allan

Search Terms: ASTHMA HYPERVENTILATION -------------------------------------------------------------------------------- Designated for electronic publication only UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS No. 96-1425 Norbert A. Knappman, Appellant, v. Togo D. West, Jr., Secretary Of Veterans Affairs, Appellee. http://search.vetapp.gov/isysquery/953aa5f...30a133a8/1/doc/

Overbreathing resulting from modern living is the cause of breathing-related diseases. Hyperventilation is not just a result of asthma, hyperventilation is the main contributor of asthma. Professor Buteyko believes that genetic predisposition determines which illnesses people develop from overbreathing. As a result, each person who hyperventilates or overbreathes is affected individually, based on hereditary factors. Source: http://www.asthmacare.ie/blog/?p=151

Try this link TS http://www.hadit.com/forums/index.php?act=...ost&id=1196

No, I didn't delete it. After posting I checked it to make sure it was functioning OK. Allan

Dept of Veterans Affairs (DVA), is not likely to pay for emergency room care in the private sector unless it is agreed to in writing, in advance. The Veterans Affairs Medical Center (VAMC), ER wards will likely watch you die through the window and say "what a shame" if you have to go there. If you believe your condition is serious enough to go to an emergency room, you should go to one nearest you. . Lord help those that can only go to the VAMC emergency room. Allan

