Citation Nr: A21016348 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 200619-95791 DATE: October 5, 2021 ORDER Entitlement to basic eligibility for enrollment in the Department of Veterans Affairs (VA) healthcare system is dismissed. FINDING OF FACT Service connection for tinnitus with a rating of 10 percent was granted in an October 2020 rating decision. CONCLUSION OF LAW The criteria for dismissal of the claim for entitlement to basic eligibility for enrollment in the VA healthcare system have been met. 38 U.S.C. §§ 1705, 1710; 38 C.F.R. §§ 17.36, 20.205. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from October 1962 to September 1967. He had additional reserve service. Entitlement to basic eligibility for enrollment in the VA healthcare system In November 2018 the Veteran completed VA Form 10-10EZ, Application for Health Benefits. He indicated therein that he served in Vietnam between January 9, 1962, and May 7, 1975. Therefore, he did not complete the income section of the form. The Veteran was denied enrollment in the VA healthcare system because he did not complete the income information on VA Form 10-10EZ and the available records did not show that he served in Vietnam. VA shall furnish hospital care and medical services which VA determines to be needed to any veteran for a service-connected disability; and to any veteran who has a service-connected disability rated at 50 percent or more and to other veterans in certain priority categories. 38 U.S.C. § 1710. Generally, a veteran must be enrolled in the VA healthcare system as a condition for receiving VA health care. 38 C.F.R. § 17.36(a). VA determines which categories of veterans are eligible to be enrolled, based upon enumerated priorities; with veterans who do not have any service-connected disabilities assigned the lowest priority. 38 C.F.R. § 17.36(b). VA manages the enrollment of veterans in accordance with the following priority categories, in the order listed: (1) Veterans with a singular or combined rating of 50 percent or greater based on one or more service-connected disabilities or unemployability; and veterans awarded the Medal of Honor. (2) Veterans with a singular or combined rating of 30 percent or 40 percent based on one or more service-connected disabilities. (3) Veterans who are former prisoners of war (POWs); veterans awarded the Purple Heart; veterans with a singular or combined rating of 10 percent or 20 percent based on one or more service-connected disabilities; veterans who were discharged or released from active military service for a disability incurred or aggravated in the line of duty; veterans who receive disability compensation under 38 U.S.C. § 1151; veterans whose entitlement to disability compensation is suspended pursuant to 38 U.S.C. § 1151, but only to the extent that such veterans' continuing eligibility for that care is provided for in the judgment or settlement described in 38 U.S.C. § 1151; veterans whose entitlement to disability compensation is suspended because of the receipt of military retired pay; and veterans receiving compensation at the 10 percent rating level based on multiple noncompensable service-connected disabilities that clearly interfere with normal employability. (4) Veterans who receive increased pension based on their need for regular aid and attendance or by reason of being permanently housebound and other veterans who are determined to be catastrophically disabled by the Chief of Staff (or equivalent clinical official) at the VA facility where they were examined. (5) Veterans who are not covered under categories 1 through 4 but are unable to defray the expenses of necessary care as determined under 38 U.S.C. § 1722(a). (6) Veterans of the Mexican border period or of World War I; veterans solely seeking care for a disorder associated with exposure to a toxic substance or radiation, for a disorder associated with service in the Southwest Asia theater of operations during the Gulf War (the period between August 2, 1990, and November 11, 1998), or for any illness associated with service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998, as provided and limited in 38 U.S.C. § 1710(e); Camp Lejeune veterans pursuant to §17.400; and veterans with 0 percent service-connected disabilities who are nevertheless compensated, including veterans receiving compensation for inactive tuberculosis. (7) Veterans who agree to pay to the United States the applicable copayment determined under 38 U.S.C. § 1710(f) and 1710(g) if their income for the previous year constitutes "low income" under the geographical income limits established by the U.S. Department of Housing and Urban Development for the fiscal year that ended on September 30 of the previous calendar year. For purposes of this paragraph, VA will determine the income of veterans (to include the income of their spouses and dependents) using the rules in §§3.271, 3.272, 3.273, and 3.276. After determining the veterans' income and the number of persons in the veterans' family (including only the spouse and dependent children), VA will compare their income with the current applicable "low-income" income limit for the public housing and section 8 programs in their area that the U.S. Department of Housing and Urban Development publishes pursuant to 42 U.S.C. 1437a(b)(2). If the veteran's income is below the applicable "low-income" income limits for the area in which the veteran resides, the veteran will be considered to have "low income" for purposes of this paragraph. To avoid a hardship to a veteran, VA may use the projected income for the current year of the veteran, spouse, and dependent children if the projected income is below the "low income" income limit referenced above. This category is further prioritized into the following subcategories: (i) Noncompensable zero percent service-connected veterans who are in an enrolled status on a specified date announced in a Federal Register document promulgated under paragraph (c) of this section and who subsequently do not request disenrollment; (ii) Nonservice-connected veterans who are in an enrolled status on a specified date announced in a Federal Register document promulgated under paragraph (c) of this section and who subsequently do not request disenrollment; (iii) Noncompensable zero percent service-connected veterans not included in paragraph (b)(7)(i) of this section; and (iv) Nonservice-connected veterans not included in paragraph (b)(7)(ii) of this section. (8) Veterans not included in the above priority may be eligible for care but only if they agree to pay to the United States the applicable copayment determined under 38 U.S.C. §§ 1710(f) and 1710(g). This required copayment category is further prioritized into the following subcategories: (i) Noncompensable zero percent service-connected veterans who were in an enrolled status on January 17, 2003, or who are moved from a higher priority category or subcategory due to no longer being eligible for inclusion in such priority category or subcategory and who subsequently do not request disenrollment; (ii) Noncompensable zero percent service-connected veterans not included in paragraph (b)(8)(i) of this section and whose income is not greater than ten percent more than the income that would permit their enrollment in priority category 5 or priority category 7, whichever is higher; (iii) Nonservice-connected veterans who were in an enrolled status on January 17, 2003, or who are moved from a higher priority category or subcategory due to no longer being eligible for inclusion in such priority category or subcategory and who subsequently do not request disenrollment; (iv) Nonservice-connected veterans not included in paragraph (b)(8)(iii) of this section and whose income is not greater than ten percent more than the income that would permit their enrollment in priority category 5 or priority category 7, whichever is higher; (v) Noncompensable zero percent service-connected veterans not included in paragraph (b)(8)(i) or paragraph (b)(8)(ii) of this section; and (vi) Nonservice-connected veterans not included in paragraph (b)(8)(iii) or paragraph (b)(8)(iv) of this section. VA will enroll the priority categories of veterans set forth in §17.36(b) beginning June 15, 2009, except that those veterans in subcategories (v) and (vi) of priority category 8 are not eligible to be enrolled. 38 C.F.R. § 17.36(c)(2). Once service connection with a 10 percent rating was granted in October 2020 with an effective date of September 2020, the Veteran met the basic eligibility for enrollment in the VA healthcare system. See 38 C.F.R. § 17.36(b), (c)(2). Therefore, the claim is now moot and is dismissed. See Smith v. Brown, 10 Vet. App. 330, 333-34 (1997) (dismissal is the proper remedy to employ when an appeal has become moot). 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.