Chuck75

An interesting Question ! Dependent wife is covered under Medicare/Medicare advantage. When she retired, her state group health plan converted to this coverage. It's been more than a year since the award qualifying her for Champus occurred. There are annual changes to medicare and the medicare advantage plans, and with politics the way they are, who knows what might happen. If Medicare Advantage is dropped, Both her and myself loose any right to reinstate it. CHAMPUS is not honored by many of the doctors, etc. in the area, due to payment problems. If somehow the government changes the medicare & medicare advantage "rules" in the middle of the road, so to speak, is there any possibility (Short of winning a couple of long standing BVA appeals) to her applying for and getting CHAMPUS coverage at a later date? The "standard rule" was so long after the award that entitled her to the coverage. When we looked at the situation a short time after the award, CHAMPUS was not a reasonable option. Now, or in the future, it may be.

It's very clear that the VA's intent is to not spend money on veterans if it thinks it can get away with it. The wount do this or that clauses in the reg make this obvious.

From personal experience - - Blocked arteries or partially blocked ones may not cause noticeable symptoms, until they get rather "serious". Depending upon a whole plethora of things, an individual may lead a "normal" life, with seemingly no problems, or perhaps symptoms so minor that they don't trigger concern or investigation. I carried an airman's first class medical for decades, with only one "oddity" that was not disqualifying. This the same medical exam and FAA certificate that an airline pilot must pass and carry. For two or more decades, the only clue that something was not quite as it should be had to do with extended moderate effort and fatigue. Since I worked in a semi sedentary position, where only occasional short term physical labor was involved, that was considered to be more or less normal. A perhaps missed clue was that a cold drink of water tended to completely relieve the symptoms. One weekend evening, about eleven years ago, I had walked briskly all over the local WM superstore with my wife with no signs of any problems. I woke up early in the AM, with moderate Angina. Eventually, after trying several things to see of that would make the pain go away, and not working, I ended up getting my wife to drive me to the local hospital. After the usual undesired delays, the emergency room staff finally decided that indeed, I was likely having the precursors of a heart attack. Well after treatment was started, the angina changed to the classic "bar of pain" across my chest. A plethora of drugs were administered, including morphine and one that caused my blood vessels to burn slightly. Finally, a clot buster referred to as TCB was given. That provided relief. When I woke up the next day, while still in intensive care, I was told that I indeed had a heart attack, and a blood clot was the culprit. Estimates of damage were in the 50% range. The local staff cardiologist was Gung Ho to do a cath the next day. Since the hospital was just beginning to get into this sort of thing, I had to decline. My cardiologist of long standing happened to be on staff of the regional heart center, less than half an hour away, and I had previous caths at the center. So, that where I ended up getting another cath and a stint. (There were/are reasons why you don't want to do a cath soon after such emergency treatment, unless there is no choice.) (Why do such things seem to always happen at the most inconvenient times, and when skeleton crews man emergency services?)

You did not post the image, you posted the ebenefits address of the image. Only you should be able to access it. As to part of your questions, it sounds like the VA is considering TDIU. (They are suppost to but often neg,ected to do so in the past.) Your DD214 should show wartime service, and possibly war zone service. I really hate the VA practice of sending out "paste up" form letters. They often don't begin to match the actual case. Some letters I and others have gotten would make one think that the VA has lost any previous evidence, did not bother to actually look at it, and so forth.

There is, in that you can say in writing that you want the claim adjudicated, based upon the evidence you previously submitted and is of record.

E-Benefits is not known to be timely or accurate! You might consider sending an IRIS or calling "Peggy".

The last time I looked, there was a deductible that might apply. That might eliminate payment for short distances.

"quote name='Berta' I certainly defer to these excellent comments but I don't understand why the VA puts so much weight on the EKGs,METS and ECHO tests for these heart disease claims,if those findings are not really accurate and no cath was done. I don't understand why the VA puts so much weight on the EKGs,METS and ECHO tests for these heart disease claims." They cost less, may favor the VA attitude of minimizing claims, and can be more easily done by VA facilities that do not have serious heart related capability. (My local VAMC is a case in point. The "Cardiologist" does not seem to be board certified, and the backup regional heart center is half the distance from me, in the opposite direction. I also doubt that the local VAMC is qualified to administer certain drugs (if they even have them) that can, in emergency, dissolve blockages. TCB is one of the drugs.

"VA HAS DENIED ALL MY smc CLAIMS AND THEY TOLD ME THEY ARE NOT ACCEPTING ANY MORE DR BASH IMO BUT THATS JUST MY LOCAL VARO" If you can somehow get that in writing it may be to your benefit, and may constitute CUE. You or your lawyer can, in writing, wave part of the process, and force the VARO to forward the appeal to the BVA. (Assuming that the claim is ready for the BVA, naturally) As far as I know, Dr. Bash's IMOs meet the requirements of the BVA. The VARO does not have the option (legally) to refuse to accept them as part of your record. They may attempt to discount the IMO by claiming that its supposition, conjuncture, etc. Dr. Bash is more qualified to opinion on certain types of cases than the usual VA C&P examiner. That's likely why the VARO is giving you flack. It sounds like you are not comfortable with the current lawyer. You do have the option of getting a different one. Your files etc. should be returned to you, or sent to the replacement lawyer. As to who pays - - you do, out of any retro. There also is another provision in the law that allows a lawyer to be paid (EJA or EAJA) How payment is made when more than one lawyer is involved is usually a matter for the court or an agreement between the lawyers. Settling "outside the court" with the VA without a lawyer's advice is usually not to your advantage. I believe the VA usually ends up paying part of the settlement to the lawyer of record. For instance, the lawyer handling my appeal(s) recently changed firms. The previous firm will get "a cut of the action" when existing appealed claims are approved, and retro is paid. It really irks me that a veteran ends up paying (indirectly), rather than the VA, who's mistakes forced the veteran to hire a lawyer.

