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Diamondrichlb
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Posts posted by Diamondrichlb
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2 hours ago, Buck52 said:
Diamondrichlb quoted
''I am looking for input from people like you - not for how to do the process, t hank you - but to confirm you have been reimbursed by the VA for travel WITHOUT pre-authorization from the VA for that travel. Thus showing that authorization from TriWest is actually authorization for travel and reimbursement for travel from the VA.''
Yes what I did was get a letter from my tri west ..>appointed private Healthcare Dr before I left I mention to them I needed it to get my travel pay from the VA that stated he has treated me and currently treating me for my Dupuytrens contraction on my left hand on date **-**-**** & The Dr signed it..I attache a copy of this to my travel pay voucher and took it to my Travel Pay office at my VAMC, I ask the travel pay clerk about the Authorization and she said yes this is all I need she would submit it for me...now this is the first one I submitted to the VA and will need to wait check my next month bank statement to see if its on there..but the VA travel pay said I had everything they need and I did ask about the authorization from the VA is she said yes its defiantly an approval because VA is the ones that called Tri West.
Again the way it works for your authorization travel pay
1. You get approved by the VA mission act Personal....once your approved VA calls tri west they give this information to them about you what is your health care problem whatever you need to see the private Dr for?) you tell them...then they search for a Dr in your Area or closes to your home and the(these tri west health care) and these private health care Dr office personal calls you to set up the Appointment...your travel pay is already authorized at this point.
Thank you.
What you describe is not what happens with me or did happen before the reshuffle to Community Care this year. Due to the fact I - and other veterans - live in Hawaii I could chose the Veterans Choice Plan. Once I choose that plan, I did not have to contact the VA at all. I could see any doctor anywhere just by calling TriWest. I could call TriWest to tell them I already had an appointment set up and they would send authorization - as long as the provider accepted VA insurance - or I could ask TriWest to setup the appointment at such and such provider. Now, with the change to Community Care, I have to call VA to request treatment, they authorize TriWest and TriWest does what they did before the change this year.
So, last year when diagnosed with prostate cancer by a local provider I chose to go to MD Anderson Cancer Clinic in Houston for treatment. They accept VA insurance and the surgeon there is one of the best. When facing the chance of wearing a diaper for the rest of my life or not, I thought going to one of the best was the thing to do. And it has paid off.
You mention the VHA Handbook 1602(b)50VHA Handbook 1602(b)50 in another response. That is what the local VA office brought up to dispute my travel reimbursement request. The Handbook states I need to obtain permission before traveling.
Since at the time in question, I did not have to ask VA for permission for treatment and was using the Veterans Choice Plan thru TriWest, I maintain, the authorization from TriWest is all the permission I needed to travel. Otherwise, how do I receive treatment? TriWest was acting as the VA's agent at the time hence contacting VA was not necessary.
The VA travel office is not in agreement.
As an odd side note, they did pay me per diem (although I think incorrectly) which they say they are going to demand I return, but have not made the demand yet. So, somebody somewhere thought I was entitled. Hmmmm......
Any other thoughts you or anyone else might have will be greatly appreciated.
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Oh, absolutely. I will keep you updated as I move along this path. Thank you for all the help and suggestions.
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No point really. When I talked to my roommate he mentioned I could look on my 759 to make sure of the date of the incident. I don't think I really need to do that as I have the 600 form with the date.
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Great! I just sent an email to the contact I have at Awards Branch to see if my roommate's email address will work to send the document or if he must use USPS.
On another note, my 759 forms do not show any of my flying in Vietnam/Thailand. The total number of hours is about right, but no individual dates until I returned stateside. My roommate says his 759 shows his flights and he was in my unit. My hours when I attended Rotary Wing qualification course and subsequent flights are shown, but as mentioned that was stateside.
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Yes, he saw my injuries.
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I just heard from my roommate during the time this happened. He remembers the incident, the holes in the aircraft, and the injuries to my leg. He has offered to write a letter on my behalf. Surely, that will help.
