Citation Nr: 21064627 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 19-11 955 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 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 $38,489 for a veteran with one dependent. 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 January 1981 to January 1985. This claim was previously before the Board in November 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. 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 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 $38,489 for a veteran with one dependent. 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). (Continued on the next page) The IVM reports show that the income of the Veteran and his spouse for 2016 was approximately $28,000 above the National Means Test. The Veteran returned a signed form in October 2018 indicating that he agreed with the income from the IVM reports and was providing evidence of deductible expenses. He wrote in November 2018 that he had a retirement account that he converted to an IRA in 2016 so as to not incur a tax penalty upon the company that held the account announcing that they would no longer service it. This was included in the 2016 income. In February 2019 the Veteran wrote that the amount from that account was $24,519. It is noted that even if that amount is excluded, the 2016 income is still above the National Means Test. The Veteran also wrote in November 2018 that he and his wife had recently been diagnosed with cancer. He provided documentation from 2018 related to their current finances. While the Board is sympathetic towards the Veteran, the record shows that the 2016 income was above the National Means Test. 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). TRACIE N. WESNER Acting 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.