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.

[rentalguy1]

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!

[Pete53]

Spike I disagree with assumption that the VA is backlogged with claims form 100% Vets asking for more. In the first place 100% are a large minority of Veterans being paid. I think many of the so called frivolous claims are caused by VSO's who see a desperate Veteran who is near or over 65 trying to get benefits to help them in retirement telling them to go ahead and file a claim and see if they can get anything.

[even_flow]

even flow wrote:

"If you have done your part and had a few visits to your VA PCP annually, ordered and taken your meds, and everything else you are supposed to do, then you will not loose your 100%."

I was not aware that one had to use the VA for there medical care for there s/c disability. Other then the C/P I was sent to a year ago or so..I have never set foot into a VA facility for any medical care. I am fortunate enough that I have other health insurance that covers the cost of my continueous care.

I did call the VAMC that is about 2 hours for me to see if I could set up an appointment and I was told there was a 3 month waiting list just to be put on a team...then after I was able to be put on a team that it would take another 90 to 120 days just to get an appointment.

So I have just stayed with my family doctor and I am content not to change. At least this way I have regular apointments and excellent care.

I never heard of anyone losing there rating for not going on yearly appointments to the VA clinics...

but then again I don't know to many disabled vets outside of the ones I have meet though this process.

MT

You have me mixed up with another board member. I didn't post that. B)

[rentalguy1]

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.

[even_flow]

even flow wrote:

"If you have done your part and had a few visits to your VA PCP annually, ordered and taken your meds, and everything else you are supposed to do, then you will not loose your 100%."

I was not aware that one had to use the VA for there medical care for there s/c disability. Other then the C/P I was sent to a year ago or so..I have never set foot into a VA facility for any medical care. I am fortunate enough that I have other health insurance that covers the cost of my continueous care.

I did call the VAMC that is about 2 hours for me to see if I could set up an appointment and I was told there was a 3 month waiting list just to be put on a team...then after I was able to be put on a team that it would take another 90 to 120 days just to get an appointment.

So I have just stayed with my family doctor and I am content not to change. At least this way I have regular apointments and excellent care.

I never heard of anyone losing there rating for not going on yearly appointments to the VA clinics...

but then again I don't know to many disabled vets outside of the ones I have meet though this process.

MT

Oh... You were probably quoting my post and inadvertantly left someone elses in. I know one person in particular who's VSO said after Voc Rehab he will be re-rated and his VA doctors keep saying he's getting better so I dunno. I know someone from the forums, on the other hand, whos rater keeps proposing reductions because the rater has to keep looking in the file, but DRO keeps current rating. I know someone who lost workers comp because the insurance company sent someone to spy on them and caught them doing yard work. The government doesn't have enough people to do that. I would guess they have the same suspicions as private sector PEOPLE. Give them the opportunity, they'll take it. Why not?

[even_flow]

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.

Were you P and T?

I think we were saying "if you're P and T" don't re-file. But you brought up a good point. I never thought of them considering a file silent.

I notice, from other vets inputs, some states are meddlesome and some or not. Makes me wonder what state you're in--not asking though. B) I dunno man... I'm not going to worry about it that much. If they call me in for another C and P I'll just go in and if they reduce my rating take care of it then.