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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”.

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 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

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

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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.

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 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

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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

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Clothing Allowance: Special VA Benefits for the Disabled Service Connected Vets

Clothing allowance is an annual lump-sum payment made when a Veteran’s service-connected disability causes the use of certain prosthetic or orthopedic appliances (including a wheelchair) that tend to wear or tear clothing, or when the Veteran’s service-connected skin condition requires the use of medication that stains the clothing. Eligible Veterans can receive a one-time or yearly allowance for reimbursement.

You may receive a clothing allowance as a Veteran who uses either of the following:

  • Prosthetic or orthopedic appliance, such as a wheelchair or crutches, because of a service-connected disability (Note: soft and flexible devices, such as an elastic stocking, are not included)
  • Medication prescribed by a physician for a service-connected skin condition that causes permanent stains or otherwise damages outer garments

Additional clothing allowances may be provided if more than one prosthetic or orthopedic appliance, or medication described above, is used and/or affects more than one type of clothing garment.

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

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

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What is Special VA Benefits for the Disabled Service Connected Vets: Automobiles, Conveyances, and Adaptive Equipment

Special VA Benefits for the Disabled Service Connected Vets: Automobiles, Conveyances, and Adaptive Equipment

Automobile Allowance

Servicemembers and Veterans may be eligible for a one-time payment of not more than $21,058.69 (10/1/2018) toward the purchase of an automobile or other conveyance if you have certain service-connected disabilities. The grant is paid directly to the seller of the automobile and the Servicemember or Veteran may only receive the automobile grant once in his/her lifetime.

Certain Servicemembers and Veterans may also be eligible for adaptive equipment. Adaptive equipment includes, but is not limited to, power steering, power brakes, power windows, power seats, and special equipment necessary to assist the eligible person into and out of the vehicle.

VA may provide financial assistance in purchasing adaptive equipment more than once. This benefit is payable to either the seller or the Veteran or Servicemember.

Important: You must have prior VA approval before purchasing an automobile or adaptive equipment.

Eligibility Requirements (Automobile Grant)

  • You must be either a Servicemember who is still on active duty or a Veteran, AND
  • You must have one of the following disabilities that are either rated as service-connected or treated as if service-connected under 38 U.S.C 1151 or, for a Servicemember, the result of disease incurred or injury contracted in or aggravated by active duty:
    • Loss, or permanent loss of use, of one or both feet, OR
    • Loss, or permanent loss of use, of one or both hands, OR
    • Permanent impairment of vision in both eyes to a certain degree, OR
    • Severe burn injury, OR
    • Amyotrophic Lateral Sclerosis (ALS).

Evidence Requirements (Automobile Grant)

To support a claim for automobile allowance, the evidence must show that you are service-connected or are treated as if service-connected under 38 U.S.C 1151 or, for a Servicemember, the result of disease incurred or injury contracted in or aggravated by active duty, for a disability resulting in:

  • The loss, or permanent loss of use, of one or both feet, OR
  • The loss, or permanent loss of use, of one or both hands,OR
  • Permanent impairment of vision in both eyes, resulting in
    1. Central Visual acuity of 20/200 or less in the better eye with glasses, OR
    2. Central Visual acuity that is greater than 20/200, if there is a visual field defect in which your peripheral field has contracted to such an extent that the widest diameter of visual fields subtends an angular distance no greater than 20 degrees in the better eye, OR
  • Severe burn injury: Deep partial thickness or full thickness burns resulting in scar formation that cause contractures and limit motion of one or more extremities or the trunk and preclude the effective operation of an automobile, OR
  • Amyotrophic Lateral Sclerosis (ALS).

To support a claim for adaptive equipment, the evidence must show that you have a disability as shown above, OR you have ankylosis of at least one knee or one hip due to service-connected disability.

How to Apply (Automobile Grant)

  • Complete, VA Form 21-4502, “Application for Automobile or Other Conveyance and Adaptive Equipment” and mail to your regional office OR
  • Work with an accredited representative or agent OR
  • Go to a VA regional office and have a VA employee assist you. You can find your regional office on our Facility Locator page
  • If you are entitled to adaptive equipment only (i.e., service connected for ankylosis of knees or hips) you should complete VA Form 10-1394, “Application for Adaptive Equipment – Motor Vehicle” and submit it to your local VA medical center. You can find your local VA medical center on the health Facility Locator page.

Conveyances

You may purchase a new or used automobile, truck, station wagon, or certain other types of conveyance if approved by VA.

