src/applications/hca/components/FormDescriptions/index.jsx
import React from 'react';
import { APP_URLS, LAST_YEAR } from '../../utils/constants';
/** CHAPTER 1: Veteran Information */
export const BirthInfoDescription = (
<>
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-bottom--3"
>
We ask for place of birth as an identity marker for record keeping. This
will not impact your health care eligibility.
</va-additional-info>
</>
);
export const BirthSexDescription = (
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
Population data shows that a person’s sex can affect things like their
health risks and the way their body responds to medications. Knowing
your sex assigned at birth, along with other factors, helps your health
care team use data to:
</p>
<ul>
<li>Interpret your lab results</li>
<li>Prescribe the right dose of medications</li>
<li>Recommend health prevention screenings</li>
</ul>
<p className="vads-u-margin-bottom--0">
We also collect this information to better understand our Veteran
community. This helps us make sure that we’re serving the needs of all
Veterans.
</p>
</div>
</va-additional-info>
);
export const ContactInfoDescription = (
<>
<p>
Adding your email and phone number is optional. But this information helps
us contact you faster if we need to follow up with you about your
application. If you don’t add this information, we’ll use your address to
contact you by mail.
</p>
<p className="vads-u-margin-bottom--4">
<strong>Note:</strong> We’ll always mail you a copy of our decision on
your application for your records.
</p>
</>
);
export const DemographicInfoDescription = (
<legend className="schemaform-label vads-u-margin-bottom--4">
What is your race, ethnicity, or origin? (Please check all that apply.)
<div className="vads-u-color--gray-medium vads-u-margin-y--1">
Information is gathered for statistical purposes only.
</div>
</legend>
);
export const SIGIGenderDescription = (
<>
<va-additional-info
trigger="What to know before you decide to share your gender identity"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
Sharing your gender identity on this application is optional. This
information can help your health care team know how you wish to be
addressed as a person. It can also help your team better assess your
health needs and risks. We also use this information to help make sure
we’re serving the needs of all Veterans.
</p>
<p>
But you should know that any information you share here goes into your
VA-wide records. VA staff outside of the health care system may be
able to read this information.
</p>
<p className="vads-u-margin-bottom--0">
We follow strict security and privacy practices to keep your personal
information secure. But if you want to share your gender identity in
your health records only, talk with your health care team.
</p>
</div>
</va-additional-info>
</>
);
/** CHAPTER 2: VA Benefits */
export const CompensationInfoDescription = (
<p className="vads-u-margin-bottom-4">
VA disability compensation (pay) provides monthly payments to Veterans with
service-connected disabilities. You may get this benefit if you got sick or
injured, or had a condition that got worse, because of your active-duty
service. We assign a disability rating based on the severity of your
disability.
</p>
);
export const CompensationTypeDescription = (
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
We use this information to help us decide these 4 things:
</p>
<ul>
<li>
If you can fill out a shorter application, <strong>and</strong>
</li>
<li>
What types of VA health care benefits you’re eligible for,{' '}
<strong>and</strong>
</li>
<li>
How soon we enroll you in VA health care, <strong>and</strong>
</li>
<li>
How much (if anything) you’ll have to pay toward the cost of your care
</li>
</ul>
<p className="vads-u-margin-bottom--0">
We give veterans with service-connected disabilities the highest
priority.
</p>
</div>
</va-additional-info>
);
export const PensionInfoDescription = (
<p className="vads-u-margin-bottom-4">
Our Veterans Pension program provides monthly payments to certain wartime
Veterans. To get a Veterans Pension, you must meet certain age or disability
requirements and have income and net worth certain limits.
</p>
);
export const PensionTypeDescription = (
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
We use this information to help us decide these 3 things:
</p>
<ul>
<li>
What types of VA health care benefits you’re eligible for,{' '}
<strong>and</strong>
</li>
<li>
How soon we enroll you in a VA health care, <strong>and</strong>
</li>
<li>
How much (if anything) you’ll have to pay toward the cost of your care
</li>
</ul>
<p>
If you have a Veterans Pension, you may pay a lower copay, or no copay,
for certain types of care and services.
