Tayo

okay,,, Well, submit, submit, submit. To me,,, as veterans,,, we deserve EVERY SINGLE DIME. Why does the government seem to make things so difficult for us? I mean, why should you even have to fight and spell things out for the VA? Why should any of us? When we "get the call to serve," we get up with no fuss. But, when we need the favor returned,,, we get the "please prove you got the ailment ---THEN--- prove why the ailment is bad enough to be treated ---THEN--- ... URGHHHH!!! Just, 71M10, I hope everything works out for you. No,,, I KNOW everything is going to work out for you. Tayo

Hello, Another thought: If the patient is unable to sign for medical reasons, a person who acts as the legal representative is allowed to sign. In that case, the legal representative will sign there name along with the veterans name. Either way,,, to me,,, the most important thing about handing in that NOD is the good ole "stamp." (the stamp that tells the day the NOD was submitted) ---smile--- Tayo

Hello, Another thought: If the patient is unable to sign for medical reasons, a person who acts as the legal representative is allowed to sign. In that case, the legal representative will sign there name along with the veterans name. Either way,,, to me,,, the most important thing about handing in that NOD is the good ole "stamp." (the stamp that tells the day the NOD was submitted) ---smile--- Tayo

71M10, I see the what you are referring to: http://ecfr.gpoaccess.gov/cgi/t/text/text-....54&idno=38 The thing to take notice here is "left ventricular dysfunction." Left ventricular dysfunction is a specific ailment alone. The ejection fraction is a measure taken with that ailment --sort of speaking---. What the VA may be looking for is, "Does this veteran have left ventricular dysfunction?" If the answer is yes,,, the VA then ask,,, "is the ejection fraction between 30 and 50%." If the answer is yes, then the rating is 60%. Take a moment and look at the rating for 100%. Once again,,, the diagnosis must be left ventricular dysfunction "with" the ejection fraction less than 30%. So, the main thing is,,, look at whether you have "left ventricular dysfunction?" ---not the LVEF--- If you do have left ventricular dysfunction, then pay attention to the LVEF. If those two are present, then by all means, you are due the 60%. Once more,,, I see why the additional 10% was granted for cardiomegaly. Cardiomegaly can be caused by HTN. As for the diuretics use,,, please ask your PRP if they can change your meds because you do not like having to urinate so frequently. Diuretics are the first line of choice and,,, depending on your B/P,,, there could be another option. Hope this helps, Tayo

SouthernBelle, Very interesting post. I was trying to think of ways those files could be located. Do you know the exact date or a date near the time treatment was given? It could be possible the information is written,,, worded,,, and documented in a specific way. If you can find those "near dates of occurrence," something could be there. Tayo

Thanks for the information. I went to the site. It was interesting to see the numbers. Now,,, my thought. How many people are working those claims? Lets say one person does 2 claims a day. There are 8 work day hours. OMG!!!

Hello, I am not sure why the VA neglected to mention parts of your claim. Well, I can share a little information about the conditions I read from your post and what the VA may be thinking. There are different types of cardiomegaly. NOTE: Basically, the older you get, the likely you will have it. As for your HTN: Yes, cardiomegaly is at least as likely as not associated with your HTN. With HTN, your heart works harder. Remember, the heart is a muscle. The more you work a muscle, the bigger it gets. Still, body builders, track runners, any sports players will have cardiomegaly. Even if you run everyday or walk everyday as an exercise everyday,,, cardiomegaly. As for your Left Ventricular Ejection Fraction. Though 50% seems horrible,,, it is actually good. The normal ejection fraction is 50% or higher. The providers did the correct test. Once again, the results of 50% LVEF is normal and cardiomegaly from HTN is common. With all that said,,, 1. I can see why the additional 10% was given for cardiomegaly. The cardiomegaly occurred because of the diagnosed HTN. 2. I can see why no rating was given for 50% LVEF. Normal VEF is 50% and above. 3. Now, your diuretics. From reading prior post, I think I am starting to see where the VA is coming from. For HTN, diuretics is the first line of treatment (hydrochlorothiazide). Yes, this drug causes you to urinate. BUT, to stop the urination, the provider can change the medication (remember, diuretics is the first line of treatment for HTN). If, for some reason, your Urinary frequency was from "over active bladder syndrome, continued infection of the prostate, or any biological reason,,," I could see where a rating may be granted. --- Still, I agree with the others,,, anytime you disagree with a rating,,, submit your NOD. Always submit your NOD. I am only going off of what I read in your post. There could be so much more in your medical records. So, please, submit, submit, submit that NOD. Hope this information helps. Tayo

