Veterans Affairs: Basic Eligibility for Disability Benefit Programs

Congressional research reportFeb 24, 2011

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Veterans Affairs: Basic Eligibility

for Disability Benefit Programs

Douglas Reid Weimer

Legislative Attorney

February 24, 2011

Congressional Research Service

7-5700

www.crs.gov

RL33113

CRS Report for Congress

Prepared for Members and Committees of Congress

Veterans Affairs: Basic Eligibility for Disability Benefit Programs

Summary

A broad range of benefits is offered to American veterans and to certain members of their families

by the United States Department of Veterans Affairs (VA). Among these benefits are various types

of financial benefits and assistance, including two disability programs: disability compensation

and pensions which pay monthly cash benefits to disabled veterans. Disability compensation

provides a monthly benefit to veterans who are disabled as a direct result of their military service.

Disability pension is paid to wartime veterans who have limited income, are no longer able to

work, or are aged 65 or older. Additional basic criteria must be met in order to be eligible to

receive either of these benefits.

This report examines the eligibility criteria and the fundamentals of the VA-administered

disability benefit programs and related issues. It supplements and condenses the relevant

materials that are available from the VA and its website. It also provides specific citations for

further information and more in-depth analysis of information contained herein.

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Contents

Introduction ................................................................................................................................1

Step One: Eligibility Criteria .......................................................................................................2

Definition of “Veteran” .........................................................................................................2

Discharge Criteria .................................................................................................................2

The Requirement of Active Service .......................................................................................4

Whether the Military Service Was During Time of War .........................................................5

Service Requirements: Length of Duty ..................................................................................6

Impediments to VA Benefits: Willful Misconduct ........................................................................6

Alcohol Abuse ......................................................................................................................7

Drug Abuse...........................................................................................................................7

Venereal Disease...................................................................................................................8

Step Two: Entitlement to Disability Benefits ...............................................................................8

Disability Benefit Programs ..................................................................................................8

Requirements for the Award of Service-Connected Disability Compensation .........................8

Requirements for the Award of a Non-Service-Connected Pension ........................................9

Contacts

Author Contact Information ...................................................................................................... 10

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Veterans Affairs: Basic Eligibility for Disability Benefit Programs

Introduction

The United States Department of Veterans Affairs (VA) offers a broad range of benefits to

American veterans and to certain members of their families. 1 Among the benefits extended to

veterans are health care and related services, such as nursing homes, clinics, and medical centers;

education, vocational training, and related career assistance; home financing; life insurance;

burial benefits; benefits for certain family survivors and financial benefits, including disability

compensation and pensions.2 This report focuses upon the basic eligibility/entitlement

requirements for disability benefits, which the VA administers through two programs, disability

compensation and disability pension. 3

Both of these programs pay monthly cash benefits to disabled veterans. Disability compensation

provides a monthly benefit to veterans who are at least 10% disabled as a result of their military

service. 4 Disability pension is paid to wartime veterans with limited income, who are no longer

able to work, or who are aged 65 or older. The pension is not related to a service-connected injury

or medical condition, and takes into consideration the material needs of the veteran (i.e., it is a

“needs-based” pension).5 A veteran cannot simultaneously receive both disability compensation

and a disability pension.

The VA uses a two-step process to evaluate disability claims, as well as to determine eligibility

for other VA benefits. First, the claimant must demonstrate that he or she is eligible for the VA

benefit. That is, the claimant must prove that he or she is a bona fide veteran and verify certain

The VA was established as an executive department by the Department of Veterans Affairs Act (P.L. 100-527, 102

Stat. 2635 (October 25, 1988)). The predecessor of the Department, the Veterans Administration, had been established

as an independent agency under the President by Executive Order No. 5398 of July 21, 1930, in accordance with the act

of July 3, 1930 (46 Stat. 1016), which authorized the President to consolidate and coordinate the U.S. Veterans Bureau,

the Bureau of Pensions, and the National Home for Volunteer Soldiers. See http://www.va.gov; go to About VA; then

go to History. Within the VA, the Veterans Benefits Administration (VBA) administers nonmedical benefits programs

for veterans and their dependents and survivors. These benefits include veterans’ compensation and pensions,

survivors’ benefits, education and rehabilitation assistance, home loan benefits, certain burial benefits, and insurance

coverage. See http://www.vba.va.gov/VBA. See generally Federal Benefits for Veterans and Dependents, published by

the Department of Veterans Affairs (2010 edition) (cited to afterward as “Federal Benefits”). See http://www.va.gov/

opa/publications/benefits_book.asp for the publication online.

