The ALS Association

ALS Ice Bucket Challenge Progress

FAQ’s: New Veterans Administration Policy for ALS

 

On September 23, 2008, the Department of Veterans Affairs published regulations establishing ALS as a service connected disease. In recognition that people have many questions about what this policy does and does not cover, The ALS Association has developed the following list of Frequently Asked Questions and answers.  We hope this information is helpful.  

We encourage veterans with ALS to contact their local ALS Association Chapter as well as a veteran’s service organization (VSO), such as the Paralyzed Veterans of America, American Legion, or others, when applying for VA benefits.  These organizations can provide guidance and assistance to veterans as they proceed through the application process.  

If you have questions not answered below, please contact The ALS Association at alsinfo@alsa-national.org or 1-800-782-4747.  This document will be updated on a continuous basis and is available via The Association’s website at www.alsa.org.

Questions

1. I am a veteran with ALS. How will this policy benefit me? 

2. How can I apply for VA benefits? 

3. What is the disability compensation rate for veterans who are service connected for ALS?

4. My spouse/parent/family member was a veteran and they passed away (either recently or some time ago) from ALS before this policy was implemented.  Am I eligible for survivors’ benefits under the policy?

5. Will this policy allow veterans to obtain coverage for Rilutek?

6. What is special monthly compensation?

7. I am a veteran with ALS who was denied services in the past.  Should I reapply at this time?

8. Is VA disability compensation considered taxable income?

9. I am a veteran with ALS who was in the reserves and did not serve on active duty. Am I eligible for benefits under the VA policy?

10. How long will it take to approve my claim?

11. The VA denied my request for benefits prior to my diagnosis with ALS.  Now my diagnosis of ALS has been confirmed.  Should I reapply? 

12. What is the impact for veterans with ALS who have more than one service connected disability?

13. I received a letter/phone call some time ago stating that the VA was waiting guidance to decide on my claim/appeal for benefits. Do I continue to wait, or do I have to re-file the paperwork?

14. Will I be eligible to receive financial help for the purchase of a van with a wheelchair ramp?

15. I have been diagnosed as having Primary Lateral Sclerosis (PLS).  Will I automatically qualify for VA benefits under the new policy for ALS?

16. Is it true that once service connected that my spouse/children are eligible for education benefits?

17. Are there also education and rehabilitation benefits?

18. Are there income limits for eligibility?  I am still working. Will this cause any issues with obtaining VA benefits?

19. How do I obtain a copy of my military record (DD 214) or other service record?

20. My spouse/parent/family member is a veteran with ALS. Are there health benefits for me under the policy? 

21. Does the VA policy cover assisted living or in home nursing care?

22. I have heard that the VA will help buy homes. Will they buy or help sell mine? 

23. I live out of the country and there are not any ALS Association offices here.  I also can no longer speak, how do I go about obtaining benefits? 

24. I am a disabled veteran with ALS and have applied for service connected benefits from the VA; can I also apply to the SSA for additional benefits?  

25. What paperwork do I need to have when applying for VA benefits, i.e. such as discharge and/or service papers?

26. If my spouse was a veteran and has since passed from ALS, do I need a death certificate or other paperwork when applying to the VA for benefits? 

27. Why do some veterans receive different levels of compensation?

28. Would a dishonorable discharge make one ineligible for the VA service related benefit?

29. I was awarded 100% disability and medical coverage through the VA, should I drop my Medicare coverage?

30. Am I eligible for a housing grant though the VA?

Answers

1. I am a veteran with ALS. How will this policy benefit me? 

It depends on your specific situation but, in general, military veterans diagnosed with ALS who have served at least 90 continuous days on active duty will be considered service connected for ALS.  This is the case regardless of when or where a veteran served in the military and regardless of the length of time between discharge from the military and a diagnosis of ALS.   

Service connection opens many benefits to veterans. An overview of those benefits is available at: http://www.alsa.org/als-care/veterans/service-connected-benefits.html 

As a quick summary, service connection allows a veteran to receive compensation based on the percentage of disability, grants for housing and/or vehicle modifications and much more.  A veteran’s spouse and dependents also may be eligible for benefits.   

