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]

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

Have your doctor write a statment B)

[entropent]

Your denial stated, "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."

Back when you were approved for the clothing allowance, the decision was still the responsibility of the RO. If the record showed that prosthetics issued some type of device for a service connected knee (for example), the rater would have no way to know if you were issued a simple elastic knee sleeve or a high speed unloader brace. He would therefore not be able to tell if the type of brace was designed not to cause wear and tear on the clothing, and would routinely approve the claim. VBA has now delegated the decision making authority to the prosthetics departments precisely because they are the ones who can make that determination. A lot fewer vets get clothing allowance now.

[deltaj]

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?

Perhaps the best way to appeal the denial of the clothing allowance would be to argue that the topical medication which was prescribed for your service connected condition causes clothing to be stained. It would probably also be helpful to mention that application of the knee brace also stretches out your polyester stretch pants at the knees. Try measuring a new pair at the knees in the same size and comparing them to your used pair that has been stretched out at the knees and include the data and photo with your appeal. I think I would also take a dictionary and include the meanings of that word designed. While it may be true that a manufacturer may have developed design specifications with the intent to design a brace that did not tend to wear out clothing, manufacture of a brace design does not necessarily mean that the manufacturer succeeded in producing a brace that actually does not wear out clothing. Ask V.A. in your appeal the name of the brace manufacturer and ask them to supply you with the product data sheet on that brace. Also ask them to supply you with a copy of the patent application on that brace. I would be willing to be you that neither the product data sheet or the patent application mention the brace tends to not wear out clothing. I suggest you search online under knee brace AND product data sheet. This will show you some examples of knee brace product data sheets. You might even be able to find a material data sheet for the brace you have so that you could include the product data sheet with the appeal. I wonder if there is a tag on the brace that includes a patent number and if the patent application for the brace which touts advantages of the brace design would mention whether the brace is designed to wear out clothing. If you could get the brand name of the brace from a label on the brace or from V.A. prosthetics department, maybe you could visit the manufacturer's website to determine if the manufacturer has made any representations or statements to the effect that the brace does not wear out clothing. I think you should also tell them in your appeal that you wear 4 braces which were prescribed by V.A. doctors for your service connected conditions including a neck brace, 2 knee braces, and a back brace and that accordingly you are asking for 4 clothing allowances as authorized by Sursely v. Peake.

Edited August 31, 2009 by deltaj

[luvHIM]

I know I haven't been checking in much like I use to. It seems that I was awarded my claim and my condition grew worse. Go figure...

Anyway, I thank everyone for their input. I will attempt to get my doc to write something. I now have a new PC and this would be my third one, since the actual issuance of my devices. I'm going to ask for new knee braces on Wed at my Ortho appointment and see what he can write.

I don't even know if it's too late for this year or not. But...nothing beats a fail but a try.

[broncovet]

Their reasoning is faulty: Are any prosthetic appliances "designed" to wear clothes out faster? I don't think so. That would be like saying they designed a car to be unsafe.

It really would not matter what the prosthetic appliance was "designed" to do..after all, you body was not "designed" for prosthesis!

The design of the prosthesis has nothing to do with whether or not it wears your clothes out. Did they ever hear of faulty design? Is it your fault they designed the prosthetic device to not wear out clothes, but they do anyway?