Quarterly Training

Report
Training Agenda
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VBR/CSO Quarterly Training
June 2012
Thomas Meadows
TDVA Training Officer
615-441-3384 or [email protected]
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Welcome to the VBR/CSO Quarterly
Training presented by the TN
Department of Veterans Affairs
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FULLY DEVELOPED CLAIMS
 The Fully Developed Claims (FDC)
Program is the fastest way of getting
your compensation or pension claim
processed.
 Participation in the FDC Program allows
for faster claims processing while
preserving great quality of service and
your right to appeal a decision.
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 Claim must be a rating related claim for
live compensation



Original
Secondary
Increased service connected claims
 Application form 21-526 EZ to include
Fully Developed Claim Certification
 VA forms available at
www.va.gov/vaforms or on Vetra/Spec
 You must submit all relevant private
medical records for the disabilities you
are claiming.
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 You must identify any treatment records
from a Federal Facility such as VA Medical
Center, Outpatient Clinic, or Community
Based Outpatient Clinic (CBOC)
 For Guard and Reserve members you must
submit any and all Service, Treatment, and
Personnel Records in the custody of your
Unit(s).
 Medical can be in the form of letters from
Physicians, Hospital records, or Disability
Benefit Questionnaires. (DBQ’S) Located in
Vetra/ Spec or VA site:
http://www.va.gov/vaforms/search_action.asp?FormNo=210960&tkey=&Action=Search
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 If claiming dependents, must complete
VA form 21-686c
 The evidence must show injury in
service, or a disease that began in
service or was aggravated by service.
 You must have a current physical or
mental disability related to service.
 A relationship or NEXUS must be
established between claimed disabilities
and an injury, disease, symptoms, or
event in military service.
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 PRESUMPTIVES 3.309: Example Agent
orange, POW, and Radiation.
 What if you don’t have all the evidence?


File an informal Claim Letter or a 21-4138;
must include a statement in the form of a
letter:
“I intend to apply for compensation benefits
under the FDC Program. This statement is
to preserve my effective date for
entitlement to benefits. I am in the process
of assembling my claim package for
submission”.
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NSC PENSION
 Criteria:






NSC Pension Claims
21-527EZ Original Claims
Fully Developed Claim Certification Form
must be completed.
All necessary income and net worth in
formation must be submitted
All private medical must be submitted.
Need for DBQ(see compensation
instructions)
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 Names and addresses of Federal
facilities where you receive treatment to
include dates of treatment
 21 2680 If Claiming Aid and Attendance
21 0779 If in a Nursing Home
 Guard and Reserve records
 Dependents 21-686c
 What the evidence must show:


90 Days service one of Wartime
24 Month Active Duty Requirement 9-8-80
Enlisted 10 16 81 Officers
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Permanent and Total Disability Single
60% or Combined 70% one disability
being 40% or more.
 Over 65
 Patient in a Nursing Home for long
term care
 Receiving Disability SS or SSI
 Exception 3.321 B
 Your Net Worth and Income must be
within limits.

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Handouts #1 & #2: Fully
Developed Claims
(Double click to open)
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APPORTIONMENT OF VA
BENEFITS CFR 3.450-3.461
 All or any part of the pension or, compensation,
payable on account of any veteran may be
apportioned.
 If the veteran is not residing with his or her
spouse
 If the veteran’s children are not residing with
the veteran and the veteran is not reasonably
contributing to the spouse or children’s
support.
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 In death cases where children of the
veteran are not residing with the
veterans spouse then an apportionment
may be made.
 In incarceration cases.
 Must have application for apportionment.
 Improved Pension
 Dependency and Indemnity
Compensation
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3.458 VETERAN’S BENEFITS
NOT APPORTIONABLE
 Veteran's benefits will not be
apportioned:


Where the total benefit payable to the
disabled person does not permit payment
of a reasonable amount to any
apportionee. Example vets less than 30%.
Where the spouse of the disabled person
has been found guilty of conjugal infidelity
by a court having proper jurisdiction.
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


For purported or legal spouse of the
veteran if it has been determined that he or
she has lived with another person and held
herself or himself out openly to the public to
be the spouse of such other person,
For a child that has been legally adopted by
another person, except the additional
compensation payable for the child.
Until the estranged spouse of a veteran
files claim for an apportioned share. If there
are any children of the veteran not in his or
her custody an apportionment will not be
authorized unless and until a claim for an
apportioned share is filed on their behalf.
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 No apportionment will be made when a
fiduciary has been appointed and the
fiduciary is providing for dependents.
Procedure:
 Upon receipt of request for an
apportionment the VA will develop the
income and expenses of both the veteran
and dependents. VA Form 21-0788
 Sixty day due process will be given both
parties.
 Formal decision made.
 Shorter appeal period on apportionments.

