What Veterans Should Know About LUMBAR DISC HERNIATION

What is a herniated disc?

The spine is made up of a series of connected bones called “vertebrae.“The disc is a combination of strong connective tissues which hold one vertebra to the next and acts as a cushion between the vertebrae.The disc is made of a tough outer layer called the “annulus fibrosus” and a gel-like center called the “nucleus pulposus.”As you get older, the center of the disc may start to lose water content, making the disc less effective as a cushion.

A herniated lumbar disc can press on the nerves in the spine and may cause pain, numbness, tingling or weakness of the leg called “sciatica.” Sciatica affects about 1-2% of all people, usually between the ages of 30 and 50.A herniated lumbar disc may also cause back pain, although back pain alone (without leg pain) can have many causes other than a herniated disc.

Anatomy – Normal Lumbar Disc

In between each of the five lumbar vertebrae (bones) is a disc, a tough fibrous shock-absorbing pad.Endplates line the ends of each vertebra and help hold individual discs in place.Each disc contains a tire-like outer band (called the annulus fibrosus) that encases a gel-like substance (called the nucleus pulposus).

Nerve roots exit the spinal canal through small passageways between the vertebrae and discs.

Pain and other symptoms can develop when the damaged disc pushes into the spinal canal or nerve roots

Disc herniation occurs when the annulus fibrous breaks open or cracks, allowing the nucleus pulposus to escape.This is called a Herniated Nucleus Pulposus (HNP) or herniated disc.

Signs and Symptoms

The lumbar spine consists of the five vertebrae in the lower part of the spine, each separated by a disc, also called a lumbar disc.

The discs in this part of the spine can be injured by certain movements, bad posture, being overweight and disc dehydration that occurs with age.

Although the lumbar vertebrae are the biggest and strongest of the spinal bones, risk of lumbar injury increases with each vertebrae down the spinal column because this part of the back has to support more weight and stress than the upper spinal bones.

The lumbar disc is the most frequent site of injury in several sports including gymnastics, weightlifting, swimming and golf, although athletes in general have a reduced risk of disc herniation and back problems.

Symptoms of disc herniation in the lower back are slightly different from symptoms in the cervical or thoracic parts of the spine.
The spinal cord ends near the top lumbar vertebrae but the lumbar and sacral nerve roots continue through these spinal bones.
lumbar disc herniation may cause:
Lower back pain
Pain, weakness or tingling in the legs, buttocks and feet
Difficulty moving your lower back
Problems with bowel, bladder or erectile function, in severe cases

L4 Quads/Tibialis Anterior Patellar reflex

Sensory Great toe and medial leg

L5 Strength of Ankle and great toe dorsiflexion

Extensor Hallucis Longus

Sensory to dorsum of foot

It should be noted that among patients without a pathological cause, most patients under 30 have an intact ankle reflex. However absent ankle reflexes are found in 30 percent of those between and 50 percent of those 81 to 90. Unilateral absence, however, is very rare.

S1 Ankle reflexes and sensation of posterior calf and lateral foot

Peroneals/Gastroc
Achilles reflex
Sensory to lateral and plantar foot

Diagnosis

Initial diagnosis of lumbar herniation generally is based on the symptoms of lower back pain.
Your doctor will examine your sensation, reflexes, gait and strength. Your doctor also may suggest the following tests:
X-ray — High-energy radiation is used to take pictures of the spine.
Magnetic Resonance Imaging (MRI) — An MRI provides detailed pictures of the spine that are produced with a powerful magnet linked to a computer.
Computed Tomography (CT) Scan — A CT scan uses a thin X-ray beam that rotates around the spine area. A computer processes data to construct a three-dimensional, cross-sectional image.
Electromyography (EMG) — This test measures muscle response to nervous stimulation.

Treatment

Conservative treatment of lower disc pain usually is successful over time.
It includes:
Pain medication or pain therapies such as ultrasound, massage or transcutaneous electrical nerve stimulation
Anti-inflammatory medication such as aspirin, ibuprofen and acetaminophen
Physical therapy
Steroid injections
Education in proper stretching and posture
Rest

Treatment

However, if your pain doesn’t respond to conservative treatment in two to four weeks, your condition affects your bowel or bladder function, or if it threatens permanent nerve damage, your doctor may suggest surgery.
Modern methods of surgery allow some spine operations to be performed through tiny incisions using miniature instruments while a microimaging instrument called an endoscope is used to view the surgery site

Treatment

The surgery usually includes removing the part of the disc that has squeezed outside its proper place, called a discectomy. The surgeon also may want to remove the back part of the vertebrae, called the lamina, in a laminectomy; or to surgically open the foramen, the holes on the side of the vertebrae through which the nerves exit, in a foramenotomy.Only about 10 percent of adult lumbar disc patients require surgery and even fewer children and adolescents

Treatment

UCSF Spine Center orthopedic surgeons also are investigating the effectiveness of an implant that may replace damaged lower back discs.

