Va Medication Co-pays Vs. Side Effects

[Vync]

Hello everyone,

The VA gave me some tylenol 3's and tylenol 4's to help me address my SC chronic TMJ pain, depending on the severity. It helps tone down the pain, but there are a couple of side effects.

The way I see it is like this:

SC chronic TMJ pain --> T3's/T4's --> depression/constipation

In both situations, I got a bill from the VA for a bunch of $8.00 co-pays for antidepressants and laxatives. The docs are telling me that I must be SC for constipation and/or depression before they will waive the co-pays for those meds.

I believe that they should both be SC, because the meds are used to treat side effects caused by the medication initially used to treat SC problems.

Who's right? Me or the VA?

[jbasser]

I would consider a claim for t he side effects if they become chronic. There is more than 1 way to skin a cat.

it is interesting but you should win.

J

[Vync]

Sounds like a plan. However, if I get an additional 10% rating, it should push me to 50% and co-pays would not matter any more. Another way to skin it too!

Thanks!

[carlie]

The way I see it is like this:

SC chronic TMJ pain --> T3's/T4's --> depression/constipation

In both situations, I got a bill from the VA for a bunch of $8.00 co-pays for antidepressants and laxatives. The docs are telling me that I must be SC for constipation and/or depression before they will waive the co-pays for those meds.

I believe that they should both be SC, because the meds are used to treat side effects caused by the medication initially used to treat SC problems.

Who's right? Me or the VA?

Vync,

The way I see it is like this:

VAMC RX'd T3's/T4's to treat pain of SC TMJ -

should be no charge for the RX/

VAMC RX'd XXXXX to treat constipation secondary to T3's/T4's -

should be no charge for the RX.

I do not think a claim for constipation would be granted

BUT

any meds for constipation should be provided at no charge.

Depression is a separate claim all on it's own as secondary to TMJ,

which I think you've already filed a claim for.

Myself I would have probably filed a claim for chronic pain versus

a claim for depression as I your medical evidence might be more

supportive if this.

jmho,

carlie