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    • IME and Physician conflict of interest
      Instead of continuing a thread that dealt with CUE and beating a dead horse I thought it wise to start a new thread. In the pursuit trying to fixed my messed up claim I finally have found a physician that does IMEs Here is how he responded to my email explaining my situation: <...> "I read your email. It does sound like you could use some assistance.  A bit about myself. I do perform IMEs for civilian cases but I am also employed by a company that is contracted by the VA to perform similar disability assessments. I will have to check with my employer to see if your case presents a conflict of interest." <...> Of, all the flipping luck!!! I responded and explained further my situation. Hopefully he responds soon. That said, I need any advice possible on what I should do next.  I know this could be a blessing or this could be a curse, I don't know which...
    • Gulf War undiagnose illnesses and Chronic multisymptoms
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    • Should I file a CUE or leave NOD in place?
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    • VSO
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    • Mental Health C&P
      Thanks to all of you for your input.  I am really grateful.  As an update, I had my C&P yesterday.  The Dr had a copy of my evaluation that I had when I was seeking a diagnosis for my chronic pain.  The Dr back in 2012 did tell me that she did not think my pain was all in my head.  What she failed to tell me was that "the patient is suffering from depression and anxiety and should begin treatment.  Will follow up with her in 2 weeks".  I was never told to schedule an appointment or that I was suffering (in the clinical sense) from anxiety or depression.  I never went back to Mental Health and I definitely would have if I had been told.  I guess that is neither here nor there, but, I suppose that is my service connection right there.  The Examiner also told me that I should seek therapy which indicates to me that he thinks I am still having some difficulty with life, etc.   As far as his questions go, there was a pretty in depth framework he was required to follow with specific questions.  He was really open and empathetic.  He stated up front that it wasn't a therapy session and that I might feel rushed.  He also said that he would move on the next question once he felt he had enough info to answer one.  He also said he wanted me to feel heard, so if I had more to add that I needed to assert myself and make sure I told him.  He did start at birth and moved forward from there.  Asked about my family unit growing up. If I suffered any abuse?  If I could maintain social relationships?  He asked how school was for me both socially and academically.  He asked about my deployments and about my current family situation.  He asked how many children I have and what # marriage I am on.  It was a rather in depth interview.  At the end, he asked if I had any other symptoms or information to add. He also gave me the opportunity to ask him questions about the exam.  
    • Fully Developed Cue
      There are no in service treatment records of bipolar disorder.  My first hospitalization for it was 5 months after discharge.  PTSD is the only way to service connection because of it being presumed.  Direct SC for bipolar would be a hard fight indeed.
    • Sleep Apnea Granted
      Because if one of us dies from SC in our sleep and its not service connected our spouses do not qualify for DIC. We are well aware that our other claims are subject to scrutiny but once they have been SC'd once its a lot harder for the VA to reduce without evidence, even without any protections- they still have to produce medical rationale to justify a reduction.      CAS  
    • Sleep Apnea Granted
      Most of you responding in the comments that are saying that this is great news, how you want to get your Apnea SC'd are all already reporting that your at 100%.  WHY???? Your at 100% already. Leave it alone else you run the risk of losing that rating. By filing a new claim, unless your at the 20 year protection, you run the risk of EVERYTHING being re-evaluated and reduced. You can't get more than 100%. Yes, there are some special schedulers out there, but unless you are missing limbs or eyes, ED is about the only one you should ask for. For those at less than 100%, it might be worth pursuing, but my warning applies to you too. You file a new claim, you run the risk of a reduction. I assist vets as a job. yes, I'm 100% and working. I would get fat and more lazy and then die a quick death if I didn't work, and by work, I sit on my butt behind a computer. I see reductions all of the time. PLEASE...think before you file, then file smart.
    • Bells Palsy
      I have documented evidence in my service medical record that I had numerous episodes of Bells Palsy while I was in service and the VA denied the SC!!! Their reasoning is that I did not have any residual effects from the from the Bells Palsy episodes... WTF!!! How can I be denied for something that was CLEARLY evident in my medical records and is evident on the right side of my face as being a little bit droopy!!!  But, anyway I also filed a NOD in Feb 2015 to appeal the decision (still waiting on the VA) and I sought and got a medical exam for the condition. The neurologist performed the medical exam and he stated that the results of the neurology test does show that there is some residual effects still present from the Bells Palsy. Which is what I thought because you will never completely recover from paralysis on one side of the face and I don't know how the VA don't know that! Will the VA SC me for based on the Neurology test or would I have to get a nexus letter from him to further substantiate my the bells palsy condition? Any information will be helpful in determining what my chances are with getting SC.
    • Confused --- what am I covered for?
      Hi, new to the forums. I wish I had know about this before I filed my claims. Anyway, I have chronic shoulder and neck pains that are documented in my medical file. I got denied "service connected" on it and now I'm wondering if I can still get 'help' from the VA or do I need to go to a private medical insurance. I'm a twice deployed OIF vet and I was told I had 5 years after discharge for coverage. The VA representative said that 5 years applies to ANY symptom -I- think is service related. Also, I'm rated in 'Priority 1', does that mean I get coverage without co-pays for ANY condition or only conditions that are service connected? Basically, ten years down the road, can I still go to the VA for my shoulder/neck pain as a priority 1 patient or am I out of luck? Do I still have a co-pay? I plan to appeal the neck and shoulder pain. I'm actually quite shocked it was denied. The examining doctor acted like I was making it up but I was getting treatment for it for 6 years before I was 'involuntary separated' due to force reductions. So my plan was to go 20 years and I wasn't even aware I could get VA disability payments until the mandatory VA briefings I had to attend. Thanks in advance.    

