Unauthorized Claim

[john999]

I am sending a claim to the Fee Base Office at the VA for $13,500 bucks for dental care they denied me over the last five years. I know they will deny it at first. Last time I claimed something like this they threw the claim in the trash and did not even officially reject it. I got the money, or part of what I claimed at least. It took six months. I was referred out for dental care because of them not providing me care on timely basis. They also rejected my request for dental implants saying these were" just cosmetic and elective." "What I needed was some good dentures, but in any case I would not miss those teeth that were pulled anyway." They actually told me that at the VA dental clinic. I should have raised a stink then, but I just went ahead and had the work done by a real dentist. The truth was that there was no one there who could do an implant. The VA admits this! I would not trust the creeps I have come into contact to do an implant at the VA dental clinic anyway. They should have referred me to someone who could do them since they are not cosmetic or elective. Dental implants are standard care for teeth that have to removed, but where the bone is good. Some get bridges and in some cases implants are best. If you get them done right it is an ordeal.

John

[Vync]

John,

At first, I thought you were posting about how the VA considers all Veteran claims

[Berta]

Me too. I have an unauthorized claim pending....

At least I guess you could call it that.

They opened a claim I was awarded in 1998.

I cant get a straight answer from my RO at all on that but they say it is pending along with the 2 claims I filed.

They opened this claim in April 2014.....that date does not ring a bell with me except for one thing...

I have a 1151 claim pending with one piece of evidence from the FTCA medical review VA did in 1997.

The report it is from is noted in my 1151 DIC award of 1998.

Last year 800# told me they got something in on the 1151 claim in April 2014... I assumed it was verification from VACO or OGC that this was a copy of the actual medical report.

Then for about a year VA refused to even acknowledge the 1151 claim. 800 even said there was no 1151 claim pending.

Somehow that all changed recently.

So I have 3 issues pending but dont have a clue on the third one except they now say it is for a different EED on my DIC.Which makes no sense at all.

I had problems with my DIC I didn't even know I had.

I had invested my FTCA settlement and withdrew every month an amount comparable to what my DIC would be, once my DIC FTCA offset was paid back to the VA.

The VA overdrew 40 thousand DIC bucks. I feel stupid even telling this story and told it here in 2003 when I got a large check in the mail and it took days for me to find out what it was for.

I had appealed the continuous DIC withdrawals with a letter at some point but just gave up....

After the FTCA battle and then even to be denied again under 1151,another battle I was tired of dealing with them....

In 2010 they ,under orders from OGC...another battle....had to refund the entire FTCA offset because a SC death trumps a 1151 death.

I think this reopened DIC claim has something to do with all that....

But I think they are working on a moot issue and told them that many times.

Maybe it isnt a moot issue...I have never found a similar case like mine.

Wish I could.

Has anyone here ever heard of any survivor receiving DIC awards under 3 separate bases?

DIC under 1151,1998

DIC under AO DMII contributing to death 2009

DIC under Nehmer AP IHD 2012.

Only One check a month ,per VA. I never questioned that.

Edited November 21, 2014 by Berta

[john999]

Not impossible that normal claims get shredded or thrown out as well. When you make claim for unauthorized expense it is a different world. I won it one time so why not try again. I suffered neglect, delays and horrible care so I am claiming money I had to spend to protect my health that VA rejected. So it goes. I think you should assume the VA is going either shred your claim, lose it or just bury it.

John

[john999]

Berta, you are like the Seal Team Six of VA claims for all spouses and vets also. You do the impossible on a weekly basis. What grit! They say "Rangers lead the Way", but I think Berta does it.

John

[Berta]

John, I felt bad that I sort of diverted the point in your post....

I had to fight many issues in my life for both of my veteran husbands.And they (VA EDU ,,an oxymoron sometimes)even messed up my veteran daughter's Chap 35 app.

But all of that experience has been valuable here.

I used to be a different person, until I started dealing with the VA and realized how down right stupid some of their decisions are.

And then after graduating from AMU, I turned into a real SOB.

My dead husband is proud of me I am sure...his last wish was to continue his claims if they killed him and to help his veteran brothers and sisters. I have tried to honor his wishes.

You said

"When you make claim for unauthorized expense it is a different world. I won it one time so why not try again. "

ABSOLUTELY! Nothing is impossible with the VA.

Even when we file claims that seem unusual ( my former rep said my 2003 was too unusual to ever succeed)( F him, it did succeed ) we draw the VA out to make documented statements, that we might be able to hold against them.

Even at the BVA those denials can sometimes contain clues as to how to succeed.

When I met Pete,our Mod here, at Prodigy Vets BBS in the early 1990s, our in -house online lawyer Bill Smith, former BVA attorney,. always said 99% of all claims can be won.

I don't agree it would be that high but I believe anything is possible.

Edited November 21, 2014 by Berta

[Pete53]

The Dallas VA sent me to a private Dentist and paid about 8500 3 years ago. I am currently being evaluated for more work which they deemed to be ok with but have not heard anything in 2 months. Asking for implants and other restorative work.