Wisconsin Administrative Code
Department of Veterans Affairs
Chapter VA 2 - Veterans Assistance Grants
Section VA 2.01 - Subsistence and health care aid grant programs
Universal Citation: WI Admin Code § VA 2.01
Current through February 24, 2025
(1g) AUTHORITY AND PURPOSE.
(a) The purpose of this section is to
establish rules for the administration of the subsistence and health care aid
grant programs, as authorized under s.
45.40,
Stats.
(b) The subsistence and
health care aid grant programs provide limited financial assistance to eligible
veterans or their dependents who are in need.
(c) Grants may be used up to the maximum
grant limits as specified in this section.
(1r) DEFINITIONS. In this section the following terms shall have the designated meanings:
(b) "Applicant's family" means the
applicant's spouse and dependents or, where the applicant is a dependent, the
parents, stepparents, or any custodial guardians of the dependent.
(c) "Approved treatment programs" means
treatment programs approved by the USDVA or alcohol and other drug treatment
programs certified by the Wisconsin department of health services.
(d) "Available liquid assets" means cash on
hand, including cash in checking, savings, money market or similar accounts,
owned, either jointly or solely, by the applicant or the applicant's family.
(dm) "Change in refractive error"
means an increase or decrease of sphere, cylinder or power of at least the
following: sphere power of + or - .25 diopter; cylinder power of + or - .5
diopter; axis change of + or -.25 to .75 diopters at 5 degrees, + or - 1 to 2
diopters at 3 degrees or + or -2.25 or more diopters at 2 degrees.
(e) "Declaration of aid" means a written
determination regarding the availability of county, state, or federal aid
administered by the county for an applicant. A declaration of aid must be
signed by a county official authorized to determine whether aid is available
for an applicant and the applicant's family and whether the applicant has
accepted the aid available.
(f)
"Dental care" means any care provided by a licensed dentist given to teeth, the
supporting natural and artificial structures for teeth, and any replacement or
restoration of teeth.
(i)
"Description of benefits" means a written determination that an applicant is
eligible for health care aid. A description of benefits expires 90 days after
the date of eligibility is established and printed by the department unless
extended by the department.
(j)
"Earned income" means all anticipated family monthly take home earnings from
employment including armed forces reserve and national guard pay, and work
study payments, after all payroll deductions of the applicant and the
applicant's family except payroll deductions for savings plans and payment of
debts.
(k) "Economic emergency"
means a natural disaster which damages an applicant's primary living residence,
a medical emergency, the failure of the applicant's sole means of
transportation, or a severe disruption in essential household systems caused by
a failure of the applicant's stove, refrigerator, heating system, ventilating
and air conditioning system, plumbing system, or electrical system such that it
materially compromises the applicant's ability to live.
(kr) "Extended dental care" means a dental
device, including dentures, that replaces one or more teeth and includes all
dental preparation and the manufacture and fitting of the device.
(l) "Health care" means dental care, extended
dental care, hearing care, and vision care.
(m) "Health care aid" means the payment by
the department for health care.
(n)
"Hearing care" means any care provided by a licensed audiologist related to
hearing, including hearing exams or hearing aids.
(o) "Illness or injury" means a physical or
mental health problem that has been diagnosed by a licensed physician, dentist,
optometrist, or audiologist.
(p)
"Month" means any consecutive 30-calendar day period.
(q) "Natural disaster" means a catastrophic
occurrence over which the applicant or family members living with the applicant
has no control, including, but not limited to, a fire, flood, tornado,
blizzard, or earthquake.
(r)
"Subsistence" means essential living expenses including current rent or
mortgage payments on the applicant's primary residence, food, current medical
insurance premiums, current costs for prescribed medications, essential travel,
child care required because of employment, educational, or medical reasons, and
current costs for electricity, heat, basic internet service not otherwise
covered within the applicant's basic telephone service, and basic telephone
service for the applicant's primary residence. "Subsistence" also means any
repairs or purchases required due to an economic emergency.
