TKR & 100% temp disability

[mtmorical]

We are new to the site and hoping for some help.

My husband left service in 2002 honorably and medically. After he got home and received treatment they determined him at 0%. We went about life although his R knee has always been an issue. In 2013 it finally became to much for him so in the spring he started going back to the VA, they tried to clean it out with a scope, then they tried cortisone injections, but the doc said that his knee was too far gone and that he needed a TKR so at 38 years old he put as long as he could and it was scheduled for Dec 2015.

Unknown to us the VA was doing something with his discharge and one day we got a check in the mail for over $8k, and two days later a letter explaining that his R knee has now been rated at 10% do to degenerative joint disease, arthritis and would be receiving compensation at the 10% rate. Great!

Now my questions:

Will the approve the temp disability for his TKR since he has been determined 10% for arthritis?

Is there anything that they could deny it for? Like not getting medical care (we couldnt afford it and didnt know he was VA covered)

We filed a FDC only to get paper in the mail that he needed to sign saying his had no additional information, so we signed it and sent it back, then we got flag on ebenefits stating requested information past due. So we contact a VSO, he called us back and told us that they never should of sent that letter since we submitted a FDC, that he was working with a manager and was going to request an informal expedite since its caused his claim to be suspended due to the paper that should never of been sent, the flag about requested information past due has since been removed.

Has anyone had experience with this? Will they now drop us to a standard claim because we submitted those additional documents? Has anyone had luck with an financial hardship expedite request?

 

Thank you in advance for your help!

mtmorical

Edited March 28, 2016 by mtmorical
more info

[broncovet]

If you had a second leg TKR done, then you would likely have the "bilateral factor".  Im not sure if it would be doubled or not..maybe someone with 2 TKR's could answer that.  

[mtmorical]

Awesome! Thank you so much for responding! I was kind of thinking that since they paid back to 2002 and we only got 8K.

We have not added the dependents, we do have 6 kids, 2 not at home, 1 who is in college living at home, 3 kids under 18, and we also have our grandchild that lives with us.

Do we add them now, or wait until this is completed?

So far I know once this is completed we will file a NOD (have no idea what that is though) to see about getting that 10% increased since he knee has been horrible for years and required TKR, will they back pay for that or should we just leave that alone?

Then we have to get the VA doc to start working on his left knee, we already know its bad and needs a TKR but we have to find a way to get that secondary due to having to compensate for his right? Am I correct on this? OMG I have no idea what the heck we are doing and I dont want to mess things up and do them wrong. That is why we are waiting until everything is done so we dont get kicked out of FDC or anything.

 

[broncovet]

You need to file a nod within a year of the decision or  it will be denied virtually 100% of the time.  So, look at the decision date, and make sure you get that nod filed timely. It must be received by the RO in a year, not mailed.    Yes, if you file a timely nod, and the appeal fly's, you get an effective date back to when you applied, or to when the doc said you became disabled, whichever is later.  

I see what you are doing here, and you are doing so at your own peril.  You are waiting for your current decision, to file a NOD, because you think it will delay your current decision to file a NOD.  This is not a for sure thing.  Waiting on filing the NOD, may/may not help you.  I say it probably wont make your current claim go faster.  Your claims travel at the speed VA wants them to, and not one bit faster.  And, not filing a NOD does not motivate your RO to process your claim faster.  

Filing a NOD now will at least get you a place in line because the BVA has about a 4 year backlog.  

Your appeal will be processed by the "appeals team" and your claim will be processed by the rating team, and these can go on at the same time now that many Vets claims are digital and not "just" on paper.  

And, I have seen Vets, like yourself worry about "getting kicked out of FDC".  Remember, you probably already are kicked out of FDC if you have missing evidence such as a C and P exam.  FDC assumes you have all your evidence and dont need a C and P.  Maybe you do.  Did you order your cfile and see if your doctor said your TKR was mandantory and not elective???? 

Maybe your doc told you, but did he write it down?  Go to your VAMC and ask for that exam and read it if you dont want to wait for your whole cfile.  You will know much better after you read what the doc said.  

[mtmorical]

Why would it be considered elective? The doc said that there wasn't anything else they could for treatment to improve his knee other than a TKR. He said that they don't like to do them on someone so young but that again there was nothing else they could do and he needed a TKR. So having it when he did could mean it wasn't mandatory?

[broncovet]

A few years ago Allison Hickey stated that the delays in dependents benefits were a disgrace and these should be done in days or even hours, and not months.  While I agree, Allison is gone, and so are many of her ideas.  Im still trying to get my dependents benefits from 2002...and I have pretty much given up, having been all the way to CAVC on dependents.  VA will fight you tooth and nail for every dime sometimes.  

By all means file your dependents now, dont wait until VA looses your documentation 3 or 4 times like they did with me and then disavows ever getting it.  They got it all back in 2002, but fight me on it until the death.  Send your dependent documentation, including college age, asap, and send it to the evidence intake center where its harder for them to shred.  If you are married with six kids, your retro will be thousands more if they have all your dependents.  Dont delay.  Send copies of their birth certificates, and, proof you have a kid in college over 18.  

[mtmorical]

And the VA did all of it on their own no prodding from us. They made that decision to give him 10% in 2014 so we missed that ?