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jamescripps2
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Posts posted by jamescripps2
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A joint motion for remand, JMR, is about the best that you can hope for at the CAVC. The remand is not so much the dreaded outcome, but the time that it takes to get a new decision is the morale killer. At least all claims coming back from the CAVC are given an expedited or advanced on the docket .status
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I really hated the first remand that I was handed by the BVA. You are right bronco , you go right back into the hamster wheel!
I look at remands in a different way nowdays. A remand is giving your case new life because it shure beats a denial and you get to survive to fight that rabbit another day.
I will say that I have not had to deal with multiple remands. That is a whole nother story and I really feel sorry for those guys involved in multiple remands..
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Considering that I have four 100% individual P&T awards that are all static in nature, and all are more than ten years old, along with a a box car full of lesser ratings, also considering that my final rating is the maximum rating of SMC "O" to include R-2 A&A, along with level 2 PCAFC caregivers benefits, why would I even consider filing for hypretention benefits under the Pact Act? There is no more compensation available or possible.
The reason: The PCAFC caregivers benefits qualifications are based soley upon service connected disabilities. I have been in Atrial Fibbulation. ( A- Fib ), for more than twenty five years. If I should ever suffer a stroke, It would be easy enough to service connect the stroke as secondary to the hypretention, even if the hypretention was service connected at only 0%.
Should my PCAFC caregiver level two benefit be challenged, I could use the service connected disibilities of hypretention and subsequent stroke as the basis to bolster the need of a caregiver to provide help with the activities of daily living, (ADLs).
It is prudent for a veteran to stay one step ahead of the game when dealing with the DVA and the claims process, especially when dealing with the VHA and the pitfalls involved with the PCAFC caregivers program.
Once I finally convinced myself, and decided that there was a good reason to file for the hypretention under the Toxic Exposures Pact Act. I filed on line through VA,gov. Start to finish filling out the 526 EZ application took all of twenty minutes. I expect that the next communication will be informing me of the upcoming C&P exam. I expect a 0% rating and at the most, 10%, but that should be just enough to do the trick!
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Hope you got your SMC K award for loss of use.
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SMC "O" is known as the maximum SMC rating. You shed your "K" ratings when you are awarded SMC "O". A&A ratings R-1 / R2 can be granted beyond SMC "O",
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Quote, I do like to hear other people's views and opinions.
Well brother, this is my opinion. From reading your post it sounds like you accused the VA employees, including your PCP of many things including substandard treatment. It appears that you tried to tell them how to run their clinic. Nobody is going to take that kind of behavior, neither civillian or VA.
You might try being a little more understanding, but I think that by now you hve already crapped in your nest and you will need to change your PCP and possibily change your facility. You are not going to make them do anything, not by reporting to your Senator or by going to Washington.
Broncovet is trying, in a nice way, to tell you to mend your ways and learn to be a little more tactful. I agree, and I honestly wish you the best of luck.
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You don't need a lawyer. The same qualifications that got you the R-1 rating show the need for a caregiver. It is a simple process to appeal to the BVA. Just file the va form 10182 and ask the BVA to revue your case. Don't forget to ask to be advanced on the docket for the reason that you are a R-1 rated vet. You will find that you are more knowledgable about the CPAFC program than a VSO, as they have never been trained on the caregiver's program.
Just fill out the 10182 on your own and fax it to the address on the form. A vso can fax it for you or your bank will fax it for you. Ask for a fax comformation receipt. You can handle this!
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Thanks Tbird!
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Not five minutes ago, we just completed a radio show on high blood pressure. It is archived and can be accessed for listening at your convinence. Google Exposed Vet podcast.
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You know bronco, neither one of us claim to fully understand all of it, and evidentally, neither does the VA. If the OP can read all that has been posted in this thread maybe he can figure out a direction. His question was"what can be done"?
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Thanks for the invite Broncovet!
I already know that there was no proper "Statement Of The Case" included in the written decision from the Vetrans Health Administration, (VHA) informing you of the reasons and basis of the decision and a viable reason that you did not qualify. The VHA, unlike the DVA, is not required to give you a Statement Of The Case.
I am a R-2 rated veteran and was denied level 2 PCAFC caregiver benefits through six appeals. You have options on your appeals process that were not available to me at the time. You can climb up the appeal steps, one at a time in any order that you choose, Or you can skip some, or all, and go straight to the top. Your choice. Your options are as follows.
#1 appeal the VHA decision through the VAMC Patient Advocate. You get two appeals that will be adjudicated before the same VHA people who just denied you and you can expect to be denied on both of those appeals.