CRS has available on its website a number of reports analyzing specific constituent areas of interest. See, e.g., CRS

Report R41343, Veterans Medical Care: FY2011 Appropriations, by Sidath Viranga Panangala; and CRS Report

RL34370, Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange, by Sidath Viranga

Panangala and Douglas Reid Weimer.

See CRS Report R41386, Veterans’ Benefits: Burial Benefits and National Cemeteries, by Christine Scott; CRS

Report R41435, Veterans’ Benefits: Current Life Insurance Programs, by Christine Scott; and CRS Report RS22666,

Veterans Benefits: Federal Employment Assistance, by Christine Scott.

See CRS Report RL34626, Veterans’ Benefits: Benefits Available for Disabled Veterans, by Christine Scott and Carol

D. Davis, for an overview of the broad range of benefits available to disabled veterans, including rehabilitation and

employment programs, automobile and special adaptive equipment grants, clothing allowances, housing grants, and

other benefits.

The VA evaluates the severity of a veteran’s disability and determines what percentage of employment capacity is

impaired. For example, a 10% disability (physical or psychological) is a relatively minor disability, whereas an 80%

disability determination represents a significant impairment. For a more comprehensive explanation of how benefits are

awarded through a rating system, see CRS Report RL33323, Veterans Affairs: Benefits for Service-Connected

Disabilities, by Douglas Reid Weimer.

Federal Benefits at 29. See CRS Report RS22804, Veterans’ Benefits: Pension Benefit Programs, by Christine Scott

and Carol D. Davis.

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related matters. In this sense, the eligibility relates to the veteran’s general qualification(s) for the

benefit(s). Second, the veteran must prove entitlement to the particular benefit being sought.6

There is no deadline or time limit for applying for disability benefits.

Step One: Eligibility Criteria

Definition of “Veteran”

In order to be eligible for most VA benefits, the claimant must be a veteran or, in some

circumstances, the survivor or the dependent of a veteran. By statute, a “veteran” is defined as a

“person who served in the active military, naval, or air service, and who was discharged or

released therefrom under conditions other than dishonorable.”7

In evaluating the evidence to determine whether the applicant is a “veteran” for the purposes of

VA benefits, the VA relies substantially upon military department service records. The VA is

bound by information that the service documents contain.8 Generally speaking, the VA findings

will be in accord with the information contained in the applicant’s service records.9

Such records may include an original service department record; a copy issued by the service

department with the certification that it is a true document; or a copy submitted by an accredited

agent, attorney, or service representative with special training, who certifies that it is a copy of an

original service document or a copy of a copy of such a document. 10 In addition to meeting these

criteria, the document must contain data regarding the length, time, and character of the service,

and the VA must believe that the document is genuine and accurate.11 If the claimant does not

provide the requisite documentation or other evidence, or the submitted documentation does not

meet the requirements, the VA must seek to verify service directly from the appropriate military

service department. 12

Discharge Criteria

The statutory definition of “veteran” requires that the individual has been discharged or released

from military service “under conditions other than dishonorable.”13 There are currently five types

of discharges issued by the military services: (1) honorable discharge (HD); (2) discharge under

For example, in order to be entitled to receive the disability compensation, a veteran must provide sufficient evidence

of certain elements (e.g., current diagnosis, medical evidence of an in-service occurrence, and link between the inservice occurrence and the current disability) in order to be entitled to receive the disability compensation. See

“Requirements for Disability Compensation,” CRS Report RL33323, Veterans Affairs: Benefits for Service-Connected

Disabilities, by Douglas Reid Weimer, for a more detailed discussion of the process.

