jbasser

The only way to realistically gert this problem fixed is to complain to the insurance companies that they are paying out money for conditions that are service connected and are the responsibility of the Government, Not the insurance companies. It may not effect 1 or 2 people. but you start to add tens of thousands, Then something may get done. Current situation is a form of insurance fraud.

I am going in front of the ALJ tommorrow. Wish me luck. It has been 2.5 years to get this far. J

As long as you paid the money into the system, you should be able to reap the benefits. It is worth a try.

Here is the quickest way to find out the range of your claim. Call your VSO and ask him what month and year the raters are working on. They are usually done according to the date received unless it is on remand from the BVA or Cavc. For example if your claim was filed in Jan 07 and they are working on Dec 06, Then you know it will be sooner not later. If they say february 07, Then something is holding up your particular claim. Call the 800 number and inquire abiut claim status. I called every 2 weeks when my initial claim was being processed. They can also tell you if you are submitted for a C&P exam if they will. It depends on the person on the phone.

Dont waste your ink. Call the patient rep and complain, Tell them this statement. I have health insurance which pays for medicines. I expect the medicine the doctor prescribed. The Pharmacy has no right to dictate what a provider prescribes when the medicine payment is guaranteed. Let us know the outcome.

You are correct as usual Berta, I wonder how many vet organizations even know this rule is in place? I would say not too many. I know for a fact my AL rep did not know.

Berta, thanks for re-posting this information, As you are aware, I have followed this rule from its infancy as a proposal. When this rule became final in 2006, I filed one of my appeals from a November 06 decision based on this rule. When I get it resolved, I will post the results on the board and we all will see just how strong this rule is. I believe my case will be one of the the first one using the rule. I am excited to see how it will proceed. John

I agree with Pete. Service officers who constantly give out bogus information need to be removed from their positions. They are adding to the problem, not helping solve the problem. He has no right to tell you not to file a claim or to wait to file a claim. That is not his purpose. He is to assist you with the filing of a claim. To take the claim and submit it, also to follow up as it flows through the VA and to notify you of a decision when one is made. If I were you I would tell the service officer to explain exactly what he meant when he told you that. Tape him and take it from there. I would love to hear his reasoning. It really hits a nerve with me when Service officers do this crap. I have Been known to help vets and confront these Morons. Bottom line is this, Dump this chump tommorrow and find someone else. You will be better off. J

If that is the case, These folks pay Malpractive insurance. you should go after them outside the VA. ALso check with an attorney to see what your rights are. The VA may still be responsible.

Great job. Congratulations on your win. Persistance and patience does pay off.

Mrs John M, What type od stress test did your husband have? Did he walk on the treadmill or was he injected to make his heart race? In 2005, I had a VA stress test and the Doc said it was normal. I was having angina so I went outside to another cardiologist. He did a heart Cath and found that I have Heart disease. If you can afford to do so, or if John had a red/white/blue card go for a second opinion. Take the VA notes with you. I have posted before that I do not put too much emphasis on stress tests or echos because a cath is an actual person seeing what is going on. JBasser

http://vabenefits.vba.va.gov/vonapp/main.asp Copy the link. Once you get to the site, register, fill out the entire forms. Send in the requested information. You will receive a Letter of confirmation in the mail that may request a signature. You could also pick a Veterans service organization to help you like the DAV or the American Legion. These foks usually have people at the nearest VA Hospital and you can walk in to do your claim there if needed. Be sure to take the old DD 214. Some conditions are presumptive to have occurred if diagnosed within 1 year of service separation. If that is the case then the effective date should be the date separated from service if filed less than 1 year. if more than 1 year, then is is the date entitlement arose of the date filed whichever is later. Good luck and keep us posted, J

The reason I am posting this here is thare is soon to be a FTCA claim filed. I Know a Veteran who in 2005 had a CT scan that the radiologist read as worrisome for "Lymphoma" on the report and suggested a follow up. The VA treating parties blew it of and did not schedule testing. In Sept of this year the Veteran started having several bouts with bleeding and diarrea. The Colonoscopy results are not back yet but this Vet is scared to death as he is sure has Cancer. Bottom line is this: Follow up. Even if you have to go outside. Dont take the first diagnosis. In this case it most likely has killed this Vet. J Basser

Sounds like they are wanting to play lets make a deal. it is possible if you initiate it. I would hold steadfast on your major issues and only budge on issues that are minor. I would not allow them to deny issues, If I know I am right, I will allow them to zero percent some issues if I get 100 percent P&T for other issues. That way if an issue kills me at least it will be SC'd even at 0 percent. Good Luck Tower Rat.

