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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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Poopsy Woopsy

Confused Not100% but get ChampVA

Question

I am at my witts end with confusion!! I have been denied "Accrued benefits" which should have come AFTER getting 100%. because

of IU or TDIU.

If I get ChampVA (I just read you have to be at 100% to receive it) why then wouldnt I have been awarded "Accrued benefits for ALL the 

time we were waiting on these claims to be done.

How am I not getting 100% for allotment amount and accrued benefits for back pay on pending claims.. 

They said 1: they went off an old SSI claim which was way before all his medical trouble..which Should and could also be connected to his 70% PTSD. 

I dont know how to make the Old SSI irrelevant or not count towards his claims.

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You do not have to be 100% to get DIC.  As a surviving spouse, you can (should) get DIC if your Veteran spouse dies of a service connected medical condition irregardless of the conditions rating.  In other words, if a Veteran died of a heart attack, and had a 30% rating for heart disease, then the spouse would get DIC.  There are different DIC rules regards 100% and time and non-service connected death. 

You are getting DIC and ChampVA because your husband died from a service connected condition is what I suspect.  In 2003, the changed the law and surviving spouses and children under age 18 (unless college, then 23) can get ChampVA, healthcare.

As I said before, SSDI and VA are not related.  The Va in your letter mentions the SSDI determination, but that means nothing regards your husbands service connection.  They are just agreeing to your reading of same.

Now, from what I am reading, you seem to be looking for back pay of some sorts,

Is this correct, or what exactly are you looking for from the VA.?  And from what date, etc.?  

And, where  you on ChampVA before your husband passed, or did you get that at the same time you got your DIC.?

Trying to help,

Hamslice

 

 

 

 

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Thank you guys for a speedy response!

Ok. 1. We HAD 3 claims pending "Before" my husband was killed by the negligence at the VA where they immediately conceded their wrong-doing and thats how I got DIC, AND ChampVA. SO The SSI I keep talking about is quite a few years back my husband (by the way his name is Don, so I will refer to him as Don) Don was on SS disability for his back. He had surgery and things were fixed, but the pain continued! so a lot of his records indicate pain and meds for the pain, and nothing else. this was so far back I can't remember the dates. BUT This is the reason they keep "Denying" his claim for (i am going to write straight from denial letter)  

Reason for Decision

For accrued purposes, entitlement to induvidual unemployability

The claim for individual unemployability is considered reopened. Entitlement to individual unemployability remains denied because the evidence does not show that the Veteran was unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities.   ( this is not a typeO ) " considered reopened then says remains denied"????

Is "Entitlement" the operative word here?

Continuing on right from the "Ratings" paper.       They go on to say in the next sentence. We considered the records from the social security  Administration which show the Veteran was considered disabled due to a "Back condition ". Additionally, the VA is not bound by decisions made by the social security  Administration. They go on to say Entitlement to individual unemployability remains denied because the claimant has not been found unable to secure or follow a substantially gainful occupation..??? 

Did they just ignore the fact we put in for A&A?? Twice, denied the first time.. He was also deemed by the VA after a stint in the hospital to be put in a care facility (for good) instead of going home!!! (Over my dead body!!)  Sheer HELL, then they KILLED HIM!!

I am assuming all I have to do is get them to disregard the previous SSD I just don't know how to do that??

The other thing is, I have been trying to figure out is, "You can't get DIC Or ChampVA unless you are "100%". So why am I not "Just receiving TDIU.. There is all kinds of evidence he was unable to work. medical records, previous PTSD records.The VA's own volition. (Previously stated above paragraph..I did all the work for his PTSD claim and he was awarded the first time around and in a timely manner!) He got 70% PTSD with a 50% GAF. thats pretty obvious and by all I've been reading, Not easy to get!!  ARE they just playing "DUMB"? hoping I cave or miss something so they can just dismiss the case.. It should have been automatic.....  

 

 

 

 

 

 

 

 

 

 

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Posted (edited)

Hi Hamslice!