38 U.S.C. § 101(2); 38 C.F.R. § 3.1(d).

Venturella v. Gober, 10 Vet. App. 340, 341-342 (1977); Duro v. Derwinski, 2 Vet. App. 530, 532 (1992).

38 C.F.R. § 3.203.

38 C.F.R. § 3.203(a)(1). See CRS Report RS21282, Military Service Records and Unit Histories: A Guide to

Locating Sources, by Julissa Gomez-Granger and Anne Leland.

38 C.F.R. § 3.203(a)(2), (3).

Duro, 2 Vet. App. at 532.

38 U.S.C. § 101(2); 38 C.F.R. § 3.12(a).

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honorable conditions (UHC), or general discharge (GD); (3) discharge under other than honorable

conditions (UOTHC), or undesirable discharge (UD); (4) bad conduct discharge (BCD); and (5)

dishonorable discharge (DD). 14

The language of the statute does not precisely match the current categories of the discharges, and

the VA often determines on a case-by-case basis whether the claimant’s discharge satisfies any of

the criteria and which category of discharge applies. In most cases, the VA considers honorable

discharges and discharges under honorable conditions to fall within the “conditions other than

dishonorable” category, and will usually qualify the claimant as a veteran under the first step of

the eligibility test.15 Usually, honorable and general discharges qualify a veteran for most

benefits. 16

A bad conduct discharge from a special court-martial and other discharges made under other than

honorable conditions may or may not disqualify the claimant from being considered a veteran for

purposes of benefits eligibility.17 In the case of such a discharge, the VA will make a special

“character of service determination,” based on the particular facts in the claimant’s case. On this

basis, the VA will determine whether the veteran was separated from service under “dishonorable

conditions” or under “other than dishonorable conditions.” The VA will review of the entire

period of the claimant’s enlistment(s) to assess the quality of the service and to determine whether

it is sufficient to deserve the award of veterans’ benefits.18 If a claimant has served more than one

period of enlistment, he or she may have two or more different discharge categories.

The VA Federal Benefits guide offers the following on discharges:

Dishonorable and bad conduct discharges issued by general courts-martial may bar VA

benefits. Veterans in prison and parolees may be eligible for certain VA benefits. VA

regional offices can clarify the eligibility of prisoners, parolees and individuals with multiple

discharges issued under differing conditions. VA benefits will not be provided to any veteran

or dependent wanted for an outstanding felony warrant.19

Certain exceptions permit the award of VA benefits, even if the character of the discharge would

ordinarily bar VA benefits. For example, if it is determined that the claimant was insane at the

time of the offense leading up to the discharge, the claimant may be granted VA benefits. There

does not need to be a direct connection between the insanity and the misconduct.20

Barton F. Stichman et al., Veterans Benefits Manual, at § 2.2.1 (Cited to afterward as “Veterans Benefits Manual”).

Id.

Federal Benefits at vii.

38 U.S.C. § 5303(b).

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The Requirement of Active Service

An applicant must have “active military, naval, or air service” in order to be considered a veteran

for VA benefits.21 However, not all types of service are considered active military service for this

purpose. 22

The VA Federal Benefits guide states the following on the active service requirement:

Eligibility for most VA benefits is based upon discharge from active military service under

other than dishonorable conditions. Active service means full-time service, other than active

duty for training, as a member of the Army, Navy, Air Force, Marine Corps, Coast Guard, or

as a commissioned officer of the Public Health Service, the Environmental Science Services

Administration or the National Oceanic and Atmospheric Administration, or its predecessor

organization, the Coast and Geodectic [sic] Survey. Men and women veterans with similar

service are entitled to the same VA benefits.23

Active service includes (1) active duty;24 (2) a period of active duty for training during which the

person was disabled or died from an injury or disease incurred or aggravated in the line of duty;25

and (3) any period of inactive duty for training during which the person was disabled or died from

an injury incurred or aggravated in the line of duty or from certain health conditions incurred

during the training. 26

Additional circumstances of service, and whether they are deemed to be active military service,

are set out in VA statutes.27 For example: if on authorized travel to and from the performance of

See footnote 13.

