38-U.S.C.-1722
§1722 – Determination of Inability to Defray Necessary Expenses; Income Thresholds
Pathway
Title 38 > Part II > Chapter 17 > Subchapter III > Section 1722
Details
- Reference: Section 1722
- Legend: §1722 – Determination of Inability to Defray Necessary Expenses; Income Thresholds
- USCode Year: 2013
Provision Content
(a) For the purposes of section 1710(a)(2)(G) of this title, a veteran shall be considered to be unable to defray the expenses of necessary care if—
(1) the veteran is eligible to receive medical assistance under a State plan approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
(2) the veteran is in receipt of pension under section 1521 of this title; or
(3) the veterans attributable income is not greater than the amount set forth in subsection (b).
(b)(1) For purposes of subsection (a)(3), the income threshold for the calendar year beginning on January 1, 1990, is—
(A) $17,240 in the case of a veteran with no dependents; and
(B) $20,688 in the case of a veteran with one dependent, plus $1,150 for each additional dependent.
(2) For a calendar year beginning after December 31, 1990, the amounts in effect for purposes of this subsection shall be the amounts in effect for the preceding calendar year as adjusted under subsection (c) of this section.
(c) Effective on January 1 of each year, the amounts in effect under subsection (b) of this section shall be increased by the percentage by which the maximum rates of pension were increased under section 5312(a) of this title during the preceding calendar year.
(d)(1) Notwithstanding the attributable income of a veteran, the Secretary may refuse to make a determination described in paragraph (2) of this subsection if the corpus of the estate of the veteran is such that under all the circumstances it is reasonable that some part of the corpus of the estate of the veteran be consumed for the veterans maintenance.
(2) A determination described in this paragraph is a determination that for purposes of subsection (a)(3) of this section a veterans attributable income is not greater than the amount determined under subsection (b) of this section.
(3) For the purposes of paragraph (1) of this subsection, the corpus of the estate of a veteran shall be determined in the same manner as the manner in which determinations are made of the corpus of the estates of persons under section 1522 of this title.
(e)(1) In order to avoid a hardship to a veteran described in paragraph (2) of this subsection, the Secretary may deem the veteran to have an attributable income during the previous year not greater than the amount determined under subsection (b) of this section.
(2) A veteran is described in this paragraph for the purposes of subsection (a) of this section if—
(A) the veteran has an attributable income greater than the amount determined under subsection (b) of this section; and
(B) the current projections of such veterans income for the current year are that the veterans income for such year will be substantially below the amount determined under subsection (b).
(f) For purposes of this section:
(1) The term attributable income means the income of a veteran for the most recent year for which information is available determined in the same manner as the manner in which a determination is made of the total amount of income by which the rate of pension for such veteran under section 1521 of this title would be reduced if such veteran were eligible for pension under that section.
(2) The term corpus of the estate of the veteran includes the corpus of the estates of the veterans spouse and dependent children, if any.
(3) The term previous year means the calendar year preceding the year in which the veteran applies for care or services under section 1710(a) of this title.
(g) For the purposes of section 1724(c) of this title, the fact that a veteran is—
(1) eligible to receive medical assistance under a State plan approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
(2) a veteran with a service-connected disability; or
(3) in receipt of pension under any law administered by the Secretary,
shall be accepted as sufficient evidence of such veterans inability to defray necessary expenses.
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1144, §622; Pub. L. 89–612, §1, Sept. 30, 1966, 80 Stat. 859; Pub. L. 91–500, §1, Oct. 22, 1970, 84 Stat. 1096; Pub. L. 94–581, title II, §§202(k), 210(a)(9), Oct. 21, 1976, 90 Stat. 2856, 2863; Pub. L. 96–330, title IV, §401(a), Aug. 26, 1980, 94 Stat. 1051; Pub. L. 99–272, title XIX, §19011(c)(1), Apr. 7, 1986, 100 Stat. 376; Pub. L. 100–322, title I, §102(b), May 20, 1988, 102 Stat. 493; Pub. L. 101–508, title VIII, §8013(c), Nov. 5, 1990, 104 Stat. 1388–346; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1722 and amended Pub. L. 102–83, §§4(a)(1), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 403–406; Pub. L. 104–262, title I, §101(d)(9), Oct. 9, 1996, 110 Stat. 3180; Pub. L. 112–154, title VII, §705, Aug. 6, 2012, 126 Stat. 1206.)
References in Text
The Social Security Act, referred to in subsecs. (a)(1) and (g)(1), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Social Security Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Prior Provisions
Prior section 1722, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1196, related to change of program by eligible person, prior to repeal by Pub. L. 92–540, title IV, §402(2), Oct. 24, 1972, 86 Stat. 1090. See section 3691 of this title.
Amendments
2012—Subsec. (f)(1). Pub. L. 112–154 substituted the most recent year for which information is available for the previous year.
1996—Subsec. (a). Pub. L. 104–262, §101(d)(9)(A), substituted section 1710(a)(2)(G) for section 1710(a)(1)(I) in introductory provisions.
Subsec. (f)(3). Pub. L. 104–262, §101(d)(9)(B), struck out or 1712(f) before of this title.
1991—Pub. L. 102–83, §5(a), renumbered section 622 of this title as this section.
Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted 1710(a)(1)(I) for 610(a)(1)(I) in introductory provisions and 1521 for 521 in par. (2).
Subsec. (c). Pub. L. 102–40 substituted 5312(a) for 3112(a).
Subsec. (d)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted Secretary for Administrator.
Subsec. (d)(3). Pub. L. 102–83, §5(c)(1), substituted 1522 for 522.
