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Va Taking My Plavix

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Hi Everyone, I am new here..Happy to have found this site...I am wondering if anyone can tell me what else I can do to keep my plavix..I had the medicated stent put in about 2 years ago..I had this done in a non VA hospital. My VA general doctor, one year ago removed me from plavix,My cardiologist gave me a letter supporting my need for the plavix, no help from the VA..I contacted my congressman ..3 weeks after contacting congressman, my VA doctor called me and gave me my plavix back,,Now 2 weeks ago, which is one year later the VA doctor calls and tells me no plavix..I contact my cardiologists and once again got a letter of support, contacted my congressman again, and yesterday my VA doctor calls me again and says this is not good enough..NO PLAVIX..Unless I pay for it myself, and I an unable to do this..Anyone have any suggestions ?..I thank you..

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I have been on plavix for 15 months. My VA Diabetes Doc tries to take me off every month and I understand that they have a 1 year rule for someone having to take it and than aspirin is all. I buy my own aspirin. When she says she wants to take me off I say my cardiologist says I need it for life I had a non medicated old style stent used Sep 2006.

Like it or not you might take your letter from the Cardiologist to the head of the pharmacy and than if no luck get the Doc to write a letter that says it is medically necessary and there are no substitutes that will work.

Good Luck and Welcome to Hadit

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At 40 percent do you still pay a medicine copay or is your heart disease SC'd?

Also, do you have insurance? If you do these guys are billing your insurance. That sir makes you a paying customer and they cannot refuse you any medication.

Try the patient representative. They can get it done if they want to. Your up against some penny pinching moron. It is about cutting the numbers and we all are numbers to the VA. How many times do you hear this? What is your last four?

Get your private doctor to call the chief of VA Cardiology, More likely than not, they know each other.

Posts like this one get me upset for I know they are looking at the dollar over health care.

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Tricare does the same thing as they took mine away at the 12 month mark. Civilian neuro had to do battle with them. Medicare also took my moms away at 12 months. Her doc could not convince them to restart. I guess it is all govt provided medical care that does this.

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    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
    • Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
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    • I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:

      2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis

      2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.

      "...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.

      First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date. 

      If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues. 


      I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.

      It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.

      Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.


      Does this help?
    • Thanks for that. So do you have a specific answer or experience with it bouncing between the two?
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