Prof.Dr.Hidayet Sarı

Physical Medicine and Rehabilitation Department

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

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What Veterans Should Know About HERNIATED DISC

 Cause

Disks are soft rubbery pads that are found between the vertebrae. The spinal cord and other nerve roots are located in the spinal canal. The disks are between the vertebrae and act as shock absorbers and allow flexibility. When a herniated or ruptured disk occurs, a portion of the nucleus center pushes through the outer edge of the disk and back toward the spinal canal where the nerves are located. The nerves are very sensitive even to the slightest pressure. When we are young, disks have high water content and the content lessens as we age. The disks become less flexible, decrease in size and the space between the vertebrae narrows.

Often a herniated disc by itself does not cause pain. Pain occurs when the membrane on the outside of the spinal cord or spinal nerves is irritated. Loss of function, such as weakness or altered sensation, can be caused by pressure from the herniated disc on the nerve roots or spinal cord. Pain or numbness may occur in the area of the body to which the nerve travels

The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back (lumbar region). Branches of the sciatic nerve extend through the buttocks and down the back of each leg to the ankle and foot.

A herniated disc may compress one or more of the nerve roots that form the sciatic nerve. Pressure on one of these nerve roots will often produce distinctive symptoms of sciatica, such as pain, numbness, weakness, and tingling in the affected leg. Although a herniated disc is the most common cause of sciatica, sciatica can also be a symptom of other problems, such as narrowing of the spinal canal (spinal stenosis), nerve root compression resulting from injury, and certain rare tumors.

Risk Factors

Age – Middle age is the most common age group 35 – 45, due to degenerative disks.

Weight – Cause more stress on the disks

Smoking – Decreases oxygen levels in your blood, which deprives them of vital nutrients

Height – Men taller than 5’ 11” and women taller than 5’ 7” have increased chances of a herniated disk Physically demanding jobs that require repetitive movements or sitting or standing too long.

 Signs and Symptoms

Symptoms include pain, numbness or weakness in neck chest, arms and hand. Sometimes there will be pain in the legs. Also, muscle spasm or cramping, sciatica. Sciatica is a symptom frequently associated with a lumbar herniated disk. Pressure on one or several nerves that contribute to the sciatic nerve causing pain, burning, tingling and numbness that extends from the buttock into the leg and sometimes foot. Diagnosis is made by a medical exam from a doctor, X-Rays, MRI or CT Scan.

Treatment

Herniated disks are usually first treated with non-surgical treatments including rest activities, physical therapy, medicines to relieve pain and inflammation. A doctor will recommend surgery if there are nerves being pinched or spinal pain.
Alternative treatments
Acupuncture
Acupressure
Massage
Non-Invasive Treatment
Chiropractic Care
Drugs – OTC
Acetaminophen (Tylenol)
NSAIDS (non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen)

Treatment Continued

Prescription Medications Prescription NSAIDs Muscle relaxants (i.e.. Valium) alleviates spasms Oral steroids – used to reduce swelling Uploads Codeine, morphine – alleviates intense pain Anti-depressants – block pain messages from being received by your brain and increase the effects of endorphins, which are your bodies natural pain relievers. They also help you sleep better. Spinal Injections – Epidural steroid Injections contain corticosteroids which are potent anti-inflammatory agents. May take a few days to work and no more than three injections can be given in a year.

Exercise

Exercise is an effective way to strengthen and stabilize low back muscles, helps prevent further injury and pain. Being at your ideal weight is important. Extra weight constantly strains your back. Simple stretching and aerobic exercises can effectively control pain. Stretching programs such as yoga and pilates, moderate aerobic activities like waling, bicycling, swimming. Start any new aerobic activity slow and gradually increase. Active Treatments Improve flexibility, posture, strength, core stability and joint movement. Surgery most common is discectomy which removes all or part of the damaged disc.

Dr. Ryan Lambert-Bellacov, chiropractor in West Linn, OR

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

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How Veterans Can Establish Service Connection for the VA Disability Condition Claims

When applying for service-connected compensation, you must provide a nexus between your military service and your current, diagnosed condition. There are several ways to establish service connection for your condition. In some cases, the U.S. Department of Veterans Affairs (VA) presumes service connection for veterans who develop specific medical conditions during active duty service.