Subsec. (e)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted Secretary for Administrator.
Subsec. (f). Pub. L. 102–83, §5(c)(1), substituted 1521 for 521 in par. (1) and 1710(a) or 1712(f) for 610(a) or 612(f) in par. (3).
Subsec. (g). Pub. L. 102–83, §5(c)(1), substituted 1724(c) for 624(c) in introductory provisions.
Pub. L. 102–83, §4(a)(1), substituted administered by the Secretary for administered by the Veterans’ Administration in par. (3).
1990—Subsec. (a). Pub. L. 101–508, §8013(c)(1), designated par. (1) as entire subsec. (a), redesignated cls. (A) to (C) as pars. (1) to (3), respectively, substituted amount set forth in subsection (b) for Category A threshold in par. (3), and struck out former par. (2) which read as follows: For the purposes of section 610(a)(2)(A) of this title, a veterans income level is described in this paragraph if the veterans attributable income is not greater than the Category B threshold.
Subsec. (b). Pub. L. 101–508, §8013(c)(2), amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: For the purposes of this section:
(1) The Category A threshold—
(A) for the calendar year beginning on January 1, 1986, is—
(i) $15,000 in the case of a veteran with no dependents; and
(ii) $18,000 in the case of a veteran with one dependent, plus $1,000 for each additional dependent; and
(B) for a calendar year beginning after December 31, 1986, is the amount in effect for purposes of this paragraph for the preceding calendar year as adjusted under subsection (c) of this subsection.
(2) The Category B threshold—
(A) for the calendar year beginning on January 1, 1986, is—
(i) $20,000 in the case of a veteran with no dependents; and
(ii) $25,000 in the case of a veteran with one dependent, plus $1,000 for each additional dependent; and
(B) for a calendar year beginning after December 31, 1986, is the amount in effect for purposes of this paragraph for the preceding calendar year as adjusted under subsection (c) of this subsection.
Subsec. (c). Pub. L. 101–508, §8013(c)(3), struck out paragraphs (1) and (2) of before subsection (b) of this section.
Subsec. (d)(2). Pub. L. 101–508, §8013(c)(4), amended par. (2) generally. Prior to amendment, par. (2) read as follows: A determination described in this paragraph is a determination—
(A) that for the purposes of subsection (a)(1)(C) of this section a veterans attributable income is not greater than the Category A threshold; or
(B) that for the purposes of subsection (a)(2) of this section a veterans attributable income is not greater than the Category B threshold.
Subsec. (e)(1). Pub. L. 101–508, §8013(c)(5)(A), substituted the amount determined under subsection (b) of this section for the Category A threshold or the Category B threshold, as appropriate.
Subsec. (e)(2). Pub. L. 101–508, §8013(c)(5)(B), added par. (2) and struck out former par. (2) which read as follows:
(A) A veteran is described in this paragraph for the purposes of subsection (a)(1) of this section if—
(i) the veteran has an attributable income greater than the Category A threshold; and
(ii) the current projections of such veterans income for the current year are that the veterans income for such year will be substantially below such threshold.
(B) A veteran is described in this paragraph for the purposes of subsection (a)(2) of this section if—
(i) the veteran has an attributable income greater than the Category B threshold; and
(ii) the current projections of such veterans income for the current year are that the veterans income for such year will be substantially below such threshold.
1988—Subsec. (g). Pub. L. 100–322 substituted section for sections 610(b)(2) and.
1986—Pub. L. 99–272 amended section generally, revising and restating existing provisions as subsec. (g) and adding subsecs. (a) to (f).
1980—Pub. L. 96–330 substituted provisions relating to the facts that will be accepted as sufficient evidence of an individuals inability to defray necessary expenses for provisions relating to the use of statements under oath to establish the inability to defray necessary expenses.
1976—Subsec. (a). Pub. L. 94–581, §202(k), substituted 610(a)(1)(B) for 610(a)(1) and 632(a)(2) for 632(b).
Subsec. (b). Pub. L. 94–581, §210(a)(9), substituted such veterans inability for his inability.
1970—Pub. L. 91–500 designated existing provisions as subsec. (a) and added subsec. (b).
1966—Pub. L. 89–612 inserted reference to section 632(b) of this title.
Effective Date of 1990 Amendment
Amendment by Pub. L. 101–508 to remain in effect through the period covered by Pub. L. 102–145, see section 111 of Pub. L. 102–145, set out as a note under section 1710 of this title.
Amendment by Pub. L. 101–508 to remain in effect through the period covered by Pub. L. 102–109, see section 111 of Pub. L. 102–109, set out as a note under section 1710 of this title.
Amendment by Pub. L. 101–508 applicable with respect to hospital care and medical services received after Nov. 5, 1990, see section 8013(d) of Pub. L. 101–508, as amended, set out as a note under section 1710 of this title.
Effective Date of 1986 Amendment
Provisions of this section as in effect on the day before Apr. 7, 1986, applicable with respect to hospital and nursing home care furnished on or after July 1, 1986, to veterans furnished such care or services on June 30, 1986, but only to the extent that such care is furnished with respect to the same episode of care for which it was furnished on June 30, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.
Effective Date of 1976 Amendment
Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.
Initial Increase Under Subsection (c)
Pub. L. 99–272, title XIX, §19011(c)(3), Apr. 7, 1986, 100 Stat. 378, provided that the first increase under subsection (c) of this section, as added by section 19011(c)(1) of Pub. L. 99–272, was to take effect on Jan. 1, 1987.
U.S. Encyclopedia of Law Coverage
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