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Richard1954
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Posts posted by Richard1954
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1 hour ago, Grumpbox said:
@Richard1954 Richard - fill me in on all should know about Medicare, please Sir??
Lets say I do this...apply for SSD. Naturally, I will lose my Tricare.
Question 1. I assume my daughter who is under 18 and wife can continue to remain on Tricare? But I will have to start Medicare, which comes out of my social security disability. The social security office told me this amount was about $134.00. However, I researched the Medicare.com site and this is for Medicare Part B. The entire Medicare program is a conundrum to me.
Then there is drug coverage? But can't I continue to receive this through the VA?
You will not lose tricare, For you it will become Tricare for LIfe, your family cost for tricare continue for you it will be free if and only if you take Medicare. Part A Medicare is free, Part B is outpatient care , and everyone pays for it out of social security benefits. You can continue to receive medical care from the VA, the Military on base, or use Medicare and Tricare off base. So you will actually have three way to get care, and your family will still have on base. or tricare of base. I have paid for Medicare part B since 1999, Tricare and Medicare pay for my portable oxygen concentrator and a stationary concentrator plus supplies each month with no copay's. I use VA for some care and I use the Army Medical Center for same day appointments ,or emergencies. I only pay for Medicare part B.. it is well worth the cost.
ADDED: You have to take Medicare Part B to keep your family's and your Tricare benefits, but you will only pay for tricare for the wife and kids.
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Grump,
You do Not want to waste any monies on a Lawyer! With all you medical conditions and armed with your medical records, as well as your VA ratings, you will very likely be able to get SSD on your own. I can't figure out why you would wait to apply for a benefit that you are clearly eligible for. Let me recommend that you first apply yourself, supply all the information they need to award SSD. If they deny you then think about a Lawyer and the appeal.. it is not impossible to get SSD with out a Lawyer, I did it myself.
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On 4/26/2018 at 3:51 PM, Grumpbox said:
Hey folks...I wasn’t sure where to put this, so here goes.
I guess this year, Tricare made some changes. My total pay out is now $3,000.00 before Tricare Insurance starts to kick in.
I am 100% P&T but don’t live close to a VA facility; plus, I have my daughter (16) and wife on my insurance. These amounts are piling up!!! I called Tricare and they said it doesn’t matter if I am 100% P&T.
Can anyone provide me with some advice. I’ve got all the Tricare numbers/website, but is there something I am missing being 100% P&T that I am overlooking that could offset these mounting bills???
Many thanks!!
Grumpbox
Since you have tricare, you must be retired. Since you are 100%, I assume you are also on Social Security Disability, and are paying for Medicare. If you have both Medicare and Tricare, you should not be paying any copays.
I am retired since 1999, I am also on social security with Medicare, ( you have to take Medicare or you lose tricare) ... I have never paid a co-pay....
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I was offered ramp, an attorney told me to stay away, they do not know what they are doing and those offered the early chance are guinea pigs. And if you have more than one issue pending, you can't decide to do just one issue, its all or none, Now no one knows how this new system will work, doesn't it make sense to stay with the system you know. Heck, the va makes so many mistakes, and ramp is going to be a mess for a while to come. One thing for sure just because they have a new system doesn't mean it will be quicker. Really, how many time has the va told us things will get better...
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On 4/26/2018 at 11:33 AM, Galen Rogers said:
I may be wrong in my assumptions on what requesting to re-open my OSA claim due to new evidence being available. If i did only that and not for reason of a CUE, would my effective date if approved be retro to 2008 or the date of the claim re-opening?
Unless you get a CUE approved, you would not get retro back to 2008. You only have a year to appeal so appealing wound not work either.
If you reopen the claim, it will automatically be a new claim even if you did not have new evidence and you would only get paid from the date of the new claim
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Ok.... is it possible to get a sleep apnea approved even if nothing is in your active records... YES I am living proof it is possible. You had more in your active records than I had in mine, I had nothing. I got out of service in 1986, I got sleep apnea rating last April.
1. You have to have a present diagnosis
2.You need too speak with a doctor and ask for an independent medical opinion but only after he/she reviews all your medical records
3. Do research to see if your service connected conditions can cause sleep apnea you will be surprised what causes sleep apnea.
