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Birth Defects Assistance - Payments For Children With Spina Bifida Whose Parents Served In Vietnam Or Korea

September 29, 2023

The U.S. Department of Veterans Affairs (VA) has long recognized the sacrifices made by those who served in the Vietnam and Korean wars. As part of its ongoing commitment to veterans and their families, the VA has established a specialized program to provide compensation rates for children of these veterans diagnosed with spina bifida.

This assistance program is not just about financial compensation. It's a testament to the VA's dedication to acknowledging the indirect consequences of war and ensuring that the families of those who served are not left to face these challenges alone. The compensation is designed to alleviate some financial burdens associated with medical treatments, therapies, and other care needs that children with spina bifida might require.

In this guide, we will delve into the eligibility requirements and application process for VA's Birth Defects Assistance Program, which supports children with spina bifida whose parents served in Vietnam or Korea.

Program Contact1-888-820-1756 & 1-800-829-4833
Additional InfoSpina Bifida Health Care Benefits Program (SBHCBP) - Community Care 
Managing AgencyU.S. Department of Veterans Affairs (VA)

Definition Of Spina Bifida Occulta

Spina bifida occulta is the mildest form of spina bifida. In this condition, there's a small gap in the spine, but no opening or sac on the back. The spinal cord and the nerves usually remain normal, without any visible or apparent disabilities. Many people with spina bifida occulta don't even know they have it, as it's often discovered accidentally during an X-ray for another reason.

Background On Birth Defects Assistance Program

The Birth Defects Assistance Program was established to provide financial support to the children of veterans who served in Vietnam, Thailand, or in or near the Korean Demilitarized Zone (DMZ) and have been diagnosed with spina bifida or certain other birth defects. The compensation rates are determined based on the severity of the child’s disability, ranging from least to most disabling.

Compensation Rates For 2023 (Effective From December 1, 2022):

  • Vietnam and Korea Veterans’ children with spina bifida:

    • Level I (least disabling): $394

    • Level II: $1,339

    • Level III (most disabling): $2,279

  • Women Vietnam Veterans’ children with certain other birth defects:

    • Level I (least disabling): $184

    • Level II: $394

    • Level III: $1,339

    • Level IV (most disabling): $2,279

To determine if a child is eligible for compensation, the veteran parent must have served in Vietnam or Thailand, or in or near the Korean DMZ. If the child has been diagnosed with spina bifida or certain other birth defects, they may qualify for compensation and other disability benefits.

The VA also provides information on birth defect compensation rates for past years, ensuring transparency and clarity for veterans and their families.

The Birth Defects Assistance Program is a testament to the VA's dedication to supporting the brave men and women who served their country and their families who face the challenges of birth defects.

Eligibility Requirements

The U.S. Department of Veterans Affairs (VA) offers a range of benefits for children who have spina bifida or certain other birth defects and are the biological offspring of Veterans who served in Vietnam or Korea. These benefits are designed to support these children based on the degree of their disability.

Parental Military Service Requirements

For a child to be eligible for the VA's Birth Defects Assistance Program, the birth parent must have served:

  • In Vietnam during the period from January 9, 1962, through May 7, 1975.
  • In or near the Korean demilitarized zone (DMZ) anytime between September 1, 1967, and August 31, 1971. Veterans who served in this region during this timeframe are presumed to have been exposed to herbicides.

It's essential to note that the affected child must have been conceived after the Veteran first entered Vietnam or the Korean DMZ during the qualifying service period.

Diagnosis Of Spina Bifida Occulta

Children who have spina bifida, with the exception of spina bifida occulta, and are biological offspring of Veterans with the above-mentioned service qualifications may be eligible for the VA's Birth Defects Assistance Program. Spina bifida occulta is a milder form of spina bifida where there's a small gap in the spine but no opening or sac on the back. The spinal cord and nerves usually remain normal.