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tmoe

Augusta Ga Va Clothing Allowance

30 posts in this topic

I know this has been mention 100 times,but this is what VA is trying to do with clothing allowance, I had a back brace that was not through

VA and the first guy says it has to be through VA to get paid. My responce was I don't get care for my back from VA, its through

a private Dr, VA won't see me for my back problem. So the supervisor who pays clothing was in a meeting until I ask for the regulation

that says it has to be issue through VA to get paid,they could'nt. Then she says I have to appeal the decision and to write a NOD as

to why I disagree, so I ask for paper to write my disagreement she don't have any, so one of the co worker gave me some paper and

told me to write everything they said and before I could get it wrote the supervisor say stop right there sign it I will pay you for the brace.

I was suppose to get three but my left hand is not sc for carpal tunnel just the right and the back. I just had to show the prescription for

my back brace and the brace it self. So dont let them s**t you they must pay you. ALL this was after I recieve my letter, just got paid for

one,but was denied 2 other. Now the back brace was approve today!!

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tmoe - thanks for the great info!!! I'm sure it'll help someone.

pr

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tmoe -

I received a letter months ago and still haven't seen any cloting allowance from the Augusta VAMC. I too applied for dual and was told over the phone that I was only approved single.

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I am still waiting on my clothing allowance. I called the prosthetics department and I was told that they are still processing it.

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First to be sure, the VA isn't going to pay more than two clothing allowances to any veteran. The rules only call for payment of two , not three. four or more. Now, to be sure, if your brace was not issued by the VA then legally according to VA Handbook 1173.15 they cannot and should not pay you any clothing allowance. So if you got a brace from the private sector and the VA employee agreed to pay you the clothing allowance they are breaking the Law. You really should download a copy of the handbook and read it. The VA here in San Antonio will not only refuse to pay a clothing allowance for a private sector issued brace, but they also refuse to pay a clothing allowance if your brace or appliance was issued by a different VA Hospital or A Military Hospital. The Handbook specifically states that the item must be issued by the VA, ( not the Local VA). The new clothing allowance form shows an example of an appliance being issued by Walter Reed Medical Center... so even the example on the form contradicts the Handbook. I presently am fighting with VA San Antonio because of refusal to pay the second clothing allowance because as they stated they did not issue my AFO, Canadian crutches , or manual wheelchair... at the local va there fore even when I present medical records showing they were issued at other va medical centers they still refuse to pay for the second clothing allowance. I generated a congressional inquiry today after playing their games for over a year. So in response to your last sentence, what you were told was against the law, and no other veteran should expect to be paid for a clothing allowance under the conditions you outlined, The appliance that warrants the clothing allowance by law must be issued by the VA for a service connected issue.

