GLOSSARY
Accredited – as in an “accredited veterans service officer”. The term “accredited” has a specific meaning in DVA and veteran service organization parlance. 38 CFR 14.629 provides the general guidance. It means the individual has been trained through a VA-approved course of instruction and sponsored by an organization that it recognizes (generally chartered by Congress). Furthermore, that organization has forwarded documentation to the effect that they wish the individual to work on their behalf and has been properly trained, plus some supporting information. The Office of Counsel then forwards a Letter of Accreditation and an identity card (pocket card) to the individual. The terms “registered” and “certified” do not mean the same thing. These are internal veteran service organization terms used to describe post or chapter level service officers or state, county, and local political entity service officers who have undergone a special course of training to assist veterans. They can “certify” documents as true copies of the originals, hence the term. The level of their duties is in no measure the same, and the DVA will not talk to them directly, unlike accredited officers. The quality of their training and the quality of their performance has been an ongoing problem over at least the last decade. See also Veteran Service Officer.
a.k.a. – “also known as”
Benefits Delivery
Network (BDN) – is the major
computer system used by the Veterans Benefits Administration to process claims,
records, fiscal awards, and related actions. This collection of databases and
component programs is the source of the master record files for veterans and
their beneficiaries, and generates the payment information that is sent to
Treasury for producing the benefits checks. The system installation began in
the late 1970’s and was formerly known as the TARGET system. As used in this study, the term connotes
outbased computer access to the VA claims processing and information system
which includes BDN and other components, key among these being MAP-D and the
States Benefits Reference System.
Certified or Registered – See “Accredited” for an explanation of this often confusing term.
Community-Based Outpatient Clinics (CBOC)
– Changes
have been made in VA’s identification of its outpatient clinics. Over the years, the following terms have been
used: hospital-based clinics,
independent clinics, mobile clinics, satellite outpatient clinics, community-based
clinics, and outreach clinics. VHA
Directive 97-058 (Department of Veterans Affairs, Veterans Health
Administration, Washington, DC, November 24, 1997) clarified how the clinics
are to be identified. The nomenclature
"hospital-based clinic" -- which is defined as an outpatient clinic
that functions in a hospital – has not been changed. The same is true for "independent
outpatient clinics," which are full-time, self-contained, freestanding
ambulatory care clinics with no management, program, or fiscal relationship to
a parent facility, and for "mobile clinics," which are specially
equipped vans with multiple, scheduled stops, providing outpatient care. However, "satellite outpatient
clinics," "community-based clinics," and "outreach
clinics" are now all categorized as "community-based outpatient
clinics." Some may be staffed with
VA personnel, but the majority of the clinics are contracted.[1]
See VHA.
Dependency and Indemnity Compensation (DIC) -- sometimes called “compensation based on service-connected death”. It is a benefit for survivors of certain deceased veterans or service members. DIC is potentially payable to surviving spouses, children, and/or dependent parents of the following:
· Service members who die during military service of causes that are not due to the person’s willful misconduct;
· Veterans who die of a service-connected disease or injury;
· Veterans who are former POWs who die after September 30, 1999, and were continuously rated 100 percent for service-connected disabilities for a period of not less than one year immediately preceding death[3].
Disability Compensation – is a monetary benefit paid to veterans with service-connected disabilities. “Service-connected” means that the disability was the result of a disease or injury incurred or aggravated during active military service. To be eligible for disability compensation, the veteran must have been discharged under conditions other than dishonorable and the disability must not have resulted from the veteran’s willful misconduct.
Disability compensation is graduated according to the degree
of the veteran’s disability on a scale from 0 percent disabling to 100 percent
disabling, in increments of 10 percent. Benefits in addition to the 100 percent
disability rate are payable to veterans with extremely severe disabilities such
as the anatomical loss or loss of use of a hand or foot, blindness, or deafness
DVA – The Department
of Veterans Affairs, most commonly referred to as the “VA.”
