diabetes Va Reimbursal For Service Connected Disabilities

[RSG]

1: va reimbursal for service connected disabilities back to earlier effective dates? true or not true, read a few cfr's that say yes.

2: Does va have to pay disability at a different rate if spouse and children are included in the retro figures and in evidence on file?

3: Does VA have to reimburse for all medications from non va when the disability is Sc'd?

4: does VA consider physical ailments as secondary to PTSd/depression, such as diabetes and spinal degeneration..

I think VA has missed a few dollars in my retro On the CUE claim I was granted....RSG

[USMC_VET]

1) depends on your EED, effective date. Whatever date the VA says it is is what they will pay back to, depending on your situation i dont know.

If you mean you filed for say PTSD in 2005 were denied and then filed again now and are awarded. No they will not retro back to 2005, etc. UNLESS they ignored evidence in 2005 that would have given you the award back then. That is a CUE case and hard to prove, and a pain, but worht it if you can approve. I filed for PTSD in 2006 and then when they called me for evidence i decided not to go forward with the claim. i was denied, but i was granted after a claim i made i n2012 back to the application efffective date of 2011. They did not retro me back to 2005 because it was a closed claim and it wasnt a case of them not looking at evidence and being in the wrong.

2) They will have to pay the retro according to your family situation ie wife and 2 kids, etc. This should be included in the retro, check. I dont know for sure but if sya your retro is ten years and you were married 2 years ago and had 1 kid a year ago, then that retro might not include them before they were part of you fmaily unit.

3) I dont know for certain. I dont think they have to pay for medications gotten in private if SC'd however they do have to pay back (they did with me) what you paid for care at VA treatments during the period the retro covers.

4) you have to claim those as secondary, and could get retro back to the original retro for the PTSD etc. if awarded if They do grant secondary to SC etc.

This is my opinion, there are much more experienced folks out there who can give you better details and case law.

Edited June 26, 2015 by USMC_VET

[broncovet]

1. Im guess you are talking about "reimbursed" medical care for SC disabilities. When I got SC'd, I went to the VAMC guy and he refunded to me my copays back to the effective date. I had to ask for this, they dont do this automatically, and required a copy of my decision.

2. Yes, you should get retro for dependents, also. The VA will pay your retro as follows: New Rate MINUS What you have already been paid so far. This they do for each month.

3. I dont know if VA will reimburse private care for SC conditions, but doubt it. You could have gone to VAMC, but, for whatever reason did not.

4. VA will likely consider service connecting "physical ailments" to mental health disorders on a case by case basis. Essentially, you will need a doctor stating to the effect that your xx (ailment) is "at least as likely as not secondary to your service connected depression/PTSD". If your doctor makes such a statement, then that should be probative evidence that would be difficult for VA to refute. Generally, VA does not "connect the dots", but instead requires a doctor to make this medical determination.

[RSG]

1. Im guess you are talking about "reimbursed" medical care for SC disabilities. When I got SC'd, I went to the VAMC guy and he refunded to me my copays back to the effective date. I had to ask for this, they dont do this automatically, and required a copy of my decision.

2. Yes, you should get retro for dependents, also. The VA will pay your retro as follows: New Rate MINUS What you have already been paid so far. This they do for each month.

3. I dont know if VA will reimburse private care for SC conditions, but doubt it. You could have gone to VAMC, but, for whatever reason did not.

4. VA will likely consider service connecting "physical ailments" to mental health disorders on a case by case basis. Essentially, you will need a doctor stating to the effect that your xx (ailment) is "at least as likely as not secondary to your service connected depression/PTSD". If your doctor makes such a statement, then that should be probative evidence that would be difficult for VA to refute. Generally, VA does not "connect the dots", but instead requires a doctor to make this medical determination.

2. ok, the VA did not include this in my retro..Thank you.

3. In my original paperwork the VA and the navy denied any benefits of going to the VAMC for anything...In black and white..I did not know any better t the time, that they could not do this..So I was originally fighting for that.. until I found out that they could not do that..Did not find out until 2002..

[broncovet]

2. You need to ask for an audit, if you think the compensation is wrong.

3. Go ahead and try. YOUR best shot is "fee basis".