access the VA health care system

Medicare coverage comes with Social Security Disability Insurance (SSDI) after a waiting period

Medicaid coverage is provided to all SSI recipients

Multiple forms of medical coverage may be accesses simultaneously

Let’s start with the DoD and VA benefits…

Veterans may get benefits from either DoD or the VA or from BOTH

at the same time!

Military Retirement Due to Disability

Military retirement benefits are administered by DoD Military retirement is available to persons with 20+

years of active service in the military Individuals may retire as disabled regardless of %

level of disability if found unfit for service by reason of physical disability

Individuals with less than 20 years of active service at the time they are removed from the military by reason of physical disability may be either “separated” or retired, based on a variety of factors

Benefits may be dispensed as either a monthly check or as a lump-sum severance payment depending on the person’s circumstances

Advantages of Military Retirement due to Disability Recipients of these benefits are NEVER

subject to a review of their disability rating Retired veterans with disabilities get the same

benefits as all other military retirees including use of commissaries, military hospitals, and Tricare coverage for themselves and family members

Military retirement is NOT affected by paid employment in any way!

VA Disability Benefits – How to Apply Most veterans apply for VA benefits when

they are first separated from the military due to being “unfit for active duty”

Veterans’ may apply at any point after this by completing VA Form 21-526 – Veteran’s Application for Compensation or Pension

Veterans may also apply online at: http://vabenefits.vba.va.gov/vonapp/main.asp

Questions? Call toll free 1-800-827-1000

Disability Evaluation under the VA System Disability is assessed using a percentage

system in intervals of ten from 0% - 100% The higher the disability rating, the higher the

monthly disability benefit payment The rating was originally intended to

represent the degree to which a veteran’s earnings capacity is diminished by the disability

Determinations are based on the VA Schedule for Rating Disabilities or VASRD

More about the VA Rating System

The VA considers all service-connected disabilities and the totality of the changes in the person’s medical condition that occurred during military service

Unlike the DoD, the VA process permits reevaluation of service-connected disabilities if a condition worsens or improves over time

The DoD and VA use different rating systems – it is possible for a veterans two have two different ratings from the two agencies

Rating Designations

Total disability based on 100% schedular rating

Total disability at less than 100% schedular rating based on “individual unemployability”

Permanent and total disability

These designations are important because they allow higher benefits to be paid and may entitle veteran’s to additional benefits

VA Disability Compensation

Disability must be “service connected” - incurred or aggravated during active military service

Separation or discharge from the military must be under conditions other than dishonorable

VA Compensation is an entitlement program and is not means-tested in any way!

VA compensation benefits may be reduced if certain DoD benefits such as military retirement or disability severance pay are received.

More About VA Disability Compensation Vets with ratings or 30% or more are eligible

for additional allowances for dependents Vets with certain types of disabilities (loss of

limb or use of organs) may be eligible for “Special Monthly Compensation” (SMC) in addition to regular VA compensation

Vets with 100% ratings who are “housebound or bedridden” may get an additional SMC payments known as “Aid and Attendance and Housebound Allowance”

VA Disability Pension

Available to veterans with non-service connected disabilities

Must have at least 90 days of active military service, with at least one day during a period of war (in some cases, more service required)

Disability must be assessed as being permanent and total

Separation or discharge must have been under conditions other than dishonorable and disability must not be due to willful misconduct

More about VA Disability Pension

VA pension is intended to bring the veteran’s total income up to a minimum level set by Congress

Eligibility is based on strict income and asset guidelines

Payments are reduced by the amount of countable income of the veteran, the spouse, or dependent children

Pension calculations are complicated – leave this to the VA to determine!

Other VA Benefits for Veterans with Disabilities Veteran’s Medical Benefits Package Vocational Rehabilitation and Employment

Services (VR&E) Specially adapted housing grants Service-disabled veteran’s insurance Assistance with adapting an automobile to

meet disability needs Annual clothing allowance

Where to Get More Information about VA Benefits VCU CWIC Training Manual – Module 3 at

www.vcu-ntc.org A Handbook for Injured Service Members & Their

Families http://www.fallenheroesfund.org/common/page.php?ref=familyinfo

Federal Benefits for Veterans and their Dependents http://www1.va.gov/opa/vadocs/current_benefits.asp

Veterans Benefits Explained

http://www.military.com/benefits/veteran-benefits/veterans-benefits

How Employment Affects DoD and VA Disability Benefits Military retirement is never affected by earned

income in any way! VA Disability Compensation is not affected by

earned income EXCEPT that in some cases, substantially gainful employment may cause a reduction in disability rating

VA Disability Pension is reduced dollar-for dollar by earned income and gross income is what counts

Employment and VA Disability Ratings

Disability ratings are NOT reviewed for individuals who are:

Elderly (age 69 or older) Designated as being totally disabled (100%

schedular rating or designated as having permanent & total disability)

Designated as being totally disabled due to “individual unemployability” for a period of 20 or more continuous years

Employment and VA Disability Rating

Persons at potential risk of reduced disability rating due to employment include:

Veterans under age 69 with schedular ratings under 100%

Veterans who are rated as being totally disabled based on individual unemployability, who have been on benefits for less than 20 consecutive years, and who are working in a “substantially gainful occupation”

What is a Substantially Gainful Employment?

