Citation Nr: 22017630 Decision Date: 03/25/22 Archive Date: 03/25/22 DOCKET NO. 19-16 630 DATE: March 25, 2022 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 proper, and the claim is denied. FINDING OF FACT The Veteran's attributable household income for the year 2016 exceeded the VA National Means Test threshold of $32,075 for a veteran with no dependents. CONCLUSION OF LAW The criteria for treatment without a copay in the VA healthcare system for income year 2016 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 duty from October 1974 to July 1978. The issue was previously before the Board of Veterans' Appeals (Board) and remanded in December 2019 and October 2021 for additional adjudication. In the most recent remand of October 2021, the Agency of Original Jurisdiction (AOJ) was instructed to provide the Veteran an opportunity to submit additional financial information for income year 2016 and issue a supplemental statement of the case (SSOC). The AOJ complied with both instructions, sending the Veteran a letter requesting additional financial information for income year 2016 and issuing a SSOC. The Veteran did not respond. 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 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 $32,074 for a veteran with zero 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 Veteran is enrolled in the VA healthcare system. The IVM reports show that the 2016 income of the Veteran was approximately $235,098 greater than the National Means Test for a veteran with zero dependents and revealed that the income was in excess of the National Means Test threshold largely due to investment income. Without such investment income, the Veteran's income was below the National Means Test threshold. The Veteran wrote in July 2018, December 2018, and February 2019 that the investment income was not used for daily living expenses. Specifically in the July 2018 statement, he wrote that the investment gains and proceeds were reinvested. Reinvested income is not exempt from income for VA purposes. See 38 C.F.R. § 3.272. Therefore, the investment income from the IVM reports should be included in the income for VA purposes. The Veteran also indicated that the Veteran had medical expenses in the amount of $210. However, given that reinvested income is not exempt from income for VA purposes, the Veteran's 2016 income was still above the National Means Test threshold even when medical expenses are deducted. The record shows that the Veteran's income for VA purposes was $268,058. The record does not show that the income from the 2016 IVM reports was substantially incorrect or that there are exclusions from income for VA purposes, such as medical expenses, that brings the income below the National Means Test. In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's claim. As the evidence of record persuasively weighs against finding 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, the benefit of the doubt rule does not apply. 38 U.S.C. § 5.107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, No. 2020-2067, 2021 U.S. App. LEXIS 37307 (Fed. Cir. Dec. 17, 2021). 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.