Citation Nr: 21028700 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 10-40 246 DATE: May 11, 2021 ORDER The change in the Veteran's means test eligibility category from copay exempt to geographic means test copay required in the VA healthcare system for income year 2007 was improper, and the appeal is granted. FINDING OF FACT 1. The Veteran's attributable household income for the year 2007 exceeded the VA National Means Test threshold of $28,429 for a veteran with no dependents. 2. Giving the benefit of the doubt to the Veteran, his household income for 2008 was substantially less than the VA National Means Test threshold. CONCLUSION OF LAW The criteria for treatment without a copay in the VA healthcare system for income year 2007 have been met. 38 U.S.C. §§ 1710, 1722, 5107(b); 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 March 1952 to March 1956. The Veteran requested a hearing on his August 2010 appeal to the Board (VA Form 9) at a local VA office before a Veterans Law Judge. Since this decision is a complete grant of the benefits sought on appeal, the Board may proceed without the Veteran being scheduled for the requested hearing. 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 2007. 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 geographic means test copay required in the VA healthcare system for income year 2007 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 U.S.C. § 1722; 38 C.F.R. § 17.36. For the year 2007, the National Means Test threshold was $28,429 for a veteran with no dependents. 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 IVM reports show that the Veteran's income for 2007 was approximately $5,000 greater than the National Means Test for a veteran with no dependents. His income was below the geographic means test of $36,050 for a veteran with no dependents for where the Veteran lived. 38 C.F.R. § 17.36(b)(7). Therefore, the Veteran was required to pay copayments at the reduced geographic means test rate based on his 2007 income. See id. The IVM report shows that the Veteran had approximately $6,500 of income from unemployment benefits. This could not be expected to recur in 2008. Without this income, the Veteran's income for 2008 was likely below the National Means Test. Furthermore, approximately $10,000 of the Veteran's 2007 income was from working, and based on his receipt of unemployment benefits, it is not clear that he was still employed at the end of 2007. (Continued on the next page) Under the benefit of doubt, to avoid hardship, the Board finds that the Veteran should not be assigned a copayment in conjunction with VA health care for income year 2007, and the Veteran's claim on appeal should therefore be granted. 38 U.S.C. §§ 1722(e), 5107(b); 38 C.F.R. § 17.47(d)(6). 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.