Citation Nr: 22017563
Decision Date: 03/25/22	Archive Date: 03/25/22

DOCKET NO. 19-16 579
DATE: March 25, 2022

REMANDED

Whether the change in the Veteran's Means Test eligibility category from copay exempt to copay required for income year 2016 was proper, is remanded.

REASONS FOR REMAND

The Veteran had active duty from January 1969 to October 1970.  The issue is on appeal before the Board of Veterans' Appeals (Board) from a May 2018 notification letter from the Health Eligibility Center (HEC) in Atlanta, Georgia, denying the Veteran's claim.

The Veteran was scheduled for a hearing before a Veterans Law Judge in September 2021.  Prior to the hearing, he submitted a written request in August 2021 to withdraw his hearing request and cancel the scheduled hearing.

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 the IRS and Social Security Administration 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, is remanded.

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 summary of evidence in the April 2019 statement of the case (SOC) includes in the list of evidence that on August 3, 2018, a HEC Form 200-1A with option 3 selected, signed and dated on June 6, 2018, an incomplete 1040 for 2016, Wells Fargo printout, and typed letter was received by the HEC.

Additionally, in a statement attached to his notice of disagreement, the Veteran stated that he was enclosing a copy of his 2017 taxes, which he had previously submitted to VA.

The record does not contain these documents.  These missing documents must be associated with the claims file before the claim is decided on the merits.

The matters are REMANDED for the following action:

1. Associate with the claims file the documents submitted by the Veteran including his HEC Form 200-1A with option 3 selected, signed and dated on June 6, 2018, an incomplete 1040 for 2016, Wells Fargo printout, typed letter, and copy of 2017 taxes.

2. If these documents are unavailable and further attempts to obtain these records would be futile, the HEC must note such unavailability in a Memorandum of Unavailability and associate it with the claims file.

 

 

H.M. WALKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Lee

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.