Disability Pension – A monetary benefit paid to wartime veterans who are age
65 or older, or permanently and totally disabled as the result of a nonservice-connected
disability. In either case, the veteran’s annual income must not exceed the limit set by statute in order to qualify for
this benefit.
Eligibility -- Most VA benefits require that the veteran be discharged
from active military service under any condition other than dishonorable. In
addition to this general requirement, there are specific statutory and
regulatory requirements for each of the benefits programs.
FTE – “Full-time Equivalent”. Can be expressed in years or man hours. In the federal government, a full-time employee is calculated as being hired for 2086 man hours in a year, of which 1776 man hours is actually calculated as effective labor for project management purposes (excludes sick time, holidays, training, etc.). Originally, FTE referred to the authorized position and work time allowed and not an employee. For example, two 1000 FTE hour employees are one FTE position.
FY – Fiscal Year. See Fiscal Year 2002.
Fiscal Year (2002) – a.k.a. FY 2002. The fiscal year beginning October 1,
(2001) and ending September 30, (2002). The Department of Veterans Affairs
operates under this budgetary schedule.
Healthcare Enrollment Priority Groups (a.k.a. Medical Priority Groups) – A simplified definition follows. The Veterans’ Health Care Eligibility Reform Act of 1996 established a national enrollment system to manage inpatient and outpatient care for veterans. The law required that most veterans must enroll to receive care. Veterans who have a service-connected disability rated 50 percent or more or if seeking care for a service connected disability do not have to enroll, although all veterans are encouraged to enroll. The national enrollment system is based on seven groups of patients, with group 1 receiving the highest priority [for enrollment]. Following enrollment, health care service is provided on a first-come, first-served basis, rather than the health care priority groups. Enrollment priority groups are defined in Title 38, Section 1705 as follows. Groups 1 through 6 are considered Category I, “must treat”, if the budget allows (which is incidentally discretionary and not mandatory in the current federal authorization and appropriation system). However, all others are Category II. That means the VA “may treat” in accordance with its capacity or capability.
· Priority Group 1: Veterans with service-connected disabilities rated 50% or greater
· Priority Group 2: Veterans with service-connected disabilities rated 30% or 40%
· Priority Group 3: Veterans who are former prisoners of war, veterans awarded the Purple Heart, veterans who have service-connected disabilities rated 10% or 20%, and veterans who were discharged from active duty due to disability incurred or aggravated in the line of duty, and veterans awarded special eligibility classification under to 38 USC Sec.1151
· Priority Group 4: Veterans in receipt of increased pension benefits based on need of aid and attendance or permanent housebound status and veterans who are catastrophically disabled.
· Priority Group 5: Veterans with nonservice-connected and veterans with noncompensated service-connected conditions who are rated zero percent disabled, and whose income and net worth are below an established threshold.
·
Priority
Group 6: All other eligible veterans who are not required to make
co-payments for their care. This includes: World War I and Mexican Border War
veterans; Veterans solely seeking care for disorders associated with exposure
to a toxic substance, radiation, or for disorders associated with service in
the
· Priority Group 7: Includes Priority Groups (7-1) and (7-2). Veterans with nonservice-connected disabilities and veterans with noncompensated service-connected conditions who are rated zero percent disabled, and who have income or net worth above the statutory threshold and who agree to pay specified co-payments
· Priority Group 8 (added by LVMAC): Veterans with no rating, do not fit in the other above groups, and have the ability to defray the cost of treatment. This group was closed to new accessions on 17 January 2003 for lack of service capacity and congressional budget.
· Priority Group 90: Veteran user not in Enrollment File
Insurance and
Indemnity –
Life Insurance – Government life insurance programs were created to provide life insurance at a “standard” premium rate to members of the armed forces who are exposed to the extra hazards of military service, including deadly hazards of war. Few commercial insurance companies offer insurance that includes coverage against death while in the armed forces. Those that do offer coverage charge a high premium rate because of the additional risk. Members leaving the armed forces are eligible to maintain their VA insurance following discharge. In general, a new life insurance program was created for each wartime period starting with World War I. The various Insurance programs can be conveniently grouped into the following three categories: Matured Insurance Programs, Disabled Veterans Insurance Programs, and Uniformed Services and Post-Vietnam Veterans Insurance Programs.