</p>
</div>
</va-additional-info>
);
/** CHAPTER 3: Military Service */
export const ServiceDateRangeDescription = (
<div className="vads-u-color--gray-medium">
If you don’t know the exact date, enter your best guess
</div>
);
export const OtherToxicExposureDescription = (
<div className="vads-u-margin-top--2 vads-u-margin-bottom--4">
<a
target="_blank"
rel="noreferrer"
href="https://www.publichealth.va.gov/exposures/index.asp"
>
Learn more about exposures on our Public Health website (opens in new tab)
</a>
</div>
);
/** CHAPTER 4: Household Information */
export const DeductibleExpensesDescription = () => (
<legend className="schemaform-block-title">
Deductible expenses from {LAST_YEAR}
<span className="sr-only">.</span>
<div className="vads-u-color--base vads-u-font-family--sans vads-u-font-size--base vads-u-font-weight--normal vads-u-line-height--6 vads-u-margin-y--2">
These deductible expenses will lower the amount of money we count as your
income.
</div>
</legend>
);
export const DependentDescription = () => (
<va-additional-info
trigger="Who we consider a dependent"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
<strong>Here’s who we consider to be a dependent:</strong>
</p>
<ul>
<li>A spouse (we recognize same-sex and common law marriages)</li>
<li>An unmarried child (including adopted children or stepchildren)</li>
</ul>
<p>
<strong>
If your dependent is an unmarried child, one of these descriptions
must be true:
</strong>
</p>
<ul className="vads-u-margin-bottom--0">
<li>
They’re under 18 years old, <strong>or</strong>
</li>
<li>
They’re between the ages of 18 and 23 years old and were enrolled as a
full-time or part-time student in high school, college, or vocational
school in {LAST_YEAR}, <strong>or</strong>
</li>
<li>
They’re living with a permanent disability that happened before they
turned 18 years old
</li>
</ul>
</div>
</va-additional-info>
);
export const DependentEducationExpensesDescription = (
<div className="vads-u-color--gray-medium">
Only enter an amount if they had gross income to report to the IRS in{' '}
{LAST_YEAR}. This income is the minimum amount of gross income the IRS
requires to file a federal income tax return.
</div>
);
export const DependentSupportDescription = (
<va-additional-info
trigger="What we consider financial support for a dependent"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
We consider any payments, even if they aren’t regular or the same
amount, to be financial support.
</p>
<p className="vads-u-font-weight--bold">
Financial Support includes payments for these types of expenses:
</p>
<ul className="vads-u-margin-bottom--0">
<li>Tuition or medical bills</li>
<li>Monthly child support</li>
<li>One-time payment financial support</li>
</ul>
</div>
</va-additional-info>
);
export const EducationalExpensesDescription = (
<va-additional-info
trigger="What we consider college or vocational expenses"
class="vads-u-margin-y--1"
uswds
>
<div>
<p className="vads-u-margin-top--0">
College and vocational expenses include payments for these expenses
related to your own education:
</p>
<ul>
<li>Tuition</li>
<li>Books</li>
<li>Fees</li>
<li>Course materials</li>
</ul>
<p className="vads-u-margin-bottom--0">
Only include expenses for your own education (not your dependents’
education).
</p>
</div>
</va-additional-info>
);
export const GrossIncomeDescription = (
<>
<div className="vads-u-margin-y--1">
Gross income is income before taxes and any other deductions are
subtracted.
</div>
<va-additional-info
trigger="What we consider gross annual income"
class="vads-u-margin-y--1"
uswds
>
<div>
<p className="vads-u-font-weight--bold vads-u-margin-top--0">
Gross income includes these types of income from a job:
</p>
<ul className="vads-u-margin-bottom--0">
<li>Wages</li>
<li>Bonuses</li>
<li>Tips</li>
<li>Severance pay</li>
</ul>
</div>
</va-additional-info>
</>
);
export const IncomeDescription = (
<>
<p>
Please fill this section out to the best of your knowledge. Provide the
previous calendar year’s gross annual income for you, your spouse, and
your dependents.
</p>
<p>
<strong>Gross annual income:</strong> This income is from employment only,
and doesn’t include income from your farm, ranch, property, or business.
When you calculate your gross annual income, include your wages, bonuses,
tips, severance pay, and other accrued benefits. Include your dependent’s
income information if it could have been used to pay your household
expenses.
</p>
<p>
<strong>Net income:</strong> This is the income from your farm, ranch,
property, or business.
