Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • homepage-banner-2024-2.png

  • donate-be-a-hero.png

  • 0

21 Days In Hospital Rule

Rate this question


evandc

Question

  • HadIt.com Elder

Have vet friend that was in VA hospital in March-April 2011 for PTSD. She is S/C for Anxiety. Applied for the 21 days in hospital & she was turned down because she was admitted for PTSD and not anxiety. I was going to copy 38CFR CH.1 4.29 and pass it along to her. I have 7-1-11 Edition & I'm having a problem. Before it read something like "be admitted for what you are S/C for or TREATED FOR WHAT YOU ARE S/C FOR". Now reading different "total disability rating (100 percent) assigned...it is established that s/c disability has required hospital treatment..in excess of 21 days." Question has this rule changed to drop the part about "treated for what you are s/c"? If it changed was she in hospital before it changed? Just passing along to help this vet..and never know why she didn't get connected for PTSD..but that's another thing.

Thanks,

Don

Link to comment
Share on other sites

  • Answers 8
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Recommended Posts

The VA only rates the highest (or worse) mental condition to prevent pyramiding. In my case I am rated for Bi-Polar, but was also diagnosed with PTSD. This last time I saw my Social Worker, she asked me if I was also diagnosed with PTSD and I told her I was, but it was a long time ago in a different RO. She told me that she wondered, because she couldn't find it in my notes. I guess I will have to look through my c-file to find it, because they have asked me to attend PTSD treatment in the past.

Makes one wonder if they are deleting PTSD diagnoses, with the new PTSD regulations...

Link to comment
Share on other sites

".and never know why she didn't get connected for PTSD..but that's another thing."

Was she admitted specifically for the 21 day inhouse PTSD program?

Link to comment
Share on other sites

  • HadIt.com Elder

Was in program for PTSD more than two months. She has 90% S/C think 70% of it Anxiety. Pending TDIU..already has Ssd.

Link to comment
Share on other sites

Let me see if I understand this correctly

veteran is rated for anxiety.

veteran is admitted to hospital for 21 days for non-service connected PTSD

Veteran is seeking temporaty 100% for the 21 day hospital stay

No the veteran would not be entitled to the temporary 100% because the conditon for which treatment was required was not service connected. The one exception is listed below:

Even when hospital admission is for a nonservice-connected (NSC) disability, hospitalization benefits are payable if, during the hospitalization, treatment for an SC disability is initiated and continues in excess of 21 days.

Now If the claim for service connected is pending and later awarded then it is possible the veteran could receive the temporaty 100% rating based on the hospitalization.

The following is a September 5, 2008 change......

a. When to Assign a Hospitalization Rating

Provided a total, 100-percent rating cannot be assigned under other provisions of the rating schedule, assign a temporary 100 percent evaluation under 38 CFR 4.29 for

  • periods of hospitalization in excess of 21 days for medical treatment of an SC disability, or
  • a disability for which compensation is payable under either 38 U.S.C. 1151 or 38 U.S.C. 1160.

b. Granting Hospitalization Benefits When Admission is for an NSC Disability

Even when hospital admission is for a nonservice-connected (NSC) disability, hospitalization benefits are payable if, during the hospitalization, treatment for an SC disability is initiated and continues in excess of 21 days.

Reference: For more information on hospitalization ratings when admission is for treatment of a NSC disability, see 38 CFR 4.29(b).

Edited by Teac
Link to comment
Share on other sites

  • HadIt.com Elder

Teac-that's my question. She would be your exception treated for what she was S/ C for during her stay. But when I read 2011 version it seems to leave out that exception.. Also if it changed 7-1-11 & she was there March April 2011 wouldn't she still be awarded temp 100%?

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Guidelines and Terms of Use