TYPES OF SERVICE CONNECTION

Service connection can be established in one of the following ways:

  • Direct service connection
  • Presumptive service connection
  • Aggravation
  • Secondary service connection
  • 1151 service connection

DIRECT SERVICE CONNECTION

Direct service connection involves a connection between a veteran’s military service and a veteran’s current, diagnosed condition.

To establish direct service connection, we can draw upon medical records, military service history, physicians’ statements, and opinions from experts.

PRESUMPTIVE SERVICE CONNECTION

The VA presumes certain conditions to be service-connected if a veteran meets certain criteria.

Presumptive service connection includes exposure to herbicide agents. This presumption applies to veterans who were exposed to herbicides during their time in service, such as those stationed in Vietnam, and have a certain medical condition as a result.

A Veterans service organisation or a veterans disability lawyer can review your service and medical records to determine if you are entitled to presumptive service connection.

AGGRAVATION

You can also establish service connection if your military service aggravated a preexisting condition.

For example, you may have injured your knee prior to service, but certain training exercises worsened the condition. You may be entitled to service connection based on aggravation if you can prove that your military service caused your knee condition to get worse. Additionally, if you have a service-connected back condition that aggravates a non-service-connected neck condition, you may be able to get service connection for your neck based on aggravation.

SECONDARY SERVICE CONNECTION

Secondary service connection can be established when a veteran’s condition is the result of another service-connected condition.

For example, a veteran might develop peripheral neuropathy as a result of their service-connected Type II diabetes. Then, peripheral neuropathy would warrant secondary service connection.

1151 SERVICE CONNECTION

If you received treatment for a medical condition in a VA hospital, and your treatment led you to develop a disabling medical condition, you may be entitled to service connection by filing an “1151 claim”.

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What Veterans Should Know About the Difference Between the Higher-Level Review Lane and the Supplemental Claim Lane

The difference between the Higher-Level Review lane and the Supplemental Claim lane is who reviews your appeal and whether you can submit new evidence.

THE HIGHER-LEVEL REVIEW LANE

In RAMP’s (the Rapid Appeals Modernization Program) Higher-Level Review Lane, you send your appeal for review by a more senior VA official than the person who initially reviewed your claim. The senior reviewer can overturn a decision, return a decision for a correction, or confirm the previous decision. This review is done based on the evidence of record.

THE SUPPLEMENTAL CLAIM LANE

In the Supplemental Claim lane, a rating specialist will review your appeal and any additional evidence you submit and determine whether to grant or deny your claim. Veterans who choose this lane will be able to include additional information with their appeal.

In this lane, VA has a “duty to assist” veterans in obtaining the evidence they need to support their claim.

ARE THERE ANY OTHER OPTIONS IN RAMP?

Not at this time. Once the new Appeals Reform system is fully implemented, there will be a third appeal lane- the Notice of Disagreement Lane (Board Lane).  This lane allows you to appeal your case directly to the Board. However, this lane is not available to RAMP participants until October 2018 at the earliest.

CAN I CHANGE LANES IF I CHOOSE THE WRONG ONE?

Yes, but not immediately. If you file your appeal in one lane but realize you chose the incorrect one, you must wait until you receive a decision in that lane before you can opt in to a different lane. For example, say you chose the Higher-Level Review lane but realize that the issue stemmed from a lack of evidence establishing service connection. You would need to wait until a decision is made on your appeal in the Higher-Level Review Lane before moving your appeal to the Supplemental Claim lane.

AM I ELIGIBLE TO JOIN RAMP?

When VA first rolled out RAMP at the end of 2017, it limited access to the program by only inviting a set number of veterans to participate in the program each month. Those who wanted to switch from the “Legacy” (current) system to RAMP had to wait to receive a letter inviting them to participate.

However, due to a low number of veterans actually opting in to the program, in April 2018, VA opened RAMP to all veterans with pending appeals (i.e., you submitted a VA Form 9, you filed a Notice of Disagreement, the Board remanded your appeal, or the Board certified your appeal but it has not yet been activated for a decision). That means you can join even if you did not receive a letter inviting you to opt in.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

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What Disabled Veterans Should Know About 30% PTSD RATING

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur in people who have experienced or witnessed a distressing, shocking, or otherwise traumatic event. Unfortunately, many veterans experience PTSD stemming from their military service. The symptoms of PTSD can often be very debilitating and have a negative impact on an individual’s daily life.

HOW DOES VA RATE PTSD?

Once you are service-connected for PTSD, VA will assign a disability rating. In doing so, VA will consider the frequency, duration, and severity of your symptoms along with the resulting level of social and occupational impairment. In other words, your disability rating reflects how you are affected in both your personal life and your work life. Generally, the more severe your symptoms are, the higher your disability rating will be. To determine your disability rating for PTSD, VA uses the General Rating Formula for Mental Disorders. This rating scale ranges from 0 percent to 100 percent with in-between ratings of 10, 30, 50, and 70 percent.

