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What Should I Expect From The Va?

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jesse(ss)

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About five years ago while underway I had a backwards fall and landed my head on steel door lip.

I got an awesome scar across the back of my head and about ten staples to close up the gash.

I was medivac of the boat, not because of the head injury but because I had neck pain.

The first year after my injury was absolutely horrible and my Docs attitude towards my complaints and request for treatment was at best apathetic. (not looking for sympathy just illustrating that I received no follow up care) I never even heard of the term TBI until a few months ago.

In 2005 I separated (HON) and went to see a DAV rep for help with filling a claim. The VSO advised me that it would not be good thing to have a rating while pursuing a career in law enforcement and that I could file the claim at a later date. Obviously I took his advice, and I even kind of guessed on my own it would not be a good idea to seek treatment from my personal physician lest it be documented.

Im not criticizing the VSO, he didnt pressure me not to file the claim.

Fast forward to today, with the prodding of a fellow vet and being fed up with the ailments that are still present I have decided to file a claim. (Well maybe not)

Currently I have these symptoms they are in order of "most annoying" i.e. driving me nuts. Everything has pretty much been stabilized for past 2 ½ years

Insomnia (almost every night)

Headaches (wake up with massive ones 3-5 times a month) + dull ones all the time

Tinnitus (both ears comes and goes daily sometimes it actually hurts(I don't know if anyone has ever heard of painful tinnitus?))

Memory- try selling a car to someone whose name you can't remember (I can't remember all the things I can't remember)

Concentrating + Learning things for work (It's like I forget what I'm doing)

Scar and back of my head still somewhat painful. (I think I remember my chief nicknaming me divot but, I don't trust my memory anymore I could be imagining that.)

So anyway, as I mentioned I did not receive follow up care and I'm pretty sure that my CoremaN didn't document very much (before separating I got my hands on my med rec., wasn't very thick), the only thing I am sure of is that on my separation medical I listed the accident, headaches and some of the other incidentals too.

My question is, (drum roll) without any further documentation/ treatment is my claim doomed? I would almost rather not pursue this, than to have a 10% rating and bottle of Motrin thrown at me. Not worth my time or the insult to injury and stigma of a tbi. From reading these boards I am worried that by the end of the claim process I will have to add anger issues to the form.

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So, I went ahead and filled a claim in February. About a month ago I received a letter letting me know that my claim is being processed. I have called on several occasions to inquire about medical appointments for the purpose of adjudicating the claim and getting treatment for my conditions, they just tell me that they are working on it and that they do not know when or if I will be sent for an evaluation.

(Does this sound familiar to anyone?)

I have been told by the local VA hospital that I can go there for treatment but because I am not yet rated, my P.P.O. and I will have some sort of financial obligation for services. I am concerned about this because I do not know how this will affect my benefit maximums with my insurer and the possibility of the VA trying to bill my insurer even after being service connected/rated. So for now I'm just waiting and thinking that McDonalds or Kinko's could do better job taking care of veterans.

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This might be of some help..

First figure out which priority group you will be in based on your income level. Let say you are required to pay copay's, and they bill your insurance ( they will try this even if it is service connected ).. If you win your service connection, they have to pay it back, and you can actually go back two years and file for your medical bills to be reimbursed. ( I am not sure if this works, but I was told this, but I don't entirely believe it.. ) but either way your VA bills will be taken care of..

Also when you get your bills from the VA, call the billing department and say you are in the middle of a claim, and these bills will be service connected. You can even let it pile up for a few months and ask for a hardship forgivness of the bill.

If you are smart in your scheduling.. you really only have one copay per day, no matter how many appointments you have.. So you just schedule as much as you can in one day.

As far as them billing your insurance.. they will try and whatever they get, they get, but if your insurance tells them to go pound sand, then they will not come after you. Not as long as you are enrolled in the VA health care system and assigned to a priority group.

I would say that your delay is related to the fact that you are not being seen by the VA. Did you submit all of your private medical records and military medical records with your claim?? The VA will still request them from your doctors, and that is what delays the initial claim.

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