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    • PTSD Denied NSC - Schizophrenia NSC
      You are most welcome. :o) Does he refuse psych treatment? Schizophrenia is a serious illness, but patients can often enjoy substantial improvement with treatment. With the NSC 50% rating for schizophrenia, he can receive free treatment at a VAMC or VA outpatient clinic.  When was he discharged? @THOMAS89031's point about continuity of symptoms is an important one. I've done several C&P exams with vets who were not diagnosed with schizophrenia in service but who began to manifest symptoms shortly after service. Schizophrenia usually starts with prodromal symptoms before progressing to the full-blown disorder, so if those symptoms can be identified as beginning during military service, and then continuity of symptoms can be demonstrated, then the veteran should be service-connected. (Of course, the ultimate decision is up to VBA or the BVA, as you know.) He might very well also suffer from PTSD, but it will help to see what the C&P examiner said about that. Yes, being wounded by an explosive booby trap is certainly a traumatic stressor. It sounds like they are not disputing that fact, but are instead saying that he is not displaying PTSD symptoms (or not many) currently.  You really need a psychiatrist or psychologist with experience conducting C&P exams, otherwise they won't know what kind of information VBA needs to determine service connection. Also, keep in mind that when a doctor completes a DBQ, he or she is declaring him or herself to be an expert witness, offering an expert witness opinion in a federal legal proceeding. Consequently, psychologists and psychiatrists who know what they are doing will devote sufficient time to conduct a thorough, evidence-based evaluation, and write a cogent report to support their diagnosis and opinion(s). So, you're talking at least 5, and as many as 10 hours for a good evaluation and report. At anywhere from $150 to $300 per hour (psychiatrists usually charge more), you're looking at $750 to $3000 for a well-written, persuasive report.  A potentially effective, but less expensive option is a "report critique", in which the psychologist or psychiatrist reviews all the relevant records, and then critiques the C&P exam report, pointing out deficiencies particularly with regard to following established VA guidance for C&P exams, and professional standards for such evaluations. Such a critique can support a request for reconsideration and a new C&P exam. If granted, the critique puts the new C&P examiner on notice that they better conduct a thorough, evidence-based evaluation consistent with VA guidance and relevant professional standards ... because you (and your experts) are watching.  Keep us posted!  All the Best, Mark  
    • Curious
      Hi Everyone! Would Like To Say Happy Memorial Day To My Fellow Comrades And All The Fallen Veterans For Paying The Ultimate Price Of Life! I Went On Ebennie Friday, May 27, 2016 And Seen Where My Claim Went To PDA. I Originally Filed For Three (3) Contentions: hysterectomy, bilateral foot condition and cervical radiculopathy. I received both C&P examinations on May 13, 2016 for hysterectomy and bilateral foot condition, but have not received one for the cervical radiculopathy. Have there ever been a situation where the rater may possibly rate the cervical radiculopathy along with the other two, if I have sufficient evidence in my records?
    • New VA Malpractice stats from reporter
      Its a crying shame these veterans died  from the substandard health care the VA  has give them. I know the VA will eventually kill me off. As my pcp just looks at my chart and I don't think she even reads it.  Example The last time I went in to see my PCP by Appointment  6 month check-up She was in a hurry  it was 2:00pm  she had a Meeting with the big wigs there at the Hospital at 3:00pm she said my vitals look ok do you have any questions? she never read my chats I watched her, I said yes mam I do have,  she said well let me look at you and she listen to my heart lungs  vowel sounds  ect,,ect,, took  maybe two minutes.. I went in for my exam at 2:00pm and it was over at 2:10 pm then I sit back in the chair by her desk at the computer, I was going tell her I had this chronic disabling pain in my right hip..she said well its probably arthritis you do have DJD, I'll send you to X-Ray.&  I wanted to tell her I been having a coughing spree for the last 2 months and wanted to get her to check that out too  then she said alright this ends your exam  just stop by the X-Ray dept on your way out  walk me to the door  like get the hell out of here I'm busy with a meeting at 3:00 ...I was there every bit of 5 minutes and never got a chance to ask he about my swollen Prostate and the problems its been causing me   I was going to let her know the med's she has me on for that don't seem to be working  but she had to go to that meeting with the big wigs  and it was at 3:00 pm according to the Tech that check my B.P. Vitals she did renew my meds.  guess that's a good deal. so needless to say it pissed me off  but what can be done about it...this is maybe nothing to worry to much about  but it could turn in to be worse or cost me my life at some point &time she use to be throual and check me out from hear to toe and talk with me explain things to me  and I really started to like her..but I'm in doubt now. What about the other veterans that are in worse shape than me...I tell ya the VA Kill us all if nothing is done about this VA substandard heath care. If I had the $$ or insurance I'd sure use private care..I hope to live a little longer. JMO .........Buck      
    • DRO hearing
      Berta the P&T was in fact my whole case I brought up to the DRO. I had the POA go over and asked them to approve the P&T and I would drop the bowel and bladder issues. They refused. So since they want to go that route then I am going to make them pay big time as in extra scheduling such as SMC. I gave them a chance to fix themselves but the DRO is dumb enough to refuse. Oh well the CUE will settle and fix everything because this should have been rated whenever they rated my legs during the De Novo Review back in Feb. They cannot pick and choose what and what not to rate when the evidence is overwhelming and I am not going to let them.
    • Miss Figured EED?
      Buck, we can not answer that question unless we had way more information.  The effective date is the later of the date the doc said you are disabled, or the date you applied.  Since I dont know when the doc said this vet was disabled, I can not answer.   However...I would treat this as a reduction, and appeal that reduction, since the reduction amounted, apparently, to a later effective date, even with the new disability.  
    • When can the VA reduce my rating "again" after reduction?
      Va can/does lower your rating at any time.  How long ago did they reduce you?  You may still be able to appeal.  You see, VA can NOT reduce 100% P and T Veterans, UNLESS they can show "actual improvement" under "ordinary conditions of life", that is, while working.  If you are not working, then you should appeal.  
    • New VA Malpractice stats from reporter
      I can say with some certainty its "not just" NY VA.  My VA also gives mostly substandard care, but there are some great parts about my VAMC.  For example, the audio department is superb.  Last week I  got hearing aids adjusted from the audiologist who did my 2002 exam.   This means she was there for 14 years.  I dont think she would have stayed that long unless the department was running at least somewhat right.  
    • New VA Malpractice stats from reporter
      This is the same reporter who called me last year, interested in NY VA malpractice issues. I was the only FTCA case here in NY that I had documentation on so I didn't want to let him use solely my story..it will be in my book anyhow.... http://www.nydailynews.com/news/national/legal-settlements-veterans-affairs-triple-article-1.2654179 His focus was solely on NY FTCA - VA cases and all I could do is give him some tips because these settlements are very well hidden by the VA. No one here responded as a NYer with a FTCA issue when he asked me to post his contact info here. He and another reporter found some large cases but they do not reveal how much  was paid out in 1151 when FTCA was not an option ( or the claimant or survivor filed both FTCA and 1151claims.) After a 1151 offset is recouped by VA for FTCA settlements ,then the subsequent SC payments under 1151 are not part of the whole picture...VA pays out more for malpractice then we know. There is no record (except what I have in my settlement papers of what their malpractice on my husband cost them. I added up a recent audit and it all ,in my case, is a staggering sum.) Interesting article and they did a good job in the article with the evidence they found. The rest of VA's secret malpractice cash pay outs is well hidden. And there are probably many malpractice claims that are never filed because the vet or their survivor never considered VA could have been grossly negligent in their VA health care.  
       
    • When can the VA reduce my rating "again" after reduction?
      Sorry to hear of your issues, as I too have Asthma bud. I am so tired of the VA coming after us. I just went thru this last month. I too am 100% P&T, yet the VA called me on 2/29 to come in for a Review on my 40% for Bladder issues. Well we drove over 300 miles round trip for a 10 min exam. Well what happened next, they continued my 40%, but then the Damn VA lowered my 30% for Scars down to 10%, even though I never had an Review Exam for my Scars and the Doc never asked me anything about it. Luckily it did not affect my 100% P&T. 

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Omg-Sue

Good News I Guess

28 posts in this topic

We got the brown envelope. However, we get the benefits but not the money. They are holding it until they find a fiduciary to manage the money. ALL OF IT. They claim he is incompetent. Includes the 70% he was already getting. We will have to ask for every penny.

I appreciate the insurance so very much because I have not had any of my meds since December. ChampVa is the answer to a prayer.

K already got his free hunting/fishing license today. The hunting part is a hoot 'cause he is blind. Blind Rifle Association!

We're not desperate for money at all but the plan had been to pay off everything we owe with the retro. K is afraid to object as he fears they will take it all back. His claim was for TDIU but they gave him 100% P/T instead. Whats the difference?

HADIT information has been wonderful. Berta told me about Watchdogtoday.org and I read everything I could find there on fiduciary assignment. OMG, what happened to Democracy? Good intentions gone terribly wrong.

Overall, I am so glad this is finally over. Or is it? Nobody wants some stranger to have their nose in their business. Oh yes, the fiduciary gets 3% per month out of the pension. Not much except for the retro which was about $12,000. All these years I have managed K's money for nothing! I coulda made 3% too. LOL

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Or is it? Nobody wants some stranger to have their nose in their business.

Oh yes, the fiduciary gets 3% per month out of the pension. Not much except for the retro which was about $12,000. All these years I have managed K's money for nothing! I coulda made 3% too. LOL

Omg,

Can't you be appointed the fiduciary ?

Also, please clarify, is he getting VA pension (which is income limited) or VA disability compensation?

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Omg,

Can't you be appointed the fiduciary ?

Also, please clarify, is he getting VA pension (which is income limited) or VA disability compensation?

Hi Carlie, K is getting disability comp & filed for TDIU to make 100%. He did ask by letter for me to be the fiduciary just today.

VAWatchdogtoday.org has some disturbing experiences related by vets on this subject.

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Congrats on the award, but this really cooks my chaps.

They are holding it until they find a fiduciary to manage the money. ALL OF IT. They claim he is incompetent. Includes the 70% he was already getting. We will have to ask for every penny.

Omg,

I would like to know this also. Did a social worker come to visit

as you stated in your other post. If so, did you tell them that you

wanted to be fiduciary?

I'm very interested in this, because I think I may be headed down

this same road. I will be eligible for over 4 yrs of retro if approved.

There has to be a way to keep these vultures out of our pockets. There

has been too much corruption in this fiduciary fiasco, and I will not

stand by and allow someone to control the rest of the little time that I have here.

Omg,

Can't you be appointed the fiduciary ?

Also, please clarify, is he getting VA pension (which is income limited) or VA disability compensation?

Edited by Sidney56

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does anyone think maybe power of attorney for a spouse would be a good quick fix to this type of problem? until the vet gets their retro..

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A POA only allows someone else to act "as you, for you" but doesn't remove your ability to act for yourself. A fiduciary removes your ability to legally act for yourself and names a responsible party to act for you. Usually the VA doesn't want you to urinate your money away, due to drugs or alcohol, and requires a fiduciary to prevent this. Personally, I would fight it but the spouse can be named, if you desire. jmo

pr

does anyone think maybe power of attorney for a spouse would be a good quick fix to this type of problem? until the vet gets their retro..

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Phillip I think the intentions of this program started out well because homeless vets were being schmoozed by 'nice' folks who helped them get their claims processed & then skipped out with the money. Some addicts & alcoholics actually do need some help managing. But K has an excellent track record with our lives. Exceptions were PS episodes where he was taken to the emergency room. But he has ALWAYS let me handle the money because he is blind, not because of his SC condition. We discuss all expenditures; I even read the grocery receipt to him. He looks up the bank account on computer daily.

It's been over 20 years since he stopped smoking and drinking (at the same time). Thats also a pretty good reference I think. Has no bad habits, controls his diet/chloresterol. How the heck is he incompetent. Also, as someone suggested, maybe he IS incompetent, so let me keep handling the finances. We both have good credit, just bought a home in Tx & still have our Mo home rented out.

The letter said we can ask for an in-person hearing. Yes we will! We can have friends/fam speak for K. Yes, we will fight this. Dont you think it would be demoralizing to tell a depressed man he is incompetent?

Sidney, No one has come to the house yet to 'explain' how they are here to help. As I read again & again these papers, it seems the VA has this idea all sewed up anyway. They dont seem to care if we fight this; it was pre-won already. How discouraging. K wrote out the request yesterday for me to be the fidicuary and DAV SO sent that in.

Thank you to everyone who is trying to help. We need all the help you can offer it seems. Like I said before at least I can get ChampVa now.

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On the surface, it sounds like the VA is playing fast and loose. I'd say that with just the information given, a rapid response disagreeing with the fiduciary appointment, etc. is needed.

Further, If there is any way to involve one of the better Pro Bono Veteran lawyers, I'd do so.

You don't have much time. Also, you need to do something concerning any existing funds in bank accounts before they may become subject to VA fiduciary control, and you no longer have access.

One of the problems can be that the notification letter was dated in the VA files well before the VA got around to actually mailing it. (Keep the envelope with the actual date of mailing postage)

This VA mailing delay can effectively shorten the time you have to respond with a disagreement notice. Five to ten days out of thirty is significant!

I'd at least contact a veterans VA lawyer before the sun sets!

One National Pro Bono is:

NVLSP

PO Box65762

Washington, DC 20035

202-265-8305

Fax 202-328-0063

info@nvlsp.org

Edited by Chuck75

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Chuck and everyone is right you really need to jump on this.

I was awarded VA P/T without a problem because of my heart and given SMC-s because of my other issues but nowhere did they ask if I felt I could not/or could control my money!

Now SSDI which I was just awarded after the VA, did ask if I felt I could handle my money and I said of course I have been doing it all my life and I also said I do most of my bills by computer and automatic each month. They did not mention anything about it when I was awarded!

I think again if you jump on this right away you should be fine!

Congrat on the Champ US my wife needed that too! So we are truly blessed!

Good Luck to you and K!

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Chuck & Stillhere, I am proud to have all you guys in our corner. I am positive the Pro Bono will hear from me tomorrow. Advice from the HADIT family has kept me going. K has so much 'control' meds that he is handling this better than me. I do love a challenge but this one is the worst I ever had in my 64 years. I hope the current cases going on right now just blows this program apart. Buncha BS I'd say.

Thanks again guys, I'll keep you posted.

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Changing the subject just a little.

Now that you have access to CHAMPVA, remember that it will pay MOST of your healthcare, but, there is some that they won't pay (like 25% or so), and, for that, my Wife has a supplemental policy that picks up ALL the rest of her healthcare costs that CHAMPVA does NOT cover. Her policy is with AMRA (American Military Retirees Association) but there are others, also. The policy is, like, $20+ dollars a month. She has some VERY expensive medications that she takes on a ongoing basis that costs several hundred dollars a month, so it is a "no-brainer" money-wise.

CHAMPVA is one of the best benefits that a veteran's family has, as far as I am concerned.

I will now return you to your regularly scheduled programming.

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Sue- Congrats on the win!

Sorry about the complications but I'm sure you'll resolve them and be on Happy Street! :smile:

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Changing the subject just a little.

Now that you have access to CHAMPVA, remember that it will pay MOST of your healthcare, but, there is some that they won't pay (like 25% or so), and, for that, my Wife has a supplemental policy that picks up ALL the rest of her healthcare costs that CHAMPVA does NOT cover. Her policy is with AMRA (American Military Retirees Association) but there are others, also. The policy is, like, $20+ dollars a month. She has some VERY expensive medications that she takes on a ongoing basis that costs several hundred dollars a month, so it is a "no-brainer" money-wise.

CHAMPVA is one of the best benefits that a veteran's family has, as far as I am concerned.

I will now return you to your regularly scheduled programming.

I was thinking Medicare with ChampVa would pay everything. Thanks for the advice. My meds run $26,000 a year before medicare pays. I did have 'extra help' before K was awarded 70%. Now I am too rich, lol. I think my Humira is $750 a month. This is why I have had NO meds since December because my co-pay was $688. Looking forward to getting that insurance card.

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I was thinking Medicare with ChampVa would pay everything. Thanks for the advice. My meds run $26,000 a year before medicare pays. I did have 'extra help' before K was awarded 70%. Now I am too rich, lol. I think my Humira is $750 a month. This is why I have had NO meds since December because my co-pay was $688. Looking forward to getting that insurance card.

To be honest with you, I do not have any experience when it comes to Medicare and how it "intertwines" with CHAMPVA (we don't have Medicare), but, I can tell you this: The CHAMPVA folks are really helpful (unlike SOME of the VA departments) and they are, seriously, just a phone call away. Call them and ask them about any un-paid balances and how your Medicare and CHAMPVA will co-ordinate your medical expenses. But, just remember, there are "supplemental" policies available to CHAMPVA recipients, just in case your Medicare does not pay the remainder of your bills.

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We got off the subject a bit. About the fiduciary program.....best info I have read is at VAWatchdog.org and click on fiduciary. Outright theft, fraud, and mismanagement. No accountability at all. At the end of the column (its long) Jim gives a series of steps to take when this all begins. Very good advice. Some of these folks are no friend of the disabled Vet.

Of all the dumbest things, I moved to Waco, Tx just in December! The most notorious RO ever! But K sends his heartfelt thanks to all of you who have 'gone before' and share information with us. I am read to file NOD about his incompetency.

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Don't forget that 100% Veterans who own their own home have a total exemption granted in Texas. This is a very big benefit in my opinion. Probably the reason my wife and I will stay in the home we bought in 1971.

ChampVA works very well with Medicare and unlike the Medicare prescription the cost of meds are hardball negotiated at VA prices so even though you have a copay it is not all that bad.

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OMG-Sue said:

"was thinking Medicare with ChampVa would pay everything"

as long as you have Part A and Part B Medicare ,in my case ,between the two of them, they have paid everything so far.

I do pay an annual co pay when I get my meds and I think it is 50 dollars.

The CHAMPVA man who was on some of our SVR shows told me to send in receipts for all of my med co pays as they will refund those co pays after the annual deduction.

It only took my pharmacist a few minutes to give me a full printout of my meds and co pays to send to CHAMPVA for refund.

The CHAMPVA booklet is full of good info on what they pay and any limits to coverage.Also you will get a periodic CHAMPVA magazine that also is full of excellent info.

You have to formally apply for CHAMPVA and I think that can be done on line at the CHAMPVA web site.

It is a fabulous benefit.

I believe it also can be retro-depending on the CHAMPVA entitlement date but not sure of that.

The CHAMPVA man, Glenn, in the SVR show archives -I believe even gave out his work phone number for any questions.

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My wife has BC/BS and ChampVA. ChampVA works well with BC. BC pays first and then ChampVA pays the rest. The BC was about the only decent thing I got from my 20 years as federal employee.

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If you go to the Hadit/SVR archives here:

http://www.hadit.com/svr.html

Just click on the archives button, and when you are at the archive click on the Glenn Johnson-ChampVA button...

He talks about ChampVA co-pays and Medicare issues...This is from a VA ChampVA head person...

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I stayed up late to check the bank & glad I did! K's direct deposit was for the 100% amount. All the fuss about fiduciaries is about the RETRO money only. Nobody has called, written, or answered and questions. Maybe it's like Berta said they should trash this program anyway. It's a broken program.

I cannot start to list the Hadit friends here who have helped us thru it all (so many). Not only good advice, legal information, but you all kept us from 'losing it' while waiting these 10 months for a decision. I know Sidney is going thru this too and wish the best for him. At first they said all K's money would be seized. Now how the heck am I going to pay bills? But you guys kept us cool and some of it turned out to be O.K.

Now we will stay with you for the rest of the story, and your stories.

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If you go to the Hadit/SVR archives here:

http://www.hadit.com/svr.html

Just click on the archives button, and when you are at the archive click on the Glenn Johnson-ChampVA button...

He talks about ChampVA co-pays and Medicare issues...This is from a VA ChampVA head person...

Stretch, sorry I did not get back to you. This ChampVa info was exactly what I needed. I am sending virtual peach cobbler to you!

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THE DIFFERENCES BETWEEN BEING “RATED” AT 100% AND BEING “ASSIGNED” 100% TDIU

http://ow.ly/4qZhM

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THE DIFFERENCES BETWEEN BEING "RATED" AT 100% AND BEING "ASSIGNED" 100% TDIU

http://ow.ly/4qZhM

Yes the award letter said he is 100% rated, instead of 70% plus TDIU. I guess he couldnt be unemployable and incompetent at the same time?

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Does it say P & T?

Does it say DEA benefits have been awarded?

CHAMPVA eligibility depends on the P & T status.

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OMG-Sue said:

"was thinking Medicare with ChampVa would pay everything"

as long as you have Part A and Part B Medicare ,in my case ,between the two of them, they have paid everything so far.

I do pay an annual co pay when I get my meds and I think it is 50 dollars.

The CHAMPVA man who was on some of our SVR shows told me to send in receipts for all of my med co pays as they will refund those co pays after the annual deduction.

It only took my pharmacist a few minutes to give me a full printout of my meds and co pays to send to CHAMPVA for refund.

The CHAMPVA booklet is full of good info on what they pay and any limits to coverage.Also you will get a periodic CHAMPVA magazine that also is full of excellent info.

You have to formally apply for CHAMPVA and I think that can be done on line at the CHAMPVA web site.

It is a fabulous benefit.

I believe it also can be retro-depending on the CHAMPVA entitlement date but not sure of that.

The CHAMPVA man, Glenn, in the SVR show archives -I believe even gave out his work phone number for any questions.

Yes, it's retro --- back to the date of the Veteran's effective date at 100% P&T. I'm in the process of photocopying 5 years worth of my rx and medical bills as ChampVA will reimburse us for any out of pocket co-pays, deductibles, etc we paid.

The hardest part was remembering some of the doctors I'd seen 5 years ago ! Called our insurance company and they sent me a print out as you have to send in an itemized statement

to ChampVA for the medical. With the insurance printout of the Explanations of Benefits (EOB's) I was able to recall a few docs I'd missed. For most I have already called them and asked for an itemized statement and they have all been really helpful. A printout of the rx from the pharmacy is sufficient so long as it has what ChampVA wants .... NDC#, prescriber, quantity, etc. It's in the ChampVA packet they

send out to you after you file for it. ChampVA has been great to work with .... this was a surprise benefit (the 5 yrs reimbursement part) and well worth it. ChampVA did suggest sending in the rx and the medical statements separately as they are both processed by different departments.

Edited by VetsLady

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A VA Fiduciary appointment covers more than Retro pay.

Once the paper makes it to the bank, expect to find that the you no longer have access to anything in the direct deposit account.

The entire amount may get transferred without prior notice to the fiduciary's account, and who knows where it might be.

Waco is notorious for it's fiduciary account practices.

Did you contact a lawyer qualified to deal with the VA?

Did they give you advice on how to deal with the situation now?

Have you filed a NOD? Time is flying!

I stayed up late to check the bank & glad I did! K's direct deposit was for the 100% amount. All the fuss about fiduciaries is about the RETRO money only. Nobody has called, written, or answered and questions. Maybe it's like Berta said they should trash this program anyway. It's a broken program.

I cannot start to list the Hadit friends here who have helped us thru it all (so many). Not only good advice, legal information, but you all kept us from 'losing it' while waiting these 10 months for a decision. I know Sidney is going thru this too and wish the best for him. At first they said all K's money would be seized. Now how the heck am I going to pay bills? But you guys kept us cool and some of it turned out to be O.K.

Now we will stay with you for the rest of the story, and your stories.

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Oh Chuck, this nightmare is never going to stop, will it? K has requested myself as fiduciary (as suggested by Mo DAV SO). However, in k's file is a letter (also suggested by another DAV SO, Waco) from my civilian PCP to whom it may concern: Sue, K's wife, has been dx'd with beginning Alzheimers. In theory that was supposed to hurry up their decision. Didnt work. We live in Waco now.

My point is this: a Vet with paranoid schizophrenia & wife with Alzheimers. No way they will let me do this. Now my daughter has a responsible position at a Waco Hospital and we could ask for them to appt her? Is that just a letter or form?

About the lawyer, he is with Blinded Veterans Assn & he is in Denver. I asked him about a NOD & he said to wait till they actually appoint someone. By your advice, we will be in deep credit doo-doo if I wait. Ok,so I will get going with NOD. Thanks Chuck & everyone else can chime in here; we need all the help we can get.

Oh yes, do I move his money to my account? or mattress?

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We received advice today that we should just pay the bills as usual and be responsible as usual; file NOD and wait. And not to 'borrow trouble' as Gran used to say. Everything legal and honest. Sounds good to me.

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