john999

Do you mean Medicare Advantage? The Medicare Advantage has either a PPO or is an HMO that is why it is cheaper. They watch costs better than Medicare. Medicare administrative costs are nil. Nobody at Medicare is really watching the cash register very well. Original Medicare denied some of the charges I had for my cutting edge OSA surgery just because they have never seen those kind of charges before and assume they are "not medically necessary". I kept my insurance from my job to cover my wife and I after i retired. It costs me $445 a month which is really a good deal, but still blows a hole in my crummy federal pension. I will keep this insurance until my wife gets medicare and then with ChampVA we won't need it. Will Obama Care not afford you anything in your situation. I think it is pretty awful a 100% vet has to have full coverage due to poor quality of VA care. Disgrace and shame on the VA. VA has denied me treatment at least twice and I had to use private doctors. John

If pain is part of our claim I would be going to the VA pain clinic. I would have the VA prescribe my pain meds for me. I get pain meds from the VA every month. This involves them having me fill out a questionnaire rating my pain from 1-10. I rate my pain at between 7 and 8 every month without the pain meds. With the pain meds it is a 3, so they are doing me a world of good. I am documenting my benefit from pain meds because I say that they improve every function of my life.

I would appeal any rating less than 60% if I was you. I was rated 0% after a C&P by some Nurse who did my exam. She did not even ask for testing of any sort beyond what I had in my record. I appealed and got 60% as secondary to DMII. This was before you could get it on its own due to AO. If you don't like your rating appeal. I just do it as routine because the VA are lying rats. You don't even need new evidence to appeal. Often you can just get lucky. However, having some new evidence to support a higher rating helps. If you had a heart attack you should get more than 10%. A heart attack is not mild heart disease. My father had one heart attack and it killed him. John

I don't know if it was in there, or not but I would like a site that explains what to do when the VA refuses a treatment option for a vet such as refusing to do cataract surgery, or dental implants with just an opinion that "You don't qualify for that treatment". I have believed that if you have a medical problem the VA needs to provide treatment, or refer you to someone who can and not just tell you that "We don't do that here", or " We don't have a neurosurgeon on staff" etc., etc. It always seems the VA is years behind the FDA on any number of treatments. The VA claims to be on the cutting edge of treatment for vets and provides the best treatment in the world. In fact, the VA seems to be the last choice for anyone who has decent insurance or cash. I just had a surgery to do a "hypoglossal nerve pacemaker implant" for sleep apnea. The VA never heard of it, and not many non-professionals outside the sleep apnea world do either, but it is a revoluntionary way to treat OSA. FDA approved, but hard to get even Medicare to pay for it all. I am tired of VA telling me what they can't do. I don't believe it. I think it is just about the money they don't want to spend. John

TBI means to me that your brain was damaged to some extent from an external blow to your head of some sort. If you had water on the brain then how did that happen? If you could show that some force caused the water on the brain then I think that it would be a TBI. Did you ever have heat stroke? If you had some disease that caused your brain to swell I don't think that is TBI. What is the exact definition of TBI? If you slipped and fell or were punched in the face that could result in a TBI. My wife slipped and fell and the doctors checked her for a TBI even though she just cut her lip and chin. TBI is such a knew field of medical inquiry. After WWII thousands of military were released with TBI, but they had no concept of what it was and thought that as long as you did not show gross symptoms you were fine. After Vietnam it was the same deal. Only after OIF/OEF did the military begin to really pay attention to TBI where there was not concussion from bomb blasts. The experssion shell shock is slang for TBI before it was understood a little bit. I don't think VA understands it fully now. John

Currently, time is an obsticle. You must file within 15 years or BCMR does not even have to consider your appeal. I tried getting my honorable changed to medical. No dice. Too late, so sorry, Charlie. About all it would mean is Tricare if after getting a lawyer and spending 10 grand I won it. Long shot indeed for me. John

Can he afford to get tested outside the VA and have doctor write report for him? Trusting the VA to do the right thing is a long shot. I have problem with my neck as well, but surgery is the last resort when you can't raise your arm or you are numb to the bone. I sure as heck would not let the VA operate on my neck. Does he have Medicare? If someone is going to cut into my neck it is going to be the best doctor in town and not some hack at the VA. His life is at stake in any operation. A little to much gas and you are at the VA's boot hill.

