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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.

      VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
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      Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.

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    • VA has a special where we can ask questions TODAY, at 3:00 to "people that matter?"  Someone should ask why we can not ask them questions EVERY day, why today only? (This is a big problem with VA..the 800 number often does not give specific answers).  We should have people in VA who "solve Vets problems" like Allison Hickey did a few years ago. 
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    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
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slangpdx

Posting here as closest related topic

Question

I was awarded 70% SC in 2010.  Was just awarded SSDI in July.  I opted out of Medicare Part B immediately because of expense and because the health care expenses I use outside the VA would not be covered by Medicare anyway (alternative practitioners).   I am considering opting out of Part A also because I have read either here or elsewhere that if the VA knows you have any other type of insurance strange things start happening such as cancellation of appointments with one day notice that were made six months earlier, etc. in an attempt to force the vet to use their coverage elsewhere.  I do not want to rock any boats.  To the extent the above occurs it could be VA site specific I suppose; I use the Portland Oregon VAMC, which is generally a cut above the average from what I can tell though I have witnessed three vets busting out of the Patient Advocate office while waiting for records requests to be filled screaming to whoever will listen about what is happening to them.  

Anyone with any knowledge of the VA vs.  outside insurance issue please advise.  

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Dont opt out of Part A.  There is no compelling reason to do so.  Yes, I have medicare advantage, and yes, VA (may) bill medicare advantage for some portion of my care, but its affect on me is exactly "0".  

I suggest the next time you go to the VA, and check in the kiosk, you tell VA about your part a coverage.  

Dont worry about stuff  like this:

Quote

 I am considering opting out of Part A also because I have read either here or elsewhere that if the VA knows you have any other type of insurance strange things start happening such as cancellation of appointments with one day notice that were made six months earlier, etc. 

Yes, appointments sometimes get cancelled that were made months earlier, but that has nothing to do with Part A.  It has more to do with a doctor getting sick, taking vacation, getting fired, or quitting which means you could have to be rescheduled.  

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 BRONCOVET,

I don't know if I am understanding this whole thing here?

I have medicare and I told my VA clinic clerks I have it and they scan my medicare card in the machine....but I also have a supplement to the medicare....but since I never use it I cancel this supplement  it was with mutual of Omaha....

do I need to tell the VA I Cancel this supplement?

I was paying like 130.00 monthly for it that I never was using...I use VA for all my healthcare...so for I have not had to use the medicare   but someday I may need too...but that supplement was just a waist of good money.  jmo

Edited by Buck52

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I opted out of B for the same reasons, you did........I have A, which is at no cost and have since 2009.  I am 100% PT through the VA, and have never had anyone messing around with me about canceling appointments.  The only problems I have are when providers leave, etc.  Keep your A and when you get to retirement age add the B (you won't be charged the penalty then) if you choose, that is my plan if things haven't changed giving us more choices.  I refuse to pay hundreds of dollars a month for service connected disabilities through medicare plus the copays and meds.  THAT is a bs scam  imo.

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1 hour ago, seminoles said:

I opted out of B for the same reasons, you did........I have A, which is at no cost and have since 2009.  I am 100% PT through the VA, and have never had anyone messing around with me about canceling appointments.  The only problems I have are when providers leave, etc.  Keep your A and when you get to retirement age add the B (you won't be charged the penalty then) if you choose, that is my plan if things haven't changed giving us more choices.  I refuse to pay hundreds of dollars a month for service connected disabilities through medicare plus the copays and meds.  THAT is a bs scam  imo.

--Keep your A and when you get to retirement age add the B (you won't be charged the penalty then)--

That was my thinking also, but now I am confused as to if the penalty applies from "the first date you are Medicare eligible", from SSDI and not from declining it at 65.  Do you know for sure about this?  thanks

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I took both A & B since there was no cost to me. My wife and I like to travel in our RV and there are a lot of times that there is not a VA facility close. While I am eligible for Veterans Choice it can be a hassle actually getting the bills paid at times. I figure having Medicare is there for emergency use and it sometimes helps by having a civilian doc to double check the VA docs. I have never had appointments cancelled because of it.

Edited by bobz

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  • Our picks

    • This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.

      VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
        • Thanks
        • Like
      • 5 replies
    • I don’t say thank you enough to all of you...
      You, yes you, are the reason HadIt.com has remained a resource-rich resource. Thousands come each month to read, ask questions, or to feel a sense of community.

      Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.

      You all made that possible. Thank you.
        • Like
      • 3 replies
    • Help HadIt.com stay online buy a subscription
      If you can afford it and want to help hadit.com consider buying a subscription this gives you as free viewing of the site and allows me to budget in subscription payments.
       

      You can try it for 1 month for $5 or get a monthly subscription or a yearly subscription.

      Subscribe here https://community.hadit.com/subscriptions/
      • 1 reply
    • VA has a special where we can ask questions TODAY, at 3:00 to "people that matter?"  Someone should ask why we can not ask them questions EVERY day, why today only? (This is a big problem with VA..the 800 number often does not give specific answers).  We should have people in VA who "solve Vets problems" like Allison Hickey did a few years ago. 
        • Like
      • 8 replies
    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
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      • 9 replies
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