Spousal Healthcare Benefits

[wilspeak]

Do spouses of veterans that are 100% disabled receive healthcare through the VA? If thy do, what is the process? Thanks in advance.

[Buck52]

No. sorry he needs to be 100% P&T and the VAMC is a participating  with  CITI ChampVA

However it depends what it is ..you may check with your local VAMC admitting office  some times they will make exceptions. 

[Berta]

I think any vet who gets some retro for a TDIU or 100% that is not P & T, should save some of the retro for a potential P & T claim...if they will need an IME or a Certified Vocational Specialist's opinion.

That could be a very good investment ,if they feel the evidence would warrant P & T because CHAMPVA would then be given to their family as well as DEA (Chapter 35 Educational Benefits)

I have both,used both,  and they are wonderful.I have the doctors of my choice ( VA did treat me years ago briefly) and only  pay a 50 buck annual co pay. CHAMPVA told me if I switch to Meds by Mail the co pay would be gone.

I only take one med 2 times a week.And really  have no trust in the VA pharmacy because they made a medication Meds by Mail error for my husband years ago and tried to blame the Post Office but could not get out of the error.It caused my most recent 1151 award. The med error happened over 22 years ago.There is no time limit on 1151 claims.

I had a hell of a time with a different 100% P & T issue.Maybe this will help someone out there.

My deceased husband was granted 100% P & T for SC PTSD.Then I was granted 1151 DIC in a 1998 decision. The 1151 disability was rated wrong, and also set up SMC. I had to CUE it and they awarded it all. The decision contained 4 or 5 CUEs.

BUT in calls to and from and emails with the Director of my VARO she kept saying the 100% 1151 was total but not permanent.   ????

I asked for proof from her that VA completely cured the 1151 stroke shortly before my husband died.

Of course they didnt cure anything.They caused the stroke in the first place.

My evidence of P & T was lengthy ( and since he was dead this evidence for my accrued benefits had to be in VA possession at time of his death)and it was.

This is only some of the evidence they were trying to ignore:

SSDI awards (he had 2 separate awards)

A Student loan waiver whereby a VA doctor stated he was 100% P & T due to the stroke.

A letter from a former VA Secretary that stated he was 100 % P & T due to the stroke.

A VA VOC Rehab report stating that due to his stroke, his ability to continue Voc Rehab would be unfeasible.

The established fact in VA case law that if a veteran dies with a continuous100% rating, they also then  have  a Permanent 100% status for the same Total status.....(unless the VA miraculously cured them completely of the 100% shortly before they died.yeah right)

This is supported by the fact that TDIU is never awarded to a dead veteran, because the evidence that could have awarded TDIU in their lifetime,is moot because TDIU is only for living veterans.

This is why VA  never even mentioned my husband's TDIU claim, well supported by evidence, in his lifetime ,when they made the posthumous 100% P & T awards.CUE in a 1998 decision. Awarded in 2012. Cued again and awarded 2015 I think.

100% P & T for stroke under 1151 in addition to SMC due to HB and also 100% P & T SC PTSD.1997 accrued.

It is still wrong but I have an appeal in.I want the BVA to decide the appeal and am filing a Motion to Advance on docket due to the legal criteria of those MOA regs, when an appeal involves a legal issue..that is way beyond (per my experience) the competence level of my VARO.

 

 

 

 

 

Edited January 14, 2017 by Berta

[Buck52]

Ms berta

when a veteran as more than 1 CUE  say he has 5 CUE's  do they rate the favor in the veterans side  for only 1 CUE  or Do they rate on each CUE Filed?

for the same claim.

Edited January 14, 2017 by Buck52

[Berta]

They will decide each CUE that is filed .I still have one pending that they have ignored since 2004.....but I  brought that up in my Motion to Advance....

I am focusing the legal part of the MOA regs, not the age part or the other criteria.

I had 5 CUEs in a single 1998 decision.I said 4 here many times but I keep forgetting the recent one they awarded last year. All of those CUEs have been favorably resolved except for one legal issue I want the BVA to decide ,because it involves a General Counsel Opinion ,that my RO refused to consider.And it involves more retro. 

This Pres Op opinion was reiterated and explained by one or two additional

VAOGC Pres Ops over the years because apparently the ROs were still not getting it's point.

The point was that a veteran with SCs and also 1151 ratings cannot be deprived of any compensation they are entitled to and OGC specifies the word "ALL" 2 or 3 times regarding what they are entitled to as comp....ALL comp when a successful SC and additional 1151 award has been made.

The Pres Op applies to accrued awards as well.

 

 

 

 

 

 

Edited January 15, 2017 by Berta

[broncovet]

You asked if spouses of 100% Vets received healthcare at VA.  To answer your question, you must first answer if its P and T.  In your decision it should state whether or not any future exams are scheduled, and whether or not you are entitled to Ch. 35.  

If your decision states, "no future exams are scheduled" or "you/your dependents are eligible for CH. 35" this is VA speak for P and T.  

If you are P and T 100%, you can have your spouse go to the Va.  My VAMC allows spouses of 100 percent P and T Vets to get health care there.  But it is a decision made at the local VAMC level, since some VAMC's are so crowded  its not a good idea to allow spouses also.  

YOur spouse should get CHAMPVA, which is some of the best health insurance available.  Your spouse should apply for champva if you are P and T.  

In summary:

1.  Check your dec ision to see if you are P and T, if you dont know. 

2.  If you are, your wife should apply for Champva health insurance. 

3.  Your wife can go to your local VAMC, and they will decide if she can get medical care there, based upon their criteria, probably how crowded your VAMC is.  The idea is they dont want to turn away eligible VEts for spouses, if they are too crowded.  

[Gastone]

Wil, just tuned in to your posts. After looking back at your prior posts, me thinks your currently 90% SC and apparently haven't filed for IU. You never received an "Inferred IU Claim," stipulated on your last SC Award?

If that's the case, the whole Chapter 35 for T & P No Future Exams, CHAMPVA and other associated Benefits is somewhat premature. Do You have an IU Rating? Are you discussing a hypothetical future 100% SC Rating?

What exactly makes up your Combined SC Rating of 90%? Getting an C-SC bump to 100% is not only difficult, it's almost impossible. For the most part, you need a New SC DX or Secondary SC that is rated at 50%.

We might be able to assist you but definitely need to know what your working with. Could you posr redacted copies of your Award/Denial Letters and C & P DBQ's?

Semper Fi