Missing claim AGAIN

[Rhodesia]

Ok I have a problem again, I filed a claim for a service connected injury for a Total knee replacement on 4/15/2018 all necessary paperwork including VA forms were submitted, that claim somewhat disappeared 4 months later, so I submitted a second total knee replacement claim on 08/01/2018 they have labeled it as a secondary condition claim because I had to have it done all over again to replace the total knee again I had in the first place so in another words I had two total knee replacements on the same knee., I submitted all necessary VA forms and documentations as before, this morning on 09/14/2018 I was notified that I need to submit evidence all over again and I have until 10/10/2018 and the claim was move back to 05/15/2020 (What the Hell) what I uploaded all disappeared again, plus they are asking for Tri West billing statements this time because it was paid through the choice care program and approved by the VA. that's a first. They did not ask for that the last time so I resubmitted all documentation all over again and the new VSO I went with she is about as useless as pigs with wings. So am I missing something here or is the VA trying to NOT pay the 100% temp for the second knee replacement and making it a secondary condition. I have not found anything that makes a second total knee replacement a secondary condition unless someone out that has gone through this before? 

Edited September 15, 2018 by Rhodesia

[Berta]

Many of us have experienced this crap.

I found the stuff they said they never got ,in my C file.

"I will estimate half of all appeals involve "loss of" or VA not reading the evidence, but that estimate could be low.  "

I would think probably 30% or more  of C & P exams are faulty.

I have had many claims issues with the VA since assuming my husbands claim when he died and I received denials on everyone of them but I fought back. The biggest reason for the denials was their ability to ignore the most probative evidence I had. 

Ben Krause ( disabledveterans .org) did an article on the right to file veteran's  class action cases, due to Monk V Wilkie- I posted that here in a different topic, and the comment section  ,up to 41 already , was closed.

He mentioned some of the paperwork and problems getting a class 'certified" but I think it could be easier than he thinks.

 

 

[vetquest]

Why did you need to refile.  Any VSO worth their salt keeps copies of everything submitted scanned into their computer server.  If this VSO did not you need a new VSO.  I will bet the VA is trying not to pay the 100% temp.  Once my records disappeared from the San Diego VA.  They wrote to my senator that I had never been treated at their hospital.  they agreed to add any copies of their records that I had.  I had copies of some of them.  I then tried to get an appointment and they said I could not because their records said I had missed three appointments.

[broncovet]

Key evidence disappearance has been around a very long time at VA.   Many/most experienced Vets advocates mail stuff certified mail, return receipt requested, and send it to Janesville, where 3rd parties scan it into the computer.  Better yet, submit it electronically via ebenefits.  

Like yourself, I would not have beleived VA would do this to Vets 15 years ago, when I was still wet behind the ears.  I actually thought the problem was mostly solved with documents being scanned into janesville.  VA employees have figured out a way to lose it electronically.  

I will estimate half of all appeals involve "loss of" or VA not reading the evidence, but that estimate could be low.  

In 2008, the VA had "the October incident" where a half dozen VARO's were caught red handed with Vets evidence in the shred bin by the VAOIG.  The VA "fixed" the problem by no longer doing shred bin inspections, and by "allowing" Veterans to submit a "Special Handling request due to mishandled evidence" but for only an 18 month period beginning in 2007.  The VA wasnt required to adjuticate the Special Handling Request, however, so the VA can just say, "Ok, we gave you special handling, and we denied you anyway".  
"

[Rhodesia]

You should have seen what the VA facility did when I worked for then before I retired, from the VA would charge the Veteran for his service connected injury's during  his visits through his own health insurance plan, like Blue Cross for example which has nothing to do with his injury's so then the VA would charge his insurance company and in order to help pay for veterans that did not have health insurance and the billing office says this was legal and the veteran should not complain because he is helping the veteran out by not having health insurance. because this happened to me so I made sure Blue Cross denied any claim the VA was sending to them for payment for my service connected injury's. Talk about scam and the funny thing is that most if not all private health insurance company's don't know what the VA is doing and they just pay the bill. prime example it took me 3 months to get the VA to return $8,000 back to Blue Cross and Blue Shield, Now when the VA asked me if I have private health insurance I have blue cross block the VA from using them for payment. I think the VA has taken a major wrong turn in the wrong direction. 

[broncovet]

Rhodesia

    I dont have a problem with VA billing insurance companies.  VA has limited resources, obviously, so if a Veteran DOES have alternative insurance, then I see no problem shifting the burden from the VA to a private insurance company.  

    Many Vets have private insurance in addition to VA.  Personally I have a medicare Advantage plan, and it makes "0" difference to me what/if (Humana) pays any portion, as long as I dont have to pay anything.  I have this because it gives me more choices.  I dont always want to be forced to HAVE to use VA, sometimes, or even lots of the times, private care is better.  Some Vets wont set foot in a VA facility, and many have real valid reasons for not doing so.  

    Since its (apparently) legal for Va to bill our insurance companies, I say, if this makes VA's  finite resources go further to help more Vets, then, I think they should do this.    Of course, I dont think this gives VA a carte blanche check to steal from VA and Vets, but there is legislation proposed which would have stricter penalties on government corruption.  Of course, much of the government  corruption can come from some very high levels of government, where prosecution is very tough.  

     Rooting out government corruption is more than just "fair", its essential to our continued prospertiy.  We have way, way too much government corruption, and VA is probably the worst  of the worst, apart from politicians themselves.  I think government corruption is behind 85 percent of first time claimants gettting denied.  The VA simply does not have resources necessary for both government corruption and to take care of Veterans, so guess which they give priority to?  

[Rhodesia]

1 hour ago, broncovet said:

Rhodesia

    I dont have a problem with VA billing insurance companies.  VA has limited resources, obviously, so if a Veteran DOES have alternative insurance, then I see no problem shifting the burden from the VA to a private insurance company.  

    Many Vets have private insurance in addition to VA.  Personally I have a medicare Advantage plan, and it makes "0" difference to me what/if (Humana) pays any portion, as long as I dont have to pay anything.  I have this because it gives me more choices.  I dont always want to be forced to HAVE to use VA, sometimes, or even lots of the times, private care is better.  Some Vets wont set foot in a VA facility, and many have real valid reasons for not doing so.  

    Since its (apparently) legal for Va to bill our insurance companies, I say, if this makes VA's  finite resources go further to help more Vets, then, I think they should do this.    Of course, I dont think this gives VA a carte blanche check to steal from VA and Vets, but there is legislation proposed which would have stricter penalties on government corruption.  Of course, much of the government  corruption can come from some very high levels of government, where prosecution is very tough.  

     Rooting out government corruption is more than just "fair", its essential to our continued prospertiy.  We have way, way too much government corruption, and VA is probably the worst  of the worst, apart from politicians themselves.  I think government corruption is behind 85 percent of first time claimants gettting denied.  The VA simply does not have resources necessary for both government corruption and to take care of Veterans, so guess which they give priority to?  

So just to understand this, are you saying that it is ok for the VA to charge my private insurance for my combat related injury's and it's ok for me to pay my own deductible in order for the VA to help pay health insurance for a fellow veterans care that has no insurance?  Sounds like socialized healthcare. from what I understand and working for the VA all combat related service connected injury's are paid by the government NOT your private health insurance or am I missing something here?