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Handout #3: Apportionments
(Double click to open)
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INCARCERATED VETERANS
COMPENSATION
 Any person specified in paragraph (c) of this
section who is incarcerated in a Federal,
State or local penal institution in excess of
60 days for conviction of a felony will not be
paid compensation or dependency and
indemnity compensation (DIC) in excess of
the amount specified in paragraph (d) of this
section.
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 Beginning on the 61st day of incarceration. VA
will inform a person whose benefits are subject
to this reduction of the rights of the person's
dependents to an apportionment while the
person is incarcerated.
 In addition, VA will also notify the person's
dependents of their right to an apportionment if
the VA is aware of their existence and can
obtain their addresses.
 Compensation or DIC is not payable on behalf of a
veteran or dependent for any period during which
he or she is a fugitive felon.
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 Applicability-The provisions of this section
are applicable to the following persons:
 A person serving a period of
incarceration after September 30, 1980
(regardless of when the felony was
committed).
 Amount payable during incarceration —(1)
Veteran rated 20 percent or more. Reduced
to 10% rate / $127.00
 (2) Veteran rated less than 20 percent. A
veteran shall receive one-half the rate of
compensation payable / $63.50.
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 Apportionment —Compensation. All or part
of the compensation not paid to an
incarcerated veteran may be apportioned to
the veteran's spouse, child or children and
dependent parents on the basis of individual
need. In determining individual need
consideration shall be given to such factors
as the apportionee claimant's income and
living expenses, the amount of
compensation available to be apportioned,
the needs and living expenses of other
apportionee claimants as well as any special
needs, if any, of all apportionee claimants.
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 DIC. All or part of the DIC not paid to an
incarcerated surviving spouse maybe paid to
children.
 These apportionments shall be made on the
basis of individual need giving consideration
to the factors previously mentioned.
 Effective dates: An apportionment under this
section shall be effective the date of
reduction of payments made to the
incarcerated person, if an informal claim is
received within 1 year after notice to the
incarcerated person. Otherwise, payments
may not be made for any period prior to the
date of receipt of a new claim.
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 Incarcerated dependent: No
apportionment may be made to or on
behalf of any person who is incarcerated.
 Notice to dependent for whom
apportionment granted. A dependent for
whom an apportionment is granted under
this section shall be informed that the
apportionment is subject to immediate
discontinuance upon the incarcerated
person's release or participation in a
work release or halfway house program.
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 Resumption upon release- The released
person's award shall be resumed the date of
release from incarceration if the Department
of Veterans Affairs receives notice of
release within 1 year following release;
otherwise the award shall be resumed the
date of receipt of notice of release.
 Retroactive awards: Whenever
compensation or DIC is awarded to an
incarcerated person any amounts due for
periods prior to date of reduction under this
section shall be paid to the incarcerated
person.
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 Conviction overturned on appeal: If a
conviction is overturned on appeal, any
compensation or DIC withheld under this
section as a result of incarceration for such
conviction (less the amount of any
apportionment) shall be restored to the
beneficiary.
 Fugitive felons: Compensation is not payable
on behalf of a veteran for any period during
which he or she is a fugitive felon.
Compensation or DIC is not payable on behalf
of a dependent of a veteran for any period
during which the veteran or the dependent is
a fugitive felon.
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 For purposes of this section, the term
fugitive felon means a person who is a
fugitive by reason of: Fleeing to avoid
prosecution, or custody or confinement
after conviction, for an offense, or an
attempt to commit an offense, which is a
felony under the laws of the place from
which the person flees; or Violating a
condition of probation or parole imposed
for commission of a felony under Federal
or State law.
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INCARCERATED VETERANS
PENSION
 If any individual to or for whom pension
is being paid, is imprisoned in a Federal,
State or local penal institution as the
result of conviction of a felony or
misdemeanor, such pension payments
will be discontinued effective on the 61st
day of imprisonment following conviction.
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 The payee will be informed of his or her
rights and the rights of dependents to
payments while he or she is imprisoned
as well as the conditions under which
payments to him or to her may be
resumed on his or her release from
imprisonment. However, no
apportionment will be made if the veteran
or the dependent is a fugitive felon.
 Disability pension - Payment may be
made to the spouse, child or children of a
veteran disqualified under this section:
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(1) If the veteran continues to be eligible.
 (2) If the annual income of the spouse or
child is such that death pension would be
payable
 (3) At the rate payable under the death
pension law or the rate which the veteran
was receiving at the time of imprisonment,
whichever is less.
 (4) Payable from the day following the
date of discontinuance of payments to the
veteran, subject to payments made to the
veteran over the same period, if an
informal claim is received within 1 year.

