Jump to content
Ads Keep HadIt.com Online. Consider Turning Off Ad Blockers to Keep HadIt.com Online! ×
  • 0

Guideline For A 1151 Claim?


Guest Jim S.

Question

Does the failure by the VAMC Primary Care Dr. and/or Psychiatrist, to test and evaluate the Veteran's history of a mental disorder during service and/or if it may have some bearing on their current diagnoses of an associated mental disorders and/or conditions, rise to the level of a 1151 claim for failing to address the in service diagnosis for treatment and/or how it may bear on the effect and/or treatment of the current diagnosed mental disorder?

I have repeatedly asked to be evaluated for my inservice diagnosis of an acute schizophrenic episode, to determine it's state of remission and or how it may have some bearing on my current diagnosis, but I am rebuffed each time that they are only interested in treating me for my current diagnosis.

Must the Veteran exibit the extreme symptoms of his mental disorder, in order for the VAMC Dr's and/or Psychiatrist's to take notice and do something to help the Veteran cope with the total picture, of his mental disorder?

Jim S. B)

Link to comment
Share on other sites

  • Answers 8
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

8 answers to this question

Recommended Posts

  • HadIt.com Elder

I don't understand why everyone is so interested in 1151 Cliams as they will deduct it from your check.

Link to comment
Share on other sites

  • HadIt.com Elder

Pete

I thought Berta said they added the 1151 rating to your check?

Link to comment
Share on other sites

Pete

I thought Berta said they added the 1151 rating to your check?

Pete,

The 1151 can add compensation if the severity of a service-connected condition has been increased/aggravated by some type of VA medical negligence; the amount of compensation would be determined by the ratings criteria and the severity of the condition before and after the incident. Also, if the veteran wins an 1151 for something not SC then the VA has to pay "as if" it were SC.

The VA takes the 1151 claims seriously--each claim REALLY is a big deal--so these claims are not to be entered into lightly. Every jot and tittle of the veteran's medical record will be reviewed, if need be. I say "if" because sometimes the case is so clear that the facts "jump out" at the higher ups and they have no reasonable defense against the claim. It's not a matter of "as likely as not" or "more than likely" in these claims, rather the veteran must prove that the VA negligence CAUSED the injury. It is not a clear-cut case just because something happened right after VA-prescribed medication, treatment, etc.

The offset you might be thinking about is the tort settlement. If a vet wins an 1151 claim and a tort claim for a NSC, the VA compensation is offset up to the tort amount. In other words, the offset avoids duplicate payments for the same negligence/injury. However, if the injury involves an already SC condition, the offset does not apply. In that case, I interpret the law to say the vet could be paid twice for the SC condition. It's confusing, as are most VA issues past reading the compensation rate table. Come to think of it, even that is a little weird. B)

Carrie

Link to comment
Share on other sites

  • HadIt.com Elder

Thanks Carrie and John I think I can understand it a little better.

Link to comment
Share on other sites

I certainly hope the 1151 adds to my check... It had better considering they wastedmy life and shortened it without doubt. Because of thier wanting to cover up the error, I spent 5 friggin years in a wheelchair and will more than likely be back in one soon if I don´t got physical therapy soon.

Hmmm I am looking for 100% with SMC R1. This and nothing less... period... end of story.

Link to comment
Share on other sites

I certainly hope the 1151 adds to my check... It had better considering they wastedmy life and shortened it without doubt. Because of thier wanting to cover up the error, I spent 5 friggin years in a wheelchair and will more than likely be back in one soon if I don´t got physical therapy soon.

Hmmm I am looking for 100% with SMC R1. This and nothing less... period... end of story.

Josh,

Sorry you have gone through so much. Are you getting PT set up now? It would be a shame to end up back in a wheelchair when you can do something to head it off. What about Aid and Attendance, do you need that?

