BEnefits Corner
By Joe Glover, Oregon Department of Veterans’ Affairs
A deeper look
Catastrophic Disability Some of the most severely in need veterans may qualify for VA health care even if their medical conditions are not service-related.
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n the state of Oregon, it is estimated that only three of every ten veterans are receiving the care and benefits that they are entitled to. It is our goal at the Oregon Department of Veterans’ Affairs to minimize or eliminate that gap entirely. One of the primary benefits that veterans seek, particularly as they get older, is VA health care. Unfortunately due to sufficient income or a lack of military related disability, a veteran who served honorably may not be eligible for health care enrollment at this time. But there is an eligibility loophole that is little known and rarely used called the catastrophic disability designation. The Veterans Health Administration has defined a “catastrophically disabled” veteran as “one who has a severely disabling injury, disorder, or disease that permanently compromises the ability to carry out the activities of daily living to such a degree that the individual requires personal or mechanical assistance to leave their home or bed, or requires constant supervision to avoid physical harm to self or others.” A veteran designated “catastrophically disabled” is not required to have a militaryrelated disability or meet low-income thresholds to be eligible for enrollment. It
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doesn’t matter where you served, when you served, or what your job was. Catastrophically disabled veterans are placed into a “priority group” within the VA health care system that makes them exempt from inpatient, outpatient and prescription copayments. They are also exempt from copayments for non-institutional respite care, non-institutional geriatric evaluation, non-institutional adult day health care, homemaker/home health aide, purchased skilled home care, home based primary care, and any other non-institutional alternative extended care services. This is in addition to free hearing aids, eyeglasses and mental health support. If you or someone you know served in the military honorably and has a permanent medical condition unrelated to military service that has left you permanently and severely disabled, you may be eligible for the catastrophic disbility designation. If this sounds like someone that you know, or even if we’re describing you — please reach out and give us at ODVA, your local county veteran service office, or a local VA health care enrollment specialist an hour to talk. It may make a world of difference.
If a veteran meets one of the following permanent conditions because of life events unrelated to military service, they will likely qualify for the catastrophic disability designation: 1. Quadriplegia and quadriparesis. 2. Paraplegia. 3. Legal blindness, defined as visual impairment of 20/200 or less visual acuity in the better seeing eye with corrective lenses, or a visual field restriction of 20 degrees or less in the better seeing eye with corrective lenses. 4. Persistent vegetative state. 5. Amputation. 6. Dependent in three or more activities of daily living. 7. Mental health behavior that is considerably influenced by delusions or hallucinations, or serious impairment in communication or judgment, or inability to function in almost all social areas.
