Do you qualify for veterans benefits? There are several factors that apply for those with questions about their eligibility.

A veteran with an honorable discharge qualifies, at the very least, for consideration when it comes to most federal benefits. But others in different circumstances may or may not qualify for veterans benefits depending on the nature of their circumstances.

Who Does Not Qualify For Veterans Benefits

Most anticipate that this section deals with people who left military service with discharges not characterized as Honorable. Believe it or not, even those with Dishonorable discharges may qualify for certain VA benefits, but definitely not all.

There is only one category of military service that does NOT qualify for veteran benefits across the board. That category is made up of those who did not complete basic training, troops who washed out of advanced training, etc.

Sometimes those who make it a bit farther along in the process but are ultimately released from their military obligations due to issues such as failure to adapt to a military training environment, etc.

In other words, those who do not make it past the initial training phase and wind up back in civilian life are not considered veterans and do not qualify for veteran benefits.

You must graduate basic training and meet the DoD standards for advanced training, OJT, or other requirements and be assigned to your first duty station as a “permanent party” member of that branch of service.

Do You Qualify For Veteran Benefits?

There are some basic types of applicants for certain veteran benefits:

• Servicemembers
• Veterans
• Dependent spouses
• Military spouses
• Veteran spouses
• Dependent children

Benefits for veterans are not necessarily offered to dependents, but there are several categories where they are provided. What follows is a list of common benefits, and who generally qualifies. Federal benefit rules are subject to change, what is found here is current at press time but always contact a VA representative to learn what the latest rules and requirements are.

Veterans Hiring Preference for Federal Jobs

Veterans with honorable discharges are offered hiring preference for federal jobs. Some family members may also be entitled to this preference depending on circumstances.

FedsHireVets.gov discusses something called Derived Preference which is a benefit for spouses, surviving spouses, and parents of a veteran who “may be eligible to claim veterans’ preference when the veteran is unable to use it,” adding that both parents and spouses may qualify for that preference at the same time under the right circumstances.

VA Home Loan Benefits

VA home loan benefits include a no-money-down mortgage with no VA-required mortgage insurance and no VA-required minimum FICO score.

The VA official site lists the criteria for VA home loan benefits which include a minimum time in uniform. This requirement varies depending on when you joined the military. Veterans who served the minimum time qualify for the VA loan program regardless of whether they are still serving or not.

VA literature reminds that to qualify for VA benefits, “the Veteran’s character of discharge or service must be under other than dishonorable conditions.”

Dependents are generally not entitled to VA home loan benefits. There is an exception for certain qualifying surviving spouses of military members who have died as a result of military service. These benefits must be applied for by the surviving spouse and are not automatic.

GI Bill Benefits / VA Education Benefits

This section can be confusing for those new to veteran benefits programs. For GI Bill benefits, there is a requirement that the applicant have an Honorable Discharge. Post 9/11 GI Bill benefits can be used by a veteran or currently serving military member.

They can be transferred to dependents including spouses and college-age children, but only while the service member is on active duty. Doing so requires a revised service commitment and you must serve a minimum time on active duty.

Other VA educational benefits programs such as Survivors’ and Dependents’ Educational Assistance simply require the veteran’s discharge be anything other than Dishonorable.

VA Insurance Benefits

VA life insurance is provided specifically for the veteran. There is no discharge requirement for VGLI or Veterans Group Life Insurance. Service Disabled Veterans Life Insurance and Veterans Mortgage Insurance, no Dishonorable discharges are allowed.

VA Disability Compensation

VA disability pay itself is reserved for veterans. You must file a claim for service-connected medical conditions as part of your discharge process or shortly afterward, and the VA has the final determination as to what will be compensated, how, and for how long. Spouses and dependents do not qualify for this compensation.

That said, the VA official site reminds dependent spouses and children, “In certain cases, you may also qualify for health care benefits due to a disability related to your Veteran’s service”. Military members who qualify for VA compensation for their medical issues may also be entitled to additional financial consideration if they have a severely disabled spouse. This is handled on a case-by-case basis and is not automatic.

Primary caregivers including family members may qualify for VA disability benefits relating to the care of a disabled veteran.

VA Disability Pension

Anything other than a Dishonorable discharge qualifies a veteran to be considered for VA pension benefits and services.

The VA Disability Pension is a benefit paid to wartime veterans with limited income who are no longer able to work. In this case, “wartime” includes the Gulf War era which began on August 2, 1990 and has no end date at the time of this writing.

You may be eligible for a VA disability pension if you served 90 days or more of active duty with at least one day of military service during a wartime period. However, those who serve today generally have to be on duty for 24 months or “the full period for which a person was called or ordered to active duty”.