4. When you get a C/P tell the doctors why you think you had apnea in service, some will listen my c/p doctor did. ( I told them what my buddies and later wife said about my sleeping)
5. The va must consider all medical evidence you submit even those you find on the internet, but if you don't have a current diagnosis and IMO, your get stuck with a c/p doctors opinion.
6. You have to look at the va claim like an insurance claim, the C/P doctors work for the insurance company, don't be caught without and IMO from your own doctor it makes it to easy to get a denial. This applies to almost any claim after the initial claim.
7. The trick is to have all the information available so that they cannot deny your claim.
Just because your overweight doesn't mean it caused apnea, ( I'm 150 overweight, my weight was never mentioned in the c/p exam but that's another story)
Check out this web page this guy wrote my IMO for my case... its expensive ( 1500) but in the end worth it.
he also wrote a book about apnea its on amazon.com
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I remember wondering years ago if my rating would ever increase from what it was to what it is now. I would ask people who's job it was to advise people about benefits. The one constant thing I heard was don't ask for an increase unless your willing to take a reduced rating... what I said, and was told yes the va is more likely to review all your issues and reduce your rating... So you know what I did.. I did exactly the opposite. ( I could write a book about all the actions I took to get my rating to where it is.. but no one really cares about it but me)... so my answer to you would be... if its important enough for your to raise the question then its important enough to request an increase. If you can't do it yourself seek out a lawyer ( most only get paid if you win) , or a good advocate. Best of luck to you...
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I took a look at the petition.... I would love to sign it but, I cannot agree that the way disabilities are combined are unfair. There are many ratings in the guidelines that seem unfair.
For veterans, with Sleep apnea in certain instances never actually receive a rating even though they are service connected. IE; Veterans with asthma/copd/sleep apnea can only be rated once under the guidelines , but sleep apnea is not a respiratory disease and when this is challenged at the court, the court defers to the Secretary saying they cannot over ride the secretary on this matter. And it is almost impossible to consideration for extra scheduler relief. Is it fair for veterans with one or more actual respiratory disease along with sleep apnea to only get one rating ... no its not...
Also it isn't fair that the va does not apply bradley v peak retroactively they made the mistake not the veteran, but they will still deny retroactive payments....
I think many veterans that are rated 100% based on just one disability are getting screwed. For example, some veterans could have many ratings that add up to 200-300 but one of the ratings is 100% alone. They don't get compensation for the other ratings except by means of an smc.
I honestly don't know how the va determined what a person rated 50% should get, but it certainly wasn't based on what someone rated 100% gets... I would be interested to know how they came to the dollar amounts.
I can also tell you that allowing only post 911 veterans the care giver benefit is unfair also.
There are many things unfair about the compensation system but I don't think it has anything to do with the way ratings are combined..
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On 10/2/2016 at 5:09 PM, john999 said:
I developed sleep apnea after I was service connected for DMII. Do you think there is any medical evidence that a lawyer could use to make a connection, so I could get the OSA as secondary to DMII? I know I will need strong medical opinions and a strong argument to do this. I have found most doctor very reluctant to make these sorts of connections. They are only interested in doing sleep studies and getting you a CPAP. Is there a lawyer here that has worked with these kinds of cases who could advise me? I know it takes money to prime the pump on these sorts of cases.
just noticed date of thread is over a year ago
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On 4/26/2018 at 12:17 PM, marina53 said:
BVA website states they are now adjudicating cases with docket numbers to veteran law judges with docket numbers up to May 2015. My case was January 2015 and I still have not heard anything. How long does it take to get a docket number and how will they let me know that I have one? Thanks.
This is a good question, I just had a BVA video conference on 29 Apr, and to this date even after asking, I do not have a docket number. My case originated exactly 10 years ago.
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On 4/23/2018 at 12:20 PM, andrewdc said:
My nuerologidt submitted letter that memory disorders more than Likely caused by my copd and sleep apnea. If awarded 100% for mental would I be granted l or s
I just reread what you stated... yes this is very possible
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Broncovet,
Ironically, in my case the newer OGC placed limitations on who could be rated Housebound.