Effective Dates 3.400 General 3.400-1 3.401 Veterans 3.401-1 3.402 Surviving spouse 3.402-1 3.403 Children 3.403-1 3.404 Parents 3.404-1 3.405 Filipino veterans and their survivors; benefits at the full-dollar rate 3.405-1 §3.400 General. Except as otherwise provided, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is the later. (Authority: 38 U.S.C. 5110(a)) (a) Unless specifically provided. On basis of facts found. (b) Disability benefits: (1) Disability pension (§3.3). An award of disability pension may not be effective prior to the date entitlement arose. (i) Claims received prior to October 1, 1984. Date of receipt of claim or date on which the veteran became permanently and totally disabled, if claim is filed within one year from such date, whichever is to the advantage of the veteran. (ii) Claims received on or after October 1, 1984. (A) Except as provided in paragraph (b)(1)(ii)(B) of this section, date of receipt of claim. (B) If, within one year from the date on which the veteran became permanently and totally disabled, the veteran files a claim for a retroactive award and establishes that a physical or mental disability, which was not the result of the veteran’s own willful misconduct, was so incapacitating that it prevented him or her from filing a disability pension claim for at least the first 30 days immediately following the date on which the veteran became permanently and totally disabled, the disability pension award may be effective from the date of receipt of claim or the date on which the veteran became permanently and totally disabled, whichever is to the advantage of the veteran. While rating board judgment must be applied to the facts and circumstances of each case, extensive hospitalization will generally qualify as sufficiently incapacitating to have prevented the filing of a claim. For the purposes of this subparagraph, the presumptive provisions of §3.342(a) do not apply. (2) Disability compensation: (i) Direct service connection (§3.4(b)). Day following separation from active service or date entitlement arose if claim is received within 1 year after separation from service; otherwise, date of receipt of claim, or date entitlement arose, whichever is later. Separation from service means separation under conditions other than dishonorable from continuous active service which extended from the date the disability was incurred or aggravated. (ii) Presumptive service connection (§§3.307, 3.308, 3.309). Date entitlement arose, if claim is received within 1 year after separation from active duty; otherwise date of receipt of claim, or date entitlement arose, whichever is later. Where the requirements for service connection are met during service, the effective date will be the day following separation from service if there was continuous active service following the period of service on which the presumption is based and a claim is received within 1 year after separation from active duty. © Death benefits: (1) Death in service (38 U.S.C. 5110(j), Pub. L. 87-825) (§§3.4©, 3.5(b)). First day of the month fixed by the Secretary concerned as the date of actual or presumed death, if claim is received with 1 year after the date the initial report of actual death or finding of presumed death was made; however benefits based on a report of actual death are not payable for any period for which the claimant has received, or is entitled to receive an allowance, allotment, or service pay of the veteran. (2) Service-connected death after separation from service (38 U.S.C. 5110(d), Pub. L. 87-825) (§§3.4©, 3.5(b)). First day of the month in which the veteran’s death occurred if claim is received within 1 year after the date of death; otherwise, date of receipt of claim. (3) Nonservice-connected death after separation from service. (i) For awards based on claims received prior to October 1, 1984, or on or after December 10, 2004, first day of the month in which the veteran’s death occurred if claim is received within one year after the date of death; otherwise, date of receipt of claim. (ii) For awards based on claims received between October 1, 1984, and December 9, 2004, first day of the month in which the veteran’s death occurred if claim is received within 45 days after the date of death; otherwise, date of receipt of claim. (Authority: 38 U.S.C. 5110(d)) (4) Dependency and indemnity compensation: (i) Deaths prior to January 1, 1957 (§3.702). Date of receipt of election. (ii) Child (38 U.S.C. 5110(e), Pub. L. 87-835). First day of the month in which entitlement arose if claim is received within 1 year after the date of entitlement; otherwise, date of receipt of claim. (iii) Deaths on or after May 1, 1957 (in-service waiver cases) (§§3.5(b)(3) and 3.702). Date of receipt of election. (See §3.114(a)). (d) [Removed] (e) Apportionment (§§3.450 through 3.461, 3.551). On original claims, in accordance with the facts found. On other than original claims from the first day of the month following the month in which: (1) Claim is received for apportionment of a veteran’s award, except that where payments to him (her) have been interrupted, apportionment will be effective the day following date of last payment if a claim for apportionment is received within 1 year after that date; (2) Notice is received that a child included in the surviving spouse’s award is not in the surviving spouse’s custody, except that where payments to the surviving spouse have been interrupted, apportionment will be effective the day following date of last payment if such notice is received within 1 year after that date. (f) Federal employees’ compensation cases (§3.708). Date authorized by applicable law, subject to any payments made by the Office of Workers’ Compensation Programs under the Federal Employees’ Compensation Act over the same period of time. (g) Correction of military records (38 U.S.C. 5110(i); Pub. L. 87-825). Where entitlement is established because of the correction, change or modification of a military record, or of a discharge or dismissal, by a Board established under 10 U.S.C. 1552 or 1553, or because of other corrective action by competent military naval, or air authority, the award will be effective from the latest of these dates: (1) Date application for change, correction, or modification was filed with the service department, in either an original or a disallowed claim; (2) Date of receipt of claim if claim was disallowed; or (3) One year prior to date of reopening of disallowed claim. (h) Difference of opinion (§3.105). (1) As to decisions not final prior to receipt of an application for reconsideration or to reopen, or prior to reconsideration on Department of Veterans Affairs initiative, the date from which benefits would have been payable if the former decision had been favorable. (2) As to decisions which have become final (by appellate decision or failure to timely initiate and perfect an appeal) prior to receipt of an application for reconsideration or to reopen, the date of receipt of such application or the date entitlement arose, whichever is later. (3) As to decisions which have become final (by appellate decision or failure to timely initiate and perfect an appeal) and reconsideration is undertaken solely on Department of Veterans Affairs initiative, the date of Central Office approval authorizing a favorable decision or the date of the favorable Board of Veterans Appeals decision. (4) Where the initial determination for the purpose of death benefits is favorable, the commencing date will be determined without regard to the fact that the action may reverse, on a difference of opinion, an unfavorable decision for disability purposes by an adjudicative agency other than the Board of Veterans Appeals, which was in effect at the date of the veteran’s death. (i) Disability or death due to hospitalization, etc. (38 U.S.C. 5110©, (d); Public Law 87-825; §§3.358, 3.361, and 3.800.): (1) Disability. Date injury or aggravation was suffered if claim is received within 1 year after that date; otherwise, date of receipt of claim. (2) Death. First day of month in which the veteran’s death occurred if a claim is received within 1 year following the date of death; otherwise, date of receipt of claim. (j) Election of Department of Veterans Affairs benefits (§3.700 series). (1) Unless otherwise provided, the date of receipt of election, subject to prior payments. (2) July 1, 1960, as to pension payable under Pub. L. 86-211, where pension is payable for June 30, 1960, under the law in effect on that date, including an award approved after that date, if the election is filed within (generally) 120 days from date of notice of the award. The award will be subject to prior payments over the same period of time. (3) January 1, 1965, as to pension payable under Pub. L. 86-211 (73 Stat. 432) as amended by Pub. L. 88-664 if there was basic eligibility for pension on June 30, 1960, under the law in effect on that date and an election if filed prior to May 1, 1965. (4) January 1, 1965, as to pension payable under Pub. L. 86-211 (73 Stat. 432) as amended by Pub. L. 88-664 if there was basic eligibility on that date for pension on the basis of service in the Indian wars or Spanish-American War and an election is filed prior to May 1, 1965. (5) January 1, 1969, as to pension payable under Pub. L. 86-211 (73 Stat. 432), as amended by Pub. L. 90-275 (82 Stat. 64), if there was basic eligibility for pension on June 30, 1960, under the law in effect on that date and an election is filed prior to May 1, 1969. (6) August 1, 1972, as to pension payable under Pub. L. 86-211 (73 Stat. 432) as amended by Pub. L. 92-328 (86 Stat. 393) if there was basic eligibility on that date based on death of a veteran of the Spanish-American War and an election is filed prior to December 1, 1972. (k) Error (§3.105). Date from which benefits would have been payable if the corrected decision had been made on the date of the reversed decision. (l) Foreign residence. (See §3.653). (m) Forfeiture (§§3.901, 3.902). Day following date of last payment on award to payee who forfeited. (n) Guardian. Day following date of last payment to prior payee or fiduciary. Note: Award to guardian shall include amounts withheld for possible apportionments as well as money in Personal Funds of Patients. (o) Increases (38 U.S.C. 5110(a) and 5110(b)(2), Pub. L. 94-71, 89 Stat. 395; §§3.109, 3.156, 3.157): (1) General. Except as provided in paragraph (o)(2) of this section and §3.401(b), date of receipt of claim or date entitlement arose, whichever is later. A retroactive increase or additional benefit will not be awarded after basic entitlement has been terminated, such as by severance of service connection. (2) Disability compensation. Earliest date as of which it is factually ascertainable that an increase in disability had occurred if claim is received within 1 year from such date otherwise, date of receipt of claim. (p) Liberalizing laws and Department of Veterans Affairs issues. See §3.114. (q) New and material evidence (§3.156) other than service department records. (1) Received within appeal period or prior to appellate decision. The effective date will be as though the former decision had not been rendered. See §§20.1103, 20.1104 and 20.1304(b)(1) of this chapter. (2) Received after final disallowance. Date of receipt of new claim or date entitlement arose, whichever is later. ® Reopened claims. (§§3.109, 3.156, 3.157, 3.160(e)) Date of receipt of claim or date entitlement arose, whichever is later, except as provided in §20.1304(b)(1) of this chapter. (Authority: 38 U.S.C. 501(a)) (s) Renouncement (§3.106). Except as provided in §3.106©, date of receipt of new claim. (t) Whereabouts now known. (See §3.158©.) (u) Void, annulled or terminated marriage of a child (38 U.S.C. 5110(a), (k), (l); Pub. L. 93-527, 88 Stat. 1702; §3.55): (1) Void. Date the parties ceased to cohabit or date of receipt of claim, whichever is later. (2) Annulled. Date the decree of annulment became final if claim is filed within 1 year after that date; otherwise date of receipt of claim. (3) Death. Date of death if claim is filed within 1 year after that date; otherwise date of receipt of claim. Benefits are not payable unless the provisions of §3.55(b) of this part are met. (Authority: 38 U.S.C. 103) (4) Divorce. Date the decree became final if claim is filed within 1 year of that date; otherwise date of receipt of claim. Benefits are not payable unless the provisions of §3.55(b) of this part are met. (Authority: 38 U.S.C. 103) (v) Termination of remarriage of surviving spouse (38 U.S.C. 5110(a), (k); 38 U.S.C. 103(d) and 5110(l) effective January 1, 1971; §3.55): (1) Void. Date the parties ceased to cohabit or date of receipt of claim whichever is the later. (2) Annulled. Date the decree of annulment became final if claim is filed within 1 year after that date; otherwise date of receipt of claim. (3) Death. Date of death if claim is filed within 1 year after that date; otherwise date of receipt of claim. Benefits are not payable unless the provisions of §3.55(a) of this part are met. (Authority: 38 U.S.C. 103) (4) Divorce. Date the decree became final if claim is filed within 1 year after that date; otherwise date of receipt of claim. Benefits are not payable unless the provisions of §3.55(a) of this part are met. (Authority: 38 U.S.C. 103) (w) Termination of relationship or conduct resulting in restriction on payment of benefits (38 U.S.C. 5110(m), effective January 1, 1971; §§3.50(b)(2) and 3.55). Date of receipt of application filed after termination of relationship and after December 31, 1970. Benefits are not payable unless the provisions of §3.55(a), as applicable, of this part are met. (Authority: 38 U.S.C. 103) (x) Effective date of determination of incompetency (§3.353). Date of rating of incompetency. (Not applicable to an incompetency determination made for insurance purposes under 38 U.S.C. 1922). (y) Effective date of determination restoring competency (§3.353). Date shown by evidence of record that competency was regained. (z) Claims based on service in the Women’s Air Forces Service Pilots (WASP), or on service in a similarly situated group (Pub. L. 95-202). (1) Original claim: Date of receipt of claim or date entitlement arose, whichever is later, or as otherwise provided under this section (e.g., paragraph (b)(1) of this section) except that no benefits shall be awarded for any period prior to November 23, 1977. (2) Reopened claim: Latest of the following dates: (i) November 23, 1977. (ii) Date entitlement arose. (iii) One year prior to date of receipt of reopened claim. [26 FR 1593, Feb. 24, 1961; 56 FR 25044, June 3, 1991; 57 FR 10426, Mar. 26, 1992; 58 FR 32443, June 10, 1993; 60 FR 18356, Apr. 11, 1995; 60 FR 5286, Oct. 11, 1995; 61 FR 67950, Dec. 26, 1996; 62 FR 5529, Feb. 6, 1997; 68 FR 34542, June 10, 2003; 69 FR 46434, Aug. 3, 2004; 71 FR 44919, Aug. 8, 2006; 71 FR 52457, Sept. 6, 2006] Supplement Highlights references: 8(1), 15(3), 18(2), 25(1), 27(2), 57(1), 63(1), 72(2), 73(2). Editorial note: For other Federal Register citations affecting §3.400, see the List of CFR Sections Affected in the Finding Aids section of Title 38 of the Code of Federal Regulations. SOURCE: http://www.warms.vba.va.gov/regs/38CFR/BOO...ART3/S3_400.DOC

