diabetes Retroactive Calculations

[jsdwd]

The effective date of most of my claim was july 2008. One payment was effective as from the exam date, March 30, 2009:

1. Post traumatic stress disorder

30% effective Jul 8, 2008

Diabetes mellitus tlpe II

20% . effective Jul 8, 2008

Bilateral hearins loss

0% effective Jul 8. 2008

Tinnitus

10% effective Jul 8, 2008

Peripheral neuropathy of right foot

l0% effective Mar 30,2009

I estimated the retro check i would receive using those dates and the payment table they provided on my cover letter.

"Your Award Amount and Payment Start Date :

Your monthly entitiement amount is shown below:

$728.00 Aug 1,2008 Original Award (50%)

$770.00 Dec 1,2008 Cost of Living Adiustment

$974.00 Apr 1,2009 lncreased Compensation Rate (from 50% to 60%)" - - - - parenthesis mine

So I calculated a daily rate (monthly rate x 12 ÷ 365) for each payment rate and multiplied that times the number of days that rate applied, starting with July 8, 2008 and going forward to the rating date of July 14, 2009. I assumed that I would get the remainder of July 2009 from the rating date onward on August 1, 2009.

Doing the math, I expected a retroactive check of about $10,000 ($9895.67), The check arrived today and was for $8914 almost $1000 less than I thought ($982). It is possible that on August 1, 2009 I will receive a check for all of July 2009, but it still is about $500 less than I thought. I tried to back into their number and found that if one starts payment at August 1, 2008 and ends it at June 30, 2009 and uses the payment rates they supplied, it equals to $8914, the amount of the check.

So the period between July 8, 2008 and August 1, 2008 and the period from July 1, 2009 and July 14, 2009 (the date of the rating) is uncompensated. What gives?

Is there guidance as to how this should be calculated? If they made a mistake how do I contest that?

[john999]

If you claimed PN in your original claim you should have the earlier effective date and not the date of the claim. If you had an existing diagnosis of PN in your records prior to the exam date you should have gotten EED. The VA plays this game a lot with DMII and secondary conditions. I think I would appeal that.

[Pete53]

Most people miss their calculation by one month cause the VA does not pay for a month the until the first of the next month.

So I guess you are in the ballpark

Congrats now it should continue without a problem. 50% means free meds and VA has to take care of you for everything, Its pretty important.

Edited July 23, 2009 by Pete53
typo

[Philip Rogers]

You never get the remainder of a month. If they award you on July 8, the payment period starts beginning the 1st of the following month, with the actual payment being received the 1st of the next month. You were awarded as of 7/8/08 and you'll actually receive payment for the month of August/08 on 9/1/08.

pr

The effective date of most of my claim was july 2008. One payment was effective as from the exam date, March 30, 2009:

1. Post traumatic stress disorder

30% effective Jul 8, 2008

Diabetes mellitus tlpe II

20% . effective Jul 8, 2008

Bilateral hearins loss

0% effective Jul 8. 2008

Tinnitus

10% effective Jul 8, 2008

Peripheral neuropathy of right foot

l0% effective Mar 30,2009

I estimated the retro check i would receive using those dates and the payment table they provided on my cover letter.

"Your Award Amount and Payment Start Date :

Your monthly entitiement amount is shown below:

$728.00 Aug 1,2008 Original Award (50%)

$770.00 Dec 1,2008 Cost of Living Adiustment

$974.00 Apr 1,2009 lncreased Compensation Rate (from 50% to 60%)" - - - - parenthesis mine

So I calculated a daily rate (monthly rate x 12 ÷ 365) for each payment rate and multiplied that times the number of days that rate applied, starting with July 8, 2008 and going forward to the rating date of July 14, 2009. I assumed that I would get the remainder of July 2009 from the rating date onward on August 1, 2009.

Doing the math, I expected a retroactive check of about $10,000 ($9895.67), The check arrived today and was for $8914 almost $1000 less than I thought ($982). It is possible that on August 1, 2009 I will receive a check for all of July 2009, but it still is about $500 less than I thought. I tried to back into their number and found that if one starts payment at August 1, 2008 and ends it at June 30, 2009 and uses the payment rates they supplied, it equals to $8914, the amount of the check.

So the period between July 8, 2008 and August 1, 2008 and the period from July 1, 2009 and July 14, 2009 (the date of the rating) is uncompensated. What gives?

Is there guidance as to how this should be calculated? If they made a mistake how do I contest that?

[sharon]

Sep 728

Oct 728

Nov 728

Dec 728

Jan 770

Feb 770

Mar 770

Apr 770

May 974

Jun 974

Jul 974

8914

Jul 8 is effective 1 Aug. Aug is paid in Sep. Cola in Dec is paid in Jan. Increase in Apr is paid in may. The VA pays a month in arears. Jul is paid in Aug.

Edited July 23, 2009 by sharon

[jsdwd]

Sep 728

Oct 728

Nov 728

Dec 728

Jan 770

Feb 770

Mar 770

Apr 770

May 974

Jun 974

Jul 974

8914

Jul 8 is effective 1 Aug. Aug is paid in Sep. Cola in Dec is paid in Jan. Increase in Apr is paid in may. The VA pays a month in arears. Jul is paid in Aug.

Gotcha. Thanks for clarifying. I am not complaining, I'm just confused... if I get 728 in September '08 for Aug '08, as you indicate, then what happens to the period from July 8, 2008 until August 1, 2008, I don't get anything?

[Philip Rogers]

Correct, you don't get anything for the period 7/8/08 - 7/31/08. August 1, starts the new month. That's just the way it is. They only pay for full months.

pr

Gotcha. Thanks for clarifying. I am not complaining, I'm just confused... if I get 728 in September '08 for Aug '08, as you indicate, then what happens to the period from July 8, 2008 until August 1, 2008, I don't get anything?