(s) "Subsistence aid" means the grant payment
provided by the department for subsistence.
(t) "Unearned income" means the estimated
amount the applicant and the applicant's family receives in benefits or grants
during any month from the USDVA or other government agencies, scholarships,
fellowships, grants, tuition and fee waivers, all other definite awards other
than loans, including amounts paid to the applicant or the applicant's family
or to the school on behalf of the applicant or applicant's family for
vocational rehabilitation by the USDVA or any other agency, income from trusts
or inheritances, unemployment insurance benefits, worker's compensation, social
security payments, net rentals from real estate, interest or dividend income or
other income not included under earned income. "Unearned income" does not
include death benefits paid by the USDVA or other federal agencies.
(u) "Vision care" means a vision exam
provided by a licensed vision care provider and a prescription for lens and
frame.
(2) SUBSISTENCE AID.
(a)
Application.
1. A grant application for subsistence aid
shall be submitted on a form approved by the department.
Note: The application for subsistence aid (form WDVA 2453) may be obtained at WisVets.com or by request: 1-800-WIS-VETS or 2135 Rimrock Road, PO Box 7843, Madison, WI 53707-7843.
2. The application may be submitted through a
county veterans service officer, through any other department authorized agent,
or directly to the department, either manually or electronically.
3. The application shall be submitted to the
department no later than 12 months following the verified loss of income due to
illness, injury, or natural disaster.
4. A declaration of aid shall be submitted
with the application. The declaration shall state that the applicant has
applied for all aid offered through or administered by the county, including
aid from the federal or state government.
5. The application shall list all of the
applicant's household assets and the household living expenses for the period
of 6 months immediately preceding the date of the application.
6. If requested by the department the
applicant shall submit evidence establishing that all other available aid has
been applied for and accepted.
7.
The department may request additional verification of any information provided
in the application.
8. The
department shall notify the applicant or the applicant's county veterans
service officer if any required documentation is missing or if further
verification is required to make a decision on the applicant's eligibility. The
department may terminate an application if such documentation or verification
does not arrive at the department's central office within 60 days of that
notification.
(b)
Eligibility. An applicant is eligible to receive grant funds
under this subsection when all of the following apply:
1. The applicant satisfies the requirements
of s.
45.01(12),
Stats., to be considered a veteran, or is a spouse or dependent of an
individual who satisfies the requirements of s.
45.01(12),
Stats.
2m. The applicant has
suffered a loss of income due to illness, injury, or natural disaster. If the
loss of income is the result of alcohol or other drug abuse, the applicant
shall verify current participation in a department-approved treatment
program.
3m. Except for an
applicant who is eligible under par. (d), the applicant's household income may
not exceed 200 percent of the federal poverty guidelines, in effect on the date
the application arrives at the department's central office, for the number of
family members living in the primary residence.
4. The applicant lacks other assets or income
to meet basic subsistence needs and is not eligible to receive aid from other
sources to meet those needs.
(c)
Unremarried surviving spouse and
dependent of a veteran who dies in the line of duty. An unremarried
surviving spouse and a dependent claiming eligibility due to the death of a
veteran in the line of duty shall submit evidence from the appropriate military
service indicating that the veteran died in the line of duty.
(d)
Spouse and dependent of activated
or deployed member. A spouse and dependent of a member of the U.S.
armed forces or of the Wisconsin national guard claiming eligibility shall
submit evidence that the service member has been deployed or activated, that
due to the activation or deployment a loss of income has occurred, that an
economic emergency has occurred during the activation or deployment, and that
the spouse and dependent are residents of the state.
(e)
Limitations.
1. Subsistence aid is available for the
90-day period following the date of the verified loss of income due to illness,
injury, or a natural disaster.
2.
An application for subsistence aid shall be submitted within 12 months
following the date of the verified loss of income.
3. Payments may be provided in 30-day
increments or for a 90-day period, beginning with the date of eligibility, as
determined by the application.
4.
Subsistence aid shall be limited to the difference between the amount of earned
and unearned income available before the loss of income and the earned and
unearned income being received after the loss of income, subject to the
limitations under s.
