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100% Convalescent Pay For Surgery Denied?

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Vet2015

Question

I had a surgery in 2014 I had a nerve release in my elbow because they said it would help my already service connected tendon repair in my hand/wrist.

That happen on Dec 12 and I was home bound and away from work until Jan 17 in cast for left elbow surgery but at the time it was not service connected but i file the claim 2 months after surgery and it became secondary to my already sc claim of left hand tendon repair.

The rater admitted that it was valid for 100% for the month of Dec-Jan, but he told me that because it was done before It was determined as secondary and awarded as secondary, I could not get paid 100% for that month because by law they could not go back and pay me.

Does this sound about right. Even though the surgery was due to my already sc claim.

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  • HadIt.com Elder

What was the EDD listed in the award? If this precedes the hospitalization, you have a good chance of success with an appeal, or

even possibly CUE if the laws/regs were not followed.

It sounds like you filed after the event, and this may be the killer to the RO. The medical evidence filed with the left hand tendon repair may be very important,

and allow grounds for an NOD/appeal/CUE.

Edited by Chuck75
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  • HadIt.com Elder

For what it's worth, I agree w/Chuck, for the most part. The VA is famous for sh*t like this. You need to appeal this decision, or they win.

pr

Thanks, "a for the most part" shows that I'm not completely out in left field! Actually, with the VA, it's often difficult to see what they will do,

regs or not. Sometimes you can get them to look at and change things administratively, other (most) times a full blown formal appeal has to be initiated.

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its should an inferred claim which will be " raised of record"' do not give up.. most raters dont know thier ass from a hole in the ground and vets have been getting ripped off so long they think its standard procedure. Many times AFTER the one year recovery period or shortly before, people inside the hospital will set up a CP exam.. you will get rated, but they wont tell you you were eligible for the temporary 100 rate and should get back pay..

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  • HadIt.com Elder

The VA mis-applied the effective date according to title 38 CFR 3.400. The date the condition arose ( Surgury Date or Diagnosis date) or the date the claim was filed. ( Whichever is later). Shove that down their throats on a NOD and ask them to cue themselves on this issue.

I am so sick of the way these Vermin operate.

J

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  • HadIt.com Elder

yes I agree with Jbasser,

this veteran can win this claim...just make sure you get your NOD in in-time.

those raters will say anything to scare off the veteran from my experience anyway.

check all the Regs 38 CFR's & VA applied laws and usually the raters are wrong in there decision making.

jmo

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

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