For example, National Guard and Reserve duty are not considered active service unless an individual performing this

duty was disabled or died from a disease or injury incurred or aggravated in the line of duty. (38 U.S.C. § 101(24); 38

C.F.R. § 3.6(a)).

Federal Benefits at vii.

Active duty is considered to include (1) Full-time service in the Army, Navy, Marine Corps, Air Force, or Coast

Guard, other than active duty for training (38 U.S.C. § 101(21)(A); 38 C.F.R. § 3.6(b)(1)); (2) Full-time service as a

commissioned officer in the Public Health Service (38 U.S.C. § 101(21)(B); 38 C.F.R. § 3.6(b)(2)); (3) Full-time

service as a commissioned officer at the Coast and Geodetic Survey, Environmental Services Administration, or

National Oceanic and Atmospheric Administration (38 U.S.C. § 101(21)(C); 38 C.F.R. § 3.6(b)(3)); (4) Service as a

cadet at a military academy (38 U.S.C. § 101(21)(D); 38 C.F.R. § 3.6(b)(4)); (5) Attendance by active-duty members at

certain prep schools associated with military academies (38 C.F.R. § 3.6(b)(5)); and (6) Authorized travel to or from

such duty or service (38 U.S.C. § 101(21)(E); 38 C.F.R. § 3.6(b)(6)).

Active duty for training is a tour of active duty that is used for training members of reserve and other components to

fill the Armed Forces during time of war or national emergency. Active duty for training has been determined to mean

(1) full-time duty for training performed by Reservists (38 U.S.C. § 101(22)(A); 38 C.F.R. § 3.6(c)(1)); (2) full-time

duty for training purposes as a commissioned officer in the Reserved Corps of the Public Health Service (38 U.S.C. §

101(22)(B); 38 C.F.R. § 3.6(c)(2)); (3) full-time training duty by members of the Air or Army National Guard of any

state (38 U.S.C. § 101(22)(C); 38 C.F.R. § 3.6(c)(3)); (4) duty by members of the Senior ROTC program on field

training or a practice cruise (38 U.S.C. § 101 (22)(D); 38 C.F.R. § 3.6(c)(4)); and (5) authorized travel to and from duty

for training (38 U.S.C. § 101(22)(E); 38 C.F.R. § 3.6(c)(6)).

38 U.S.C. § 101(24). Inactive duty for training has been defined to mean (1) duty, other than full-time duty, for

Reservists (38 U.S.C. § 101(23)(A); 38 C.F.R. § 3.6(d)(1)); (2) other duties authorized for Reservists performed on a

voluntary basis (38 U.S.C. § 101(23)(B); 38 C.F.R. § 3.6(d)(2)); (3) training (other than active duty for training) by a

member of, or applicant for membership in, Senior ROTC (38 U.S.C. § 101(23)(C); 38 C.F.R. § 3.6(d)(3)); and (4) for

the members of the Air or Army National Guard of any state, such training means duty other than full-time duty (38

U.S.C. § 101(23); 38 C.F.R. § 3.6(d)(4)).

38 U.S.C. §§ 101, 106. See Federal Benefits at vii-viii.

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active duty training or inactive duty for training, the person is disabled or dies while proceeding

directly to or returning from such duty, the duty will be considered to be active duty for training

or inactive duty for training. 28

The determination of whether a claimant has met the “active service” requirement may not be a

simple process. It is possible that the claimant and the VA may have to scrutinize the claimant’s

service record(s) to determine whether the claimant’s service fits into one of the many categories

of active service, or whether an exception has been made for his/her service, so that it is

considered to be active service for the purposes of veterans’ benefits. In addition, a claimant may

have more than one period of service, which may further complicate the determination.