45.40(1m) (b) and (3), Stats.
(f)
Loss of income
verification.
1. The applicant shall
verify the loss of income by submitting verification of income forms, certified
public accounting statements, or any other evidence the department deems
credible.
2. If the loss of income
is due to an illness or injury, the illness or injury shall be verified in
writing on a form approved by the department.
Note: The Verification of Illness or Disability form (WDVA 2045) may be obtained at WisVets.com or by request: 1-800-WIS-VETS or 2135 Rimrock Road, PO Box 7843, Madison, WI 53707-7843.
3. When the department has evidence that the
incapacitation will cause an income loss for 90 days or longer, subsistence
grants will be prorated for each of the 30-day periods unless the department
determines that an alternate distribution of the grant would benefit the
applicant.
(g)
Maximum amount of subsistence aid.
1. An application approved by the department
shall have the balance of the maximum available aid allocated unless the
applicant indicates a lesser amount in writing.
2. The maximum amount of subsistence aid
payable in a consecutive 12-month period is $3,000.
(3m) HEALTH CARE AID.
(a)
Application.
1. A grant application for health care aid
shall be submitted on a form approved by the department.
Note: The grant application (form WDVA 2450) may be obtained at WisVets.com or by request: 1-800-WIS-VETS or 2135 Rimrock Road, PO Box 7843, Madison, WI 53707-7843.
2. An application may be submitted through a
county veterans service officer, through any other department-authorized agent,
or directly to the department, either manually or electronically.
3. The application shall list all of the
applicant's household assets.
4. A
declaration of aid shall be submitted with the application. The declaration
shall state that the applicant has applied for all aid offered through or
administered by the county, including aid from the state or federal
government.
5. The department shall
notify the applicant or the applicant's county veterans service officer if any
required documentation is missing or if further verification is required to
make a decision on the applicant's eligibility. The department may terminate an
application if such documentation or verification does not arrive at the
department's central office within 60 days after that notification.
(b)
Eligibility.An applicant is eligible to receive grant funds
under this subsection when all of the following apply:
1. The applicant satisfies the requirements
of s.
45.01(12),
Stats., to be considered a veteran, or is a spouse or dependent of an
individual who satisfies the requirements of s.
45.01(12),
Stats.
2. Except for an applicant
who is eligible under par. (f), the applicant's household income may not exceed
200 percent of the federal poverty guidelines, in effect on the date the
application arrives at the department's central office, for the number of
family members living in the primary residence.
3. The applicant's liquid assets may not
exceed $1,000. When determining the liquid assets of the veteran, the
department may not include the first $50,000 of cash surrender value of any
life insurance policy.
(c)
Requirements.
1. An application approved by the department
shall have the balance of the maximum available aid allocated unless the
applicant indicates a lesser amount in writing.
2. The department shall indicate on each
description of benefits the type of aid authorized, the date the department
confirmed that the applicant was eligible for the grant, a date 90 calendar
days from that date, the unallocated amount available for the type of aid and
for the cumulative limits of aid under this section, and the amount of aid
being authorized.
3. The
department's determination of whether the veteran has sufficient available
liquid assets to contribute towards a payment is based on verification of the
applicant's income at the time of the application. If the veteran's income
increases after the department determines eligibility, the veteran shall notify
the department in writing within 30 days. The department shall determine
whether the veteran remains eligible for future aid payments based on the
veteran's availability of liquid assets and capability to make payments on any
outstanding statement balances from a health care provider.
(d)
Payments.
1. No more than one description of benefits
may be outstanding at any time, except where a health care provider has
submitted a binding quote prior to the issuance of more than one description of
benefits, and is willing to accept payment from this program in full for any
service rendered to the applicant in accordance with the description of
benefits.
2. The department shall
pay the lesser amount of either the actual cost of services invoiced or the
binding quote submitted by the health care provider.
3. No payment shall be made by the department
unless an itemized written invoice is received by the department within 60 days
of the expiration date, or any approved extension of that expiration date, as
identified in the applicable description of benefits.