Children Covered By The Benefit Program

The VA's Birth Defects Assistance Program covers:

  • Children with spina bifida (except spina bifida occulta) who are the biological offspring of Veterans who served in Vietnam or the DMZ in Korea during the Vietnam era.

  • Children with certain other birth defects who are the biological offspring of women Veterans who served in Vietnam. The eligibility period for these women Veterans is from February 28, 1961, to May 7, 1975. The affected child must have been conceived after the Veteran first entered Vietnam during this qualifying service period.

  • The birth defect must have resulted in a permanent physical or mental disability, and the covered birth defects do not include conditions due to family disorders, birth-related injuries, or fetal or neonatal infirmities with well-established causes.

To apply for these benefits, one can complete the VA Form 21-0304, which is an application for benefits for certain children with disabilities born of Vietnam and certain Korea Service Veterans. This form can be mailed to the address provided on it for further processing.

For any queries or more information, individuals can reach out to the VA through their toll-free numbers: 1-888-820-1756 or 1-800-829-4833 (TDD for the hearing impaired).

Types Of Benefits Offered

The Department of Veterans Affairs (VA) offers a range of benefits to the children of Vietnam veterans diagnosed with spina bifida. These benefits are tailored to support these children based on the severity of their condition and the associated challenges they face.

Monetary Allowance

The VA provides monetary allowances to children diagnosed with spina bifida who are the offspring of Vietnam veterans. The amount of this allowance is determined based on the child's degree of disability. The monetary benefit is designed to assist families in managing the financial challenges associated with spina bifida and its related complications.

Health Care Services And Rehabilitative Care

In addition to the monetary allowance, the VA offers health care benefits specifically tailored for the treatment of spina bifida and related medical conditions. It's essential to note that the health care benefits provided under this program are limited to treatments necessary for spina bifida and its associated conditions. This means that the program does not cover medical services unrelated to spina bifida. Beneficiaries are advised to maintain a comprehensive health care plan for other unrelated health care needs.

Some of the key features of the health care services offered include:

  • Vocational Training: The VA’s Vocational Rehabilitation and Employment Service is available for eligible children. This service aims to provide vocational training and job assistance, ensuring that the child can achieve a feasible vocational goal.

  • Provider Options: Beneficiaries have the freedom to choose their preferred health care provider, provided the provider is appropriately licensed and certified. An alternative to VA-financed health care is the Shriners Hospitals for Children, a non-profit charitable corporation offering comprehensive services to children under the age of 18.

  • Medical Benefits: The program covers most health care services and supplies that are medically or psychologically necessary for the treatment of spina bifida and related conditions.

To apply for these benefits, families can complete the VA Form 21-0304, Application for Spina Bifida Benefits. It's recommended to seek the assistance of a Veteran Service Officer (VSO) when applying to ensure that the application is complete and contains all the necessary information.

Department Of Veterans Affairs Benefits Overview

The Department of Veterans Affairs (VA) is committed to supporting the children of Vietnam and Korea Veterans diagnosed with spina bifida. The VA offers a comprehensive range of benefits tailored to the needs of these children, ensuring they receive the necessary care and support.

Program Guidelines And Eligibility Criteria For Qualifying Children

The VA provides monetary allowances, vocational training, rehabilitation, and VA-financed health care benefits to certain Korea and Vietnam Veterans' birth children diagnosed with spina bifida. To qualify for these benefits:

  • The child must be a biological offspring of a Vietnam or Korean Veteran.
  • The child must have been diagnosed with spina bifida, as defined by the VA. This includes all forms or manifestations of spina bifida, excluding spina bifida occulta.

  • The child must have been conceived after the date the veteran first entered the Republic of Vietnam (between January 9, 1962, and May 7, 1975) or Korea (between September 1, 1967, and August 31, 1971).

Determining Monthly Allowance Amounts

severity of their condition. The exact amount is determined after a thorough assessment of the child's condition and the associated challenges they face. The Veterans Health Administration Office of Integrated Veteran Care (VHA IVC) manages the spina bifida health care benefits program, including the authorization of benefits and subsequent processing and payment of health care claims.