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Teac,dont know who told you you are allowed only two clothing because i only filed for two but they had me for three and this was why

the allowances are late because people are filing 3-4 clothing or this is what Augusta been telling me. I say again VA DON'T TREAT

ME for my sc back but I have a prescription for a back brace from private doctor she says she would pay me for it thats all I said. San

Antonio could be giving you some of their bull because that don't even sound right you can/t use a brace from another VA who prescribe it

you go back and read that handbook some more. I got my letter tuesday money 741.00 in bank wednesday now waiting for the second

allowance so believe as you will. This is why I don.t post because I get call a liar or telling something wrong but it ok I got mine only trying

to help another person

Edited by tmoe

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tmoe -

I received a letter months ago and still haven't seen any cloting allowance from the Augusta VAMC. I too applied for dual and was told over the phone that I was only approved single.

justrluk,her name is Mrs Price the supervisor i went to her office because she quit answering her phone she is a pain in the butt a month ago she said i was approve

i call a week later my claim have not been approve nor summited yet. I would check with her again, also it will show on ebenefits as a claim open

and close decision sent or something like that

Edited by tmoe

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First to be sure, the VA isn't going to pay more than two clothing allowances to any veteran. The rules only call for payment of two , not three. four or more. Now, to be sure, if your brace was not issued by the VA then legally according to VA Handbook 1173.15 they cannot and should not pay you any clothing allowance. So if you got a brace from the private sector and the VA employee agreed to pay you the clothing allowance they are breaking the Law. You really should download a copy of the handbook and read it. The VA here in San Antonio will not only refuse to pay a clothing allowance for a private sector issued brace, but they also refuse to pay a clothing allowance if your brace or appliance was issued by a different VA Hospital or A Military Hospital. The Handbook specifically states that the item must be issued by the VA, ( not the Local VA). The new clothing allowance form shows an example of an appliance being issued by Walter Reed Medical Center... so even the example on the form contradicts the Handbook. I presently am fighting with VA San Antonio because of refusal to pay the second clothing allowance because as they stated they did not issue my AFO, Canadian crutches , or manual wheelchair... at the local va there fore even when I present medical records showing they were issued at other va medical centers they still refuse to pay for the second clothing allowance. I generated a congressional inquiry today after playing their games for over a year. So in response to your last sentence, what you were told was against the law, and no other veteran should expect to be paid for a clothing allowance under the conditions you outlined, The appliance that warrants the clothing allowance by law must be issued by the VA for a service connected issue.

e. When the veteran certifies use of an appliance and/or medication which damages clothing and there is no record of VA issue, a physical examination needs to be scheduled prior to a recommendation for denial of entitlement. In determining whether these devices and/or medications tend to damage clothing, each individual application is to be considered on the objective findings of the case; this may include a medical examination and an inspection and evaluation of the device(s) claimed to cause damage to the clothing. Staff must ensure that they do not routinely require the production of worn or torn clothing.

NOTE: Reasonable doubt should be resolved in favor of the veteran. This don.t say you can.t get paid if not issue through VA only they would have to check it to see if it cause wear and tear to clothing

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1641 handbook

Edited by tmoe

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e. When the veteran certifies use of an appliance and/or medication which damages clothing and there is no record of VA issue, a physical examination needs to be scheduled prior to a recommendation for denial of entitlement. In determining whether these devices and/or medications tend to damage clothing, each individual application is to be considered on the objective findings of the case; this may include a medical examination and an inspection and evaluation of the device(s) claimed to cause damage to the clothing. Staff must ensure that they do not routinely require the production of worn or torn clothing.

