Caregiver

[jfrei]

So the woman trying to explain to me why I don’t qualify for the program. She said you could be 100% scheduler which I am Permanent and total which I am but not require constant care by someone as it’s not in any of your doctor notes. My doctors are treating me so that I can perform my ADLs  just to be able to them. The doctors don’t talk about me needing a constant caregiver which is not even what I’m trying to show the highest tier isn’t needed but my wife helps me and  persuades me so I don’t get hurt. She says well that may be but you don’t qualify for this program. I am talking to her again tomorrow I haven’t even formally applied she said she was just giving me a heads up since she runs it at my local VA. Does anyone know of what I should ask her? I thought the requirement to being 100% for my TBI meant that I needed surpervsion at least most of time for danger of hurting myself which is easy to show if she just talks to my wife again.... but I must be missing she says a big determination factor is I am able to drive down the street to the VA hospital to go to my appointments, I was mad I live less then 5 miles away and it’s literally down the street... she like this has nothing to do with your compensation which is why you can be 100% and still not qualify as an OEF vet..

[Buck52]

Great information from superman

Also remember the combined ratings are figure in with the VA crazy Math 10% is not like being 10%  due to the way VA does the math

if a veteran is 80%  he will need an additional 90% to reach 100%.

so when your looking to add up all your separate smaller ratings be sure to use the combined calculator found here on hadit.

The raters are suppose to inferre the SMC when a Veteran meets the criteria but they some times don't and the veteran is not aware of it and gets beat out of  his well deserved benefits.

no telling how many veterans that have passed on and got beat out of there benefits.  grrrrrrrrrr

[Buck52]

Basically jfrei

a veteran needs to be totally helpless and in need for some one to help him get dressed, feed him, go to the bath room  and he sure can't be driving any where.  caused by or due to his S.C. Disability's 

Medical documentation needs to mention all of this, this  is how they decide the program for the veteran 

the form 21- 2680 does not  go into enough detail to show just how bad a veteran truly is  and for this reason they come back with a denial saying not enough evidence or some other non-sense  which is just B.S

Most veterans are bed ridden  but not all are.& under special circumstances they do make exceptions to the severity of the disability  but in most cases when a veteran can't help him self  he is pretty bad shape.

At the VA Those Dr's watch us like a Hawk  they visualize us as  were walking/ talking and getting around  and even though they don't know all of our disability's they assume were not qualified to meet the A/A Program  and most VA Dr's don't know how the claims process works.

so they just make up crap to satisfy the Veteran   they have a mind set that all of us are just plain stupid (which is intimidating to say the least.)

you might PM James Cripps He knows how the steps to SMC's work and he can sure give you some very good Advise..he was on Hadit radio show last week and they talked about SMC 's and meeting the criteria  what all a veteran needs to be to qualify. 

Edited October 29, 2017 by Buck52

[SupermanCannedy]

    Jfrei, I agree that you should definitely get connected with someone who knows the SMCs well to increase your S to an L, like James Cripps. For what to do in the VA Caregiver Program, I can tell you that your wife will need to step up. Have her contact other caregivers who have been through the process. Some are new to it and some have done it from the start (2 1/2 years ago it started?) She will find lots of advice and info on the Hidden Heroes site I pointed you to. Take advantage of any opportunity you have to gain knowledge from those with the education or experience to assist you! 

    Buck, I am pleased to say that I was able to increase my vet's SMC from S to L 1/2 using that very inadequate form. No new medical info added, just the form and a back up letter from the neuro so he could explain his reasoning because the form is so limited.  It helped that I studied the CFRs, especially 'Entitlement to SMC Based on the Need for A&A' under 38 U.S.C. 1114 (l), all of section H, and anything else I could find that could help with understanding what the DO needed as evidence and to help with responding to the odd and oversimplified wording on the 21-2680. It really helped that we have a good report with the VA neuro and that he actually cares about his patient.  I interact during all of the appointments as well because my vet has such a bad memory and is so easily confused he can barely answer the questions asked. 

   The reality is that most people will take that form to their PCP, who will scratch a few words on it here and there, providing no clue to the DO of how helpless they really are.

    Hopefully, another form will be created with questions that better address the cognitive, memory and behavioral deficits of veterans with TBI or other neurological dysfunctions who are seeking an increase in their A&A. My vet is physically fit because exercise is the one thing that has been constant since he left the USMC. It keeps depression and anxiety at bay. He has all of his limbs, they all function, and he isn't bed ridden. He is housebound because, not only can he no longer drive, he can't even walk anywhere without supervision. He gets lost, can't recall his address, doesn't take his phone and talks with strangers. He has been in a few skirmishes with people, walks in the middle of the road or parking lot and has caused traffic problems, experienced near accidents, etc etc. and then is an emotional wreck, like a child. He is housebound due to memory deficits and mental incompetency. The A&A isn't to provide nursing care, but home health aids or caregivers to assist with his daily needs, provide supervision, and keep him safe from harm. I run his household as well as my own, so my time and energy I have to take care of him is limited, yet his needs increase with time as his brain continues to degenerate. Without hired help, I would collapse...then, he would be (?).

     I think we will see an increased number of veterans needing care for the neurological diseases that develop in chronic cases of TBI. This war is 16 years in and TBI has been prevalent from the beginning. They eventually set up protocols to treat acute cases, but still have nothing for the devastation that happens in chronic cases. Multiple TBIs, especially when untreated or layered in later years with more TBIs (accidents, fights, etc) can develop over a long period of time into other neurological diseases like Parkinson's, CTE, Alzheimer's and other dementias. Life can even seem "normal" for awhile or as if the TBI was treated and gone. It can take decades before the problems from all those dead brain cells start to really create problems. But, by the time it is realized, the brain is riddled with damage that no one has yet found a way to reverse or slow down.  We've met a few vets who have had TBIs for just over a decade that are now presenting mid stage dementia. I wouldn't be surprised if there are a lot more of conditions like these within the next 5 years. The VA needs to be prepared because they are a residual of those service connected TBIs and will require higher levels of A&A and/or long term care. 

Didn't mean to get so heavy!  I thought about erasing those last few lines....but, no. 

 

[Buck52]

Roger that  supermanC

Great post there buddy.

[jfrei]

thanks for all the information folks I will look into the website tomorrow these pass two weeks ive been spending a lot of catch up time with the family its about time just glad its not to late