Temp 100% Convalescent Pay After A Surgery

[foleyj]

I submitted a claim for convalescent pay after spine surgery and the doctor put that I would be out for 3 months. I just received that payment, but it is a lower amount then I was told. I am rated at 60% with a spouse and one child. The 100% rate would be 2932.00. If I am doing the math correctly 2932.00-1129.00=1803.00. The difference is 1803.00 and that should be the amount that I should have gotten for the 3 months for a total of 5409.00. The payment that I received was 4335.00. Is this the way the VA calculates this, or is there a different rate table for this type of situation?

[121212]

If you were house bound after your spine surgery, you can file for that, I got it for 3 months and it was 3123 dollars I think, I know it was over 3100 dollars, you might want to check in to that.

Ken

[foleyj]

Well I finally got in touch with a very helpful VA rep on the phone. I was actually surprised that this person was so helpful, but anyway here is the response that was sent to me. Now keep in mind that the original claim was for 3 months.

Mr. Foley:

This is in response to your inquiry dated January 29, 2010, regarding retroactive pay.

Based on the notification letter, the VA granted temporary 100% for two months, September 2009 and October 2009. September 1, 2009 - October 31, 2009 $3,756.00 for temporary 100% with 2 dependents.

I am trying to figure out why I was only paid for two months instead of three. The letter that I sent in from the doctor clearly states that the convalescence will be 3 months.

[Berta]

I suggest you ask them to CUE themselves on their financial error-tell them why the amount is wrong and send them copy of the doctor's statement.

It seems the response you got only confounded the issue more.

[Quint7]

I had the exact same situation post spinal surgery. You must remember that the date of the operation is not the date you are paid from. If you had the operation on Jan. 3rd (as I did last year) you will get nothing for Jan. as you weren't 100% for the entire month and VA does not pro-rate.

So if the 3 months of total disability doesn't begin on a 1st of the month and go to the last day of the 3rd month you will get bumped down to only two months pay. That is what I was given.

I had surgery on Jan 3rd and was off work until June 15th. I requested 4 months of temp 100% due to Jan. and June not being complete months. I received 2 months due to my claim being awarded in March. I have on appeal a request for the other 2 of the 4 months and should win. My claim is supposedly at the final rater and is awaiting authorization.

Hope that makes sense.

[foleyj]

Thanks for the info it does somewhat clear things up. The only problem with my situation is that the surgery was on 7/8/2009, so if the VA starts the rating on the 1st of the next month shouldn't it have started on the 1st of August? The other problem is that this is not mentioned anywhere in the regulation that explains the rating criteria. So would it help if I went back to my doctor and had him amend the order for my convalescence? I was actually off of work until November, I just read the regulation and told him to make it 3 months and he said if I needed more to just tell him.

[foleyj]

I just the regulation for this and this is what I found;

A total disability rating (100 percent) will be assigned without

regard to other provisions of the rating schedule when it is established

by report at hospital discharge (regular discharge or release to non-bed

care) or outpatient release that entitlement is warranted under

paragraph (a) (1), (2) or (3) of this section effective the date of

hospital admission or outpatient treatment and continuing for a period

of 1, 2, or 3 months from the first day of the month following such

hospital discharge or outpatient release.

So I see where it says from the first day of the month, but it also says that the effective date is the date of admission or treatment. So this is confusing. If the effective date is the date of admission, than why isn't paid from this date? This is the date at which you become 100%.