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seminoles

Senior Chief Petty Officer
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Everything posted by seminoles

  1. That is great if you A. want to pay for Medicare part B and the cost is actually worth it but for me, it is far from it! Medicare doesn't cover MH for crap and I have many sc disabilities and no other health insurance including Tricare. I have the VA and nothing else. It is almost impossible to find providers here accepting medicare patients unless you buy an advantage plan (which costs more than just paying for part B). Everyone is in a different circumstance but I am not paying hundreds of dollars a month and still not getting the healthcare I need. As much as I despise relying on the VA at least I am not throwing money away for care I can't receive anyway. I can at least be driven to another VA to receive care or fight for care outside the VA which happens all the time and the VA has to provide it. Some of my medications cost over 4k a month and I know that if I was not on a very expensive advantage plan that covered $$$ drugs I would be screwed.
  2. This is exactly why I opted out of Part B, it is horrible coverage and I would have to purchase an advantage plan which still offers next to zero mental health coverage and there are still significant copays so I will opt in at retirement age and NOT pay that penalty........so many don't know this is an option!
  3. This is great news, I need to file 2 separate CUEs and they both would result in a nice chunk of change, it would be nice if they were handled by a different VARO honestly I hope yours goes well!!
  4. YES, getting my medical records and being able to prove I was seen for some of those conditions is what won me some of those ratings. I don't think the raters at the RO would have caught them, I had a rater call me about my shoulder and ASK where in my medical records I was seen because he couldn't find it? Some don't look too hard
  5. Your "friend" has no idea what he is talking about, my first claim was for two things, both were granted low balled of course but granted 10 years after I was discharged. That was in 2006, since then I have added additional sc issues and two of them as recent as 2018. I am 100% PT when I was first granted SC in 2006 it was for 20%. I filed for not only increase but also new issues. I am adding that I had in service treatment records for everything that I claimed as well as current diagnoses and ongoing treatment for my sc claims being current issues for me as well as any current sc condition having worsened. Many people claim all sorts of things but I had been out over 20 years when I was awarded by last few sc and one of them was a 60% rating by itself.
  6. And yes, the VA sends you a letter, at LEAST one with a proposal to reduce and what your options are. Not only did the veteran not attend the exam he was scheduled for he/she then ignored the proposal for reduction letter thinking it would go away? Yes, it is good that he/she has filed for another exam but a lot of stress and aggravation could have been thwarted by following directions and procedures put in place to protect veterans and the VA. We are best served to use them to our advantage and seek counsel when we don't know what to do. Wishing him or her the best.
  7. He apparently didn't show up for a schedule cp exam, that will do it and if that along with not seeing anyone for care within the VA.......the veteran is double screwed. So many veterans think they get rated and can just waltz through life thinking they will retain that rating, with things that are exactly permanent in nature like PTSD you are guaranteed you will be called in for exams.
  8. I was in this exact situation, I was rated IU PT, and then awarded an addition rating for a new service connected condition completely which was rated at 60% and was denied the SMC S. St. Pete has absolutely no idea what they are doing. The entire reason I had opened a claim to begin with was for A & A. laughable really, idiots
  9. This is the shadiest crap I have heard of, I would be flipping my SH#$ honestly. I would not be filing an appeal, what I did was wait for my brown envelope and then I wrote very detailed concise emails to every high up person in the VA including documentation how that sc condition had not in fact improved according to all my VA records and voila and email response within days and RO response in less than 2 weeks stopping my reduction and reopening all my other crap, oh and an apology. askholes trying to get away with stuff outside regulations, and they KNOW IT. I also had another cp exam for a condition I was seem for while AD and they examiner wrote it all up as if it were going to be rated at the 60% rating how terrible it was, would even impact my ability to work........then said it was from having too many kids??? Except I did complain about it while AD and it was before I had my first child and I did have two children while AD which doesn't matter anyway. That was also granted in that same letter from the RO, so my 70 IU PT proposal to reduce to 60% then went to 90% IU PT with deferred issues.........I then went to 100% with SMCs all from the same claim. Amazing what happens when you don't roll over!