Hello, In terms of diagnosing HTN,,, there is a basic protocol that is followed: Taking 3 separate reading; 1 per week. What is funny, depending on the reading,,, providers might say the patient has "white coat HTN." That is when the blood pressure is high due to seeing a provider. Crazy huh. So, I'm not sure if showing signs of HTN in service is reason enough to say HTN occurred during service. I guess what I am trying to say is,,, many people may come into the clinic with the blood pressure a little elevated. Hmmm, an idea... If you were on ANY medications during the time of that blood pressure for a specific ailment that you received a rating for,,, even a 0% rating,,, maybe there could be a possibility you could connect your HTN to medications taken for an ailment diagnosed during active service. Hope that helps, Tayo

I have read a lot about this on this site AND have heard veterans in the hospital talk about this. Please, when a provider "ignores you,,," STOP THEM. FOCUS THEM. They are no different than anyone else. Well, yes they are,,, they provide your medical care,,, they work for you--- in your best interest. I pose a question,,, if you hired someone to fix something in your house and they ignored you,,, what would you do? you would "stop them and focus them." That gets their attention. Keep in mind, this is your health, not theirs. I am sure they would want exceptional "service" when they go to their provider. Now, all this doesn't mean to be "rude." What is the saying,,, "you get more flies with honey." LOL I think that is right? All in all, 1. Be nice 2. Stop them 3. Focus them on you. 4. When the appointment is over, thank them. Hope this helps, Tayo

All of these are very good answers. My only concern would be if the SSDI examiners pose the question, "can the patient be placed on a new drug to avoid the side effect." Usually, the answer is yes. We have to keep in mind that a lot of people work while taking medications for pain and mental conditions. If the medication for pain causes you to have no pain,,, well, the SSDI examiners may feel that since the meds work,,, the patient can work. Same with the mental meds. If the mental meds cause the patient to "base-line" the patient can work. Now, say you are taking meds for a condition that has already made you unable to work. The original condition is what causes you not to be employed. Those meds normally will not affect the decision. Side effects,,, side effects would have to be severe--- debilitating (not sure if that is the right word). For instance, if a med caused you to have a stroke. Hope this helps, Tayo

I have a neurological condition affecting "short -term memory," ---among other things---. Anyhow, at the time of my C&P exam, the examiner stated that I was incompetent to handle my VA benefit. He spoke with me and told me why he stated that I was incompetent. The reason,,, based off reading my medical records, he was backed into a wall, esp. because of my "short-term memory loss. Meaning, he has only and will only see me this 1 time which is not enough to state I am competent. Once again, I understood what he was saying. Once I got the decision of proposed incompetency, I went to my neurologist ( the one treating my condition) and he wrote a letter stating that I was competent to handle my VA benefits. I took that letter to my Veteran Service Representative and he said that was all I needed,,, esp. because it was written by the treating specialist. I am still waiting for the final decision. I was told that my claim was at the rating board. What does that mean? ----claim is at the rating board--- (will I have to wait long?) Anyhow, please try to understand where the C&P examiner is coming from. If you feel that incompetency is going to be an issue,,, alway go to the treating provider to get a letter stating your competency. Hope this tid-bit helps. Ohhh, can someone please explain that "rating board" thing? Thanks, Tayo

WOW!!! THIS IS GREAT INFORMATION!!! I ACTUALLY CALLED AND CHECKED INTO THIS!!! OMG!!! Everyone,,, this is a benefit I knew NOTHING about!!! I even called the Hawaii hotel to see if I could get a room. OMG!!! I told them my status (100% P&T) --- that is all I needed. OMG!!!! Of course,,, I fell under category 2,,, or something like that. Still, what a great benefit!!! I truly appreciate hadit.com. Every time I log into this site, I learn something new ---tearing up---. Once again,,, thanks to all of you!!! Tayo

Stretch, I read this and then,,, well, I had to read this three or four times to try to grasp what you are saying. I read that he was granted 30% for retirement. Then, the VA could not find him (now, I did read something about VA not finding people and then stopping the payments). But, once he was found, I would think the payments would start again. I am not a lawyer but, if someone told me that I was to old to receive my retirement,,, "RED FLAG." I know years have passed,,, but I hope you have a personal copy of his medical information. Anything would do. Now, you spoke of life support. I do not know his current medical condition and in no way state whether he is terminal. BUT, if his provider believe him to be terminal,,, I am not sure why the VA would hold his case,,, once again,,, "RED FLAG." I am so glad you retained a lawyer in this case. Hope everything works in your favor. Tayo

Hello, The psychiatrist does both (write scripts AND counsel). If you are given meds by a psychiatrist,,, I believe that you should be seen by them every few months. If you want to also be seen by a psychologist, I would just ask your psychiatrist for such an appointment. Hmmm, normally it is easier to get appoint with psychologist than it is with psychiatrist. I am also 100% P&T with complications dealing with nuero. Didn't take long at all to get either appointment. Hope this helps. Tayo

