TRICARE and You – Veterans’ Affairs

This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.

Written by Cmdr. Paul Fawcett

If you’re separating or retiring from active service you may be considering applying to the Department of Veterans’ Affairs (VA) for benefits. If you have a service related injury or illness you may be eligible to file a claim for compensation, or receive care from a VA medical facility. Preparing correctly can make the process of obtaining VA benefits much easier and receive any authorized benefits faster.

Claims

The VA classifies claims under several categories: 1) claims for conditions you had before you entered the service, and got worse due to service, 2) claims for conditions you got as a result of service, 3) claims for post service disabilities as a result of service. When submitting a claim the VA will review your records and assign you a disability percentage, which will result in a compensation amount, if you claim is substantiated.

To file a claim you can visit the nearest VA Regional Office (VARO), or complete forms and mail them to the VA. To locate a VARO, or get more information regarding how to file a claim, visit the VA compensation page.

You may also file a claim up to 180 days prior to separation or retirement from active duty. The Benefits Delivery at Discharge option allows you to file 60-180 days before you separate; the Quick Start program allows you to file 1-59 days before discharge. Learn more about the pre-discharge claims process from the VA Pre-Discharge page.

Preparing for Discharge

You should begin thinking about separation months before you’re ready to walk out the door. The Coast Guard Medical, COMDTINST M6000.1F, states that active duty members and reservists on orders longer than 30 days shall have a separation physical prior to discharge. You should schedule that physical approximately six months prior to your separation date. This allows for documentation in your medical record of any conditions noted by your doctor. It also allows time for referrals for treatment to address any concerns before you retire. If you are given a referral for care, be sure to schedule and attend your appointment before your retirement date. Once you retire, any referrals in the system expire and you will need to start the process again.

Be sure that any documentation from your visits to specialists on the TRICARE network makes it back to your clinic and is included in your medical record. This is important documentation not only for continued care, but also for any VA claims that you wish to make.

Before you depart on terminal leave make a copy of your medical record. See your health records custodian or servicing clinic about making a copy of your record. But do not take your original medical record under any circumstances. There are no backup copies of your record. If you lose your original medical record, it is not replaceable. Additionally, the VA will not accept your original record from you to start a claim you may make. Your original record will be digitized and uploaded to a database that the VA can access, so that your claim can be adjudicated.

TRICARE and VA Medical Care

If you’re separating from service with a service related injury or illness, you may be entitled to care at a VA facility, even if you have TRICARE benefits. If you aren’t sure if you qualify for VA medical benefits you can visit with a VA benefit counselor who can review your case to determine your eligibility. Many DOD military treatment facilities have VA representatives who can assist you with this. If you aren’t near a DOD military treatment facility you can call 877-222-VETS for more information about meeting with a VA representative. It’s particularly important to see a VA counselor if you are separating due to a medical board, as a VA counselor may assist you with setting up care in the VA system, if you are entitled, after you medically retire.

If you are eligible for TRICARE and VA medical benefits you will want to compare the differences between your two entitlements. Visit the TRICARE and VA Benefit Comparison page to see a side by side comparison. It is possible that you may use both benefits. Service members who have conditions received while on active duty may utilize VA facilities for that care and TRICARE benefits for routine and other care. If you think you are eligible for care you can complete and submit a VA form 10-10EZ for a determination.

FAQs

Q: Are family members of service members eligible for VA medical care?
A: In certain very closely defined circumstances, family members may be eligible for VA care. Caregivers of OIF/OEF veterans may be eligible, spouses or widows of members totally disabled as a result of a service disability may also be eligible. Visit the VA Health Benefits Page for more information.

Q: I have a service connected condition; do I have to visit a VA facility to receive treatment?
A: Both TRICARE and the VA recommend that you seek care for service disabilities at VA facilities. It may depend on your condition, status at discharge, the availability of VA care in your area and TRICARE resources in your area.

Q: Where can I get more information about VA programs and services?
A: Visit the VA Homepage at www.va.gov.

For TRICARE questions or problems you can also contact a Coast Guard Health Benefits Administrator at 1-800-9-HBA-HBA or CGHBA@uscg.mil. You can also leave your comments below!

 

Comments

comments

Tags: , , , , , , , ,