Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

spike

Senior Chief Petty Officer
  • Posts

    413
  • Joined

  • Last visited

About spike

  • Birthday 03/04/1976

Profile Information

  • Location
    unknown
  • Interests
    I have many affiliations with several Veteran Orgs

Previous Fields

  • Service Connected Disability
    100%

Recent Profile Visitors

826 profile views

spike's Achievements

  1. I apologize for my long absence. It happens when people are very busy. Here is the take that the VAMC's are going to tell you. However, the facts are this. Your clothing allowance has to go in. The prostetics departments are going to have to get Central Office guidance. If you received a denial by a person at the VAMC, that is because they do not have the knowledge background on the case. The Central Office will have to rule. I do not believe it will be a matter of an appeal at the VBA. I believe it will be a matter of reconsideration once the Central office gives guidance. I would wait until the middle or end of August. Here is the thing everyone. This case went ABOVE the BVA...it is a Federal Circuit Court decision. The VA already lost their case for denial. The ONLY way this decision can be overturned is in the US Court of Appeals. This is not up to the CAVC.
  2. Apply...Sorry I've been busy and away at conferences, meetings and stuff sorry for the long delay
  3. Fletch, I am going to help you out a little more in regards to this and provide you with something I think is important for everyone to know...but it relates to you here because you have several questions and it sounds like your navigating through the VA system.... There are 7 ways to be Service Connected: 1. Direct 2. Aggervated 3. Paired Organ 4. Vocational Rehab 5. Hospital Care 6. Presumptive 7. Secondary You are SC now....from 10 years from SC date VA can not take away your Service Connection. However, disabilities are more likely than not to get worse and not better, your able to put in for an increase. In order to get your SC you were able to prove the following requirements: 1. (AN INJURY) You had an injury in military service (or one followinging if the above), a disease that began in or was made worse during military service or there was an event in service that caused an injury or disease and; 2. (A DIAGNOSIS aka MEDICAL OPINION)You have a current physical or mental disability shown by medical evidence (diagnosis and/or treatment records) and; 3. (A CONNECTION BETWEEN #1 AND #2) There is a relationship between your disability and an injury, disease or event in military service. Medical records or medical opinions were required to establish this relationship (or lay statements, buddy statements, etc). However, under certain circumstances the VA has in the past and may conclude that certain disabilities were caused by service even if there is no specific evidence proving this in your particular claim (presumptive). This cause of disability is presumed for the certain veterans eras (i.e. Vietnam, Persian Gulf, POWs,and many others). What you need now is to build a case of how your disabilities have gotten worse or become more frequent or how they have affected you more. If they haven't great. If they have take a look at the two Regulations one is USC (United States Code) Title 38 and CFR (Code of Federal Regulations) Title 38 Part 4 Adjudication Schedule for rating disabilities.... Oh by the Way Marine.....Semper Fi .....
  4. Jbasser, I showed him how to understand how they come up with the percentages, and the calculator is an amazing tool....(however we have to work on getting it a box to check of for bilateral factor)......and what I was getting at with fletch was if he is SC at 0% thats half the battle won.....you can get an increase but proving SC is a major part of the rating process..
  5. for example this is how the combined rating schedule gets you 4 ratings at 50% and only gets you 94% and when it rounds down you get 90% unless you apply for I/U.....(unless you count any bilateral factors but here goes the explanation if you take a whole 100% and you take a 50% away you get= 50% so now you have 50% ability now your at 50% and 50% of that is 25 so add that to the 50 and you get 75% for those who are keeping track that is 2 ratings at 50%= 75% combined take 75% and now you have a remaining 25% of functional health.... what is 50% of that remaining 25%= 12.5 that gives you 88% so now you have three ratings at 50% right? like I said not considering any bilateral factors......what is 50% of the remaining 12.5% of functional ability 6.25 add that to 88% and you get 94.25=rounded down to the nearest whole number= 94% rating. However when they give you your rating letter they will say you are 90% SC not 94%.....but if you were to file a claim they would go from that percentage......94. I am not saying I agree with the math. However, I have said it before, I go through training and conferences, and ask questions to the outlets/resources available to me. Now oddly enough, I can do this in my head without looking at the combined rating schedule until we start going into SMC and it doe make it slightly harder when we consider bilateral factors......but thats the VA Math explained So thats how they get the 4 50's don't equal 200% not 100%....ratings in themselves have been scrutinized by many as not evaluating the veteran as a whole but by its parts.....both in the VARO and VAMC....
  6. shouldnt this be under percoset refill post topic john??
