Chuck75

Another example of the VA telling veterans one thing, and doing something different! Why? I suppose it's designed to keep down the chance of a veteran influencing things up front. I don't know how many times the VA PCPs in the past were told (under the table, as well as in obsolete directives) to not generate or fill out documents that could be used as a medical opinion in a veterans claim.

Which ever is LESS usually applies! The part that always gets to me was that the distance to the VAMC and appointment scheduling always forces me into one or two meals out. The VAMC cafeteria is not a restaurant I'd ever freely choose!

Outsourcing care will not be wholly effective unless and until the VA seriously streamlines the process, regardless of what they call it. Fee paid was sort of working, with delay, but it got hammered by the VA's "Choice" program schemes. In 2014, I started an effort to use VA fee paid. The reason was simply that the co-pay/out of pockets for an in hospital proceedure had more than doubled. That, coupled with the level of expertise in the procedure at a local area regional medical center were the primary drivers. The total time involved from the start of the process to the procedure was more than six months. (Without the VA being involved, the time from contacting the doctor and hospital was about a week.) (Or less, depending!)

That's what they were supposedly required to do, and chose to use the "program".

Old news, but useful in understanding the VA ways of doing things. Feb xx, 2012 Reference: VAMC Reply xxxx/xx Dear Representative xxxxxxx In my opinion, the VAMC Director's reply letter tries to justify the use of an inaccurate computer program, and fails to properly address past and current underpayments to veterans. Please note that a round trip doubles the amount shortchanged veterans. The DVA is obliged by law to pay travel reimbursements at a certain rate per mile, less a deductible. By law and regulation, mileage is from the veteran’s residence or point of travel origin, whichever is the lesser. The shortest reasonable driving distance is also a factor, since roads don't usually go directly from point a to point b.. The DVA’s on line posted information (copy previously furnished) show that accurate methods exist and that the DVA acknowledges them. Use of the program clearly failed the accuracy requirement. Obviously, the most advantageous reimbursement to a veteran is the most accurate. Particularly since the DVA’s present policy is to not offer currency, but rather to send a check or direct deposit. Expediency and the convenience of the DVA do not outweigh the need and legal requirement for accurate reimbursement, particularly when a deductible is subtracted from any reimbursement. The DVA has frequently prosecuted veterans for claiming and accepting reimbursements based upon inflated or incorrect mileage. Several cases a year are publicized in national news. Unfortunately, veterans do not have a similar option when the DVA intentionally uses a method that reduces reimbursement to a lesser amount than is provided by law and DVA stated policy/practice. The cost to the DVA of the administrative paperwork and process involved in using the only options a veteran has in asking for redress exceed by far the cost difference between paying a veteran an accurate reimbursement and the lesser amount provided by the DVA’s computer program. The program is believed to have been derived from a "standard" automotive insurance industry program used to help calculate insurance rates by using zip code to zip code related distances. Although a relatively minor amount of money is involved per veteran per trip, the issue clearly demonstrates that the DVA can state something in writing, and then deliberately do something else. This is even more serious than a monetary error, and clearly demonstrates that the DVA cannot be believed in what they say and do. The end result is that veteran’s mistrust of the DVA to do things as they should, and as they are required to do is fully understandable, and justified. When you apply such an error to the amount of funds involved in veteran reimbursements, using a conservative number per VAMC the amount is staggering. The number of VAMCs is about 152. Using about one half the error involved in the 43 vs 53 mile issue that I experienced, and assuming that the VAMC has an average number of veteran patients (I believe that it is one of the smaller VAMCs.). The total amount of money short changed veterans from all VAMCs that used the computer program easily exceeded tens of millions of dollars a year nationwide. How many years has this program been in use? How many claims are involved? What happened to the funds that were not paid to veterans? It’s also possible that a veteran might be overpaid. I’d be curious to see if the VA continues to use the computer program in these cases, or uses the actual travel mileage to avoid over-payment. A later change involved the VA using the shortest distance reported by any of the approved methods. Notes: At the time, the VA OIG was "Too Busy" with other tasking to deal with such a "minor issue". (Millions of dollars!) The VAMC Director's reply was less than useful. It basically said that they were eventually going to change to a "new" method that supposedly meets the requirements in law. The new method seems to more or less match the distance methods called out in law and regulation. Some changes to this document were made prior to posting to help prevent identifying the VAMC Director and the Representative. It's also of note that the Director was replaced (transferred), in part due to the scheduling scandals.

