ALS claims from OIG

[Berta]

We all know this but it bears repeating:

 

VA Provides Benefits to Veterans with ALS and Families

Military veterans, regardless of the branch of service, the era in which they served, or whether they served during a time of peace or a time of war, are at a greater risk of dying from ALS than if they had not served in the military.  For reasons as yet unknown, veterans are, in fact, twice as likely to be diagnosed with ALS as the general population.

In 2008, the Department of Veterans Affairs (VA) implemented regulations to establish a presumption of service connection for ALS, thanks to the efforts of The ALS Association, key members of Congress, and advocates.  Under the regulations, the VA presumes that ALS was incurred or aggravated by a veteran’s service in the military.  As a result, veterans with ALS and their families and survivors are eligible for “service connected” benefits.

Anyone who served at least 90 days of continuous active duty in the U.S. military may qualify for VA benefits.  Survivors of veterans may be eligible for benefits, including monthly compensation, regardless of when their loved one was lost to the disease.

http://web.alsa.org/site/PageServer?pagename=va_provides_benefits

I got from this from the OIG this AM_---VERY disturbing:

“The VA Office of Inspector General (OIG) conducted this review to determine whether Veterans Benefits Administration (VBA) staff accurately decided veterans’ claims involving service-connected Amyotrophic Lateral Sclerosis (ALS), commonly referred to as Lou Gehrig’s disease.”

 

And in part :

“About 45 percent of ALS claims completed from April through September 2017 had erroneous decisions. These errors resulted in estimated underpayments of about $750,000 and overpayments of about $649,000 to a total of 230 veterans. These errors were due to the complexity of these claims. ALS claims can involve a wide range of medical complications, evaluations, and special monthly compensation (SMC) levels, and most rating personnel do not decide ALS claims often enough to maintain proficiency. Also, the OIG determined that VBA staff generally did not tell veterans about additional SMC benefits that may be available.”

 

The full OIG report is here:

https://www.va.gov/oig/pubs/VAOIG-18-00031-05.pdf

 

 

 

 

[vetquest]

I know a lady whose husband died from ALS last year?  I believe he was military.  She could be eligible for benefits?

[Berta]

She  certainly could eligible if his service fits into the above criteria.

If she files for DIC ASAP, and succeeds with the claim, she will get the date of his death for DIC retro,

unless a year has already passed after his death- then a successful DIC award would be  retro back to the date they get the DIC form.

 

 

[vetquest]

Bertha, I assume we need medical records, DD214, and death certificate.  Is there anything else we will need that you know of? 

[broncovet]

This makes no sense (from OIG report):

Quote

OIG determined that VBA staff generally did not tell veterans about additional SMC benefits that may be available.”

huh??   The va does not have to "tell them about SMC" (which they dont anyway).  Instead the va is supposed to PAY THEM for smc as you dont have to apply but qualify for it when you meet the criteria.  

[Berta]

That is why I won my SMC CUE. SMC is "mandated" as an inferred issue when the established evidence reveals it should be awarded.

Vet quest, this is a lot to the 21-534 DIC form but I think she might be able to use the 534 EZ form.

She will need a copy of their marriage license,  medical proof of the ALS, which I assume is listed as Primary cause of death on the death certificate, and the DD 214.

If it is not listed as prime cause, it should be listed (hopefully,) as a contributing cause of death.

It has been so long, since I field for DIC- I dont know what else the VA would need.....but they will ask for what ever they might need.

Copy of autospy also ,if one was done.They wil probably accept copies of most of the above-but  they might ask for a Raised seal copy of the Death Certificate.