Other qualifying criteria include being permanently and totally disabled or being age 65 or older with family income below a federal cap. Those without military discharges (civilian spouses, dependents) are not eligible to receive this specific VA benefit.

VA Medical Care

In general, a veteran must have any military discharge other than dishonorable conditions to qualify for VA health care. However, some veterans with Dishonorable discharges may still qualify. The VA will make a determination based on your application.

VA health care is limited in part by budgetary issues. To mitigate this, the VA established priority groups who would receive VA health care first, and who would fall in line behind them. You must apply for health care benefits to be considered, there is no automatic process.

Dependents and spouses may qualify for certain VA health care benefits. They include, but are not limited to:

• Spouse
• Surviving spouse
• Dependent child
• Family caregiver

TRICARE

Qualifying family members of active-duty, retired, or deceased service members including Guard and Reserve members may qualify for TRICARE. These may include, but are not limited to:

• Survivors
• Former spouses
• Medal of Honor recipients and their families

TRICARE offers health coverage for those with special needs.

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Current spouses, surviving spouses, and children of qualifying deceased veterans or veterans with disabilities who do not qualify for TRICARE may still qualify for health insurance through CHAMPVA. This is a cost-sharing program.

The Camp Lejeune Family Member Program

Those who lived on U.S. Marine Corps Base Camp Lejeune or Marine Corps Air Station with an active-duty spouse or parent for “at least 30 cumulative days from August 1953 through December 1987” may qualify for medical conditions related to contaminated drinking water in those areas.

If you have a medical condition associated with this contaminated water issue, you may qualify for VA health care benefits.

The Spina Bifida Health Care Benefits Program

“Biological children” of Korean War or Vietnam War veterans diagnosed with spina bifida may qualify for VA health care and disability benefits.

Children of Women Vietnam Veterans Health Care Benefits Program

Children of veterans of the Vietnam War diagnosed with “certain birth defects” may qualify for VA health care related to “covered birth defect and related medical conditions” according to VA.gov.

Pharmacy Benefits

For those who qualify for CHAMPVA, Spina Bifida, and Children of Women Vietnam Veterans programs, may qualify for VA prescription benefits.

Burial in a VA National Cemetery

VA national cemetery burial benefits depend on the nature and duration of military service. A veteran who dies on active duty is eligible. So are those who served a minimum amount of time-in-service, those who have any discharge besides Dishonorable, and qualifying family members.

The VA official site states that VA burial benefits include “burial with the Veteran, perpetual care, and the spouse or dependents name and date of birth and death will be inscribed on the Veteran’s headstone, at no cost to the family” according to the VA official site.

Military Funeral Honors

Funeral honors are separate from VA National Cemetery criteria, since all eligible veterans qualify for DoD-provided military funeral ceremonies including flag presentation, the playing of Taps, etc. Funeral honors such as these are offered for the servicemember.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News

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The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health benefits program in which the VA shares the cost of covered health care services and supplies.

When you separate from the military, you normally lose your spouse’s TRICARE coverage. Unfortunately, civilian health insurance can cost thousands of dollars per year – or more. This reality makes securing coverage for your spouse a key priority for separating service members. Fortunately, a low-cost option exists for the spouses of some disabled veterans: CHAMPVA. As such, we’ll use this article to explain how to get health insurance for spouses of disabled veterans with CHAMPVA.

Specifically, we’ll discuss the following:

• CHAMPVA Overview
• Who Qualifies for CHAMPVA?
• Out-of-Pocket Costs with CHAMPVA
• Applying for CHAMPVA Health Insurance
• Final Thoughts

CHAMPVA Overview

Generally speaking, only active-duty and retired service members and their families have access to TRICARE, the Department of Defense’s health insurance program. But, what about veterans who separated before full retirement? These individuals and their families don’t qualify for TRICARE. Without access to this program, veterans potentially need to pay thousands of dollars to get health insurance for their spouses and children. Fortunately, CHAMPVA solves this problem for the families of some disabled veterans.

CHAMPVA stands for the Civilian Health and Medical Program of the Department of Veterans Affairs. The program offers health insurance for qualified family members of disabled veterans. More precisely, CHAMPVA covers the cost of some health care services and supplies for enrolled members, a system known as cost sharing.

CHAMPVA Benefits & Covered Services

As a CHAMPVA beneficiary, the program will cover health services and supplies when the VA determines that they were A) medically necessary, and B) received from an authorized provider. This begs the question, what’s an authorized provider? According to the VA, any medical providers performing services within the scope of their license or certification qualify as authorized providers.

Services covered by CHAMPVA include:

• Ambulance service
• Ambulatory surgery
• Durable medical equipment (DME)
• Family planning and maternity
• Hospice
• Inpatient services
• Mental health services
• Outpatient services
• Pharmacy (prescription medicines)
• Skilled nursing care
• Transplants

How Does CHAMPVA Differ from VA Health Care for Disabled Veterans?