Adaptive Equipment

A veteran or servicemember who qualifies for the vehicle allowance also qualifies for adaptive equipment unless he or she is blind, requires a driver, or doesn’t have a valid State driver’s license or learner’s permit. See the attached list for more information about adaptive equipment. Important: VA will not pay for the purchase of add-on adaptive equipment (equipment furnished by someone other than the automobile manufacturer) that is not approved by VA. Contact the nearest VA health care facility for more information on add-on equipment. The adaptive equipment benefit may be paid more than once, and it may be paid to either the seller or the veteran or servicemember.

Special drivers training for disabled veterans should contact the nearest VA health care facility to request this training.

To Apply use VA form 21-4502, http://www.vba.va.gov/pubs/forms/VBA-21-4502-ARE.pdf.  There is no time limit for filing a claim; however, the claim must be authorized by VA before you purchase the automobile or conveyance.

Special Instructions to Veteran or Servicemember,

1. Complete all items of Section I in duplicate and submit both copies to VA. If you have previously applied for disability compensation, send the form to the VA regional office where your claims folder is located. If you have not applied for disability compensation or have not separated from military service, send the form to the nearest VA regional office.

2. VA will determine your eligibility and, if eligibility exists, VA will complete Section II and return the form to you.

3. Purchase a vehicle. When you receive the vehicle and the adaptive equipment from the seller, complete Section III.

4. Give the original VA Form 21-4502 to the seller.

5. Submit any invoices for adaptive equipment and/or installation not included on the seller’s invoice to the nearest VA health care facility. These invoices, identified with your full name and VA file number, must show the itemized net cost of any adaptive equipment and installation charges, any unpaid balance, and the make, year and model of the vehicle to which the equipment is added.

Special Instructions to Seller:

1. Make sure that Section II of VA Form 21-4502 is completed and signed by VA.

2. Deliver the vehicle, including VA-approved adaptive equipment provided and/or installed by the seller.

3. Obtain the original copy of VA Form 21-4502 from the veteran or servicemember after he or she has completed Section III.

4. Submit the original copy of VA Form 21-4502 and itemized invoice to the VA regional office shown in Section II, Attention: Financial Division, for payment.

The itemized invoice must include the following:

  • The net cost of any approved adaptive equipment and installation charges. If certain items of approved adaptive equipment (automatic transmission, power seats,     etc.) are included in the purchase price, also submit a copy of the window sticker.
  • A list of which adaptive equipment is standard on the vehicle or combined with other items.
  • The unpaid balance due on the vehicle which is to be paid by VA.
  • A certification that the amounts billed do not exceed the usual and customary cost for the purchase and installation of the adaptive equipment.

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 Military Veterans Should Know About VA Home Loan Guaranty Benefits

VA Home Loan Guaranty Benefits

Home Loans

VA helps Servicemembers, Veterans, and eligible surviving spouses become homeowners. As part of the VA’s mission to serve you, the VA provides a home loan guaranty benefit and other housing-related programs to help you buy, build, repair, retain, or adapt a home for your own personal occupancy.

VA Home Loans are provided by private lenders, such as banks and mortgage companies. VA guarantees a portion of the loan, enabling the lender to provide you with more favorable terms.

Benefits

Purchase Loans help you purchase a home at a competitive interest rate often without requiring a downpayment or private mortgage insurance. Cash Out Refinance loans allow you to take cash out of your home equity to take care of concerns like paying off debt, funding school, or making home improvements. Learn More

Interest Rate Reduction Refinance Loan (IRRRL): also called the Streamline Refinance Loan can help you obtain a lower interest rate by refinancing your existing VA loan. Learn More

Native American Direct Loan (NADL) Program: helps eligible Native American Veterans finance the purchase, construction, or improvement of homes on Federal Trust Land, or reduce the interest rate on a VA loan. Learn More

Eligibility

You must have suitable credit, sufficient income, and a valid Certificate of Eligibility (COE) to be eligible for a VA-guaranteed home loan. The home must be for your own personal occupancy. The eligibility requirements to obtain a COE are listed below for Servicemembers and Veterans, spouses, and other eligible beneficiaries.

VA home loans can be used to:

