john999 Elder
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john999 last won the day on January 10

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About john999

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  • Birthday 01/09/1950

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  • Location
    Tampa FL
  • Interests
    VA law and history of the Blues

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  • Service Connected Disability
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    history, computers, reading

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  1. Don't let anyone operate on your neck! Pain doctors will want to do injections which usually don't work but line their pockets.
  2. I agree with ArNG11 and I agree Allan, Buck and Mike. All see how screwed up the VA claims system is and that perseverance is key. I don't trust any VSO to do more than just send in the evidence and forms you give them. When I have a claim at the RO I usually call about once a month to chat with the VA rep on the line. What I am looking for is something that is lacking. When I requested my father's VA SMR's I did not follow the request closely. The VA turned my simple request for records into a claim for benefits and sat on it for a year while I forgot about it. This is the wrong approach. You have to inquire regardless. When you deal with the VA you know you will be screwed. It is just a matter of when and what you do to remedy the situation if there is a remedy. Not all claims are fixable.
  3. Mike I think the VA fundamentally stinks. Even at the level of the Veterans Court of Appeals errors are made and caught in the process which may involve a remand back to the BVA and then back to the Court. I spent almost 8 years on a CUE and I had a lawyer and both BVA and Court made errors such as using the wrong law to rate my claim etc. This added years to the process. Congressmen are useless and lawyers are not always that much better because I had some of the best and I lost on a technical letter of a wrong headed regulation meant to screw a million vets. This is one reason that when a vet gets TDIU or 100% they never usually give it up to try and better themselves because it took so long to get it.
  4. I think sometimes VSO's will take it upon themselves to send in a Form 9. I don't like it because if you got a new IMO and then submitted it and asked for a personal hearing the VA has to give it to you. I have done this before after a DRO denial. Once that claim goes to the BVA you won't see it again for 3-5 years. There is no automatic appeal to the BVA that I know about since I went a few years ago. There are no automatic appeals because the VA always hopes you will just drop it. There is no automatic NOD, DRO, BVA or Court appeal. Many thousands of vets lose millions of bucks at large due to not filing the most basic NOD. Now you have to use a form which makes it even more difficult for illiterate vets to help themselves. When I was working with recruits back in the 70's at least one in three was functionally illiterate and could barely sign their names. Maybe appeals should be automatic but I am sure they are not. You could die waiting for a BVA Hearing.
  5. My question would be that if you have cancer do you want to have to wait for your "gatekeeper" to refer you to a specialist who is part of your HMO plan? If I were hard up against it I would take a Medicare Advantage plan with a PPO. If the plan is a large one then most of the doctors will be in it. I just want to be sure in the case of some more rare or quasi-experimental disease or treatment that I have the best shot possible to get the care I need. The one thing I would not do is try to save a buck at the risk of my health. Medicare is one of the few good things our government dreamed up for the masses. Unless you are a lawyer you cannot understand the fine print in Medicare Advantage plans or any insurance plan for that matter. Medicare is the most straight forward plan of all in my opinion. It all does depend on what you can actually afford. I probably spend too much on insurance. I bought a disability insurance plan for individuals about 30 years ago. It was cheap and it just paid a supplement to SSDI and my OPM disability, but I have been drawing it since 2002 every month. The first year it paid for itself concerning all my premiums.
  6. I have TDIU P&T plus "S" and I don't believe I would fight with the VA for the 100% rating because unless you are 100% for a single disability you are not really scheduler. If you already have "S" there is not much point unless the disability is a life threatening one. Of course, since you are not dead yet your married status could change. Many things can change. The advantage of having TDIU P&T is that you have a bird in hand. However, I filed many claims after I was TDIU due to agent orange. This is how I got "S". You could just let the remanded claims be decided. I would not back off until all my claims were decided. What is the chance for an EED on any of your important claims? I tried for an EED that was thirty five years earlier. I failed but I learned a lot about the VA and so did my lawyer. It was an expensive school for him and an eye opener for me. The BVA and the VA Court are some corrupt institutions IMO. I think that describes the "Deep State" at its deepest. A circular system that is almost impossible to break out of to federal court. I know because I went there. This is besides the point which is that IMO you should pursue your claims since you filed them. John
