Enrollment in VA healthcare is limited by the amount of funds the VA receives from Congress each year. The VA has set up Priority Groups to give enrollment priority to certain groups of veterans.
To be eligible for VA healthcare, you must first meet the general eligibility qualifications and minimum duty requirements. After that, your priority level will be assigned based on several factors, including your disability rating.
Veterans Eligibility for VA Healthcare
First, a service member must have served in active military service and have been discharged under conditions other than dishonorable to be eligible for VA benefits. To meet the minimum duty requirements, most veterans who enlisted after September 7, 1980 must have served for 24 continuous months, or the full period for which they were called to active duty.
The VA uses an annual enrollment system that helps to manage its provision of healthcare. Eligible veterans will be assigned a priority group based on several factors. Your enrollment in VA healthcare will be based on your priority groups.
Priority Groups for VA Healthcare
The first priority group is limited to veterans with service-connected disabilities that the VA has rated as 50% or more disabling and veterans determined by the VA to be unemployable due to service-connected conditions.
The second priority group is limited to veterans with VA-rated service connected disabilities at 30% or 40% disabling.
The third priority group is limited to former POWs, veterans who were awarded a Purple Heart, veterans discharged due to a disability that was incurred or aggravated in the line of duty, veterans awarded the Medal of Honor, veterans who were specially eligible due to a disability from treatment or vocational rehabilitation, and veterans with 10% or 20% rated service-connected disabilities.
Because higher priority groups are given preference for VA healthcare enrollment, the rating assigned to your disability can determine how long you have to wait to receive VA healthcare. In addition, your disability rating also determines how much monthly VA disability compensation you receive.
If your disability has worsened since the time the VA initially assigned you a rating, or you were given a VA disability rating that you believe is too low, you may want to consider filing a claim for an increased rating or appealing your claim. Getting an increased disability rating can affect both your VA compensation and your priority for VA healthcare enrollment.
For help with your appeal, consult with an experienced veterans law firm. Chisholm Chisholm & Kilpatrick helps veterans across the United States get the benefits they deserve. Call us at 401-331-6300 to schedule a no-cost consultation.