| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | patient(+) | 0;1 | POINTER | 2 | B | Enter in this field the patient associated with this income relation. |
| .02 | individual annual income(+) | 0;2 | POINTER | 408.21 | AIND | Enter in this field the individual whose income is associated with this income relation. |
| .05 | married last calendar year(+) | 0;5 | BOOLEAN | 1:YES 0:NO | Enter 'YES' in this field if the veteran's marital status was either married or separated on Dec 31st of last calendar year. Otherwise, enter 'NO'. | |
| .06 | lived with patient | 0;6 | BOOLEAN | 1:YES 0:NO | Enter whether the veteran and relation lived together last calendar year. | |
| .07 | amount contributed to spouse | 0;7 | NUMERIC | This response must be a number. If the veteran did not live with his or her spouse, enter in this field the amount the veteran contributed to his or her spouse last calendar year. If the amount the veteran contributed is less than $600, then the spouse will not be considered a dependent for financial assessment. | ||
| .08 | dependent children | 0;8 | BOOLEAN | 1:YES 0:NO | Enter in this field whether the veteran had any UNMARRIED children or stepchildren under the age of 18 or between the ages of 18 and 23 and attending school, or any unmarried children over the age of 17 who became permanently incapable of self-support before reaching the age of 18 last calendar year. School attendance does not have to be full-time but it should be regular. The child can be enrolled in high school, college, or vocational school. If the worksheet is being completed during a break between regular school terms, consider the child to be attending school if the veteran indicates that the child plans to enroll in the next regular term (excluding summer sessions). If the child is under the age of 18, the child does not have to be attending school. DO NOT INCLUDE FOSTER CHILDREN. If the veteran says 'YES', all dependent children must be entered for the means test thresholds to be properly determined. | |
| .09 | incapable of self-support | 0;9 | BOOLEAN | 1:YES 0:NO | Enter in this field whether the child is unmarried, over the age of 17, and became permanently incapable of self-support before reaching in age of 18. | |
| .1 | contributed to support | 0;10 | BOOLEAN | 1:YES 0:NO | Enter in this field a Yes or No to indicate whether the veteran contributed any dollar amount to the child's support last calendar year. The contributions do not have to be in regular set amounts. For example, a veteran who paid a child's school tuition or medical bills would be contributing to the child's support. | |
| .11 | child had income | 0;11 | BOOLEAN | 1:YES 0:NO | ||
| .12 | income available to you | 0;12 | BOOLEAN | 1:YES 0:NO | ||
| .13 | number of dependent children | 0;13 | NUMERIC | This field is computed by the system. Dependent children include any unmarried children or stepchildren who are under the age of 18 or between the ages of 18 and 23 and attending school, or any unmarried children over the age of 17 who became permanently incapable of self-support before reaching the age of 18. | ||
| .14 | married this year | 0;14 | BOOLEAN | 1:YES 0:NO | Enter 'YES' in this field if the veteran's marital status currently is either married or separated. Otherwise, enter 'NO'. | |
| .15 | living with patient | 0;15 | BOOLEAN | 1:YES 0:NO | Enter whether the veteran and relation are living together. | |
| .16 | residing in the community | 0;16 | BOOLEAN | 1:YES 0:NO | Enter 'YES' if the spouse or dependent is residing in the community. Enter 'NO' if the spouse or dependent is institutionalized. | |
| .17 | legally separated | 0;17 | BOOLEAN | 1:YES 0:NO | Enter 'YES' in this field if the veteran and spouse are legally separated. | |
| .18 | child 18-23 in school | 0;18 | BOOLEAN | 0:NO 1:YES | ||
| .19 | amount contributed to child | 0;19 | NUMERIC | Enter in this field the dollar amount that the veteran contributed to the child's support last calendar year. The contributions do not have to be in regular set amounts. For example, a veteran who paid a child's school tuition or medical bills would be contributing to the child's support. | ||
| 31 | annual means test | MT;1 | POINTER | 408.31 |
Not Referenced