Glossary of US Veteran Affairs Definitions

Introduction

There are five types of U.S. veterans. Under Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), a veteran may be classified as a disabled veteran, recently separated veteran, active duty wartime or campaign badge veteran, or Armed Forces service medal veteran.

Main Item

Glossary of United States Department of Veterans Affairs Terms and Definitions

1151 Benefits

VA awarded monthly compensation benefits for disability or death incurred as the result of VA hospital care, medical or surgical treatment or examination, but only if the disability or death was proximately caused by negligence or an unforeseen event.

Access

Access is the veteran's ability to obtain medical care at their desired location. Components, such as availability of health care services, site of health care facilities, recreation, hours of operation, and cost-effective health care delivery, determine the ease of access. Efforts to improve access often focus on improving the efficiency of healthcare delivery processes.

Adjunct Condition

An adjunct condition, for medical treatment purposes, is a non-service-connected condition that may be associated with and held to be aggravating an adjudicated service-connected condition. VA bills health insurance plans for treating an adjunct condition and may charge a copay for treatment as applicable.

Adult Day Health Care

Adult Day Health Care is a therapeutic daycare program that provides medical and rehabilitation services to disabled veterans in a congregate setting.

Aid and Attendance (A&A)

A VA compensation or pension benefit awarded to a veteran determined to need the regular aid and attendance of another person to perform basic functions of everyday life. A veteran may qualify for aid and attendance benefits if they:

(1) Is blind or so nearly blind as to have corrected visual acuity of 5/200 or less in both eyes or concentric contraction of the visual field to 5 degrees or less.

(2) Is a patient in a nursing home because of mental or physical incapacity.

(3) Proves a need for aid and attendance under established criteria.

Allowable Deductions

Allowable deductions are those payments made by veterans for certain non-reimbursed medical expenses, funeral and burial expenses, and educational expenses. Veterans can exclude allowable deductions from their total gross household income to determine their VA health care benefits eligibility.

Appeal

A process used to request VA reconsider a previous authorization or claim decision.

Applicant

A person who has submitted a formal request for VA health care benefits and for enrollment in the VA health care system.

Asset

Property or resource of an individual which includes: cash, stocks and bonds, individual retirement accounts, income producing property, etc.

Bereavement Counseling

Bereavement counseling is assistance and support to people with emotional and psychological stress after the death of a loved one. Bereavement counseling includes a broad range of transition services, including outreach, counseling, and referral services to family members.

Catastrophically Disabled

A veteran who has a permanent, severely disabling injury, disorder, or disease that compromises the ability to carry out the activities of daily living to such a degree that they require personal or mechanical assistance to leave home or bed, or requires constant supervision to avoid physical harm to self or others.

Chronic Care

Long-term care of individuals with long-standing, persistent diseases or conditions. Chronic care includes care specific to the problem and other measures to encourage self-care, promote health, and prevent loss of function.

Combat Service

A status applied for a veteran who served on active duty in a theater of combat operations during a period of war recognized by the VA.

Commonwealth Army Veterans

The term "Commonwealth Army veterans" refers to persons who served before July 1, 1946, in the organized military forces of the Government of the Philippines. These Filipino forces were made a part of the U.S. Armed Forces by a military order of the President dated July 26, 1941. Finally, these veterans were discharged or released from this period of service under conditions other than dishonorable.

Community Residential Care

Community Residential Care provides health care supervision to eligible veterans not in need of hospital or nursing home care but who, because of medical and psychosocial health conditions as determined through a statement of needed care, are not able to live independently and have no suitable family or significant others to provide the needed supervision and supportive care. The veteran must be capable of self-preservation with minimal assistance and exhibit socially acceptable behavior.

Compensable Disabilities

A VA-rated service-connected disability for which monetary compensation is authorized for payment. You might even be compensated when your disabilities are rated 0% disabling.

Congressional Appropriation

The funding allocated by Congress to VA for providing benefits and medical services to eligible VA beneficiaries.

Consultation

Service provided by a physician whose opinion or another physician requests and regarding evaluation and management of a specific problem.

Contract Provider

Any hospital, skilled nursing facility, extended care facility, individual, organization, or agency that has a contractual agreement with VA for providing medical services to veterans.

Copay

A specific monetary charge for either medical services or outpatient medications provided by the VA to veterans whose financial assessment determines they can pay.