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Hmmmm......if I could get a unit roster from the other unit taking over the mission I might be able to recognize the name. There could not have been that many 1st Lt. pilots in the unit. Most of the pilots were CW-2 or Captains.
Can I request the unit records from a unit I was not a member of? And can I ask for just certain parts of the Unit records like the roster?
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16 minutes ago, Buck52 said:
I have used tri west health care approved from the VA tri care sits up the place for you to call and make an appointment, you need something from the private provider to show you were treated by the private provider...and attach it to your travel pay voucher. mainly your address and the private health care provider so they can caulate the milage..and don't for get to date it and sign it thats all I had to do.
if they said no then check with your travel pay office and ask why?
Thank you. I have provided all documentation needed. VA has acknowledged I traveled and was treated. Calculating mileage and per diem is not an issue. Simple math.
The issue is this. The VA here says in order for me to be reimbursed for travel I had to obtain approval from the VA (not TriWest) in advance - before I traveled. The VA here says TriWest authorization for treatment at an outside clinic/hospital/doctor does not constitute authorization for travel. If it is not authorization for travel it is not authorization for reimbursement for travel.
I am looking for input from people like you - not for how to do the process, thank you - but to confirm you have been reimbursed by the VA for travel WITHOUT pre-authorization from the VA for that travel. Thus showing that authorization from TriWest is actually authorization for travel and reimbursement for travel from the VA.
Keep in mind I live in Hawaii. Travel can be expensive when authorized to go to the mainland. They do not want to pay. I'm going to appeal to a higher power, but would like to know I'm barking up the right tree.
Thanks for your help. Please let me know if I need to restate the issue.
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Hi GBArmy, Yes, I am under no false hope that the Awards Branch is just going to hand me my Purple Heart after this current step. While the letter and clinic documents are genuine and real, it would be too easy if they took that as the total package. Life is hardly ever like that.
My platoon leader at the time has died. He was the one who took me to the clinic.
I can get a buddy letter from my roommate at the time.
It would be great to find the 1st Lt who was in the right seat, but I have no idea how to go about that. I don't know his name and he was from another unit.
There were only 4 of us Army pilots in the Unit at any one time as we were TDY to an Air Force base.
My records don't show the TDY orders. Someone told me the TDY orders would be in the Company records. If true, my TDY orders as well as the 1st Lt. TDY orders from the other unit would be in his Unit records. Is it possible to obtain Company records?
There were holes in both wings and the cockpit and damage to the equipment in the cockpit that was hit. Do you know of any way to get maintenance records for the aircraft from that long ago? That could at least show it happened.
Any suggestions from anyone who has gone thru this process will be greatly appreciated.
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8 hours ago, Buck52 said:
OF YOU GET APPROVAL FROM TRI WEST TO GO TO YOUR OUTSIDE CARE FACILITY , JUST GET A POINT OF CONTACT FROM THE Dr that treats you ask the girls in the Dr office just let them know you need something from the Dr signed that says he is treating you or had treated you on the date your appointment...then go home and print out the travel pay voucher 10-3542 sign it and attach your Dr's contact report to it ( make copies) then take it up to your travel pay window have them to send it in if your direct deposit then no problem , thats what I do...if they give you cash at the window ...I am not sure./..then you ask the travel pay clerk. about that...as long as your approved by tri west because VA contacts them and they contact you.
if you have no way to print the 10-3542 then pick you up some from your travel pay office.
Good Luck with it.
Good morning,
I'm not asking about the process nor the paperwork. I know the form. The process is not the problem. There is no question if I was treated. There is no need for anything from my doctor.
The question that needs answered is whether an authorization from TriWest for treatment is an authorization to travel to the treatment and have the VA reimburse the veteran for the travel. Or, does the Veteran need additional authorization from the VA for travel to a TriWest authorized appointment.