No I have not appealed the effective date for A&A. I was not eligible for A&A until I received my 100% award and then received A&A at the same time because of a statement my VA doctor wrote and placed in my medical records. In the end I was awarded A&A at the L 1/2 due to having a separate disability rated 50% or more.
I am working on another claim that if approved will result in an increase step award under A&A. But that is for another day.
thanks again for your information.
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3 hours ago, Berta said:
Thanks for clarifying that.
I too searched the BVA web site and found nothing based on your question.
However if you received SSDI solely for the TDIU condition in that time frame 2001-2007, and the VA was aware of that SSDI award- it sure could have been a CUE if they should have awarded 100% based on the SSDI award during that time frame.
I appreciate the response. Let me try to clarify what happened.
I was granted TDIU in 1998 for a single condition that was rated 60%. In 2001 another separate rating was increased to 60%. Unknown to me at that time I should have been considered for Housebound, but housebound was never considered. . In 2007, the separate 60% rating was increased to 100%, the TDIU was revoked, (even though it was for a different condition other than the 100& rating) , and I was awarded A&A. In 2008, along comes the Bradley v Peake decision. After my do diligence learning about housebound, and the rules and regulations that governs the awarding of Housebound and I had learned all I could about Housebound, General Counsel Opinions, and the regulations, I made a decision to claim CUE on the 2001 decision because the record shows no consideration to award Housebound. My argument was based on the use of the GCO 6-99 dated 7 Jun 1999, as the reasoning for not considering Housebound. Its a simple argument, the VA had two general Counsel Precedence Opinions in effect at the same time and they contradicted each other. One was General Counsel Opinion 2-94 the other 6-99. The 2-94 was in agreement with 1114(s) indicating a TDIU could be used as the basic for award of Housebound, the 6-99 contradicted with 1114(s) and indicated TDIU could not be used for Housebound. At no time since the 6-99 opinion was published did the VA take into consideration that in was in conflict with the 1141 (s) and the other 2-94 opinion. Therefor, how could the VA make a valid decision knowing they had conflicting general counsel opinions and did nothing to fix the issue. It was not until the Bradley v Peake decision was published and the court ruled that the 2-99 opinion was invalid, that the va revoked the 6-99 opinion, leaving in place the 2-94 opinion and 1114 (s). So my cue argument is based on these facts and non-consideration of Housebound at the time it should have been awarded. If my argument was solely based on Bradley v Peake, the regional office and the BVA would rule that Bradley v Peake does not allow for retro awards based on the decision, and the Cue would be denied using the reason that ", the decision (2001) was based on the laws in effect at that time". Of course this was the reason the Regional Office used in the end to deny me the CUE. When I made my argument via video conference to the BVA, the Judge mentioned that he was impressed with my argument, and he would give it due consideration. Now, my argument is not saying anything new, in fact my argument comes directly from the Bradley V Peake ruling it just leaves all the BS out and makes it easier to understand. Rater than to CUE based on Bradley v Peake, I claimed CUE based on the GCO 6-99 which conflicted with the regulation. It seems to me, if I can prove my argument to the BVA without actually claiming Bradley v peake, that I will have a better chance to win the claim. But the minute I claim CUE based solely on Bradley v Peake, they va will say that any award date would be 8 Nov 2009 the date the Bradley v Peake decision was made. In my case an award date of 8 Nov 2009 would not help me in any way because in 2007 I was awarded A&A and I am arguing for a date from 2001 - 2007 as the dates I should of had Housebound.. Hope this makes it easier to understand.
Again I wasn't looking for any opinion on how to get an award of Housebound, just wondering if anyone had ever won a cue claim based on the above outline or Bradley v Peake or does anyone know of a case.
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1 hour ago, Berta said:
Richard -you do realize (I hope) that A &A encompasses HB.
A vet with A & A is obviously Housebound but A & A as far as I know is rated higher that SMC S-I could be wrong-----
The VA will not award both at the same time....at least not as far as I know------
Yes I am well aware thatA&A is a higher benefit that Housebound, and you can not have both Housebound and A&A at the same time.