  10. I would get a copy of all those exams, file for any another increases and any other new conditions you haven't filed for in the past. Also, were any of those conditions you were proposed a reduction for "protected" because they were over a certain number of years old, in that, they need to show marked improvement over time? The St. Pete RO pulled this on me, when I filed for A&A and had the nerve to go by the CP exam given by a quack GP contracted who spent less than 5 minutes with me for two conditions!! after my neuro filled out the paperwork for A&A, I freaked. It would have dropped my rating below 70% losing my IU PT, with kids in college using Chapter 35. I was LIVID. I had held that rating for 10years and it was documented very thoroughly in my VA records, anyway I said screw that and filed for every single thing I have never filed for before, I went from 70% IU PT to 100% schedular with SMCs after a year of so much stress and grief. I was sent an actual apology but only because I raised hell.
  11. Exactly, I am in Florida and some of the county appraiser offices are well less than informed and you have to file the correct paperwork and there is a deadline in Florida to file it, not sure how it works for when you buy during the year, etc. which is why I advised to call.......
  12. I know we have to file by a certain day of the year the first time and then they send us a renewal now every year in our county, I would call the county appraisers office and find out what you need to do.
  13. My kids have taken classes online some semesters at their college and have been fine as long as they are certified by the VA certifying official at their school all is good. They get their full amount if they are full time. It isn't like post 9/11 gi bill and having to attend at least one class on campus for BAH for your area. Chapter 35 amount is the same no matter what as long as the VA certifying official at the school certifies the classes, she will get the amount for full, 3/4 or 1/2 time whatever her schedule is.
  14. When you are up against an government entity like the VA that doesn't bother to follow their own rules, well then I choose to do whatever I have to in order to ensure that I don't get screwed. Plain and simple.
  15. I filed for aid and attendance on the advice of my neurologist who filled out the proper paperwork, as did my primary care doctor. I did not know that filling out that paper work would then send me to new CP exams FOR EVERY SINGLE THING I am service connected for. As soon as I realized this I was like okay, wanna play that game, I am going to file for the things that I haven't filed for that I should have. I was IU PT and all my ratings were over 5 years old, most over 10. The condition my neuro filled out my aid and attendance for I was sent to a general pracitioner for and he also did an exam for a surgery that was also already sc for a finger. That exam lasted less than 5 minutes, outside provider through I can't remember who. I as denied any SMC and sent a letter to propose my rating from 50 to 0, which my neuro for over 8 years was saying I needed aid and attendance for??? and this quack was saying is rated at 0% YEAH okay. I freaked. Another exam for a new condition I hadn't claimed the examiner at the VA filled it out as if it was horrible and not only fit the rating criteria for 60% but would impact my ability to work. NOT SERVICE CONNECTED, why? I had too many babies........except I complained about it in service BEFORE I had children. I freaked out, I had 2 kids in college using chapter 35, I have severe PTSD and going to a hearing isn't something I can handle honestly. I got out my evidence of my in service treatement of conditions, my cp exams, the proposal to reduce and I attached them with a very well written and clear email written to every high up person within the VA I could think of and emailed it to every single one of them. I had an email back within days telling me I would hear from my RO wtihin 2 weeks. I received an apology, my proposal for reduction was stopped and my mh cp exam was thrown out and I was given a new one by an outside provider, which increased it to 70%, they added the 60% rating as they should have. They deferred a couple things and I ultimately did get sc on all but one and I am filing a CUE about another. My first objective was to stop the reduction which was clearly bs and not within guidelines. If I had listened to all the people giving me advice I would have been a basket case honestly. My VSO honestly after it was all said and done was impressed that I was able to get done something he had never seen before. I don't bother with my congressman, his staff is useless and they know less than I do and he is a veteran and a physician. How sad is that? They actually don't give a crap about us except for talking points and votes, we don't have enough lobbying money to care about. It is kinda pathetic that if a post 9/11 veteran has their caregiver apply for benefits their entire claim doesn't get opened up and scrutinized but the rest of us, somehow we have to then prove yet again that we are still disabled, for a few hundred bucks. OH and they still haven't opened up the caregiver program to those Vietnam era vets and older yet, no one seems to be upset about that???? We should be! That was supposed to happen 2 months ago. They can come up with all sorts of social media crap and apps but not a program for caregivers. I don't buy it for a second.
