Who Is Eligible For VA Healthcare Benefits?

Determining If You’re Eligible for VA benefits

Military discharge papers are an important component when determining eligibility for benefits. Your DD 214 form provides you with essential information for the application process. Be sure to take note of the character of your discharge. These can be as follows:

  • Honorable
  • General under honorable conditions
  • Under other than honorable conditions
  • Uncharacterized or entry-level separation
  • Bad conduct
  • Dishonorable

This status will be a key factor in the level of benefits you will receive.

Uncharacterized or entry-level separation is defined as a separation given to a service member with less than 180 days of military service or if discharge action is initiated before putting in 180 days service. It is characterized as neither good nor bad. These servicemembers are not eligible for veterans benefits unless they were injured as a result of service

or an illness occurred as the result of service.

 

VA benefits will require a variety of documents for the application process. One of the most essential documents is your proof of military discharge or your DD 214 form. This form is given to you when you separate from the service and will indicate your discharge status which will impact the benefits for you and your dependents.

Some other important paperwork you want to keep in a safe place in case they are needed for application are the originals of the following documents:

  • Birth certificate
  • Social Security card
  • Passports
  • Marriage license
  • Divorce papers
  • Will
  • Medical care directive
  • Letter of last instructions or funeral plans

Replacing Lost Documents

If for any reason you lose essential documents and need replacements, military veterans and their next of kin can get duplicates from the National Personnel Records Center, Military Personnel Records: NPRC (MPR). In this situation, next of kin is defined as surviving spouse as long as not remarried, mother, father, son, daughter, brother or sister. The most convenient way to receive a duplicate copy of any form needed is to complete a request online by using the E-vetrecs website which is at www.archives.gov/veterans/evetrecs/

It is important to note that in 1973 there was a fire at the National Personnel Record Center which destroyed approximately 16 to 18 million official military personnel files.  What was lost?

Army personnel discharge between November 1, 1912 to January 1, 1960 lost 80% of their records.

Air Force personnel discharge between September 25, 1947 to January 1, 1964 with names that started alphabetically after Hubbard, James E. lost 75% of their records.

There are no duplicate copies of these records maintained anywhere else and there was not yet microfilm copies produced. There is no complete list available of the records that were lost.

Requesting Documentation

Request can be submitted by mail for duplicate record copies to the following address:

National Personnel Records Center

Military Personnel Records

9700 Page Ave.

Saint Louis Missouri 63132–5100

Fax: 314–801–9195

More than one request can be included in each envelope or fax but a separate request form must be filled out for each individual whose records are being requested.

This process does take a significant amount of time seeing as at the present the NPRC (MPR) has a pending workload of approximately 90,000 request and receives almost 5000 request each day. The majority of requests for separation documentation can be filled in approximately 10 days, however, reconstruction of the information lost in the fire of 1973 can take up to six months or longer.

Medical Benefit Eligibility

A wide range of outpatient and inpatient services are available to all enrolled veterans through VA, however, care cannot actually be accessed by all veterans enrolled. When each veteran is enrolled they are assigned a priority group and this is the key to being able to you use your benefits. Priority groups are a ranking system developed by the VA to control the number veterans who actually use their healthcare system. Afghanistan and Iraq war casualties have stretched the Department of Defense healthcare system and VA system to the limits. Due to this, veterans who will have service-connected disabilities and those who are below the low-income thresholds are given priority over other enrolled members.

Most of the veterans’ health care benefits eligibility criteria are based only on active military service in either the Marines, Navy, Army, Air Force or Coast Guard and a discharge status other than dishonorable discharge. VA health benefits may be given to National Guard members and reservist who are activated into active-duty by a Federal Executive Order. Special eligibility for medical services, hospital care, and nursing home care is available for those returning servicemembers including National Guard members and reservist who served on active duty in a theater of combat for two years following discharge from active-duty, however, steps are being taken to increase the length of coverage to five years after discharge.

There are situations in which it is not a requirement to enroll to receive VA healthcare benefits, however it is strongly recommended. These special circumstances are as follows:

The veteran has been assigned a rating of 50% or more service-connected disability

The veteran who has been discharged for less than 12 months and is seeking care for a disability the military has determined did occur in the line of duty or was aggravated in the line of duty but yet has not received a rating

The veteran is solely seeking care for a service connected disability

Emergency Medical Attention

Veterans covered under VA health benefits are required to receive treatment at a VA hospital or associated facility.  However, in the case of an emergency where life is imminently threatened making it necessary to go to the nearest treatment facility, VA may reimburse the veteran or pay for the care altogether.

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