Covered Benefit

Medically necessary care and services included in the Medical Benefits Package as defined within 38 Code of Federal Regulation (CFR) 17.38.

Diagnosis

The identity of a medical condition, cause, or disease.

Deductible

An amount that a veteran must pay for covered services in a specified period before VA benefits begin.

Dependent

Spouse or unmarried child (to include a biological, legally adopted, or step-child under the age of 18, or between the ages of 18 and 23 and attending school, or a child who was permanently and totally disabled before the age of 18)

Disenrollment

The discontinuation of a veteran's enrolled status. Disenrollment may result because the veteran requests not to participate in VA enrollment or when VA determines that certain priority groups will no longer be provided services. Requests to dis-enroll must be in writing.

Domiciliary

A VA facility that provides care on an ambulatory self-care basis for veterans disabled by age or disease who do not need acute hospitalization and who do not need the skilled nursing services provided in a nursing home.

Durable Medical Equipment

Equipment intended for frequent use in the treatment of a medical condition or injury. Examples include wheelchairs, hospital beds, walkers, etc.

Earned Income

Money you receive from working

Emergency

An emergency medical condition is a medical condition manifesting itself by acute symptoms of sufficient severity such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in 1) placing the health of the individual in serious jeopardy, 2) serious impairment to bodily functions, or 3) serious dysfunction of any bodily organ or part.

Enrollee

A veteran who has applied for VA medical services under 38 United States Code (U.S.C.) 1710 and 38 CFR 17.36 has been accepted for such care, and who has received confirmation of enrollment in the VA health care system.

Enrollment

The process for providing veterans access to VA health care benefits covered by the medical benefits package.

Enrollment Group Threshold (EGT)

The enrollment priority group level, as determined by the Secretary of Veterans Affairs, at which veterans will be accepted for enrollment into the VA health care system.

Environmental Contaminants / Gulf War Illness

Gulf War veterans were exposed to a wide variety of environmental hazards and potentially harmful substances during their service in Southwest Asia. These include depleted uranium, pesticides, the anti-nerve gas pill pyridostigmine bromide, infectious diseases, chemical and biological warfare agents, vaccinations (including anthrax and botulinum toxoid), and oil-well-free smoke and petroleum products. VA recognizes that Gulf War veterans encounter other health risk factors. Veterans with service during the Gulf War are eligible to receive treatment for conditions related to this service.

Formulary

A formulary is a list of medicines from which your VA provider can choose to treat your medical condition. This list of medicines has been looked at and approved by a group of highly trained VA physicians and clinical pharmacists. New medicines are usually added to the formulary based on a complete review of published medical studies and available patient safety data. VA groups medicines as Formulary, Formulary-Restricted, or Non-Formulary. Formulary-Restricted medicines can usually be used only by providers with specific experience in prescribing and monitoring these medicines. For example, oncologists are usually the only VA providers who can prescribe medicines to treat cancer. Non-Formulary medicines are prescribed for those patients who have failed or cannot tolerate any of the VA Formulary medicines.

Financial Assessment

A means of collecting income and asset information used to determine a veteran's eligibility for health care benefits.

Geographic Means Test (GMT) Threshold Copay Required

A copay status assigned to a veteran whose household income is above the VA means test income threshold but below the GMT income threshold. GMT copay for inpatient care is reduced by 80%; all other copay amounts remain the same. GMT income thresholds are based on established geographic income thresholds.

GMT - Below the Means Test Threshold

Veterans whose household income and net worth are below the VA National income threshold such that they are unable to defray the expenses of care; therefore, they are not subject to copay charges for hospital and outpatient medical services.

GMT - Above the Means Test and GMT Threshold

Veterans whose household income and net worth are ABOVE the VA National income threshold and income ABOVE the geographically-based income threshold for their resident location who do not otherwise qualify for placement in a higher enrollment priority group. These veterans must agree to pay copays for hospital care and outpatient medical services.

GMT - Above the Means Test and Below the GMT Threshold

Veterans with household income and net worth are ABOVE the VA National income threshold and income BELOW the geographically-based income threshold for their resident location who do not otherwise qualify for placement in a higher enrollment priority group. These veterans must also agree to pay copays for hospital care and outpatient medical services, but their inpatient medical care copays are reduced by 80 percent.