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 Death pension - Payment may be made to
a child or children where a surviving
spouse or child is disqualified under this
section:
 (1) If surviving spouse is disqualified
payment may be made to child or
children at the rate of death pension
payable if there were no such surviving
spouse; or
 (2) If a child is disqualified, to a surviving
spouse or other child or children at the
rate of death pension payable if there
were no such child, and
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(3) From the day following the date of
discontinuance of payments to the
disqualified person, subject to
payments made to that person over
the same period if evidence of income
is received within 1 year.
 (4) The income limitation applicable to
eligible persons will be that which
would apply if the imprisoned person
did not exist.

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 Resumption of pension upon release from
incarceration - Pension will be resumed as of
the day of release if notice (which constitutes
an informal claim) is received within 1 year
following release; otherwise resumption will
be effective the date of receipt of such notice.
 Fugitive felons - Pension is not payable on
behalf of a veteran for any period during
which he or she is a fugitive felon. Pension or
death pension is not payable on behalf of a
dependent of a veteran for any period during
which the veteran or the dependent is a
fugitive felon.
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Handout #4: Incarcerated
Veterans
Double click to open 
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AUTOMOBILE GRANT
 Financial assistance in the purchase
of one automobile and adaptive
equipment
 Inferred issue for VA rating board
 APPLICATION: 21 4502 no time limit
to apply.


May apply while on Active Duty
10-1394 R for adaptive equipment
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 Auto grant currently $18,900 one time
grant
 Do not purchase or contract for
vehicle until approval is received from
VA
 ELIGIBILITY:
 Loss or permanent loss of use of
one or both feet
 Loss or permanent loss of use of
one or both hands
 Blindness both eyes 20/200
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 May receive adaptive equipment for a
fusion of one or both knees or one or
both hips
 Adaptive equipment may be approved
for no more than 2 vehicles in a four
year period
 Specific questions about adaptive
equipment should be referred to
VAMC prosthetics department
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Handout #5: Automobile &
Special Adaptive Equipment
Grants
 Double
click to open
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HOME MODIFICATIONS
PROGRAM
 VA has three main grant programs to
assist disabled veterans and service
members with necessary home
modifications.
 Specially Adapted Housing (SAH)
Grant 26-4555
 Special Home Adaptation (SHA) Grant
 Home Improvements and Structural
Alterations (HISA) Grant 10-0103
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What Is a Specially Adapted
Housing (SAH) Grant?
The SAH Grant is designed to help provide a
barrier-free living environment that affords the
individual a level of independent living they may not
otherwise enjoy, such as creating a wheelchair
accessible home. Veterans and service members
with specific service-connected disabilities may be
entitled to a grant for the purpose of constructing or
modifying a home to meet their adaptive needs.
This grant is currently limited to $63,780.
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 The SAH grant is available to veterans
who are and service members who will
be entitled to disability compensation for
permanent and total disability due to:


Loss or loss of use of both lower
extremities, such as to preclude
locomotion without the aid of braces,
crutches, canes, or a wheelchair, or
Blindness in both eyes, having only light
perception, plus loss or loss of use of one
lower extremity, or
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