Service connection also qualifies a veteran for enrollment in the VA health care system, which provides coverage for medications, equipment and other health services.  Medications such as Rilutek and equipment such as power wheelchairs that are directly related to a service connected condition like ALS are covered.  

2. How can I apply for VA benefits? 

There are two basic types of benefits for which you can apply.  One is service connected benefits such as compensation and grants and the other is enrollment in the VA health care system. You will need to complete and submit separate application forms for service connected benefits and health benefits. 

Steps to apply for benefits: 

 We strongly recommend that you submit forms through your selected veterans’ service organization. 

3. What is the disability compensation rate for a veteran who is service connected for ALS? 

On December 20, 2011, the U.S. Department of Veterans Affairs published regulations that increased to 100% the minimum disability rating automatically provided to all veterans with ALS who qualify for service connected benefits. The rating is provided regardless of the progression of the disease or whether or not a veteran is totally disabled at the time of their evaluation. 

The disability rating is used to calculate monthly compensation payments and eligibility for other benefits.  The 100% disability rating means that veterans will receive a higher level of compensation from the start, helping to speed access to benefits and decrease the burden on veterans and their families.  

Although service connection for ALS provides a minimum rating of 100%, additional factors such as a spouse or number of dependents can increase your compensation rate. 

The most recent compensation rates are available here: http://www.vba.va.gov/bln/21/Rates/comp01.htm. 

Note that veterans with ALS also may qualify for additional compensation, potentially more than $8,000 per month, depending on a number of other factors including those listed below.  

  • Additional Payments for Dependents - Veterans with service-connected disabilities, like ALS, are entitled to additional allowances for dependents.  Payment rates for veterans with dependents can be found here: http://www.vba.va.gov/bln/21/Rates/comp01.htm.
  • Other Major Factors Affecting Payment Levels:
    • Adjustments to rates are based on a number of factors in addition to dependents.  Among factors that can have a significant effect on amounts are:
      • Veterans with severe service-connected disabilities may receive compensation at a monthly rate of $8,000 or more.  Various special monthly compensation rates apply when a veteran experiences complete loss or loss of use of one or more limbs; loss of one or more of the senses of sight, hearing or speech; loss of a reproductive organ or its use, or loss of breast tissue by a female veteran.
      • Allowances may be made for veterans requiring aides, such as bedridden individuals who need assistance with eating, bathing or certain other activities of daily living.  This adjustment is referred to as “aid and attendance.”
    • Disability compensation for veterans is not subject to federal or state income tax.

Special Monthly Compensation rates are available here: http://www.vba.va.gov/bln/21/Rates/comp02.htm. Additional information about Special Monthly Compensation is available here: http://www.vba.va.gov/VBA/benefits/factsheets/serviceconnected/smc.doc. 

 Additional details on disability compensation benefits available to veterans can be found here: http://www.vba.va.gov/bln/21/Compensation/index.htm 

4. My spouse/parent/family member was a veteran and they passed away (either recently or some time ago) from ALS before this policy was implemented.  Am I eligible for survivors’ benefits under the policy?

Under the regulations, survivors are eligible for benefits even if the veteran/survivor had been denied benefits in the past.  There are certain general requirements that must be met and benefits can include monthly compensation, education benefits for spouse and/or children, home loan guaranty, medical insurance and burial benefits just to name a few.  Additional information is available on the Survivors Benefits Homepage:  http://www.vba.va.gov/Survivors/.  We recommend you work with your local veteran service organization to determine whether you may qualify for survivors’ benefits.   

5. Will this policy allow veterans to obtain coverage for Rilutek?

Yes, when you enroll in the VA health system.  Any veteran enrolled in the VA health care system is able to obtain medications on the VA formulary. Since medications required for service connected diseases/conditions are provided for free, full coverage for Rilutek is provided for those service connected for ALS. 