Geriatric Evaluation

Geriatric evaluation, which is part of the basic benefits package, is the comprehensive assessment of a veteran's ability to care for themselves, physical health, and social environment, which leads to a plan of care. The plan could include treatment, rehabilitation, health promotion, and social services.

Gross Household Income

Generally, the gross income of the veteran, spouse, and dependent children is counted for determining a veteran's eligibility for VA health care benefits. This includes earned and unearned income but excludes most need-based payments such as welfare, Supplemental Security Income (SSI).

Gross Income

Income before allowable expenses are subtracted

Hardship

A "hardship" exist when there is a significant change in your family income and net worth from the previous calendar year to the current year. You could have been working in the previous year and, due to a recent disability, can no longer work. Chances are this type of situation would create a significant change in your families income.

Head or Neck Cancer

Veterans with cancer of the head and neck and a history of receipt of Nasopharyngeal (NP) radium therapy are eligible for treatment. There are precise dates and locations where this activity occurred. Eligibility for this special class needs to be verified. (Not all veterans receiving head and neck cancer treatment fall into this treatment category.) During the 1920s, nasopharyngeal (NP) radium therapy was developed to treat hearing loss caused by repeated ear infections. Radium-tipped rods were inserted into the nostrils and left in place for several minutes. Military physicians used NP radium to treat aerotitis media (barotrauma) in submariners, aviators, and divers. It is estimated that between 8,000 and 20,000 military personnel received NP radium treatments during World War II and until the 1960s. Veterans also included are those with documentation of NP radium treatment in the active military, naval or air service; those who served as an aviator in the active military, naval, or air service before the end of the Korean conflict; or underwent submarine training in active naval service before January 1, 1965. Veterans exposed to NP radium treatments are eligible for treatment for conditions related to this exposure, including head and neck cancer. Suppose the veteran is being treated for any condition during this episode of care related to Head and Neck Cancer. In that case, the veteran does not have to pay a copay for the visit or the medication.

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is a federal law enacted in 1996. It was designated to improve the availability and portability of health coverage and the efficiency of the health care system by standardizing the electronic exchange of health information and protecting the security and privacy of member-identifiable health information.

Home Health Care

Skilled nursing and other therapeutic services provided by VA or a home health care agency in a home setting as an alternative to confinement in a hospital or skilled nursing facility.

Homemaker/ Home Health Aide Services

The Homemaker / Home Health Aide (H/HHA) Program provides services as an "alternative" to nursing home care. The H/HHA Coordinator and the interdisciplinary team make a clinical judgment that the veteran would require nursing home equivalent care in the absence of H/HHA services.

Hospice/Palliative Care

Hospice/Palliative Care programs offer pain management, symptom control, and other medical services to terminally ill veterans or veterans in the late stages of the chronic disease process.

Hostilities

"Hostilities" means any armed conflict in which the member's of the Armed Forces are subjected to combat conditions comparable to a period of war. The Secretary of the VA determines the periods of armed conflict in consultation with the Secretary of Defense.

Housebound Benefit

The VA's Housebound benefit is an additional amount available to eligible veterans and dependents who are entitled to VA pension or VA compensation. The housebound allowance may be paid to veterans, dependent spouses, or surviving spouses who, because of their physical limitations, cannot walk or travel beyond their home and are reasonably certain the disabilities or confinement will continue throughout their lifetime. Certain restrictions apply.

Housing and Urban Development Geographic Index

Congress wanted to grant relief from making VA copay for some veterans with marginal incomes, recognizing that income alone is not always a fair measure of one's standard of living because of sometimes large differences in the cost of living in different areas of the country. Congress modified the VA's system of determining veterans' ability to pay for health care by creating a geographically-based income limit and reducing inpatient copay for those veterans whose income falls below these new geographic income thresholds. The new geographic income thresholds are adjusted for all standard metropolitan statistical areas (SMSAs) and are updated periodically to reflect economic changes within the SMSAs. The geographic means test thresholds are based upon the geographically based low-income threshold set by the U.S. Department of Housing and Urban Development (HUD) for public housing benefits.

Inpatient Care

Services received during a patient's hospital stay.

