Long Term Issue

[jecsb4]

I am trying to figure out that once you have SC for your disabilities and you are ok with the percentage and don’t plan on any NOD’s, etc. What happens next?

In other words if your SC conditions are stabilized and don’t get worse do you have to do to a Dr. periodically to show you are seeking treatment? And if you don’t do that will the VARO possible try and get you for a reduction?

Thanks

[jbasser]

The final push is to get your disabilities rated permanent and total (P&T). Once that is obtained and time passes by there are protected rating criteria that comes into play at various intervals.

Once the protected ratings are set, there can be no reductions unless the VA finds there was a CUE in the original decision.

[Berta]

Unfortunately the VA can pull stuff even on a 100% P & T vet-

A friend of mine I helped has 100% P & T for AO cancer, colostomy due to SC (SMC) and also 100% because the VA shortened his lifespan due to major malpractice.

They actually tried to set him up for another C & P last year to see if he "improved"- he had even gotten 50% SC PTSD award on top of the other stuff 2 years ago and then got this letter- he was fit to be tied-

long story- I helped him respond to the RO and then he got a letter saying NO more future exams. ever.

Only if the VA finds significant documented medical improvement in a disability-can they attempt to mess around with the comp-

but even 100% P & T vets might be called in for future C & Ps-

(to see if they have improved)

It pays to always get continuous documented treatment and meds for SC disabilities.

(By the way this vet has 2 PHs but always denied PTSD. I knew he had it and yet he didnt want to have it- finally his vet rep talked him into applying for PTSD comp and right away the doc knew he had it too-I see this sometimes where a vet has bonafide proof of stressors (PHs are conceded by VA as stressors) but they dont want to have a PTSD diagnosis.)

[john999]

I say that it is wise to keep going to the VA and getting treatment for your disabilities. Go forth and complain loudly to your doctor. This is your insurance policy against reductions down the road. Our conditions tend to get worse with age.

All I get from the VA is pills but all that is noted in my records. I get an exam twice a year, and I take my wife with me to prod me to mention all the problems I am having. I have fallen at least three times from the drugs I take. "Help, I've fallen and I can't stay down".

[SSGMike.Ivy]

I say that it is wise to keep going to the VA and getting treatment for your disabilities.

This is a very true and wise statement. Just because you are rated by the VA does not mean you just stop and don't attend any group therapy meetings, physical therapy, take your meds, renew your meds etc. It is extrememly important.

A lot of Vets go to get their disability, then say hey great I got it and forget to attend the VA for anything. Even taking your meds, renewing them etc is critical.

Those that do not follow up with any visits are hurting themselve and the ones who need the disability.

The word on the street is that the VA has been looking at those who are not straight 100%, but those who are IU and requesting further proof that you are still IU. Remember the VA has a large amount of new Veterans attempting to get into the system and funds are tight.

The VA can turn around until you've reached 20 years and request a new C&P etc.

[Ricky]

If you suffer from medical conditions that have caused you a disability why would you not want to go to the doctor? I go to control my medical conditions because the next stroke could mean the last day of life with my loved ones.

[jbasser]

Here is a little bit of Insight from the M21 as a heads up to claims personnel.

"Exercise care to avoid violation of the provisions of 38 CFR 3.951 and 38 CFR 3.952 for compensation and pension disability benefits."

Do not reduce an individual disability evaluation that has been continuously rated at or above the current level for 20 years or more except in the case of fraud per 38 CFR 3.951(B).

Measure the 20-year period of 38 CFR 3.951(B) from the earliest effective date of the combined or individual evaluations.

Note: For purposes of determining whether benefits were received for a continuous period of 20 years, include periods during which recoupment or deduction applied to an award.

Now also the date benefit granted is the effective date. For Vets who win older claims. If you have been Service connected for 20 years and they are trying to schedula an exam in an attempt to reduce a rating, You should quote the regulation. Doing this in their case is actually a violation of the reg and can be counter filed as a cue claim. It also may be a form of harrassment.

Also,if you are disabled enough to get VA comp, and you improve and can work more power to you. Dont quit going to appointments and if your in pain, tell them.

People with progressive diseases like ALS or MS, or Neurologic problems, paralysis, mestatic cancers, Restrictive, obstructive lung diseases should not worry too much about this issue. You have no choice but to go to MD appts.