HOW DO I RECEIVE A 30% RATING?

Each rating under the General Rating Formula for Mental Disorders has specific criteria that a veteran must meet in order to receive that evaluation. Here, the criteria are based on a number of symptoms as well as the varying severity of those symptoms. The criterion for a 30% PTSD rating under 38 C.F.R. 4.130, Diagnostic Code 9411, is as follows:

  • 30% – “Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)”.

WHAT DOES THE 30% RATING CRITERIA MEAN?

The criteria for a 30% PTSD rating outlined above are meant to represent mild PTSD symptomology. In this case, “occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks” might mean that you are starting to periodically miss work due to your lack of motivation associated with PTSD. However, your PTSD does not fully prevent you from performing and succeeding in a work environment. Furthermore, you may experience symptoms such as depressed mood, anxiety, and panic attacks. This may cause you to occasionally isolate yourself. Nonetheless, you are still able to maintain your relationships with others. Overall, a 30% PTSD rating is assigned when a veteran demonstrates these symptoms presented in a mild manner, intermittently over time. However, it is important to note that a veteran does not need to endorse all of these symptoms to qualify for this rating. Even if a veteran only has a few of the specific PTSD symptoms listed, he or she can still receive a 30% rating.

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What Veterans Must Know About Ancillary Benefit-Restored Entitlement Program for Survivors (REPS) and Ancillary Benefit-Dependents Educational Assistance (DEA)

Ancillary Benefit-Restored Entitlement Program for Survivors (REPS)

Special allowance payable under Section 156 of Public Law 97-377 is called the Restored Entitlement Program for Survivors (REPS).  The REPS allowance is a payment to certain surviving spouses and children of individuals that died

  • on active duty prior to August 13, 1981, or
  • as a result of an service-connected disability that was incurred or aggravated prior to August 13, 1981.

This allowance replaces certain Social Security benefits that the provisions of the Omnibus Budget Reconciliation Act of 1981 either reduced or terminated.

Note: An ancillary benefit is an additional benefit that is related to, or derived from entitlement to certain service-connected benefits.

Ancillary Benefit-Dependents Educational Assistance (DEA)

Note: An ancillary benefit is an additional benefit that is related to, or derived from entitlement to certain service-connected benefits.

Dependents’ educational assistance (DEA) under 38 U.S.C. Chapter 35 provides payment of a monthly education or training allowance to the spouse and children of a Veteran who

  • has a total service-connected disability that is permanent in nature, or
  • died
    • of a service-connected disability, or
    • while a service-connected disability was evaluated as total and permanent in nature.

Dependent and Spouse Educational Assistance provides education and training opportunities to eligible dependents of certain veterans.

An eligible dependene or spouse of a veteran can receive up to 45 months of education benefits. These benefits may be used for degree and certificate programs, apprenticeship, and on-the-job training. If you are a spouse, you can take a correspondence course. Under certain circumstances, remedial, deficiency, and refresher courses may be approved.

Who Is Eligible? 

You must be the son, daughter, or spouse of a veteran. In order to be eligible the veteran must be:

  • A veteran who died or is permanently and totally disabled as the result of a service-connected disability. The disability must arise out of active service in the Armed Forces.
  • A veteran who died from any cause while such service-connected disability was in existence.
  • A servicemember missing in action or captured in line of duty by a hostile force.
  • A servicemember forcibly detained or interned in line of duty by a foreign government or power.
  • A servicemember who is hospitalized or receiving outpatient treatment for a service connected permanent and total disability and is likely to be discharged for that disability. This change is effective December 23, 2006.

When Are You Eligible?

Child-Son or Daughter:

A son or daughter of a veteran who wishtes to receive benefits for attending shcool or job training must be between 18 and 26 years old. Under certain circumstances it is possible to start at an earlier age and to continue after age 26. Marriage does not exclude you from this benefit.

If you are in the Armed Forces, you may not receive this benefit while on active duty. You can however obtain the education benefits after discharge from military service as long as your discharge is not under dishonorable conditions. The Veterans Administration can extend your period of eligibility by the number of months and days equal to the time spent on active duty. This extension cannot generally go beyond your 31st birthday, there are some exceptions.

38 U.S.C. Chapter 35 provides educational assistance to “eligible persons,” including “children whose education would otherwise be impeded or interrupted by reason of disability or death of a parent from a disease or injury incurred or aggravated in the Armed Forces.”  38 U.S.C. § 3500.  For purposes of DEA benefits under chapter 35, “eligible person” means a child of a person who, as a result of qualifying service, died of a service-connected disability or has a total disability permanent in nature resulting from a service-connected disability, or who dies while a disability so evaluated was in existence.  38 U.S.C. § 3501(A)(1)(a).

