100% pay when not at 100%

[DD_Carter]

So it has been awhile. But the last two months I have gotten paid at 100% even though my e benefits says I am 90%. I had applied awhile back for convalescence compensation but it was denied and I received a letter stating that. I am super confused and not sure what I should do.

 

Thanks,

Lee

[DD_Carter]

I am very confused now. I called and she said that my payment was correct and she asked if I had received the letter. I told her no I had not so she offered to either mail me a copy or fax me a copy. I opted to have it faxed. It was the Convalescence compensation but it says on here:

We made the following decision(s):

Entitlement to special monthly compensation based on housebound.                                                  Mar 20, 2017

• Entitlement to special monthly compensation is warrented in this case because criteria regarding housebound were met until July 1, 2017

Lumbar strain with interverebral dis syndrome and spondylolysis of L5 vertebrae              20%                 100%             Mar 20, 2017

Lumbar strain with interverebral dis syndrome and spondylolysis of L5 vertebrae              100%                20%              Jun 1, 2017

• An evaluation of 100 percent has been assigned effective March 20, 2017 based on surgical or other treatment necessitating convalescence.
• We have assigned a 20 percent evaluation for your lumbar strain based on 1. Combined range of motion of the thoracolumbar spine not greater than 120 degrees 2. Forwardflexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees. Additional symptom(s) include: 1. With no incapacitating episodes during the past 12 months, 2. Painful motion upon examination. 
• the provisions of 38 CFR 4.40 and 4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and applied under 38 CFR 4.59
• A higher evaluation of 40 percent is not warrented for interverebral disc syndrome unless the evidence shows: Favorable ankylosis of the entire thoracolumbar spine; or, forward flexion of the thoracolumbar spine 30 degrees or less.
• A higher evaluation of 40 percent is not warrented for interverebral disc syndrome unless the evidence shows: Intervertebral disc syndrome with incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months. 

 

what the hell does all this mean?

[MikeHunt]

Sounds like you're granted both housebound and 100% for convalescence.

Maybe someone else could chime in, but housebound adds, again, the 100% rate, if I understand the tables correctly, so about $6000

That's not what I understood you're getting paid- You said it was around the 100% rate; ~ $3000

Likely, based on the actual pay, they just haven't stopped the convalescence pay, and FUBARed the letter.

[DD_Carter]

@MikeHunt Ya im just really confused. The lady on the phone said it was correct and sent me that letter. Hopefully someone else can give me some insight into what this all means. Thanks for your reply. 

[Gastone]

Your Convelesent pay, effective 03/20/2017 (100%)  will be reduced to 20% SC 06/01/2017. The SMC S (1) Scheduler Housebound Award ends 07/01/2017. Kinda Sucks, doesn't it.

Just about all "Nam Vets" that were DX'd with Prostate Cancer (AO Presumptive) collected 100% Comp from the date of the Cancer DX until they had their Prostate removed. Unbeknownst to 99.999% of these Vets, that 100% Rating was reduced to about 20% SC about 6 mos after the successful Surgery.

Quite often, these Vets were receiving the 100% Comp for over a year, when they got reduced to the 20% comp level. At least you haven't got too comfortable with the 100% pay yet.

Semper Fi

 

[DD_Carter]

1 hour ago, Gastone said:

Your Convelesent pay, effective 03/20/2017 (100%)  will be reduced to 20% SC 06/01/2017. The SMC S (1) Scheduler Housebound Award ends 07/01/2017. Kinda Sucks, doesn't it.

Just about all "Nam Vets" that were DX'd with Prostate Cancer (AO Presumptive) collected 100% Comp from the date of the Cancer DX until they had their Prostate removed. Unbeknownst to 99.999% of these Vets, that 100% Rating was reduced to about 20% SC about 6 mos after the successful Surgery.

Quite often, these Vets were receiving the 100% Comp for over a year, when they got reduced to the 20% comp level. At least you haven't got too comfortable with the 100% pay yet.

Semper Fi

 

I got ya. But the last thing that does not make sense is why am I just now receiving the pay? If the housebound ended on July 1, 2017, I should have received the last payment on July 1 2017 correct?

[Gastone]

VA's like the old Battleship analogy takes a long time to turn or stop. If you get overpaid, even if it's the VA's fault, they're quick to do a "Claw Back" from your monthly comp Deposit. If you're not sure, don't spend it if it starts to accumulate.

Do you agree with the ROM's evidenced in your Denial? Were any ROM testing results referenced that caused you pain?

Semper Fi