Philip Rogers

The VA has so many days to respond to an FOIA request. Something like 21 or 30. Six weeks is to long and a year is way too long. jmo

Thank you, Rick! I hope you don't let them get you down. I have a feeling you and I are very similar in the going overboard dept. My intent is only to post info that is true, factul and verifiable and I never mind being corrected. I gave up on perfection long ago. Peace.

jstacy - Thanks for the clarification. It appears both rickb54 and I were either half right or half wrong, depending on how you look at things. Whichever, thank you again for clearing that up. I certainly hope rickb54 isn't leaving because of our minor dispute. I'm just glad there is evidence to confirm what's posted. jmo

We can agree to disagree and move on, I'm just asking you to verify with rules your statement "I simply posted the fact the va is not supposted to charge the insurance of veterans who are rated 50% or more." If you can't, don't want to or feel it's not important, just say so. Just please don't accuse me of "running for cover," I think your statement was. I'm merely trying to help. Don't shoot the messenger. Not to say I've never been wrong, at one time or another and will admit when I am. I'm a big believer in backing statements with regs, etc. jmo

You "should" be able to get your co-pays reimbursed, including the co-pays for office visits from your carrier.

And that is just what your statement is "an opinion." Just because you weren't billed means they don't. Maybe they didn't know about your insurance. A friend never got billed until his wife inadvertently gave the VA the insurance info and once they had the info the VA billed as far back as they could. Don't you have Tricare and is that the insurance you're talking about? Anyway, feel free to attack me as you do Terry for speaking of "just his experiences." jmo

rickb54, It couldn't be more clear. How about proving your theory? Can you back it with statutes, regulations, rules, etc. You can think or not think anything you want but can you back it? Congress didn't say "except for those 50% or over." Oh, by the way, they, the 50% and overs, do get them free but VA can and does bill their private insurance carrier. I'm not going to argue about something so trivial. Got better things to do with my time.

H.R.3118 Veterans' Health Care Eligibility Reform Act of 1996 (Engrossed Amendment as Agreed to by Senate) -------------------------------------------------------------------------------- `SEC. 207. AUTHORITY TO BILL HEALTH-PLAN CONTRACTS. `(a) RIGHT TO RECOVER- In the case of a primary beneficiary (as described in section 201(a)(2)() who has coverage under a health-plan contract, as defined in section 1729(i)(1)(A) of title 38, United States Code, and who is furnished care or services by a Department medical facility pursuant to this title, the United States shall have the right to recover or collect charges for such care or services from such health-plan contract to the extent that the beneficiary (or the provider of the care or services) would be eligible to receive payment for such care or services from such health-plan contract if the care or services had not been furnished by a department or agency of the United States. Any funds received from such health-plan contract shall be credited to funds that have been allotted to the facility that furnished the care or services. `(B) ENFORCEMENT- The right of the United States to recover under such a beneficiary's health-plan contract shall be enforceable in the same manner as that provided by subsections (a)(3), (, ©(1), (d), (f), (h), and (i) of section 1729 of title 38, United States Code.'.

Congress enacted a bill some years back that allows the VA to recover from the veterans private insurance for all medical services, even if service connected. Last I knew VA charged one rate which was for emergency services @ $239 per visit, which I would think would be illegal. Office visits are billed as emergency services. As of now they don't bill medicare.

You should be able to get an EED, back to 1994, if you have the evidence. If this is for PTSD, I think the criteria changed back around then and they would have to use whatever is most favorable to you. jmo

Alcohol consumption has nothing to do with benefits. Substance abuse often co-exists with PTSD and in many cases is secondary to the PTSD - called self-medicating. If a claimant plans on attending an in-patient PTSD program, part that program requires that the patient be clean & sober during the program. As for your statement I don't believe the VA ever did that. jmo

One need only be a veteran or spouse/significant other to be seen at a Vet Center. Vet Centers are independent of the VA, but their funding come from the VA's budget.

Thanks for the link. Guess I need to update.

It's none of my business but you might try getting him seen at a Vet Center. They can see him, treat him and give the diagnosis and there wouldn't be any cost, except for the travel to and fro. The VA also accepts diagnoses from certified counselors and psychologists. Vets Center counselors can assist in your claim and are usually willing to do so. jmo

Current editions can be found on-line. Previous editions can be found at your VARO "reading room." Each VARO has a reading room, where these documents are kept and are open to the public. "Back in the day," this was the only way to get this info. Now we have the internet. I'm sure the VA curses it everyday.

Anyone purchasing the VBM on-line at the Lexis-Nexis site might be able to use this promotional code "LNSTORE" for a 20% discount.

Getting back to the original subject, isn't there something wrong with the claim, in that had the claimant complained he'd had a "mental condition" that it would have triggered the required C&P being scheduled? By claiming he had PTSD it required a diagnosis of PTSD to win. jmo

I agree with the BVA. Claimant didn't have a diagnosis which is required, period.

If you have a relative working at the VA service center there is a good possibility your claim was transferred out of state for that reason. VA employees and relatives of employees are generally shipped out of state to prevent any impropriety. jmo

Frosty69 - don't you know, by now, that everything VA employees tell you is a lie! Request the print out and then file the claim. There's a saying: "If it can't be read it wasn't said!" The worse thing that happens is that they deny the claim but as you know, if you appeal you can win. VA rules state that employees can't be held responsible for what they say. He may be a nice guy but the 30 day thing is an outright"lie." jmho

I'd request a printout for the whole 10 yrs and then file a claim. And yes they deduct the $6 per round trip, up to 3 times a month. I understand VA employees now are getting around 43 cents a mile for VA travel.

They deduct $3 per, one way trip, the way the crow flys. So on a round trip it is $6, unless they've now added a fuel surcharge. They do this the first 3 visits in the month and after that the vet gets the full rate. That money goes into a slush fund that the RO director can use for whatever he wants.

Get a copy of all your appointments that you attended. Then request an audit or list of all payments made to you by travel section. Then file a claim for all dates you didn't receive payment for. They don't like you to do it but they will pay.

The suspense date is the next date the VA is scheduled to look at your claim.

All of that may be true but the VA bases your disabililty comp level on your ability to handle work and life, now and in the future. The fact that you overcame adverse conditions previously has no bearing today. It's called post traumatic stress disorder and can come back to haunt us many years after the stressor occurred. You'll need to show how you currently meet the specific ratings criteria you are seeking. You also don't need to meet all of the examples in that percentage criteria. The hardest part is establishing service-connection. jmho