My claim is for housebound for the time period 2001 thru 2007. This was for a period of time that I was rated TDIU for one disability and had an additional disability rated 60%.
I received A&A from 2007 thru the Present due to a 100% rating and a separate 50% rating ( L 1/2)
I was never awarded Housebound, and it does not appear by the record that it was ever considered during the period in question.
My question was only that: Does anyone know of any case were the BVA awarded housebound based on a cue argument due to Bradley v Peake as I could not find one case when I looked.
I will have my answer from the BVA within the next 3 months.
Thank you for your input.
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1 hour ago, broncovet said:
You wont be able to allege that VA violated a regulation that had not occurred yet. VA may have violated regulations, but they cant violate those regulations which have not yet become law.
To allege Cue, you must cite the specific regulation VA violated.
Actually I can clam CUE ( proving it is the hard part) and did because VA had two General Counsel Precedence's in place that conflicted with each other, and the newer one which was not in line with the regulations was used as the basic of denial. After bradley v peak was decided the va revoked The General Counsel Precedence (GCO) that was in conflict with the regulations and left the older GCO in place along with the regulations. So the VA was in fact violating it own regulations by using a poorly conceived General Counsel opinion to deny Housebound. By your reading, since no CUE existed, there would be no way to get retro for the time period I mentioned.
Anyway I am not asking anyone how to appeal the denial, the appeal has already been done, and the BVA conference is done, so this discussion is moot in that regard. . All I am really asking is if anyone has seen housebound awarded based on CUE in light of Bradley v Peake decision. I am just inpatient waiting for word from the BVA and curious if anyone knows of such a case.
Thank you
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26 minutes ago, broncovet said:
But with SMC S (housebound) your effective date is the date you became eligible
Sorry, but your recommendation would only work if I was talking about an award for a date after Bradly v Peake became the law of the land. In order for me to get a retro award (2001-2007) I have to show that the VA made a mistake, or never considered it to begin with. From all that I have read, the only people getting retro Housebound under Bradley v Peake are those that had a claim pending when the Bradley decision was made ( NOV 2008). If a claim is generated after Bradley V Peake was decided then the effective date is no earlier Nov 2008, or when the veteran become eligible. It would do me no good to claim Housebound from 2008 because in 2007 I was awarded A&A and a 100% rating.
The regional office already indicated my claim was moot, because I was entitled to A&A in 2007, and the Bradley decision only effected claims that were already in the system and not retroactively.
I appealed it to the BVA in hopes that the BVA Judge is more understanding to my argument.
I was just trying to find out if anyone knows of a decision from the BVA for a retroactive Housebound award based on CUE and citing Bradley v Peake as the reasoning.
There are numerous awards at the BVA level but everyone that I have found concerned a claim that was already in the system pending adjudication( Before Nov 2008) many have retro awards back years prior to Bradley, but only because the claim was already in the system.
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Can anyone tell me if they know of any awards based on CUE for Housebound under the Bradley v Peake ruling?
I submitted my CUE indicating that the VA never considered Housebound based on my TDIU for a single issue and a separate 60% rating
I argued to the BVA on the 20 Apr 2018 that because two separate Gen Counsel Opinions were in effect (and conflicted with each other, ) at the time of my TDIU award, that Housebound was not considered.
The BVA Judge seemed to be intrigued with my argument, and even indicated it was a well though out appeal.
I know the argument being used by the VA is that the change in interpretation of a law does not allow retro compensation base on the bradley v peake decision, unless you have had the claim in prior to the Bradley decision
Those of you familiar with Bradley v Peake know that the VA tossed out Gen Counsel Opinion 6-99 but kept the GCO # 2-94 and the regulations in place. I argued because the va had two conflicting opinions, that Housebound was never considered resulting in a CUE
Of course the Regional Office denied the appeal because they said the change in interpretation of a law does not allow retro compensation, and therefor there is no cue.
Thank you for and response
Tricare New Changes cost WAY MORE!!
in CHAMPVA
Posted
You have to sign up for Medicare Part B, Part A is automatically Free