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M21-1, Part IX, Subpart i, Chapter 7 – Clothing Allowance

Overview


In This Chapter

This chapter contains the following topics:
Topic
Topic Name
1
2
3
4
5
6

1.  Eligibility for the Annual Clothing Allowance


Introduction

This topic contains information on the eligibility requirements for the annual clothing allowance, including

Change Date

September 27, 2016

IX.i.7.1.a.  ACAP
Eligibility Requirements

The regulatory authority for an annual clothing allowance payment (ACAP) is 38 CFR 3.810.  An ACAP is payable on application when
  • prosthetic or orthopedic appliances, such as an artificial limb, rigid extremity brace, wheelchair, or crutches, worn or used by a Veteran, for a disability or disabilities for which 38 U.S.C. Chapter 11 disability compensation has been established, tend to wear and tear clothing, and/or
  • physician-prescribed medication, used by a Veteran for a skin condition for which 38 U.S.C. Chapter 11 disability compensation has been established, causes irreparable damage to the outer garments.
38 U.S.C. Chapter 11 disability compensation means
  • service-connected (SC) disability, or
  • disability under 38 U.S.C. 1151 that is compensated as if SC.
38 CFR 3.810 provides for entitlement to more than one ACAP.
Multiple allowances are permitted when multiple qualifying appliances and/or medications affect distinct qualifying types of clothing articles.
Example:  Multiple allowances may be awarded if a prosthetic leg used for an SC amputation causes wear and tear to pants and a physician-prescribed medication for an SC skin disorder irreparably damages shirts.
Two allowances may be paid for a single type of affected garment if
  • more than one appliance
  • medication for more than one skin condition, or
  • an appliance and a skin medication
independently qualify for an ACAP and together tend to wear and tear and/or irreparably damage the single type of garment at a greater rate than either would independently.

IX.i.7.1.b. Medical Evidence Needed to Establish Eligibility

In order for an ACAP to be paid, available medical evidence must demonstrate findings consistent with the regulatory requirements for the benefit.
Refer to the table below for a description of the types of evidence necessary to support eligibility to an ACAP.
If the basis for the ACAP claim is …
Then the medical evidence must include …
Indicating that …
use of prosthetic or orthopedic appliances where there is special monthly compensation for loss of use of an upper or lower extremity at a rate specified in 38 CFR 3.350(a-d) or (f)
a Department of Veterans Affairs (VA) examination or equivalent hospital or examination report
the qualifying appliance(s) tend to cause wear and tear to clothing.
use of prosthetic orthopedic appliances necessitated by another qualifying disability
certification by the Under Secretary for Health or a designee (VA Outpatient Clinic (OPC) Director)
the qualifying appliance(s) tend to cause wear and tear to clothing.
physician-prescribed medication
the qualifying prescribed medication causes irreparable damage to outer garments.
Notes:
  • Irreparable damage does not include stains that are removable through regular laundering or dry cleaning.
  • A Veteran does not lose ACAP eligibility after returning to active duty and may receive the payment concurrently with active service pay, as per VAOPGCPREC 4-2010.

IX.i.7.1.c. Jurisdiction of Clothing Allowance Claims Processing

In August 2003, the Veterans Benefits Administration (VBA) transitioned the processing of annual clothing allowance claims to the Veterans Health Administration (VHA).
Any clothing allowance claims received by a regional office (RO) should be forwarded to the VA medical center (VAMC) or OPC of jurisdiction, to the attention of the Prosthetic and Sensory Aids Service.
Exceptions:
  • Claims for accrued clothing allowance are to be processed by the pension management center of jurisdiction.
  • The Pittsburgh RO coordinates with the Pittsburgh VAMC on annual clothing allowance claims received from Veterans residing in foreign countries.
References:  For additional information on

IX.i.7.1.d. Informing Veterans of Potential Eligibility for the Annual Clothing Allowance

If a rating decision establishes service connection (SC) for the anatomical loss or loss of use (L/LOU) of a hand or foot, the decision notice must
  • inform the Veteran of potential eligibility for the clothing allowance
  • provide contact information for the VAMC or OPC of jurisdiction, and
  • inform the Veteran to return the application to the VAMC or OPC, to the attention of Prosthetic and Sensory Aids Service.