When you go for mental health C&P exam the "doctor" can do all sorts of things to either help you or hurt you just based on the few minutes you spend with him/her. It seems the exams for PTSD do follow a script whereas if you were to claim any other mental health disorder they just wing it. Beware the exam doctor who asks leading questions about your childhood, drug use, alcohol use, police record, school discipline record and family discord. These are the things used to say you have pre-existing personality disorder, or that your current valid mental health disorder is just continuation of something you had before enlistment. Considering that most of us had almost no mental health screen before actual enlistment how the VA determines this years after service I don't know. When you enlist if the military finds you fit then just about their only fall back is to find that you have a personality disorder that explains everything since. The attitudes of VA C&P doctors astounds me. Even the doctors I have seen over the years who came down on my side showed anti-veteran attitudes. It seems to me from my experience that most of these doctors think vets are trying to get welfare. I suppose it you go into an exam as a double amputee from stepping on a mine, or IED then the facts speak for themselves, but not the total facts as some here can tell. I think my evidence really showed a 100% rating for mental health was the right call, but since I got TDIU I want no part of another mental health C&P. Without IME's I would still be at 30% even though I was on SSDI for my MH service connected condition. I had to get IME's to get initial 70%. Then another to get TDIU, and another to get P&T. Because I had been in treatment via private sector for many years I was referred by current doctor's to other docs who did IME's for me. I don't know how many others are that lucky. The VA relied entirely on the VA exam doctor's when my claim was first denied for increase. Not until I paid for professional IME's did I get the increases I should have gotten thirty years before that time. So as usuall I agree with Kelly that the VA is a mafia where vets are victims of fraud and abuse at the hands of fellow Americans via the VBA. The more contact you have with them the more you hate them has been my experience. I am not the hostile guy I seem from my posts. I don't argue and fight with VA employees. I just bottle up my anger, and get even by finding evidence to beat them. I do write letters to congressmen about the awful treatment I have received at the VA hospital. It does little good. I usually reach into my pocket to get the treatment I need. I am not waiting for the VA to kill me. About the only really good thing I got from career as federal civil service employee was decent insurance. This I have used for IME's, but now has become almost impossible for mental health due to rule changes to benefit insurance companies. John

Seeing a good shrink is something to be proud of in my opinion. Seeing a good private psychologist soon after I got back from the army and Vietnam saved my life I think. I found someone who believed in what I was telling them, and did not call me a liar like army shrink or VA personnel. I went to a group for many years with other vets and these guys really woke me up to reality. I was in a daze and depressed as hell. Mental health counseling got me over the rough places in the first 5 years after I got out of the army. The years after that were a learning process which helped me get more out of life and deal with bad events. If not for that couseling I would be dead or living in an institution. The men and women who really go off the deep end are the ones who believe they have no problems, and everyone else is crazy. When bad things happen to you it tends to leave scars. Counseling helps heal and shrink these scars so you can see reality as it is and not as blurred vision from mental scar tissue invokes in us. John

Maybe? Just keep checking your bank account. There is not fixed time for getting retro.

I think you should file now. Think what it may be like in 30 years. If you wait years to file the VA will find all sorts of excuses as to what may have happend to you since. What seem like minor conditions to the 20 something guy/gal become major concerns to the 40 year old who has a mortgage, wife and kids in school. When we are young we never think that one day things will change and maybe for the worse from that injury you just ignored for years. My feet and knees hurt in the army. I did go for xrays one time. All that documentation disappeared from my SMR's. Now at age 64 I don't even walk so well. I can't prove a thing because my records are "silent on this issue" just like other things since I was just a kid when I went in and when I got out. I did not know these things would come back to haunt me. John

If your hearing loss is depressing you I would make an appointment with VA mental health. Hearing loss is a definite barrior to employment. Usually, you must be deaf as a post to get more than 10% for hearing. I knew a union electric worker who had to retire on worker's compensation because of hearing loss and the fact the noise was going to make it worse. He became very depressed after that. If the miiltary caused your deafness they are responsible for any secondary conditions. You must use medical evidence to prove this. That means an IME/IMO.

I think 30%. To show you how things have changed when I was discharged in 1971 after service in Vietnam I filed for a mental health issue. I was unable to work and spent 2 weeks in VA mental ward. I got 10% for schizophrenia because they just could not understand that Vietnam might have had something to do with my condition. They had no idea what was wrong with me. The VA has come a long way, but has a long, long way to go.

The VA has changed my mental health diagnosis at least 5 times in the last 40 years. The rating is what counts.

How much did the opinion cost you? It is a high class IMO from what I can tell. If you paid less than 2500 bucks you got a good deal. If it gets your husband a high rating it is probably worth every penny even if you paid 5 grand. You get your investment back in a few months. Bash destroys the C&P exam doctor's credibility.

I think a 10% rating is too low. I have 60% and I think I may be in better shape than your husband.. I started out at 0% but appealed with new evidence and got 60%. When I got the 0% thanks to idiotic C&P done by ARPN, I asked my PCP for some testing. I got testing and appealed the rating. I was TDIU at the time and the 60% I got was good enough to get SMC "S". Does your hubby have DMII? You still have time to appeal it. I would appeal considering the stent and current condition of the heart. What kind of meds is your husband on now? John

Berta I submitted new evidence in 2001-2002 including letters from 2 doctors, evidence of being approved for SSDI and rejection by Voc Rehab. I was fired from my long time job in 2001, so I went into overdrive. The VA based the 70% rating on all that evidence. I got even more evidence and continued on until I got TDIU P&T. When I was out of work and disabled at age 51, I experienced the sort of fear that rockets you to take any and all action to win your claim now. So I guess since the VA based their decision on the new evidence I submitted I am stuck with 2001 effective date? I was low balled for so many years. I just did not understand what it would take to get a higher rating than 30% because I was still able to work even if it was light duty for the rest of my days. I was on limited/light duty for about 5 years during the time I was appealing the denial of a rating greater than 30%. John

