Citation Nr: 21061317 Decision Date: 10/01/21 Archive Date: 10/01/21 DOCKET NO. 19-04 387 DATE: October 1, 2021 ORDER The change in the Veteran's means test eligibility category from copay exempt to copay required for income year 2016 was proper, and the claim is denied. FINDING OF FACT The Veteran's attributable household income for the year 2016 exceeded the VA National Means Test threshold of $40,694 for a veteran with two dependents. CONCLUSION OF LAW The criteria for treatment without a copay in the VA healthcare system for income year 2016 have not been met. 38 U.S.C. §§ 1710, 1722; 38 C.F.R. §§ 3.271, 3.272, 17.36, 17.47. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from April 1976 to April 1979. This claim was previously before the Board in October 2019, at which time the Board remanded it for additional development. The requested development has been completed, and the claim is properly before the Board for appellate consideration. Income Verification Match (IVM) is a secure procedure by which VA may obtain income information from the Social Security Administration (SSA) 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 2016. 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 or his spouse. 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 for income year 2016 was proper 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 will be responsible for a copayment for VA healthcare services that relate to nonservice-connected disabilities. The Means Test income threshold is updated annually and published in the Federal Register. See 38 C.F.R. § 3.29. For the year 2016, the National Means Test threshold was $40,694 for a veteran with two dependents. The 2017 tax return submitted by the Veteran shows that he is married and has a child he claimed as a dependent. The spouse and child will be considered dependents for VA purposes for 2016. The Veteran also claimed a grandchild as a dependent on his 2017 taxes. The record does not show that the Veteran has adopted his grandchild, and therefore she may not be considered a dependent for VA purposes. See 38 U.S.C. § 101(4)(A). Determinations with respect to attributable income shall be made in the same manner, including the same sources of income and exclusions from income, as determinations with respect to income that are made for assessing eligibility for pension under 38 C.F.R. §§ 3.271 and 3.272. Payments from any source shall be counted as income during the 12-month annualization period in which received unless specifically excluded under 38 C.F.R. § 3.272. See 38 C.F.R. § 3.271. The term "attributable income" means income for the calendar year preceding application for care, determined in the same manner in which an income determination is made for pension purposes under 38 U.S.C. § 1521. See 38 U.S.C. § 1722(f)(1), (3); 38 C.F.R. § 17.47(d)(4). The Veteran is enrolled in the VA healthcare system. The IVM reports show that the income of the Veteran was approximately $14,000 greater than the National Means Test for a veteran with two dependents. The Veteran wrote in May 2018 that the income information from the IVM report includes overtime pay and money withdrawn from a retirement account. There is no exclusion for such income for VA purposes, and therefore it is proper to include it in the Veteran's income. See 38 C.F.R. § 3.272. The Veteran also wrote that he paid approximately $6,000 in child support. Child support payment are not deducted from income for VA purposes, and the Veteran's child has been included as a dependent herein. See id. The record does not show that the income from the 2016 IVM reports was incorrect or that there are exclusions from income for VA purposes that brings the income below the National Means Test. (Continued on the next page) Because the evidence preponderates against the claim, the benefit of the doubt doctrine is inapplicable, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). H.M. WALKER 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.