Whether the Military Service Was During Time of War29

Whether or not a veteran has served during time of war may impact his/her potential VA benefits.

All military service is classified as either wartime or peacetime service. Certain benefits are

extended only to veterans with wartime service. 30

Congress has set out the periods of “wartime” for the purposes of veterans’ pensions and other

benefits. 31 To be considered to have “served during wartime” by the VA, a veteran does not have

to have served in an actual combat zone, but during the specified periods of war set out below.

Those time periods not designated by Congress as “wartime” are considered to be “peacetime.” If

a veteran served his/her duty part during wartime and part during peacetime, the veteran would

meet the “wartime” criteria if he or she served 90 consecutive days, at least one day of which

occurred during a period designated as wartime.

Following is a list of those periods of “wartime” designated by Congress:32

•

Indian Wars—January 1, 1817, through December 31, 189833

•

Spanish-American War—April 21, 1898, through July 4, 190234

•

Mexican Border War—May 19, 1916, though April 5, 191735

•

World War I—April 6, 1917, through November 11, 1918; extended to April 1,

1920; by regulation extended to July 1, 1921, under certain specific conditions36

•

World War II—December 7, 1941, through December 31, 1946, extended to July

25, 194737

38 U.S.C. § 106(d); 38 C.F.R. § 3.6(e).

See CRS Report RS21405, U.S. Periods of War, by Barbara Salazar Torreon.

For instance, only veterans having wartime service are eligible for non-service connected disability pension benefits

(38 U.S.C. § 1521(j)).

38 U.S.C. § 101 (6)-(11); 38 C.F.R. § 3.2.

See Federal Benefits at 2.

See 38 C.F.R. § 3.2(a).

38 U.S.C. § 101(6); 38 C.F.R. § 3.2(b).

38 U.S.C. § 101(30); 38 C.F.R. § 3.2(h).

38 U.S.C. § 101(7); 38 C.F.R. § 3.2(c).

38 U.S.C. § 101(8); 38 C.F.R. § 3.2(d).

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•

Korean Conflict—June 27, 1950, through January 31, 195538

•

Vietnam Era—August 5, 1964, through May 7, 197539

•

Persian Gulf War—August 2, 1990, through a date to be prescribed by

Presidential proclamation or law40

Service Requirements: Length of Duty

Prior to September 8, 1980, there was no minimum length of service necessary to vest most VA

benefits. However, for an individual who enlisted after September 8, 1980, there are now certain

minimum length of service requirements. The general requirement is either 24 months of

continuous active duty or the “full period” for which the service person was called or ordered to

active duty. 41

Several significant exceptions exist to this general rule. For example, service-connected

compensation benefits are exempt from the minimum active duty requirements. Thus, a veteran

with a disease or injury incurred during active service should almost always be able to receive

service-connected compensation for his/her condition or disability. 42 Other significant exceptions

to the minimum service requirements include claims for VA insurance benefits,43 hardship

discharges,44 and persons retired or separated from service because of a service-related

disability.45

If the former service member does not fall within one of the two eligible categories (24 months of

active duty or the “full period” of active duty), or falls within one of the statutory exceptions, then

the veteran has not completed a minimum period of active duty and is “not eligible for any

benefit under Title 38, United States Code or under any law administered by the Department of

Veterans Affairs based on that period of active service.”46

Impediments to VA Benefits: Willful Misconduct

If the VA determines that an injury or disease resulted from “willful misconduct” on the part of

the claimant, such misconduct may serve as a bar for any disability benefits. Regulations define

willful misconduct as “deliberate or intentional wrongdoing with knowledge of or wanton or

38 U.S.C. § 101(9); 38 C.F.R. § 3.2(e).

38 U.S.C. § 101(29); 38 C.F.R. § 3.2(f).

38 U.S.C. §§ 101(33), 1501(4); 38 C.F.R. §§ 3.2(I), 3.3(a)(3), 3.17, 3.54(a)(3)(viii). At the present time, no

termination date has been established.