#2 you can file a VA form 20-0996 for a Higher Level Revue (HLR) appeal. In submitting a HLR, you cannot submit additional evidence and once again, the decision is up to the VHA, the same people who have already tossed you under the bus.
#3 You can file a VA form 20-0995, Decision Revue Request, Supplimental Claim. You can submit additional evidence but once again, the same VHA people who have been denying you get to shoot you down again.
#4 file a VA form 10182 Decision Revue Request and ask the BVA to revue your claim. If you are in fact an R-1 rated veteran it will be a slam dunk at the Board. Filing the VA form 10182 will remove your case from the eyes of the VHA and place it in the more capable hands of the Veterans Benefits Administration (VBA). There you will find justice according to the regulations that govern the PCAFC caregiver program.
I would suggest that you avoid all of the VHA denials and go straight to the Board by filing a 10182. At the same time ask the Board to advance your case on the docket based upon the reason that you are an R-1 rated veteran.
When my dog was first in the fight i did not have the right to take a PCAFC case to the BVA. After my final VHA appeal, and thanks to the Beaudette V. Mc Donough CAVC court case, ( FYI)-VA Has Begun Mailing Court-Ordered Notice to Hundreds of Thousands of Veterans and Caregivers as a Result of Beaudette v. McDonough Class Action) I gained the right to appeal my case to the BVA. On June 22, 2021, I won the very first ever PCAFC caregivers case to ever be heard and granted for level 2 caregiver benefits at the BVA. (BVA docket No. A22011682.
I have written much more on the PCAFC caregiver subject on my web site.
vatheredneckway.wordpress.com
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10 hours ago, brokensoldier244th said:
OK, but he's not asking about ILP. ILP isn't going to give him stuff to start a Bonsai business.
16 hours ago, shrekthetank1 said:Can they help with a computer and such?
This is the question that I answered.
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Yes, you can go through VR&E, fill out the half page application, and you will be assigned a case worker. If it is determined that you are not a candidate to be re educated to go back to work, they will put you in their Independent Living Program. There you can request anything that you need to be able to live in your home and community more independently.
In the ILP I requested and was given a computer, a printer, software, Dragon Naturally Speeking Program, $3,000.00 theraputic box springs with matress, sheets pillows, pillow cases, matress covers, and a $2500.00 stand up recliner.
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Bronco, you might say that we are not in the land of NOD. LOL
Seriously, a legacy participant in the CPAFC caregiver program is a veteran who was admitted into the caregiver program on or before October 1, 2020. Anyone admitted after October 1, 2020 is not considered legacy.
The appeal process is much different for the legacy participant than it is for, say, the Vietnam era veteran. In either case, a NOD is not part of the caregiver appeal process. These cases are VHA cases until they make it to the BVA and then they are handed off to the VBA for adjudication, whereupon a BVA decision, they are returned back to the VBA, not the RO, for implmentation of the BVA decision.
I will say one more time, if a veteran was denied by the VBA for caregiver benefits, there was no statement of the case (SOC) issued, because the VBA was not required to furnish a SOC. If the veteran asked why he was denied, the answer seemed to be a secret. For that reason, all of the caregiver appeals are being remanded by the BVA, and the remand order is for the VBA to furnish a SOC so the Board can analize the decision in order to determine the VBA had made the correct decision.
My case remains the only case to not be remanded, but instead, to be granted by the Board, as of Jan 1, 2023. The reason that my case was granted at the Board was because it was cut and dried, was in compliance with all of the rules, met the qualifications, and therefore it needed no remand for a SOC.
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Bronco, you still don't get it! We, in this thread, are talking about the post 9/11 legacy participants in the PCAFC caregiver program. The discussion has nothing to do with the legacy and AMA appeals awaiting a BVA decision.
You can google VA's PCAFC caregiver program to see what we are talking about in answering the op's qustion.
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Go to my website and read what I have written about loss of use of feet. What I describe there could apply in your own case. If so, pm me or post on hadit and I will tell you how to procede with a loss of use claim. If you think you might have the problem that I describe then get an appointment with your VA Podiatrist and ask him/her if you do indeed have drop foot.
As far as filing use a VSO who works for the American Legion, VFW, DAV, VVA Your county or state rep, or you can do it online.
My website, vatheredneckway.wordpress.com
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At this time I am rated at R-2. Can you even imagine how many times one has to file for an increase or just outright appeal a decision to finally reach the maximum rating? The fear of being reduced never hendered me or kept me from filing. I not only was working for my own benefits but for benefits for my family as well.