  16. I had a mh cp exam which included PTSD conducted by VES at a non va location after disputing the VA CP exam as inadequate and inappropriate in nature, which was very evident in the comments of her exam. She made comments about my wealth??? I am far from wealthy but even if I were it would have no bearing on my disabilities or whether they were service connected. It wasn't just that I could pay my bills and didn't need a fiduciary it was FAR beyond that and bizarre to say the least. I already had a diagnosis for PTSD by the VA so there was no question about diagnosis. I was already sc for mh as well.
  17. I have had horrible experiences at a VA facility but I don't discount that facility and refuse to go there. I refuse to see the individual who treated me horribly, but thankfully after 10 years that person is no longer there. I also choose to not go to one particular clinic at my local VA, I choose to be driven 3 hours to another VA after they could not find me care in the community after my community care provider closed. That va clinic was subject to an IG investigation in regards to my care and I do not have to be seen there because of that investigation and the horrible care I was given, I am paid travel. CP exams are a different matter and well I doubt you will find even half of the staff still there from 15 years ago. I hope you can take someone with you, PTSD exams are never easy but sadly we have to put up with the crap. If your exam isn't handled well, you can ask for a new exam, always remember that. I have had to do that in the past for an inadequate exam, I was then given one by an outside vendor.
  18. As far as the education debt, for 3k I would not ask for forgiveness for that small of an amount, you can ask for income sensitive repayment plans, and other plans while you are having a financial hardship to defer payments until you figure out everything else. Federal education loans are forgiven after 10 years of payment so even if they put you on a $10 a month payment plan for 10 years it is gone. You may find that at some point you want to go back to school, your disabilities improve, etc. Also, you may want to look into voc. rehab at some point and that would make you ineligible for many federal programs for additional money. Think ahead. Best of luck!!
  19. I have had amazing dental implants done at my VA in Gainesville, my oral surgeon and prosthedontist were absolutely the best. They did them right and it is a long process with having them properly done but definitely worth it! Lots of people don't realize how much time and effort goes into dental implants, from having your teeth pulled, bone grafts, proper healing, then the implants, healing some more then the crowns, it take 12- 18 months from start to finish but will last a long time and the results are amazing.
  20. I had an exam from a contracted provider, I can't remember which one honestly but it was at a fitness center. They had a back office and it was in there, I thought it was kind of strange but I was thankful it was the only exam I haven't had to drive 3 plus hours away.
  21. lots of folks don't know they can go into that section and see if permanent and total is an option to choose or even how to navigate through it I understand where you are coming from too and the VA sends those pamphlets out by mistake often sadly. Hopefully in this case it wasn't a mistake.
  22. I am not talking about the commissary letter I am talking about when you go to generate letters on ebennies you will either have the ability to check the box that you are permanent and total or not........if you aren't P and T that box won't be there to check when you are generating letters to print.
  23. easy enough, just go on ebenefits and see if you are permanent and total............there will either be a box for you to check it in the generate letters section or there won't be
  24. Social Security and the VA do not have the same criteria necessarily, there are many veterans rated 100% PT and work full time jobs for the federal government as well as every other job you can imagine really. The only way to determine whether you are eligible for SSDI is to apply, you will not receive SSI, your income will exceed the guidelines so if you don't have enough recent work credits then you will be pretty much out of luck. You can look up the difference between SSI and SSDI on the social security website but if you truly cannot work then you should apply.
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