VA-GLI Eligibility Question
I am a veteran who served as a combat-engineer for the Army. I was honorably discharged in '97 and have a service-connected disability. I was never married until 2010 and had let the life insurance I once had go because of my single status.
The reason I'm writing is because I recently became 100% permanently disabled and received a description of benefits. So, I applied for life insurance and was deemed ineligible because my increase to total disability did not involve a new disability ordiagnosis.
I have written my Indiana senator, Dan Coats, whom suggested writing the senate committee on Veterans Affairs. I did write them two weeks ago, but have not gotten any reply. I just do not understand the logic of this rule. If I receive a new disability, unrelated to my service-connected disability, then I am eligible to receive or apply for disabled life insurance--BUT--if I become permanent and totally disabled from my existing disability, I am not eligible. Why does this not sound ridiculous to the VA committee?
In addition, I see that there is NO rule that if a veteran becomes married and has a family, he or she would be re-eligible to apply for life insurance. Do not most people obtain life insurance to protect their children, spouse, or family? I find it a disservice to veterans who couldn't/wouldn't marry during their service due to the dangerous nature and deployment-prone-status of serving in the armed forces to begin with.
What is the most disheartening is that veterans who receive a new, and by deductive reasoning, a non-service rating that is new, are eligible to apply to receive life insurance. Yet I, who have become 100 percent and now have a family, am ineligible, denied, black-balled, left behind when it is needed the most.
I plan on getting this message across to other veterans and I picked up a copy of the Veterans’ Voice at a restaurant and loved the stories about Korea, Four Chaplains, and many others. I was most impressed at how they protected and gave veterans advice about their benefits. Anyway, thanks for your publication--I have also written my Indiana State Representative, Holli Sullivan, and plan on writing another soon. Thank you for your service.
Good evening Ben, Thanks for writing in to the Veterans’ Voice.
I think there may be some confusion here. First, the VA has a group life insurance program that is similar to the military’s Service-member’s Group Life Insurance (SGLI), which is basically a term life insurance. You pay it, you die, then others benefit. But the VA’s program is only available for a short time after leaving the military. You must transfer SGLI to the VA-GLI within 1-year and 120 days or so after ETS. After that, the only life insurance is from the civilian market and the rules they have in place.
Next, the VA’s benefit handbook describes several insurance programs; it also reads that a veteran can apply for Service Disabled Veterans Insurance (not VA-GLI) within two-years of a newly diagnosed “service-connected” medical condition. I assume that the original decision granting benefits to you was more than 2-years before applying for the insurance, then when you were deemed 100% permanent it was only an increase in the same disability that had been diagnosed and linked to your military service. There was no new service-connected issue that was diagnosed. New non-service connected medical issues would not make you eligible for a VA insurance program.
This would seem standard(not necessarily fair) as almost all insurance programs I have seen, whether government or commercial, come with clauses for time constraints. I believe you may be incorrect in believing that a non-service connected medical diagnosis would make you eligible for any VA insurance policy.
You can do further research at www.insurance.va.gov or call 1-800-669-8477. Also check out what your state’s agency for veteran’s affairs. I hope this is of assistance to you.
Will VA fill prescription from private doctor?
I was active duty Air Force from 1971 to 1975 and I am a non-combat vet. While I was AD, I experienced personal trauma that I'd rather not go into. I buried it for many years and hid it from my wife. When our kids were grown and out of the house, I had less to do and the memories of the trauma came back with a vengeance. I tried to hide it from my wife, but she knew something was wrong and she insisted that I get help. I finally went to the local VA hospital and asked for help a few years ago.
I was diagnosed pretty quickly with PTSD and I started one-on-one therapy and group sessions. I was initially rated at 70%. After a couple of years of therapy and drugs, my VA doc and I discussed IU and he supported it. I filed for IU last spring and a new C&P exam resulted instead in a "100% PTSD, P&T, no future exams" rating.
