Appeals

[Guest YolandaT]

My brother-in-law had kidney failure and a quintruple bypass in 2004, he went to emergency at a regular hospital, he didn't understand his options and did not realize there was a VA hospital in our area. Since he did not have VA benefits at the time he wouldn't have gone to VA hospital anymore for fear of being turned away. He was near death.

After the fact but also in 2004 he applied for VA benefits due to Agent Orange problems caused by being in Viet Nam.

He was approved at 100% disability.

However, they don't want to go retroactive and pay the hospital bills because they say he should have gone to a VA hospital. He didn't know his options and needed emergency treatment immediately.

He is appealing now, but doesn't know how to write the letter.

How could they approve him and then refuse to pay for the same problem they approved him for.

[jessejames]

The Va requires notification before paying for private treatment. The common practice is that the veteran is stabilized at the nearest hospital and then transferred to the VA hospital for treatment. They will not pay for treatment when authorization was not requested at the time, you only have I think 72 hours to notify the VA and the private hospital would have been required to either state the veteran could not be moved without consequences (death) to the VA medical center. It's a terrible mess, the VA does not have adequate treatment services in a lot of cases, but they won't authorize private treatment. Congress is to blame.

[Guest Berta]

Your brother in law presents a severe disabilty picture-

I am assuming- but might be way off- that he was service connected for diabetes due to AO and these are complications of it- cardiovascular and renal disease?

If so he might be eligible for a higher disability rating criteria-

Special Monthly Compensation-

what did the VA say about that in his award letter?

If this is diabetes- can't be sure- due to AO-

the VA has to rate the complications.

[john999]

Jesse

Is that 72 hour notification thing written in stone regardless of the level of emergency? I just wonder if there are any loopholes.