Rules Governing Disabled Veterans With Dependent Children Receiving Benefit Payments

Once the VA determines a child's eligibility for spina bifida benefits, the child (or their guardian) is registered for health care benefits. Detailed information about covered and non-covered services, preauthorization requirements, and claim filing instructions are provided to beneficiaries.

Additionally, the VA offers pharmacy benefits, including Meds by Mail, a service that delivers non-urgent maintenance medications to beneficiaries' doors. The OptumRx Retail Pharmacy Network also processes pharmacy claims and services beneficiaries through a vast network of retail pharmacies.

It's essential to note that the Spina Bifida Health Care Benefits Program meets the coverage standards set by the Affordable Care Act (ACA). Enrolled beneficiaries do not need to take additional steps to meet the ACA's health care law coverage standards.

For those interested in applying or seeking more information, the VA provides various resources, including program guides, brochures, and fact sheets. The Spina Bifida Association website is another valuable resource for families and individuals seeking more information about spina bifida and available support.

Application Process For Benefit Program Participation

The Spina Bifida Health Care Benefits Program (SBHCBP) is a specialized program administered by the VA, designed to cater to the needs of Vietnam and certain Korean Veterans' birth children diagnosed with spina bifida (excluding spina bifida occulta). The program offers comprehensive health care that is deemed medically necessary and appropriate for the condition.

Eligibility And Enrollment:

Initial Eligibility: To be considered for the Spina Bifida Health Care Benefits Program, a child must first qualify for a monetary award under the Veterans Benefits Administration (VBA). The determination regarding this entitlement is made by the Denver VA Regional Office.

  • Automatic Enrollment: Once the VBA has granted a monetary award, they notify the Office of Integrated Veteran Care. Following this notification, the enrollment in the Spina Bifida Health Care Program is automatic.

  • Provider Participation: Health care providers wishing to participate in the SBHCBP must meet specific criteria. They should be appropriately licensed in their state and should not be listed on the Medicare exclusion list. Furthermore, providers are required to accept the VA-determined allowable amount for care. An essential note for community care providers, including those under the SBHCBP, is that they must enroll for Electronic Funds Transfer (EFT), ensuring that payments are directly deposited into their bank accounts.

Application And Claim Process:

  1. Standard Billing: Providers are expected to use a standard billing form, such as the UB-04/CMS 1500, to provide the necessary information for claims.

  2. Claim Filing: Detailed guidelines on how to file claims for payments, including a list of required documentation, can be found in the "How to File a Claim for the Spina Bifida Health Care Benefits Program" section provided by the VA.

  3. Preauthorization Requirements: Certain services require preauthorization. These include attendants, day health care as an outpatient service, dental services, durable medical equipment costing over $2,000, health-related homemaker services, outpatient mental health services exceeding 23 visits per calendar year, substance abuse treatment, training for family members or guardians, transplantation services, and specific travel expenses. 

Preauthorization requests can be sent via fax to 303-331-7807.

Get Help With The VA's Birth Defects Assistance Program

In the face of challenges that families of veterans face, especially those whose children are diagnosed with spina bifida, the VA's Birth Defects Assistance Program stands as a beacon of hope and support. This program not only acknowledges the sacrifices made by our veterans but also ensures that their offspring receive the necessary care and assistance they deserve. As we navigate through the intricacies of the program, from eligibility to benefits and the application process, it's evident that the VA is deeply committed to serving those who have served the nation. For families eligible for this program, it offers a pathway to better healthcare, financial support, and an improved quality of life.

Find out how to claim PTSD VA Disability by checking out our detailed guide. Visit American Veteran and browse through the available resources to learn more.

Michael Blair contributes his expertise to help veterans access government benefits and resources. Through his informative articles and guides, he plays a vital role in empowering veterans and improving their quality of life.
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