6. What is Special Monthly Compensation? 

VA can pay additional compensation, called Special Monthly Compensation (SMC), to a veteran who, as a result of military service, incurred the loss or loss of use of specific organs or extremities.  This includes loss of use of a hand or foot, paralysis and inability to communicate by speech.   Compensation can be as much as $8,000 per month or higher.  

To learn more about SMC, go here: http://www.vba.va.gov/VBA/benefits/factsheets/serviceconnected/smc.doc. 

SMC Compensation rates can be found here:  http://www.vba.va.gov/bln/21/Rates/comp02.htm.  

7. I am a veteran with ALS who was denied services in the past.  Should I reapply at this time? 

Yes.  We recommend that you contact your local ALS Association Chapter as well as the veterans’ service organization of your choice (eg, Paralyzed Veterans of America, American Legion, Disabled American Veterans).  These organizations can provide guidance and assistance to determine whether you can reopen your claim.  Current VA policy generally permits claims to be reopened if new evidence exists.  

8. Is VA disability compensation considered taxable income?

No.  Disability compensation for veterans is not subject to federal or state income tax.  

9. I am a veteran with ALS who was in the reserves and did not serve on active duty. Am I eligible for benefits under the VA policy? 

Most likely no.  The policy requires that a veteran must have served at least 90 continuous days on active duty. However, we encourage you to work with your local ALS Association Chapter and a veteran service organization, such as the Paralyzed Veterans of America, to see if you may qualify for benefits.   

10. How long will it take to approve my claim?

The length of time it takes the VA to process and approve your claim can vary (approx. three months) and will depend on a number of factors, including whether you have fully completed the appropriate forms.   The ALS Association strongly encourages veterans and survivors to submit claims with the assistance of a veteran service officer from the Paralyzed Veterans of America, American Legion or other service organization, who can help ensure your claim is complete.  In addition, while it is vital that you submit complete information, do not delay in submitting your claim because benefits will be retroactive to the date your claim was filed.  

Finally, be sure to request that your claim be expedited as the VA can expedite claims for life-threatening and fatal conditions.   

11. The VA denied my request for benefits prior to my diagnosis with ALS.  Now my diagnosis of ALS has been confirmed.  Should I reapply?   

Yes.  We recommend that you contact your local ALS Association Chapter as well as the veterans’ service organization of your choice (eg, Paralyzed Veterans of America, American Legion, Disabled American Veterans).  These organizations can provide guidance and assistance to determine whether you can reopen your claim.  Current VA policy generally permits claims to be reopened if new evidence exists.   

12. What is the impact for veterans with ALS who have more than one service connected disability?

When a veteran has more than one service connected disability, the percentages are not simply added together to produce a new rating.  Instead, a formula described in federal regulations calculates the overall rating. For more information see the Combined Ratings Table in the Code of Federal Regulations.  

13. I received a letter/phone call some time ago stating that the VA was waiting guidance to decide on my claim/appeal for benefits. Do I continue to wait, or do I have to re-file the paperwork?

Contact your local ALS Association Chapter and the veteran service organization of your choice (Paralyzed Veterans of America, American Legion, Disabled American Veterans) to discuss your options.  If a claim is awarded on appeal, benefits may be retroactive to the date of the initial submission.  

14. Will I be eligible to receive financial help for the purchase of a handicap accessible vehicle or to adapt a vehicle? 

Yes. The VA will grant more than $11,000 for the purchase of an accessible vehicle. There are prerequisites that must be met. Prior to purchasing a handicap accessible vehicle, contact your local ALS Association Chapter and the veteran service organization of your choice (Paralyzed Veterans of America, American Legion, Disabled American Veterans) to discuss your options.  Additional information is available here: http://www.vba.va.gov/bln/21/index.htm.  

15. I have been diagnosed as having Primary Lateral Sclerosis (PLS).  Will I automatically qualify for VA benefits under the policy for ALS? 

Not at this time.  The presumption was established for ALS specifically and does not apply to a diagnosis of PLS.  However, any disease or condition can be rated as service connected if it is shown to be caused or aggravated by military service.  In some instances, the VA has determined PLS to be a variant of ALS and therefore has rated those cases as service connected.   Contact your local ALS Association Chapter or veteran service organization for assistance applying for benefits.   