“Substantially Gainful Employment is defined as employment at which non-disabled individuals earn their livelihood with earnings comparable to the particular occupation in the community where the veteran resides.”

(M21-1MR, Part IV, Subpart ii, Chapter 2, Section f)

Substantially Gainful Employment is NOT…… Marginal employment. Marginal employment

exists when a veterans’ earned income does not exceed the current Federal Poverty Guidelines for a household of one.

Earnings can go over the FPG and still not be considered substantial if the work occurred in a protected environment such as a family business, a sheltered workshop, or when supported employment services are provided.

Now lets’ look at SSA disability benefits

Many veterans are eligible to receive disability benefits from both DoD/VA and the Social

Security Administration. Veterans should be encouraged to apply!

Overview of Disability Benefit Programs Administered by SSATitle II Social Security

Disability Benefits

Entitlement program based upon insured status

Assumes 3 different forms – SSDI, CDB and DWB

Comes with Medicare coverage

Title XVI Supplemental Security Income (SSI)

Funded by federal tax dollars, not SSA trust fund

Welfare program based upon financial eligibility

Comes with Medicaid coverage

Applying for SSA Disability Benefits

Applications for benefits are generally completed in local SSA Field Office. The process can be started online or over the phone

One application for both Title II and Title XVI benefits

State contracted Disability Determination Service (DDS) makes disability decision

Local SSA office handles all other initial determinations

SSA’s Definition of Disability

“the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

Important Concepts in SSA’s Disability Definition

Individual must have a disability which can be documented by a qualified medical examiner — meet a certain level of disability

The disability must be expected to last 12 or more months or result in death

Individuals must either not be working at time of application, or if working must have countable earnings of less than SGA level ($940/$1,570 per month in 2008.

If blind, meet SSA’s definition of statutory blindness – the SGA test is waived for blind individuals in the SSI program

Eligibility for Social Security Disability Benefits (Title II) Be medically disabled as defined by the SSA. Not be working or earnings are under SGA

limit ($940/$1,570 GROSS per month for 2008).

Have earned sufficient “credits” by paying into the system yourself,have a deceased, retired or disabled parent who paid in on your behalf (CDB), or be eligible for Disabled Widow(er)s Benefits (DWB).

Eligibility for Title II Disability Benefits continued

Resources and other forms of unearned income are irrelevant and are not considered in SSD eligibility determination. 

OTHER DETAILS: There is a 5-month waiting period of initial eligibility before the SSD check begins. There is also a 24-month Medicare Qualifying Period. In the meantime, SSI and Medicaid may be received by persons meeting applicable eligibility standards.

Eligibility for SSDI

Must have insured status on own work record At least 20 credits in the 10 years prior to onset of

disability Those disabled prior to age 31 need fewer credits

to qualify Possible to earn up to four credits per year -one

credit = $1,050 in 2008 Benefits may be paid retro-actively back to date of

disability onset or 12 months prior to application – whichever is less

Some Things to Remember about SSA Title II Disability Benefits Title II disability benefits are a form of insurance - not

welfare These benefits are NOT means-tested. There are no

limits on resources or unearned income The amount of disability benefits payable under title II

is determined by the number holder’s work record. The maximum monthly payment for 2008 is $2,185

The SGA limit on countable earned income applies at initial application and forever onwards. The SGA Limits for 2008 are $940/$1570 per month in countable earned income

Employment and Title II Disability Benefits There is no gradual reduction of payments in

this program – all or nothing deal Work incentives consist of a series of

“phases” – each successive phase provides less protection than the one before

The phases include Trial Work Period (TWP), Extended Period of Eligibility (EPE) and Extended Period of Medicare Coverage (EPMC)

Employment and Title II Disability Benefits The work incentive phases are complex and

difficult to understand – get help! Worst case scenario, beneficiaries who have

not used any of their TWP will keep their full payment for a minimum of 12 months after going to work – no matter how much they earn.

