tdiu Clothing Allowance

[luvHIM]

I was denied my clothing allowance by VAMC Prosthetics dept. Their reasoning makes no sense.

I am 100% TDIU/P&T. I wear a back brace and two knee braces, as well as use a neck brace. I also use a cane to assist with ambulation. But I applied based on the back and knee braces that were issued back in 2004/2005.

I use to get the CA and then got a letter saying it would be stopped back in 2006.

I reapplied after getting my new rating and am still being denied. How do I fight this? They say if I disagree with their decision to appeal. Well, last time I appealed the same dept handled the appeal. So, who would I appeal to in order to get an unbiased review of the claim?

[sharon]

Are you service connected for your back and knees?

[Philip Rogers]

If you are SC for back and knees, I'd file an appeal w/the prosthetics dept, in addition to filing for a second CA, for the knees, or back. Since they each wearout different clothing, you should be able to get two awards. I believe the appeal process is the same, as for standard comp claims.

pr

I was denied my clothing allowance by VAMC Prosthetics dept. Their reasoning makes no sense.

I am 100% TDIU/P&T. I wear a back brace and two knee braces, as well as use a neck brace. I also use a cane to assist with ambulation. But I applied based on the back and knee braces that were issued back in 2004/2005.

I use to get the CA and then got a letter saying it would be stopped back in 2006.

I reapplied after getting my new rating and am still being denied. How do I fight this? They say if I disagree with their decision to appeal. Well, last time I appealed the same dept handled the appeal. So, who would I appeal to in order to get an unbiased review of the claim?

[pacmanx1]

If you don't mind can you post their reasons, what was your past clothing allowance approved for? Knee braces should not be a problem especially if you got an increase on them. What type of back brace and knee braces do you use?

[rentalguy1]

service connection does not matter when it comes to a clothing allowance. If it has been more than a couple of years since you've seen your docs about your braces or since you've received new braces from prosthetics, then you will likely be denied. The record would paint a picture that you are no longer wearing the braces, and therefore have no need for a clothing allowance. I typically wear out my knee braces about once per year, and my back brace takes a bit longer than that. I don't know how long my new AFO will last, though, since it's made out of carbon fiber.

[sharon]

§3.810 Clothing allowance.

(a) Except as provided in paragraph (d) of this section a veteran who has a service-connected disability, or a disability compensable under 38 U.S.C. 1151 as if it were service-connected, is entitled, upon application therefor, to an annual clothing allowance as specified in 38 U.S.C. 1162. The annual clothing allowance is payable in a lump sum, and the following eligibility criteria must also be satisfied:

(1) A VA examination or hospital or examination report from a facility specified in §3.326© discloses that the veteran wears or uses certain prosthetic or orthopedic appliances which tend to wear or tear clothing (including a wheelchair) because of such disability and such disability is the loss or loss of use of a hand or foot compensable at a rate specified in §3.350(a), (, ©, (d), of (f); or

(2) The Chief Medical Director or designee certifies that because of such disability a prosthetic or orthopedic appliance is worn or used which tends to wear or tear the veteran’s clothing, or that because of the use of a physician-prescribed medication for a skin condition which is due to the service-connected disability irreparable damage is done to the veteran’s outergarments. For the purposes of this paragraph “appliance” includes a wheelchair.

(:o Effective August 1, 1972, the initial lump sum clothing allowance is due and payable for veterans meeting the eligibility requirements of paragraph (a) of this section as of that date. Subsequent annual payments for those meeting the eligibility requirements of paragraphs (a) of this section will become due on the anniversary date thereafter, both as to initial claims and recurring payments under previously established entitlement.

© (1) Except as provided in paragraph ©(2) of this section, the application for clothing allowance must be filed within 1 year of the anniversary date (August 1) for which entitlement is initially established, otherwise, the application will be acceptable only to effect payment of the clothing allowance becoming due on any succeeding anniversary date for which entitlement is established, provided the application is filed within 1 year of such date. The 1-year period for filing application will include the anniversary date and terminate on July 31 of the following year.

(2) Where the initial determination of service connection for the qualifying disability is made subsequent to an anniversary date for which entitlement is established, the application for clothing allowance may be filed within 1 year from the date of notification to the veteran of such determination. (Authority: 38 U.S.C. 1162)

(d) If a veteran is incarcerated in a Federal, State, or local penal institution for a period of more than 60 days and is furnished clothing without charge by the institution, VA shall reduce the amount of the annual clothing allowance by 1/365th of the amount otherwise payable for each day the veteran was incarcerated during the 12-month period preceding the anniversary date for which entitlement is established. No reduction shall be made for the first 60 days of incarceration. (Authority: 38 U.S.C. 5313A)

[rentalguy1]

I stand corrected. What I meant to say was that a clothing allowance does not come from the VARO, and that a veteran's rating percentage does not matter. When the last prosthetic or orthotic piece of equipment was prescribed or replaced does matter a great deal, though. In other words, if you are sc'd at 0%, and got a replacement knee brace last year, then you would be able to get your clothing allowance. If you are a 100% P&T vet who has not had a new or replacement orhotic prescribed in the last 5 years, then you will not get a clothing allowance. The reason for this is because it would appear that you no longer wear the piece of equipment.

Thanks for posting the reg, Sharon.