Living The Claim

[spike]

Listen,

I am giving a piece of advice here. I understand many veterans find something that is 'wrong' with them, but if you are 100% P&T I would advise against living the claim. Let it be. Let yourself work on your health. One of my friends have said a good metaphor about this....."It's like poking a bear with a stick"-Hadit member (formerly) Jay Johnson. Your asking for the VA to re-investigate your claims. If you are 100 % PT, don't start making all kinds of different claims right away. Think about it this way and I hate to say it this way. What if the person at the VA Claims office, just got in a fight with his wife, slept in the car, back is hurting, and your the first claim he or she gets. Think that they might not 'dig' into your C-file to see if every I is dotted and T is crossed?. I have heard of some vets, losing their ratings because they started a new claim and something in the time that they had the new C&P exam (something they said or did) in the exam triggered the Rating Officer to change their rating for one of their previous ratings. Maybe because the new doctors opinion was different. Take this with a grain of salt. If you don't believe it happens, I am sorry but it does.

[even_flow]

Spike, while I respect your experience in helping vets, I have disagree and say that your logic is flawed. If you have a condition, even if it is P&T, you WILL be called in to have a C&P prior to that 20 year mark. In essence, you are saying to not file claims in order to avoid something that is un-avoidable. That just doesn't make any sense. Now, I wouldn't advise a 100% schedular or IU vet to file for just anything. However, if that vet has a condition that he knows could end up being life threatening, such as a heart condition, then he should file. Likewise, if the vet knows that he meets the criteria for something, PTSD for example, where he could be paid at the 50% rate, then he should file, also, in order to receive his SMC that he is entitled to. You should not, however, file for a musculoskelatal condition that you know would be rated at less than 50%. That would not benefit the vet at all. But not filing because you are afraid of another C&P that you're going to have to do at some point anyway...well, that dog just don't hunt. Merry Christmas!

How do you know for sure you will be called in? Do you know because you've heard or you or were you a DVA RO, VSO etc.? That's a pretty bold statement and important info so for the sake of accuracy...

BTW, good with the logic in your post.

I read there is less liklihood of re-exams (already know the 20 year rule) at the five year, and so on mark. Any truth to that?

[rentalguy1]

even flow: I was not P&T. I am in TN and have to go through the Nashville RO. They seem to be fairly even keeled. The reason I made such a bold statement about being called in for a C&P is due to the numerous times I've read it on this board. Let me add this caveat, though; I bet if we were to go back and look in those vets' files, we would find out that they had not made any visits to the VA in a long time. If the VARO starts looking in your file in an attempt to find somewhere to cut costs, and sees that you are continuing your care and that you have established that you aren't getting any better, then it satnds to reason that they would pass you up for an easier target.

[mountain tyme]

rentalguy1

wrote:

"I bet if we were to go back and look in those vets' files, we would find out that they had not made any visits to the VA in a long time. If the VARO starts looking in your file in an attempt to find somewhere to cut costs, and sees that you are continuing your care and that you have established that you aren't getting any better, then it satnds to reason that they would pass you up for an easier target."

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I am not sure if that is true or not about visits to the VA...I have been to a VA facility once and that was for a C/P...when I first was awarded s/c compensation I did call the VAMC to make an appointment for my condition and I was told that due to the increase case loads and lack of doctors that there was a waiting list to even get on a team (wait time appx. 60-90 days). Then once I was placed on a team the waiting time for an appointment was 60-120 days. I decided I would keep going to my family doctor and save the 2hr drive just to hurry up and wait.

I think and I may be wrong on this I am new to this VA stuff...but as long as you are seeking care on a continuous basis and keep all your medical records you should be fine if the VA decides to call you in for a review.

Once I move to another state the closest VA facility is 4.5 hours away so my doctor is going to refer me to a specialist there.

I would hope that would cover the VA critria for continue care.

MT

[Jim MAC]

Yeah..that was me that wrote that. My reasoning for going to the VA is those records are immediately retrievable by the VARO. I have private insurance myself, and had always went to a private physician, until the VARO decided that "since the records were silent" I must be all better...calling me in for a C&P where their examiner lied through his teeth. Now I go exclusively to the VA, even though I have pretty good medical insurance.

Hey Rental Guy

I agree with you I have Tricare since I am retired AF. I use the VA 100 percent of the time because then my whole medical file is there for them to see.

Jim

[rentalguy1]

mountain tyme: yeah...the wait times can suck for sure. And you are right, if you have all your records from private docs you should be fine when you get called in. My point was that if they go on a witch hunt and your name pops up, when they see the records on the computer, then they would probably go elsewhere.

[Pete53]

I use the VA for Meds and see Primary and Diabetes Doc, Dental and see a skin Doc now but anything else I use my Medicare HMO. I quit going to Mental Health which may be a mistake but I am prescribed Xanax and Gabapentin for Panic Attacks. I agree with even flow and am not going to worry about it till it happens.