Survivors and Dependents Benefits -- Death After Active Service http://www.vba.va.gov/bln/dependents/index.htm

M21-1MR http://www.warms.vba.va.gov/M21_1MR.html

Section D. Examination Reports http://www.warms.vba.va.gov/admin21/m21_1/...3/ch03_secd.doc

Hello Williamn, keep in mind that a "nexus" is not just the wording a doctor uses, such as "on a more probable than not bases". The Dr must support his statement using medical science and medical records showing how your currant condition is connected to your in-service injury or illness. This is one place I see the VA Dr's and VA contracted Dr's providing IMO's repeated fail. They either come up with a favorable or not favorable opinion that is supported by thin air. Mostly because they primarily use General Practitioners and Internal Medicine MD's who site what the RO dictates. They use phrases like the records are absent for, the records do not support the Veteran and so on. They will ignor lab results, xrays, MRI's muscle function tests and statements any dr made before them. VAMC C&P examiners and the private C&P contractors like QTC will focus "only" on what the VARO, BVA etc ordered. They will not look through all your records trying to find something to give you a service connection for. It does matter what you bring them, if it wasn't sent in a sealed packet from the VARO. The "ONLY" way to have a therough evaluation of your overall records(inservice, since service and current), is if you can afford to pay for someone to spend a couple weeks disecting it.