I'd guess that the "decision makers" wanted something else from the rater. What is anybody's guess.

The BVA "should" go back to the date of the original claim, based upon what you stated.

No, just standard practice.

It's really hard to tell. Once they award 100%, any sense of urgency seems to be lost. I've heard remarks that were basically Well, you were awarded 100%, what else do you want? (Ignoring the possibility that SMC, A&A, etc. might also be appropriate. The famous one is the VA's reluctance to award or even consider TDIU, unless a veteran specifically claims it.

I don't know about one page. Things like indexes, "executive summary", "foot notes", and time line flow charts come to mind. When you state that this caused that, you will need medical opinions that validate the cause and effect for the individual case. In an ideal situation, you setup things so that the RO cannot take the position that the evidence is "general", and may not/does not directly pertain to this specific case. Even with this accomplished, the RO may, (seemingly randomly) decide to deny or approve. My experience with the Nehmer review was that they actually read, listed, and weighed the evidence, unlike the original denying Atlanta RO and DRO,who ignored, downplayed, and tried to discount positive evidence.

Strange that E Benefits thing! Anyway, the development letters sent to me were not much more than acknowledgement of the claim(s), and a generic "we need all the evidence", even when they already had it. There was no way to know if they really wanted/needed a specific piece of evidence from the letter. There also may be a clause that says you may elect to tell them to adjucate the claim with the evidence on hand.

There does not seem to be a universally "Safe" drug, period. Drugs that are used in the mental health area are such that what works for one may cause serious problems for another. Then when you add CHF and IHD to the mix, and the drug interactions that can easily occur, the problem is compounded. All you can really do is rely on a doctor you can trust, results, and perhaps do a little research on drug induced symptoms. It can be necessary to do more frequent tests and exams (perhaps even over an extended period) just to see what an individual is experiencing with the multi-drug "cocktail" that can result from treatment of the conditions you mentioned.

100% PTSD P&T - - - May get you involved with the feduciary program, if you say to the VA such things as the wife manages the checkbook.

I'd recommend that you find out if the medical providers your wife uses accept CHAMPVA before you make a decision. Payment from CHAMPVA has been a problem, and not a few refuse it in my area.

If the VA knows that you are going to have surgery, you can just about bet that they will delay any decision they can until the surgery is completed. If it's done by the VA, at least the records will be available. You should be eligible for temporary compensation during the hospital stay and recovery period.

"Medically Unfit for Service" Although the VA Schedules don't work this way, in principal, that should result (if other details allow) in something other than 0%. Basically, the Navy says that you are 100% disabled for their purposes. The VA's compensation system is based upon a dual standard. First the impact of the condition on your ability to do your military tasks and meet the military's requirements. Next, the VA schedule of conditions and percentages. When something like this occurs, supposedly, the VA "should" treat it as an "extra Schedular" problem. They did, in part, sort of do this, by rating secondary or related conditions. However, they did not properly deal with the SC condition that resulted in the medical discharge. To my way of thinking the Navy also dropped the ball. In this sort of case, you may have two seperate processes to deal with - - the VA, and the Navy. If you are medically unfit as a result of a service connected condition or disability, supposedly the military should be paying some sort of pension. All to often, the military avoids doing this any way possible, and dumps the discharged service member on the VA. Interestingly enough, I ended up with a perforated eardrum as a result of poor environmental conditions (cold, damp, no heat, etc.) during a great lakes training cruise on the USS Portage, PCE 904 in the 1960's. The eardrum healed, with a small scar. None of my military medical records from that time frame even show that it existed, and only show treatment with antibiotics for an "infection". I later served in Vietnam, and for decades after, was able to pass the same FAA flight medical exams as an airline pilot must take. One trainee in the group had both eardrums perforated, with puss dripping from both ears at morning quarters just before the end of the training. He was medically discharged the same day.

Besides the VA problems, the SSA/SSN related problem may turn out to be that someone else has been using the same SSA account and or SSN. Or, there is another person that has a name match in the SSA system. This can be a real can of worms, screwup such things as credit ratings, result in the police knocking not so gently on your door, and so forth!

Looking at the SSA site - - You may be able to apply for early SSA retirement on your wife's account if you are 62. SSDI seems to not apply, unless you meet the quarter requirement for your age. I'd look at the actual laws and regs if I were you. Sometimes generalities don't exactly agree with specific circumstances.

Good luck and congratulations to you for surviving the events! Some didn't! Hopefully, the stent will solve most of your problems. Consider taking Nitro tablets initially (one) when you have symptoms that may progress into angina, or perhaps an unexplained feeling of fatigue, along with quite a few others. "Heavy-ness in the legs" is another one. Taking a drink of cold water may also stop (well, cold) some of the early symptoms. I would imagine that the cath to do the stint implantation also included imaging that should show any other potential problems.

A confirming outside diagnosis by a qualified doctor is what I'd do. Glaucoma and loss of vision is nothing to fool with.