In general, an eligible child’s period of eligibility for educational assistance under chapter 35 ends on his or her 26th birthday.  38 U.S.C. § 3512(a); 38 C.F.R. § 21.3041(a), (b), although there are some exceptions.  38 C.F.R. § 21.3041(g).  The general rule is that the commencing date of an original award of educational assistance is the latest of:  (a) the date the educational institution certifies the course; (b) one year before the date of receipt of the claim; or (c) the effective date of the approval of the course, or one year before VA receives approval notice, whichever is later.  38 U.S.C. § 3672; 38 C.F.R. § 21.4131(a).  When determining the effective date of an award under Chapter 35 the Secretary may consider the individual’s application as having been filed on the eligibility date of the individual if that eligibility date is more than one year before the date of the initial rating decision.  38 U.S.C. § 5113(b).

Pursuant to 38 U.S.C. section 5113(b)(2) the criteria for an earlier effective date under this statute requires that the claimant is an eligible person who:

(A) submits to the Secretary an original application for educational assistance under Chapter 35 of this title . . . within one year of the date that the Secretary makes the rating decision;

(B)   claims such educational assistance for pursuit of an approved program of education during a period preceding the one-year period ending on the date on which the application was received by the Secretary; and

(C)   would have been entitled to such educational assistance for such course pursuit if the individual had submitted such application on the individual’s eligibility date.

Spouse:

If you are a spouse, benefits end 10 years from the date VA finds you eligible or from the date of death of the veteran. If the VA rated the veteran permanently and totally disabled with an effective date of 3 years from discharge a spouse will remain eligible for 20 years from the effective date of the rating. This change is effective October 10, 2008 and no benefits may be paid for any training taken prior to that date. For surviving spouses (spouses of servicemembers who died on active duty) benefits end 20 years from the date of death.

What You Need To Do

Make sure that the program you want to enroll in is approved for VA training.

Obtain and complete the application, VA Form 22-5490, Application for Survivors’ and Dependents’ Educational Assistance. Send it to the VA regional office with jurisdiction over the State where you will train. If you are a son or daughter, under legal age, a parent or guardian must sign the application.

If you have already started training, take your application to your school or employer. Ask them to complete VA Form 22-1999, Enrollment Certification, and send both forms to VA.

DOWNLOAD: Survivors’ and Dependents’ Educational Assistance Program booklet (PDF)

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

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What are the Requirements of Non-Service Connected Survivors Pension Benefit, aka “Non-Service Connected Death Pension”

Non-Service Connected Survivors Pension Benefit, aka “Non-Service Connected Death Pension”

The Non-Service Connected Survivors Pension benefit, which may also be referred to as Death Pension, is a tax-free monetary benefit payable to a low-income, un-remarried surviving spouse and/or unmarried child(ren) of a deceased Veteran with wartime service.

The following requirements apply for the survivor pension:

  1. Discharge Requirements for the deceased Veteran remain the same, and
  2. Service Requirements for the deceased Veteran remain the same, and
  3. The surviving spouse is the current spouse and is unmarried, and
  4. The surviving unmarried children of the deceased Veteran are either:
    1. under 18 years of age,
    2. became permanently “helpless” before 18 years of age
    3. between the ages of 18 and 23 and is in the process of pursuing a course of study at an approved institution such as college or vocational school.
  5. “Net Worth” Limitations remain the same.
  6. “Countable Income” Deductions remain the same.
  7. The MAPR rate limit for each child is $2,250.
  8. Extra benefit of aid and attendance and housebound status requirements remain the same.
  9. EVR reporting requirements remain the same.

 

The Maximum Annual Pension Rate (MAPR) or “Countable Income Limits” are different for Survivors Pension. The Effective Rates as of 12/01/2017 are:

 

Standard Medicare Deduction: Actual amount will be determined by SSA based on individual income.


