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Denial Of Dental Services


qmcorps

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When I was on active duty I used the VA dental clinic. One of the procedures was the removal of a tooth and the placement of the "screw" for an implant. When it was time to fit the prosthetic tooth, it was discovered that the "screw" was placed at an angle and was not properly lined up. At this time I had retired and this was considered work in progress. aproximately a year later the "screw" was removed and the hole was filled with a bone graft. Aproximately six months later the surgeon was prepared to place another "screw" in the same site and complete the procedure. When I returned for the procedure I was told "I was not entitled to anything and I should just move on". I complained in writing to the patients advocates office and the hospital director. I also sent an email to the VA IG's office. I received a canned letter from the directors office after I filed a congressional(which is still pending). I have run out of options as how to address this, any suggestions?

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All dental regs that cover veterans are found within 38 CFR 17.161 - there is a statement in this reg that I believe might provide you with continued dental service-it is at the bottom under G or J-

I don't have a 38 link- I am reading pages 695-695 of the 2005 edition of the VBM.

38 CFR can be accessed through hadit at our Home page I believe-

Also see 38 USC 1712 if 38 CFR doesnt help.

It seems, based on your post here, that these regs would assure you continued VA care.

Then again- you said "retired"-have you accessed Tricare regs on this?

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My husband is dealing with the same issue. From what I can see the regs cover dental work as service connected for DENTAL CARE for dental problems that occured after 180 days of service. Then they have service connection FOR COMPENSATION - which requires trauma, injury, unique conditions.

They seem to get these two tangled up. My husband claimed for dental care when he retired. They denied it - but the BVA remanded it back to the RO as he was just seeking DENTAL CARE. The SOC reads that he is denied for COMPENSATION but that he had been refered to the Outpatient Clinic reguarding treatment. But then the BVA decided he Might be able to get compensation too - so they remanded it again. Then both the RO and BVA denied dental for COMPENSATION - so he thought they denied the dental CARE.

I THINK the note that he has been referred for outpaitent treatment indicates he can get treatment..but we have to check that out - and no one we talk to seems to know. He didn't realize he has been recommended for treatment since 1999 - but that is what the claim says.

I would think if they continued to do treatment after you retired - that would indicate that tooth would still be covered. From the regs it looks like they cover the particular tooth that has been affected. But I don't know anything for sure...lol

If the VA made sense it would sure make life easier. :unsure:

We will keep checking...

Tri-Care has horrid dental programs. Costs lots and pays little.

Free

When I was on active duty I used the VA dental clinic. One of the procedures was the removal of a tooth and the placement of the "screw" for an implant. When it was time to fit the prosthetic tooth, it was discovered that the "screw" was placed at an angle and was not properly lined up. At this time I had retired and this was considered work in progress. aproximately a year later the "screw" was removed and the hole was filled with a bone graft. Aproximately six months later the surgeon was prepared to place another "screw" in the same site and complete the procedure. When I returned for the procedure I was told "I was not entitled to anything and I should just move on". I complained in writing to the patients advocates office and the hospital director. I also sent an email to the VA IG's office. I received a canned letter from the directors office after I filed a congressional(which is still pending). I have run out of options as how to address this, any suggestions?
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Dental care is tight even for those with 100%. I receive compensation for having my upper teeth blown out when a mortar round landed near me and a few other Marines the first time I was wounded. The term "traumatic injury" is the key to getting dental care and not being 100%. I would suggest that you see your Primary Care physician at your VAMC and get the doctor to make a referral for you to dental. I suspect the VA is seeing your dental issues as customary and routine. If your not 100%, it just makes it more difficult.

If your seeking compensation, you must show the VA that it was indeed as a result of a "traumatic injury" to receive compensation. I hope you success in doing so, but don't spend all that compensation money in one place!! :rolleyes:

Patrick

Edited by Patrick428
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Just a short note on this topic to all AO Vets with DMII. I included dental exams and proceedures I had and had my dentist write a letter stating it was more likey than not, that periodontal desease stemmed from the DMII diagnosed years ago. The VA Dentist wrote "as likely as not". Both being 50%>, my pcp set an appointment for treatment and new teeth (I am 100% TDIU). Also, there is plenty of research about DMII and connection to periodontal desease throughout various websites. I know there are many Vets with this dental problem with a nexus to DMII, and they should jump on the research train and get the dental work done courtesy of the VA. They earned it!!

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  • HadIt.com Elder

There is evidence that gum disease is an aggvating factor in heart disease. If you have DMII and dental problems it is important to get it taken care of since DMII is also a very definite factor in heart disease. If you have peridontal disease that is an infection that can get into your blood stream.

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