  7. Until you see it in black and white I would not trust a word your DRO or VSO says. I thought I had won a CUE via the DRO until the DRO was overruled by his boss. You need the formal decision letter to be sure you are not being jacked around here. Do you have a letter from the VA saying you are approved for TDIU with effective date? If you won a CUE do you have the same letter source? In a DRO Hearing the DRO can say anything but until you get official notice I would not be sure. Sometimes CUE claims can upset the VA's apple cart. They would not approve my CUE because it would have allowed about ten million vets to get EED's on their claims. I know that RO claims don't set precedents, but someone would know that a vet got something.
  8. Bronco I would trade my VA care for ChampVA in about sixty seconds. I have used the Choice Program and they send me to these half ass doctors and clinics that are in the program. My dentist has tried to sign up with the VA and they just won't process the paperwork so he gave up and I won't use a VA dentist. They pulled the wrong tooth and would not pay for an implant to replace it. Some people love the VA. These are mostly vets who are broke or don't have any other insurance. If you are destitute VA care seems pretty good. My VAMC is really an old folks home in disguise. Most patients I see are old and in wheelchairs or about half dead. I see few young guys. Most of the Vietnam Era vets with the standard VA cane or knee braces etc. I mean these guys are not healthy. I am a 67 year old with 87 year old body and I look good compared to most I see. Good info about the PPO's for Medicare Advantage. Why are we treated like trash by the VA? This is a rhetorical question since we all know the answer which is that we are lower than whale shit to our beloved government. These people have improved my ability to hate.
  9. Buck I am lucky since when my wife had to have abdominal surgery I got her to a local private hospital just in time and we had good insurance via OPM. What happened was she had a spot in her gut that was getting ready to start leaking material into her body cavity thus causing a massive infection. She was not in the hospital that long but it was scary and every time I went to see her which was multiple times a day she would be thrashing around in pain. I would start hollering and get her a shot of morphine. I got her to the local hospital and they had her on the operating table within an hour. When I got the staff infection in my foot it was due to a podiatrist's malpractice. I hired a lawyer, but they dropped the case because no doctor would come out and say that the podiatrist was responsible for the staff infection. He was responsible, of course, but the doctors won't say it because that would put all those jerks on the hook. I found out that this same podiatrist had been reported and punished by the medical board in Florida. Yet the guy was still able to practice in Florida. He would not even admit that his procedure caused the infection or that I had an infection. In another week I would lost my foot or my life if the infection had of gotten into my blood stream. People think it is easy to sue doctors but it is not easy. They are well protected by the AMA and their friends in state legislatures. Money talks and doctors have money to donate to greedy politicians. There is the usual quid pro quo that goes unstated. You help me and I will help you. My wife only goes to the doctor when she has an emergency. I have told her time and again we will both be sorry that she does not take better care of herself but she is afraid of doctors except when she is in severe pain and I have to haul her ass to the ER. She has high blood and it is untreated because she won't go to a doctor and do what the doctor says. I have to keep the insurance on her because when she has a stroke it will break us without maximum insurance coverage.
  10. Buck What happened to you and your wife with the heart operation sounds like malpractice to me. They treated you as a charity case. The local vet treats dogs and cats better than that. I had a staff infection in my foot that required being dressed and undressed every day for 8 weeks. My wife could not have done it. I could not have done it. It hurt like hell. Your wife could have gotten a staff infection just like I did and she might have died. Keep that Medicare A&B when you get it and make sure she gets it when she turns 65. I cannot believe the VA would have sent her home after 3 days with no follow-up and no wound care! Since she has champVA it should coordinate with Medicare in a good way. Wound care is so important I would never take myself or my wife to the VA if I had other means. They are bastards. If you have no other means you have no choice. I worked at the VA back in the early 80's. I remember going to one of the hospital floors and hearing somebody screaming. I looked into the door where the screams were coming from and there was an old vet and a frustrated looking nurse tying to insert some kind of drain into the old guys chest. He as screaming his head off, but it was just another day at the funny farm for us medical supply clerks. It was the only job I could get.
  11. Yes, if you want to appeal a rating you should have your C-File so your IMO doctor can claim he read all ten thousand pages. You know the VA C&P exam doctors never read the C-File, but the VA insists your doctor should carefully review it and all your SMR's and VA medical records. Double standard, oh yeah! You need to beat them at their own game with their own rules. Who did your C&P exam? If it was the VA it is easier to get your copy. If it was a contract hitman it is harder to get them. They make you stand on your head. I think the VA actively tries to discourage you from getting a copy of your exam in a timely manner. You need that exam to file a decent NOD.
  12. TBI