In general, the VA laws/regs were written in such a way that they sound good on the surface, and become less so when all the gory details are put in to play. Examples: 1. The VA is entitled to deduct $100 from the 20% fee a lawyer gets for successfully winning a claim. But, when the VA stretches things out, and forces a veteran to file multiple claims and appeals, the VA get to deduct multiple $100 fees. 2. When the VA takes years to finally award a claim, not only is no interest paid, the claim is paid according to the year by year statutory amounts. No adjustment is made for inflation. It's possible that a retro claim going back a decade or so, if inflation was taken into proper account, might involve far far more than the VA is obligated by law to pay. To get an idea of the differences, one method is to use the government's own tables used in procurement and contracting. 3. VA medical treatment is often based more on cost than quality or appropriateness for a specific veteran's conditions. This also can be found outside the VA when insurance companies are involved. A situation I ran into involved a VAMC that has a reputation for recommending false teeth instead of more costly alternatives. One of my daughters got into a major fracas with an insurance company over treatment while she was pregnant. The insurance company wanted her to use an approved less costly treatment that would have required an abortion. With the help of multiple doctors, she was able to obtain the optimum treatment for the condition, and not have an abortion. She and the now few months old baby boy are doing well. And it just goes on!

If it makes anyone feel better, in that they are not alone concerning the VA's evaluation of evidence. This afternoon, I was finally able to download the results of a recent in person BVA Appeal hearing. Although there is retro involved, it looks like the judge decided to evade or avoid issues that would significantly raise the total SC'd percentages that would involve awarding the next higher SMC level. Further, some of the conditions have existed for more than a decade, and are documented in my medical records and "C" file. It looks like some of the records were ignored in favor of later C&P results. Even worse, one condition falls under the "combat veteran" regs, with unchallenged positive information and records, yet the BVA judge remand orders the VARO to schedule a C&P. ????

SMC K would likely not be applicable. It's usually used when there is no other option. There is a scheduler code and rating level that is applicable. You will have to at least get the VA to generate a C&P request, or have enough detail from the treating physician and/or an IMO to make the C&P redundant.

It's generally worth the trouble to obtain a P&T rating, due to the additional federal and state benefits. Have you obtained SSDI? This can help if the SSDI basis is service connected. I'd likely try to get the heart problems SC'd, as you mentioned. If this takes a couple of years (Likely), it increases the chances that the VA will not attempt to reduce any of the existing awards. There is a difference in the VA's regs and mind set that is related to less than 55 or more than 55.

And you expected something different? Bureaucrats protect (who else) themselves. The regulations and laws have been slanted in their favor for years. If things go really wrong, they reorganize, and shuffle people around so that the "new" people can claim "no knowledge, not on my watch". (And then, without outside intervention, they go back to the same old behavior the same old way.) (Been there, watched it happen!)

Very Good! I hope that some real changes may result! For a very long time, VA employees thought of veterans as a troublesome necessary evil that they had to endure. Anything that re-enforces "You are here for the veterans benefit, they are not here for your convenience" in general, and specifically that the veterans must be treated with respect should be encouraged.

Actually, MSDOS is an emulator these days. It more or less died when the win 9x versions were retired. That caused all kinds of problems with various application programs that expected to have certain kinds of hardware access.

I suppose that the wording of the denial might have a real impact for or against the veteran. In any case, the past practice has been to file an NOD, in order to get the denial details. (SOC-SSOC) If they ignored positive evidence (nothing new) and or tried to say no evidence is negative, then there is a possibility of an appeal being successful. In any event, don't let any of the deadlines slip by. I've seen denials that were obviously wrong, and clearly not in compliance with the laws and regs.

The Navy 214 showed basic Vietnam Service awards, and shipboard assignments (Sea Pay) But at the time, the ships, although they were amphibious, were considered "Blue Water" by the VA. I was able to prove "Feet on ground". via, of all things, USAF records. Actually, my A.O. exposure was likely the result of being in the water at various places, including rivers and just offshore. More recently, when one of the crew members was denied, we got the Navy History operation that maintains ships records and writes the ship's history to come up with deck logs, and correct the history to show in country service. That was before the "Brown Water" list had more than a few ships on it. At a result of efforts by various veterans, the ships ended up on the list, one by name, and both by type. After that, I did obtain a DD 215 that showed combat related awards. Before I had that, I did send a copy of one of the awards in with a claim. The 215 to the VA made it and the others official. The 215 was generated by the records center at St. Louis. The process you mentioned was needed if the discharge character needed to be changed.

