Rich T

It has been quite awhile since I posted last, I am really sorry that I have not been able to be here and help others with claims. My wife has been in-patient, either; acute care, skilled care, or LTAC since July 14, 2010. As I posted before her Medicare part A has been exhausted and it has been a hassle trying to get facilities to use ChampVA. As secondary payee we had no problems. However, after the exhaust date the facilities try to bill ChampVA directly. You cannot do that.. Medicare must be billed each time and get a denial, then that EOB should be sent to ChampVA. They pay very well if the proceedure is followed correctly. What does it mean to have Medicare part A exhausted? A person on Medicare may be in a facility 100 days before benefits exhaust. However, you get 150 life-time days, which can be used at anytime. The 100 days resets if you are not admitted during a 60 day period. My main problem came last year when Judy was being transferred from an acute care to a LTAC (long term acute care). Case managers were telling me they couldn't take her because they didn't have a 'contract' with the VA. I explained till I was blue in the face and even threw a case manager out of the room, saying that ChampVA IS NOT THE VA!! Well a facility in Tampa took my wife into their LATC as a good will gesture. They have since been paid by ChampVA.. She left there and we went to a nursing rehab in Lakeland (again because opthers closer to home wouldn't take the 'VA". I lived away from home for nearly nine months because of this silliness. In March this year she was again in an acute care for 47 days and ready to go to another LTAC. It looked like we were going to have to go back to Tampa (maybe 75 miles from home). I called and explained again to the local LTAC in Orlando about ChampVA, but they insisted they 'don't have a contract with the VA'. I got fed up with all the run around so I looked up 42 CFR 489.25 - Special requirements concerning CHAMPUS and CHAMPVA programs and called the local CEO. She told me that they operate by their own regulations. HA, I called the home office in Mechanicsburg, PA and asked for that CEO.He wasn't available. Right, so I said I want a call from somebody that he assigns before the day is out. Within the hour an exectuive of some title called me. I read him the 42 CFR 489.25 and suggested they run it by their legal people. At 5:05 PM I got a call and the person said, "You are right, if we have a bed, and meet your wife's need, we will take your wife as a patient." Bingo KNOWLEDGE IS POWER, thank you T-Bird for allowing me to be a Hadit member since 1996. I was invited by SkipDawg, It sure is nice to sleep at home. Wife is in ICU here and not doing very well, your prayers and concern are greatly appreciated.

The 'may be' would mean that the dependent can apply for the certificate of eligibity.

Aqua, I would search adaptive auto and read previous posts.

I get $150 for each auto, as long as the new phone purchase is made in the approximate time of the auto purchase.

I just bought my 5th SA vehicle in 10 years. This time they are allowing leather seats (due to my loss of bowel and bladder - skin problems) and power doors. An item that is often overlooked is the$150 cell phone allowance with each vehicle {See VHA Handbook 1173.4 (14 f - h)}.

I was granted $50,000 in 2003. I just found out that Public Law 109-233 authorized up to three usages of grant benefits. Public Law 110- 289 raised the amount to $63,780. I called my agent and he told me I can fill out form VA 25-4555 and request $13,780 additional grant be applied to my mortgage since I am fully equiped with all necessary adaptations. I will also be entitled to make another request after a period of time and future increases are granted.

Just Google "Automobile Adaptive Equipment (AAE) Program"

Sorry, I see the file is too big.

FYI, I just bought a new vehicle and wanted to see what may have been added for Special Adaptive Equipment. This newest 02/02/2011 download was very helpful.

I'm sorry Berta, I know that you can have A&A and receive an 'M' award. What I meant is that regular A&A is given an 'L' and of course more can be added to it to reach 'M'. In fact, here are at least 27 other combinations of pay codes that can include regular A&A. The main criteria is the veteran has to meet needs in CFR 3.351

First of all I am able to post some now. My wife has been an in-patient since July 13, 2010. It has been a whirlwind of a ride. She was intubated and had to be weaned off the ventilator. Later she went into kidney shock. I want to tell you we were making funeral plans 10 days ago. An alternative, if she could go home, seemed like the hospice nurses would need to be called and we just go home. However, we prayed earnestly and The Lord was good to us. Judy had a miraculous turn around and was moved to a Nursing Rehab center last night. My physical limitations make it very difficult to help her, but we are going to learn to use a hoyer lift and some techniques that she will help with diapers and bed matt changing. I am looking at the Toyota Sienna that has an ACC seat already installed, both for me and my wife. The question as stated in the topic has to do with a young lady from our church that we pay to help out at home. I learned that her mom uses ChampVA, so I asked Jenn (age 28) more about her Chapter 35 usage etc. She knew nothing about it. Her mom didn't allow her to know anything about the divorced dad, and he passed away 23 years ago. The mom told Jenn he was a secret spy (really) and nobody was ever allowed to know about him. She told Jenn to never question the VA about benefits, as she was afraid they would take away her income. On the other hand, Jenn's mom says she informed her about chapter 35 when she was 18, but of course at that age who listens? Jenn dropped out of high school at 16 and had a baby. She lived a very limited self centred life style until she gave her heart to the Lord Jesus two years ago. Now she is on track with a good life-style. She studies every minute she can with self study courses at the library, or at our house. She is enrolled at the local community college this May. She applied forHer mom wouldn't tell her the dad's social,or his service number. We (her and I) called ChampVA and with being the beneficiary, asked if she ever had claims as a child, we used her social. They told her that she did, so we asked what the sponsors number. They told us. We used that to call the VARO and see if she may qualify for chapter 35. Of course they told her she was too old. I had her apply anyway stating she never knew about the benefit. Naturally, she was denied. In the denial the RO said she would have to 'PROVE' she never knew about chapter 35. My quest here is to find a VA 'magic' word that Jenn can use to prove her case. By 'magic' word, I mean words we know to use, like; 'More likely than not, etc. Any ideas would be helpful. The appeal has to be right the first time, so we are trying to gather as much info as possible. The shame is Jenn has older brothers and sisters that too know nothing. --Ah, my dear sir, bingo. Jenn is NOT alone. If they were not told (statements from others) then more than likely she was not told. Thank you all for your input.

SMC L is regular A&A, The next level of A&A is Special A&A paid at R1. In order to get R1 a veteran has to be rated for 2 seperate and distinct 100% ratings that require A&A under CFR 3.351. A&A at smc M is a misnomer.

If you have any qualifying disabilities that can be rated under CFR 3.350(K) then you may receive up to 3 'K' awards as long as you have 0% compensation up to 'N' smc. 'K' awards may not be added to R1 or R2. To have any other smc (L to O)you need at least a 100% statuatory rating.

SAH, SHA & TRA have to be approved by the rating board. What you want right now is the HISA grant administered by the VAMC.

Meds by mail through ChampVA allows you to avoid the cost share if you don't mind the generic drugs.