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?

[jsdwd]

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

Ah. My VSO told me that it would be retroactive to the date of the informal claim (July 8th). It's not a ton of money and it's mostly that I was surprised by the amount and started trying to figure it out.

Thanks for the help

[WHOLESALE]

July 8 is your claim date but payment always starts on the 1st of the next month. Even if you put in a claim on July 1st your payment would start on August 1st.

Frank

Ah. My VSO told me that it would be retroactive to the date of the informal claim (July 8th). It's not a ton of money and it's mostly that I was surprised by the amount and started trying to figure it out.

Thanks for the help

[deltaj]

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.

Google the phrase M-21 AND inferred issue. You'll find some material in the M-21 about inferred issues in relation to diabetes. The example in the M-21 is about hypertension secondary to service-connected diabetes but this would be similar to peripheral neuropathy secondary to service-connected diabetes.

Edited July 24, 2009 by deltaj