Maximum Annual Pension Rate (MAPR) Category Amount
MAPR Without Dependent Child $8,830
To be deducted, medical expenses must exceed 5% of MAPR or $ 442
MAPR With One Dependent Child $11,557
To be deducted, medical expenses must exceed 5% of MAPR or $578
Housebound Without Dependents $10,792
Housebound With One Dependent $13,514
A&A Without Dependents $14,113
A&A Without Dependents (SAW Veteran’s Surviving Spouse) $14,685
A&A With One Dependent $16,837
A&A With One Dependent (SAW Veteran’s Surviving Spouse) $17,347
SBP/MIW Annuity Limitation $8,830
Add for Each Additional Child $2,250
MAPR FOR CHILD ALONE $2,250
Child Earned Income Exclusion effective 1/1/2000 $7,200
(38 CFR §3.272(j)(1)) effective 1/1/2001 $7,450
effective 1/1/2002 $7,700
effective 1/1/2003 $7,800
effective 1/1/2004 $7,950
effective 1/1/2005 $8,200
effective 1/1/2006 $8,450
effective 1/1/2007 $8,750
effective 1/1/2008 $8,950
effective 1/1/2009 $9,350
effective 1/1/2012 $9,750
effective 1/1/2013 $10,000
effective 1/1/2014 $10,150
effective 1/1/2015 $10,300
effective 1/1/2016 $10,350
effective 1/1/2017 $10,400
effective 1/1/2018 $10,650

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What Veterans Should Know About Veteran Benefits-Survivors Benefits

A veteran’s compensation benefits end at the death of the veteran. A surviving spouse does not continue to receive the veteran’s benefits. However, the law creates a separate Dependency and Indemnity Compensation (“DIC”) benefit that dependent spouses, minor children, children up to age 23 who are in school, and, in some cases, parents can claim after the death of a veteran. Each DIC claim is its own original claim for VA benefits that is legally independent of the veteran’s award.

The key issue in a DIC claim is usually whether the veteran’s death was service-connected. Generally, if the principal cause or one of the contributory causes of a veteran’s death was a service-connected condition, an eligible survivor is entitled to DIC. DIC can be awarded even if the condition was not service connected at the time of death or even if the veteran never filed a claim with VA, if service-connection can be established by existing evidence. A DIC claim can be filed at any time, even decades after the veteran’s death, but if it is filed within one year of the veteran’s death compensation will start from the date of death rather than the date of the application.

DIC is paid to a surviving spouse of a qualifying veteran who died from a service-connected disability.  38 U.S.C. § 1310; Dyment v. West, 13 Vet. App. 141, 144 (1999), aff’d sub nom. Dyment v. Principi, 287 F.3d 1377 (Fed. Cir. 2002); Hanna v. Brown, 6 Vet. App. 507, 510 (1994)Darby v. Brown, 10 Vet. App. 243, 245 (1997).  A veteran’s death will be considered service connected where a service-connected disability was either the principal or a contributory cause of death.  38 C.F.R. § 3.312(a).  A service-connected disability is the principal cause of death when that disability, “singly or jointly with some other condition, was the immediate or underlying cause of death or was etiologically related thereto.”  38 C.F.R. § 3.312(b).  To be a contributory cause of death, the disability must have “contributed substantially or materially” to death, “combined to cause death,” or “aided or lent assistance to the production of death.”  38 C.F.R. § 3.312(c)(1).  The Board’s determination of whether a veteran’s death was service connected is a finding of fact that the Court reviews under the “clearly erroneous” standard.  38 U.S.C. § 7261(a)(4); Wray v. Brown, 7 Vet. App. 488, 492 (1995).

A “surviving spouse” is defined as a person of the opposite sex who was the spouse of a veteran at the time of the veteran’s death, and who lived with the veteran continuously from the date of marriage to the date of the veteran’s death (except where there was a separation which was due to the misconduct of, or procured by, the veteran without the fault of the spouse) and who has not remarried or (in cases not involving remarriage) has not since the death of the veteran, and after September 19, 1962, lived with another person and held himself or herself out openly to the public to be the spouse of such other person.  38 U.S.C. § 101(3); see also 38 C.F.R. § 3.50(b).  However, no compensation shall be paid to a surviving spouse unless the surviving spouse was married to the veteran:

(1)   before expiration of fifteen years after the termination of the period of service in which the injury or disease causing the death of the veteran was incurred or aggravated; or

(2)   for one year or more; or

(3)   for any period of time if a child was born of the marriage, or was born to them before the marriage.

38 U.S.C. §§ 1102, 1304, 1541(f); 38 C.F.R. § 3.54(c).

In determining whether a claimant is the veteran’s “surviving spouse” for purposes of VA benefits, the validity of the marriage depends on “the law of the place where the parties resided at the time of the marriage or the law of the place where the parties resided when the right to benefits accrued.”  38 U.S.C. § 103(c); see also 38 C.F.R. § 3.1(j).  A claimant “has the burden to come forward with preponderating evidence of a valid marriage under the laws of the appropriate jurisdiction.”  Aguilar v. Derwinski, 2 Vet. App. 21, 23 (1991); see also Sandoval v. Brown, 7 Vet. App. 7, 9 (1994) (stating that “before applying for benefits, a veteran’s spouse must supply proof of her or his marital status” to achieve claimant status); 38 C.F.R. § 3.205 (providing for a number of ways that a spouse can prove marital status).  The validity of a divorce decree regular on its face will only be questioned by VA if such validity is questioned by a party.  38 C.F.R. § 3.206(a).  The Board’s determination regarding whether a person is a surviving spouse of a deceased veteran is a question of fact that the Court reviews under the “clearly erroneous” standard.  38 U.S.C. § 7261(a)(4); Dedicatoria v. Brown, 8 Vet. App. 441, 443 (1995).