Loss or loss of use of one lower extremity
together with (1) residuals of organic
disease or injury, or (2) the loss or loss of
use of one upper extremity, which so
affects the functions of balance or
propulsion as to preclude locomotion
without the aid of braces, crutches, canes,
or a wheelchair or,
Loss or loss of use of both upper
extremities such as to preclude use of the
arms at or above the elbow, or
A severe burn injury (as so determined)
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What Is a Special Home
Adaptation (SHA) Grant?
The SHA grant is for modifying an existing home
to meet adaptive needs, such as assistance with
mobility throughout the home. Veterans and
service members with specific service-connected
disabilities may be entitled to this type of grant.
The grant is currently limited to $12,756. A
temporary grant may be available to veterans and
service members who are/will be temporarily
residing in a home owned by a family member.
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 The SHA grant is available to veterans
and service members who will be
entitled to disability compensation for
permanent and total disability due to:



Blindness in both eyes with 5/200 visual
acuity or less or,
The anatomical loss or loss of use of both
hands or extremities below the elbow, or
A severe burn injury (as so determined).
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What Is a Home Improvements
and Structural Alterations (HISA)
Grant?
Under the HISA program, veterans may receive
assistance for any home improvement necessary for
the continuation of treatment or for disability access to
the home and essential lavatory and sanitary facilities.
A HISA grant is available to veterans who have
received a medical determination indicating that
improvements and structural alterations are necessary
or appropriate for the effective and economical
treatment of their disability. A veteran may receive both
a HISA grant and either a SHA or SAH grant.
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 The HISA program is available for both
service-connected veterans and non
service-connected veterans.


Home improvement benefits up to $4,100
may be provided to service-connected
veterans
Home improvement benefits up to $1,200
may be provided to nonservice-connected
veterans.
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HOW CAN I APPLY FOR
SAH, SHA or HISA GRANTS?
 You can apply for the SAH and SHA grants by
completing VA Form 26-4555, Veterans Application
in Acquiring Specially Adapted Housing or Special
Home Adaptation Grant, and submitting it to your
local VA regional office.
 You can apply for a HISA grant by completed VA
Form 10-0103, Veterans Application for Assistance
in Acquiring Home Improvement and Structural
Alterations, and submitting it to your local VA medical
center.
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Handout #6:Home Modifications
(Double click to open)
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CLOTHING ALLOWANCE
 Annual payment made to veterans
who meet certain criteria.
 Loss or loss of use of one hand or foot.
 Service connected disabilities that
require use of one qualifying prosthetic
or orthopedic appliance (including but
not limited to a wheelchair) which
tends to wear or tear clothing.
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 Veteran uses medication for skin condition
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which causes irreparable damage to the
veteran’s garments.
Two clothing allowances.
Payable in late August or early September of
each year.
August 1 anniversary date.
Application form 10-8678.
Processed by VAMC closest to vets residence.
Amount payable $742.00
Withholding for incarceration 1/365th for each
day beyond 61st day of incarceration.
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Handout #7:Clothing Allowance
(double click to open)
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Concurrent Retirement And
Disability Payments (CRDP)
 Provides for a 10 year phase out of the
offset to military retired pay due to
receipt of VA disability compensation.
 Rates increased by approximately 10% a
year and totally phased out in 2014
 Must be retiree based on 20 years
service and elect compensation.
 Includes Guard and Reservists at age 60
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 Includes CH61 retirees with 20 years
service.
 Must have disability of 50% or more as
rated by VA
 No application necessary, automatic
data exchange.
 Benefits under this program are taxable.
 Program began 1-1-04
 Veterans rated 100% receive full retired
pay 1-1-05
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Initial & Additional Rates
Initial Rates: Year 2004
 100% 750
 90%
500
 80%
350
 70%
250
 60%
125
 50%
100
Additional Rates by Year
 2005: 10%
 2006: 28%
 2007: 49.60%
 2008: 69.76%
 2009: 84.88%
 2010: 93.95%
 2011: 98.18%
 2012: 99.64%
 2013: 99.96%
 2014: 100.00%
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How does CRDP Work?
 Example:
Vet rated at 50% with no dependents
$770
-$100 (initial calendar year 04 rate)
= $670 x 84.88% (calendar year 09)
= $568.70 + 100 = $668.70 Total CRDP
VA Comp @ 50% - CRDP Amount =
Amount of retired pay withheld: $770.00 –
$668.70 = $101.30
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 Benefits not payable until after 10-01-09
 Retro will be paid to 01-01-05
 Payment due from DFAS not VA
 Toll Free DFAS #: 1-800-321-1080
 Handout #8
(Double click to open)
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Combat Related Special
Compensation (CRSC)
 THE DEFENSE AUTHORIZATION ACT
OF 2003 ESTABLISHED CRSC.
 PURPOSE: TO COMPENSATE
RETIRED VETERANS FOR COMBAT
RELATED DISABILITIES
 6-1-03 INITIAL ENTITLEMENT DATE
 DISABILITIES EVALUATED 10% OR
MORE FOR WHICH A PURPLE HEART
WAS ISSUED
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 DISABILITES EVALUATED ALONE OR
COMBINED EVALUATION OF 60% OR
MORE
 INITIALLY FOR VETERANS RETIRED
BASED ON 20 YEARS SERVICE
 ELIGIBILITY DETERMINED BY
VETERANS RESPECTIVE BRANCH AND
PAID BY DEPARTMENT OF DEFENSE
(DOD) NOT VA
 THIS IS A DOD AND NOT A VA
PROGRAM. VA ASSISTS WITH
DOCUMENTATION AND SHARING OF
INFORMATION
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 APPLICATION FORM DD 2860 APRIL
2008: NEED COPY OF RATING, TO
INCLUDE CODE SHEET, COPY OF VA
NOTIFICATION LETTER, AND COPIES
OF DD 214’S.
 CHANGES 1-1-04
 ADDED 20 YEAR REETIREES FROM
GUARD AND RESERVE WITH
RETIREMENT AT AGE 60
 QUALIFYING COMBAT RELATED
DISABILITIES AT ANY %
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 QUALIFIERS:




