Citation Nr: 21042018 Decision Date: 07/11/21 Archive Date: 07/11/21 DOCKET NO. 19-36 413 DATE: July 11, 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 2017 was proper, and the claim is denied. FINDING OF FACT The Veteran's attributable household income for the year 2017 exceeded the VA National Means Test threshold of $39,259 for a veteran with one dependent. CONCLUSION OF LAW The criteria for treatment without a copay in the VA healthcare system for income year 2017 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 December 1962 to September 1964. 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 2017. 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 or his spouse. 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 2017 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 2017, the National Means Test threshold was $39,259 for a veteran with one dependent. For 2017, the Veteran had one dependent, his spouse. 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. The IVM reports show that the income of the Veteran and his spouse for 2017 was approximately $410,000 greater than the National Means Test for a veteran with one dependent. The Veteran submitted the 2017 tax return of him and his spouse, which shows total income of $23,619. This includes a farm loss of $311,935 and capital gain losses of $3,000. Gross income from a business, farm, or profession, reduced by operating expenses, is included in the computation of income for VA purposes. See 38 C.F.R. § 3.271(c)(1). A loss sustained in operating a business, profession, farm, or investments may not be deducted from income from any other source for VA purposes. See 38 C.F.R. § 3.271(c)(3). Therefore, the Veteran's farm losses and capital loss for 2017 are $0 for the purposes of calculating income for the National Means Test. The 2017 tax return shows $338,554 of income when the above losses are not deducted. While this is well under the approximately $450,000 of income from the IVM reports, it is still considerably over the National Means Test threshold of $39,259. The Veteran wrote in statements submitted with his February 2019 notice of disagreement and August 2019 substantive appeal (VA Form 9) that the losses should be deducted from his income and that Federal agencies should not have differing definitions of income. The Board is bound to follow the statutes and regulations regarding how VA calculates income. Because the Veteran's income for 2017 was above the National Means Test according to how VA calculates income, he is not exempt from copayments in the VA healthcare system for 2017. See 38 U.S.C. §§ 1710(a)(2)(G). (Continued on the next page) 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). 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.