Major Programs (an Overview):[4]
- Burial: Primarily
through the National Cemetery Administration, VA honors veterans with a final
resting place and lasting memorials that commemorate their service to the
nation.
- Compensation: The
compensation program provides monthly payments and ancillary benefits to
veterans, in accordance with rates specified by law, in recognition of the
average potential loss of earning capacity caused by a disability, disease, or
death incurred in, or aggravated during, active military service. This program
also provides monthly payments, as specified by law, to surviving spouses,
dependent children, and dependent parents, in recognition of the economic loss
caused by the veteran’s death during active military service or, subsequent to
discharge from military service, as a result of a service-connected disability.
- Pension: The pension
program provides monthly payments, as specified by law, to needy wartime
veterans who are 65 years old or who are permanently and totally disabled. This
program also provides monthly payments, as specified by law, to needy surviving
spouses and dependent children of deceased wartime veterans who die as a result
of a disability not related to military service. [Currently Compensation and
Pension programs are grouped under one organizational entity of the VBA to
administer.]
- Education: The
education program assists eligible veterans, service members, reservists,
survivors, and dependents in achieving their educational or vocational goals.
- Housing: The housing
program helps eligible veterans, active duty personnel, surviving spouses, and
selected reservists to purchase and retain homes.
- Insurance: The
insurance program provides veterans, service members, and family members with
life insurance benefits, some of which are not available from other providers
such as the commercial insurance industry due to lost or impaired insurability
resulting from military service. Insurance coverage will be available in
reasonable amounts and at competitive premium rates comparable to those offered
by commercial companies. The program ensures a competitive, secure rate of
return on investments held on behalf of the insured.
- Medical Care: VA meets the health care needs of
- Medical Research: The medical research program contributes to the Nation’s
overall knowledge about disease and disability.
- Vocational Rehabilitation
and Employment: The vocational rehabilitation and employment program
assists veterans with service-connected disabilities to achieve functional
independence in daily activities. It provides the support and assistance
necessary to enable service-disabled veterans to become employable and to
obtain and maintain suitable employment.
- Program Participants: VA
serves a significant portion of the veteran population. In 2002, more than 4.6
million patients used VA healthcare, over 2.7 million veterans and survivors
received monthly VA disability compensation payments, and more than 2.5 million graves of deceased veterans and eligible family
members were maintained at our national cemeteries. The following table
summarizes the number of veterans or dependents who received benefits or
services in each of our major programs during 2002.
Modern Award Processing – Development (MAP-D) – is the replacement for the Claims Automated Processing System (CAPS). It contains records for all cases and reduces manual data entry and the potential for data input errors. When provided to outbased locations, it will expedite and streamline claims processing.
Non-rating actions - average days pending – Elapsed time, in days, from date of receipt of a claim (for which work has not been completed) in the regional office to current date. Non-rating actions include the following types of claims: original death pension, dependency issues, income issues, income verification matches, income verification reports, burial and plot allowances, claims for accrued benefits, and special eligibility determinations. (from DVA P&A Rpt FY02)
Outbase – is a VBA term for a field office, a place of service not located at the Regional Office. Sometimes the term also excludes VAMCs.
Outreach – is a VBA term meaning “the act or process of reaching out in a systematic manner to proactively provide information, services, and benefits counseling to potentially eligible beneficiaries to ensure they are fully informed about and receive assistance in applying for benefits.”[5] It can be done either from a Regional Office or an outbase location. Examples are the Separation Examination Program, the “Benefits Delivery at the Discharge Site” Programs, TAP, and Homeless Veterans Program
Rating-related actions – average days pending – Elapsed
time, in days, from date of receipt of a claim (for which work has not been
completed) in the regional office to current date. Rating actions include the
following types of claims: original compensation, original disability pension,
original DIC, reopened compensation, reopened pension, routine examinations,
and reviews due to hospitalization. (from DVA P&A Rpt FY02)
SDVA – is an acronym meaning State
Department/Division of Veterans Affairs. The DVA commonly uses this acronym
when it wishes to distinguish a state-level governmental veterans’ service
organization from a nonprofit veterans service organization. See Veterans
Service Organization.