Hello Rockhound, Hopefully this can help: I am not sure what your rating is with the VA. STILL,,, if you asked your primary care provider for the consult,,, they usually will address that information then,,, ie: notate the request in the "plan" section of the progress note. I would just call your primary care provider and check to see if they place the consult. If they say yes, feel free to call the nuero-psych clinic to see if they scheduled you. They should give you a date. Further, they will normally say that they mailed out the scheduling date to you. Now, when you are scheduled depends on availability of appoint. Hope this helps. Tayo

Hello all, Hopefully this info will also help. There really is no difference between brand and generic. Brand named drug becomes generic when patent expires. When this happens,,, other drug companies can produce the drug thus the "generic" term. So, when you hear about pharmaceutical companies charging an "arm-n-leg" for new meds,,, that is because they hold the patent. Then after a few years,,, the patent expires,,, the drug gets a new name,,, many pharmaceutical companies reproduce the drug,,, the cost goes down. THEN,,, a new drug is created,,, cost for med is high,,, wait a few years,,, patent expires,,, many pharm companies reproduce drug,,, cost goes down. Then... (you get the message). I tell people to not get confused about "Brand Names" and "Generic Names." One can think of it as going to the store and buying Concord Grape Jelly for $5.00 instead of buying Kroger's Grape Jelly for $1.99. Same thing,,, just one is "Brand" and the other is "Generic." Hope this helps. Ohhhh, as for bottling, that is "specific for the company." Ummm, one can use the "jelly" example above to get what I mean. Drug interactions. All pharmacies MUST have the "red warning." VA, CVS, Walmart. It is a FDA safety thing. I admit, many providers have a bad habit of "poor handwriting AND poor spelling." All those years in school did nothing to correct this issue. So, when pharmacist attempts to decipher what was written and inputs the information, if it is wrong,,, RED FLAG appears. Or, if the providers prescribes a med and is counter acts another med,,, when the pharmacist inputs the info,,, "RED FLAG." As for where meds are made. Once more FDA. FDA is very strict on ensuring that the specific medication meets the standards on strength, effectiveness, etc. for the med. Okay, hope all this helps. Doc

Hello Berta and Rentalguy1, I really have a question and a situation I would like to share with you concerning my NOD. I tried sending a private message but had no luck. I could imagine that many people try to send you two messages this way. Is there any way I can get in contact with you. I would like to share with you my NOD. Thanks again, Tayo

Hello, If ever you are prescribed a script and do not want to take it, just tell the doctor. Same as if you ever wanted to change doctors, do that. You not wanting to take a certain medication does not mean that you are not in compliance with your medication regime. The provider can state that the patient refused the certain medication but with that information, they must state why. I have refused many medications and medical procedures AND have even changed a provider because I lost confidence in them. With that said, I have had no complications with my compensation claim or treatment given by the VA. Maybe I am one of the lucky ones but, I actually have confidence in the treatment the VA is providing me. As for the cost of medications, my total medication bill comes up to over $7,000 a month,,, all paid by the VA. Many of those drugs had to be approved and every single one that needed approval, got the approval. Funny thing, you hear a lot of complaints about the VA. My experience with the VA has been wonderful. The VA has saved my life,,, a few times. I can recall using my civilian insurance and went from doctor to doctor and my health continued to decline. Then,,, eventually ended up at the VA and,,, HERE I AM!!! ---smile--- So, if you do not want to take a med, tell the provider. Remember, if you accept the medication and do not take it,,, it becomes a waste of medication,,, a waste of money,,, and well, that is not really fair to other Vets and tax payers. If you do not feel comfortable with a provider,,, change the provider because your health is what is important. Lastly, if you come across a medication and you want the provider to look into that medication,,, please bring that information up to them. Good luck, Tayo

Hello Berta and Rentalguy1 and everyone else, Yesterday, I received a letter from the VA entitled, "Request For Outpatient Treatment Or Drugs And Medicines." I am guessing that this is form FL 10-483. That information was at the bottom left hand corner. Now, I have never heard or read anything about this form. This is what it says: " Request for Outpatient Treatment Or Drugs And Medicines" You are entitled to needed outpatient care including drugs and medicines from the VA for treatment of any non-service-connected condition as long as you are receiving increased pension or compensation, based on the need of regular aid and attendance, or by reason of being permanently housebound. If you desire to obtain treatment at other than VA expense, you are still entitled to drugs and medicines from VA pharmacy when prescribed by a private doctor of medicine or osteopathy. When you wish to apply for either benefit, please indicate your election in the appropriate space below, sign this letter and mail it to the VA station address printed on this letter. Please check your preference by checking one of the following boxes. If at a latter date you desire to change this election, you may write, telephone or visit the VA medical center furnishing your outpatient treatment or drugs and medicines. Dental care is not included under either benefit. ___ I wish to apply for outpatient treatment (includes drugs and medicines). ___ I wish to receive drugs and medicines from the VA Pharmacy for treatment provided at other than VA expense. Then the letter ask for my signature, social security number, and date of signature. The form states that it supersedes VA Form 10-1151, Nov. 1973 Have you any of you heard of this? Now, the treatment I would need is from my service connected condition. Thus, I guess checking box 1 is not an option for me. However, option two may be my option because I actually have to pay for that I.V. treatment from my pocket. Is this saying that now the VA is going to pay for the treatment? I see that I now fall under Category 4, not Category 1, because of receiving aid and attendance. I also saw that if I needed outside treatment, my co-pay is something like $8 not to exceed $940 a year. This is all new to me and my mind is already half bad. --lol--- I actually have another question but will do so after I get some info about this one. I don't want to over load you all with to many questions at once. You all are SUCH A BIG HELP!!! THANKS FOR ALL YOU ARE DOING ---smile--- Tayo