Ionizing Radiation

Atomic veterans may have been exposed to ionizing radiation in a variety of ways at various locations. Veterans exposed at a nuclear device testing site (the Pacific Islands, e.g., Bikini, NM, NV, etc.) or in Hiroshima and Nagasaki, Japan, may be included. Atomic veterans exposed to ionizing radiation are eligible to receive treatment for conditions related to this exposure. VA has recognized the following conditions by statute or regulation as being associated with radiation exposure:

Low-Income Threshold

Veterans with gross household income under the "low-income threshold" are eligible to receive certain health-related benefits at no cost to the veteran. The low-income threshold is set by law and varies according to the veteran's family size and the benefit applied for.

Means Test

The formal financial assessment process used by VA to measure a veteran's gross household income and assets. The means test determines veterans' copay responsibilities and helps to determine enrollment priority.

Means Test Copay Exempt

Veterans not required to make copays for medical care provided by VA.

Means Test Copay Required

A copay status assigned to a veteran who is required to make medical care copay based on financial status relative the applicable means test income threshold.

Medicaid

A jointly funded federal and state program that provides hospital expense and medical expense coverage to persons with low-income and certain aged and disabled individuals.

Medical Benefits Package

The term "Medical Benefits Package" refers to a group of health care services that are provided to all enrolled veterans.

Medical Need

The determination that care or service(s) are required to promote, preserve, or restore a veteran's health as specified within 38 CFR 17.38(b). A treatment, procedure, supply, or service is considered medically necessary as determined by the patient's care provider and generally accepted clinical practice standards.

Medicare

A federal program that provides health care coverage for people aged 65 and older, as well as some younger individuals with specific health problems. Medicare Part A covers hospitalization, extended care, and nursing home care; Medicare Part B covers outpatient services and is subject to a monthly premium.

Military Sexual Trauma (MST)

Sexual trauma experienced while on active duty in the military. Sexual trauma is sexual harassment, sexual assault, rape, and other acts of violence. Sexual harassment is further defined as repeated unsolicited, verbal, or physical contact of a sexual nature that is threatening. If the veteran is being treated for any condition during this episode of care that the provider believes is related to MST, the veteran does not have to pay a copay for the visit or the medication.

Nasopharyngeal Radium Therapy

Because it was effective in treating otitis media, military physicians used NP radium to treat aerotitis media (barotrauma) in submariners, aviators, and divers due to enlarged tissue in the throat combined with rapid pressure changes. It is estimated that between 8,000 and 20,000 military personnel received NP radium treatments during World War II and until the 1960s.

Net Worth

Simply put, "net worth" means the market value of everything you own minus what you owe. There are exclusions; not everything you own or owe is considered. VA has some particular guidelines on how it computes net worth. The VA Means Test uses the same rules as the VA pension to determine your net worth.

Non-compensable

Non-compensable refers to awards of service connection that the VA determines do not warrant the award of monetary compensation.

Nonservice-Connected Pension

A monetary support benefit awarded to permanently and totally disabled, low-income veterans with 90 days or more of active military service, of which at least one day was during wartime. Veterans of a period of war who are 65 or older and meet service and income requirements are also eligible to receive a pension, regardless of current physical condition. Payments are made to qualified veterans to bring their total income, including other retirement or social security income, to a level set by Congress.

Nonservice-Connected Veteran

An eligible veteran who has been discharged from active military duty, and does not have a VA adjudicated illness or injury incurred in or aggravated by military service.

Nursing Home

The term "nursing home care" means the accommodation of convalescents or other persons who are not acutely ill and not in need of hospital care, but who require nursing care and related medical services, if such nursing care and medical services are prescribed by, or are performed under the general direction of, persons duly licensed to provide such care. Such term includes services furnished in skilled nursing care facilities, intermediate care facilities, and combined facilities. It does not include domiciliary care.

Open Enrollment

The process of accepting applications for enrollment at any time during the year.

Other than dishonorable conditions

All veterans are potentially eligible for most veterans' health care benefits are based solely on active military service in the Army, Navy, Air Force, Marines, or Coast Guard (or Merchant Marines during WWII), and discharged under other than dishonorable conditions

Outpatient Care

Refers to health care a patient receives without being admitted to a hospital. Examples include office visits, x-rays, lab tests, and some surgical procedures.

Palliative Care

Care is provided primarily to relieve symptoms of a disease or condition rather than for curative purposes.

Pension Benefit

VA pension is a monetary award paid every month to veterans with low income who are permanently and totally disabled, or are age 65 and older, may be eligible for monetary support if they have 90 days or more of active military service, at least one day of which was during a period or war. Payments are made to qualified veterans to bring their total income, including other retirement or social security income, to an annual level set by Congress. Veterans of a period of war who are 65 or older and meet service and income requirements are also eligible to receive a pension, regardless of current physical condition.

