Benefit Amount Dropped But Percentage Remains The Same

[Fire Courage]

Today on ebenefits my claim went from prep for decision to Closed- Decision Notification Sent. It says notification was mailed out today. So, I went into download VA letters on ebenefits and found out that I lost money.

My benefit amount last month was $1,949 but this month it is $1,847 but my percentage remains at 80%. I do have a dependents claim that I filed in August of last year but the 1800 number says a decision has not been made on the dependency claim yet.

How can my benefit amount drop but my percentage remains the same?

Edited June 12, 2014 by Fire Courage

[Chuck75]

Has the VA been paying you for some time, or was the 1,949 a one time payment, that might have included more than the usual monthly benefit?

[ejfrank]

I had the same thing happen . It turned out to be money the pharmacy said I owed. My amount deducted was 206. When the statement came it was alot of small charges like 6.00 etc.

[Philip Rogers]

We need the actual amount(s) paid to figure out why there's a difference.

pr

[Chuck75]

To add further complications.

The VA pharmacy charges may or may not be actually due.

Turns out that the VA often "forgets" to change a veteran's

status from co-pay to no co-pay when appropriate. I had to request an

"insurance audit" from my VAMC. That disclosed that the pharmacy charges were

improper, and resulted in the VA paying the funds back with interest.

For a few months, there were even instances of "someone" in the VA changing

no co-pay status prescriptions to co-pay. ????

It's also of note that there is language in the myriad of VA's utterings etc. that co-pay for "presumptive"

conditions should not be charged. Yet it may be charged anyway. ???

This one has to do with how the VA sometimes interprets presumptive, vs. everyone else.

[ejfrank]

How would he request an insurance audit? I have had this happen three times and I am 50%.I hope this will get his money back.

[Vync]

Definitely check on this. Have them do an audit on all of your copays and insurance payments back to your effective date. I only added insurance info here because they are also famous for continuing to charge private insurance for treatment of SC issues. Stupid insurance company gets the bills and keeps paying them.