  • Buy a home, a condominium unit in a VA-approved project
  • Build a home
  • Simultaneously purchase and improve a home
  • Improve a home by installing energy-related features or making energy efficient improvements
  • Buy a manufactured home and/or lot.
Status Qualifying Wartime & Peacetime Periods Qualifying Active Duty Dates Minimum Active Duty Service Requirement
Veteran WWII 9/16/1940 – 7/25/1947 90 total days
Post-WWII 7/26/1947 – 6/26/1950 181 continuous days
Korean War 6/27/1950 – 1/31/1955 90 total days
Post-Korean War 2/1/1955 – 8/4/1964 181 continuous days
Vietnam War 8/5/1964 – 5/7/1975 *For Veterans who served in the Republic of Vietnam, the beginning date is 2/28/1961 90 total days
Post-Vietnam War 5/8/1975 – 9/7/1980 *The ending date for officers is 10/16/1981 181 continuous days
24-month rule 9/8/1980 – 8/1/1990 *The beginning date for officers is 10/17/1981
  • 24 continuous months, OR
  • The full period (at least 181 days) for which you were called or ordered to active duty
Gulf War 8/2/1990 – Present
  • 24 continuous months, OR
  • The full period (at least 90 days) for which you were called or ordered to active duty
Currently On Active Duty Any Any 90 continuous days
National Guard & Reserve Member Gulf War 8/2/1990 – Present 90 days of active service
  • Six years of service in the Selected Reserve or National Guard, AND
    • Were discharged honorably, OR
    • Were placed on the retired list, OR
    • Were transferred to the Standby Reserve or an element of the Ready Reserve other than the Selected Reserve after service characterized as honorable, OR
    • Continue to serve in the Selected Reserve

*If you do not meet the minimum service requirements, you may still be eligible if you were discharged due to (1) hardship, (2) the convenience of the government, (3) reduction-in-force, (4) certain medical conditions, or (5) a service-connected disability.

Spouses

The spouse of a Veteran can also apply for home loan eligibility under one of the following conditions:

  • Unremarried spouse of a Veteran who died while in service or from a service connected disability, or
  • Spouse of a Servicemember missing in action or a prisoner of war
  • Surviving spouse who remarries on or after attaining age 57, and on or after December 16, 2003
    (Note: a surviving spouse who remarried before December 16, 2003, and on or after attaining age 57, must have applied no later than December 15, 2004, to establish home loan eligibility. VA must deny applications from surviving spouses who remarried before December 6, 2003 that are received after December 15, 2004.)
  • Surviving Spouses of certain totally disabled veterans whose disability may not have been the cause of death

Other Eligible Beneficiaries

You may also apply for eligibility if you fall into one of the following categories:

  • Certain U.S. citizens who served in the armed forces of a government allied with the United States in World War II
  • Individuals with service as members in certain organizations, such as Public Health Service officers, cadets at the United States Military, Air Force, or Coast Guard Academy, midshipmen at the United States Naval Academy, officers of National Oceanic & Atmospheric Administration, merchant seaman with World War II service, and others

Restoration of Entitlement

Veterans can have previously-used entitlement “restored” to purchase another home with a VA loan if:

  • The property purchased with the prior VA loan has been sold and the loan paid in full, or
  • A qualified Veteran-transferee (buyer) agrees to assume the VA loan and substitute his or her entitlement for the same amount of entitlement originally used by the Veteran seller. The entitlement may also be restored one time only if the Veteran has repaid the prior VA loan in full, but has not disposed of the property purchased with the prior VA loan. Remaining entitlement and restoration of entitlement can be requested through the VA Eligibility Center by completing VA Form 26-1880.

Certificate of Eligibility

After establishing that you are eligible, you will need a Certificate of Eligibility (COE). The COE verifies to the lender that you are eligible for a VA-backed loan. This page describes the evidence you submit to verify your eligibility for a VA home loan and how to submit the evidence and obtain a COE.

Evidence Needed

The evidence you need depends on the nature of your eligibility. Consult the table below to determine your category and the evidence you will need when applying.

Applying for a COE

After gathering the evidence you need, you can apply for your Certificate of Eligibility (COE) in the following ways.

Servicemembers, Veterans, and National Guard and Reserve Members

Apply online

To get your Certificate of Eligibility (COE) online, please go to the eBenefits portal. If you already have login credentials, click the Login box, and if you need login credentials, please click the Register box and follow the directions on the screen.  If you need any assistance please call the eBenefits Help Desk at 1-800-983-0937.  Their hours are Monday-Friday, 8am to 8pm EST.

Apply through your lender

Most lenders have access to the Web LGY system. This Internet-based application can establish eligibility and issue an online COE in a matter of seconds. Not all cases can be processed through Web LGY – only those for which VA has sufficient data in our records. However, Veterans are encouraged to ask their lenders about this method of obtaining a certificate.

Apply by mail

Use VA Form 26-1880, Request for Certificate of Eligibility.

Surviving Spouses

Spouses can take the VA form 26-1817 to their lender for processing (see Apply Through Lender above) or may mail the 26-1817 and DD214 (if available) to the following address:

Download VA Form 26-1817, Request for Determination of Loan Guaranty Eligibility – Unmarried Surviving Spouses

If you can’t print the form, just call 1-888-768-2132 and follow the prompts for Eligibility and we will mail the form to you.

Send the completed form to:
VA Loan Eligibility Center
Attn: COE (262)
PO Box 100034
Decatur, GA 30031

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