Where a DIC claimant submits evidence that an attempted marriage was invalid because of a legal impediment, such as the nonrecognition of common law marriages, see VA Gen. Coun. Prec. 58-91 (June 17, 1991), the marriage will still be “deemed valid” if:

(1)   the marriage occurred one year or more before the veteran died or if a child was born of the marriage;

(2)   the claimant entered into the marriage without knowledge of the legal impediment;

(3)   the claimant cohabitated with the veteran continuously from the date of marriage to the date of death; and

(4)   no claim has been filed by a legal surviving spouse who has been found to be entitled to death benefits.

38 U.S.C. § 103(a); 38 C.F.R. § 3.52.  “The determination of a claimant’s knowledge of a legal impediment is viewed in terms of ‘what the appellant’s state of mind was at the time that the invalid marriage was contracted.'”  See Lamour v. Peake, 544 F.3d 1317, 1323 (Fed. Cir. 2008) (quoting Dedicatoria, 8 Vet. App. at 444).  In VA General Counsel Opinion 58-91, the Secretary stated that “the lack of knowledge requirement must have a broader meaning, encompassing lack of knowledge of the law prohibiting marriage, not just ‘knowledge of the factual ground which activated the law.'”  VA Gen. Coun. Prec. 58–91 (June 17, 1991).

The surviving spouse of a deceased veteran is entitled to dependency and indemnity compensation benefits (DIC) when the veteran’s death was not the result of his or her own willful misconduct and the veteran “was in receipt of or entitled to receive . . . compensation at the time of death for a service-connected disability rated totally disabling if . . . the disability was continuously rated totally disabling for a period of 10 or more years immediately preceding death . . . .”  38 U.S.C. § 1318(b)(1); see also 38 C.F.R. § 3.22(a).  A surviving spouse is also entitled to dependency and indemnity compensation benefits where the deceased veteran had a disability that “was continuously rated totally disabling for a period of not less than five years from the date of such veteran’s discharge or release from active duty” or where “the veteran was a former prisoner of war who died after September 30, 1999, and the disability was continuously rated totally disabling for a period of not less than one year immediately preceding death.”  38 U.S.C. §§ 1318(b)(2)-(3); 38 C.F.R. § 3.22(a) (2).

As described above, a key to a spouse’s eligibility for benefits after the death of a veteran is that the spouse was married to the veteran at the time of death.  If a surviving spouse remarries after the death of a spouse, the issue of eligibility for benefits becomes complicated.  If a remarriage has ended, the spouse is eligible for DIC.  If still remarried, eligibility depends on when the spouse reached age 57, when the remarriage occurred, and whether a claim was pending on a certain date.  This is a complicated area and VetFirst urges surviving spouses who have remarried to contact an experienced service officer or attorney to determine eligibility for their specific situation.

 The child of a deceased veteran is entitled to DIC when the veteran dies as the result of service-connected disabilities.  38 U.S.C. §§ 1313, 1314.  For purposes of determining eligibility for this benefit, a child must be unmarried and must

(1)   be under the age of 18,

(2)   have become permanently incapable of self-support before the age of 18, or

(3)   be between the ages of 18 and 23 and pursuing a course of instruction at an approved educational institution.

38 U.S.C. § 101(4)(A); 38 C.F.R. §§ 3.356, 3.57(a)(1).  Further, section 3.356 provides that the question of a child’s permanent incapacity is one of fact for determination by VA, and that it will be decided on the basis of whether the child is “permanently incapable of self-support through his own efforts by reason of physical or mental defect” at the date of attaining the age of 18 years.  38 C.F.R. §§ 3.356(a), (b); Dobson v. Brown, 4 Vet. App. 443, 445 (1993).  The Board’s determination of permanent incapacity for self-support is a finding of fact that the Court reviews under the “clearly erroneous” standard of review.  38 U.S.C. § 7261(a)(4); 38 C.F.R. § 3.356(b); see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

What Veterans Must Know About VA Life Insurance Programs

Over the years the VA has offered a number of different life insurance plans.  Some of these plans are still open for enrollment while others are closed to new enrollees.