State Benefits Reference System – is a comprehensive,
computerized DVA inventory of state veterans benefits. The new State Benefits Reference System
enables front-line VA employees and approved VSOs to link veterans to state
services that can range from special vehicle license plates to personal
property tax exemptions. Accreditation
and TRIP training are required for VSOs.
Training, Responsibility, Involvement, and Preparation of Claims (TRIP) – is a DVA initiative begun in 1998 and intended to expand its partnership with veterans’ service organizations through the training and certification of their VSO to enhance their ability to assist veterans with the claims process. This training occurs subsequent to “accreditation.” The concept is a work in progress: varying from improving and expediting claims submissions to bringing cases to ready-to-rate status by the veterans’ service organizations themselves. A large degree in the success of the program hinges upon outside (outbased) access and the use of the BDN and other VBA information and claims filing system components, but delays have occurred for various reasons beyond the prerequisite of TRIP training. The dissolution of the Veterans Services Division in the 1990’s has caused the DVA to increasingly seek veterans’ service organization assistance at the input stage of claims processing. TRIP formally recognizes that need.
Transition Assistance Program (TAP) – is a workshop with
benefits information and resources for service members who are separating from
the military and transitioning into civilian life. It is authorized by
legislation and jointly implemented by DoD, DOL, and VA as agreed upon in a
memorandum of understanding.
VA – The abbreviation for Veterans Administration,
the predecessor of the Department of Veterans Affairs (DVA). Most veterans and
officials today still refer to the DVA as simply the “VA.”
VBA – The Veterans Benefit Administration,
one of the three major administrations that constitute the Department of
Veterans Affairs. It is the organization that is responsible for veterans’
benefits services less healthcare, the responsibility of the Veterans
Healthcare Administration (VHA) and
cemeteries, the responsibility of the National Cemetery Administration (NCA).
VHA – The Veterans Healthcare
Administration, which is responsible for veterans’ healthcare. The current
drive within the VHA has been outpatient clinics, including creating Community
Based Outpatient Clinics (CBOC), most of which are essentially contracted
offices, a private medical practice of varying but small size. The VHA is
reassessing its workforce and facilities under the Capital Asset Realignment
for Enhanced Service (CARES) program, which is the DVA version of the
Department of Defense Base Realignment and Closure (BRAC) program. It will have
far-reaching effects on future services.
Veteran – A person who served in the active military for a specified period of consecutive days (changes from time to time) and who was discharged or released under conditions other than dishonorable.
Veterans Service Organization (VSO) – In the study the term is used to denote a state, county, or local political entity or a veterans’ organization that provides accredited veterans’ service officers (VSO). It is an organization that represents the interests of veterans. The term is more commonly used to denote a nonprofit, chartered veterans organization such as the VFW or American Legion. Most veterans’ service organizations have specific membership criteria, although membership is not usually required to obtain assistance with benefit claims or appeals. Note that the acronym is used to denote a veterans’ service officer as well.
Veterans Service
Officer (VSO) – At national level, often called a National Service Officer
(NSO) in a veterans organization. See also “Accredited” and “TRIP.” The acronym is also used to denote
“veterans’ service organization”, but will not be used for this purpose in the
study. Their closest equivalent
DVA counterpart is the combining of a veteran service representative on the
Public Contact team with a Pre-determination service officer, both found in the
The following description of a VSO’s duties and
responsibilities was copied and slightly altered from its original form on the
Vietnam Veterans of America, Inc. web site. It provides a fairly complete description
of a VSO’s function. The term VSO includes state, county, local and veteran
organization service officers when accredited. See above for the
definition of “accredited.”