4. If the department does not receive an
itemized written invoice within 60 days of the expiration date, or any approved
extension of that expiration date, as identified in the applicable description
of benefits, the healthcare provider, except for a department-approved payment,
may not charge the applicant and shall only accept payments from any of the
following sources:
a. The applicant's health
insurance.
b. Third-party payments
on behalf of the applicant.
c. A
department-approved payment from the applicant.
5. An authorized application for health care
aid may not be withdrawn without the agreement of the provider of the health
care aid.
(e)
Unremarried surviving spouse and dependent of a veteran who dies in the
line of duty. An unremarried surviving spouse and a dependent claiming
eligibility due to the death of a veteran in the line of duty shall submit
evidence from the appropriate military service indicating that the veteran died
in the line of duty.
(f)
Spouse and dependent of activated or deployed member. A spouse
and dependent of a member of the U.S. armed forces or of the Wisconsin national
guard claiming eligibility shall submit evidence that the service member has
been deployed or activated, that due to the activation or deployment a loss of
income has occurred, that an economic emergency has occurred during the
activation or deployment, and that the spouse and dependent are residents of
the state.
(g)
Health care
providers.
1. The department may
grant payments for health care aid to a health care provider if the health care
services are rendered within 90 days after the department confirms that the
applicant is eligible and only after a description of benefits has been
transmitted to the applicant or the county veterans service officer.
2. The department may accept a second
application for the health care listed on the first description of benefits if
the department receives a statement from the health care provider, within 14
calendar days before the expiration listed on the first description of
benefits, that the health care authorized is still being provided and that the
patient will not incur costs.
(h)
Extensions. A health
care provider providing health care services under par. (g) may submit an
application to the department to request an extension of the 90 days. The
application requesting the extension shall comply with all of the following:
1. Include a statement that the health care
services to be provided are included in the description of benefits authorized
under par. (g).
2. Include a
statement that the patient will not incur additional costs for health care
services authorized under par. (g).
3. Be received by the department no later
than 14 calendar days before the expiration date listed on the description of
benefits authorized under par. (g).
(i)
Limitations.
1. The department may provide a grant only if
the health care provider agrees to accept and only accepts payments from any of
the following sources:
a. Grant
funds.
b. The applicant's health
insurance.
c. Third-party payments
on behalf of the applicant.
d. A
department-approved payment from the applicant.
2. The department may approve a payment by
the veteran when a provider refuses to accept the maximum grant available to
the veteran as payment in full if the veteran has sufficient available liquid
assets to contribute an amount that will induce the provider to accept the
aggregate payment as payment in full.
(j)
Types of health care
aid.
1. 'Dental care aid.'
a. A dental care provider shall indicate in
writing that the dental procedure performed was directly necessary to dental
care.
b. Aid for dental procedures
may not exceed $800.00 in any consecutive 12-month period.
c. Aid for extended dental care may not
exceed $4,000 in any consecutive 24-month period.
2. 'Hearing care aid.'
a. Hearing care aid may not exceed $200.00 in
any consecutive 12-month period except where a left or right hearing aid, or
both, is required.
b. Aid for each
hearing aid may not exceed $1,875 in any consecutive 24-month period.
c. An applicant may qualify for a grant for
an additional or more costly hearing aids and a related examination if a
hearing care provider identifies, in writing, a medical condition that warrants
additional financial assistance.
3. 'Vision care aid.'
a. A grant for vision care may not exceed
$400.00 in any consecutive 12-month period; however, an applicant may obtain a
grant for replacement glasses before 12 consecutive months have elapsed if the
eyewear is prescribed because of a documented change in refractive
error.
b. An applicant may qualify
for vision care aid for an additional visit to a vision care provider and for a
more costly set of corrective eyewear or for an additional set of corrective
eyewear if an optometrist or an ophthalmologist identifies, in writing, a
medical condition that warrants additional financial
assistance.
Disclaimer: These regulations may not be the most recent version. Wisconsin may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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