tdiu Va Taking Away Benefits! Chapter35!

[Buck52]

I was awarded TDIU P&T back in 2003 with Chapter 35 for my spouse, she started using the VAMC for her Healthcare, she had triple by pass Heart surgery from the VA back in 2005 & it saved her life and she has been using the VA ever since.

She had Back surgery was being treated there (VAMC) for years and now the ChampVA says the VA has closed all specialty clinics to her wtf?

She can only use her PCP for general health & even tho Her PCP puts in request to these other clinics but today the clinic called and said she no longer can receive these benefits.

So I guess Chapter 35 no longer exsit? or the benefits don't exsit?

We Appreciate all the medical Help the VA has provided her in the last 12/13 years and now to be turned away eh!

Just makes me feel like I been degrading as a Veteran and my country has turn its Back on us.

so now were up a creek! eh!

Any other Veterans having this problem?

[Chuck75]

"why can we not make that choice?"

The bureaucrats insist on controlling the matter?

Congress and the VA are afraid that the veterans will leave VA medical care for better care outside?

It might cost more money, and the VA is afraid that the example might result in the VA's downsizing?

Just a few of the likely reasons!

Personally, I'd prefer that the VA just pay the premium costs for insurance (use the Medicare rates for premium, out of pocket, and deductible reimbursements)

I believe that would actually produce a large savings by reducing the need for VA medical facilities.

The current law places the financial burdens on veterans and families by requiring such things as paying Medicare and or other insurance premiums, then the government

benefits as a result.

[georgiapapa]

Chuck,

You are absolutely right. Given the choice, veterans would leave the VA healthcare system in droves and go to the private sector. This should be a no brainer for our government and for veterans. Veterans going to the private sector would receive the "best healthcare" available as promised and they would have a lot more choices regarding their healthcare providers and methods of treatment.

Currently, veterans choices are very limited at VAMCs. The so called PCPs (often NPs not doctors) make most of the decisions, not the veterans, when it comes to seeing a specialist, treatment options and medications. The VAMCs seem to be years behind the private sector when it comes to new treatments and medications. Even when new medications or treatment options are approved for public use, VAMCs usually opt for the older medications and treatment options because they are cheaper.

Our politicians frequently say, "our nations veterans deserve the best healthcare available", but their actions say "our veterans deserve the cheapest healthcare available regardless of the quality of the healthcare." Actions do speak louder than words and our nation's politicians from both parties have failed our nation's veterans. JMO

[Buck52]

Well for the last ten years or longer my spouse has used the VAMC for all her medical care, 2005 she had triple by pass heart surgery, that saved her life, but no after care I Clean her wound and re-bandage it for 6 weeks, and that's fine but she developed an infection first week she was home,,,took her back to the VA Hospital and the surgeon that did her surgery just took a pair sissors in a exam room and cut her wound open to wipe out the infection no antistic or pain reliever or anything for pain it was painful because she cried out I never want to see her go through that ever again.

After her recovery from heart surgery...she has had numerous injections fpr acute pain in her Back because her spine is like mush they say she has had the geoplastic or something like that did to her back, she has RSL she has HBP,& Sleep Apnea , she had fractures in both arms legs & pelvis due to osteoporosis and degenretive bone desease weak bones along with arthritics pibromyaligia...and other medical conditions she had.

she had a bad seizure one time scared the hell out of me, she has been to the VA Mill and back a few times over the last 10/ 12 years ,After her heart surgery she was placed in the pain clinic and they sent her to special clinics....not that that was a cure but trying to control her pain

and now there turning her away...makes no sense to me...but when did the VAMC ever make a lick of sense.

I am getting unable to care for her when she gets down because my health is not good...so we have to figure something out.

However were both thankful to the VAMC for helping her and doing what they could for her.

Edited January 9, 2015 by Buck52

[Philip Rogers]

Philip

Maybe I am getting ChampVA and the VA confused?

if all chapter 35 is just for education benefits and not health care...but she can use the ChampVA in the private sector & pay the ductible we know that!

Why is the VA turning her away? don't VA...> Bill ChampVA?

We been trying to find private Dr's that accepts ChampVA And pay the 50.00$ Yearly &25% dedutible..but its hard to find private Dr's That will accept ChampVA... for her pre-medical conditions and the ones that do have a 6 month waiting period on current medical conditions.

So were looking into that and hopefully she can still use the VA pcp for her Meds...she probably takes combined 2000 $$ worth of meds or more monthly so the 6 months would kill us if we had to pay 100% on her meds.

Buck52 - Yes I think you are mixing up the 10yr Chap 35 rule and ChampVA. ChampVA has no 10yr rule. The VA can't bill ChampVA because it's like Medicare, and the gov't doesn't bill another gov't agency. The decision to not treat your spouse is a decision made by "your individual VAMC" and is done to save money. A friend's wife, from my vet's group, still gets treated by our VAMC and they still refer her to Boston, when needed. It's up to each VAMC to decide what they want to do.

You can contact ChampVA and they should be able to give you a list of doctors, in your area, that accept ChampVA. Also, you can see a doctor, who doesn't "accept assignment" of ChampVA and you pay the bill and get reimbursed whatever ChampVA allows. In other words, lets say your doctor charges $150 for a visit and ChampVA allows $100 - you would pay the doctor the $150, then you send ChampVA the receipt - ChampVA allows $100 and they reimburse you $75, which is 75% of the "allowed" rate. I think I've explained correctly.

pr

[Philip Rogers]

Buck52 - judging by all the disabilities, you've stated your spouse has, it sounds like she should be receiving SSDI. If she was receiving SSDI, w/Medicare, her ChampVA would pickup the co-payments and Medicare would be the primary payer. Also, depending on how much her employment pays, she may be allowed to continue working. It might be worth checking into. If you call SSA remember that the lowest person on the pecking order answers the phone and therefore may not know what they are talking about. jmo

pr

[Buck52]

Oh ok we will certainly do that ,we have to go to the VAMC Monday she has to see MH for some meds & we will go to the ChampVA office and ask for a list of outside Dr's

Thanks Philip I appreciate that Buddy