So, here's my question:
I love my VA therapist/psychologist, but I don't care for my VA psychiatrist at all. He doesn't listen to me and he shuffles me out the door in short order every six months when I meet with him. There is only one other psychiatrist that I can see at my local VAMC and I met him in one of my group classes and I can't understand him when he speaks, so he isn't an option. My family doctor knows about my anxiety and I can get my anxiety medication from him. So, if I tell my current VA psychiatrist that I no longer need the VA to provide my anxiety medication and that I'm getting it from my private doc, am I out of order and will that endanger my rating in any way?
BTW, I plan on continuing my one-on-one therapy with my VA therapist/psychologist as he is great and although I'm not much better than I was a few years ago, I'm not any worse and I count that as a positive.
Thanks, Texas Vet
Getting your own doctor to prescribe your medication will not harm any benefits you already have. Since you are already rated P&T any prescriptions your doctor gives should be honored by the VA pharmacy for free.
How this is done I am not sure. If your VA medical facilities are like here in WA State, you should be interviewed by a pharmacist with your prescription and they will explain the procedures.
From personal experience, PTSD can be dealt with in such a manner so to minimalize its effects. Knowledge in power.
The best to you, Thom
Trying to help the vets I counsel
I am a social worker who works with veterans at the VA. I love my job. This is not a query about disability benefits. My understanding is that they have been redirected to Comp and Pen to complete, at least at our facility.
Our psychiatrists have been advised by Regional Counsel that they are not to complete ANY forms in which they are asked their opinion about the veteran's ability to work. Many of our veterans, including those with service connection have become too disabled to work, have left their employment, and in order to survive financially, must submit evidence from their treating psychiatrist on their ability to work. This is required for short term and long term disability insurance claims.
Yet, our Veterans Service Center Director has stated this is up to the discretion of the psychiatrist. Even when someone needs a form completed for public assistance, they are denied. I have worked at the VA for over 10 years. We social workers used to assist in the process. Not any more. Our "old timers" doctors are retired and we have newer ones who seem fearful to complete the forms, rightfully so, if they are told by the attorney not to.
I was curious about the prevalence of this issue, as we have always done these forms in the past, so I googled the issue and found a VA regulation that stated this: completion of work related forms, was mandatory or obligatory of the treating physician. Also, that this regulation from a few years ago was not renewed. Dont know exact year. So, I question if this may be the rationale, as well as the assumption that logically, such a statement in favor of the veteran's inability to work could ultimately and indirectly support a service connected claim.
In any case, regardless of the rationale, I am trying to help the vets I counsel. So, I located an agency in the community (IMA) that specializes in occupational assessments. I called our fee basis staff, explained the problem, and inquired if this service might be an appropriate referral for the VA to pay via fee basis as it is a (one time)evaluation the patient needs that we do not provide. The fee basis person seemed annoyed at our doctor’s refusals and asked, “well then, if they won’t do it, how has your clinic arranged it to be done?” I informed her there was no plan, that is why I thought of fee basis. She advised me to contact the VA attorney. Instead, I discussed it with the psychiatrist as I believe he should be the one to submit the request given the referral is to another doctor. The psychiatrist consulted with our program director. He phoned me and stated,” no, it is not a clinical service, we cannot request fee basis.” I disagree.
One female vet whom I counsel has severe PTSD related to MST. She was granted service connectionfor that but not 100%. She was fired from her federal employment as the PTSD was exacerbated by the workplace. She attained SSDI. Recently, she became eligible to file for Federal Retirement Disability yet the psychiatrist cannot fill out the form. So, the vet risks foreclosure on her home and because of all this her PTSD is much worse. It seems unfair. What is your opinion on this matter and do you have any recommendations for me to help vets who cannot afford to pay a private psychiatrist for this evaluation?
Hi, sorry it has taken so long to give you a decent reply. I have spoken to several VA staff who are providing social work services to veterans and those with PTSD.
