Can You Submit A Claim 100% Temporary Disability In Advance?

[xray328]

Hello everyone.

My wife is rated at 10% for her knee. She's going to have a total knee replacement surgery on September 11. I know she is eligible for 100% temporary disability for 13 months after the surgery. Does anyone know if we can submit the claim now to cut down on our wait after the surgery for the benefits to kick in? If we go through the online claim process, what paperwork will we need from her doctor, and how do we submit that since were doing the claim online?

Thank in Advance!

[Pete53]

I don't see why you could not if you know they time of surgery. In the past it seems that VA has worked this type of claim quickly it helps their miserable record and is automatic.

[Eric_M]

I filed for the temp 100% prior to surgery. Still took them about month and 1/2 after the surgery for them to render a decision.

I'm not familiar with the on-line process, but I would simply send the surgical / discharge notes to your regional office with a note explaining what was done. I'm sure there's fancy VA form number. As long as it's go your claim number on it, should be fine.

Good luck.....Eric

[sharon]

If you send it too early they will deny it based on the fact that the surgery has not occurred. It's all in the timing. You can file for an increase now as the condition has gotten worse. Send in the hospital report immediately after the surgery.

Edited July 17, 2009 by sharon

[12R3G]

I suppose you could, but much simpler to either write a letter or use VA Form 21-4138 Statement in Support of Claim (download the fillable pdf). Attach a doctor's letter explaining what's happening and when. If you call the 800 number they will give you the fax number for the VARO, or you can mail.

The VONAPP is designed for initial claims...pretty much overkill for what you are trying to do. the 21-4138 fills the bill, and can even be used to add new disablities (which sounds like a new claim to me) after the original claim.

Total knee replacement and she is only rated 10%? What's up with that?

good luck...

[Quint7]

I had a spinal fusion in Jan. 09 and I don't know if there is something I'm missing or what but I read and was told that temp 100% post-op falls under the conversant rating. It says that it can only be granted for 1,2 or 3 months and "maybe" another 3 under special circumstances.

It also is like a claim in that if the operation doesn't occur on the first day of the month you get nothing for that month because they don't pro-rate for partial months.

I was out of work for 5 1/2 months and was granted one month at 100% and have an appeal in to get the other 2 months worth.

January doesn't count because the operation was on the 9th and June doesn't count because I went back to work on the 15th. I didn't specifically ask for only 2 more months, I requested all 4 complete months at 100% and was basically told it won't happen, that 3 months is usually the max.

I also informed them pre-op that I wanted the 100% and was told no.

Just the info I was given and told.

[sharon]

I had a spinal fusion in Jan. 09 and I don't know if there is something I'm missing or what but I read and was told that temp 100% post-op falls under the conversant rating. It says that it can only be granted for 1,2 or 3 months and "maybe" another 3 under special circumstances.

It also is like a claim in that if the operation doesn't occur on the first day of the month you get nothing for that month because they don't pro-rate for partial months.

I was out of work for 5 1/2 months and was granted one month at 100% and have an appeal in to get the other 2 months worth.

January doesn't count because the operation was on the 9th and June doesn't count because I went back to work on the 15th. I didn't specifically ask for only 2 more months, I requested all 4 complete months at 100% and was basically told it won't happen, that 3 months is usually the max.

I also informed them pre-op that I wanted the 100% and was told no.

Just the info I was given and told.

This is not correct. Attached is the regulation reference.

temporary_100_.doc