NOTE: Reasonable doubt should be resolved in favor of the veteran. This don.t say you can.t get paid if not issue through VA only they would have to check it to see if it cause wear and tear to clothing

http://www1.va.gov/v...asp?pub_ID=1641 handbook

I guess it depends on how you read it... " when there is no record of va issue" In my case the local va said that there was no record of issue, and that even though I provided medical evidence showing the va did issue my stuff, they said but it must be issued by this va and since it was not it does not qualify for the clothing allowance. I filed an appeal citing exactly what you show above. They did not afford me an examination, although the fact that my appliances are used is in my medical records because every time I see a doctor they write it down. My appeal was signed for on 15 Oct, they have by law ( va directive clinical appeals) 30 days to provide an answer. They fail to reply, my congressional inquiry went to my senator yesterday. Now I am not a big fan of contacting senators because they rarely do help... normally you end up with the same answer regardless of who is asking, only with a congressional you might get a faster answer..... Technically your are correct when there is no record of issues does not mean the va must issue the item.... but according to the local va it means that it must be issued by the va........and I can tell you if every va did the same thing according to the rules we would not have any problems... but very few va's do the exact same thing.

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My clothing allowance has been approved for appliances I have received from the military hospital as a military retiree/tricare prime patient and not the VA.

VA tried that same "it wasn't issued by us" and denied it two years ago and when I sent them my appeal the next day, it was approved within a week; haven't had that problem since.

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justrluk,her name is Mrs Price the supervisor i went to her office because she quit answering her phone she is a pain in the butt a month ago she said i was approve

i call a week later my claim have not been approve nor summited yet. I would check with her again, also it will show on ebenefits as a claim open

and close decision sent or something like that

Thanks, tmoe - I'll call (bug) them today and see what happens.

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Thanks, tmoe - I'll call (bug) them today and see what happens.

justrluk,just got my second clothing deposit today so good luck with yours

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justrluk,just got my second clothing deposit today so good luck with yours

Congrats! I heard yesterday they were working on the "Ls". I'm in that list, but haven't seen anything yet. Did you see it on eBenefits or as a deposit first??

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Congrats! I heard yesterday they were working on the "Ls". I'm in that list, but haven't seen anything yet. Did you see it on eBenefits or as a deposit first??

Did you see it on eBenefits or as a deposit first?? This one was deposit first nothing on ebenefit yet, but the first one was on ebenefit in compension & claims first

Edited by tmoe

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I decided to stop by the prosthetics department on Monday the 10th of December after my appointment to check on my clothing allowance. I was told that one of my clothing allowance was granted and one was denied. She asked me if I got a copy of their decision letter and I told her no so she printed out a copy and gave it to me. I could not believe the reasoning behind their denial it stated "You were denied based on the following: off the shelf back brace is several years old which does not substantiate continuous use that could cause wear and tear to clothing." I told the lady yes I have had the back brace for years but it was molded for my back and it still fits and I still wear it, I also told her that I was never told that I needed a new one. I have had you all check my braces for years for clothing allowance and never once did you all say I needed braces, I told her. She whispered to me, they are not going to tell you, that's how they are going to deny your claims, and she said you are not the only one they did like that. You need to get new braces every six months to get the clothing allowance. I asked her why didn't I receive a copy of this decision in the mail, she said I should have. I told her this letter is date September 11 and I called up here in Sep, Oct and Nov and was told it was still being processed but the date on this decision shows it was already completed since early Sep and I still haven't received payment for the one that I was granted. She gave me a number to call. I called the number to inquire on the decision and this guy to me to appeal it to the Chief of prosthetics if I don't agree with the denial, so I asked him why haven't I received payment for the one I was granted he told me to hold on, I was on hold for over ten minutes when he came back and said I would receive it in ten days, my friends again they surprise me I received it this morning but I have also submitted a letter to appeal the denial of my back brace.

