sbrewer

Hi, My husband suffers from diabetes with neuropathy among other things. He contacted the Pain clinic in Tampa, and was referred by his primary care, however the ball has been thrown back in the primary care's lap, due to one of the requirements for the pain clinic is excercise, he would have to be cleared with cardiologist which he would fail due to severe cornary artery disease. Question...does anyone know of a VA facility or perhaps an outside facility that specializes in neuropathy? We've read a little about John Hopkins. Has anyone had any experience with them? He is in severe pain most of teh time. Thank you, sbrewer

Hi, Does anyone know if the VA drug formulary list is available online? I thought I had it bookmarked one time, but can't seem to find it. Thanks, sbrewer

Hi, If your granted 70% for a condition, but are paid 100% TDIU. if asked what % you are, what do you put 70 or 100? Thanks, sbrewer

My husband has been denied 2 times and we appealed. I think the next step is the ALJ hearing, which when we appealed, they said it would be 12 to 16 months before we heard anything and that was about 3 or 4 months ago. Anyway, he has never been given any kind of exam from SS as of yet. He applyed for diablity for depression(100% TDIU) and CAD. His cardiologist has written stating that he can not work because of his heart disease alone. So, even with a claim in for 2 different reasons, he has been denied so far twice. Should SS had done an exam of some kind of him, or do they sometimes not do exams? sbrewer

WE too, went to the patient advocate and got no where. She called the head Pharmacist and was told that the Renexa prescription should be written in it's other name Ranolazine. We went back to outside cardio. and he wrote the RX with that name and still got denied. My thing is this...you need the meds, the VA has the meds, the VA bills your insurance for the meds, the VA collects from your insurance for the meds, just why in the ---- can't you get the meds from the VA? I don't know if any good will come from writing to Senators, but I think we may try that next. sbrewer

Hi All, Apparently the VA Pharmacist has more pull in the hospital on medicines, than the VA Cardiologist. Long story short, husband was denied Plavix and Renexa that outside Cardio. says he needs, so his VA Primary sent him to VA Cardio. The VA Cardio agreed he needed these meds and put in for them and low and behold they were denied by pharmacy.... Time to write a long letter Oh, and of course they bill our private insurance for all his meds anyway, so I don't get it. sbrewer

Thanks, I sent you an e-mail. I hope you received it. If not, please let me know. sbrewer

Testvet, I read (I think under the GAF topic) that you were 100% for depression, but appealing a decision for your heart disease. If you don't mind my asking, are you linking yur heart disease to the SC depression? Thanks, sbrewer

Just wondering, can you win without a lawyer at the Alj hearing. I know everyone says to hire a lawyer, but if my husband were to win, then FERS gets all for the first year, so if he won and it is back dated, we collect nothing. I think I have this right. thanks, sbrewer

Thanks everyone... He is 70% for depression, paid at the 100% level with no future exams, and I get champva and all the other benefits. Also, he has never been scheduled from SS for any kind of exam what so ever. Is this normal? thanks, sbrewer

Thanks guys He not only has severe coronary artery disease, but is 100% TDIU schedular through the VA for depression. He is medically retired from the VA hospital where one of there own Pych's said he was unable to work. He has diabetes(controled with meds), he has neurapathy and an ongoing toe pain that requires codeine or lyrica and a tens unit and after the lyrica he is knocked out for hours. All the heart meds alone cause drowsiness and SS says " Even though he can not do the job he was doing, he can still work". Oh by the way, he was a computer manager, so we don't understand what they say he can now do. Along with the toe pain, drowsiness from drugs, and shortness of breath from the heart disease, he also has consentration problems from the depression.... thanks, sbrewer

My husband was notifyed today from SS that he was turned down again. This is round 2. He really gets so tired of fighting, as I'm sure everyone does, but I guess we'll move on to round 3. You would think a note from a cardiologist would be worth the paper it's written on, but I guess not... sbrewer

Hi, Has anyone had sucess in getting non formulary meds approved at the VA? Plavix(is formulary) is really a big one that they will not give now even though outside cardiologist says my husband definitely needs this to survive. Also he has another heart med. he needs, but his primary care will not try to get. We have talked to patient rep. and nothing there either.... thanks, sbrewer

Thanks Berta for your quick response. Even though my husband is 100% TDIU, he was not vn veteran, so I did not know much about that topic. Again thanks for all your help... sbrewer

Hi, I talked to the wife of a Vietnam Vet yesterday, and she knows nothing about how to get started with a claim. Should they talk to an SO first or should they send for his SMR's or what should be done first? Also, is there a list of presumative illnesses for VN vets? thanks, sbrewer

My husband is on Plavix and has been for awhile. He goes to an outside cardiologist. When he ordered his meds, the Plavix did not come. He re-ordered and it still did not come. He called TAPS and was told they were no longer carrying Plavix at all. So, we went and talked to the patient rep and she called the pharmacy(while we were sitting there), and the pharmacist said his presciption had expired. He went to the dr. and got a knew RX but we have not been to the hospital yet. Will keep you posted as to what happens... sbrewer

Thanks John, It doesn't sound too good from the CHAMPVA. I just received my card a week or 2 ago, so I'm getting the info from 2 dr. visits that I had before receiving the card. I guess I'll see what happens. Thanks for your input.. sbrewer

Thanks guys, John, We too have Federal BCBS, which we want to keep on my husband(he is the disabled vet), so he can keep his cardiologist on the outside. He has had this dr. since his heart attack 10 yrs ago, and he definitely does not want the VA messing with his heart. I was just thinking of dropping the BCBS on me and going with CHAMPVA, but I still don't know if I would be covered if something happened to him before the 10 yr. mark, like DIC. How does BCBS and CHAMPVA work together...is your co-pay waived from BCBS? thanks, sbrewer

If something happens to my husband before the 10yr. rule or non sc, would I get to keep CHAMPVA or would it terminate? We're thinking of dropping the medical insurance that we have on me and keeping it just on him. Thanks, sbrewer

Thanks Jesse. I knew the 60/40 rule, but the lady on the phone today at OPM said there would be no change. So, this was what through us. Steve, I ask the question in two different forums, because not everyone visits both forums. I asked in two forums, because I know there are federal retired people in both forums and I wanted to hear if anyone knew if this lady knew what she was talking about! Furthermore, you did not have to answer in both forums! sbrewer

This is under FERS. sbrewer

My husband is currently 100% TDIU and receives disability retirement from Federal Service. He applied for SS and was turned down. He called OPM, and was told that if he is turned down for SS then his federal disability retirement would not change. It was suppose to be as follows...First yr. Federal Disability keeps 100% SS and after the first yr., the federal would be reduced and also keep 60% of the SS... Question..If he does not receive SS disability, does the federal retirement, after the first yr., stay as it is currently or is it still reduced? Thanks, sbrewer

Stillhere, November will be his 10 yr. mark since his quadruple bypass. He goes to an outside cardiologist who knows his history very well, and wants him on as many blood thinners as possible. They say he would not be a candidate for another surgery and has some blockage that can not be fixed. Maybe he should talk to the patient rep. and if that doesn't work keep going up the chain. He was flat out told they did not even carry Plavix anymore in the VA system... sbrewer

The VA just suddenly canceled husband's Plavix without any waring. He called to renew his meds and this one never came in. He called TAPS and they said that medicine was no longer carried by the VA because "it was the same as asprin" (which he also takes). They also said letters were sent out, which he never received. Has anyone else had this problem? thanks, sbrewer