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Claim A Secondary Contention


Navy4life
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Okay I hope I am in the right section.....

I have been s/c for my Eating Disorder Anorexia Nervosa. Most recently on 11/16/14 I took a pretty good tumble/spill and fainted due to my eating disorder and the fall resulted in me cracking/chipping my front upper teeth. They are turning grey/black as we speak and it is evident I am going to need dental work. The ER noted the fall due to Anorexia Nervosa so I want to get the dental s/c secondary to my anorexia nervosa.

Both consults presented to Dental were denied due to I don't have 100% dental s/c. The consults were put in by my PCP and my MH doctor.

Here are my questions:

1) If I go to outside dentist to get the work done and pay for it out of pocket can I submit the payment request with an FDC?

2) Should I get both PCP and MH to type a letter up on this?

3) MyhealthyVet notes show the ER visit and the evidence of my teeth damage due to Anorexia Nervosa. I should submit this with FDC - is that enough? If not shoudl I;

4) Get a statement from the dentist I am going to see to get my teeth fixed?

I can't wait to get s/c because of the condition/infection I would risk with my teeth in the state they are in....

5) Do you think I could get the s/c for my teeth????

I think an FDC is warranted in this case?? Thoughts???

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1) If I go to outside dentist to get the work done and pay for it out of pocket can I submit the payment request with an FDC?

2) Should I get both PCP and MH to type a letter up on this?

3) MyhealthyVet notes show the ER visit and the evidence of my teeth damage due to Anorexia Nervosa. I should submit this with FDC - is that enough? If not shoudl I;

4) Get a statement from the dentist I am going to see to get my teeth fixed?

I can't wait to get s/c because of the condition/infection I would risk with my teeth in the state they are in....

5) Do you think I could get the s/c for my teeth????

I think an FDC is warranted in this case?? Thoughts???

Here are my opinions:

1. If the VA will not pay you now, I assume they still will reject the payment request until it is SC. However, including it does make sense.

2. Have them tie the incident together. Hopefully they will state "is due to your service connected anorexia nervosa".

3. Some folks say submit the entire record for that date, but other say that if it is in your VAMC medical notes then the VA will see it. If you send the entire record for that date, be sure to highlight the key sections.

4. It could help, but he was not there. He's just wanting your $ to fix the problem. Infection prevention is key. If a DBQ is needed, they might be willing to fill out the portion from the dental point of view.

5. I believe it is possible, but you need to get all of your bases covered. A strongly worded IMO from your PCP and MH doc can help. Ask them to work together, if necessary, to ensure it is worded properly. The PCP will likely defer to the MH doc because they are a specialist and it carries more weight. Having a FDC can definitely help speed things along.

Good luck

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