As long as the beneficiary does not consistently earn over the current SGA amount ($940/$1,570 per month in 2008), full cash benefits can be retained indefinitely

Extended Medicare Coverage

Even if title II disability cash benefits are lost due to work, Medicare coverage (Parts A & B) can be retained for a minimum of 93 months after the end of the Trial Work Period

SSA will bill the individual for Part B premiums each quarter

In 2008, the Part B premium is $96.40 per month Medicare Part D pays for prescription drug

coverage. Part D can be retained as long as either Part A and/or Part B are retained.

Special Work Incentives for Title II Disability Beneficiaries Work incentives in this program are used to

reduce countable earnings during SGA determinations

Impairment Related Work Expenses (IRWE) Subsidy and Special Conditions

Employer Subsidies Special conditions provided by third parties Subsidy for self-employed persons

Eligibility for SSI

Be medically disabled as defined by the SSA  Not be working or earnings under SGA limit

($940/$1,570 GROSS for 2008) at time of application ONLY! Parental income counts for children under 18. Spousal income counts for married persons.  

Have unearned income of less than the current FBR. For 2008 the FBR is $637 for an individual and $956 for an eligible couple.

Eligibility for SSI Continued

Resources under $2,000 or $3,000 for an eligible couple

Countable resources do NOT include: home you live in, one car (some restrictions), life insurance policy, burial plot, burial funds or pre-paid funeral expenses up to $1,500, personal effects and household goods, and property essential to person's self-support.

Amount of SSI Payment Affected by Many Things

Earned Income – wages, net earnings from self-employment, in-kind items in lieu of pay

Unearned income In-kind support & maintenance (ISM). Full

ISM results in a 1/3 reduction of SSA base rate ($424.67)

Overpayment recovery

Employment and SSI

1.Start with the GROSS monthly earnings and subtract a $20.00 general exclusion.

2.Next, subtract a $65.00 earned income exclusion.

3.Take the remaining amount and divide it by two. You are left with what is called countable earned income.

4.Subtract the countable earned income from the base SSI rate for the person. The remaining amount is the adjusted SSI check.

A simple way to explain this …

The first $85.00 that you earn each month does not count against you. For anything above $85.00, the SSA will take away one dollar from your SSI check for every two dollars that you earn. SSI recipients ALWAYS come out ahead by working!

1619(b) Extended Medicaid

Even after earnings cause the loss of SSI cash payments, Medicaid can be continued indefinitely - Must still be disabled Must meet the Medicaid “needs” or “use” test Must have annual earnings under the current

threshold amount for your state Must meet ALL other SSI income and

resource rules

Special Work Incentives for SSI Recipients

Student Earned Income Exclusion (SEIE) Impairment related Work Expenses (IRWE) Blind Work Expenses (BWE) Plans for Achieving Self-Support (PASS)

Where to get more information about SSA disability benefits Social Security’s Website

http://www.socialsecurity.gov/work/index.html VCU’s WIPA National Training Center

Website:

www.vcu-ntc.org SSA’s Redbook on Work Incentives

http://www.socialsecurity.gov/redbook/eng/main.htm

How VA and SSA Disability Benefits Interact VA Disability Compensation is not affected by

receipt of SSA disability benefits in any way! Many veterans would be eligible for SSDI and are encouraged to apply

VA Disability Pension would count SSA title II benefits (SSDI) as income. This income could cause ineligibility for VA Pension benefits, or would cause a dollar-for-dollar reduction in VA Pension payments. SSI payments do NOT count against VA Pension!

How VA and SSA Disability Benefits Interact Receipt of DoD/VA benefits would not impact

a veteran’s eligibility for SSA title II disability benefits

SSDI is not reduced by VA disability benefits, but may be reduced when military retirement payments based on disability are received

SSI is means-tested and would count DoD/VA cash benefits as unearned income

Special VA Programs Disregarded by the SSI Program Aid and Attendance or Housebound

allowance Disability compensation payments resulting

from unusual medical expenses Benefits paid on the basis of a Medal of

Honor or special act of Congress Payments made as part of the VA Vocational

Rehabilitation and Employment program VA clothing allowance

State Veterans Benefits

Many states offer additional benefits to veterans- what is offered varies by state

Benefits may include educational assistance, discounts on taxes and/or fees, home loans, free hunting or fishing privileges, and more

A Directory of State Veterans benefits can be found at:

http://www.military.com/benefits/veteran-benefits/state-veterans-benefits-directory

Getting Help with VA and SSA Benefits Every state has SSA funded WIPA projects

that can help beneficiaries understand how DoD/VA and SSA benefits are affected by employment

To be eligible for WIPA services, persons must be age14-65 and be receiving SSA benefits based on disability

To locate your local WIPA project go to:

https://secure.ssa.gov/apps10/oesp/providers.nsf/bystate