If we understood your question correctly, when a veteran is attempting to be rated Individual Unemployable (I/U) in other words totally disabled (100%), that the VA staff are not allowed to provide an opinion on this issue. They are further constrained from referring a veteran to the civilian side, despite regulations put out by 38 CFR.
I can think of a hundred reasons why the VA would do such a thing. The first thing I see is the possibility that the VBA is trying to remove as much subjective information, negative or positive, from the claim‘s process. The evidence, as objective as possible, stands on its own when it goes before the rating board.
From personal experience as a former rater, I found that very few of the medical people who work in the trenches day to day putting veterans back together truly understand the claim’s process. The process is so simple, yet incredibly convoluted. First - the vet makes a claim for a benefit (the claim must come from the veteran). Second - evidence is gathered. Lastly - the claim is adjudicated and benefits awarded or not.
VA staff’s first priorities are to treat, build evidence, and not be in direct support of the claim’s process. This has always been the program since I first became involved in 1995.
The vet has to know what he or she wants to achieve and understand the requirements. The claim must come from them, and then the Regional Office must provide an examination (VAE) either at the VA or in the community. This examination does two things: provides a diagnosis and evidence of severity. A little research is needed before the claim is submitted. Knowledge is power for all concerned. The evidence must be clear and compelling as to make the average reasonable person accept it as fact.
Compelling evidence is essential and should be looked at very carefully for completion. Evidence can come from almost anywhere. I suggest very strongly that the veteran gathers the evidence themselves as much as possible and not leave things to the system or to chance. Quality before quantity.
For a vet who is too disabled to work because of “service connected issues”, the veteran must provide the evidence to such. This is a brutal situation for the vet. All too often the vet is reliant on their previous employer to provide documentation that it was a service connected issue that caused the ending of employment. If it was over a year, then employer proof is not needed.
For vets who are disabled because of non-service connected medical conditions, there are Pension Benefits. These can be granted if they provide a better benefit to the veteran than compensation. There are also educational benefits that can be granted to aid a vet to circumvent the disability and return to satisfying employment.
Opinions are great only if they are presented with facts. An example would be – “it is my opinion as a physician of 20-years that due to the progressive nature of this disease that Mr. So-in-So is not able to earn a living at this time. This disease is painful, distracting, and limits the full movement of the veteran’s back.”
Usually the rating board will accept only a doctor’s diagnosis, but others certainly do provide the needed evidence to help a veteran. Vet centers keep only written records, or used to, but these records are to be available to the rating board. The veteran can have the Regional Office request them, but it is better that they obtain them for themselves and send them in. As a rater it was frustrating for me to wade through reams of medical records and find no information pertaining to the claim being made. I have told many counselors to be aware of the treatment being given and its effect on possible future compensation claims.
I strongly feel that your supervisors owe you explanations for the way things are done, if for no other reason than to make you more effective. I asked many questions about why things are done the way they are, and the VA staff almost always did their best to provide an answer.
Yet there are lots of oxygen thieves working for the VA. I have encountered some who lied and deceived to satisfy their own egos. The best way to expose these schmucks (because they hurt veterans) is bring their names to the media. This has been very successful. If you and others feel there are empire-builders impeding what is right for the veteran, there are many ways around them and their rules. I have not had much success with knuckle heads at CO, but the various media are hungry for dirt on the VA.
I hope I addressed all the issues to the point for you and you find this helpful. Feel free to contact me or the Veterans Voice at any time. The use of the VA’s multiple websites are a great resource too. There is also the VA’s handbook of Federal Benefits and there are also counterparts in civilian bookstores and free smartphone apps.
I am not negative towards the VA, as I have encountered some of the most dedicated people while working there. Sometimes I was asked to break a law or two - but it was to circumvent a rule to help a needy veteran. After I left the VA I was asked by a Vet Center to help a few veterans with their claims due to the center’s limitations.