I Need Your Help For My Disabled Husband

[cdog]

Hello!

I am writing this on behalf of my disabled Husband of 13 years. He served for 22 years.

A little history-

He filed for his disabilities in Oct 2008 when he retired and was initially awarded 80%. He initially received the VA catch all diagnosis of Chronic Adjustment Disorder, which in reality has been diagnosed by outside Dr's as Bipolar Disorder. He receives treatment from the VA for Bipolar Disorder. Shortly after, he received a more specific mental evaluation and diagnosis for a Chronic Pain Disorder with both Psychological factors and a General Medical Condition, service connected. He also received an increase to 30% for migraines, which increased his total award to 90%, and was granted IU based on all of the above factors a month after his original award.

He is currently 90% with IU for a Chronic Adjustment Disorder with Mixed Anxiety and Depressed Mood, 40% for BPH, 30% for Tension Headaches (Migraines) 20% for Chronic Lumbar Strain, and 10% for Left Knee Arthritis-Post Surgery and also rated Incompetent to handle his own financial affairs. His right Knee was never addressed during his original C&P exams even though his Retirement Physical clearly showed it had severe Arthritis, and needed surgery. He just did not do it at that time.

Shortly after his/our VA Award he received SSDI award for his service connected issues, in addition to several other issues.

He had several conditions claimed on his retirement physical for which the VA did not address. He claimed he had spine issues of extreme pain, stiffness, lack of range of motion, in addition to hand pain and numbness, severe neck pain, stiffness, and lack of range of motion which the VA did not address. We'll we were adamant that there was something wrong and convinced his PCP to request MRIs. Of course the MRIs showed a Lumbar bulging disc, Degenerative Disc Disease throughout his spine, severe lack of disc space in his cervical area, and Moderate Bi lateral Carpal Tunnel. He was complaining of shortness of breath and lightheadedness so eventually his PCP arranged a VA stress test that revealed a Right Bundle Branch Block which causes him light headed ness and shortness of breath. Lots of issues not addressed during his initial C&P Exams.

Flash Forward almost 5 years- He has continued to deteriorate both physically and mentally. He has not worked, nor is he able to do so. He has continued to seek treatment for his mental and physical disabilities both through the VA and his personal Psychologist. The VA health providers do what they can. He goes to his appointments and takes his medication. They tell us we can medicate or operate. As an example, he recently was given a new MRI on both knees (not just the SC Left Knee) and was found to have degraded over the last 8 years to the point where he is taking Synvisc injections as a last ditch effort to delay TKR. He is 53 and the Ortho Dr recommended that he wait as long as possible before he has them both replaced, which is his only option.

His Psychologist prepared both an evaluation and completed a DBQ stating in clear concise words that due to his service connected disabilities, he is permanently and totally disabled with no chance of improvement. So he has his current award, SSDI, IU, continuing treatment and medications, a downward spiral mentally and physically, and a current eval from his Psychologist. VA records also show no significant improvement in any of his SC conditions. He just struggles to get by day to day. He has constant thoughts of suicide. I don't think he has a plan that I am aware of, but I am very concerned.

He sent a letter through the DAV requesting P&T status, not an increase, just P&T. Today he received a call from the VA informing him that he is now scheduled for 3 of his conditions to be looked at again.

I understand that he is at the 5 year mark and was going to be re-examined for these 3 conditions (MH, Prostate, and Lumbar Strain), none of which have noticeably improved. His mental health conditions have not improved, in fact his MH meds for his Bipolar Disorder and associated Depression and Anxiety were just increased a few months ago. He was recently given an OCD diagnosis by the VA. He lives on pain meds, muscle relaxers, meds for his Tension Headaches, and he takes his prostate medications and unfortunately he now has to wear ...pads to collect his excess dribbling. His Chronic Lower Back Strain causes him daily problems with pain and stiffness. He can not bend, turn, or twist without pain and stiffness.

So.....

My question to all of you is what can he expect? Can they easily take his/our ratings away given that none of his ratings have noticeably improved? He is planning on taking his Shrinks DBQ and Eval with him to the C&P Exam. He also plans to take a list of his VA prescribed Meds. What else can he take with him that may assist him in his C&P exams and ultimately towards P&T?



Thank you in advance for any and all of your help, advice, and direction.

Concerned Spouse

[boomer2]

I doubt that they will try and take away your husbands ratings as there has been no improvement. Also, I doubt the examiner will look at the DBQ his private doc filled out (they might). Based on what you have written he should be P & T. Are you working with a VSO? If not you should be, because they can submit the DBQ for you as evidence for the P & T.

[john999]

Does he have private medical records. He does not need to have all his medical care at the VA. Whatever the VA tells me I get a second opinion via medicare or in his case Tricare. At his age and condition I doubt they will take anything away. He is TDIU. Unless he goes back to work he is OK. I have been on TDIU for about 12 years. Just send in the employment questionnaire every year.

John

[Berta]

"He sent a letter through the DAV requesting P&T status, not an increase, just P&T. Today he received a call from the VA informing him that he is now scheduled for 3 of his conditions to be looked at again"

The P & T request is a good move.

I assume he possibly gets either CRDP or CRSC .

A P & T SC status awards the dependents Chapter 35 Educational Benefits as well as CHAMPVA medical benefits. I have used both of these benefits and they are wonderful.

However I assume you are on Tricare as his dependent and I dont know if both Tricare and CHAMPVA can be awarded, yet the dependent can pick one benefit to use.???others will advise on that.

With CHAMPVA I pick my own medical providers and my co pay is only $50 per year.

We have Chapter 35 info here as well.
.

The incompetency factor alone should be strong enough for P & T in my opinion, but wasn't ,otherwise VA would have awarded P & T already.

"His Psychologist prepared both an evaluation and completed a DBQ stating in clear concise words that due to his service connected disabilities, he is permanently and totally disabled with no chance of improvement. "

Good. That should do it!

He should submit a copy of it on a 21-4138 in support of the P & T request and give the DAV a copy too.

[Berta]

Gee , I am glad I had a minute to check this out:



"In some cases a person may appear eligible for either program. However, if you are the spouse of a military retiree or the spouse of a Servicemember who was killed in action, you are and will always be a TRICARE beneficiary. You cannot choose between the two plans:"

http://www.benefits.gov/benefits/benefit-details/318

I am not sure about Chap 35 benefits either, but this might help with that if he had the GI bill and falls into the Post 911 criteria ::


"Transfer Post-9/11 GI Bill to Spouse and Dependents

The transferability option under the Post-9/11 GI Bill allows Servicemembers to transfer all or some unused benefits to their spouse or dependent children. The Department of Defense (DoD) determines whether or not you can transfer benefits to your family. Once the DoD approves benefits for transfer, the new beneficiaries apply for them at VA. To find out more, visit the DoDs website or apply now."

http://www.benefits.va.gov/gibill/post911_transfer.asp

There are other benefits state by state such as possible property tax exemptions that also come with the P & T status.

[cdog]

Thank you all for your posts.

He retired as a Reservist, that is the impetus for us filing for P&T, to receive Medical benefits as I and our two minor children have no Health Care to speak of.

Yes we are working, loosely, with the Local DAV office.

He does not have any private records beyond his personal Shrink as he receives all of his care through the VA.

I sent in a "witness statement" as I see how he struggles day to day both Mentally and Physically.

Anything else you can tell us as to what he may expect at the actual C&P would be appreciated.

Thank you all, God Bless

[cdog]

Let me just add, he was Active duty for 16 years but had a manic episode and ...well that was the end of his career.

Edited April 20, 2014 by cdog