Citation Nr: 21076561 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 19-00 566A DATE: December 27, 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 improper, and the appeal is granted. FINDING OF FACT The Veteran's attributable household in 2016 did not exceed the VA National Means Test threshold of $38,489 for a veteran with one dependent. CONCLUSION OF LAW The criteria for treatment in the VA healthcare system without a copayment requirement for income year 2016 have 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 October 1965 to September 1967. The Veteran testified before the undersigned Veterans Law Judge at a videoconference hearing in May 2021. A transcript is of record. 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 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). The Veteran is enrolled in the VA healthcare system. In the decision on appeal, his copay exempt status was changed from copay exempt (Priority Group 5) to copay required (Priority Group 8). This was based on the IVM reports showing income that was above the National Means Test threshold for a veteran with no dependents. However, the record shows that the Veteran is married. At the May 2021 hearing, the Veteran testified that he had been married for over 50 years. In addition, VA treatment records that have been associated with the record beginning from May 2018 contain notations of the Veteran having a spouse, as does the personal information in the claims file for this claim. Therefore, the record shows that the Veteran has one dependent, his spouse, for VA purposes. The IVM reports show income for 2016 that is approximately $1,000 below the National Means Test threshold of $38,489 for a veteran with one dependent. Accordingly, the Board finds that 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 improper, and the appeal is granted. JOHN Z. JONES 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.