Don was 70% ptsd. so we had a TDIU claim in to get it brought up to 100%, because he couldnt work. While waiting for the claim to be processed the VA KILLED HIM!!!!   So they gave me DIC and I received ChampVA with it

(FYI: Visited a VA rep for Cathy McMorris Rodgers here in WA to see if they could check on the status of his clams. He was anxious to help but said all Don's claims were closed . I knew NOTHING about not having claims no longer open) 

ANYWAY! When I received the letter stating they wanted to "Rate" the claims finally!.. (I was shocked AND elated! to find out they somehow were going to go ahead and rate his claims! Go figure)    I sent the letter they sent me, back in to them. They neeeded just a signature from me so they could go ahead and rate the afore mentioned TDIU claim. I received a speedy letter back "DENYING THE CLAIM"  I thought it was obvious and cut and dried, and that i would receive a positive response because it was basically "Inferred"  There reasoning for denial, as previously stated in the above paragraph was they were saying that the "Very OLD SSDI claim (for his back) was why they denied it!! because that meant that the TDIU was not based on his existing PTSD, but that they were going off of the existence of the back SSDI. So it was denied because of the back. BUT they didnt have to take the SSDI into consideration they said. SO again what Im asking is how do I override the SSDI or show cause to not consider it.

How do you get the VA to "STOP" considering the OLD SSDI so it is NOT relavant to his TDIU claim.

Are they wanting me to just send evidence of why he is TDIU..aside from the SSDI? even though the A&A papers should have been enough? 

Thats "WHY" I  am so confused.. EVERYTHING I read says he should be getting TDIU, no problem from his already 70% PTSD..Why are they "Referring" back to the SSDI at all.. it was a long time ago and everything he was dealing with was after that!!  Sounds like they are playing me for "DUMB" They shouldn't mess with the wrath of a widow... 

till my dying breath... I will fight for what was his!  

Edited by Poopsy Woopsy

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Posted (edited)

poopsy woopsy stated

 ''How do you get the VA to "STOP" considering the OLD SSDI so it is NOT relavant to his TDIU claim''

This is unclear as to the meaning of it? Unless the Back Surgery Improved Don S.C. Condition and he showed improvement? by medical records to state this fact from SSA And VA Read these records.

ok opposite this above

Actually any medical evidence favorable to the veteran is probative evidence (great evidence)  records from SSA  that determine an individual is'' total disabled'' is excellent evidence  and the VA will take that INFO  into consideration.

''How do you get the VA to "STOP" considering the OLD SSDI so it is NOT relavant to his TDIU claim''

I think were missing your point here?

Maybe the claim was under a

 R.T.C .(Rate the Claim)is actually a F.D.C. (FULLY DEVELOPED CLAIM) if it was that type of claim that means all evidence has been submitted and the claim is actually ready to rate  with no more evidence to add..vs a Regular claim filing

Again I think were not understanding your question here?

Before another claim was filed to boost the ptsd 70% up to the 100%  this will take a 60%  Separate rating or additional 30% increase on the PTSD 

Also if your hubby was rated 70%PTSD  ..ok if he could not work due to the PTSD they use the regulation CFR 38 4.15 (b)   when a Veteran is not rated 100% but is unable to secure employment due to his S.C. Condition and that condition is rated below the 100& rating  then the CFR38 415 (b) is inferred for the Veteran to be paid at the 100 P&T & rate to include all benefits as a 100% Veteran to include ChampVA however the Veteran rating is still 70% but being paid at the 100% rate with the TDIU.

":NOTE THE P&T  THAT MAYBE THE DIFFERENCE in determine eligible benefits. (like ChampVA)

To get ChampVA a veteran needs to be rated P&T

Veterans with a 60% or higher rating but less than to 100% rating  is eligible for TDIU if their sc.conditions prevents them form working or finding employment that meets the yearly threshold income.

 & under special circumstance a veteran with a 40% sc condition can be eligible for IU

so go back and check his current rating at the time of his death  to see if he was Actually awarded the P&T.

Now I am not sure on your retro dates  but the Appeal date would certainly be a factor.

Also if your hubby died from malpractice CAUSED from  the VA then this would be  TORT CLAIM 

and Ms Berta is the expert for those type claims.

Edited by Buck52

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Take a look at the decision letter VA sent you when granting benefits (your Rating Decision). On some Rating Decisions there is a Permanent and Total box that will be checked if your 100% disability is permanent. On others, there may be language like “Eligibility to dependents Chapter 35 DEA / CHAMPVA are established” or “No future exams are scheduled” – both of which indicate permanence. The exact language may vary with different VA regional offices.

If, however, the letter says that future exams are scheduled, then your total disability ratings is considered temporary by VA.

Q: IF I QUALIFY FOR TDIU DOES THAT MEAN I’M P&T?

Not necessarily. TDIU (or simply IU) stands for Total Disability based on Individual Unemployability. If you receive TDIU, you are considered totally (100%) disabledeven if your disability rating is less than 100 percent. But TDIU can be permanent or temporary. So it’s important to check your rating decision as discussed above.

 

SOURCE  =CCK Attorney's

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