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]

I'd love for the VA to send me to an outside dentist solely so they can give me nitrous oxide during procedures. Plus, any time I have to go to the VAMC for dental work, I have these horrible flashbacks of Steve Martin from Little Shop of Horrors.

[john999]

Yeah, my VA said implants were like cosmetic surgery. What BS and malpractice from the heart of the VA Mafia. I had experience with an Army doctor who did an extraction. God, was a mess he made of my jaw in 1969. It bled for three days. I paid for private dental care due mostly to fact that the VA dentists I had at my local VA could not even do a filing right. The VA denied me cataract surgery which was probably for the best since I would probably be blind.

[Chuck75]

That's almost funny!

The area VAMC Dental Dept. has signs and brochures concerning implants, leading one to believe that they are available.

In reality, The Dental Dept's preferred remedy in reality is extraction and dentures. They farm out the extractions, and then, as they choose

the false teeth. (Less cost and effort, don't you know!).

[Buck52]

I've had 3 set of dentures made at the VA and not any has been comfortable to me and I go back and forth trying to get them to adjusted and one time I ask can you just make me some more because they still don't feel right...altho I tried to use them eat with them and I can't...so I ask the VA to make me some more and hope they will fit or work so I can use them...my regular dentist retired and I got a young guy he made me some more dentures about 4 months ago and I am having problems with them now they just don't stay in good when I eat.. and I've mention that to him he adust them and so forth but still they just don't fit right...& it takes 3 months to see the dentist at my VAMC.

I never ask for implants but my spouse has Met Life through ChampVA a VA group plan and is really nice for her but I can't use it....so I just suffer with it I'm just so fed up with the VA medial care and the Dentist.

[Chuck75]

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.

99% is a bit high!

On the other hand, there are so many obvious errors in even successful claims that it's remotely possible in the hands of a skilled and experienced lawyer.

Virtually every claim I've looked at had errors. Most were to the veterans detriment. One that struck me as too common was ignoring aggravation of another condition.

Another is ignoring the evidentiary related provisions in law that relax requirements for "combat veterans". Finally just another one is requiring all" checkmarks" be met

for the next higher rating. The actual law basically says the closest rating to the condition, allowing just the majority of the "checkmarks" to be met. The most common

of this is drawing a line for DMII between oral and injection. "Regulation of activity" is commonly ignored. That's bad enough, but not a few of these also occur at the BVA as well.

Edited November 22, 2014 by Chuck75

[john999]

Extractions leading to dentures is the VA idea of dental health. The VA preaches about how important oral health is because oral infections can lead to systemic blood infections and organ infections. Yet, only select few even get dental care via the VA. I get dental care from the VA but it is so poor I get most of my work done from private dentists. This is just unacceptable and is based on rationing and putting costs before the welfare of patients. I get VFW and DAV magazines and every month some vets are raving about wonderful care they get at the VA. What planet do they live on? I think VA employees are directed to write these organizations with this crap. There is a conspiracy against a certain group of Americans by their own government and that would be us vets. I would not have spent 13,500 bucks for private dental if VA dental was worth a damn at my VA.

With all this we vets sit back and accept this crap decade after decade. I know VSO's have vested interest in keeping the system the way it is now. Just about any dolt knows that if VA offered medicare-like card to vets the majority would get care from their own doctors and not take some foreign doctor who thinks vets are just gaming the system. This is the general attitude I have felt at the VA where I get my care such as it is.

John