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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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VA Dental Care for 100%SC

Question

After successfully maneuvering through the VA C&P, I am now at 140% through a combination of multiple SC disabilities.  However, I am only paid at 90%.  I have a need for dentures and have inquired with the VA on my eligibility.  However, with the VA's strange math in compensation amounts, at 90% I am not eligible..  According to the Dental Clinic at the Saginaw, MI VA Hospital I am not entitled to dental care through the VA.  According to them, their interpretation is that a veteran must be receiving 100% in compensation or need dental treatment for a specific SC dental disability.  Typically, the policy is confusing.  And, civilian dental insurance requires you to pay into a plan for a year before you can use it for dentures. No need for a plan if I have no teeth.   Does anyone out there know the real deal?  Thought I heard last year that the VA was looking into VA Dental Care for all veterans.  FAKE NEWS I guess?

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Posted (edited)

Unfortunately, they are correct.

For VAMC dental coverage, you'll need to either have a 100% combined rating (schedular) or be SC for a dental disability.

The VA doesn't use straight math addition to formulate the combined rating, which is why your rating is 90% instead of 140%.

Going from 90% to 100% is a steep uphill climb. If your SC disabilities preclude your ability to work, you could file for IU. Otherwise, you'll need to figure out what increases or additional disabilities are needed to get you to 100%. You can use the Hadit calculator and plug in each of your percentages to get a rough idea. If you have any bilateral disabilities, you'll need to calculate them separately.

https://www.hadit.com/disability-calculator

Below is a link explaining how the VA calculates your combined rating. Warning: It reads like stereo instructions.

https://www.govinfo.gov/content/pkg/CFR-2017-title38-vol1/xml/CFR-2017-title38-vol1-sec4-25.xml

Edited by Vync

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Posted (edited)

We share your frustration with VA.  "VA math" permeates all of VA where VA is allowed to interpret their regulations as they please, in part, because of Chevron Deference.  (Chevron is a supreme court case which states that an "agency interpretation" can not be overturned by the courts except in some unusual circumstances.)

In other words, according to VA, 140 percent is "less than 100 percent" in regard to dental health benefits.  The only good answer is for you to file for an increase if some or all of your disabilities have gotten worse, since the last c and p exam where you were rated a combined 90 percent.  

Getting from 90 to 100 is extra tough because of VA math, aka "the whole man theory".  If you are at 90, you need an additonal 50 percent to get to 100.    If you are not working, then consider applying for TDIU, which, if awarded, would get you to 100.  

Edited by broncovet

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Posted (edited)
2 hours ago, broncovet said:

Chevron Deference

More details about that can be found here: https://www.law.cornell.edu/wex/chevron_deference

Unless Chevron is overturned by the Supreme Court, the only way real around it is for Congress to be specific about legislation instead of delegating responsibility to individual agencies.

However, last month, the Supreme Court recently agreed to review the law. Should be interesting to see if anything happens...
https://www.eenews.net/stories/1060109209

 

Edited by Vync

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I am at 90% being paid at 100% for TDIU. The VA is covering my dental. With all that’s going on with your high ratings have you tried TDIU?  That’s my suggestion FWIW. Good luck

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Thanks All for responding.  You all confirmed for me what the VA has a difficulty doing.  VA Dental is still SNAFU.  Same with most VA "policy informational guidelines".  Confirmed that they are talking to lawyers, politicians and lobbyists and not the veterans.  Thanks for the TDIU info.  Not willing to go that route as I am still employable and did not want to cheat the system from those who may need it.  Besides after fighting for 6 years to get where I am now in compensation makes me weary of starting the fight all over again.  I have found a nationwide dental group "Aspen Dental" that does limited pro bono work on Veteran's Day to needy vets.  I checked with one of their Michigan Clinics and while not free, they do offer discounts and sound willing to work with the vet/patient on a payment plan.  Their price for what I need is about $700 less than the dental norm in this area.   Just as a side note; I've sent a comment to my Congressional Rep who is a retired Marine 1 star.  Asking for a non-BS, spun, response.  Just asked for a situation report.  Will see what happens.  We all know what happens to logic when it gets to DC.

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