The VA here says I needed to go to them before travel and get their approval. Because I did not they do not want to reimburse. I'm trying to find other veterans who have traveled to a TriWest authorized appointment without talking to the VA about travel and been reimbursed for travel by the VA. It looked like you had done this from what you had written.
You offered to ask the travel clerk about this. I'm asking if you did ask and what the VA travel clerk said.
Do you understand what I'm asking? Please let me know if you don't understand and I will restate the question/issue.
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I have not received a reply from the email sent from those old posts. Have not heard from my request for info on the Mohawk site.
I talked to the Army Awards Branch. They told me to email the request for award and supporting documents to them. I did. They were kind enough to email back and say I needed to USPS the docs as gmail and yahoo email address attachments are stripped from any emails they receive due to cyber issues. My email address is a gmail address. So, I snail mailed them. Ok, a fast snail using Priority Mail. Let's see what they have to say.
Thanks for all the help.
Aloha
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On 9/18/2019 at 2:25 PM, Buck52 said:
With the New Mission Act passing in June 2019 VA Does use the Tri West HealthCare Alliance out of Phoenix AZ.. after VA Contacts Tri West and give the outside Approval then this is when Tri West contacts the Veteran and gives him/her the information needed to have the out side private care.
I print off all my 10-3542 pfd on my computer and when I use out side care I make sure I get something from the treating facility approved by the Tri West and VA...and just attach it to the travel pay voucher 10-3542.
I have never used this method..But I use travel pay to my VAMC And sit up a direct deposit for them to send the travel pay.
So I am not sure I will be approved either.??
I'll ask the travel pay clerk tomorrow about this Approval thing..its suppose to be already Approved when the VA Contacts Tri West.
I'll let ya know what the travel pay clerk said??
For Veterans that is not famiuler with this VA CC (VA Community Care Program.
It is for veterans that can't get a timely appointment with their VAMC within 30 days or if the VA don't do this particular procedure you need....
you can ask your VA PCP for a Consult to the VACC Program..once your approved for Private out side health care VA Contacts a large healthcare company called Tri West HealthCare Alliance. they will call the veteran in need and sit up an appointment at a treating facility or when you talk to the ladies at Tri West you can request a treating facility of your choice.
I have conflicting replies from TriWest whether their authorization for treatment constitutes approval for travel and reimbursement for the cost of travel.
Can you tell me what the travel pay clerk said?
Aloha
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It's great that your daughter has been able to help so many. For those of us having never dealt with the military mumbo jumbo it's really helpful to have folks like you offer a path forward.
I'll see if any of those emails work and if there is any helpful info on the other end.
Thanks again.
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Hey Buck,
I hope your meeting with the travel pay clerk was fruitful. Can you tell me what, if anything, the clerk told you regarding TriWest authorization as it pertains to travel reimbursement?
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Yes, I was in Vietnam. I flew Birddogs for a month out of Kontum, then was assigned to the 225th in Phu Hiep. I flew the Mohawk using SLAR and then IR out of that base.
I flew the Mohawk out of Phu Hiep then Tuy Hoa. Then, we picked up the TDY mission operating out of Thailand. The 131st, I think they were the Spuds, had the mission immediately before us, as I remember. This mission was a 6 month assignment. As I remember, I was assigned to Thailand after I volunteered for my second posting to Vietnam. I was ordered out of Vietnam after the first 6 months of my second year. From there I was assigned to Helicopter Qualification Course. I believe that is when and where the request for the Purple Heart originated. The incident was on December 1, 1971 while flying over Laos.
When I left Vietnam in January of '72 another Mohawk unit was going to take over from us in Thailand. I have been told by my roommate in Thailand at the time, that the 73rd was taking over. The night I was injured I was training a new 1st. Lt pilot. He was operating the IR equipment in the right seat and because it was a full moon and we were only about 500 above ground level, he saw the guys on the ground that hit our aircraft. I have been looking for that 1st Lt. as a witness to the event. Even though I have the letter from a Captain Reynolds requesting the Purple Heart be awarded, and the 600 medical report, I thought another witness would be good to have.
