VNA

[Holllie Greene]

Hi, Happy Friday everyone.  Today a visting nurse (from the VNA) came to my home to examine me (vitals) and talk about how my MS and asthma limits my life.  She was very nice.  She is also going to recommend PT and OT.  Medicare will pay for this.

She considered me homebound (true since MS will limit your life big time)  and I asked her how does this translate into "VA speak...she said she did not know but to see my new primary again.  I think I will wait till the county VSO returns from training and pay him a visit.

Any thoughts on this?  Any and all thoughts are appreciated.

I am researching theVeterans Choice still.  Thank you.

Holllie G

[Gastone]

Aaaaaaaaaaand, check out the VA chapter 31 IL (Independant Living Program), comes under the Vocational Rehabilitation Chapter 35 Program. Many additional benefits available to the Disabled Vets.

You can also start a claim for the IL Program by applying On-line at your E-Ben site for Vocational Rehab, you'll meet with a Counselor and they'll put you into the IL Program. I had the same Councilor for the Voc Rehab and IL program. as did 2 other Vets that I assist.

Semper Fi

[Holllie Greene]

Hi jefmil50,  thank you for the information.  The MS is truly the pits and more.  However I will keep it positive.  The scooter and lift would be wonderful to have...just to get out of the house for a little while, you know?  I wonder if it will ever be discovered what causes this &$%*@) disease?  All these injectable so called medicines to "slow down the progression" but wouldn't it make sense to know what causes it in the first flipping place?  I have basically interrogated my VA neurologist about all the shots (especially the ones I was given for my one year tour in South Korea) but he said it is not that. 

What, if anything, do you take to help with your MS?  Did you develop cataracts from prednisone?  There is a good natured joke at my ophthalmologist office (civilian doc) about how I am his youngest cataract patient.

It would be best for my hubby to be my caretaker (he laughs at all my dumb jokes).

From a female perspective that neurogenic bladder issue is a real Witch.  If a friend wants to go to lunch I have to take one, then spend the next day flooding my system with fluid to make sure my kidneys work.

Hand in there.  Thanks again.

HG

Edited January 17, 2016 by Holllie Greene
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[Holllie Greene]

9 hours ago, Gastone said:

Aaaaaaaaaaand, check out the VA chapter 31 IL (Independant Living Program), comes under the Vocational Rehabilitation Chapter 35 Program. Many additional benefits available to the Disabled Vets.

You can also start a claim for the IL Program by applying On-line at your E-Ben site for Vocational Rehab, you'll meet with a Counselor and they'll put you into the IL Program. I had the same Councilor for the Voc Rehab and IL program. as did 2 other Vets that I assist.

Semper Fi

Hi Gastone,   Thank you for this bit of knowledge...first time I have heard about VA chapter 31 IL...no kidding.  I appreciate all this great information. :)

HG

[broncovet]

Hollie

    Based on your posts, its clear you should get AT LEAST SMC S  (housebound) and, more likely SMC L

Aid and Attendance.  You have a visiting nurse, and Im sure she does not go to your home to play tiddly winks.    Read carefully over the criteria, Im sure you know better if you qualify than I do.  Please make sure that you DONT HAVE TO BE BEDRIDDEN, but VA sometimes may may think you have to be.  There are several levels of A and A:

 3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a) Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (§ 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

(b) Basic criteria for the higher level aid and attendance allowance.

(1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(2) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran's home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(3) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (b)(2) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.

(4) A person performing personal health-care services who is a relative or other member of the veteran's household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.

(5) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(Authority: 38 U.S.C. 501, 1114(r)(2))

(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

[Holllie Greene]

21 minutes ago, Holllie Greene said:

Hi jefmil50,  thank you for the information.  The MS is truly the pits and more.  However I will keep it positive.  The scooter and lift would be wonderful to have...just to get out of the house for a little while, you know?  I wonder if it will ever be discovered what causes this &$%*@) disease?  All these injectable so called medicines to "slow down the progression" but wouldn't it make sense to know what causes it in the first flipping place?  I have basically interrogated my VA neurologist about all the shots (especially the ones I was given for my one year tour in South Korea) but he said it is not that. 

What, if anything, do you take to help with your MS?  Did you develop cataracts from prednisone?  There is a good natured joke at my ophthalmologist office (civilian doc) about how I am his youngest cataract patient.

It would be best for my hubby to be my caretaker (he laughs at all my dumb jokes).

From a female perspective that neurogenic bladder issue is a real Witch.  If a friend wants to go to lunch I have to take one, then spend the next day flooding my system with fluid to make sure my kidneys work.

Hand in there.  Thanks again.

HG

Here is my edit:  I wrote "if a friend wants to go to lunch I have to take one"...  Take one is a medicine called TOVIAZ  (Maybe you all have seen the TV commercial where a woman is playing tennis or is it a round of golf and she is just wishing she had taken a TOVIAZ.  TOVIAZ works, dare I say a bit too well. 

HG

[Holllie Greene]

47 minutes ago, broncovet said:

Hollie

    Based on your posts, its clear you should get AT LEAST SMC S  (housebound) and, more likely SMC L

Aid and Attendance.  You have a visiting nurse, and Im sure she does not go to your home to play tiddly winks.    Read carefully over the criteria, Im sure you know better if you qualify than I do.  Please make sure that you DONT HAVE TO BE BEDRIDDEN, but VA sometimes may may think you have to be.  There are several levels of A and A:

 3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a) Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (§ 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

(b) Basic criteria for the higher level aid and attendance allowance.

(1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(2) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran's home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(3) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (b)(2) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.

(4) A person performing personal health-care services who is a relative or other member of the veteran's household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.

(5) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(Authority: 38 U.S.C. 501, 1114(r)(2))

(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

 

Edited January 17, 2016 by Holllie Greene
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