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gcooper5071

VOC ReHab denial and HIPPA Laws

Question

**re-posted from main forum**

BLUF:

-90% service connected disabled

-Currently have a claim in the hopper for new conditions and increases.

No SSDI and No I.U.

 

Applied for Chapter 31 Voc Rehab, was denied based on what my Voc Rehab Counselor saw in my medical records.  Main question is, are the Voc Rehab Counselors allowed, under HIPPA laws to have access to 100% of my medical records?  To be clear, while in the Voc Rehab appointment, my counselor was able to access online all of my medical records and notes from all of my Drs.  Also, she had copies of my QTC exam results (which I don't even have), for an ongoing claim which has not been decided yet.  For PTSD the QTC DR stand "total occupational and social impairment", which was the main reason that Voc Rehab denied me.  

 

Any help, advice, etc. would be greatly appreciated

Thanks in advance


 

 
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Here's how this works. When you acquiesce to free medical at VAMCs, you create a record at VHA. When you file for compensation and submit your civilian medical records, you create a record at VBA. You create one composite .PDF file now which is referred to as the claims file. A VBA Examiner looking at your claim for PTSD, or, in this case, a VBA Vocational Rehabilitation Counselor (VRC) deciding a Chapter 31 entitlement, make a determination as to whether you can be trained "vocationally" or whether you are considered incapable of employment or that vocational training for you might be "unproductive" and your potential for future employment success highly doubtful.

At that point, they declare you infeasible for employment  and you are then eligible for the other side of the benefits-i.e. Independent Living Program under 38 USC 3120 and 38 CFR 21.160, 21.162. Or you can file a NOD and appeal this. Many here, including me, find it useful to "force VA's hand" into saying you are not trainable which, by admission means you should be on TDIU at 100%. Repair order? Get denial from VR&E. File for 4.16 IU based on VR&E assessment.

As for HIPPA, that isn't for application. When you enter a govt. system like VA, all your records, both medical and compensation, are free game for VA to use to award/deny entitlements. VR&E is part of the VBA and has equal access to Virtual VA, VBMS, VACOLS and C/winnrs computer systems. That includes the VHA's VistA computer as well.

To get a copy of your c-file, send in a  VA 3288 and request one. To get a copy of all your VHA medrecs, go to a VAMC ROI office and ask them to print it up for you. Anything before 1995 is archived in microfiche and will have to mailed.

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On 9/20/2016 at 2:07 PM, asknod said:

Here's how this works. When you acquiesce to free medical at VAMCs, you create a record at VHA. When you file for compensation and submit your civilian medical records, you create a record at VBA. You create one composite .PDF file now which is referred to as the claims file. A VBA Examiner looking at your claim for PTSD, or, in this case, a VBA Vocational Rehabilitation Counselor (VRC) deciding a Chapter 31 entitlement, make a determination as to whether you can be trained "vocationally" or whether you are considered incapable of employment or that vocational training for you might be "unproductive" and your potential for future employment success highly doubtful.

At that point, they declare you infeasible for employment  and you are then eligible for the other side of the benefits-i.e. Independent Living Program under 38 USC 3120 and 38 CFR 21.160, 21.162. Or you can file a NOD and appeal this. Many here, including me, find it useful to "force VA's hand" into saying you are not trainable which, by admission means you should be on TDIU at 100%. Repair order? Get denial from VR&E. File for 4.16 IU based on VR&E assessment.

As for HIPPA, that isn't for application. When you enter a govt. system like VA, all your records, both medical and compensation, are free game for VA to use to award/deny entitlements. VR&E is part of the VBA and has equal access to Virtual VA, VBMS, VACOLS and C/winnrs computer systems. That includes the VHA's VistA computer as well.

To get a copy of your c-file, send in a  VA 3288 and request one. To get a copy of all your VHA medrecs, go to a VAMC ROI office and ask them to print it up for you. Anything before 1995 is archived in microfiche and will have to mailed.

That's interesting. I thought, despite Voc Rehab being for getting jobs, that no one, including tdiu's was refused for school who were disabled. Maybe I was mistaken, but my phcp also thought the same thing too. Felony convicts get unlimited education for life, presumably for snitching on citizen students to cancel their school benefit programs.

I was just refused flat for a Chapter 31 program I had a significant chance to successfully complete once I found out my root cause tbi analysis: after I got my TBI nexus and put in for a tdiu (all within the definition of the VA Chapter 31 providing the MAXIMUM opportunity for the disabled Veteran's career in a chosen field of their choice - I have been SEH, Significant Employment Handicapped since 2012 - he does not have a leg to stand on.) A new VRE counselor was just shooting it from both sides of his mouth looking above my head rolling his eyes in circles while talking to me (like an autistic person may do.) He left me high and dry 6 months now. Needless to say, I'd like to get him fired from his $85K/year job saying things that no knowledgeable VRE counselor would say. I do not see anyone jumping in to save him, including his boss who is his puppet master (and actually, his boss is a pretty nice guy - ?) 

Hippa is for care taker privacy of patient's personal information, and Chapter 31 regulations are for VRE's (or other applicable regulations and laws.) VRE counselors live in a bubble of regulations that make it difficult for them to do anything outside ethical procedures (well written regulations.) I know what I'm doing next week.

 

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All of A-NOD's and, File an IU FDC YESTERDAY Based on the VOC REHAB DENIAL LETTER. Attach a copy of the Voc Denial Letter or reference it on the claim. At the very least, start the IU FDC on your E-Ben site, to lock in the Retro.

But Wait there's more, if you pay Residential Property Tax and your State has a DAV Residential Property Tax Exemption, take a copy of the VR Denial Letter to your City Tax Authority.

Semper Fi

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TBI is rated in the same vein as PTSD. The deficits associated with it are predominantly mental from VA's standpoint. Getting a designation of being infeasible of attaining and/or keeping a job is a VA technique to fence you out of VR&E in any form. The law is clear. The Independent Living Program is for those of us who fall into the infeasible category. VA has purposefully allowed the ILP to fall into disrepair and now only hands out trinkets like grab bars at showers/toilets,  can grabbers and electric can openers. No more metal detectors for a hobby on the beach. No more toy tractors for small-scale farming. Some of you discovered the back door. If you are not trainable, then you are unemployable. Bingo. TDIU at 100% right? VA is now trying desperately to plug that loophole.

ILP was headed to extinction until I asked for a computer and greenhouse in 2011. I kept pushing and finally got the computer in 2012 but no dice on the greenhouse. I filed my NOD in fall 2012. They sent out a SOC about a month later with more denial babble. I filed the VA 9 a week after that in 11/2012 and they "lost" it. After 60 days, they declared the claim unappealed and dead. I produced my green card and showed receipt of the VA  9 in 3/2013. They reinstated the appeal but refused to answer my SSOC rebuttal or issue the VA 8 certifying it for appeal. They must have figured I was a dumb Vet and would give up. I filed an Ex Writ at the CAVC demanding they do the appeal in January 2015. Got my VA 8 a month later on February 17th. Got my BVA travel Board Hearing April 29th. The Judge was appalled and granted me an advance on the docket. Got my win on the greenhouse 4 months later on September 4th, 2015.

I finally filed for a new Ex Writ at the CAVC in June 2016 asking them to quit screwing around and build it. Then I wrote Secretary Bob a long letter. I fought until yesterday to get them to give me what I needed.  The VR&E Officer finally threw in the towel at 0930 and agreed to everything I had asked for-hydroponics and high pressure sodium lighting/propane heat in a 20 X 28 ADA greenhouse (slab on grade with rubber mat fall protection). I was feeling pretty lucky so I decided to see how far I could stretch this.  I told we had a deal if he'd throw in a $1,750.00 composting portapotty due to my short bowel syndrome. Who wants to empty a portapotty full of poop? It stinks. He cried/denied and then emailed and agreed to it about 1330. Feeling even more emboldened, I asked for a two-year subscription to the Lexis Nexis Veterans Benefits Manual (VBM) to do pro bono work to help my Vet buddies for $350/year. He refused and then called back and relented about 1500 hrs. I said we had a deal if he'd throw in the propane, electric bill and the hydroponics nutrients for a year. He absolutely refused and said he was sending it up to DC and it would take forever to get the ghouse. I said "So be it, sonny." That broke the camel's back until 1620 hrs. He called back and said 90 days on propane and nutrients and that was his final offer. We shook hands over the phone and I told him to get his sorry ass over on Monday so we could sign around on it. He thanked me profusely and promised to be here with bells on at 1000 hrs. And that, ladies and gentlemen, is how you deal with VA. Always get to the high ground first and defend it. Unconditional surrender is the only technique. MacArthur taught us that in 1945. 

The ninety day suspension date ended at 1630 hrs and we got his ILP completed with ten minutes to spare. I'm guessing he was calling VR&E Services in Washington DC and getting authorization for all these little extras at the last moment because his voice was beginning to crack  when he agreed to the VBM. Sometimes you have to be prepared to stand and fight. I'm sure you all learned that concept when you did your combat training. I spent five and a half years getting here but I proved a point. The M 28 means nothing. The VR&E Officer is the OIC. He makes the decisions. Mine complained for five and one years and told me I'd never get it. In the end, he was agreeing to anything and everything just to meet 38 CFR 21.98(b) and the CAVC deadline for compliance. I was thinking about asking for a refrigerator to keep the beer cold out there too. It's going to be 70 degrees in there and hydroponics is thirsty work.

The best part is I can now go in to talk to him and tell him to give a Vet a tractor or metal detector because he did it for me. Being a VA Agent now also allows me to roam the VARO or call and talk with the Director about "problem" VA employees. 

Edited by asknod
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