I know it is intense to fight through this, but be sure to push for everything that is rightfully yours. I am working through much of the same for my husband. He's in a wheelchair, too, because of poor VA medical care. He's getting PT three times a week now, but there's not much hope of it helping him. His claim for SMC R went to a rater last Friday, and she called me at 6:00 pm for a follow up, so I guess she must have been working late. We're hoping it was his claim that kept her there so late. I guess we'll find out soon. We revoked the POA with his SO because he made such a mess on the last claim. I finally fixed the trouble he caused and we won the claim and SAH entitlement. Now we are on our own again. This is too important to let an uninformed or untrained SO make it harder.

I've done a lot of research on Sec. 1151 and SMC R1/R2 so let me know if you think I could do anything to help you. (But you might want to wait and see if I win the claim for my husband. B))

Thank you for serving our country.

Carrie

Link to comment
Share on other sites

Carrie- that was quite a good assessment of 1151 claims!

glad you explained the offset-

Also Sec 1151 claimants can get SMC if appropriate-under 1151, but this is still an "as if" claim-

what bothers me is that I believe they combine the SC with the Sec 1151 to arrive at a comp figure-but I heard of a 100% vet who gets additional check for Sec 1151 disability.

When my claim is resolved I too will understand that part better-

Sec 1151 surviving spouses are not eligible for CHAMPVA, Chap 35, Home Mortgage Certificate,

and many other ancilliary benefits -under Sec 1151 deaths.

If the vet was direct SC 100% P & T before their Sec 1151 death -then the spouse would be eligible for CHAMPVA and Chap 35.

Link to comment
Share on other sites

Berta, When the two of us get our claims approved, we will have a lot of information to add to HADIT. It looks like you, Carrie, and myself are all playing the waiting game at this point.

Today I go into a orthopod to have the back checked out further and may get some PT added. Physical therapy here is the jungles of Colombia is really hard.. Most assuredly.. not available and cannot leave the farm unattended.

Oh yes FYI, I am currently 100% NSC with AA and that was granted because of a Misdiagnosis of MS rather than Infectious Encephalomyelitis which is the real problem. It will be interesting to see how they work out the conversion to 1151 100% with the SMC attached. That will happen hopefully in my lifetime. if not then in my wife´s lifetime as she saved my butt bigtime bringing me here to get the IV antibiotics.

Hugs to my Hadit "accomplices,"

We will win this fight!

Josh

Link to comment
Share on other sites

Guest
This topic is now closed to further replies.


  • veterans-crisis-line.jpg
    The Veterans Crisis Line can help even if you’re not enrolled in VA benefits or health care.

    CHAT NOW

  • question-001.jpeg

    Have Questions? Get Answers.

    Tips on posting on the forums.

    1. Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery instead of ‘I have a question.
       
    2. Knowledgeable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title.
      I don’t read all posts every login and will gravitate towards those I have more info on.
       
    3. Use paragraphs instead of one massive, rambling introduction or story.
       
      Again – You want to make it easy for others to help. If your question is buried in a monster paragraph, there are fewer who will investigate to dig it out.
     
    Leading too:

    exclamation-point.pngPost straightforward questions and then post background information.
     
    Examples:
     
    • Question A. I was previously denied for apnea – Should I refile a claim?
      • Adding Background information in your post will help members understand what information you are looking for so they can assist you in finding it.
    Rephrase the question: I was diagnosed with apnea in service and received a CPAP machine, but the claim was denied in 2008. Should I refile?
     
    • Question B. I may have PTSD- how can I be sure?
      • See how the details below give us a better understanding of what you’re claiming.
    Rephrase the question: I was involved in a traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?
     
    This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial of your claim?”
     
    Note:
     
    • Your first posts on the board may be delayed before they appear as they are reviewed. This process does not take long.
    • Your first posts on the board may be delayed before they appear as they are reviewed. The review requirement will usually be removed by the 6th post. However, we reserve the right to keep anyone on moderator preview.
    • This process allows us to remove spam and other junk posts before hitting the board. We want to keep the focus on VA Claims, and this helps us do that.
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • VA Watchdog

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×
×
  • Create New...

Important Information

{terms] and Guidelines