38 U.S.C. § 5303A(b); 38 C.F.R. § 3.12a(a)(1).

38 U.S.C. § 5303A(b)(3)(C); 38 C.F.R. § 3.12a(d)(4).

38 U.S.C. § 5303A(b)(3)(E); 38 C.F.R. § 3.12a(d)(5).

38 U.S.C. § 5303A(b)(3)(A); 38 C.F.R. § 3.12a(d)(1).

38 U.S.C. § 5303A(b)(3)(B); 38 C.F.R. § 3.12a(d)(2).

38 U.S.C. § 5303A(b)(1); 38 C.F.R. § 3.12a(b).

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reckless disregard of its probable consequences.”47 Such willful misconduct is an act that involves

conscious wrongdoing or a known prohibited action.48

Veterans whose health conditions or disabilities resulted from willful misconduct may not receive

compensation from either the non-service-connected pension plan49 or the service-connected

disability compensation program. 50 Likewise, vocational rehabilitation benefits and certain other

benefits will be denied, as such benefits are based on a service-connected condition. 51

Customarily, the VA reviews all of the circumstances of each claimant’s case to determine

whether there was willful misconduct on the part of the claimant.

Alcohol Abuse

For the purpose of VA benefits, alcohol abuse has been defined as “the use of alcoholic beverages

over time, or such excessive use at any one time, sufficient to cause disability to or death of the

user.”52 Alcohol abuse is deemed to be “willful misconduct,” even though the “simple drinking of

alcoholic beverage is not of itself willful misconduct.”53

Drug Abuse

The VA has defined drug abuse rather broadly. For the purposes of VA benefits, drug abuse has

been defined as the use of an illegal drug, the use of a prescription drug illegally or illicitly

obtained, the use of a drug for a purpose other than that for which it was medically intended, or

the use of a drug (any substance other than alcohol) to enjoy its intoxicating effect.54 Should the

claimant’s use of a drug coincide with any portion of this definition, then the claimant’s use is

considered drug abuse. Any resultant death or disability is then not considered to have occurred in

the line of duty.55

The VA considers it not to be a case of willful misconduct, however, when a drug is used for

medical purposes or when during the use of drugs for medical purposes, addiction or habituation

to drugs results from a service-connected disability.56 Accordingly, if a claimant develops a

medical problem because of the use of prescribed medications used as prescribed to respond to a

service-connected problem, the resultant problem could be considered to be service-connected

and not willful misconduct.

38 C.F.R. § 3.1(n)(1).

Id.

38 U.S.C. § 1521(a); 38 C.F.R. § 3.301(b).

38 U.S.C. § 105(a); 38 C.F.R. § 3.301(a).

38 U.S.C. § 3102.

38 C.F.R. § 3.301(d).

38 C.F.R. § 3.301(c)(2).

Id. § 3.301(d).

Id.

38 C.F.R. § 3.301(c)(3).

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Venereal Disease

Under certain circumstances, the VA will consider the effects of venereal disease not to be the

result of willful misconduct. Thus, disabilities that result from venereal disease contracted during

a period of military service may be compensable.57 However, such compensation may be

withheld if it is determined that the venereal disease predated military service and that the

medical problems were a result of the progress of the disease.58

Step Two: Entitlement to Disability Benefits

Disability Benefit Programs

Once it has been determined that the claimant is eligible for veterans’ benefits, then it must be

determined whether the claimant is entitled to certain benefits. Again, there are two basic

disability benefit programs for veterans: the disability compensation program and the pension

program. The disability compensation program is service-connected, and the pension program is

non-service-connected.

