VetsLady Posted September 21, 2009 Share Posted September 21, 2009 If a Vet becomes 100% P%T, can he go back and put in for reimbursement of out of pocket medical expenses for he and his family to the date that he became 100%? Where can I get more information on this? Also, does someone know where in the docket the AMC is at in deciding claims? I know many of you have appeals at the BVA and/or AMC. My husband's was remanded back to the RO, then we dropped one of the issues and there is only 1 issue on appeal presently. We know for certain (well, haven't actually "seen" the file there with our own eyes) I'm getting conflicting information on a docket date. His file was sent to BVA in Sept. 08, hearing was Nov. 08, remand date is March 09. I sent an inquiry in to AMC and no response. Just sent an IRIS, maybe they know. Trying to gauge a timeline of when his claim may be decided as his claim is marked Hardship. I was given information that his file is in the developing dept. - all developing has been done already - but this is the last info I have. I'm told that if it goes well in development and is SC then his file will be walked upstairs for a rating, AMC is doing the rating. BVA doesn't want to see this file back as the RO really mucked it up. Thank you for any information you can provide. VetsLady Link to comment Share on other sites More sharing options...
HadIt.com Elder Pete53 Posted September 21, 2009 HadIt.com Elder Share Posted September 21, 2009 You can get your copay back till effective date. If spouse has ChampVA I am not sure how far they will go back but press them Link to comment Share on other sites More sharing options...
HadIt.com Elder jbasser Posted September 21, 2009 HadIt.com Elder Share Posted September 21, 2009 Champ VA recipients have a limited number of months to file claims for medical treatment and precriptions back to the effective date of the P and T award. I believe it is 180 days. J Link to comment Share on other sites More sharing options...
carlie Posted September 22, 2009 Share Posted September 22, 2009 His file was sent to BVA in Sept. 08, hearing was Nov. 08, remand date is March 09. I sent an inquiry in to AMC and no response. Just sent an IRIS, maybe they know. Thank you for any information you can provide. VetsLady Vetslady, No guess here as to when, but hopefully it won't be too long for ya'll now. Did you request a copy of the BVA Hearing transcript's ? If yes, Have you received them yet ? carlie Link to comment Share on other sites More sharing options...
VetsLady Posted September 22, 2009 Author Share Posted September 22, 2009 Thanks for the replies.... No, I haven't requested the actual transcript. We did receive the remand. The 1 issue still on appeal, the VLJ had nothing in the remand regarding it specifically. He wanted the SSD records associated with the file as VA w wasn't aware he was on SSD. We had a (yes had) a very poor VSO, which didn't help things along at all. There were 4 requests in the remand itself, 1 - for the SSD records, 2 -a QTC exam be done re: PTSD 3 - stressor verfication 4 - Readjudicate the Claim after the above is done, if not granted then provide an SSOC, etc and so on. We dropped the PTSD issue as he does not have and has not been treated for PTSD, has been examined many times, it's a depression issue related to his SC conditions and the remaining issue on remand. The VLJ saw the proof in the pudding sitting in front of him during the hearing. That, with the 2 strong Nexus and medrecs to substantiate the condition should be enough. Yes, 1 - something happened to him in service to cause an injury/disease. Yes, 2 docs (1 from QTC) say that the in-service event was the reason that caused his injury/disease. The 3 elements required are there, it's just the waiting and they lost his file, his file is so large, how could they? No one wanted to do anything on it, VSO forgot about us, didn't return calls...so we went a different direction. Seriously, if I knew then what I know now, I would have never given a VSO POA. They got their dough almost 8 years ago, and in those 8 years, he has gone down hill, 3 phases of chemo, a bunch of other stuff is cropping up, he had to quit work and the $ we have spent on meds, geeeez. We had no idea he had the med available at VA until earlier this year. So, went from 4/08 - 12/08 out of pocket, with private med ins., but still, very expensive and could not drop it or change in any way for fear of not getting onto another plan. Pre-existing condition thing. I feel he has a strong claim, but until the pennies are in the pockets, we don't feel comfy cozy. When this part is over, we'll have increases to go for on what he is already SC for. It's sad to watch him deteriorate. Enough about this.... Does anyone know how long a file can stay at the AMC for decision? What happened to expediting claims? VLJ mentioned it should be expedited in the remand. Thought there was some time frame, but perhaps appeals are on a different boat. Can't believe they would have anything else to "develop" - they have it all. I made sure of that, sent via Certified Mail/RRR. Link to comment Share on other sites More sharing options...
carlie Posted September 22, 2009 Share Posted September 22, 2009 Thanks for the replies.... Does anyone know how long a file can stay at the AMC for decision? What happened to expediting claims? VLJ mentioned it should be expedited in the remand. Thought there was some time frame, but perhaps appeals are on a different boat. Can't believe they would have anything else to "develop" - they have it all. I made sure of that, sent via Certified Mail/RRR. Vetslady, I do not know of any reg that states any time frame regarding how long a file can stay at the AMC, or other levels for a decision to be made. Regarding "expediting claims", there are thousands of claims in front of our's that BVA and the Court, have also requested that they be expedited. In my opinion we are just placed into a different line to wait in. jmho, carlie Link to comment Share on other sites More sharing options...
VetsLady Posted September 22, 2009 Author Share Posted September 22, 2009 Oh am sure of that Carlie. Hurry up and wait. Link to comment Share on other sites More sharing options...
Question
VetsLady
If a Vet becomes 100% P%T, can he go back and put in for reimbursement of out of pocket medical expenses for he and his family
to the date that he became 100%? Where can I get more information on this?
Also, does someone know where in the docket the AMC is at in deciding claims? I know many of you have appeals at the BVA and/or AMC.
My husband's was remanded back to the RO, then we dropped one of the issues and there is only 1 issue on appeal presently. We know for
certain (well, haven't actually "seen" the file there with our own eyes)
I'm getting conflicting information on a docket date. His file was sent to BVA in Sept. 08, hearing was Nov. 08, remand date is March 09.
I sent an inquiry in to AMC and no response. Just sent an IRIS, maybe they know.
Trying to gauge a timeline of when his claim may be decided as his claim is marked Hardship. I was given information that his file is in the
developing dept. - all developing has been done already - but this is the last info I have. I'm told that if it goes well in development and is
SC then his file will be walked upstairs for a rating, AMC is doing the rating. BVA doesn't want to see this file back as the RO really mucked it
up.
Thank you for any information you can provide.
VetsLady
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