The answer to this revolves around who receives service. As a disabled veteran, you’ll personally qualify for health care services provided by the VA. But, this doesn’t mean your spouse or children qualify for VA healthcare.

CHAMPVA provides health insurance coverage for spouses and children of disabled veterans – not the veterans, themselves.

Who Qualifies for CHAMPVA?

To qualify for CHAMPVA, you cannot also be eligible for TRICARE. After confirming someone doesn’t qualify for TRICARE, CHAMPVA provides coverage to the spouse or widow(er) and children of a veteran who:

• Is permanently and totally disabled (P&T) because of an adjudicated service-connected disability, or
• Died as a result of an adjudicated service-connected disability or who at the time of death was rated P&T, or
• Died while in an active duty status and in the line of duty, not due to misconduct. The term “active duty” may include periods of inactive duty for training.

NOTE: In most situations, family members in this final category will qualify for TRICARE.

Out-of-Pocket Costs with CHAMPVA

Generally, CHAMPVA will pay health care providers the associated Medicare / TRICARE rates. This means that, if civilian providers accept one of these plans, they’ll likely also accept patients with CHAMPVA coverage. But, CHAMPVA beneficiaries need to understand the out-of-pocket costs for this service.

In the military, TRICARE coverage means no payments. That is, if you go to a base clinic for treatment of an illness or injury, you don’t receive a bill. With most civilian health insurance plans, beneficiaries need to pay something (e.g. deductibles, co-pays, etc.) when they receive medical service, with insurance paying the remainder. CHAMPVA falls into this category.

CHAMPVA has two types of out-of-pocket costs:

1) An outpatient deductible ($50 per person up to $100 per family per calendar year)

NOTE: No deductible requirement exists for inpatient hospital services, ambulatory surgical centers, psychiatric partial hospitalization programs, hospice, services provided through VA facilities, or for medication received through the Meds by Mail program.

2) A cost share up to 25% of the catastrophic medical treatment cap (up to $3,000 per calendar year)

NOTE: No cost share requirement exists for hospice, services received at VA facilities, or medications obtained through the Meds by Mail program.

This is the maximum out-of-pocket expense a family can incur for CHAMPVA-covered services and supplies in a calendar year. Once you meet this limit, CHAMPVA pays 100% of the allowable amount for covered services for the remainder of the calendar year.

In other words, CHAMPVA beneficiaries won’t need to pay more than $3,100 for covered medical services in a given calendar year. While this may seem like a lot of money, medical treatments can total tens to hundreds of thousands of dollars. CHAMPVA coverage protects beneficiaries from these astronomical costs.

Applying for CHAMPVA Health Insurance

If you, your spouse, and – potentially – children meet the above requirements, you can apply for CHAMPVA health insurance by submitting the following forms:

• Application for CHAMPVA Benefits (VA Form 10-10d) (PDF), and
• Other Health Insurance Certification (VA Form 10-7959c)

However, you only need to submit the second form if the CHAMPVA applicant currently has another type of health insurance coverage (e.g. an employer-sponsored plan). You do not need to stop this additional coverage to apply for and use CHAMPVA.

If applying for CHAMPVA coverage for children of veterans, you’ll also need to submit:

• A copy of each child’s birth certificate or adoption papers
• If aged 18 – 23, a school certification of full-time enrollment

Technically, you don’t need to submit anything else with your CHAMPVA application. But, to significantly speed up the process, you should also include copies (not originals) of the following documents. If you don’t, the VA will need to independently verify this information with other federal agencies, potentially adding months to your application timeline.

• The VA letter reflecting the veteran’s permanently and totally disabled status (you can access these forms online via eBenefits)
• If the veteran is deceased, his or her death rating
• The veteran’s DD-214 (Certificate of Release of Discharge from Active Duty)

What Happens Next?

Once you submit your application and supporting documentation, the VA will review it for completeness and accuracy. If there are any issues, the application will be returned to you with further instructions. This only delays the process, so before submitting your application, make sure you’ve A) reviewed it for completeness, and B) signed in all required fields.

Once the VA receives the completed application, it typically takes around six weeks to fully process. After that time, you will receive a package from the VA including the beneficiary’s CHAMPVA ID card and informational material. This ID card serves as a beneficiary’s proof of insurance.

Final Thoughts

Separating from military service, the cost of civilian healthcare can be a nasty surprise for veterans. Fortunately, CHAMPVA offers spouses and children of certain disabled veterans a low-cost option for quality health insurance coverage.

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Maurice “Chipp” Naylon spent nine years as an infantry officer in the Marine Corps. He is currently a licensed CPA specializing in real estate development and accounting.