16. Is it true that once service connected that my spouse/children are eligible for education benefits?

Possibly yes. Survivors’ and Dependents’ Educational Assistance Program (DEA), http://gibill.va.gov/benefits/other_programs/dea.html, provides education and training opportunities to eligible dependents of veterans who are permanently and totally disabled due to a service-related condition, or who died while on active duty or as a result of a service related condition. The program offers 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 may take a correspondence course. Remedial, deficiency, and refresher courses may be approved under certain circumstances.  

17. Are there also education and rehabilitation benefits?

Yes. Vocational Rehabilitation is a program whose primary function is to help veterans with service-connected disabilities become suitably employed, maintain employment, or achieve independence in daily living.  

The program offers a number of services to help each eligible disabled veteran reach his or her rehabilitation goal.  These services include vocational and personal counseling, education and training, financial aid, job assistance, and, if needed, medical and dental treatment.  Services generally last up to 48 months, but they can be extended in certain instances.  

18. Are their income limits for eligibility?  I am still working. Will this cause any issues with obtaining VA benefits?

No. Service connected benefits do not have any income thresholds. The only thing currently having a job would effect would be a claim for total disability due to individual unemployability (TDIU).

19.  How do I obtain a copy of my military record (DD 214) or other service record?

The Department of Veterans Affairs does not maintain records of veterans’ military service, except as necessary for providing benefits from the VA. 

To obtain or amend a copy of your military service record and/or your Official Military Personnel File (DD-214, OMPFs), please visit the website for the Military Personnel Records Center (MPRC) in St. Louis, which is part of the National Archives and Records Administration (NARA). If you have been discharged from military service, your personnel files are stored at NARA, the official repository for records of military personnel who have been discharged from the U.S. Air Force, Army, Marine Corps, Navy and Coast Guard.

NARA also has an online document request service called eVetRecs which allows you to Request Copies of Military Personnel Records online. This system provides a customized order form to request information from your or your relative's, military personnel records. 

To get to the NARA website and eVetRecs, you will need to leave the VA website and go to http://www.archives.gov/veterans/military-service-records/.

This site gives instructions to submit a SF 180 - Request Pertaining to Military Records. It also has links for:

  • Personnel Files (OMPFs) 
  • Request Service Records or Proof of Military Service 
  • Locations of Military Service Records 
  • Medical and Health Records 
  • Correcting Service Records and Discharges 
  • Replacement Medals and Awards 
  • Military Service Records at the National Personnel Records Center's Archival Research Room

Questions about your military records may also be sent to:

National Personnel Records Center 
Military Personnel Records Center 
9700 Page Boulevard 
St. Louis, MO 63132-5100   

20. My spouse/parent/family member is a veteran with ALS. Are there health benefits for me under the policy? 

Yes, as long as the veteran meets certain requirements. The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries.

To be eligible for CHAMPVA, you cannot be eligible for TRICARE/CHAMPUS and you must be in one of these categories:

1. the spouse or child of a veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office, or

2. the surviving spouse or child of a veteran who died from a VA-rated service connected disability, or

3. the surviving spouse or child of a veteran who was at the time of death rated permanently and totally disabled from a service connected disability, or

4. the surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).

In general, the VA’s CHAMPVA program covers most health care services and supplies that are medically and psychologically necessary. Upon confirmation of eligibility, you will receive program material that specifically addresses covered and noncovered services and supplies in the form of a CHAMPVA handbook.

Veterans with spouses and dependent children also are entitled to additional compensation allowances.  In addition, spouses and dependents may be eligible for educational assistance and training.  Parents of a deceased veteran also may be eligible for monthly compensation based on need. Additional information is available here: http://www.vba.va.gov/bln/21/index.htm.  

