Multiple Sclerosis Centers of Excellence
What Are My VA Benefits for Multiple Sclerosis
Marsha L. Tarver, PhD, MA, National Education and Training-Associate Director of Education, MS Center of Excellence, Seattle, WA
Robert M. Baum, VISN Prosthetics Manager, VA Southwest Health Care Network, Mesa, AZ
Veterans Health Administration Benefits for Veterans
Veterans may be eligible for a broad range of programs and services provided by the Department of Veterans Affairs (VA). These programs are based upon enrollment eligibility and discharge status from active military service. There are several categories of eligibility based upon a variety of factors. Some of these factors are related to time of service and priority groups. For example: If you are a Veteran that served in a theater of combat operations after November 11, 1998 you are eligible for an extended period of eligibility for health care for five years post discharge. Enrollment Priority Groups range from 1 – 8, with 1 being the highest priority for enrollment. Priority Group 1 Veteran has service-connected disabilities rated 50% or more. A Priority Group 8 Veteran has a gross household income above the VA national income threshold and the geographically-adjusted income threshold for their resident location, and who agrees to pay co-pays.
VA determines your eligibility for VA’s comprehensive medical benefits package once you enroll through the online application process at www.va.gov/healthbenefits, submission of VA’s Application for Health Benefits (10-10EZ) at a local VA medical facility, or by calling VA at 1-877-222-VETS (8387). If you are already enrolled in VA healthcare, you can update your information online. More detailed information about VA eligibility status is found on the Veterans Health Administration website.
Women Veterans are eligible for the same VA benefits as male Veterans. Their eligibility is based upon the same Enrollment Priority Group process mentioned above. Once eligibility is determined, women Veterans can receive their medical care from specialized Women’s Centers available at each VA Medical Center.
Service-Connected Benefits for Multiple Sclerosis (MS): Service-connected (SC) status refers to Veterans who are disabled by an injury or disease that was incurred or aggravated during active military service. MS is a presumptive condition and benefits are based on the presumption that the disability is service-connected (SC). Veterans with symptoms of MS in the military or within seven years after honorable discharge may be eligible for SC disability.
NonService-Connected Benefits for MS: Nonservice-connected (nonSC) status refers to Veterans who have a disability or health issue that is not related to their military service. Veterans diagnosed with MS after the presumptive period of seven years could be eligible for VA benefits under the nonservice-connected status.
Medical care for eligible Veterans with MS includes disease modifying therapies, other medications, physical and occupational therapy, and other health care services and medical equipment.
Prosthetic and Sensory Aids Service
Veterans with MS are eligible for many services from the Prosthetic and Sensory Aids Service (PSAS) program. The basic eligibility for prosthetic items is enrollment in the VA system and proper medical justification. Service connection does not have a role in eligibility except for certain programs.
PSAS is an integrated delivery system designed to provide eligible Veterans medically prescribed devices such as hearing aids, eyeglasses, speech and communication devices, home dialysis supplies, orthopedic braces/supports/footwear, wheelchairs, home respiratory aids, hospital beds, and other daily-living aids.
Home Improvement Grants
There are several types of grants to make medically necessary home improvements like roll-in showers and widening of doorways. The Home Improvements and Structural Alterations (HISA) program will pay a lifetime benefit up to $6,800 for home alterations for a SC disability and a lifetime benefit up to $2,000 for other Veterans.
- The Specially Adaptive Housing (SAH) grant is generally used to make a home wheelchair accessible and has a maximum of $64,960. The Special Housing Adaptations (SHA) grant is limited to $12,992 and is related to specific losses of hand mobility and blindness. The Temporary Residence Adaptation (TRA) grant is also available.
- Mobility Benefits: It is common for many individuals who have MS to experience changes in their mobility and require different accommodations to help maintain mobility. A consult should be sent to Physical Medicine and Rehabilitation Services (PM&RS) or another appropriate interdisciplinary Mobility Clinic to reevaluate changes in mobility needs such as needing a power chair.
- Driver Rehabilitation: Maintaining independence is important and the VA assists in getting Veterans with disabilities back on the road again. Services include driving assessments and training.
- Modifications: SC Veterans qualify for a one-time automobile adaptive equipment benefit up to $19,505 toward the purchase of an automobile or other conveyance. SC and nonSC Veterans can apply for other vehicle modifications like van lifts.
- Clothing Allowance: SC Veterans may receive an annual monetary allowance for clothing that has been damaged by prosthetic or orthopedic appliances up to $753.
The typical medication prescription co-pay is $8 per prescription for a 30-day supply. Depending upon eligibility status co-pays can be waived.
Aid and Attendance
Veterans and survivors who are eligible for a VA pension and require the aid and attendance of another person, or are housebound, may be eligible for additional monetary payment.
Mental Health Services
All mental health services provide support and focus on recovery. VA works with Veterans to meet a variety of mental health needs. Eligible Veterans can receive services that include medications, counseling, and other mental health therapies. Visit the Mental Health website to take anonymous self-guided screening tools for depression, PTSD, alcohol and drug abuse/dependence and to find support services to address these problems. www.mentalhealth.va.gov
The VA recognizes the importance of supporting family caregivers and provides a temporary relief benefit for unpaid caregivers. The family caregiver can relax and renew while the Veteran receives respite care in their homes or at a VA facility. If a Veteran requires a caregiver then they could be eligible for up to 30 days of respite care a year.
In summary, the VA offers a variety of medical and support services and programs for people with MS. It is important to contact your local VA medical center social work department and review your eligibility for the benefits discussed. The VA provides Patient Advocates to help with this process and you can always contact one of the Veterans Service Organizations like Paralyzed Veterans of America, United Spinal and Disabled American Veterans for additional support. The VA is committed to work with Veterans and their families toward a better quality of life.
Updated: June 2013