This eBook will teach you how to get C-Files (paper and electronic) from the VA Regional Office.
How to Get your VA C-File


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    • Exams during flare up?
      So they would most likely assign the minimum rating for pain? And not assign a rating for range of motion effected by the flare up? 
    • Exams during flare up?
      It must be considered as part of the claim, as it could effect the rating percentage, but rarely is this done in the first examination. At least from 6 exams I have had. You usually have to fight for the secondary issues caused by a service connected injury.   JMO.
    • Exams during flare up?
      A friend of mine who is a fellow Vet were talking about the C&P process. Like me he has a lot of inflammation issues in his shoulders. I told him how the examiner asked me if I was having a flare up when she examined my knee. We both became curious if that has any effect on a rating.   So if a veteran is experiencing a flare up during a C&P exam. Does the assigned rater take that into consideration and rate it at less of a percentage based on the restriction of movement due to a flare up? Or do they rate it as scheduled no matter what?    
    • My husband died in motorcycle accident
      Page1006 I never intended to up set you in any way and I know all this has to be upsetting to you to say the least. I hope you have sent in statements like this one? for evidence of record   your lay statements will be considered. I agree with you I believe your hubby did have some type of episode just right before his Accident..Proving it will be hard.
    • VSO
      JoebobCVSO Thanks for your service to vets and your honesty about working claims when you can get to them. Frankly, no matter how good you are you needs the Vet's evidence and lots of it to convince the VA. Although many characterize them as the enemy in some cases, I see them as hero's that are working theirs tales off to help Vet's. Have I had some negative experiences with exams, claims and interactions with the VA-yes. But, although my rater did not give me all that I expected, it's on me to provide more solid and compelling evidence. I learned early on, that no one is going to care more about a Vet's claims than themselves. So, it's very important for vets to learn as much as they can about the disability process and help you to help them. Recently, I've agreed to help some relatives with their claims due to what I have learned so far and my claims success. But, many of them just want to hand a pile of medical records and be told when to wait by the mail box for a big check? Before I submitted my claim, I do a great deal of work to put the package together. The head of a VA CP Section looked at my submission packages and remarked that they were the most organized that he had seen in 25 years. I told him that I did not want to leave much to chance and that I had some one once tell me that you have to make it easy for the rater to rate in your favor. For me, my VSO was not very good but I know that their are great one out there doing their best and helping Vets. I for one want to thank you for your incite and help via this post. Can you talk about the 3  to 7 big trends or  no/no-s that are hurting vets as they submit their claims packages right now? Goodspeed Rootbeer22
    • Mental Health C&P
      When possible, posting redacted copies of your Award/Denial letter and discussion of evidence reviewed, would still be of great assistance. Semper Fi
    • New guy here!
      I guess at least on the bright side, I'm pending an MRI via the Choice Program, should find out what's going to happen Tuesday. Beyond that, the first person I'll be calling will be my VSO :-) thanks. Patience is a virtue, Complacency kills. Never settle, never surrender.
    • Mental Health C&P
      I am so glad that you are seeing progress.  YAY!  It's great when a Veteran finally gets a little bit of what they deserve.  This whole process is so convoluted and frustrating.
    • Mental Health C&P
      Gastone, I just ordered a copy of my C file.  My exams were all done at QTC facilities so I can't get them online. It was a MH exam that was requested by the original C&P examiner on 4/26.  He even read me the referral request when I first walked into the room on Wednesday.  He also stated that it wasn't therapy but a fact-finding mission for the VA.  I asked if I could get a copy and he said it wasn't his to give.  It belonged to the VA to use for my claim.  I saw my file during my first C&P and it had a big red EXPEDITE stamp on it so maybe that is why the turn around was so quick?
    • New guy here!
      E Benefits dates are a joke.  You cannot assume that they have much meaning, honestly.  They whip around every so often without explanation, so dont take it seriously. Your best contact for updated info is the VSO, if you can get his cooperation.  He has access to more than any of the RO info that we dont.  If he doesn't, call peggy (800-827-1000).  Sometimes it is just best to forget it for a while and let it go.  Patience can be a killer. If you take a hit on your income, are facing foreclosure, you can also put in for hardship.  I know that losing your job is a lot of stress.

  • HadIt.com Veteran to Veteran providing FREE information and community to veterans since 1997.

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yoshi

Obama Care

21 posts in this topic

I am fully covered by the Dept of VA. Are there any benefits to enrolling into additional health care coverage? Just asking because I received a letter from the VA today asking me if I want to enroll. What are the pluses to enrolling into additional coverage's, and how does enrolling int additional coverage's affect a Veteran's current coverage?

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It is a form letter sent to most vets who use VA. No changes to Veterans care as it is not effected by the New Healthcare laws.

J

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Are there any benefits to enrolling into additional healthcare coverages?

Curious because I usually use the VA for all of my health care needs, but I am thinking of enrolling in Medicaid/Medicare for additional coverages where the VA lacks-i.e. hospitals in the local area. I like my benefits the way they are now. I just don't want to lose any coverage from the VA if I pick up an additional carrier. Does anyone know what kind of affect adding an additional insurance will have on my VA Healthcare plan? Thanks.

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But those of use stuck in limbo can get any help for our dependents!!!! I can't wait for 2016....

Edited by rpowell01

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Its my understanding that if you get VA coverage it will not be easy to enroll in Obamacare.

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One benefit of having multiple coverages: VA and civilian health insurance medicaid etc, is that you have a doctor choice. With exclusively VA care, you are limited to practitioners who work under VA rules. If you are a civilian, you can go to any doctor, and seek the best docs in his field. Many VA docs are from foreign countries and many do not even speak English as their first language. I can understand about half of what my VA docs say, so how am I ever going to comply with "doctors orders" when I dont even know what they are???

Sadly, "doctor choice" isnt possible for many Vets. They have no choice but to go to VA. My wife, who is eligible for Champva And VA, gets far, far better health care than I do, as a Vet. Why? She can go to any doc, (VA or non VA) and get it paid either by VA or Champva. I dont have that option, I must go to the doc VA says I have to go to, whether he is my "favorite" doc or not.

Edited by broncovet

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I must go to the doc VA says I have to go to, whether he is my "favorite" doc or not.

Not really So, If it's their only doc in that field yes it's true, However I have changed PCP's More then once because of the way the treated me. You just need to ask to be assigned a new PCP.

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In our experience, having additional medical insurance coverage does not take anything away from care I receive from the VAMC. If anything, the VA Health Administration may attempt to bill any health insurance you have for care you receive through them. But seeing as you're rated at 50%, can't imagine the VA would attempt to charge anyone for care they said you get for free. We're a retired military family, and the VAMCs I've used have yet to attempt to bill TRICARE either before or after I received my 60% rating.

Broncovet is dead on in his description...more insurance means more choice. It's allowed me to pick and choose what I get from the VA rather than have to accept whatever they'd like to throw at me. With my conditions being complicated, I'm much more comfortable working with top doctors in our region rather than VA specialists. In fact, when I've mentioned to my VA PCP which practices are treating me, the response is that the VA cannot top that.

Edited by TiredCoastie

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If anything, the VA Health Administration may attempt to bill any health insurance you have for care you receive through them. But seeing as you're rated at 50%, can't imagine the VA would attempt to charge anyone for care they said you get for free. We're a retired military family, and the VAMCs I've used have yet to attempt to bill TRICARE either before or after I received my 60% rating.

They go after my insurance for any treatment that is NOT service connected....I usually don't mind because it wipes out my Deductible....

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Oh BTW: That's how my private insurance found out I have Diabetes. Now I get all kinds of Phone Calls and Material in the mail from my private insurance for the DM....

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When VA collects from our Insurance they turn over all our Medical Records to Insurance and Insurance turnsd it over to their reporting Agency. So much for medical privacy.

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Are there any benefits to enrolling into additional healthcare coverages?

Curious because I usually use the VA for all of my health care needs, but I am thinking of enrolling in Medicaid/Medicare for additional coverages where the VA lacks-i.e. hospitals in the local area. I like my benefits the way they are now. I just don't want to lose any coverage from the VA if I pick up an additional carrier. Does anyone know what kind of affect adding an additional insurance will have on my VA Healthcare plan? Thanks.

Medicare is a must if you intend to use non VA local medical services and doctors. Many of the employers are basically forcing retired employees out of the mainline medical insurance carried by "active" employees. The replacement is something like "Medicare Advantage" or a similar program. For those who don't mind paying, say two to three thousand a month, they may be able to maintain coverage in the active employee plans. The Medicare advantage plans basically require that the insured maintain Medicare A&B, as well as drug coverage. (They do NOT consider VA drug benefits as qualifying) So, in essence, someone under this scheme will pay roughly $200+ for Medicare coverage with a few extra perks.

Edited by Chuck75

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In our experience, having additional medical insurance coverage does not take anything away from care I receive from the VAMC. If anything, the VA Health Administration may attempt to bill any health insurance you have for care you receive through them. But seeing as you're rated at 50%, can't imagine the VA would attempt to charge anyone for care they said you get for free. We're a retired military family, and the VAMCs I've used have yet to attempt to bill TRICARE either before or after I received my 60% rating.

Broncovet is dead on in his description...more insurance means more choice. It's allowed me to pick and choose what I get from the VA rather than have to accept whatever they'd like to throw at me. With my conditions being complicated, I'm much more comfortable working with top doctors in our region rather than VA specialists. In fact, when I've mentioned to my VA PCP which practices are treating me, the response is that the VA cannot top that.

They can try to bill "private" insurance. They cannot bill Medicare or other government medical "insurance". An exception seems to be Tricare, in that Tricare picks up some of VA charges for non SC'd conditions.As far as I know, they can bill insurance companies that insure government employees.

Years ago, until the government changed the laws, the VA or a military hospital would not have been paid by a private insurance company.

For a short time, (1970's) we were impacted by the old law. My then employer, due to contractual agreements with the government, ended up picking up the difference, (other than a $25-30 copay)

When all was said and done, military retirees using military medical services, and that had "private" group insurance were paying the premiums, and the military medical system was reaping benefits.

Edited by Chuck75

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They can try to bill "private" insurance. They cannot bill Medicare or other government medical "insurance". An exception seems to be Tricare, in that Tricare picks up some of VA charges for non SC'd conditions.As far as I know, they can bill insurance companies that insure government employees.

Years ago, until the government changed the laws, the VA or a military hospital would not have been paid by a private insurance company.

For a short time, (1970's) we were impacted by the old law. My then employer, due to contractual agreements with the government, ended up picking up the difference, (other than a $25-30 copay)

When all was said and done, military retirees using military medical services, and that had "private" group insurance were paying the premiums, and the military medical system was reaping benefits.

You're right, Chuck. The VA is prohibited from billing Medicare. However, not every VAMC participates with TRICARE. As a result, I'm waiting for a VAMC to reimburse me the co-pays I shelled out for care prior to receiving my 60% rating.

In fact, there's a change that was just announced in how TRICARE For Life recipients (military retirees on Medicare with TRICARE as a secondary insurance) will be billed for treatment of non-service connected conditions if the retiree is rated less than 50%. In the past, TFL picked up 80%. Now they'll pick up only 20%.

http://www.moaablogs.org/healthcare/2013/08/beware-non-service-connected-vatfl-healthcare-users/

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Thanks for all the responses. I think I will go with both. I suspected Medicare would open more choices. What is the biggest difference between Medicare and Medicaid? Also, I am going to talk to Social Services soon, what are some questions I should ask them about medical coverages? Are they preset in stone? I prefer to know what I am getting myself into. I like the idea of multiple insurance coverages primarily for a peace of mind. I thought this would be a great thread for myself, and others who follow. Thanks for the responses again!

Edited by yoshi

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Medicade is for the very poor. Medicare is for everyone who paid into it for a certain number of quarters. I have VA, medicare A&B and Blue Cross. As long as I can afford it I will take it. I even get coverage from worker's compensation for a few things. If your house is paid off and your car is paid the other big expense is insurance. I get second opinions on everything.

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I suggest all vets with private insurance to check with VA billing to get a report of what was paid and billed. You will be surprised to see many service connected conditions being billed. That is what I call VA Insurance fraud. The Vet commits fraud he goes to jail, The VA commits fraud, they get a bonus.

J

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You are right about that, John. I told BC/BS the VA was billing them for NSC stuff and they just said it was not worth investigating. The VA billed them for my C&P exam. I went for eye exam for DMII and the VA billed my insurance.

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Yeah, no joke! I find that 90% of VAMC treatment for my SC conditions are being rubber stamped to be billed to my private insurance.

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Well I wish we could find a whistle Blower. Any fed up billing people around. I am sure there is one somewhere that the VA is giving a hard time about a claim or something.

I am going to do a poll to get a number for research only

J

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Its funny how we read that that VA has the best medical care in the U.S.A. but we also read how they are the most underfunded in the country.

Edited by rpowell01

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