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Flyfishingnut

IU

Question

Folks, I have 100% IU.  Recently, I applied for Aid and Attendance.  I went and had an exam, lasted 15 min. The Dr. never checked me physically.  Naturally, it was denied, but also the prior Disability has been downgraded.  I was a natural 90%.  Was wondering since I was awarded 100%, IU, with P&T, will I still be at 100% IU?  I recently had an appt. at the VA hospital, and my Dr. stated that I still have the original condition.  I checked my eBenefit, but everything is blank. I'm wondering if I wake up if it would all change.  I'm wondering if I have a fight coming up.

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Posted (edited)

If you had evidence when you had your last C&P For the A&A..And the Dr failed to read it or mention it in his report   that could change the outcome from a denial to an award...  then you may want to check out with your NOD &File  a CUE.

if it was denied  your other rating IU P&T should stay the same  unless they call you in for another C&P for your current rating  and then they need hard core medical evidence that your current S.C. Condition has improved and a Dr to state so  They need two different Dr opinions to say your s.c. condition has improved and they both need to examine you physically.

On these exams that only last 5 -15 minutes  something is not right and you sense it

Veterans need to speak up and ask the examiner questions like Sir did you see in my medical records where Dr Smith mention my condition has got worse and he referred me to A&A or what ever your Dr writes up in his report that is favorable.

We need to not let these examiners get away with this type crap.

Edited by Buck52

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In regard to A and A, VA often misinterprets regs  to mean you are "bedridden".  The regs are carefully crafted to allow VA raters to mistake this to mean you have to be bedridden to get a and a, but its not true.  Bedridden IS ONE way to get a and a, but its not the only way.    The operator "OR" means that bedridden is not required, but any of the following is sufficient:  

Its one of the ways VA loves to lowball.  Criteria for a and a:  *Did you miss the "and" permanently bedridden??

 
Quote

 

3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a)Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance ( § 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

(b)Basic criteria for the higher level aid and attendance allowance.

(1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(2) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran's home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(3) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (b)(2) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.

(4) A person performing personal health-care services who is a relative or other member of the veteran's household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.

(5) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(Authority: 38 U.S.C. 501, 1114(r)(2))

(c)Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

 

 

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