Citation Nr: 21064609 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 19-19 504 DATE: October 21, 2021 ORDER 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, and the appeal is denied. FINDING OF FACT The Veteran's attributable household income for the year 2017 exceeded the VA National Means Test threshold of $39,259 for a veteran with one dependent. CONCLUSION OF LAW The criteria for treatment without a copay in the VA healthcare system for income year 2017 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 duty in the Air Force from November 1972 to August 1976. The issue was previously remanded by the Board of Veterans' Appeals (Board) in January 2020 for additional development and readjudication. The requested development has been completed and the claim is properly before the Board for appellate consideration. Additionally, the Veteran wrote on his May 2019 substantive appeal that he was charged for backpay of VA medical expenses of $640 and that due to his current financial situation, payment of the debt would cause undue hardship. In May 2020, the Veteran submitted a letter to VA Health Eligibility Center that he had paid the $640 in full, and had he simply waited, then his debt would have been suspended as part of VA's COVID-19 debt relief package. The Veteran stated that he wished to change his current appeal to receive a refund of the $640 as he remains on a limited income. This claim has not yet been adjudicated by the Agency of Original Jurisdiction (AOJ). As the Board is required to refer to the AOJ for adjudication in the first instance, the Board refers this claim to the AOJ. 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 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 2017, the National Means Test threshold was $39,259 for a veteran with one dependent. For 2017, the Veteran had one dependent, his spouse. 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 and his spouse for 2017 was approximately $9,300 greater than the National Means Test for a veteran with one dependent. The Veteran does not dispute that the assessed income for him and his spouse for income year 2017 is incorrect. In his February 2019 NOD, the Veteran explained that that his appeal was not based on his previous income but the income as of the date of letter. The Veteran stated that he retired in February 2019. The Veteran wrote that upon retiring, the Veteran and his wife relied solely on his monthly Social Security benefit for income, which was a reduced amount from when he was employed. The Board acknowledges that the Veteran's monthly income was reduced upon his retirement in February 2019. Unfortunately, the income year in question is solely for 2017 and therefore, the attributable income for the calendar year preceding application is the evidence considered when determining this appeal. See 38 U.S.C. § 1722(f)(1), (3); 38 C.F.R. § 17.47(d)(4). Because the Veteran's income for 2017 was above the National Means Test according to how VA calculates income, he is not exempt from copayments in the VA healthcare system for 2017. See 38 U.S.C. §§ 1710(a)(2)(G). In conclusion, as 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). TRACIE N. WESNER Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Lee 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.