Section C. Requesting Records http://www.warms.vba.va.gov/admin21/m21_1/...1/ch01_secc.doc

Your VA Health Care Services http://www1.va.gov/visns/visn02/vet/benefits/services.cfm

BENEFICIARY TRAVEL FREQUENTLY ASKED QUESTIONS Eligibility for Travel Q: Who is eligible for travel? A: -Veterans rated 30% or more SC for travel relating to any condition -Veterans rated less than 30% for travel relating to their SC condition -Veterans receiving VA pension benefits for all conditions -Veterans with annual income below the maximum applicable annual rate of pension for all all conditions -Veterans who can present clear evidence that they are unable to defray the cost of travel -Veterans traveling in relation to a Compensation and Pension (C&P) Examination -Veterans in an authorized Vocational Rehabilitation Program for all conditions -Certain veterans in certain emergency situations -Certain non-veterans when related to care of a veteran (attendants, donors) -Allied Beneficiaries Types of Travel Q: What travel can the Department of Veterans Affairs (VA) provide? A: VA has authority to provide eligible beneficiaries reimbursement for mileage, special mode transportation (when medically justified by a VA health care provider), and in certain circumstances, taxi or hired car. Mileage Rates Q: What are current mileage rates for travel? Why are rates different for veterans and VA employees? A: VA currently reimburses .11/mile for ALL veteran travel, including C&P exams. When VA has determined that a deficiency exists in relation to a C&P exam (need to repeat a lab test, x-ray, or through no fault of the veteran not all exams in relation to the C&P were completed) reimbursement is .17/mile. This is travel for the “Convenience of the Government”. Mileage rates for veterans and VA employees are determined under separate authorities and take different criteria under account. Title 38 United States Code (U.S.C.) 111and 38 Code of Federal Regulations (CFR) 17.143-145 are authorities for Beneficiary Travel. 41 CFR Chapter 301 provides guidance for employee travel. Special Mode Q: How is it determined that a veteran requires “Special Mode” transportation? What eligibility requirements must be met? A: Special mode transportation includes ambulance, ambulette, air ambulance, wheelchair van, and other modes which are specially designed to transport certain disabled individuals. Special mode DOES NOT include public transportation such as taxi, bus, subway, train, airplane, or privately owned conveyance. In order to be eligible for special mode transportation two criteria must be met. The veteran first has to be administratively eligible for transport at VA expense. Unless this basic criterion is met the veteran is not eligible for special mode transportation. Once administrative eligibility is established, a VA clinician must then determine that a special mode of transportation is clinically required to transport the veteran for VA health care. Unless one of the forms of special mode transportation is required and documented as such, this method of transportation is inappropriate. Should it be clinically determined at one VA facility that such transportation is required, this should be accepted at all VA facilities, unless there is reason to think a veteran’s condition may have changed. Local procedures should be established to determine special mode requirements, as well as communication guidelines to other VA facilities when it is necessary to send veterans with this requirement to Tertiary Care, other VA facilities, or non-VA providers for treatment. Mileage Rate Increase Q: With the price of gas increasing, the mileage rate does not cover expenses. Is the mileage rate going to change? A: Beneficiary Travel is a discretionary program. Money for provision of Beneficiary Travel comes directly from the yearly health care appropriation for VA, therefore, any money used for Travel directly impacts that available for direct patient care. The Secretary is required to undertake a yearly evaluation in order to determine whether VA has sufficient funds to continue to provide veteran transportation, and whether any rate changes should occur. VA spent approximately $172 million in FY 2003 for Beneficiary Travel. A recent evaluation indicated that raising the mileage rates 5 cents to .22 and .16 per mile would increase travel costs at least another $24 million per year. An increase in mileage rates to that of federal employees (currently 36.5 cents per mile) would cost approximately $127 million per year. Therefore, due to the recent rapid increase in veteran patient workload, the Secretary has decided to maintain the current rates of reimbursement and not decrease funds available for direct medical care. Travel Discretion Q: How much discretion does a facility have if a veteran does not meet eligibility standards and extenuating circumstances exist? A: There is no authority to provide transportation at VA expense for veterans who do not meet eligibility requirements, except in the case of Organ Transplants (VHA Directive 2001-027). Ineligible Beneficiaries Q: Is there anything we can do to obtain travel for ineligible beneficiaries? A: When a veteran does not meet eligibility for Beneficiary Travel, other sources, including the DAV network, family and community should be aggressively pursued. VA Form 3068, “Reduced Rate transportation” is also available for field use. This form can be presented to transportation carriers for possible reduced rates for veterans needing to travel in relation to VA health care. It is mainly used for bus transportation; however acceptance by other carriers, including airlines is being explored. In addition, VA facilities should be pro-active in assisting the veteran explore possible VA options that would give him/her eligibility for Beneficiary Travel. These include: -Service Connection: Is the veteran potentially eligible? Refer to Service organization, VBA representative, Regional Office, VA Web site -Housebound/A&A: For veterans not receiving these benefits is their income at or below the income thresholds for these benefits? VHA Directive 2004-026, “Income Thresholds Used in Identifying Veterans Exempt from Extended Care Service and Outpatient Medication Co-payment and in Determining Eligibility for Beneficiary Travel” provides details how veterans not receiving A+A/ housebound may still be determined eligible for Beneficiary Travel. 2 -“Hardship” review: -Is veteran unable to defray the cost of transportation? Has veteran lost job? Does it appear future income will be less? Fee Basis Travel Q: Does VA have authority to provide transportation for Fee Basis or visits when an eligible veteran chooses to use private health insurance to pay for care? A: VA has authority to pay for transportation of veterans traveling to VA authorized non-VA health care when a deductible (if applicable) is met. If VA is not paying for the care, travel at VA expense will not be provided. Travel to “Preferred” Facility Q: What if a veteran chooses to go to his “preferred” facility instead of the closest VA facility that can provide the care? A: Veterans have the choice to go to any VA facility they choose for care. However, travel can only be authorized to the nearest facility that can provide the needed care. Therefore, should a veteran choose to go to another facility than that closest to his home, he or she is responsible for any costs beyond that for transportation to the closer facility. This includes mileage and special mode transportation. Mileage Determination Q: How do we determine mileage for reimbursement purposes? A: VA has not established use of a single reference. Mileage should be determined using authoritative guidance such as Rand McNally or Map Quest. Most references are available on line. P.O. Box Address Q: What if a veteran has a PO BOX and physically lives elsewhere? A: Beneficiary Travel is intended to assist veterans with transportation from their place of residence to the VA health care facility that can provide the needed care. Because of required implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) veterans now have the option of having their official mail sent to any place they choose. However, this does not imply that Travel should be paid from that point. Similarly, a veteran’s home address could be in another state but he or she is currently staying in the area. Therefore, Travel should not necessarily be paid from the distant address. In order to determine appropriate travel reimbursement it is necessary that a veteran establish a current place of residence. If there is any question as to this, a veteran can be asked to provide a bill, or some document establishing his or her address. Should a veteran refuse to provide this information, remember you are only authorized to provide travel to the closest VA facility that can provide the required care, not necessarily where the veteran chooses to seek care or treatment. In those cases should another VA facility be closer to the veteran’s “Home” address and that VA facility can provide the care then Travel reimbursement should only be to that point. $18 Deductible Q: Is the $18 per month deductible for each facility or does it pertain to travel to all VA facilities for health care? Who is required to pay the deductible? A: The $18 is the total monthly deductible amount for travel to all VA facilities. Therefore, should a veteran be going