    Bronco The vets you mention did not have TBI's to my knowledge. I agree it is a grey area. If you are 100% for PTSD and you are able to work full time and the VA finds out you are then I bet you would face a reduction. Since TBI is a physical as well as mental condition/disability I wonder how the VA would view a 100% TBI vet being able to work full time? The whole idea of treating mental and physical disabilities differently gets my goat. You can be a quadruple amputee and if you are able to find a job all is well, but if you are 100% for PTSD you may and probably will have a problem. If you have PTSD it is even hard to get a 70% rating if you are employed. When I went for C&P exams for mental health the first question the prostitute shrinks would ask me is " Are you working". When I said "yes" it was all downhill from there with my claim for increase being denied by the VA who used the exam result to deny. Before I went to work with a 100% TBI I would get assurance from many sources that it would not affect my rating. If not for IMO's I would still be sitting at 30% from the VA even though I eventually got SSDI for the same condition. They were hostile to me due to years of prior exams and complaints about the quality of the exams. John
  13. Buck Yes, getting to 65 has the advantage that you get Medicare before they throw dirt on you. For those between ages 50-64 who find themselves disabled or unemployable they suck on a very tuff old hooter and it is the hind one as well. Imagine be 50 years old and not having any medical insurance! Most of us could not afford to get ill in that case. I get most of my meds from the VA. If I have serious medical problems I go to private doctors. I am SC for CAD due to Agent Orange. The VA has never sent me to a cardiologist. My VA PCP is my cardiologist. She is not qualified. Therefore I have a private cardiologist. I have private pulmonologist because the VA never would have DX'ed me with OSA even though I complained about poor sleep for years. The VA never follows up on any of my chronic conditions unless I demand it. Then they attempt to bill my insurance as they did when they encouraged me to get the aortal aneurism exam. I realize now that this was just a way for the VA to capture some insurance money since I had no indications of having an aneurism. I thought it would be a good idea to get the exam but did not know they would bill my insurance for it. I wonder if they would have tried to bill me if I did not have the insurance. They did try and bill me for treatment of drug abuse even though I was not getting treatment for drug abuse. So I trust the VA not at all. Get all the insurance you can afford but see if it coordinates with Medicare. I wonder if the 7% increase in VA budget will show up in the form of better medical care for us or will disappear down the rat hole into bonuses for VA incompetent employees?
  14. I think all Medicare Advantage policies are HMO type policies. To me Medicare advantage is for people who can't afford Medicare and some sort of medigap and drug policy. If you are P&T and your spouse has ChampVA she/he must have Medicare A&B after when they turn 65. I kept my employee insurance from the Feds since I worked for the USPS when I retired. Even though my wife has ChampVA I keep her on my family policy from the Post Office. I do this because I just don't trust the VA or our government to not cut insurance benefits in the future. I probably overpay for medical insurance because just in the last 5 years I had a surgery that cost $100,000 Plus and my wife went to the ER and ran up a $30,000 bill in just three hours. Our insurance to include Medicare A&B and ChampVA and NALC Insurance paid our bills entirely. Can anyone here afford to fork out $130,000 for medical care? I went to my dermatologist and had a few spots frozen on my arm and leg. The doctor wrote this up as surgery. They do this to get paid. My brother's employee insurance denied him coverage for his dermatologist doing the same thing. He has an HMO but not Medicare. He still works and his employee insurance sucks IMO. I have advised him to check out his future costs for this insurance when he retires to see how it coordinates with Medicare. ChampVa coordinates perfectly with Medicare. The VA does not coordinate with Medicare and they attempt to steal from my private insurance by billing them for service connected treatments. I guess what I am saying is get all the medical insurance you can afford. If you have to cut back on anything don't let it be your medical insurance. I and my wife have long term care insurance. It costs me plenty, but if I or my wife end up in assisted living or a nursing home I want to choose my own or have my wife choose. The VA is responsible for my long term care, but they have the option of sending me to their version of a "euthanasia home" or a decent nursing home. I don't want those MF'ers to let me rot in some understaffed and cheaper home. This they will do since they only thing they care about is money. When I was an employee I had a private disability policy and I had the group plan as well. I am getting payments from the private disability policy16 years after I applied for total disability from SSDI, OPM and the VA. The group plan stopped paying as soon as I got OPM and SSDI. It was a ripoff. So I guess what I am saying is that if you do not completely CYA you may regret it in the worst way. Your dependents may suffer because I foresee that future health care systems are going to face cuts from our masters in congress no matter who is in charge. Our masters give the orders and we take them.
  15. The VARO does not have to do anything in a timely manner. This is why I say to try and get your claims decided in your favor at the VARO level. Once they get to the BVA it could take years. The last time I went to the BVA I had a lawyer. It only took about one year to get there but it took six months to get a denial of my appeal and the years to go to the Court of Vet Appeals and back to the BVA and back to the Court and then to Federal Court. I lost even with my lawyer and what I thought was a slam/dunk. This is why it is best to try and win at the VARO. Just throw everything you can at them locally and don't hold anything back. You have much more access at the VARO than at the BVA and none at the Court. To wait 4 years for a BVA hearing and then to be denied will easily set you back 6-8 years before all is said and done to you. I have used the DRO most often and even more than once with the same claim. Just try and keep it local and wear them down with evidence and good representation. If you had Berta in your back pocket or Asknod or some other expert it would be nice but lawyers can be good. John