</p>
<p className="vads-u-margin-bottom--4">
<strong>Other income:</strong> This includes retirement and pension
income; Social Security Retirement and Social Security Disability income;
compensation benefits such as VA disability, unemployment, Workers, and
black lung; cash gifts; interest and dividends, including tax exempt
earnings and distributions from Individual Retirement Accounts (IRAs) or
annuities.
</p>
</>
);
export const MaritalStatusDescription = (
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-top--2 vads-u-margin-bottom--3"
uswds
>
<div>
<p className="vads-u-margin-top--0">
We want to make sure we understand your household’s financial
information to better determine what health care benefits you can get.
If you’re married, we also need to understand your spouse’s financial
information.
</p>
</div>
</va-additional-info>
);
export const MedicalExpensesDescription = (
<va-additional-info
trigger="What we consider non-reimbursable medical expenses"
class="vads-u-margin-y--1"
uswds
>
<div>
<p className="vads-u-margin-top--0">
Non-reimbursable medical expenses include costs you or your spouse paid
for these types of health care for yourselves, your dependents, or
others you have the moral obligation to support:
</p>
<ul>
<li>Doctor or dentist appointments</li>
<li>Medications</li>
<li>Medicare or health insurance</li>
<li>Inpatient hospital care</li>
<li>Nursing home care</li>
</ul>
<p className="vads-u-margin-bottom--0">
We only consider expenses non-reimbursable if your health insurance
doesn’t pay you back for the cost.
</p>
</div>
</va-additional-info>
);
export const OtherIncomeDescription = (
<>
<div className="vads-u-margin-y--1">
Other income is additional income that doesn’t come from a job.
</div>
<va-additional-info
trigger="What we consider other annual income"
class="vads-u-margin-y--1"
uswds
>
<div>
<p className="vads-u-font-weight--bold vads-u-margin-top--0">
Other income includes things like this:
</p>
<ul className="vads-u-margin-bottom--0">
<li>Retirement benefits</li>
<li>Unemployment</li>
<li>VA benefit compensation</li>
<li>Money from the sale of a house</li>
<li>Interest from investments</li>
</ul>
</div>
</va-additional-info>
</>
);
export const SpouseBasicInformationDescription = (
<>
Spouse’s personal information
<span className="sr-only">.</span>
<div className="vads-u-color--base vads-u-font-family--sans vads-u-font-size--base vads-u-font-weight--normal vads-u-line-height--6 vads-u-margin-y--2">
Fill this out to the best of your knowledge. The more accurate your
responses, the faster we can process your application.
</div>
</>
);
export const SpouseAdditionalInformationTitle = (
<>
Spouse’s additional information
<span className="sr-only">.</span>
<div className="vads-u-color--base vads-u-font-family--sans vads-u-font-size--base vads-u-font-weight--normal vads-u-line-height--6 vads-u-margin-top--2">
Fill this out to the best of your knowledge. The more accurate your
responses, the faster we can process your application.
</div>
</>
);
export const SpouseAdditionalInformationDescription = () => (
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-top--1 vads-u-margin-bottom--4"
uswds
>
<div>
<p className="vads-u-margin-top--0">
This information helps us determine if your spouse was your dependent in{' '}
{LAST_YEAR}.
</p>
</div>
</va-additional-info>
);
export const SpouseFinancialSupportDescription = (
<va-additional-info
trigger="What we consider financial support for a spouse"
class="vads-u-margin-y--2"
uswds
>
<div>
<p className="vads-u-margin-top--0">
We consider any payments, even if they aren’t regular or the same
amount, to be financial support.
</p>
<p>
<strong>
Financial support includes payments for these types of payments:
</strong>
</p>
<ul className="vads-u-margin-bottom--0">
<li>Monthly spousal support</li>
<li>One-time payment financial support</li>
</ul>
</div>
</va-additional-info>
);
/** CHAPTER 5: Insurance Information */
export const EssentialCoverageDescription = (
<va-additional-info
trigger="Learn more about minimum essential coverage."
class="vads-u-margin-y--2 vads-u-margin-left--4"
uswds
>
To avoid the penalty for not having insurance, you must be enrolled in a
health plan that qualifies as minimum essential coverage. Being signed up
for VA health care meets the minimum essential coverage requirement under
the Affordable Care Act.
