Clothing Allowance Deadline August 1, 2016

[Vync]

Hello everyone,
It is VA clothing allowance time again. For those who do not know, some new rules were introduced last year.

 

http://www.benefits.va.gov/COMPENSATION/claims-special-clothing_allowance.asp

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Applications are collected throughout the year and held until the closing date of August 1st. They are then processed and Veterans will receive payments between September 1st and October 31st. This is an annual payment and will only be made during this time frame. If you have not received your payment by October 31st, you should contact your local prosthetic representative.

Additional information about how to deliver clothing allowance claims may be found here: http://www.prosthetics.va.gov/psas/Clothing_Allowance.asp

The PSAS handbooks can be found here: http://www.prosthetics.va.gov/psas/PSAS_Handbooks.asp

The current version of the Clothing Allowance handbook (dated May 14, 2015) found here: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=3112

 

More restrictive claims

This link was posted on Hadit recently, but here it is again with more details
http://clarksvillenow.com/local/veterans-voice-va-changes-clothing-allowance-eligibility-disability-claims-processing/

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This year, however, many veterans who previously were awarded clothing allowance for certain knee or spine braces are receiving denial letters. That’s because the Veterans Health Administration updated their handbook in May of 2015. Previous to this change, any “rigid” spine or knee brace qualified for the annual allowance whether or not it was covered in fabric. Under the new guidelines, any brace that has hinges or plastic or metal stays covered in fabric no longer qualify.

“Examples of items that do not tend to tear and wear out clothing include: soft orthotics, transcutaneous electrical nerve stimulation (TENS) units, shoes, shoe inserts, non-specialized wheelchairs (sedentary/sitting purposes), scooters, canes, rollador walkers, elastic/flexible braces, items with Velcro stays, hinged braces covered in fabric (metal stays covered), braces with plastic stays covered in fabric.”

 

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6. CLINICAL EVALUATIONS/RE-EVALUATIONS:

b. The treating physician will re-evaluate the Veteran to determine whether the prosthetic, orthopedic appliance or skin medication is still medically necessary for their service-connected disability or disabilities. An annual re-evaluation of the Veterans prosthetic, orthopedic appliance or skin medication is recommended.

NOTE: In no circumstances will the Veteran be instructed to provide any articles of clothing for clinical evaluations/reevaluations (e.g., requiring Veterans to bring in clothing to VA medical facility). For unusual circumstances Veterans can submit pictures to certify their prescribed prosthetic or orthopedic appliance, or skin medication causes wear, tear or irreparable staining. Submission of pictures by the Veteran is considered sufficient evidence.

 

It is important to note that the first part of 6b appears to almost contradict itself. First, they state the treating physician "will re-evaluate", but then they turn around and state that an "annual re-evaluation...is recommended". If the VA denies your request because you did not have an annual re-eval for it, then it might be worth reminding them that the re-eval is recommended, but not required, per the handbook.

It is also important to be aware of the "Note:" portion. If the VA asks you to bring in actual damaged clothing, then they are breaking their own rules. They state that "For unusual circumstances...submission of pictures is considered sufficient evidence". I guess this makes sense that it could generate a health hazard if a veteran hauls their damaged dirty laundry and dumps it out at the VAMC's prosthetics desk.

 

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8. PROSTHETICS, ORTHOPEDIC APPLIANCES AND SKIN MEDICATIONS: While the ultimate determination is left to the individual treating provider, the following guidance is provided:

a. Examples of items that tend to tear and wear clothing include: Prostheses, rigid braces, ankle/foot orthosis (AFO) with hooks, rigid AFO, manual wheelchairs without clothing guards, specialized wheelchairs with sliding board/sliding transfer functionalities, and wheelchairs with positioning and posturing adaptations, crutches, wrist braces, prosthesis, rigid orthotics, service dogs, colostomy or ileostomy, cervical braces.

A guide and updated listing created by the Orthotic and Prosthetic (O&P) Field Advisory Committee identifies prostheses and orthotics that may cause wear and tear to outergarments. It is available under the Clothing Allowance folder on the Prosthetic and Sensory Aids SharePoint at:
http://vaww.infoshare.va.gov/sites/prosthetics/default.aspx. NOTE: This is an internal VA Web site and is not available to the public.
Prostheses and orthotics not included in the guide should be reported to VHA’s Rehabilitation and Prosthetics Services (10P4R). The O&P Field Advisory Committee will review the prostheses and orthotics to determine its impact on clothing. Consultation with local VHA Orthotists and Prosthetists can substitute when a prompt decision is needed.
This list is updated by the O&P Field Advisory Committee on a semi-annual basis, provided new prostheses and orthotics may qualify for the clothing allowance benefit.

b. Examples of items that do not tend to tear and wear clothing include:  Soft orthotics, transcutaneous electrical nerve stimulation (TENS) units, shoes, shoe inserts, non-specialized wheelchairs (sedentary/sitting purposes), scooters, canes, rollador, walkers, elastic/flexible braces, items with Velcro stays,
hinged braces covered in fabric(metal stays covered), braces with plastic stays covered in fabric.

 

 

A while back, I found a topic here on Hadit where elcamino_77us posted a PDF VA letter stating off the shelf braces no longer qualify for CA because the manufacturers stated "they do not damage clothing". Others on that topic stated they had to bring in damaged clothing to prove it to the VA. Per the rules (6 b), this should NOT be required.

The "do not tend to tear and wear clothing" part is important. From talking with the people at my VAMC prosthetics desk, all of the braces they issued have fabric covering the metal and plastic parts and clothing allowance would not be paid for them.

Despite what the VA thinks they know about the braces they give us, I can indeed confirm that my wrist and lumbar braces damaged my clothing due to friction and velcro.

[JayBrown1]

Yes it is, today I checked my bank account and was surprised to see my clothing allowance was post to my account. First time that I got it in August, usually won't see it until November.

[JR Reihs]

Yup, they are starting to disburse, time for some new dud's.   Early this year for some reason. 

[wjack12412]

I am 100% P&T and I had surgery on a non service connected part of my body. The surgery caused an infection and was required to use a steroid cream, am I entitled to a clothing allowance since it was the surgery that caused my skin disorder?

[Grunt509]

wjack12412

You should be able to get the allowance for this since you are 100%.

I just want to know if no one has received their clothing allowance yet? The VA here in Clarksburg has been telling us they can't put the paper work in. They say it is a nationwide problem. I want to see if anyone else is hearing the same.

Thanks folks!

[Scottiewheels]

I have not received mine yet!!! In 17 years this is the latest it has ever come!! Anyone else still waiting for their clothing allowance?

 

Scotty

[Vync]

3 hours ago, Scottiewheels said:

I have not received mine yet!!! In 17 years this is the latest it has ever come!! Anyone else still waiting for their clothing allowance?

Scotty

I received my rubber stamp denial letter after about 5 weeks, so I sent pictures of damaged clothing. Waiting...