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VetsLady

Is It True?

Question

If a Vet becomes 100% P%T, can he go back and put in for reimbursement of out of pocket medical expenses for he and his family

to the date that he became 100%? Where can I get more information on this?

Also, does someone know where in the docket the AMC is at in deciding claims? I know many of you have appeals at the BVA and/or AMC.

My husband's was remanded back to the RO, then we dropped one of the issues and there is only 1 issue on appeal presently. We know for

certain (well, haven't actually "seen" the file there with our own eyes)

I'm getting conflicting information on a docket date. His file was sent to BVA in Sept. 08, hearing was Nov. 08, remand date is March 09.

I sent an inquiry in to AMC and no response. Just sent an IRIS, maybe they know.

Trying to gauge a timeline of when his claim may be decided as his claim is marked Hardship. I was given information that his file is in the

developing dept. - all developing has been done already - but this is the last info I have. I'm told that if it goes well in development and is

SC then his file will be walked upstairs for a rating, AMC is doing the rating. BVA doesn't want to see this file back as the RO really mucked it

up.

Thank you for any information you can provide.

VetsLady

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You can get your copay back till effective date. If spouse has ChampVA I am not sure how far they will go back but press them

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Champ VA recipients have a limited number of months to file claims for medical treatment and precriptions back to the effective date of the P and T award.

I believe it is 180 days.

J

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His file was sent to BVA in Sept. 08, hearing was Nov. 08, remand date is March 09.

I sent an inquiry in to AMC and no response. Just sent an IRIS, maybe they know.

Thank you for any information you can provide.

VetsLady

Vetslady,

No guess here as to when, but hopefully it won't be too long for ya'll now.

Did you request a copy of the BVA Hearing transcript's ?

If yes, Have you received them yet ?

carlie

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Thanks for the replies....

No, I haven't requested the actual transcript. We did receive the remand.

The 1 issue still on appeal, the VLJ had nothing in the remand regarding it

specifically. He wanted the SSD records associated with the file as VA w

wasn't aware he was on SSD. We had a (yes had) a very poor VSO, which

didn't help things along at all. There were 4 requests in the remand itself,

1 - for the SSD records, 2 -a QTC exam be done re: PTSD 3 - stressor

verfication 4 - Readjudicate the Claim after the above is done, if not granted

then provide an SSOC, etc and so on.

We dropped the PTSD issue as he does not have and has not been treated for

PTSD, has been examined many times, it's a depression issue related to his

SC conditions and the remaining issue on remand.

The VLJ saw the proof in the pudding sitting in front of him during the hearing.

That, with the 2 strong Nexus and medrecs to substantiate the condition

should be enough. Yes, 1 - something happened to him in service to cause an

injury/disease. Yes, 2 docs (1 from QTC) say that the in-service event was

the reason that caused his injury/disease.

The 3 elements required are there, it's just the waiting and they lost his file,

his file is so large, how could they? No one wanted to do anything on it,

VSO forgot about us, didn't return calls...so we went a different direction.

Seriously, if I knew then what I know now, I would have never given a VSO POA.

They got their dough almost 8 years ago, and in those 8 years, he has gone down

hill, 3 phases of chemo, a bunch of other stuff is cropping up, he had to quit work

and the $ we have spent on meds, geeeez. We had no idea he had the med

available at VA until earlier this year. So, went from 4/08 - 12/08 out of pocket,

with private med ins., but still, very expensive and could not drop it or change in

any way for fear of not getting onto another plan. Pre-existing condition thing.

I feel he has a strong claim, but until the pennies are in the pockets, we don't

feel comfy cozy. When this part is over, we'll have increases to go for on what

he is already SC for. It's sad to watch him deteriorate.

Enough about this....

Does anyone know how long a file can stay at the AMC for decision? What happened

to expediting claims? VLJ mentioned it should be expedited in the remand. Thought there

was some time frame, but perhaps appeals are on a different boat. Can't believe they

would have anything else to "develop" - they have it all. I made sure of that, sent via

Certified Mail/RRR.

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Thanks for the replies....

Does anyone know how long a file can stay at the AMC for decision? What happened

to expediting claims? VLJ mentioned it should be expedited in the remand. Thought there

was some time frame, but perhaps appeals are on a different boat. Can't believe they

would have anything else to "develop" - they have it all. I made sure of that, sent via

Certified Mail/RRR.

Vetslady,

I do not know of any reg that states any time frame regarding how long a file can stay

at the AMC, or other levels for a decision to be made.

Regarding "expediting claims", there are thousands of claims in front of our's that BVA

and the Court, have also requested that they be expedited.

In my opinion we are just placed into a different line to wait in.

jmho,

carlie

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