For details of the VA Life Insurance Program refer to VetsFirst Knowledge Book VA Life Insurance,.

As a general rule if you have questions regarding VA life insurance you should visit the VA’s insurance website at www.insurance.va.gov or call VA’s Insurance Center toll-free at 1-800-669-8477.  Specialists are usually available between the hours of 8:30 a.m. and 6 p.m., Eastern Time, to discuss premium payments, insurance dividends, address changes, policy loans, naming beneficiaries and reporting the death of the insured.

When contacting the VA regarding an insurance matter if the insurance policy number is not known, use whatever information is available, such as the veteran’s VA file number, date of birth, Social Security number, military serial number or military service branch and dates of service to:

Department of Veterans Affairs Regional Office and Insurance Center

Box 42954

Philadelphia, PA 19101

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

Specially Adapted Housing and Special Home Adaptation Grants: Special VA Benefits for the Disabled Service Connected Vets

The VA offers 4 different grants for qualifying Veterans and Servicemembers to assist them with the building, remodeling, or purchasing an adapted home.   The four grants are:

  1. Specially adapted housing (SAH) grants, 
  2. Special housing adaptation (SHA) grants,
  3. Temporary Residence Adaptation (TRA) grants, and
  4. Home Improvements and Structural Alterations (HISA) grants.

1. Specially adapted housing (SAH) grants help veterans with certain service-connected disabilities live independently in a barrier-free environment.  SAH grants can be used to:

  • Construct a specially adapted home on land to be acquired
  • Build a home on land already owned if it is suitable for specially adapted housing
  • Remodel an existing home if it can be made suitable for specially adapted housing
  • Apply the grant against the unpaid principal mortgage balance of an adapted home already acquired without the assistance of a VA grant.

A SAH grant, which allows up to $81,080 (2018), can be used a maximum of three times up to the allowable dollar amount.  Veterans with certain permanent service-connected conditions qualify for an SAH grant if their service-connected conditions:

  • Are permanently and totally disabling,
  • Preclude locomotion without the aid of braces, canes, or a wheelchair due to the loss, or loss of use of
    • both lower extremities,
    • one lower extremity together with residuals of organic disease or injury, which so affects the functions of balance or propulsion, or
    • one lower extremity, together with one upper extremity, which so affects the functions of balance or propulsion
  • Result in the loss, or loss of use, of both upper extremities at or above the elbow, or
  • Cause blindness in both eyes, having light perception only, combined with the loss or loss of use of one lower extremity.
  • Include certain severe burn injuries

Veterans who served on or after September 11, 2001, and become permanently disabled on or after that date may also be eligible for SAH benefits if they have the loss or loss of use of one or more lower extremities which so affects the functions of balance or propulsion as to preclude ambulating without the aid of braces, crutches, canes, or a wheelchair.

To apply for a SAH grant, fill out and submit VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant.

2. Special housing adaptation (SHA) grants help veterans with certain service-connected disabilities adapt or purchase a home to accommodate their disability.  SHA grants can be used in the following ways:

  • Adapt an existing home the veteran or a family member already owns in which the veteran resides
  • Adapt a home the veteran or family member intends to purchase in which the veteran will live
  • Help a veteran purchase a home already adapted in which the veteran will live

SHA provides for a grant amount up to $116,217 (2018).  A SHA grant may also be used a maximum of up to three times until the maximum grant amount has been utilized.  A SHA grant will be awarded where the veteran has a service-connected disability for one of the following:

  • Blindness in both eyes with 5/200 visual acuity or less
  • Anatomical loss or loss of use of both hands
  • Certain severe burn injuries
  • Certain severe respiratory injuries

To apply for a SHA grant, fill out and submit VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant.

3. Temporary Residence Adaptation grants

May be available to SAH/SHA eligible veterans and Servicemembers who are or will be temporarily residing in a home owned by a family member.  This assistance, up to $35,593 (2018) for veterans eligible for a SAH grant or $6,355 (2018) for veterans eligible for the SHA grant, may be used to adapt the family member’s home to meet the veteran’s or Servicemember’s special needs at that time.

4. Home Improvements and Structural Alterations (HISA) grants

The VA Home Improvement and Structural Alteration (HISA) grant program helps veterans who are enrolled in the VA health care system and requires home improvements for the continuation of medical treatment or for basic access to the home and essential bathroom and sanitary facilities for veterans with certain disabilities.  Unlike most other benefits shown on this page, HISA grants are available for both service-connected and nonservice-connected veterans (with different maximum amounts).

  • Veterans with service-connected disabilities the home improvement benefit is $6,800 (2018)
  • Veterans with non-service-connected disabilities the home improvement benefit is $2,000 (2018)

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims! Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency