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Chuck75

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Everything posted by Chuck75

  1. Never do today what you can do tomorrow (or next week, or - - - ) Seems to be part of the VA's standard practices!
  2. It can turn out that the VA is obligated to consider some things as an informal claim. Hospitalization can trigger such an event, along with other things. When they do it, you always suspect that something may be going on that you need to know about. When you try to trigger a look at an informal claim that may exist, the VA usually fights about it.
  3. I would be curious to find out what happens in a malpractice case when a VA contracted provider (say Choice program) is involved. Going back to my work with government (DOD) and contractors, some of the contracts had clauses that at least partially protected the contractor.
  4. Going just from the reg cited, you are correct! The VA often seems to fail to read the more veteran favorable portions of the schedule. As I previously mentioned, the C&P Examiner's report will have a great deal to do with what happens. If you feel that you meet the 60%, go for it, and mention it to the examiner.
  5. Just because the % decreases as the result of treatment does not remove the SC classification, unless the condition was "temporary", and totally eliminated by treatment. The C&P exam will be a governing factor. Eliminating the symptoms does not always eliminate the cause. Even so, successful treatment may result in a no compensation rating.
  6. According to the VA, we are all a bunch of shady veterans, trying to take the government for whatever we can! <G>
  7. I'd say that DY with some guidance is likely the best when it's other than a very simple cut and dried claim..
  8. The VA can use what they term an analogous rating or code. What that might be is beyond me. But, they should use the one that is most favorable, something that they haven't always done. The bit about computer programming hit a sensitive spot! I also wrote, modified and debugged programs until I had a heart attack induced by a treadmill test, and then a CABG. At the time, separate from work, I was developing a program that was specifically for reading and writing Midi data dumps to/from Yamaha keyboards to an Apple II+. I had the required relocatable machine code to do this more or less complete, and had just started thinking about the user interface code. I wanted the machine code to be such that FP Basic could "call" it, and so forth. In order to do this, memory normally used as graphics display memory had to be used to avoid conflicts. A side effect was that the data could be showed as changing color blocks on the graphics screen as it was moved around, Afterwords, I found that the ability to see beyond the code immediately in front of me and the tie together was almost lost.
  9. There are some general clauses in the law that in essences say that the VA must use the most favorable method to the veteran (within the law) to calculate the disability (for payment amount). With TDIU - It can easily be argued that since you cannot ever equal 100%, some minimum percentage is all that is required. Once this is reached, the rest of the disabilities should be calculated separately, and in what ever order is most beneficial, and still within the law. Lets say that the TDIU and 60% (SMC S) is reached. If the remaining disabilities warrant, SMC can be increased. (This is where the VA must be watched like a hawk to make sure things are done correctly!) I seem to remember that there was a court case about a similar situation. Such things can be quite important if higher levels of SMC are involved.
  10. "but id rather be better and productive. thank you" There is even a possibility that SMC "S" is actually a lower SMC level than you may be entitled to! Beyond that, there are productive income producing ways that are not classed as employment. As an example, investment management and derived income is just one of many possibilities. This is possible for some veterans if they have received a significant amount of retro. The last few years I was still working, and waiting for the VA to do their thing, on a daily basis, I had paper gains and occasionally losses that were well above my weekly after taxes salary Investment dividend income is non employment income.
  11. I have to agree completely! Cancer is nothing to fool with. When it gets into the lymph system, that's really not good news!
  12. There is a possibility that the notice was a result of some sort of OIG audit. That aside, there is cause for a formal waver request, along with your remarks that indicate the notice may be in error. But, it's worth remembering that the VA can claw money back easier that the veteran can extract money owed to them by the VA. I got into a hassle several years ago that involved the VA charging co-pay for things that they weren't supposed to, and even extracted some $200 or so from my my IRS estimated payments. It was time consuming to get them to actually do a real audit, and even more time consuming to find out all the details. At one point, they were trying to charge interest on money they had refunded that was incorrectly charged in the first place. Sheesh!
  13. The VA has always been a bit odd about SMC. Anyway one of the ways a veteran can be entitled to SMC "S" is statutory, and also impacted by a court ruling. Basically, this says that when a veteran cannot leave his home for the purpose of work, then SMC "S" is appropriate. Under this scheme, I'd suppose working for a substantial income would put SMC "S" in question. And this is before TDIU even enters into things! But, when you have 100% Scheduler P&T and SMC "S" and the SMC S is due to 100 plus 60, I don't see how the VA could change things, other than to try reducing an existing rating.
  14. I suppose it depends on the type of implant. Some can be sort of like an abbreviated denture, and can be made to remove. How that works is not something I'm familiar with. Others are attached to the jawbone. One of the methods used in the past was to have a post or posts that the implants were attached to. A few years ago, I started looking in to things, due to the unexpected loss of four teeth at about the same time. My local area VAMC dental department has traditionally been known to take the cheapest and easiest way out by recommending pulling all a veteran's teeth at one time, and approving dentures. That was not what I had in mind! I suppose I'm going to have to re-examine options when I end up having to have another tooth pulled. Hopefully not anytime soon.
  15. "However I'm rated 100% TDIU P&T" That's why! Service Connected is not a requirement for 100% P&T
  16. Besides the what brand, there are more things to consider. First and foremost, the number of them per year done by the surgeon, and the success rates. Next, what is the VA facilities reputation in regards to things like in hospital induced infections, etc. What is the "level" of the VA facility capability in relation to the local community hospitals. My local area has a VAMC about 50 miles away, with a limited surgical capability. On the other hand, There is a regional hospital about eighteen miles away that routinely does really major surgery, including such things as heart lung and other organ transplants. The last time I had to listen to a VA PCP tell me that he wanted to refer me to the 50 mile away VAMC, I had to try hard to not laugh in his face. But the reason was that the "Choice" program was in total disarray, (Still isn't much better!) and the VAMC had stopped using fee paid in order to transition to "Choice". After all, pulling money from a program that works to help fund a new program that has lots of administrative time funded for training, etc. is a bureaucratic wet dream!
  17. In short, a lower level believed the claim was ready. An upper level asked for either more evidence, a further evaluation of existing evidence, or just plain didn't want the claim to "sit" on his/her desk. Some also claim that there is an under the table practice of controlling the number of claims per month, and the outcomes. Think quotas. A complex claim may go through this back and forth process several times.
  18. What interests me is that although I've had multiple C&P's the VARO has never sent a single letter saying that I have a C&P scheduled on a certain dat and time at a specific location, with one exception. The notification has always been by phone, and with as little as a few days notice. The exception was for a C&P to be done by a an outside contracted examiner. That C&P actually got cancelled, due to VA regs that prohibited the C&P lab test called for. (too dangerous!)
  19. "Did it actually go back to review of evidence even though it says notification sent AND it now shows I have a rating on my profile?" "Also my estimated completion date changed from 3/29 to 6/06-10/20." The claim process has "steps' that involve different individuals. As each gets the package, they may ask for more information, make a pass it on the process decision, or even make an actual decision. There are multiple steps in the "review" portion, that seem to be more extensive when it looks like a claim will be granted. It's the old miller bit about wheat and chaff. As milling gets finer, the chaff increases, and it's harder to tell the difference. On top of that, bureaucratic entities will evade/avoid making a decision until they are required to do so, even when the decision may be quite obvious.
  20. No real clue - - But, the VA has/had the opinion that too many SA claims were being granted under the 'old" rules.
  21. One little detail that the VA tries to ignore, and it ain't so little! If an injury/condition occurred as a result of combat/enemy action, the law provides a relaxed evidentiary requirement. In essence, the VA supposedly has the onus to prove that the veteran does not have the condition, and/or it's not related to the combat service. This really comes into play at CAVC. and occasionally at the BVA. The RO's tend to totally ignore. For decades the VA fought Korean War Chosen Reservoir claims, (frostbite, etc) and ignored the provisions of the law. Thus, even though it's the law, the VA has managed to degrade it's intent and so forth. Never the less, it is another nail to be used when the opportunity arises. It might be used with some success to challenge a denial at the level of cue.
  22. Percentages aside, there may be a case for SMC S (housebound) Has to do with the combined impact of bi lateral conditions along with all the rest.
  23. The VA acts like a bunch of control freaks! Many of the current "Choice" program problems stem from the desire of the bureaucrats to keep their place in the "sun". Can't have those pesky veterans make their own decisions when we can make them instead!
  24. "but going over the 100% does set up a veteran for SMC's Obviously" That's exactly what the VA seems to try and avoid! Even with SMC S, it's possible that a veteran may be entitled to a higher SMC level, due to the combination of conditions, and not the exact percentages. It would be a tough road to go down, simply because traditionally, the VA has done everything possible to prevent success!
  25. Let's see - - a 100% schedular rating and other lesser ratings. You supposedly set the 100% aside, and calculate the remainder via the VA's scheme. SMC gets complicated, but a simpler one is 100 + 60 SMC S Homebound. What happens when there are alternative ways to calculate? The VA is required to use the method that most favors the veteran (By court decision). In the past, they have not always done so. Where things come unglued - - - 100% single condition 100% using VA math for some but not all remaining conditions, (usually rounded). In theory, the remaining conditions are to be added, not run through VA math.
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