In accordance with 38 CFR 14.629,
after completion of a VA-approved course of instruction and an internship (in
some organizations like the DAV), an organization (recognized by the DVA)
sponsors the individual and sends a request for accreditation to the VA Office
of General Counsel. Upon review the individual is credentialed with a Letter of
Accreditation and receives a pocket card stating the individual is accredited
to do business. The work is then done for the sponsoring organization. The
VSO’s work is mainly with claims and their initial preparation and follow-up,
although he may counsel on a full range of benefits. The veteran applying is
allowed to direct that the claim be forwarded to another veteran organization
for the rest of processing. In either event, the veteran must give the final
processing veteran organization Power of Attorney to act on his behalf before
the VA. Naturally, the VSO tries to direct the business through his sponsoring
organization, since this is the only way to assure a clean chain of custody and
a follow-up mechanism.
Purpose of a VSO: To provide quality advocacy for all US Veterans, Armed Forces members, their dependents and survivors, through benefit counseling and programs, claims, and outreach services. To reach out to all Veterans Organizations, and veterans through traditional public relations, community involvement, and by initiation and implementation of activities that encourage them to access their rightfully earned entitlements and benefits. To respond to the needs of all veterans, armed forces members, and their dependents and survivors; and to provide linkage for them to other support services.
Duties of a VSO:
- Advises and assists veterans or their beneficiaries in presenting claims for benefits under Federal, State or local laws.
- Works in cooperation with the Department of Veterans Affairs, other governmental agencies, his headquarters National Service Officers
- Conducts telephonic communication and/or written correspondence with various Federal, State, County and City Governmental agencies concerning problems or questions on behalf of veterans or their beneficiaries.
- Submits DVA claims to the appropriate DVA Regional Office. Other claims are submitted to the government agencies involved.
- Have a complete working knowledge of DVA requirements concerning the processing of claims for all types of veterans benefits. Must be able to develop a knowledge, where required, to process claims for other governmental benefits.
1. Compensation: (i.e., claims; aggravation; presumptive service connection; rates, etc.)
2. Pension: (i.e., applications; aid and attendance; income restrictions; etc.)
3. Special Service-Connected Benefits: (i.e., automobile; housing; prosthetics, etc.)
4. Medical: (i.e., hospital eligibility categories; nursing home; domiciliary; outpatient; etc.
5. Education: (i.e., vocational rehabilitation; war orphans; dependents; etc.)
6. Life Insurance: (i.e., NSLI; government; conversions; loans; death applications, etc.)
7. Death Benefits: (i.e., widow's pension; DIC, burial; grave marker; National Cemetery; Insurance; burial squad; etc.)
8. GI Loans: (i.e., eligibility; financing; business, etc.)
9. Records:
(i.e.,
- Have a complete working knowledge of other agencies veterans benefits. VSO must be able to develop knowledge to process claims within the following areas:
1. Social Security (SSI)
2.
3. County assessor (tax exemptions)
4. SDI (Job disability)
5. Employment Development Department Jobs for veterans)
6. SBA (business loans)
- Must be familiar with the Freedom of Information and Privacy Acts, and DVA regulations concerning the release of claims information.
Zero (0) Percent Disability – A zero percent disability rating means that a disability exists and is related to the veteran’s service but is not so disabling that it entitles the veteran to compensation payments. Also called a non-compensable disability.
[1]
From the Senate
Democratic Report, “Community-Based Outpatient Clinics in the Veterans Health
Administration, DVA,” 3 May 2001.
[2] 38 U.S.C. 1318
[3] Section
501 of P.L. 106-117 enacted on November 30, 1999.
[4] FY 2002 Performance and Accountability Report,
DVA, pp 15-17.
[5] Statement of Daniel L. Cooper, Under
Secretary for Benefits, before the Senate Committee on Veterans’ Affairs, 10
Jul ’04.