Catastrophically Disabled Veterans Benefit Few Veterans may be aware of this important VA health care benefit they can access regardless of their current enrollment status. Veterans are considered to be catastrophically disabled if they have a permanent, severely disabling injury, disorder, or disease that compromises their ability to carry out activities of daily living to such a degree that the individual requires: • Personal or mechanical assistance to leave the home or bed, or; • Constant supervision to avoid physical harm to self or others. Veterans, whose medical conditions involve permanent severely disabling injuries, are encouraged to undergo a Catastrophically Disabled Veteran Evaluation . Some evaluations may involve only a pertinent medical records review while others a physical examination. But the process all starts with a request by the Veteran or their caregiver/representative to the Catastrophic Disabled Veteran Enrollment Coordinator. Veterans determined to be catastrophically disabled are placed in priority group 4, unless qualified to be enrolled in a higher priority group (such as priority groups 1-3). The benefit to Veterans found to be catastrophically disabled is that they no longer have copays for medical treatment, prescription medication, outpatient extended care, respite care, adult day care, etc.
“A friend’s father had been told he did not qualify for VA benefits. He has since developed dementia, is homebound, only gets around in a wheelchair, and is cared for by his wife, who is 80 years old. I told my friend that his father should qualify under the catastrophic category. This was the first they had heard of this. The Veteran came in for evaluation and qualified, and now he and his wife are getting the care and support he deserves. He is seen by Home Based Primary Care; he has an aide that comes in several hours a week and qualifies for one day of daycare, which is a welcome relief for his wife.”
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