Va Dental Question

[VetsLady]

Hi Everyone,

Here is a question ...... A Veteran receives the decision rating them at 100% with an earlier effective date of 5 years prior.

What date are they eligible for dental care at the VAMC ? The date of the decision or the effective date ?

And, if it's the EED, then wouldn't the Veteran be entitled to reimbursement for their out of pocket dental expenses now that they have

that 100% decision in hand ? Dental isn't even a benefit until a Veteran is rated at 100%.

VetsLady

Edited January 19, 2011 by VetsLady

[broncovet]

Its not likely you will be reimbursed for dental expenses from 5 years ago. It will only apply to future dental work, regardless of the effective date. You can, however, apply for reimbursment for copayments you may have made on prescriptions back to the effective date.

This is often a nice check for people. I think mine was about $200. I just went to my VA, and there was a special person who handles such stuff. I didnt even try to figure it out, just gave him a copy of my decision and about 6 weeks later got a check.

Edited January 19, 2011 by broncovet

[VetsLady]

Its not likely you will be reimbursed for dental expenses from 5 years ago. It will only apply to future dental work, regardless of the effective date. You can, however, apply for reimbursment for copayments you may have made on prescriptions back to the effective date.

This is often a nice check for people. I think mine was about $200. I just went to my VA, and there was a special person who handles such stuff. I didnt even try to figure it out, just gave him a copy of my decision and about 6 weeks later got a check.

Thanks for the response Bronco .... it does not seem fair to deny something that a Vet is entitled to just because the decision was made 5 years later.

Unfortunately, he won't receive reimbursement for copays or RX copays as we had private insurance that we paid for. He was a Cat. 8 then, prior to any sc, which didn't happen

until '08 when he rec'd 70% so we continued to utilize our private health providers. He started with the VA medical care and RX's after his 70%....

[john999]

You can get reimbursed for dental care from your effective date. I did it. You go through Fee Base. You have to fight for it.

[broncovet]

John

Im glad you got it. I was told that I would not be reimbursed for dental care to the effective date, but it sounds like that is one of those hidden benefits that was discussed.

[jbasser]

They explained that since I did receive outside dental care before I became 100 percent, even though my effective date was for several years back, They could not and would not reimburse that portion. I had dental insurance so I gave up and let it go as I was tired after a very long battle with the RO. I did get my Medicine copays back with interest.

It really is a sad situation in this case.

J

[VetsLady]

They explained that since I did receive outside dental care before I became 100 percent, even though my effective date was for several years back, They could not and would not reimburse that portion. I had dental insurance so I gave up and let it go as I was tired after a very long battle with the RO. I did get my Medicine copays back with interest.

It really is a sad situation in this case.

J

Thank you for the response. It is a sad situation especially since if he hadn't had any of the dental care for the past 5 years, he probably wouldn't have any teeth left.

He lost 4-5 as it was. This last big bill we had was so close (7 days) to the date he received his 100% rating decision, Fee Services said to send at least that one in...

nothing to lose. 50/50 is better than if I don't send it in at all.