I appreciate your help. Let me know if you need any other info.
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Aloha,
Yes, honorable discharge.
I was a member of the 225th Surveillance Aviation Company, flying OV-1 Mohawks using IR surveillance. The Company was operating out of Tuy Hoa Air Base in Vietnam. We were originally out of Phu Hiep Army Base, but took over the air base when the Air Force moved out.
The mission in question was a TDY assignment in 1971. I believe we took it over in June of '71. The mission was assigned to the 131st out of Da Nang before we took we got it. We operated out of the Udorn Royal Thai Air Base as an independent unit. We attended Air Force briefings, but our mission orders came out of Vien Tien Laos. We flew missions daily in the Plane of Jars looking for truck convoys coming down from North Vietnam. If found we called in the fast movers from Thailand. Moonbeam was the overhead Air Force C-130 controller for the aircraft in the area. Ocean Station also gave us input for any aircraft coming south from North Vietnam. The mission was flown at night.
My injuries occurred Dec 1, 1971. I was treated at the on base emergency room and released.
Any help you can offer will be appreciated. Thank you.
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When I read about a DD-215, that doesn't sound like what I need. It seems I might need to go to Army Board for Correction of Military Records.
Has anyone had any experience with that? I believe the first step is a records search then I can go to them? I did the records search with no mention of the Purple Heart.
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Thank you for your reply. I'm not sure what link page you're talking about, but I didn't read it. I Google searched for content to get to this site and went from there. I didn't research this site nor read all the information contained herein. Usually, if you don't want to label someone something like a 'wannabee' whatever you think that is, you don't bring it up at all.
In regard to the DD-215, I've never heard of that. I'll check it out. There is no mention in my records of my TDY posting to Udorn Thailand Royal Air Force Base for the mission during which I suffered my injuries. I'm certainly no expert on Army records, but it seems that would be evident somewhere. We were the only US Army unit on the base. We supposedly got our mission orders from the Ambassador to Laos, but as a CW2 that was not my area of operation. I only flew the missions. The Air Force and Air America were operating in the same area, although the Air Force was several thousand feet above us, lucky dogs.
Thank you for the link to the criteria for the Purple Heart. I'm pretty sure I qualify, but certainly not to the extend of many who have suffered much worse injuries and/or death.
Aloha
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Aloha,
I'm not sure this is the correct forum to post this into, but during a record search at home in regard to another issue I found a letter from a Captain to a Commanding General, United States Army Vietnam requesting I be awarded a Purple Heart for wounds suffered while flying a mission in the Vietnam Theater of Operations. I also have a copy of the treatment records from the emergency room. I remember the incident and going to the emergency room. I don't remember the application for the Purple Heart. The date of the letter requesting the Award was dated after my return from Vietnam. The Captain who took me to the emergency room has since died.
I requested a full records search from the National Personnel Records Center. When going thru the records they provided a couple months later, I do not see a request for the award of the PH, award of the PH, nor denial of the request for award of the PH. The letter from NPRC which came with the copy of my records states that since the PH is not shown as an awarded medal the request was turned down. It seems to me if the request was turned down there should be a record of the request and subsequent denial.
There is the issue that the mission I was flying was Top Secret. I don't know if it still is. That's way beyond my pay grade. Would that complicate the matter?
Can anyone suggest what my next step(s) should be?
Thanks for your help.
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Thank you for all your feedback.
I live in Hawaii. When the VCP law was written, Alaska and Hawaii were exempted from some of the approval process vets on the mainland US need. Even now with the changeover to Community Care, there doesn't seem to be a problem with me using TriWest and doctors outside the VA system. I've had to go thru the approval process, but it has not made a difference.
