Individually Unemployable Health Insurance Benefits for Family

If you are found “individually unemployable” by Veterans Affairs, you may be entitled to more benefits than other veterans are.  Among these is the highly important health coverage plan for qualifying family members: the CHAMPVA program. But these things are rarely simple, and being “IU” does not automatically make you eligible to sponsor your loved ones for it.

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Individual Unemployability

What does it mean to be rated unemployable?

It’s no secret that the VA disability rating system can be complicated and confusing.  Besides the “schedular” disability rating that rates a veteran’s disability by percentage, there is also the concept of unemployability.  This means that VA can award a higher disability assessment to a veteran if it finds the schedular rating doesn’t adequately describe his or her condition.

Should a disabled veteran have a less than total, that is 100%, schedular disability rating, he or she normally would not receive the same benefits as for totally disabled veterans.  However, if the VA finds that the vet cannot sustain gainful employment – that is, cannot work – due to service-connected injuries, that person may be awarded individual unemployability.   This in turn, means the veteran can receive disability compensation at the 100% rate, just as if he or she had received a 100% schedular rating.

CHAMPVA Benefits

The Civilian Health and Medical Program of the VA is an entitlement program, a health care coverage benefit for the spouses and qualifying children of certain eligible veterans.  Generally, the veteran sponsor must be permanently and totally disabled due to service-connected injuries to be able to enroll his or her family in the program.

CHAMPVA is comprehensive and there are supplements available for fuller coverage.  Because there are no premiums, there is no reason why qualifying veterans should not apply for it.  This includes the individually unemployable described below who do qualify.

Permanent and Total Disability, CHAMPVA and Chapter 35 Benefits

If the VA also considers the disabled condition as permanent and total, the veteran should also be awarded Chapter 35 education benefits — including those who are “individually unemployable.”  When a veteran is eligible for this Chapter 35, it indicates he or she can also get CHAMPVA for spouse and children.

It is unfortunate that the VA is not always clear and consistent in its language.  You might not find “permanent and total” mentioned directly in your award letter.  Therefore other benefits you get can serve as clues, and Chapter 35 is the best indication you qualify for CHAMPVA.

Not everyone who is “IU” would necessarily be eligible for CHAMPVA.  Your condition must be regarded as both total and permanent.

Some say not being called for exams is a sign you are P&T – permanent and total.  But the surest way to tell is if you apply for it and receive it.  Keep in mind that the veteran is NOT eligible to use CHAMPVA; only his or her spouse and qualifying children are.

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This website, CHAMPVAbenefits.com, is NOT affiliated with the Department of Veterans Affairs or any part of the U.S. government. Please DO NOT send us information about yourself such as your SSN, name, address, etc. for help with CHAMPVA…. The pharmacy network for CHAMPVA now is Catamaran (formerly SXC)…. Further, we cannot guarantee that the information here is accurate and up-to-date. To ensure you have the latest information, please visit the official CHAMPVA home page at http://www.va.gov/hac/forbeneficiaries/champva/champva.asp. Your use of this site means you agree to and understand this disclaimer. Thank you!

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