Josephine it is part of the VCAA usually accompanied by a form that says wait 6 months or rate now. I have a copy of a form if you need one. I believe 1 was posted here on hadit not too long ago.

Berta, I admire you. Over the years you have battled time, the VA, and school. The sky is the limit for you. I feel you have the ability to do whatever you set your sights on and whatever that may be, I will support you. Congratulations and thank you for being there for me when I was attempting to learn the cartography of the VA maze. John

Did they give you a disabled date? I have my hearing next week and I had a marathon attorney meeting today. Anyhow, Gongrats on the win, you deserve it. Now take a break from it all, go see Mickey Mouse and have some fun.

If you qualify for 100 percent schedular, you can still work. If not, you still gety paid at the 70 percent rate. Be advised to take into consideration of the difference of the rate. The extra 1200 per month plus the SSD you can draw if the VA finds IU. No is it worth continuing working. Do you have a hobby you like to do that you can focus on? I would take all of these in consideration.

Did you have a C@P examination for that issue? You are right, I have seen several claims approved for HTN secondary to Hypertension. I am SC for hypertension and Hypertensive heart disease. I am going to file for DMII as aggravation on both ends. I have also seen cases for DMII as aggravation factors of SC hypertension and heart disease. It is called excarbation. If you have the copy of the exam, email me. J

It is not an agent orange presumptive. It is connectable only secondary Diabetes. It is presumptive during the first post service year and only if the readings are compensable. That means top line (Systolic) 160 or bottom line (diastolic) 100. Get a doctor to state it is caused by DM and you should be OK. you can do it as a NOD if it is a denied claim. if not file it as a new claim with an effective date of high BP reading taken at the VA. Remember effective date is date of claim or date entitlement arose whichever is later. 7101 Hypertensive vascular disease (hypertension and isolated systolic hypertension): Diastolic pressure predominantly 130 or more 60 Diastolic pressure predominantly 120 or more 40 Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more 20 Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control 10 Note (1): Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. Note (2): Evaluate hypertension due to aortic insufficiency or hyperthyroidism, which is usually the isolated systolic type, as part of the condition causing it rather than by a separate evaluation. Note (3): Evaluate hypertension separately from hypertensive heart disease and other types of heart disease.

Jay, tell your friend to be wise to the fact they did not examine the other issues. If he has a separate opinion, he may be ok, But I doubt it. Sometimes they will not even grant a C&P unless there is evidence of a claim. Remember the old addage of Well grounded. The VCAA supposedly kicked it out but I will go on a limb and say that if a claim does not show merit ( VA OPINION at the ro) Then it may have the old automatic denial. All Vets need to get an IMO before your claim gets this far. The more procative a Veteran is the better off they are. Am IMO is easy to get. Just call a SSD attorney and ask them for a Doctor they use for IME's (usually a Occupational doctor) They usually cost between 5 and 6 hundred. ( Cheaper than Bash). Kentucky Vets if you need one, Shoot me a message.Good Luck Jay

We are in the same boat. Let me know how it goes.

Obviously there is somemthing there or they would not have granted the motion. Good luck.

First step is to call the VA billing ofice and ask someone to do a Pharmacy Audit of your record. Make sure they know the effective date of your claim/ Get them a copy of the award letter. You can also do this in person or in writing to the patient advocate of your primary care doctor. It may take awhile but from the date you are 50 percent, you should get a medicine copay refund. Medical copays do not apply.

Josephine, They actually asked you not to call the director again? That is a hoot. I too have been accused of making a pet rock want to run away from home. Im glad you are being persistant and I am proud of you for holding up this well under these circumstances. A lot of people would have cracked by now. Just remember that the entire VA system is actually an unorganized mess from the janitors closet to the Secretary's office. In the military we had 2 words for it but I cannot post them here. But it rhymes with luster truck. Keep on hanging in there.