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SA_oatmeal

Seaman
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Everything posted by SA_oatmeal

  1. Possibly not of use to OP, but in ref to the above quote from broncovet, I can say that I have recently (Feb) had VA fill a prescrip written & submitted by civ/non-VA doctor. It was my new pcp and the appt authorization was made through what remains of the Choice program. The doctor's office faxed the prescrip order, appt. summary, and Choice authorization documentation to the Regional VHA pharmacy, and in a few weeks the prescrip came in the mail. Though more likely than not the above wouldn't hold true if not for the doctor's appt. being authorized by/through Choice.
  2. In anyone's experience in preceding a formal claim submission with an Intent To File notification, does CFR 20.305 (Computation of Time Limit for Filing) rule apply to the Intent To File process timeframe requirements for completed claim award effective date? ------- My scenario: On 8/06/2015 (Thursday) my Intent To File notification was received/logged online by VA via eBenefits. The next month my mother was hospitalised by coma and died at end of month. For several months afterwards, I did nothing with the claim. During July 2016 I completed the claim in eBenefits but could not submit for system errors over 2+ weeks of attempts (as Support Desk advised they only assisted with access to eBenefits and not any problems using it). 1-2 days before Intent To File expiry, I recreated the claim via paper form and was forced to mail it out via USPS the morning of Intent To File expiry. As a result of inquiring with VA personnel at both the regional hospital and attached CBOC, as well as via 800-827-1000, and being informed that VA would adhere to postmark date for preserving Intent To File effective date, I paid an extra fee to guarantee USPS postmark the submittal that morning (Saturday 8/06/2016) and cause issue of postmark verification document. The completed claim form was received by VA on 8/09/2016. After retention of legal representative, VA awarded me benefits for a portion of my claim's conditions (the remainder of the claim being still in Appeal) with effective date of 8/09/2016, the day they received my mailed claim submittal. If Intent To File timeframe requirement is exempt from Rule 305, then, since my mailed claim submittal wasn't received until 3 days past Intent To File expiration, my effective date is correct as presented. If Rule 305's Time Limit Computation directives DO apply to the Intent To File process, then my effective date should be nearly a full year earlier than was presented, to encompass the Intent To File's preserved receipt/initiated date of 8/06/2015. My lawyer, upon a cursory review of the information I just related above, is of the INITIAL opinion that the VA's presentation of effective date is NOT challengable due to the Intent To File process being exempt from Rule 305. This is based partly on the word choice* that frames the Intent To File process description (in at least one place, though not consistently in what documentation** of the process that I have been able to reference). Please ask away if more information is felt necessary, and I will further furnish what I can. * "received within 1 year" ... rather than "filed" or "submitted" (as with Rule 305 employing " filed within a specified period of time") ** https://www.benefits.va.gov/BENEFITS/factsheets/general/ITF.pdf
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