</va-additional-info>
);
export const FacilityLocatorDescription = (
<>
<p>
OR{' '}
<a href={APP_URLS.facilities} rel="noopener noreferrer" target="_blank">
Find locations with the VA Facility Locator
</a>
</p>
<p>
If you’re looking for medical care outside the continental U.S. or Guam,
you’ll need to sign up for our Foreign Medical Program.{' '}
<a
href="https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp"
rel="noopener noreferrer"
target="_blank"
>
Learn more about the Foreign Medical Program
</a>
.
</p>
<p>
You can also visit{' '}
<a
href="https://www.benefits.va.gov/PERSONA/veteran-abroad.asp"
rel="noopener noreferrer"
target="_blank"
>
Veterans Living Abroad
</a>
.
</p>
</>
);
export const GroupCodeDescription = (
<div className="vads-u-color--gray-medium">
Either this or the policy number is required
</div>
);
export const MedicaidDescription = (
<>
<p className="vads-u-margin-top--0">
Medicaid is a federal health insurance program for adults and families
with low income levels and people with disabilities.
</p>
<p className="vads-u-margin-bottom--4">
<strong>Note:</strong> Some states use different names for their Medicaid
programs.
</p>
</>
);
export const MedicareClaimNumberDescription = (
<>
<div className="vads-u-color--gray-medium">
You’ll find this number on the front of your Medicare card. Enter all 11
numbers and letters.
</div>
<va-additional-info
trigger="Why we ask for this information"
class="vads-u-margin-top--3 vads-u-margin-bottom--4"
uswds
>
<div>
<p className="vads-u-margin-top--0">
We use your Medicare claim number to keep track of the health care
services that Medicare covers. We use your claim number when we need
to create a Medicare explanation of benefits.
</p>
<p>
We don’t bill Medicare for any services. By law, Medicare can’t pay
for our services. But this explanation shows what Medicare would have
paid for services if they could.
</p>
<p>
We may need to bill medicare supplemental insurance or a private
insurance provider for certain services. And some providers must have
this explanation before they’ll pay the bill.
</p>
<p className="vads-u-margin-bottom--0">
<strong>Note:</strong> Having Medicare or other health insurance
doesn’t affect the VA health care benefits you can get. And you won’t
have to pay any unpaid balance that a health insurance provider
doesn’t cover.
</p>
</div>
</va-additional-info>
</>
);
export const MedicareEffectiveDateDescription = (
<div className="vads-u-margin-bottom--3 vads-u-color--gray-medium">
You’ll find this date under “coverage starts” on the front of your Medicare
card.
</div>
);
export const MedicarePartADescription = (
<p className="vads-u-margin-top--0 vads-u-margin-bottom--4">
Medicare is a federal health insurance program providing coverage for people
who are 65 years or older or who meet special criteria. Part A insurance
covers hospital care, skilled nursing and nursing home care, hospice, and
home health services.
</p>
);
export const PolicyNumberDescription = (
<div className="vads-u-color--gray-medium">
Either this or the group code is required
</div>
);
export const PolicyOrDescription = (
<div className="schemaform-block-title schemaform-block-subtitle vads-u-margin-bottom--neg2p5 vads-u-color--primary-darker">
or
</div>
);
export const PolicyOrGroupDescription = (
<div className="schemaform-block-title schemaform-block-subtitle vads-u-margin-top--6 vads-u-margin-bottom--2 vads-u-color--primary-darker">
Provide either your insurance policy number or group code.{' '}
<span className="schemaform-required-span vads-u-font-family--sans vads-u-font-size--base vads-u-font-weight--normal">
(*Required)
</span>
</div>
);
export const PolicyOrGroupTitle = (
<>
Insurance policy number or group code.
<span className="schemaform-required-span vads-u-font-family--sans vads-u-font-size--base vads-u-font-weight--normal">
(*Required)
</span>
</>
);
export const TricarePolicyDescription = (
<va-additional-info
trigger="I have TRICARE. What’s my policy number?"
class="vads-u-margin-y--2"
>
<div>
<p className="vads-u-margin-top--0">
You can use your Department of Defense benefits number (DBN) or your
Social Security number as your policy number.
</p>
<p className="vads-u-margin-bottom--0">
Your DBN is an 11-digit number. You’ll find this number on the back of
your military ID card.
</p>
</div>
</va-additional-info>
);