Citation Nr: 21028707 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 19-07 896 DATE: May 11, 2021 ORDER The change in the Veteran's means test category from copay exempt to copay required for income year 2016 was improper, and the appeal is granted. FINDING OF FACT 1. The Veteran's attributable household income for 2016 exceeded the VA National Means Test threshold by approximately $2,500. 2. The Veteran's household income for 2017 was substantially less than the VA National Means Test threshold. 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, 17.47. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from June 1982 to May 1988. 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 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 or she 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, that threshold was $32,074 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. § 3.372. See 38 C.F.R. § 3.371. The exclusions do not include retirement benefits under any circumstances. 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. 38 U.S.C. § 1722(f)(1), (3); 38 C.F.R. § 17.47(d)(4). The IVM report for 2016 shows that the Veteran's income was approximately $2,500 above the National Means threshold for a veteran with no dependents. His income included a distribution from a retirement account. Without that distribution, his income would have been below the threshold by thousands of dollars. The Veteran wrote in November 2018 that had to use some of his retirement account to pay off bills. He went for oncology treatment every six to eight weeks, and his vacation pay was used up after he had been out of work for three months because of that. In addition, he had upcoming knee surgery, which would cause him to be out of work for six weeks. Finally, the Veteran wrote that he had not received a raise in two years. It appears from the Veteran's statement that he only took distributions from his retirement account when necessary to pay bills. Furthermore, without such a distribution, the Veteran's income for 2017 was likely substantially below the National Means threshold. Consequently, to avoid hardship, the Board finds that the Veteran should not be assigned a copayment in conjunction with VA health care for income year 2016, and the Veteran's claim on appeal should therefore be granted. 38 U.S.C. § 1722(e); 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.