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P&T is permanent and total. You can either file for the TDIU or you can file for an increase on the neuropathy, but without having the schedular 100% p&T or havinrrg TDIU P&T, unfortenatetly, the dependent insurance is just not going to happen.
If you refuse to file out of fear of a reduction you are just stuck at 90% and you can expect to never obtain a higher rating.
Example. I was granted 10% per limb for neuropathy, I filed for an increase and was awarded 30% per limb. I again filed for an increase and was granted 40% per limb. I appealed and was granted 100% for loss of use of lower limbs and another 100% forloss of use of upper limbs.
If your service officer would rather talk you out of filing for an increase than filing on the increase, replace that service officer, or file it yourself.
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No, there are no medical benefits for a 90% disabled veterans dependents. Only for 100% P&T or TDIU. If you are 90% and cannot work I would suggest that you apply for TDIU. If granted TDIU you would be paid at the 100% rate and CHAMPVA insurance would provide medical benefits for your dependents. Chapter 35 benefits would also provide education benefits.
Otherwize, revue your claims foulder to see if you might be able to file an additional claim or file for an increase on an already service connected condition.
TDIU = Totally disabled and Individually unemployable
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Broncovet, that is just the problem. The VHA does not give a soc in a caregiver denial. They are not required to do that like the DVA is.
Your simple NOD is in the trash can in about thirty seconds. You cannot reason with these people so when you cite what "logic suggest" they would laugh at you. The VBA does not follow their own regulations and cannot be held to regulations like the VBA can. Dealing with the VBA and the CPAFC caregivers program is a whole new ball game and you have to re educate yourself to deal with them or just walk away.
The VBA caregivers program refuses to use the information contained in a C&P exam report and they will only consider the information contained in the medical records for the last twelve month period.
Considering what I stated above, a 11/14/2012 medical record that contained the fact that the veteran could not use his hands or feet could not be used.
The fact that the veteran could not cut up food nor get a fork to his chin is moot as the program only considers the act of chewing and swollowing the food, unlike the qualification for A&A.
Remember, you are dealing with a program that had the objective in October, 2020 to kick 90% of the legacy participants off of the program and only accept 13% of the new applicants from earlier eras who had just now been able to apply for the program.
We could not get legal representation because the lawyers and agents were fenced out of the program.
As a result of Jeremy Beaudette taking the matter to the CAVC and gaining the right for all caregivers cases to be heard at the BVA, I took my case to the Board and on June 22, 2022, I managed to win the very first case ever to be heard and granted by the BVA for level 2 caregiver benefits.
The Beaudette case, https://law.justia.com/cases/federal/appellate-courts/cavc/20-4961/20-4961-2021-04-19.html
You can see my BVA win at the BVA decisions search site, https://www.bva.va.gov/site_search.asp Type PCAFC caregiver in the search box. My case number is A22011682.
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I would suggest that you appeal the PCAFC caregivers denial directly to the BVA. Ask that your case be advanced on the docket for the reason that you are a R-1 veteran.
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38 CFR 3.352 contains all tou need to know about the qualifications for R-2, To fully understand, you will need to read it a few times.
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Also, if you do indeed have service connected loss of use of both hands and both feet you might benefit by reading the entire threads posted here at hadit on SMC "M" and "R"1 and "R-2".
With your loss of use it sounds like you should be in the neighborhood of R-1 or R-2, instead of lingering around at TDIU.
I am rated loss of use of upper extremities at 100% P&T. A&A 1 was granted for LOU of upper extremities.
Also Loss of use of lower extremities. A&A 2 was granted for LOU of lower extremities.
The two A&A awards L-1 and L-2 warrant the SMC "O",
Granting of he "O" award automatically advances the A&A to either R-1 or R-2, depending on your individual circumstances. You may have the makings of a CUE claim for an Earlier SMC effective date.
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Read my post on the PCAFC caregivers benefits here at hadit. Also read more about what I have to say about the CPAFC caregiver program at my website.
vatheredneckway.wordpress.com
Thai Vet 60% S.C.
in Success Stories
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Roadrunner, You stated that you don't intend to stop fighting for 100%. You didn't elaborate on your loss of use grant. Depending on the circumstances, there could be a vehicle grant and a specilaay adaptive housing grant, (SAH) within your grasp. If not now, it looks like you are headed in that direction with your loss of use. You might want to look up the regulations that govern those ancillary benefits to see where you stand now, and where you need to be.