Can I Get Dental S/c To Already S/c Eating Disorder?

[Navy4life]

I am S/C for my Eating Disorder.....I have numerous fainting spells documented which is what helped get me S/C for Anorexia Nervosa....

In November 2014 I passed out and was rushed to the VA hospital. I damaged both front teeth due to my eating disorder. I was treated for other issues while at the ER and released. I had two consults to the VA dental denied due to no S/C for my teeth.

I had to get over $4,500 in dental work done on the outside. I had both my dentist and specialist dentist fill out DBQ's and I submitted them along with all receipts and I did an FDC. I filled out everything needed and submitted in Feb 2015...

QUESTION...Can you get your teeth S/C(secondary) if you already have a S/C disability (Anorexia Nervosa) that attributed to the secondary issue?

I noticed on the VA site for FDC claim's it states:

Who Can File an FDC?

Veterans may file an FDC for disability compensation for the following reasons:

• An injury, disability, or condition believed to have occurred or been aggravated by military service.
• A condition caused or aggravated by an existing service-related condition.

Edited April 19, 2015 by Navy4life

[Guest]

Take a look at class III.

Have your VA mental health doctor refer you to the VA dental clinic for an evaluation for aggravation due to your disorder. I did/used this after Voc Rehab when the dental clinic refused to treat me. I was not service connected but the dental clinic continued my treatment until I was awarded 100% P & T.

http://www.va.gov/healthbenefits/resources/publications/IB10-442_dental_benefits_for_veterans_2_14.pdf

Hope this Helps

[Buck52]

just now seen your Post #9 GP

yes I agree with you on that!

..............Buck

[broncovet]

Navy

Its all going to boil down to evidence. Do you have a doc statement who provided you a nexus, that is, that your teeth are secondary to your eating disorder?

If so, you should get SC for your teeth, upon appeal.

I do agree with Pete, tho. Remember the VA treats us like we are spoiled children, so sometimes we need to fulfill the part they expect of us. Like a child, if Mom says no, then ask Dad. If both of them say no, ask Grandma.

So, go to your prime care and ask him for a dental referral.

Somewhere, there are rules about under what circumstances VA will pay for private health care, and my guess that means dental also. I seem to recall that you can use private care in an emergency, but you have to tell VA right away, and give them a chance to transfer to a VA facility if one is available.

Did you ask the people at your local VAMC to pay for it? Reminding you of the "spoiled child" theory, if that person says no, go to his supervisor, and if that person says no, go to the directors office. I recommend you work "up the chain of command", like we did in service. That is the first place to start. Several years ago, we had a board member post the rules in regard to fee services.

If they have denied your payment for your dental work through fee services, then you can appeal it like any other denial.

Edited May 31, 2015 by broncovet

[Gastone]

FDC, you should have a decision shortly, unless it becomes a Reg Axx claim.

Hindsight is always 20/20. Just wondering, why didn't you transfer to the nearest VA Hospital when your Emergency was stabilized? At 60% SC, you're covered for all Private Emergency care, but you need to contact you VAH asap to arrange transport to nearest VAH after Emergency is stabilized. Now I'm not sure about this, if the Dental work would have been ordered by VA Treating ER DR, it might have been taken care by the VA.

Just keep in mind for future reference regarding Non VA Emergency, the VA must be notified immediately of the admission to the Non VA ER for treatment. If the VAH Dr authorizes you to stay at the Non VA Hospital, the VA Picks up the entire bill. You or someone needs to advise the Non VA Hospital that you're covered by VA Medical Insurance, otherwise you could be looking at the very least a hellatious Co-Pay or upwards of 15-$20K emergency Room bill.

Semper Fi

Gastone

As to VA paying for Non VA Dental work, I think that will be a very tough sell. Very rarely would I say Good Luck but this is one occasion I would.