"Don't the veterans DD 214 Have there Vietnam service on it?" Yes, but the VA wanted "feet on ground". That was fairly easy for someone in the army assigned to a unit in Vietnam, but difficult for a sailor assigned to a ship that was home ported in say Japan. The VA does not consider the Vietnam service medal or some of the other related awards as proof of "feet on ground". But, combat related awards seem to be accepted. I went through this hassle before the "Brown Water" ships list was really developed. At one point one of the ships I rode carried boats that were considered "brown water", but the ship, an amphibious class, was not. ???? Now, all of the ships I was assigned to are on the list, even a reserve training vessel that I went to for annual training in the middle 70's.

I'll say that my past experience with the VA concerning secondary conditions resulted in separate claim filings after the VA failed to consider items of record, and the RO's issued very limited C&P requests. The DBQ's supposedly added stuff that was intended to cause such conditions to be explored. Unfortunately, that can easily take more time than the that allotted for the exam.

I agree that it should not have happened. What you choose to do about it is your business, and you can certainly make those involved very regretful. One of the needed tasks will be to identify and categorize actual harm that was done. You have to remember that decades ago, I and thousands of other veterans were required to go through such things as draft board physicals, group medical exams, and on and on. Privacy? what's that? Medical personnel frequently do discuss patients and conditions. The problem is that this was done in an inappropriate location and in an inappropriate manner by those who should know better. In this age of "equality", I have to wonder if some of the insistence on long standing female prerogatives is a bit overdone.

"Many Vets out there that are Faking or Lying about disabilities and it hurts us all." While I'm sure that there are some, I'd challenge the Many part. On the other hand, how many vets are being short changed by the VA? Certainly more than a few, and it might actually be "Many".

"This way once the claim finally does go to the board of vet appeals, the RO s will really look like asses for denying the claim. Before the claim is completed to be sent to appeals, the veteran should have an opportunity to review the file, and make sure all evidence is inclusive.." My experience was that the VA tries to evade actually having the veteran or his/her lawyer actually looking at the "real" claims file. A Nehmer ruling of several years ago that I read basically, in very restrained language, told the RO that the claims file had enough evidence to award a direct connection, and the RO should have done so. Then Nehmer awarded most of the conditions in question as presumptive. Things really got strange when you compared the Nehmer ruling and award with the VARO ruling and award that was driven by the Nehmer award.

The way I look at this is that the combined disabilities prevent you from working in any "normal" manner. So, you cannot leave the house for work if you can't work! I'd also suspect that sooner or later "teleworking" might come up, and the VA try to use it against awarding a claim for "S".

It is possible to "work" and still be considered 100% for PTSD But, there are some "sticky wickets" that have to be dealt with. Think sheltered work places, family owned business, and so forth. The VA would likely want to argue, and all the i's and t's need to be dotted and crossed.

Scars can be painful, and also limit movement. Scars from injury can be considered differently/separately than surgical scars. Depending on the original claim dates, it's also possible to get into old rule new rule determinations, and which is more favorable to the veteran. A significant difference is that the old rule assigned a minimum of 10%, and the new 0%.

I agree that the whole thing should not have happened. Having said that, you would be surprised at some of the conversations that occur inside an operating room, and even recorded!

Further, any additional claim can be used to initiate a review of the entire claims file. But there are enough restrictions on reductions to make the VA usually "back off" when a veteran fights about it. I've read a recent example of language that the VA (BVA) put in a remand, suggesting that the RO might look into a reduction, then reverse the suggestion in the same paragraph! ??? I suspect that another part of the ruling came into play, and the BVA writer belatedly had to take it into account. That part of the ruling changed the EDD, so any effort to reduce would come up against both an age and longevity limit, even before the veteran challenged it.

Under the new scheme of things, you may have to file an NOD to get any useful details out of them. (That's actually a reversion to decades ago practices.)