Citation Nr: 20004111 Decision Date: 01/16/20 Archive Date: 01/16/20 DOCKET NO. 19-19 504 DATE: January 16, 2020 REMANDED Whether the change in the Veteran's means test eligibility category from copay exempt to copay required in the VA healthcare system for income year 2017 was proper is remanded. REASONS FOR REMAND The Veteran had active service from November 1972 to August 1976. Income Verification Match (IVM) is a secure procedure by which VA may obtain income information from the Social Security Administration and the Internal Revenue Service (IRS), in order to verify income amounts that are reported to VA. The adjudication of this matter involves information provided by SSA and the IRS for 2017. However, to avoid disclosure of sensitive information, the Board’s decision does not directly cite dollar amounts included in any IVM report that has not been verified by the Veteran. Therefore, the text of this decision is not subject to the additional protections required under the IVM procedures. Whether the change in the Veteran's means test eligibility category from copay exempt to copay required in the VA healthcare system for income year 2017 was proper is remanded. VA shall furnish hospital care and medical services to any veteran who is unable to defray the expenses of necessary care. 38 U.S.C. §§ 1710(a)(2)(G). For the purposes of 38 U.S.C. § 1710(a)(2)(G), a veteran shall be considered to be unable to defray the expenses of necessary care if his attributable income is not greater than a specified income threshold, which is updated annually. 38 U.S.C. § 1722 (a)-(c). If a veteran does not qualify under 38 U.S.C. § 1710(a)(2)(G), he or she will be responsible for a copayment for VA healthcare services that relate to nonservice-connected disabilities. The summary of evidence in the April 2019 statement of the case indicates that on March 8, 2019, the Veteran submitted HEC Form 200-1A, signed and dated February 19, 2019, and HEC Form 220-1, signed and dated February 18, 2019. The record does not contain these documents. These missing documents must be associated with the claims file before the claim is decided on the merits. The record includes a VA Form 10-10EZ, Health Benefits Update Form, signed by the Veteran on February 24, 2018. The Veteran listed income and medical expenses for 2017, but then crossed out those entries and wrote “N/A.” On remand, the Veteran should also be asked to submit clarification regarding his 2017 income and medical expenses. The matters are REMANDED for the following action: 1. Associate with the claims file HEC Form 200-1A signed and dated on February 19, 2019, and HEC Form 220-1 signed and dated on February 18, 2019. 2. Request that the Veteran clarify his report regarding the 2017 income of the Veteran and his spouse, and medical expenses for 2017. Notify the Veteran that he may submit additional documents or reports regarding his 2017 income and expenses, including tax forms and medical expenses. 3. If the signed HEC Form 200-1A and signed HEC Form 220-1 cannot be obtained and associated with the Veteran’s claims file, and further attempts to obtain these records would be futile, the Health Eligibility Center must note such unavailability in a Memorandum of Unavailability and associate it with the claims file. 4. Thereafter, readjudicate the claim. If the benefit sought is not granted, the Veteran should be furnished an appropriate supplemental statement of the case, provided an opportunity to respond, and the claim should then be returned to the Board as warranted. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Scott Shoreman, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.