IX.i.7.1.e. Continued Eligibility to the Annual Clothing Allowance

Consider a Veteran to have continued eligibility to the annual clothing allowance if
  • SC has been established for anatomical L/LOUof a hand or foot, and
  • the disability requires use of a prosthetic or orthopedic device that wears out or tears clothing.

IX.i.7.1.f.  What Constitutes a Claim for the Annual Clothing Allowance
A claim for an ACAP may be any communication from a Veteran that
  • describes the device or medication used because of an SC or 38 U.S.C. 1151 disability/condition, and
  • requests payment of the clothing allowance.
Notes:  If an application for an ACAP is received, but no claim for compensation has been filed

IX.i.7.1.g.  Annual Clothing Allowance Eligibility for Hospitalized Veterans
A hospitalized Veteran, competent or incompetent, remains eligible for an ACAP.

2.  Payment of the Annual Clothing Allowance


Introduction

This topic contains information on making payments of the annual clothing allowance, including

Change Date

March 8, 2019

IX.i.7.2.a.  Pay Date for ACAPs

ACAPs are issued to Veterans who have existing eligibility as of August 1st of the payment year in question. ACAP eligibility must be determined by VHA no later than July 31st of the payment year and not prior to August 1st of the preceding year.
Example:  A Veteran eligible as of August 1, 2013, is entitled to receive the 2013 ACAP.
Generally, ACAPs are paid on or about September 1st.  An ACAP may be paid upon processing of the clothing allowance transaction if processing occurs after the last processing cycle in August of the ACAP year.
Note:  The pay date for authorized recurring ACAPs is September 1st.

IX.i.7.2.b. Payments to Veterans in Receipt of MRP

A Veteran receiving military retired pay (MRP) is not required to waive any portion of his/her MRP to receive a clothing allowance.
Note:  Authorization of ACAPs to Veterans who are not receiving compensation because they have not waived their MRP can be made only for the current annual payment.
A redetermination of eligibility on the basis of a subsequent claim is not required if the initial approval was based on a static, qualifying disability.

IX.i.7.2.c.  Payment in Philippine Cases

Claims authorized for Veterans of the U.S. Army and Regular Scouts are paid in dollars.
Persons who enlisted under Section 14, Public Law (PL) 79-190 (The Armed Forces Voluntary Recruitment Act of October 6, 1945), in the Philippine Scouts, Commonwealth Army of the Philippines, or Guerilla Service are to be paid at a rate in Philippine pesos equivalent to $.50 for each dollar authorized under law.
Note:  The Manila Treasury Disbursing Office makes the payment.

IX.i.7.2.d. Payment of the Accrued Clothing Allowance

If a rating decision or evidence in the claims folder at the date of death indicates that the Veteran met the eligibility requirements as of the August 1st date prior to death, then the lump sum clothing allowance is due and payable.
Note:  The full lump sum is payable without pro rata accumulation for any portion of a year.
Reference:  For more information on payment of accrued benefits, see M21-1, Part VIII.

3.  Payment of the Annual Clothing Allowance for Incarcerated Veterans


Introduction

This topic contains information on the payment of the annual clothing allowance for incarcerated Veterans, including

Change Date

 April 24, 2015

IX.i.7.3.a.  Provisions of Section 502 of PL 104-275

PL 104-275, Section 502, limits the clothing allowance for Veterans incarcerated for over 60 days if they receive clothing at no cost from the penal institution.
Note:  In the absence of evidence to the contrary, presume that incarcerated Veterans receive clothing at no cost from the penal institution.

IX.i.7.3.b. Payment During the Initial Period of Incarceration

General Counsel has held that the restriction on the payment of clothing allowance does not apply for the initial 60 days of any separate period of incarceration.
Therefore, the annual clothing allowance amount must be reduced by 1/365th for each day of incarceration after the initial 60 days of incarceration during the 12-month period preceding the August 1st determination of clothing allowance eligibility.

IX.i.7.3.c.  Payment When the Veteran Is Incarcerated for the Entire Clothing Allowance Year

If the Veteran is incarcerated for the entire clothing allowance year (August 1stthrough July 31st), do not pay the Veteran for that year, assuming the Veteran’s incarceration commenced more than 60 days prior to August 1st.

