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?

[luvHIM]

Are you service connected for your back and knees?

Yes, my SC award is for chronic lumbosacral strain with ankylosing spondylitis, which effects the lumbar and periphal(splg ?) joints; and secondary fibromyalgia. My knees, neck and back have been put under the lumbosacral strain and AS.

I received the CA in 2004/2005. Then a new director came on board for the Prosth dept. and I have been denied every year since.

Pete...the reason shown is: The braces that were issued to you by this prosthetic department are designed to not cause wear and tear to the clothing, even when worn for an extensive amount of time. Therefore we must deny your claim for clothing allowance based on this reason.

That is bull crap. The first time I appealed they had me bring in my braces. I did that. I was still denied.

When I wear my knee braces they stretch out my sports pants at the knees. These type clothes are primarily what I wear, except to church. The back brace does cause wear and tear on my shirts/t-shirts.

I use an ointment because one of my medications causes me to break out from time to time.

But other than my wrists bands and cane...that's it. I guess I just don't understand why I got it two years straight and now I don't...for the same devices.

[luvHIM]

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.

I was just recently seen by Chief of Ortho for my knees and am being scheduled for surgery on my right knee.

I wear the back brace and also use the INF unit. I haven't requested a new back brace because it is not falling apart and my back condition requires me to wear the brace when I drive...sit for long periods...do grocery shopping, etc. I also receive other ortho and prosthetic deivices/equipment all the time.

The knee braces I use are designed to keep my knee stable because I have no cartilage in either knee. I have a chipped bone that is seen on xray exam that needs to be removed because it is actually causing me serious problems when I walk due to locking.

[sharon]

Write up a rebuttal and appeal the decision. They are wrong.

[pacmanx1]

Does your braces have metal in them? Do they leave rust or stains on your clothes? You may need your PCP or your rheumatologist to write in your progress notes that your braces may causes damage to your clothes. Most likely they had a doctor to review your claim for clothing allowance an it was his/her opinion that it does not damage your clothes. You will need a doctor to say that it is possible that they can damage your clothes. You can also try to take them some of your clothes as proof. All situations are not normal it maybe that in normal situations that they may not damage your clothes but in your particular situation they do damage your clothes but it will be up to a doctor to decide if it is possible, you can only ask. If I am off someone else will chime in and correct me

[luvHIM]

Write up a rebuttal and appeal the decision. They are wrong.

Okay...will do...thanks!

Pete, my back brace has a metal rod insert that runs down the two sides (inside).

Edited August 2, 2009 by luvHIM

[luvHIM]

Write up a rebuttal and appeal the decision. They are wrong.

What should my rebuttal say? Couple of years back I did one and apparently it was not good enough because I was still denied.