21. Does the VA policy cover assisted living or in-home nursing care?

VA's nursing home programs include Community Living Centers, contract community nursing homes and state homes. More than 90 percent of VA's medical centers provide home and community-based outpatient long-term care programs. A patient-focused approach supports the wishes of most patients to live at home in their own communities for as long as possible. Many veterans will receive inpatient long-term care through programs of VA or state homes.

Eligibility for VA nursing home care: 

  • Any veteran who has a service-connected disability rating of 70 percent or more;
  • A veteran who is rated 60 percent service-connected and is unemployable or has an official rating of "permanent and total disabled;"
  • A veteran with combined disability ratings of 70 percent or more; 
  • A veteran whose service-connected disability is clinically determined to require nursing home care; 
  • Nonservice-connected veterans and those officially referred to as "zero percent, noncompensable, service-connected" veterans who require nursing home care for any nonservice-connected disability and who meet income and asset criteria; or 
  • If space and resources are available, other veterans also are eligible on a case-by-case basis with priority given to service-connected veterans and those who need care for post-acute rehabilitation, respite, hospice, geriatric evaluation and management, or spinal cord injury. 

For extended care services, veterans may be subject to copays determined by information supplied by completing a VA Form 10-10EC, Application For Extended Care Services. VA social workers are available to assist veterans in interpreting their eligibility and copay requirements if indicated. The copay amount is based on each veteran’s financial situation and is determined upon application for extended care services and will range from $0 to $97 a day.

Further information: 

  • Office of Geriatrics and Extended Care, http://www.va.gov/GERIATRICS/index.asp, contains information on VA Nursing Home Care, Home and Community-Based Long Term Care, or State Veterans Homes programs.  

22. I have heard that the VA will help buy homes; will they buy or help sell mine? 

No. The VA does not buy or assist in selling homes. They will provide grants to assist in purchasing or remodeling homes so that they are accessible for a disabled veteran if the veteran meets the requirements.  Additional information is available here: 

http://www.vba.va.gov/VBA/benefits/factsheets/serviceconnected/homemods.doc  

23. I live out of the country and there are not any ALS Association offices here.  I also can no longer speak. How do I go about obtaining benefits? 

Virtually all monetary benefits (compensation, pension, educational assistance, etc.) are payable regardless of place of residence or nationality.  For additional information, including VA contacts for veterans living abroad, please visit the VA’s website at http://www.vba.va.gov/bln/21/Foreign/index.htm. You also can apply for benefits online via the VA website here:

 

24. I am a disabled veteran with ALS and have applied for service connected benefits from the VA; can I also apply to the SSA for additional benefits? 

Veterans with ALS are eligible to receive both VA disability benefits as well as Social Security Disability benefits.  The application processes for the programs are different as are the eligibility requirements.  For example, in addition to being disabled, a person also must meet certain work requirements and must have paid Social Security taxes in order to qualify for Social Security. Nevertheless, veterans are eligible to receive benefits through both programs and Social Security has a number of special rules that expedite claims for people with ALS.  Additional information about applying for Social Security Disability Insurance is available online at www.ssa.gov.  

25. What paperwork do I need to have when applying for VA benefits, i.e. such as discharge and/or service papers?

There are two basic types of benefits for which you can apply.  One is service connected benefits such as compensation and grants and the other is enrollment in the VA health care system. You will need to complete and submit separate application forms for service connected benefits and health benefits.  

In addition to the completed application forms, the VA may need a copy of your discharge or separation papers, military medical records, and current medical evidence to support your claim.

Steps to apply for benefits: 

  • We encourage veterans with ALS to contact their local ALS Association Chapter as well as the veterans’ service organization of their choice (eg, Paralyzed Veterans of America, American Legion, Disabled American Veterans).  These organizations can provide guidance and assistance to veterans as they proceed through the application process.  

To identify your local ALS Association Chapter, please visit our website http://www.alsa.org/community/chapters/) or contact us at alsinfo@alsa-national.org or 1-800-782-4747.

Contact information for the veterans service organizations can be found here: (http://www.alsa.org/assets/pdfs/advocacy/vso_contact.pdf).

