Jay Johnson Posted March 15, 2006 Share Posted March 15, 2006 (edited) Sorry I've been away for so long, but the holidays were rough for the wife and the VA was, well, the VA. Anywho, I'm not sure if anyone remembers my wife's case, but I'll try to sum it up and how, exactly, we won the case (for the most part): About 2 yrs ago my wife was bumped up from 100% for PTSD to 100% P&T with A&A from the philadelphia RO...upon moving to the west coast, the seattle RO got ahold of her case and tried reducing her first to 70% IU, then to 100% with housebound and claimed she was again P&T, yet scheduled a future exam. We, of course, sent in our NOD AND I sent in a CUE about taking away the A&A without cause (they said she never deserved it in the 1st place which is against the regs) and we sent one in about scheduling an exam despite being P&T. Well, we got the typical run-around from our contacts in the seattle RO and had the same old delays for a DRO review (we even had a senator working for us...like that does anything). One day I decided to have the wife call our contact there (frank) who "use" to be the vice-director of the RO, but he had been temporarily promoted to director because the old director left....oddly enough, frank was very receptive to my wife and said he would look into the case. Two days later the DRO called my wife and asked her what, exactly, she wanted from the NOD (of course she broke down on the phone call pretty bad)...he proceeded to say that they COULD NOT schedule a future exam with P&T and that he would clear that up, but he showed reservations about awarding her the A&A again. So, the wife basically told the DRO that she didn't care about the A&A so long as she didn't have to deal with them again (which she shouldn't given she was P&T to start with). The DRO made the decision that day and we got notice by mail within 2 days saying "NO FUTURE EXAMS and 100% P&T with housebound". In the end, it came down to "who" we knew and having that person look into our case...before the acting director stepped in the DRO wasn't even supposed to get to our case until may, at the earliest, instead, we got a decision in our favor within 2 months of filing the NOD. On one hand, I'm extremely relieved that we're done with these people (we use a civilian psych so we will never set foot near a VA facility EVER again)...on the other hand, I feel terrible for everyone else who doesn't have the contacts I made in the seattle RO (which was more dumb luck then anything). Our case was blatant and bordering on criminally obvious and we still would likely not have won at the DRO level had the director not stepped in:-( Anyway, it's good to be back...I'm not sure how much time I can devote, but I hope everyone is doing well and that some of you have some success stories since my last visit:-) Edited March 15, 2006 by Jay Johnson Link to comment Share on other sites More sharing options...
HadIt.com Elder Pete53 Posted March 15, 2006 HadIt.com Elder Share Posted March 15, 2006 Nice to see you again Jay. I remember you used to post a lot of good info. Veterans deserve real choice for their health care. Link to comment Share on other sites More sharing options...
carlie Posted March 15, 2006 Share Posted March 15, 2006 Jay, Congrats on the claim. WELCOME BACK ! ! ! Hope you're going to stay with us. I've REALLY been missing your posts. carlie Carlie passed away in November 2015 she is missed. Link to comment Share on other sites More sharing options...
Dorothy Kansas Posted March 15, 2006 Share Posted March 15, 2006 Jay-- Glad to hear that you were successfull at getting her P&T back. The truth of the matter is she should never had to endure this crap anyway. As for her A/A she is entitled because she needs help to protect her they forget that this also entitles someone if they are unable to protect themselves. I have been back and forth with these idiots. They had me reduced to 90 percent and had taken my A/A. They retracted on the reduction and have reccomended HB. I am still fighting so now they are starting all of these C&P again. Link to comment Share on other sites More sharing options...
Jay Johnson Posted March 15, 2006 Author Share Posted March 15, 2006 Jay-- Glad to hear that you were successfull at getting her P&T back. The truth of the matter is she should never had to endure this crap anyway. As for her A/A she is entitled because she needs help to protect her they forget that this also entitles someone if they are unable to protect themselves. I have been back and forth with these idiots. They had me reduced to 90 percent and had taken my A/A. They retracted on the reduction and have reccomended HB. I am still fighting so now they are starting all of these C&P again. Thanks dorothy:-) It seems that they are trying to reduce most PTSD folks with A&A to HB to save some money. In my wife's case they gave NO new information in their decision and, merely said that they did not agree with her ever having been awarded it in the first place (which is against the regs and I CUED it). Basically, in the end, the HB is more advantageous to us because it allows me more freedom. Under her last award for A&A it was written that she needed me with her at all times for suicidal/homicidal ideation...there is a chance, in the future, that this level of self harm may subside, which means, technically, I would have to inform them of the improvement, or, if they found out, they could sue us for overpayment for the time she no longer required A&A (again, opening pandora's box). HB, on the other hand, is less strict and considered to be permanent (as a single disability and not several 60%+ disabilities). There is a chance that my wife could become less dependent on me (god I hope so), but there is little chance that she'll ever regain her ability to function in society independently....so, with HB I lose a couple hundred dollars per month, but I believe it gives us more stability. Also, I didn't want to put the wife through further appeals on the matter....$200 just isn't worth the hell of fighting the VA for the next few years:-( With that said, I certainly don't discourage you from getting what you deserve, but just make sure it's something you truly feel is worth the hell that the VA will put you through to get it. BTW, under the HB single disability rule you MUST be P&T to qualify and cannot have future exams scheduled, which, in my opinion, puts you on more solid ground then A&A which has no such prerequisites. Link to comment Share on other sites More sharing options...
Dorothy Kansas Posted March 16, 2006 Share Posted March 16, 2006 Jay-- I am P&T the reason they came after me is that I qualify for R1. So they figured if they killed my 100 percent then i wouldn't qualify for a higher A/A. Also you can't build on HB whereas you can with A/A. Link to comment Share on other sites More sharing options...
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