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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Most Common VA Disabilities Claimed for Compensation:   

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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usdart

Blood Thinner

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VA Formulary Medications and Supplies

"The VA National Formulary (VANF) is a list of products (drugs and supplies) that have been approved for our patients by the Medical Advisory Panel (MAP) and VISN Pharmacist Executives (VPE). The MAP-VPE group, which is composed of VA physicians and pharmacists from across the nation, thoroughly reviews medical literature and selects drugs for the formulary based on a number of factors, including safety and effectiveness. The purpose of the VANF is to provide high quality, best value pharmaceutical products while assuring the portability and standardization of the pharmacy benefit to eligible veterans accepted by VA for care. Our drug formulary guidelines allow you to obtain drugs that are not listed for your condition in the drug formulary if VA providers determine that they are medically necessary.

All prescriptions filled by a VA pharmacy must be written by a VA provider. All refills will be processed by mail.


Following listed are the most commonly used medications.
Please visit http://www.pbm.va.gov/NationalFormulary.aspxfor more information"

Prasugrel ( Effient ) is listed as non formulary but as the link shows


" Our drug formulary guidelines allow you to obtain drugs that are not listed for your condition in the drug formulary if VA providers determine that they are medically necessary"

Did the VA doc document this med was NOT necessary? then why suggest it??????

Maybe the patient advocate at your VAMC can help you get this fixed.





  • Like 1

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So, The Patient Advocate answered my question this way...

' You can write a letter to the VA in Walla Walla'. Problem is, that is where she IS.

No such thing as a Patient Advocate at the VA in my opinion.

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Perhaps your private cardiologist might write a letter stating why he prescribed Effient. If your private cardiologist is agreeable to any alternatives, he should also indicate this in his letter. If not, he should provide reasonable medical rationale as to why any alternatives would not be acceptable.

You could take the letter to your VA PCP and ask the PCP for a consult with a VA cardiologist and see if he would request Effient or an alternative if it is listed in your private doctor's letter as being an acceptable alternative to Effient.

If your private cardiologist and VA cardiologist can not agree on a medication, I would pay out of pocket for the Effient. You may also want to check with your private cardiologist to see if he has any Effient coupons which could he used at your pharmacy for a discount. When I was on Effient, my cardiologist had Effient coupons available in her office.

Good luck.

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And if you feel that this is a Patient Safety issue (meaning this non formulary med is critical for your care)
by all means contact the IG:

http://www.va.gov/oig/contact/

Georgiapapa was right:
"Was the cardiologist who implanted your stent a VA cardiologist? If it was a VA cardiologist, you should have them contact your VA PCP and order a medication that meets the requirements of the cardiologist. I believe they can get medications not on the VA formulary if it is requested by a VA cardiologist."

Use the PDF from the formulary if you need it, as I posted link above.

Is this a med for a SC cardio condition?

(I got a question yesterday from a local VAMC employee as to what the formulary list meant....

because of your question I could explain it to him. Hadit helps more people than we think sometimes.

  • Like 2

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YES,

IF the VA P Advocate is not any help (obviously there not) by all means seek higher authority!

IG like Ms Berta mention/who ever it takes to help with your medical issue

Call The new VA Sec Robert.Bob. McDonald....his number and email address is on this site!

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  • Our picks

    • Wonderful news way to hang in. I hope this gives you some well deserved peace. 
    • If HadIt.com has helped you or you believe in it’s mission then please donate even $1 helps. I hope HadIt.com has provided $1’s worth of help to you. Imagine waking up and there is no HadIt.com it could happen and that is why I’m asking for your help now.



       



      Our traffic is going up and so are our expenses, however revenues have gone down and so I am reaching out to you to see if you can help me keep Hadit.com up and running.
      • 4 replies
    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
      • 3 replies
    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
      • 7 replies
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