VA terminating medical benefits for ineligible veterans

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Internal memo indicates impacted veterans will receive 60-day notices

By Marty Finley

An internal memorandum issued by the U.S. Department of Veterans Affairs outlines a process to terminate veterans ineligible for health benefits through the agency.

A copy of the memo, which was obtained by The News-Enterprise, states that veterans found ineligible for VA health care benefits will receive a 60-day pre-termination notice before they end.

During the 60-day window, veterans can submit evidence proving why they are eligible for benefits, according to the memo, dated May 30 and sent by the acting deputy under secretary for Health for Operations and Management to network directors.

The pre-termination notices will be centralized by the Chief Business Office Health Eligibility Center, which was tasked with providing notices to affected veterans effective

June 23.

The notices, once issued, will explain why the veteran is losing VA benefits. For instance, it could be a lack of proof of one’s veteran status or lack of eligibility.

The notice also will provide the effective date when benefits will end while outlining the process the veteran can take to present evidence on their own behalf, request a personal hearing and obtain representation.

“The Veteran may contest or provide additional information before a final eligibility decision is made,” the memo states. “During this pre-decisional review, the Veteran will remain in their current enrollment group and continue to receive VA health care benefits.”

Once the 60-day period passes, the VA Health Eligibility Center will review an entire veteran’s record, including testimony and evidence provided, before issuing a final decision,

“HEC staff will ensure the Veteran’s file has been thoroughly reviewed before a final eligibility determination is rendered,” the memo reads.

If a veteran’s benefits are terminated, the VA indicates it will help with the transition to a community provider.

“In some circumstances, it may be appropriate to provide the Veteran with care during this transition period,” the memo stated. “VA social work staff should make every effort to transition health care to community providers within 30 days of the date of the final determination.”

Kristin Cunningham, director of business policy for the VA Chief Business Office, declined to comment but forwarded the inquiry to the VA communications office. No response has been received.

Dave Jarrett, a local veterans service officer with Disabled American Veterans, has read the memo but said he had not heard from veterans who received a letter. He said local veteran service officers will not be able to assist with the process because it must be appealed through the VA.

Jarrett noted the decision to terminate benefits for ineligible veterans will impact a lot of people, most of whom likely will be angry with the decision.

“Unfortunately, it’s the nature of the beast,” he said.

The VA has been embroiled in a bitter scandal nationally that has led to the ouster of top officials after it was revealed some veterans died waiting on care. Since then, the VA has noted a backlog of patients and long wait times.

The VA examines veterans’ military records, level of service-connected disabilities and income levels when determining benefits eligibility, dividing veterans into priority groups that can be found online at www.va.gov/healthbenefits/resources/priority_groups.asp.

Higher priorities are placed on certain veterans, such as those with service-connected injuries 50 percent or more disabling, those determined to be unemployable because of service-connected injuries or conditions, veterans with service-connected injuries 30 to 40 percent disabling, former prisoners of war and Purple Heart and Medal of Honor recipients.

Jarrett said some veterans removed from the rolls may be taken off because their income levels exceed requirements of the VA and they have access to other healthcare options.

Jarrett urged veterans to see their VA providers at least once every six months to keep the agency abreast of their health while also ensuring their coverage is not dropped.

“If you’re a veteran, check and verify,” he said. “Don’t assume.”

Clint Meshew, a service officer with the Fort Knox Veterans Service Office, has not read the memo but was aware of the VA decision.

Meshew believes once the issue is reviewed, many veterans removed from the benefit rolls will be those in priority group 8, many of whom don’t have service-connected disabilities or their disabilities are not related to their military service.

Meshew said Congress decided to extend benefits to veterans who were not otherwise eligible and that in turn helped create the backlog that led to a scandal.

Fixing the situation will not be easy, he said, nor will it be painless.

“No matter who’s doing the work, it’s going to be awful,” he said.

Marty Finley can be reached at 270-505-1762 or mfinley@thenewsenterprise.com.