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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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I had a heart attack 5 years ago. I had all 4 arterys blocked at least 95-100%.I had 4 stents placed in my heart . Last year they found another blocked artery. This time it re-routed its self and they did not have to do anything. All this was done by my outside doctor. He put me on Plavix 5 years ago. I had my drugs transfered to the VA. When my VA doctor re-newed my drugs this year,she did not re-new my Plavix.My outside doctor wants me to stay on plavix because of the 4 stents and the new blockage. The drug cost over $200 in the outside market. I am 70%. The VA pays 100% for all my other drugs. How can I get the VA to re-new my plavix before it runs out in 2 months?

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I would first go to my VA doc and make sure she didn't just forget to re-new the Plavix. May have been an oversight. If that wasn't the case, I would do this.

I had a similar situation and this is what I did and it worked out great.

I had my "outside" doctor write a prescription for the required drug. Then I had him give me the a copy of his chart notes which shows that he wanted me to continue with the drug in question.

I took the prescription and the copy of the chart notes into the VA clinic and, in my case, requested that the drug be mailed to me. My PCP at the VA looked at the information and then approved the drug and it was shipped to me within a week.

Hope this helps.

Edited by handler

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VA tries to make Doc's not prescribe plavix. I have been taking it going on 5 years.

Have your Doc write the prescription and explain there is nothing that can substitute for it.

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VA tries to make Doc's not prescribe plavix. I have been taking it going on 5 years.

Have your Doc write the prescription and explain there is nothing that can substitute for it.

I agree Pete53. Good stuff and it is a must if you have had stents.

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"How can I get the VA to re-new my plavix" -- - -

You see an outside doctor, likely a cardiologist or other heart related specialist. The specialist prescribed Plavix.

You take a copy of the prescription to the PCP VA doctor. (Who is likely not qualified to overrule a treating specialist.)

Ask if the drug was accidentally not renewed.

If the doctor refuses to allow the VA to supply the drug - - -

Ask to have the reason in writing. If the doctor refuses, there are several ways to go.

Perhaps the simplest is ask to speak to the patient advocate.

At least you have some time before you are out of the drug.

As a veteran, under the veteran's "drug act", the VA is basically obligated to supply the drug when it's part of the VA's drug list. (It is, with or without co-pay, as appropriate.)

You can also state in writing that the treating doctor(s) must be notified, and approve any proposed change or substitution for a drug.

As to the actual dosage and how effective plavix might be - - "Tests are available to identify a patient's CYP2C19 genotype" (from the Mfrs information sheets)

My cardiologist stated that I would likely need to take plavix the rest of my life, unless something better was developed.

I got into a minor squabble a couple of years ago concerning nicotine patches vs gum. (My skin breaks out with patches.) I was told that the gum was not available for outpatient use.

I checked the VA's drug formulary, and found that the gum was supposedly available. Turned out that the gum was more expensive, and the local VAMC was for convenience, as well as cost limiting, following a practice of just giving it to live-in vets

at the VAMC's residence hall. The VA was forcing it's PCP's to fill out a bunch of paperwork to over ride the local practice for outpatient vets. I got the PCP's curiosity aroused, and the PCP went through the process, just to see how it worked (or didn't). (The answer was not very well)

I had a heart attack 5 years ago. I had all 4 arterys blocked at least 95-100%.I had 4 stents placed in my heart . Last year they found another blocked artery. This time it re-routed its self and they did not have to do anything. All this was done by my outside doctor. He put me on Plavix 5 years ago. I had my drugs transfered to the VA. When my VA doctor re-newed my drugs this year,she did not re-new my Plavix.My outside doctor wants me to stay on plavix because of the 4 stents and the new blockage. The drug cost over $200 in the outside market. I am 70%. The VA pays 100% for all my other drugs. How can I get the VA to re-new my plavix before it runs out in 2 months?

Edited by Chuck75

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    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
    • Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
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    • I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:


      2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis


      2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.

      "...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.


      First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date. 

      If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues. 

       

      I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.

      It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.

      Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.

       

      Does this help?
    • Thanks for that. So do you have a specific answer or experience with it bouncing between the two?
    • Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.

      The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.

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