How do i ask for IU P&T?

[Sheila]

I have been rated for 15 years at 80% IU.  I went to the VA and since my family uses a subsidy (tax credit) for Obamacare, the VA told me i need to enroll and will no longer see me even though i'm priority group 1.  I even showed them the documentation that all Priority group 1 vets can be seen for their sc disabilities but they made me re-enroll.  The problem with this is we have 5 children and we really need that tax credit for our health insurance.

I'd like to open up my case and see if the VA will grant me P & T.  I've never been called back for a C & P in all of my 15 years and my disability is a result of a parachute accident so i'm not really worried as my ratings are all based on complications from the repair surgery.

When i went to the DOD website, it wanted to open up a claim for a new disability and nothing really applied.  Any suggestions?  Can i just write a letter to the Regional office asking them to consider P&T?   Thanks for any insight.

[GBArmy]

On your original question, your right. Doesn't make a whole lot of sense that you yourself have to enroll. I would call my Congressman. A lot of times the people that do the insurance sign ups don't understand the VA health system. Now if your wife has CHAMPVA, maybe she has to for the kids. Congressman's office certainly will have the answers for you. On P&T, you haven't given any details on your disability. If you have been rated at 80%, how stable have been your conditions (have they gotten any worse, or others you should apply for?) And how old are you now?

[vetquest]

Something does not sound right here.  Yes you should be seen for any SC disability.  They made you re-enroll in VA care or Obamacare?  I am missing something about how your 5 children would lose their credit?  Please add more information so I can understand this.  I might just be dense and not understand your question.

[Richard1954]

1 hour ago, Sheila said:

I went to the VA and since my family uses a subsidy (tax credit) for Obamacare, the VA told me i need to enroll and will no longer see me even though i'm priority group 1

The VA cannot refuse to treat you for any condition since you are service connected at TDIU. Many veterans have other insurance and can still use the VA. 

 

1 hour ago, Sheila said:

Can i just write a letter to the Regional office asking them to consider P&T? 

Yes you can do that, or if you use Ebenefits ( if your have an ebentits account) ,  you can request P&T there  as well.

Since it has been 15 years, the chances are the va will consider reevaluation of your disability  

best of luck

[Sheila]

29 minutes ago, GBArmy said:

On your original question, your right. Doesn't make a whole lot of sense that you yourself have to enroll. I would call my Congressman. A lot of times the people that do the insurance sign ups don't understand the VA health system. Now if your wife has CHAMPVA, maybe she has to for the kids. Congressman's office certainly will have the answers for you. On P&T, you haven't given any details on your disability. If you have been rated at 80%, how stable have been your conditions (have they gotten any worse, or others you should apply for?) And how old are you now?

I have called my Congressmen and you can not receive the tax credit and be enrolled in the VA.  I am 43 years old.  I have never had an issue not being enrolled in the VA system until this last visit.  They refused to let me see the doctor until i filled out a 10 something form requesting enrollment.  Of course that generated a letter from Obamacare stating that if i am enrolled in the VA system i lose the subsidy for myself.  You can't be enrolled into both programs.  

My disability is:  60% urinary obstruction with implant, 50% surgical complication with cystocele, 10% scar for a combined 80%IU.  My conditions have stayed static but there's no room for improvement as i've been rated as a result of the surgical complications.  I was rated 9 months after discharge.

[Sheila]

34 minutes ago, vetquest said:

Something does not sound right here.  Yes you should be seen for any SC disability.  They made you re-enroll in VA care or Obamacare?  I am missing something about how your 5 children would lose their credit?  Please add more information so I can understand this.  I might just be dense and not understand your question.

They made me reenroll in VA care as i was being seen as an unenrolled patient as this has been affecting our obamacare subsidy since 2015.  I'm not sure if this will allow me to cut and paste the "official word" from the VA on this, but it's affecting a small amount of us younger vets, esp with families rated over 50%.  https://sites.google.com/site/titan2vetshealthandwellness/disabled-veterans-and-obama-care/official-statements-from-the-va-regarding-the-disenrollment-of-veterans-from-the-va-due-to-obama-care-or-the-affordable-health-care-act

[Sheila]

36 minutes ago, Richard1954 said:

The VA cannot refuse to treat you for any condition since you are service connected at TDIU. Many veterans have other insurance and can still use the VA. 

 

Yes you can do that, or if you use Ebenefits ( if your have an ebentits account) ,  you can request P&T there  as well.

Since it has been 15 years, the chances are the va will consider reevaluation of your disability  

best of luck

Richard, how can i prove this to the VA when i show up at the counter?  They physically turned me away, even though i was there for my catheters.  Actually, it was for my blood work to get my catheters.  They made me sign the form to enroll into the VA.  I argued with them and they called down to another VA eligibility office and i had no choice.  

What do you mean by they will consider reevaluation?  Is there a chance they will removed my rating?  Everything i read sounds so scary.  I do have an Ebenefits account but when i started clicking on the claims, i don't want to increase my rating, or open a new claim.  I want to see if they will P&T it simply for my health care fiasco.