to multiple VA facilities, and the veteran notes this when applying for Travel reimbursement, it is incumbent upon the facility providing the care and travel to contact any other VA facilities to determine if the deductible has been met. The only exemptions to the deductible are; 1) Veterans traveling in conjunction with a C&P examination, 2) Non veteran donors, 3) Veterans requiring special mode transportation, and 4) When it is determined that the imposition of the deductible would cause a severe financial hardship All other eligible veterans, including those receiving care for SC conditions, are required to have the deductible applied. Facility Responsible for Travel Q: Which facility is responsible for travel when a veteran is referred to a Tertiary Care facility, or another facility that can provide the needed care on an outpatient basis? For inpatient treatment? What about veterans who do not meet eligibility criteria? A: For outpatient treatment the VA facility that is providing the care, or in the case of non-VA care the facility that authorizes the care, is responsible for arranging and providing travel to eligible veterans. Therefore, should a VA facility refer/consult a veteran to another VA facility for care, the second facility is responsible for providing travel, as they will be providing the care (as well as authorizing it). For non-VA (FEE Basis) care the VA facility that authorizes and pays for the treatment is responsible for travel. In the case of all outpatient care, including referral to another VA facility, the veteran has to meet eligibility requirements in order to receive travel at VA expense. Should a veteran not meet travel eligibility requirements, other sources such as the DAV network, inter-facility VA transportation networks, family and community resources should be explored. When it is necessary to transport an inpatient between VA facilities (Inter-facility Travel) the releasing/sending VA facility is responsible for travel. Therefore, the initial transportation will be the responsibility of the first facility, and return transport is the responsibility of second facility. The only exceptions to these rules are for certain VA Special programs such as transplant. Some of these programs require that the sending VA facility provide round trip transportation, both for inpatient and outpatient treatment. Community Nursing Home (CNH) Travel Q: Who is responsible for transport of veterans in a community nursing home in emergent situations? A: For veterans in a CNH at VA expense the placing VA facility is responsible for travel. Should a CNH veteran be placed in another VA (VISN or facility) Clinic of Jurisdiction (COJ) the initial placing facility will be responsible for travel (and CNH payment) for the first 90 days. After that time, the receiving COJ will be responsible for costs incurred, including travel for VA placement of the veteran. Veterans in a CNH at private expense must meet eligibility requirements for VA payment of non-VA emergency care as well as Beneficiary Travel in order to receive transport at VA expense. Emergency Transport Q: What authority does VA have to transport veterans in emergency situations? A: Transport from a VA facility to a community facility for emergency treatment: When a veteran develops an emergency while receiving care at a VA facility and the facility cannot provide the needed care, transport to a community provider and back to the VA facility can be authorized at VA expense. This is regardless of the veteran’s Beneficiary Travel eligibility. Transport from any point other than a VA facility to a community facility for emergency treatment: If the emergency episode of care is approved for VA payment, then transport from the point of emergency to the non-VA facility can be authorized at VA expense. However, once medically stabilized at the community provider the veteran must meet Beneficiary Travel administrative and medical eligibility criteria for further transportation at VA expense. Transport of Non-Veterans Q: Can VA pay for transport of an attendant, donor or other non-veteran? A: VA has authority to pay for transportation and associated incidental costs (lodging, food, etc.) at VA expense of certain non-veterans. 1) When it is clinically determined by a VA provider that due to the veterans mental or physical condition that an attendant is required when transporting the veteran. 2) When the non-veteran is the donor or potential donor of tissue, organ, or parts to a veteran receiving VA, or VA authorized non-VA health care. Lodging, Meals, Tolls Q: Is VA required to pay for lodging, tolls and other ancillary costs as part of authorized travel? A: VA may provide reimbursement for meals, lodging, tolls, and other incidental costs when appropriate. The need for such additional costs should be determined on a case-by-case basis, and based upon the veteran’s medical condition, distance required to travel, and any other extenuating circumstances. Reimbursement should not be provided solely because the veteran chooses to stop or take a less direct route to the VA facility. Transport to Other Than Home Address Q: Does VA have authority to transfer veterans to where they “grew up”, or where their family resides? A: VA has limited authority to provide travel for such requests. Only veterans receiving inpatient care at a VA facility, or non-VA facility at VA expense, in a terminal condition (estimated less than 6-months to live) can be transferred to a suitable health care facility in area other than where they lived upon entering the VA facility. In addition such transfer can occur only from one VA facility to another, or when VA is paying for care at a non-VA facility, and future care will be at VA expense. Veterans receiving care on an outpatient basis are not eligible for such transportation. Beneficiary Travel at Outlying VA Facilities Q: How should Beneficiary Travel at CBOCs or other outlying VA facilities be handled when there isn’t a Travel Office or agent cashier agent cashier on station? A: Each “parent” facility must develop local guidelines in order to provide Beneficiary Travel benefits to eligible veterans at remote facilities under their jurisdiction. These must include procedures to capture appropriate documents and signatures in order to meet the requirements of the Program as well as those of other involved Services such as Fiscal. Claims for Beneficiary Travel Q: How long do veterans have to submit a claim for travel? A: In accordance with Section II b of VA Form 3542, “Authorization to Report – Voucher for Mileage Allowance” claims for reimbursement for travel expenses must be received within 30 days of completion of travel or are forfeit. However, veterans can always submit an “unauthorized claim” for travel in accordance with 38 CFR 17.120. In these cases the veteran can submit a claim within the time frames noted in 38CFR 17.126, “Timely filing”. VA Authorities for Beneficiary Travel Q: What are the VA authorities for Beneficiary Travel, and where can copies be found? A: The following are current legislative, regulatory and VHA Manual guidelines for VA Beneficiary Travel and can be located at the web sites indicated: A) 38 United States Code (U.S.C.) 111, "Payments or allowances for beneficiary travel", http://www.gpoaccess.gov/ B) 38 Code of Federal Regulations (CFR) 17.143, "Transportation of claimants and beneficiaries"; 17.144, "Limitations"; 17.145, "Approval of unauthorized travel of claimants and beneficiaries"; and 17.1003, "Emergency transportation" (Mill Bill) http://www.gpoaccess.gov/ C) VHA Manual M-1, Part 1, Chapter 25, "Beneficiary Travel" http://vaww.va.gov/publ/direc/health/publi...ue&dir=desc Beneficiary Travel and Veteran Employees or Volunteers Q: Are veterans who work at a VA facility, and receive their care there eligible for Beneficiary Travel reimbursement when they have a medical appointment? What about Volunteers? A: Should a veteran take AL or SL for the entire day of their appointment then they are eligible for Beneficiary Travel reimbursement. However, should the veteran present to work and only take a period of time for their appointment then they are not eligible for reimbursement. Volunteers are not employees and are therefore eligible for Beneficiary travel reimbursement whether or not they volunteer on the same day as their appointment. Veterans Traveling Together or Who Take Non-pay Transportation Q: Are veterans who travel together all entitled to Beneficiary Travel reimbursement? What about those veterans who take the DAV system or other “free” transportation? A: Beneficiary Travel was authorized in order to help offset a veteran’s actual expenses in traveling to VA health care or treatment. Should one or more veterans travel together in a private vehicle only the owner of the vehicle is actually incurring expenses and therefore is the only person entitled to travel reimbursement. However, should multiple veterans share a vehicle such as a Taxi where they all must pay then all are entitled to travel reimbursement. Remember though that reimbursement cannot exceed actual expenses in such cases. Veterans who take non-pay transportation such DAV transportation, VA Network transportation systems or other no-cost city, state or area systems are not incurring cost and therefore are not entitled to Beneficiary Travel reimbursement. Source: http://www1.va.gov/CBO/docs/benetravelfaqs.pdf