Preferred Facility

The veteran identified the VA health care location where the veteran prefers to receive care. A preferred facility may be any VA healthcare location, for example, a VA healthcare facility, independent clinic, or community-based outpatient clinic. Suppose VA is unable to provide your needed health care. In that case, that facility will make arrangements to refer you to another VA health care facility or to one of VA's private sector affiliates to provide the required care.

Preventive Care

Health Care that emphasizes prevention, early detection, and treatment.

Primary Care Provider

The clinician who is responsible for the supervision, coordination, and provision of the veteran's medical care. This clinician provides routine health services and is the veteran's first point of contact when the veteran becomes sick. The primary care provider can easily refer patients to a specialist (such as a surgeon) should they require care outside the scope of their expertise.

Project 112/SHAD

Project SHAD, an acronym for Shipboard Hazard and Defense, was part of a larger effort called Project 112, which was conducted during the 1960s. Project SHAD encompassed tests designed to identify US warships' vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability.

Prosthetic Devices

A device that replaces all or a portion of a part of the human body. A prosthetic device can be used when a part of the body is permanently damaged, absent, or malfunctioning.

Public Law (PL) 104-262

The public law passed by Congress in October 1996, also known as the Veteran's Health Care Eligibility Reform Act of 1996. This law established national standards of access and equitable healthcare services to veterans and required that most veterans be enrolled to receive care.

Public Law (PL) 107-135

" Department of Veterans Affairs Health Care Programs Enhancement Act of 2001" provides for chiropractic care and services for veterans through Department of Veterans Affairs medical centers and clinics.

Purple Heart

A "Purple Heart" is a medal given by the military to a service person injured as a direct result of combat.

Referral

The process of referring a veteran from one practitioner to another for health care services.

Regular Filipino Scouts

The Filipino Scouts were guerrilla forces considered part of the Commonwealth Army of the Philippines. They were organized under commanders appointed, designated, or later recognized by the U.S. Army.

Respite care

Respite care gives the caregiver of a veteran a planned period of relief from the physical and emotional demands associated with providing care.

Restore Health

The process of improving a veteran's quality of life or daily function level that has been lost due to illness or injury.

Secondary Condition

A secondary condition, for medical treatment purposes, may be the result of an adjudicated service-connected condition. Veterans are encouraged to file compensation claims for non-rated secondary conditions. Non-rated secondary conditions are billable as non-service-connected conditions. If awarded service connection for the secondary condition, VA may reimburse all copays related to such service connection retroactive to the date of the original claim filing.

Service-connected

Generally a service-connected disability is a disability that VA determines was incurred or aggravated while on active duty in the military and in the line of duty. A service-connected rating is an official ruling by VA that your illness/condition is directly related to your active military service. Service-connected ratings are established by VA Regional Offices located throughout the country.

Service-Connected Veteran

A veteran who has an illness or injury incurred in or aggravated by military service as determined by VA.

Sexual Trauma

Sexual Harassment, Sexual Assault, Rape and other acts of violence. Repeated unsolicited, verbal, or physical contact of a sexual nature, which is threatening in nature.

State Veterans Homes

The eligibility for State Veterans Homes varies from state to state. But typically, veterans and sometimes their spouses can be admitted to a State Veterans Home. Medicaid, long-term care insurance, and private funds usually pay the costs long-term in a State Veterans Home. VA pays a modest share of the cost for each veteran living in a State Veterans Home. You can find information on the State Veterans Home(s) for your state by looking in the state government pages of the telephone book. VA social workers at the VA medical center where you're being treated can also provide information about State Veterans Homes.

Urgent Care

Services received for an unexpected illness or injury that is not life-threatening but requires immediate outpatient medical care that cannot be postponed. An urgent situation requires prompt medical attention to avoid complications and unnecessary suffering or severe pain, such as a high fever.

VA Form 10-10EZ, Application for Health Benefits

Veterans complete the VA form to apply for VA health care benefits. The form includes demographic, military, insurance, and financial information

VA Form 10-10EZR, Health Benefits Renewal

The VA Form used by veterans to submit their updated personal, insurance and financial information to VA.

Veteran

The term 'veteran' means a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable.