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    • YIPPEE!!!!!!! This sounds like maybe you used my favorite tactic--GCY VA- "Go CUE Yourself VA." He he. If a decision contains a legal error to a claimant's detriment, it can be much faster ( in some cases) to ask them to CUE their decision because otherwise the error stands until maybe it is resolved with a NOD, DRO , etc etc etc.... If they do not react favorably however on this type of request or Reconsideration Request, and the NOD date looms close, it is still  imperative to file the NOD. My SMC CUE retro took 9 years...but my last GCY Cue took mere weeks (maybe just days--because -I raised a ruckus with the Director of my RO on that one because it again involved probative evidence that they completely ignored and the posthumous so called C & P was prepared by ,in my opinion, someone with NO medical background at all. I believe VA makes many errors in retros and certainly in violating 38 CFR 4.1 et al ( to include the great 4.6 part). If VA can use CUE  against us, -which they try to do to reduce vets sometimes,then we can use the same regulation against them, if their legal error has cost us cash. THIS IS GREAT NEWS Gastone and I want to thank you for all of the outstanding advice you give vets here. You have helped Many and my Thank You is long overdue to you! Enjoy this  Victory!
    • I think were all special Hamslice  
    • NOD- Notice of Disagreement.The DAV sounds very supportive of this. Still ,if the VA does not favorably resolve this and the NOD one year deadline looms close, you must file a NOD at that point. You have good evidence and fortunately the "knee pain" diagnosis was changed to bursitis. They still need to give you a C & P exam,unless maybe the ortho doc's opinion was recent and thorough enough to cover how they could rate this.??? That is concerning. But ebenefits is not always a reliable source to track this stuff.
    • Funny thing is...when I went to my appointment yesterday  the clinic was like a empty clinic  not very many veterans was even in there , this was 1:40 pm most of the examining rooms were empty. and a lot of the clerks, CNA's, Dr's /Nurses were getting off duty (1:30pm?) What BS Shape our VAMC System is in.  eh! ................Buck
    • Yes sir I agree VA HealrhCare is not the best in America ,  just opposite of what President Clinton mention back in his day. I was told I had what looks to be oral cancer from a VA Dentist on 8-19-2016  he mention getting me an appointment with oral surgery clinic ENT Clinic...the earliest they could possible see me was November 24 th 2016 for a cancer screening and  Biopsy... I thought BS  I  got in touch with my PCP on myhealthyvet Secure Message..she mention she would see what she could do...never heard back, got in touch with  the Hospital So called Advocates ...little did that help, So I went to the Hospital Administrator and told him this was not Acceptable and just out right Ridiculous  and if you don't get me an appointment within a week...I will email/or I'll call Bob Mc Donald  Personally, he is the Secretary  of VA   (in case you don't know who he is ) and I'll tell him about this and a whole lot of other needless shit that's been going on Here in this VAMC. I said this is not a threat but a Promise. I got a call the next day to report at ENT Clinic on 24th Aug 2016  (which was yesterday)  they all were super nice & they did a Biopsy on me and set up a follow up appointment (Results of the Biospy on Sept 1-2016 For this very reason and about a 100 more is why I seek other private insurance. ...................Buck





evandc

21 Days In Hospital Rule

9 posts in this topic

Have vet friend that was in VA hospital in March-April 2011 for PTSD. She is S/C for Anxiety. Applied for the 21 days in hospital & she was turned down because she was admitted for PTSD and not anxiety. I was going to copy 38CFR CH.1 4.29 and pass it along to her. I have 7-1-11 Edition & I'm having a problem. Before it read something like "be admitted for what you are S/C for or TREATED FOR WHAT YOU ARE S/C FOR". Now reading different "total disability rating (100 percent) assigned...it is established that s/c disability has required hospital treatment..in excess of 21 days." Question has this rule changed to drop the part about "treated for what you are s/c"? If it changed was she in hospital before it changed? Just passing along to help this vet..and never know why she didn't get connected for PTSD..but that's another thing.

Thanks,

Don

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The VA only rates the highest (or worse) mental condition to prevent pyramiding. In my case I am rated for Bi-Polar, but was also diagnosed with PTSD. This last time I saw my Social Worker, she asked me if I was also diagnosed with PTSD and I told her I was, but it was a long time ago in a different RO. She told me that she wondered, because she couldn't find it in my notes. I guess I will have to look through my c-file to find it, because they have asked me to attend PTSD treatment in the past.

Makes one wonder if they are deleting PTSD diagnoses, with the new PTSD regulations...

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".and never know why she didn't get connected for PTSD..but that's another thing."

Was she admitted specifically for the 21 day inhouse PTSD program?

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What is her current percentage of SC ?

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Was in program for PTSD more than two months. She has 90% S/C think 70% of it Anxiety. Pending TDIU..already has Ssd.

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Let me see if I understand this correctly

veteran is rated for anxiety.

veteran is admitted to hospital for 21 days for non-service connected PTSD

Veteran is seeking temporaty 100% for the 21 day hospital stay

No the veteran would not be entitled to the temporary 100% because the conditon for which treatment was required was not service connected. The one exception is listed below:

Even when hospital admission is for a nonservice-connected (NSC) disability, hospitalization benefits are payable if, during the hospitalization, treatment for an SC disability is initiated and continues in excess of 21 days.

Now If the claim for service connected is pending and later awarded then it is possible the veteran could receive the temporaty 100% rating based on the hospitalization.

The following is a September 5, 2008 change......

a. When to Assign a Hospitalization Rating

Provided a total, 100-percent rating cannot be assigned under other provisions of the rating schedule, assign a temporary 100 percent evaluation under 38 CFR 4.29 for

  • periods of hospitalization in excess of 21 days for medical treatment of an SC disability, or
  • a disability for which compensation is payable under either 38 U.S.C. 1151 or 38 U.S.C. 1160.

b. Granting Hospitalization Benefits When Admission is for an NSC Disability

Even when hospital admission is for a nonservice-connected (NSC) disability, hospitalization benefits are payable if, during the hospitalization, treatment for an SC disability is initiated and continues in excess of 21 days.

Reference: For more information on hospitalization ratings when admission is for treatment of a NSC disability, see 38 CFR 4.29(b).

Edited by Teac

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