February 25, 2005 M21-1, Part III Change 131 CHAPTER 4. REQUESTS FOR SERVICE RECORDS CONTENTS SUBCHAPTER I. SERVICE RECORDS MIGRATION http://www.warms.vba.va.gov/admin21/m21_1/part3/chg131.doc

Depart of Veterans Affairs Healthcare Network Network Memorandum no. 10n2-115-03 July 16,2003 NETWORK 2 STANDARDS FOR MEDICAL RECORD DOCUMENTATION

Families Under Stress An Assessment of Data, Theory, and Research on Marriage and Divorce in the Military http://www.rand.org/pubs/monographs/2007/RAND_MG599.pdf

Chapter Three: Possible Health Effects of Oil Fires http://www.rand.org/pubs/monograph_reports.../MR1018ch3.html

Profiting at the expense of disabled veterans is a DISGRACE!! ~Wings Thats very true Lady. It can also be deadly. I long for the research that shows how many Veterans have taken their life as a result of these thieves getting paid to deny their claims. I also long for stiff, enforced penalties and jail time for those with bloody hands like many of the QTC rating contractors. Seattle VARO, Bay Pines and St Petersburg VARO rating specialists and contracted IMO doctors need to have a close inspection of "PAST" decisions and medical opinions. After a veteran receives a favorable C&P medical examination with medical opinion stating on a more probable than not bases", the VARO rating specialists can scribble on a note to one of their staff "contract" consultants, that they couldn't get an answer to their questions. They will continue to obtain the IMO thats needed to deny your claim, while ignoring "any" favorable IMO's you produce. After seeing Psychologists for depression and going through an "outreach" clinic over several months, they sent me to QTC to be evaluated for PTSD. I don't believe Betty & I were in the office ten minutes when the QTC C&P examiner said," you don't have PTSD, thanks for coming". That was over ten years ago and I'm still dealing with PTSD symptoms. It's blood money. The death of every veteran that has died by suicide should be investigated to include the denial of their claims. If VA C&P examiners or QTC examiners falsely deny that veterans benefits, they are partially responsible for their death and should be charged with manslaughter. Allan