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What kind of VA disability rating is possible for sleep apnea? This is a condition that, like all other VA-compensated disabilities, must have an established connection to military service in order to get an award for VA disability compensation.

Service-connected medical issues including sleep apnea may be deemed to be directly caused by military service, there may be a “presumptive” condition that includes sleep apnea, or you may experience sleep apnea as a secondary condition associated with some other VA rated issue.

The key is to understand how the VA defines sleep apnea, and under what conditions it may justify a VA disability percentage rating.

Sleep Apnea Basics

In general, sleep apnea is medically defined as a sleep disorder where breathing stops and starts, which can result in feeling tired even after a full night’s sleep. There are three basic types of sleep apnea recognized by medical authorities including the Mayo Clinic. These include:

• Obstructive sleep apnea
• Central sleep apnea
• Complex sleep apnea syndrome (which includes symptoms of both the other types above)

Obstructive sleep apnea is a common form of the problem, which occurs during sleep when the throat muscles relax and cause snoring, which can be disruptive to sleep patterns overall.

Central sleep apnea is a problem that involves the brain not sending the right signals during sleep to control breathing. Complex sleep apnea combines symptoms of the other two versions of the condition and is generally the more severe form.

To treat sleep apnea, a sleep study is usually required to properly diagnose the problem, and the use of external equipment known as a CPAP machine. CPAP, also known as a continuous airway pressure machine, helps keep the airway open during sleep to prevent sleep disturbances caused by sleep apnea.

Symptoms of Sleep Apnea

How do you know if you have a potential problem in this area? There are multiple symptoms to pay attention to. Remember that not all symptoms are automatically an indication of a medical problem, but they are worth paying attention to for future reference if you have some of the more benign types.

Don’t forget the power of a spouse, partner, roommate, or other housemates to give you information that could help your decision making about addressing this issue–if someone else tells you that you’ve been snoring or experiencing other sleep disturbances, take such reports seriously and consider having those observations committed to writing for your future claim’s sake.

Symptoms of sleep apnea include:

• Snoring
• Interrupted or stopped breathing during sleep
• Gasping for air during sleep
• Awakening with a dry mouth
• Morning headache
• Insomnia or difficulty remaining asleep
• Excessive daytime sleepiness, AKA hypersomnia
• Difficulty paying attention due to sleep deprivation
• Irritability due to insomnia or lost sleep

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How The VA Rates Sleep Apnea

There are several categories under which sleep apnea may be defined during a VA review of your health to determine what conditions you may have and which are considered by the VA to be service-connected. They include:

• Conditions that require a tracheostomy due to “chronic respiratory failure with carbon dioxide retention” or “cor pulmonale”
• Conditions that require the use of a breathing assistance device such as a CPAP machine
• Persistent day-time hypersomnolence
• Asymptomatic but with documented sleep disorder-type breathing

These ratings range from 100% disability (possible in cases where a chronic respiratory failure is documented)  all the way down to 0% (possible in cases where the patient is asymptomatic but with documented sleep disorder breathing).

The breakdown is as follows–remember that the VA rates all such cases individually but using a guide to qualifying conditions that include:

• 100 percent VA rating: awarded in cases of “chronic respiratory failure with carbon dioxide retention or cor pulmonare, or; requires tracheostomy”
• 50 percent rating: awarded in cases where the use of a CPAP machine is required
• 30 percent rating: awarded for persistent day-time “hypersomnolence”
• 0 percent rating: awarded for asymptomatic sleep apnea with documented sleep disorder breathing

Sleep Apnea And Military Service Connections

The key in getting a VA disability rating for sleep apnea involves establishing that military service caused the problem.

But in cases where you may not be able to establish a direct link between military service and the condition it may be possible that it is due to the effects of a different service-connected medical issue.

For example, PTSD is said to aggravate sleep disorders or introduce them; veterans suffering from Gulf War Syndrome or other Gulf War-related conditions may also suffer from sleep apnea as a result.

How do you establish that sleep apnea is service-connected? If the first appearance of the problem occurs in your military medical records as opposed to being a pre-existing condition, that may be a step toward a VA disability rating.

Any military member experiencing sleep disorders should, in anticipation of needing this data at a later date, request a sleep study to be done in a military medical facility where possible to establish whether or not there is a service connection to the sleep issues.

You can also see a civilian medical provider to get supporting documentation of a service-connection for sleep apnea. The key will be having as much of the issue medically documented while still serving as possible and getting supporting medical opinions in addition to whatever treatment or study of your sleep issues happen while you are still serving.

If your sleep apnea is a recent development (even if it was not present or perceived to be present during your military service) it is still important to get the sleep study, have your results evaluated, and get supporting documentation to help your claim. It’s best to use both VA and military healthcare options AND any supporting evidence from private or civilian healthcare sources.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News

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