In regard to my current travel reimbursement issue, I have already established with the VA - the approval thru TriWest, the treatment at MD, and the travel there and back. The issue is the local VA office saying I needed to go thru them in order to get their approval to travel so that I can get reimbursed. They did pay per diem, which in itself is a mixed message, but now they say they are going to ask for that money back. Not surprising since paying per diem, but not the balance of the travel reimbursement is not logical - at least in my mind.
In my opinion, approval by TrtWest constitutes approval by the VA as TriWest - at that time - was the authorized agent of the VA and had rights of approval for treatment and travel to receive said treatment. At this time, there is approval by VA for TriWest to authorize treatment. I would say that once the VA approves TriWest setting up treatment for me or other Veterans, that constitutes VA approval for treatment and travel.
The local VA travel office disagrees. I am looking for input from others, like you, who have been reimbursed for travel, after traveling for treatment authorized by TriWest with no other approval from the VA.
Please let me know what you learn when you apply for reimbursement.
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Thank you for responding.
Please let me know how it goes. In my mind TriWest is VA’s representative and they approved my trip and treatment. Of course my mind doesn’t always agree with government agencies.
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Aloha,
As a resident in Hawaii I was authorized to use VCP thru TriWest. It has since become a little more complicated with Community Care then TriWest, but it’s not an issue with my question. At least IMO. I am still using doctors outside of the VA facility.
In July of 2018, I was authorized by TriWest for treatment of prostate cancer at MD Anderson Cancer Center in Houston. At that time I was not required to talk to VA in order to use VCP. Treatment was received. I submitted a travel reimbursement to the VA within the 30 day window. I thought TriWest authorization was authorization from VA to travel. Otherwise how would I receive treatment?
Reimbursement for travel was denied because VA said they did not authorize travel in advance as per the VHA Handbook 1601B.05. Also this below from the local VA travel office who originally denied the reimbursement and handled the appeal which I made within the time window.
“According to 38 CFR 70.30 section b.2. nearest facility. We were unable to determine if Houston was the nearest facility. VA travel department was not aware of you travel. There may have been a closer facility that provided the same healthcare. We have a Physician Utilization Management Adviser (PUMA) that reviews all non-VA facilities to determine nearest facility.”
They did pay per diem at the correct 50% rate. However, after my appeal they said that that payment was incorrect and they would be sending a formal request to return the funds.
Does anyone have experience with this type issue and can shed some light on it before I go forward?
Thank you.
Travel Reimbursement
in Entitlement - Veterans Compensation Benefits Claims
Posted
The rules were different for Hawaii and Alaska. We have Tripler Army Medical Center which is on Oahu and about 8 miles from where I live. When I first called to be setup for Veterans medical coverage the person on the phone encouraged me to chose the Veterans Choice Program as it bypassed the normal VA approval system. Tis state is several islands so driving to the Veterans facility is not going to happen. That fact and that our congressional delegation at the time VCP was created was very powerful may have made the difference. Hard to know how congress works. Even now, as I am grandfathered in under the old Veterans Choice Program.
Having said the above and considering what I copied below, my situation occurred before the change over to Community Care. I never had to talk to VA about an appointment. I never had to ask VA for permission for care. I never knew I was required to ask for permission to travel as I never talked to anyone at the VA about medical care. Everything was authorized thru TriWest. TriWest was acting as VA's representative. VA paid the bills without question. Agent relationship established in my opinion. As that agent TriWest authorized my travel.
I understand the old Choice program is closed out. However, there are connections between the old and new. The following is current and from the VA's website and you would think we have no VA hospital:
"In this scenario, a Veteran lives in a U.S. state or territory that does not have a full-service VA medical facility. Specifically, this applies to Veterans living in:.
U.S. States
U.S. Territories
In this scenario, a Veteran lives in a U.S. state or territory that does not have a full-service VA medical facility. Specifically, this applies to Veterans living in:.
U.S. States
U.S. Territories
For instance, if you are a Veteran living in Guam, you would be eligible for community care because you reside in a state or territory without a full-service VA medical facility."