I filed a claim for an increase from 30% to a higher rating back in 1996 before I started using Hadit. I got the increase finally in 2002 to 70% after a trip to the BVA where my claim was denied. In late 2001 I submitted new and powerful evidence and was granted the 70%. In meantime I had claimed TDIU. I continued to appeal and got TDIU in late 2002 and then on appeal P&T in 2003. The claim for increase was constantly on appea from 1996l until I got P&T in 2003 and then I let it rest. Thinking about this I believe my effective date should have been the date I filed for the original increase which was in 1996. The VA says the 70% grant and all the other grants were based on the new evidence I supplied in 2002. Is this a possible error on the VA's part. I now that in other claims they even used the date of my C&P exam as the effective date which is all wrong. I am thinking of the difference between 30% and 70% for a period of almost 5 years which comes to a stout pile of cash. John

Have you had a TBI? People have all sorts of sleep disorders including lots of movement in sleep. Sleep walking is a disorder. Some don't have the inhibition of movement in dreams and act out their dreams which is dangerous. Any sort of head injury or brain illness can result in sleep disorder. Have you seen a neurologist?

USA government does not approve of medical MJ and neither does the VA. If MJ shows up in your urine or bloodwork at the VA you have a problem. I sure think it should be legal, but the VA has other ideas. I think all drugs should be legal since illegal drug money is what funds organized crime all over the world. John

There is new type of care for sleep apnea that does not involve CPAP. It is called Upper Airway Stimulation therapy. It involves a surgery to implant a device in your chest and neck that used electic shocks to keep your airways open. I am having it done in about three weeks. The VA won't do it so you need to have medicare and/or private insurance. This technique will revolutionize the treatment of OSA. I just cannot use the CPAP myself, and have woken up gasping for breath with the mask on before. That would make anyone panic. I went to the VA hospital for psychological evaluation about 42 years ago and landed up in rubber room myself. I was there two weeks before private psychologist I knew got me out. I would see the psychologist for sure. Make them take care of you. John

I think there is a WWP because the VA and American people are too cheap to adequately take care of veterans. I think vets who are in wheelchairs and double amputees etc. should get houses where they can live independently even if it costs a million bucks. They should get all the care they need and screw the price. They have given it all, so they should get it all.

sAhsley is basically right about the prep for VA mental health exam. The do look at your clothing, grooming, smell, eye contact and general appearance. One of the best strategies if you can stand it is to not bath for a few days and don't shave or comb hair. Women are usually neater than us guys so if a woman shows up with dirty hair and looking disheveled that means more than some of us guys who wear tea shirt and torn shorts in summer or even year round Now if you wear inappropriate clothing that scores points for being a basket case as well. I saw a guy waiting for exam wearing a shirt saying "I am not as crazy as I look". I don't know if it helped or hurt. The VA has protocol for mental illness and how you present yourself to the exam doctor is a pretty big factor. You don't have to fake it, but do your best to do your worst. The exam doctors usually say you are well groomed, good eye contact, oriented to time and space etc. This all hurts you and they do it by the numbers. If you sleep in your cloths for a few days and stay up all night drinking coffee before the exam you should have nice shaking hands by then. Score one for crazy vet! It is all a game and if the doctor is a human being you get lucky. If he is walking VA cash register they can guide you to destruction with leading questions about your childhood, teenage years, drug use, alcohol, trouble with legal system etc., before the military. I have been down both roads, maybe all three roads. These exam doctors will screw you in a second and look forward to it. John

I won a claim for increase in my DMII and eBenefits said my claim was back in "Gathering Evidence" stage. No more eBenfits or FDC for me. I will just use old fashioned paper and certified mail/return receipt system I think. My FDC took over a year to grant and it was as easy as it gets. The VA had all the evidence, and yet they waited one year to send me for C&P exam. I knew exactly what my new rating should be and that is what I got. The exam doctor did not address any of my secondary conditions just the fact I was on oral meds now for the DmII which equals 20%. This is not rocket science. This is the VA's regulations. I met a guy that was 300 lbs and VA said his DMII was managed by diet and exercise and he could barely walk with a cane.

However, you MUST get your NOD in within a year of your decision. The VA can sit on it for years. You better have proof you sent that NOD in on time as well. The VA gets benefit of "presumption of regularity" when they mail out a decision or SOC. Vets, on the other hand, must prove what they mail to the VA. Nice double standard. VA sent my decision and appeal rights to wrong address and it was returned to sender. I think the VA may still get the benefit of assumption of regularity because they will say I used money sent to my bank account. If you were starving would you look the gift horse in the mouth? It can be hard to win when the other guy holds all the aces. I am fighting it in court. I would just assume the VA is going to lose everything I send them. They are doing pretty good so far. John