Hello RentalGuy1, Thanks for your response. I need to correct myself on something that I wrote. I think I have one service connected disability rated as 100%. There is only one box under the "Medical Description" with my diagnosis (three things are lumped together in the diagnosis), then the percentage assigned is 100%. The VA just added the aid and attendance portion to my entitlement. Still, the first aid and attendance was submitted at the end of the year of 2007. That decision was granted based of a specific cognitive ailment and all medical records up to March 2008. That cognitive ailment brings about side affects that affects the motor aspects of my body whereby presenting new complications for ADL (dressing, feeding, etc.). So, my physicians submitted (April 2008) the other aid and attendance form and the home/health aide. Off course, the home/health aide was approved (which is basically a respite for my family). Further,they are writing the letters concerning the I.V. treatments given every 2 to 3 months. Since I now see that I have one 100% rating, does that mean they rated me correctly? Also, at the end of the entitlement package, they asked if I wanted to submit additional information. That is where I am going to submit the copies of the new VSO letter (aid and attendance form) completed in April concerning me needing help with basically everything else, the home/health aid request and approval which was done in April, and letters from my neurologist about the I.V. treatments. Am I on the right tract in possibly getting that second L with aid and attendance granted to move me up to the O; thus making it possible for me to be granted the R1 because of the level of care needed? ---OR--- Would the letter provided by the neurologist be enough to boost me up to R1 because of the level of care needed? Once again, thanks for everything, Stephen

Hello everyone, I am happy to report that I was approved at the "L" rate. Now, my doctors feel that I should have been approved for the "R2" rate and they are working to see what they can do. My physicians feel I should be at the "R2" rate because I have a nurse come in every month to place my I.V. infusions which last for 10 days. They realized that they did not submit the required letter explaining the need for the higher level of care. So, they are doing so. However, as I read the requirements for consideration for the higher level Aid and Attendance, it reads: 1) A veteran is entitled to the higher level of Aid and Attendance allowance authorized by 3.35o(h) in lieu if the regular aid and attendance when all of the following conditions are met: a-- the veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p). b-- the veteran meets the requirements for entitlement to the regular aid and attendence allowance in paragraph (a) of this section c-- the veteran needs a "higher level of care than is required , etc. I fall under b and c. Then, I found the Provisions of PL 96-128 which amended 38 U.S.C. 1114® concerning awarding Aid and Attendance (R1). ---when the SMC level's is n1/2 + k. R2, in this case exist if the basic criteria contained in 38 CFR 3.352 is met--- Even though I have been granted Aid and Attendance and need a nurse monthly, how can I be approved for the R2? Once again, my doctors are submitting the required letter for R2. I guess my question should read, If the need for the higher level of Aid and Attendance is justified by the physicians (all 5 of them), is that good enough to actually be approved for the R2 rate? I have two service connected disabilities rated 100%, one of which got me the Aid and Attendance. Any advice would greatly be appreciated. Tayo

Hello Pete, Cough is a common side effect for ACE inhibitors and Lisinopril falls into that category. Cozar is a great drug to switch to and falls into a different category of drugs (ARBS). That should do the trick in treating your hypertension (HTN). Keep in mind, I do not know your history, etc. Normally, if your blood pressure needs a little more help, they may add a diuretic component. Still, it is one pill,,, Hyzar ---(Cozar + Hydrochlorothiazide). Celexa is also a good drug for mood disorders (a wide range of things falls under this category ). A common side affect for this is a decrease in libido. Stomache aches, etc. are also a side effect of this drugs. But, if you are okay with this drug,,, continue with it. ;-) Good health to ya, Tayo

Hello everyone, Another alternative for those of you who want to stop smoking is "Wellbutrin." Now, it doesn't work over night but it is a great alternative. Still, the most important aspect for anyone to stop is to mentally prepare for it. That is the hard part. Tayo