FWD: From: Michael Leon [mailto:maleon64@yahoo.com] Sent: Tuesday, November 13, 2007 12:26 PM To: Cc: Col Dan; Dan Cedusky Subject: "The VA's Claim Dodge: in The American Prospect Have a gander at this piece from The American Porspect http://www.prospect.org/cs/articles?articl...vas_claim_dodge The VA's Claim Dodge Beyond the awful conditions at Walter Reed hospital, something smells fishy in the government's handling of veterans' claims. One appalling case study suggests what might be happening and why. Deb Derrick | November 12, 2007 | web only http://www.prospect.org/cs/articles?articl...vas_claim_dodge The two signature injuries of the Iraq and Afghanistan wars are traumatic brain injury and post traumatic stress disorder (PTSD). An estimated 26,000 U.S. veterans from these wars have had their brains traumatized from nearby explosions. Another 45,000 have initiated post traumatic stress disorder claims at the Department of Veterans Affairs (VA). These claims concern real disabilities that are medically hard to prove. In each VA case, it is up to the military and the Department of Veterans' Affairs to decide if and how much any given soldier's mental faculties have been impaired. These are also precisely the kinds of claims that the U.S. government has actively thwarted in the past -- and recent news and health articles suggest that a repeat performance is underway. The Defense Department is being accused of under-funding studies of traumatic brain injuries. The VA and Defense Departments are refusing to make their brain injury data public. Current PTSD claimants are finding their medical and service records missing, lost, or subject to challenge. A class action lawsuit was recently initiated on behalf of PTSD claimants. My recent investigation on the VA claims of a Navy waste disposal ship, the USS Calhoun County, provides a cautionary tale about what might be happening and why. Harvey Ray Lucas served in the late 1950s on the USS Calhoun County, a low-ranking Navy ship whose primary mission was to dump atomic and other military waste into the Atlantic Ocean. Lucas spent four years heaving radioactive materials over the side of the ship. After leaving the military, he suffered from chronic health problems and sired five children with birth defects. Lucas's testimony made my jaw drop. He described one baby whose skin oozed "bloodwater." He described the birth and death of another whom physicians termed an "anencephalic female monster." A couple years after his testimony, Lucas died of a rare cancer associated with radiation exposure. I came across Lucas's story in 1998, when I worked in a U.S. Congressional office and read the transcript of his Board of Veterans Appeals hearing. Lucas's widow, Barbara, and my boss, Congressman David Skaggs (D-Colo.), both felt that Harvey Lucas and his family's illnesses stemmed from radiation exposure in the Navy. But Barbara Lucas had been pursuing a compensation claim with the VA for 18 years without success. The VA always seemed to need more or different evidence. When our office dug up a key final document and Barbara prevailed, I decided to write a book about the USS Calhoun County and her VA claim. Deck logs and interviews with the ship's sailors, officers, and scientists suggested that the USS Calhoun County had carried excessively radioactive material and that the ship's decks had been contaminated. When I discovered a number of other sailors had experienced odd health problems, I broadened my inquiry to look at the VA cases of other USS Calhoun County veterans. I interviewed Deane Horne, whose teeth and hair had fallen out after he left the ship and whose eldest son was born without a femur. I interviewed Richard Tkaczyk, who had also lost his teeth and whose first born son had seizures and brain damage. I interviewed George Albernaz, who was half paralyzed after suffering from an odd brain disease that his physician called radiation necrosis. All had filed claims with the VA. None had made any headway. In all cases, the VA began the claims process by asserting that there was no proof that the USS Calhoun County had even carried atomic waste -- even though there was ample evidence of the ship's mission in public federal archives. In all cases, the Navy forwarded personnel files to the VA that were missing a key radiation exposure document. The treatment of these men's claims echoed what had happened with the Lucas claim. It was also entirely consistent with a vastly discouraging history of the VA's handling of hard-to-prove claims, including radiation, asbestos, Agent Orange, Gulf War Syndrome, and PTSD-based injuries. All such cases were and are handled centrally out of a special office in VA headquarters. All required Congressional or court intervention to force the VA to grant claims. In the case of radiation-based claims, the military was found omitting incriminating documents from veterans' databases; veterans' documents were destroyed in a huge and mysterious fire at a military personnel records facility; the VA was found hiding and shredding more veterans' evidence; and whistleblowers were subjected to death threats and workplace retaliation. As I unearthed this information, I was drawn into providing evidence for the claims of several USS Calhoun County veterans. In particular, I began helping George Albernaz, who had served with Lucas on the ship between 1957 and 1958. To verify his claim, I sent the VA data on the ship's atomic loads, noting that my information came from deck logs in the National Archives. The VA called my information unsubstantiated. I sent Navy documentation on them. The Navy and the VA said that they still had no proof that Albernaz himself had ever been exposed to radiation. I sent information from the Lucas claim that challenged such "zero dose" exposure estimates. It was deemed irrelevant. Looking for more evidence on Albernaz's behalf, I dug deeper in the ship's administrative archives. I came across a memo to the ship's Commanding Officer from 1956, indicating that the deck of the USS Calhoun County had become radiologically contaminated. I found another from 1958 stating that all attempts to remove the contamination had failed. But my breath failed me when I read a final memo from 1962, stating that the Navy had never, in its history, been able to render such a ship safe for use and recommending that the USS Calhoun County be sunk. If I thought that such evidence would help win the Albernaz case, however, I was quite mistaken. Albernaz and I submitted the incriminating documents between 2005 and 2007. Yet the VA omitted the documents from the "evidence of record;" the Navy re-asserted that they had no proof of Albernaz's exposure but that he'd likely only received safe doses; and the VA continued to take the Navy at its word. As of this month, the VA was demanding a long list of additional evidence to support Albernaz's claim -- much of which he and I had already submitted. The treatment of these sailors exposes a U.S. veterans' claims adjudication system that enshrines military-produced evidence as the only "objective" arbiter of claims, even when there is ample reason to doubt it. Evidence -- even documents from the National Archives -- produced by the likes of Harvey Lucas and George Albernaz is viewed and treated as potentially fraudulent. And far from making any attempt to validate or verify claims through databases, "buddy statements," or consolidated claims reviews, the VA actively dismisses their compatriots' evidence as "irrelevant" to their claims. In sum, the veterans are treated as liars, told to prove their own cases to the government, and subject to having credible evidence dismissed when it contradicts military assertions. Americans are now becoming increasingly concerned with the treatment of Iraq and Afghanistan war veterans, and they ought to be. Because unless the U.S. revamps its veterans claims system to allow for decisions made independently of the U.S. military, we are headed for another series of large VA scandals. "Keep on, Keepin' on" Dan Cedusky, Champaign IL "Colonel Dan" See my web site at: http://www.angelfire.com/il2/VeteranIssues/

