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Veteran Advisor - Non-Service Connected Pension

Reprinted from PN/Paraplegia News January 2018

One of the most misunderstood benefits the Department of Veterans Affairs (VA) offers is Non-Service Connected Pension (NSCP).

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One of the most misunderstood benefits the Department of Veterans Affairs (VA) offers is Non-Service Connected Pension (NSCP). This benefit is available for war-time veterans who incur illnesses or injuries after being separated from active duty service or expired applicable presumptive periods and who have income that falls below the Maximum Annual Pension Rate (MAPR). Expired applicable presumptive periods are periods after leaving active duty service, either the presumed direct service connection for injuries or illnesses incurred within one year following separation, or, for example, the seven-year presumptive period for the onset or diagnosis of multiple sclerosis.

Developing A Claim

To develop a claim for NSCP, an initial determination as to whether your injury or illness could possibly be related to any existing service-connected disabilities or within presumptive periods, must be made. Then, if the injury or illness is not related to any existing service-connected conditions or service-connected by presumptive period, your eligibility to this benefit must be ensured by confirming active duty service during a wartime period, in accordance with 38 USC § 1521. Without consideration of these initial factors, you or your Paralyzed Veterans of America (PVA) national service officer (NSO) could be developing an unsubstantiated claim. Once it’s determined the injury or illness isn’t related to an existing service-connected condition and you did serve during a wartime period, developing net worth can be discussed. 

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Your Net Worth

The VA may provide NSCP to you if your annual net worth is below the MAPR. The MAPR is determined by Title II of the Social Security Act (42 USC § 401 et seq.). The diagram shows the current MAPR is $12,907 for a single veteran without a spouse or child. Divide that amount by 12 months, and it comes out to $1,075.58 per month. Keep in mind the rates for the chart above are adjusted regularly with the cost of living allowance increases. You can determine net worth by subtracting legitimate out-of-pocket medical expenses (LOOPME) from your household income (HI). Then subtract the MAPR. The equation looks like this:

(HI – LOOPME) – MAPR = NSCP or over income.

If the result is a negative number, you may be eligible for NSCP, as long as the number is greater than 5% of the MAPR. If it’s a positive number or less than 5% of the MAPR, you may be considered over income.

Household Income

In order to calculate your HI, list all the income coming into your household, including a spouse’s income and anyone else living in the residence with an income. If you’re not sure what to count and what not to count, refer to VA Informational Brochure 10-454 Quick Reference Guide Income and Assets for Financial Assessment. It’s a detailed list which isn’t completely inclusive but goes beyond the regular reporting of simply wages, Social Security benefits or retirement income. Keep in mind that omission of any household income can create an overpayment. The VA may discover the overpayment when it conducts its cross-agency checks.

Medical Expenses

In order to calculate your LOOPME, utilize VA Form 21P-8416. The instruction page of the form provides a list of legitimate transportation and medical expenses. Those can include:

  • Hospital expenses, including co-pays
  • Doctor’s office fees, including co-pays
  • Dental fees, including co-pays
  • Prescription/non-prescription drug costs, including co-pays
  • Vision care costs, including co-pays
  • Medical insurance premiums
  • Nursing home costs
  • Hearing aid costs
  • Home health service expenses
  • Expenses related to transportation to a hospital, doctor or other medical facility
  • Monthly Medicare deduction

Keep in mind the Important Notes section on the form that states, “Do not include any expenses for which you were reimbursed. If you receive reimbursement after you have filed this claim, promptly notify the VA office handling your claim.” Another important note is that elective surgeries and medical expenses because of misconduct aren’t reimbursable.

Notify The VA

A common question is how NSCP will affect existing service-connected compensation.

When you’re entitled to combination ratings, that is, you’re receiving service-connected compensation and become eligible for NSCP or vice versa, refer to 38 USC § 1523 Combination of Ratings. That section explains:

(a) The secretary shall provide that, for the purpose of determining whether or not a veteran is permanently and totally disabled, ratings for service-connected disabilities may be combined with ratings for non-service-connected disabilities.

(b) Where a veteran, by virtue of subsection (a), is found to be entitled to a pension under § 1521 of this title, and is entitled to compensation for a service-connected disability, the secretary shall pay such veteran the greater benefit.

Lastly, two of the most common overpayment issues for NSCP, as well as service-connected compensation, have to do with failure to notify the VA of changes in income and changes in dependency. Failure to notify the VA of changes in income and dependency in a timely manner can result in significant overpayments. 

If you’re receiving VA benefits, you should carefully monitor them and keep your address and contact information up to date with the VA Healthcare System, as well as the VA regional office. This can be easily accomplished by providing the information to your nearest PVA service office.

For more information, visit pva.org.

A Marine Corps veteran, Gregory Treacy has been with PVA since 2007 and is a senior NSO at the VA regional office in Houston. 

 

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Veteran Advisor - Non-Service Connected Pension

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