IX.i.7.3.d. Payment When the Veteran is Released From Incarceration During the Clothing Allowance Year

If the Veteran is initially incarcerated or is released from incarceration during the clothing allowance year, pay the Veteran a partial clothing allowance.
Note:  Partial clothing allowance payments for years during which the Veteran is incarcerated are not subject to rounding to even dollars.  Therefore, partial year payments are made in dollars and cents.
Reference:  For information on calculating the partial year payment, see M21-1, Part IX, Subpart i, 7.3.b.

 

4.  Handling Disagreements With Annual Clothing Allowance Determinations


Change Date

March 8, 2019

IX.i.7.4.a.  Handling Disagreements With Annual Clothing Allowance Determinations

The VAMC or OPC is responsible for handling legacy appeals and requests for decision review under 38 CFR 3.2500, arising from decisions denying or terminating eligibility
  • on the basis that no SC conditions exist
  • on the basis that the device does not wear out or tear clothing
  • on the basis that the skin medication does not cause irreparable staining, or
  • in cases involving an issue of effective date of entitlement.

References:  For more information on


  5.  ACAP Coordinators


Introduction

This topic contains information on ACAP coordinators, including ACAP coordinator

Change Date

 January 8, 2016

IX.i.7.5.a.  ACAP Coordinator Selection

The Veterans Service Center Manager (VSCM) at each RO is responsible for selecting an ACAP Coordinator and providing his/her
  • name
  • phone number
  • position, and
  • fax number
to
  • the nearest Veterans Integrated Service Network (VISN) Prosthetic Representative, and
Note:  When an ACAP Coordinator is replaced, the VSCM will repeat the process above to ensure contact information remains current.
Reference:  For more information on the current ACAP Coordinators, see theACAP Coordinators List.

IX.i.7.5.b.  ACAP Coordinator Responsibilities

The ACAP Coordinator will, upon request from a Prosthetic Representative or designee
  • perform a payment or mailing address change
  • assist in resolving ACAP payment issues, to include coordination with Finance Activity and supporting any audit effort, and/or
  • review the claims folder and provide findings.
Note:  All technical issues or questions on processing ACAP claims should be directed to VAVBAWAS/CO/Clothing Allowance.

 6.  Annual Clothing Allowance Letter


Introduction

This topic contains information on the annual clothing allowance letter, including

Change Date
September 27, 2016

IX.i.7.6.aNotification for Annual Clothing Allowance

A system-generated notice and application is automatically sent to the Veteran for cases requiring redetermination of eligibility for the annual clothing allowance.
Note:  No specific RO action is required upon release of the system-generated notices.

IX.i.7.6.b. Actions to Take if Annual Clothing Allowance Letter Is Not Sent Automatically

Under certain circumstances, system-generation of the annual clothing allowance letter is not sent automatically.  When this occurs, the station of origination is alerted by the generation of an 800 series work item.  The message code for this work item is 820, 777, Clothing Allowance Letter Not Sent.
Follow the steps in the table below when this work item appears in the RO’s inventory.
Step
Action
1
Review the evidentiary record and electronic systems data to determine if the Veteran is now deceased.
2
Is the Veteran deceased?
  • If yes, proceed to the next step.
  • If no, proceed to Step 6.
3
Terminate any running award of compensation or pension benefits, as discussed in M21-1, Part III, Subpart ii, 8.B.
4
Add a permanent system note that includes
  • the date the work item was generated, and
  • a description of the actions taken.
5
Clear the 820 work item and take no further action.
6
  • Use the Letter Creator tool to prepare an Annual Clothing Allowance Letter (accessible from the VSC menu), or prepare an equivalent notice using Personal Computer Generated Letters.
  • Send one copy to the Veteran (and any applicable representative), and associate another with the claims folder.
7
Clear the 820 work item and take no further action.
References:  For more information on
Historical_M21-1IX_i_7_1-8-16.docx May 19, 2019 68 KB
9-27-16_Key-Changes_M21-1IX_i_7.docx May 19, 2019 69 KB
Historical_M21-1IX_i_7_9-27-16.docx May 19, 2019 60 KB
3-8-19_Key-Changes_M21-1IX_i_7.docx May 19, 2019 56 KB
Change-April-24-2015-Transmittal-Sheet-M21-1IX_i_7_TS.docx May 19, 2019 41 KB
1-8-16_Key-Changes_M21-1IX_i_7.docx May 19, 2019 61 KB
transmittal-pt09_sp1_ch3_TS.doc May 19, 2019 59 KB
Transmittal-M21-1MRIX_i_7_TS.docx May 19, 2019 43 KB
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