fwd from Colonel Dan http://www.bluewaternavy.org/ http://www.vnvets.blogspot.com/ contact your Congressman & Senator -------------------------------------------------------------------------------- From: LRUSMC@aol.com [mailto:LRUSMC@aol.com] Sent: Monday, November 12, 2007 9:20 AM To: LRUSMC@aol.com ------------- "Therefore I say; know the enemy and know yourself; in a hundred battles you will never be in peril. When you are ignorant of the enemy but know yourself, your chances of winning or losing are equal. If ignorant both of your enemy and of yourself, you are certain in every battle to be in peril." ~~ Sun Tzu -------------------------------------------------------------------------------- An editorial from our friends at BlueWaterNavy.org (with which I totally agree!!) -------------------------------------------------------------------------------- Say NO!! to the Peake Nomination -------------------------------------------------------------------------------- I believe there is NO POSSIBLE WAY, on God's green Earth, that anyone could possibly look at James Peake's background and not conclude that his nomination and possible appointment as Secretary of the Department of Veterans Affairs is anything but pure, unadulterated corruption and cronyism at its very worst. I don't know the man. I don't care to. All I need to do is to look at his personal and business relationships with Anthony Principi, and the company QTC Management, Inc. and I am absolutely certain that his appointment to a public office that deals with veteran health care is absolutely absurd and very probably illegal. It is at least one of the most blatantly unethical appointments that George Bush has attempted to date. This man has served right along side one of the most questionable personalities to ever have held a cabinet post, Anthony Principi. The mere mention of that name sends many veterans' blood boiling and reminds us that dishonesty pays ... and pays BIG. Let me relate a little history. One of the first personalities to begin the severe decline in veteran services by the Department of Veteran Affairs was Anthony Prinicipi. The VA budgets and operations fell apart on Principi's watch. Principi was Chairman of the Board of QTC, a medical services company, prior to his appointment as Secretary of Veterans Affairs. While holding that high government office, QTC was awarded billions of dollars worth of medical contracts by the Department of Veterans Affairs. That in itself should have sent up red flags so high that the man should have been strung up the day those agreements were signed. After leaving the office of Secretary of the Department of Veterans Affairs, Anthony Principi returned to QTC as Chairman of the Board, to enjoy the business of living out some of the most lucrative government contracts for outsourced medical services in the history of this country. Once again, the man wasn't arrested and jailed for his actions. That was and still is an appalling miscarriage of justice. There was what is deemed to have been a thorough investigation of the actions of Principi and his end rewards by government agencies, but no wrongdoings were found. Funny there wasn't a third part investigation service involved. Sitting on the Board of Directors of QTC is our new player in this game, James Peake. Sometimes I might dress funny, or miss a joke, but I honestly believe I'm not a stupid man. And if I am, I'm not blind. When I see a possible "should be" felon running a company that thrives on what in my humble opinion are blatantly illegal contracts with the US Government, and I see sitting next to him a man who is in a position to know the intricate details of the fleecing of public funds, I understandably conclude that this duo is complicit in these alleged crimes. To have the sheer gall and absurd misconception of immunity from prosecution as to attempt to appoint a known associate with one of the possibly most scrupulous and scandalous of thieves of this new century, is blind idiocy, pure and simple. It makes one wonder if perhaps the personage or Office of the President is getting some kick-back for making these two gentlemen fat and rich at the expense of public funds. Actually, the payback is probably through the Party Committee connections. This one is so easily spotted that George Bush needs to see his shrink. The American public needs to stand on their roof tops and shout "Enough is Enough!!" But all this information will be hidden during the confirmation hearings, I'll wager. A search under 'QTC' on the VAWatchDog.org web site will confirm all this information and provide additional eyebrow-raising information on the alleged corruption that has plagued the Department of Veterans Affairs while Principi was associated with it. Web site listing the Board of Directors of QTC Management, Inc is at http://www.qtcm.com/general/about/board.asp

Fwd from Mike, Hello All, This does not bode well. Especially on Veterans Day: http://blogs.abcnews.com/theblotter/2007/1...ng-to-serv.html Here is the "Report Card": http://abcnews.go.com/images/Blotter/chari...d_v3_071109.pdf May you all enjoy a relaxing Veterans Day. You all earned it and I'm still proud to have served with you. Warm Regards, Mike Harris

Flatbroke, call the C&P dept and let them know, both appointments need to be scheduled on the same day in the, "afternoon" because of the distance needed to travel. Also inform them if this can't be arranged, the C&P dept will need to set up food & lodging & travel arrangements for you and spouse the night before your appointment & every day you need to stay. This must be set up at least a week in advance. Some local VAMC's may want to set this up as a "reembursement". It's my understanding that the C&P dept must arrange this in advance.

VBA WARMS Site Map (U.S. Department of Veterans Affairs) http://www.warms.vba.va.gov/TOCindex.htm

e-CFR Data is current as of November 5, 2007 http://ecfr.gpoaccess.gov/cgi/t/text/text-...38/38tab_02.tpl

"Do any of you have reps who can actually access the internet?" On the VBN board you may find a few. Some come to hadit.com for answers as well. In general, I would say few know what a directive is, let alone up to date USC's CFR's or M-manuals.