Required application forms are available here:

We strongly recommend that you submit forms through your selected veterans’ service organization. 

We also recommend that when applying and working with a veteran service organization that you request the review of your application be expedited.  

Additionally, submitting a copy of your military discharge or separation papers with your signed application will expedite the process and please do not forget to sign your application.  

See question 19 in this document for information on how to obtain your service records.  

26. If my spouse was a veteran and has since passed from ALS do I need a death certificate or other paperwork when applying to the VA for benefits? 

It depends on what VA benefits you are applying for (eg, if you are applying for VA claim for life insurance, a death certificate is necessary). Please review the survivor’s benefits website for additional details www.vba.va.gov/bln/dependents/index.htm.  

27. Why do some veterans receive different levels of compensation?

The disability compensation rate for a veteran who is service connected for ALS depends on your degree of disability the severity of disability (eg, loss of use of extremities, homebound etc.) and other factors such as a spouse or number of dependents. For additional information about the disability compensation rate for a veteran who is service connected for ALS, please view question #3 in the FAQ document.

One of the factors impacting whether a veteran receives $3,000 per month or $7,000 is his or her eligibility for Special Monthly Compensation (SMC). Various special monthly compensation rates apply when a veteran experiences complete loss or loss of use of one or more limbs; the loss of one or more of the senses of sight, hearing or speech; loss of a reproductive organ or its use, or the loss of breast tissue by a female veteran. The VA will pay higher rates for combinations of these disabilities, or if a veteran is service connected for paraplegia, if you have other service-connected disabilities that, in combination with the above special monthly compensation, meet certain criteria, If a veteran is service connected at the 100% rate and is housebound, bedridden, and needs the aid and attendance of another person, then consideration of payment of additional SMC can be considered.

For additional information, please access information from the Department of Veteran’s Affairs about Special Monthly Compensation (SMC) for Serious Disabilities: http://www.alsa.org/files/cms/Public_Policy/Veteran's_Campaign/Benf_Special_Monthly_Compensation.pdf and here http://www.vba.va.gov/bln/21/Compensation/index.htm.

Veterans should work with their local ALS Association Chapter and a service officer from the Paralyzed Veterans of America, American Legion or other service organization to help ensure they receive the highest level of benefits possible.   

28. Would a dishonorable discharge make one ineligible for the VA service related benefit?

Eligibility for most VA benefits is based upon discharge from active military service under other than dishonorable conditions. Dishonorable and bad conduct discharges issued by general court-martial may bar VA benefits. Veterans in prison and parolees must contact a VA regional office to determine eligibility. VA benefits will not be provided to any veteran or dependent wanted for an outstanding felony warrant.  

29.  I was awarded 100% disability and medical coverage through the VA, should I drop my Medicare coverage? 

While the VA provides important coverage for a range of services, it generally does not provide coverage for services outside of the VA system, such as visits to an ALS clinic or to other non-VA physicians and services.   Medicare can provide needed coverage for these and other services not available within the VA.  However, we recommend that you contact your local ALS Association Chapter who can provide you with additional guidance to help you make the most appropriate decision the meets your needs.  Contact information for your Chapter can be found here:  http://www.alsa.org/community/default.cfm.   

30. Am I eligible for a housing grant though the VA?

Yes. Veterans and those on active duty who are service connected for ALS automatically are eligible for the maximum grant available under the VA’s Specially Adaptive Housing (SAH) program. The grants provide veterans with up to $68,000 to construct or adapt their homes, purchase an adapted home or pay down the mortgage on homes that already are adapted.   Because veterans with ALS are immediately eligible for the maximum grant available, they do not have to file multiple claims in order to increase the amount of the grant as their disease progresses.  Moreover, veterans with ALS do not have to wait to apply for grants until their symptoms have progressed to the degree required for SAH eligibility.  Under VA’s regulations, veterans and those on active duty who are service connected for ALS automatically are eligible regardless of the progression of their disease. 

This document will be continually updated.  If you have questions not covered by this document, please contact The ALS Association at alsinfo@alsa-national.org or 1-800-782-4747.    

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