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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
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Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
Chuck75
I ran into an interesting and frustrating situation that I and not a few other veterans seem to be in!
The VA has placed documents on it's web site(s) that indicate that an A.O. presumptive veteran is not charged Co-Pay for treatment (includes drugs)
of various problems that are related to A.O. exposure.
The first document is titled:
"VA Health Care Eligibility & Enrollment"
"Outpatient Prescription Copay"
And states:
"Exceptions to Copay Rules for Medication"
"VA does not charge a copay for medications used for treatment of --"
-
-
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"A veteran's conditions related to a veteran's exposure to:"
"Herbicides during the Vietnam-era"
-
And so forth
The document also contains a statement relating to reduction of co-pay and to contact
the "Enrollment Coordinator at your local VAMC" or for further information call the VA at 1-877-222-8387
(Who profess to no knowledge and/or expound the co-pay until "adjudicated" VA stand)
Now, moving on to the next VA document ---
Fact Sheet 164-8
2010 Copay Requirements at a Glance
Dated July 2010
This document lists the one through eight "Priority Groups" that the VA places Veterans into, and lists Co-Pay requirements in a table corresponding to each group.
Three groups of the eight are involved.
"Group 2 & 3 (Service connection 10-30%) No medication co-pay for SC condition or ex POW"
(This applies to all conditions that have been "adjudicated" as being service connected. )
The real heart of the matter.
"Group 6 Combat Veteran SHAD, SC 0% - - - Agent Orange Exposure ---- Copay rules apply if unrelated to group 6 placement". Since "adjudicated" conditions fall under group 2 & 3, this can only apply to un"adjucated" or 0% conditions.
Evidently, the VA interprets a veteran's change to Group 2 or 3 from another Group, due to one or more "adjucated" condition(s) as removing the veteran from Group 6 entirely, thus making any un"adjudicated" conditions covered by Group 6 subject to co-pay.
THE VA IS CHARGING COPAY for Group 6 conditions, AND REFUSING TO STOP UNTIL A.O. PRESUMPTIVE CONDITIONS ARE "ADJUCATED", at which time a veteran changes from Group 6 to Group 2 or 3.
Web Reference
www.va.gov/healtheligibility/Library/pubs/CopayGlance
A second web reference
http://www4.va.gov/h...iptionCopay.asp
Further, The VA Finance, VAMC Business Office, VARO, the 1000 number, etc. take the same stance about "adjudication"
In other words, The VA is saying one thing in WRITING, and doing something different in actual fact! (What else is new!)
The VA is also ignoring the difference between an A.O. related presumptive condition and a directly connected (by adjudication or law) condition.
The key difference is that a presumptive condition is, by law and regulation, to be treated as a service connected condition, unless the VA can, under strict limitations, prove otherwise. (Adjudication)
Since the amounts per drug are "only" eight dollars, those in "high places" don't seem to be concerned, or even willing to look at the matter. (For that matter, they are almost unreachable by the average veteran.)
But, when you consider multiple thousands of veterans waiting to have A. O. & SHAD claims "adjucated", and take multiple prescription drugs for their conditions, The money involved is considerable.
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