IN THE PERFORMANCE OF DUTY
UNDER CONDITIONS SIMULATING WAR
WHILE ENGAGED IN HAZARDOUS
SERVICE (e.g. FLIGHT, DIVING,
PARACHUTE DUTY)
THROUGH AN INSTRUMENTALITY OF
WAR ( e. g. COMBAT VEHICLES,
WEAPONS)
AS A DIRECT RESULT OF ARMED
CONFLICT ( PURPLE HEART)
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

PRESUMPTIVE CASES( AGENT
ORANGE, RADIATION EXPOSURE, POST
TRAUMATIC STRESS DISORDER)
SEE INSERT FOR ADRESSES, DD 2860.
CRSC RECERTIFICATION, AND
RECONSIDERATION REQUEST FORM
 AMOUNT PAYABLE:



AMOUNT EQUAL TO AMOUNT OF
COMPENSATION VA WOULD PAY FOR
THE COMBAT RELATED DISABILITIES
DID NOT INCLUDE DEPENDENTS
ALLOWANCE PRIOR TO 1-1-04
CANNOT EXCEED GROSS RETIRED PAY
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







INCLUDES IU FROM 1-1-04
NON TAXABLE
1-1-08 INCLUDES MEDICAL RETIREMENT
CH 61 LESS THAN 20 YEARS
TEMPORARY DISABILITY RETIRED LIST
(TDRL)
TEMPORARY EARLY RETIREMENT
AUTHORITY (TERA)
CAN GET ONLY CRSC OR CRDP NOT BOTH
CRSC ALWAYS BEST FOR VA RATED
DISABILITIES OF LESS THAN 50%
MUST ELECT 1 MONTH WINDOW JANUARY
OF EACH YEAR
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 EXAMPLE CRSC COMPARED TO
CRDP :
CRSC SINGLE VET 50% VA $770
WOULD RECEIVE $9240
TAX FREE ANNUALLY
CRDP SINGLE VET 60% $974
WOULD RECEIVE 11,688 ANNUALLY
TAXABLE INCOME 11, 688
 DIFFERENCE $2448: VET WOULD
HAVE TO DECIDE WHAT IS BEST FOR
THEM
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Handout #9: CRSC
(Double click to open)
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