  7. John What I am very surprised at is that your pharmacist manager wasn't willing to give you 5 day supply until the refill would be resupplied. Next time that happens, I would request to see the Director or the AOD (Administrator on Duty). Be Calm and be nice.... so you don't get a BERT Alert called on you......(I've heard them called over the PA System before) if you didn't know what that is BERT stands for B.ehavioral E.mergency R.esponse T.eam .....aka BERT Alert....Usually a Psych Doc, a social worker, police officers, an administrator, ER Team Member, etc.
  8. Fact Sheet 16-1 January 2009 2009 Copay Rates Effective January 1, 2009 Outpatient Services * Basic Care Services services provided by a primary care clinician $15 / visit Specialty Care Services services provided by a clinical specialist such as surgeon, radiologist, audiologist, optometrist, cardiologist, and specialty tests such as magnetic resonance imagery (MRI), computerized axial tomography (CAT) scan, and nuclear medicine studies $50 / visit * Copay amount is limited to a single charge per visit regardless of the number of health care providers seen in a single day. The copay amount is based on the highest level of service received. There is no copay requirement for preventive care services such as screenings and immunizations. Medications For each 30-day or less supply of medication for treatment of nonservice-connected condition $8 (Veterans in Priority Groups 2 through 6 are limited to $960 annual cap) Inpatient Services ** Inpatient Copay for first 90 days of care during a 365-day period $1,068 Inpatient Copay for each additional 90 days of care during a 365-day period $534 Per Diem Charge $10 / day ** Based on geographically-based means testing, lower income veterans who live in high-cost areas may qualify for a reduction of 80% of inpatient copay charges. Long-Term Care *** Nursing Home Care/Inpatient Respite Care/Geriatric Evaluation maximum of $97/day Adult Day Health Care/Outpatient Geriatric Evaluation Outpatient Respite Care maximum of $15/day Domiciliary Care maximum of $5 / day *** Copays for Long-Term Care services start on the 22nd day of care during any 12-month period—there is no copay requirement for the first 21 days. Actual copay charges will vary from veteran to veteran depending upon financial information submitted on VA Form 10-10EC.
  9. John, I just had to do this...please forgive me....but I am a Marine....so I just had to.... John...you have a pet rock????? Sometimes, I hear vets vent to me and they say that the VA never heard a darn thing that meant anything they were suppose to hear.....the important stuff.....but they heard the stuff that was meaningless.....and they focus on it....just like I did...... But, um John you have a pet rock??? Again the VA sometimes has a 5 second memory....oops, I've been hanging out with these guys too long...ok I'll post a more meaningful post.... I once had a veteran tell me that his doctor was out.....so the OEF/OIF counselor told him to go to the ER and he was calling down to the ER to explain....when the veteran got down to the ER the nurse who greeted the OEF/OIF Veteran said word for word this "You better have a damn good reason for coming".....Vet then asked "Say again" not thinking she would repeat and the Nurse then said again "You better have a damn good reason for coming down for this instead of waiting for your doctor to return (it was a holiday weekend in the same situation as you John) he made a complaint to the Director and a meeting was made for the supervisors/managers and an apology was made and it was made record....to my knowledge
  10. Ok...I am not a moderator but try to keep your postings/topics together if they are indeed the same subject...making multiple topics on the board about the same issue can lead to confusion and possibly someone not getting the full picture... Hope the advice helped.
  11. Mike, Looking at your profile I see that your last date of service was in 1993....that wouldn't qualify for the eligibility for Wounded Warrior Status which is have to have served during or after 9/11/01
  12. Under the Wounded Warriors provision...I would suppose they automatically put you in the category.... http://www.ssa.gov/woundedwarriors/
  13. Ok, I after reading the thread....I think I am sure what is going on here.... If you are not over the 50% SC disability....anything you are treated for that is not a SC disability can have co pays to include your medications. In addition to include more confusion on this issue....let's say your being treated for example PTSD....but it is not SC and during the whole time they are making a decision on your SC at the Rating Board, your treatment, medical co pays and co pays for medicine add up.....if they start a collection or you paid those co-pays....and you become SC your entitled to a refund of the co pays. SOME VA's are good and put the co pays in suspense but rely heavily on the veterans to tell them they applied for SC....you can find that person in eligibility in your Veteran Service Center at the VAMC. A means test is also done if you apply for financial hardship. In order to waive the co pays to help relieve you of some costs, they ask you to do a means test...to make sure you have the means to pay. NSC pension is for low income. However, if you are receiving income, you are best advised to cease the payments of the NSC Pension. NSC pension is offset by the income you make.....SSD and SC Disability is considered income in this sense. YOU WILL OCCUR A overpayment and I've I've seen/heard overpayments in the amounts of over 50k range.....no waiver request usually gets you out of this jam because it says specifically that you are to report all income........when making application....
×
×
  • Create New...

Important Information

Guidelines and Terms of Use