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Jay -

So sorry to hear you had to suffer this buffoonery...

I've also called and was told to leave a message. I left one with my name, SSAN, etc. and couldn't get any more info. I was finally able to get the woman on the phone that is supposed to be processing the claims, and she said she processed my claim. That was on Tuesday of this week. I haven't seen anything yet on eBenefits or in my account so we'll see how long it takes from her statement that it had been processed to actually getting paid. The Augusta VAMC has been pretty reliable until this year. Don't know what happened, but this is ridiculous.

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@Justrluk thanks I'm telling you its ridiculous how this years clothing allowance is being decided and the length of time its taking. I am waiting to hear what excuse they come up with on the one they denied.

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@Justrluk thanks I'm telling you its ridiculous how this years clothing allowance is being decided and the length of time its taking. I am waiting to hear what excuse they come up with on the one they denied.

This is because they are looking for reason to deny the second clothing allowance... Hell at this point I now have a congressional inquiry because San Antonio refused to deny in writing or provide a statement of the case after I appeal the decision. In fact they flat out refuse to even acknowledge that I requested the second clothing allowance...

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I decided to stop by the prosthetics department on Monday the 10th of December after my appointment to check on my clothing allowance. I was told that one of my clothing allowance was granted and one was denied. She asked me if I got a copy of their decision letter and I told her no so she printed out a copy and gave it to me. I could not believe the reasoning behind their denial it stated "You were denied based on the following: off the shelf back brace is several years old which does not substantiate continuous use that could cause wear and tear to clothing." I told the lady yes I have had the back brace for years but it was molded for my back and it still fits and I still wear it, I also told her that I was never told that I needed a new one. I have had you all check my braces for years for clothing allowance and never once did you all say I needed braces, I told her. She whispered to me, they are not going to tell you, that's how they are going to deny your claims, and she said you are not the only one they did like that. You need to get new braces every six months to get the clothing allowance. I asked her why didn't I receive a copy of this decision in the mail, she said I should have. I told her this letter is date September 11 and I called up here in Sep, Oct and Nov and was told it was still being processed but the date on this decision shows it was already completed since early Sep and I still haven't received payment for the one that I was granted. She gave me a number to call. I called the number to inquire on the decision and this guy to me to appeal it to the Chief of prosthetics if I don't agree with the denial, so I asked him why haven't I received payment for the one I was granted he told me to hold on, I was on hold for over ten minutes when he came back and said I would receive it in ten days, my friends again they surprise me I received it this morning but I have also submitted a letter to appeal the denial of my back brace.

Do you have a new prescription for your brace because if not and its not static than all you need is a new prescription and you should be fine just some more of their bull s**t

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Yes, I got a new prescription.

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Jay - have you had any success yet? I still haven't seen anything and nothing on eBenefits.

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Just called today: those of us that received a letter from July - Sept may not see payment until next month.

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Justrluk haven't heard anything from chief of prosthetics yet, I'm sure they will come up with some type of an excuse as to why my second allowance remain denied.

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I called the other day. Woman looked up my claim and said it was processed on the 17th of December. I still haven't seen a deposit.

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Clothing allowance just showed up today. What a relief!

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Has anyone using the Augusta VAMC received a clothing allowance yet?

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justlurk, which I could tell u somethng good but I hav not heard anything but will check this week when my appointment

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Thanks, tmoe. I appreciate you asking the question.

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justrluk, I just receive an approval for wrist brace but they denied the back brace saying I needed to take some worn clothing

and a new prescription to prosthetic saying I need this type of brace, and go to primary care to get a new brace something that wont

wear clothing. I was told the supervisor had complaints about not answering the phones so she is answering and giving the info over the phone

after I call her I had the letter the next 2 days. Not sure if it is deposited yet got lock out my account. I think the number or ext 6162

Edited by tmoe

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and yes the VA will pay for 3 clothing allowances. I know this to be fact guys...

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