Requirements for the Award of Service-Connected Disability

Compensation59

The award of service-connected disability compensation has several requirements. First, the

fundamental eligibility requirements discussed above—service and discharge requirements—

must be met. In addition, the veteran must prove three elements: (1) a medical diagnosis of the

current disability; (2) medical evidence, and in some instances lay evidence, of the in-service

occurrence or worsening of an injury or disease; and (3) a link between the in-service-incident or

the worsening of a disease or injury and the current disability. 60 If the VA is satisfied that these

three elements are proved, then the VA determines the severity of the disability. 61 The VA assigns

a percentage evaluation from 0% to 100% for the amount of disability that the VA determines that

the veteran has sustained.62

After the VA determines the percentage of disability, the VA sets an effective date for the award of

the disability compensation and payments begin to the veteran.63 Should the VA deny disability

38 C.F.R. § 3.301(c)(l).

Id.

See CRS Report RL33323, Veterans Affairs: Benefits for Service-Connected Disabilities, by Douglas Reid Weimer.

The report details the preparation and evaluation of veterans’ claims, including the VA rating system. Current

legislation is also discussed in the report.

Veterans Benefits Manual at § 3.1.5.

Id.

38 U.S.C. § 1155; 38 C.F.R. pt. 4. See CRS Report RL33991, Disability Evaluation of Military Servicemembers, by

Christine Scott and Don J. Jansen.

Rates of disability compensation are set by statute. See 38 U.S.C. § 1114 for the rates of wartime disability

compensation.

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benefits, or should the veteran disagree about the percentage determination, the veteran may

appeal the decision(s) through a VA appeals process.

Requirements for the Award of a Non-Service-Connected Pension

Like the service-connected disability compensation, the fundamental eligibility requirements of

discharge and active wartime service must be met prior to the award of a non-service-connected

pension. Then, several additional criteria must be met. First, the veteran must have a limited

income, 64 and the VA must ascertain that the veteran’s net worth does not provide sufficient

income to meet his/her needs, known as the “needs test.”65 Second, the veteran must be

permanently and totally disabled or aged 65 at the time of filing the pension application. 66 Finally,

the disability of the veteran must not be attributable to the willful misconduct of the veteran.67

Procedurally, a veteran’s application for pension benefits is reviewed by the VA regional office

adjudicators. They will first determine the basic eligibility of the applicant for pension benefits.

After this fundamental eligibility is established, the adjudicators will look at the claimant’s

income and net worth. If the claimant’s income or net worth is a bar to the pension benefits, the

claim will be denied without a determination of the claimed disability. If the income or net worth

does not seem to serve as a bar to pension benefits, the pension claim is sent to the rating board

for a disability determination. 68

The disability determination is undertaken on a case by case basis. Congress has provided some

guidance in this process. Specifically, a veteran is considered permanently and totally disabled if

the veteran is in any of the following circumstances: (1) nursing home patient for long term care

because of a disability; (2) disabled, as determined by the Commissioner of Social Security for

the payment of Social Security benefits; (3) unemployable because of a disability which is

reasonably certain to continue through the claimant’s life; or (4) suffering from (a) a disability

adequate to render it impossible for the average person to be gainfully employed, if the disability

is expected to continue for the life of the person; or (b) a disease or disorder determined by the

Secretary of Veterans Affairs to per se result in permanent and total disability.69 Veterans who are

aged 65 or older and apply for a pension are presumed to be permanently and totally disabled for

pension purposes. Hence, a disability determination is not required for a veteran aged 65 or older

to be granted pension entitlement.70

After the disability status is determined, 71 pension benefits are paid to the claimant on a monthly

basis.

38 U.S.C. § 1521; 38 C.F.R. §§ 3.271-273.

38 U.S.C. § 1522; 38 U.S.C. § 3.274.

38 U.S.C. § 1521(a); 38 C.F.R. § 4.17.

See discussion above at pp. 6-7.

Veterans Benefits Manual at § 6.1.2.

38 U.S.C. § 1502.

38 U.S.C. § 1513.

The monthly benefit is offset by any other income that the veteran may have. See 38 C.F.R. § 3.275(b).

Congressional Research Service

Veterans Affairs: Basic Eligibility for Disability Benefit Programs

Author Contact Information

Douglas Reid Weimer

Legislative Attorney

dweimer@crs.loc.gov, 7-7574

Congressional Research Service

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