This week we would like to highlight essential facts to help our readers understand emergency medical care for veterans. But first and foremost, if you are experiencing a medical emergency and believe your life is in danger, please go to the nearest emergency room.
According to the Veterans Health Administration Office of Community Care, veterans can seek emergency care and call for an ambulance during a medical emergency before checking with the VA. The key is in acting promptly and notifying the VA within 72 hours of admission.
“This allows VA to assist the veteran in coordinating necessary care or transfer and helps to ensure that the administrative and clinical requirements for VA to pay for the care are met,” according to the U.S. Department of Veterans Affairs.
Now that we have the most important part out of the way, let’s review service-connected emergency care and nonservice-connected emergency care to assist you in navigating through the process.
SCEC covers an urgent medical condition that has been adjudicated by the Veterans Benefits Administration as related to the veteran’s service and granted a disability rating. In order to meet the requirements for the SCEC, a veteran must meet the following criteria: the veteran’s medical emergency was perceived, by the veteran or another person without medical training, as life-threatening and immediate medical attention was needed. The veteran is receiving emergency care for a service-connected, or adjunct condition in a community emergency department; the veteran is disabled as a result of a service-connected condition or the veteran is participating in a VA Vocational Rehabilitation Program, and requires emergency treatment to expedite their return to the program.
For a service-connected emergency to be eligible, the emergency must meet five specific requirements. First, the veteran must have received the medical care at a hospital emergency department; second, the emergency was of such nature that the veteran or another person — without medical training, perceived it as life-threatening. Third, a federal facility was not reasonably available to provide the care. Fourth, the veteran has received care within a VA facility during the 24 months before the emergency care. Fifth, the veteran is financially liable to the emergency treatment provider.
Remember that time is of the essence, especially when it comes to submitting a medical claim. According to the VA, veterans who were treated for a service-connected emergency have up to two years from the date the emergency care was provided. Those who were treated for a nonservice-connected emergency have up to 90 days from the date of discharge.
Keep in mind that in order for your claim to be processed, you must allow enough time for the VA to receive and review your documentation. If your documents are incomplete or need further clarification, the processing of your claim might be delayed.
For more information about emergency medical care for veterans, eligibility and claims, visit www.va.gov/communitycare.com.
Story by Ena Sellers.