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.

[vetquest]

What a travesty.  I was not aware of this situation. 

I understand why it is scary to request an increase and P&T.  I would apply for an increase on ebenefits and request P&T.   If you are reading that the VA may reduce you if you apply this is not something that you should worry about too much.  Conditions vets have usually get worse, not better.  You appear to show chronicity in your condition.  They may on an outside chance try to reduce you but you appeal this decision and the reduction is put on hold until your case is decided.  I was at 80% and requested TDIU, the VA said on a denial that they were looking at reducing my main service rating and severing another rating and said I would be scheduled for C&P's for this.  I fought this and won.  You have some protection after five years and more protection after ten years.  The VA needs to show improvement to win a reduction with medical evidence.

There are others that will give some good advice to you in addition to this.  Just remember that people that say don't rock the boat are usually working for the VA, it makes their job easier.  I was told the same when I requested an earlier effective date on my recent award.  

§ 3.957 Service connection.

Service connection for any disability or death granted or continued under title 38 U.S.C., which has been in effect for 10 or more years will not be severed except upon a showing that the original grant was based on fraud or it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge. The 10-year period will be computed from the effective date of the Department of Veterans Affairs finding of service connection to the effective date of the rating decision severing service connection, after compliance with § 3.105(d). The protection afforded in this section extends to claims for dependency and indemnity compensation or death compensation.

  

§ 3.951 Preservation of disability ratings.

(a) A readjustment to the Schedule for Rating Disabilities shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved.

Edited July 18, 2019 by vetquest

[Sheila]

2 minutes ago, vetquest said:

What a travesty.  I was not aware of this situation. 

I understand why it is scary to request an increase and P&T.  I would apply for an increase on ebenefits and request P&T.   If you are reading that the VA may reduce you if you apply this is not something that you should worry about too much.  Conditions vets have usually get worse, not better.  You appear to show chronicity in your condition.  They may on an outside chance try to reduce you but you appeal this decision and the reduction is put on hold until your case is decided.  I was at 80% and requested TDIU, the VA said on a denial that they were looking at reducing my main service rating and severing another rating and said I would be scheduled for C&P's for this.  I fought this and won.  You have some protection after five years and more protection after ten years.  The VA needs to show improvement to win a reduction with medical evidence.

There are others that will give some good advice to you in addition to this.  Just remember that people that say don't rock the boat are usually working for the VA, it makes their job easier.  I was told the same when I requested an earlier effective date on my recent award.     

Thank you so much for your insight.  I just fear not having health insurance and being forced to use the VA solely for my health insurance.  I have not gotten better and sadly as a woman, my "girlie parts" are not going to get any perkier.  I am not worried about a C&P exam or proving my injuries.  I'm just scared of the process.  The VA, esp. for women, isn't a friendly place when proving urology and gynecological conditions from a parachute accident.  Hadit helped me TREMENDOUSLY 15 years ago and i am so glad it's still around...

[vetquest]

I added a little more information above for you.  I understand being scared.  The VA is supposed to be getting better for women.  The VA is not a nice place for us males either.  I was once flagged at the VA for a suggestion I made to a doctor who was being out of line and badgering me about my pain levels.  

[Sheila]

14 minutes ago, vetquest said:

I added a little more information above for you.  I understand being scared.  The VA is supposed to be getting better for women.  The VA is not a nice place for us males either.  I was once flagged at the VA for a suggestion I made to a doctor who was being out of line and badgering me about my pain levels.  

I so appreciate that information showing me the 10 year service connection.  I just submitted my claim online after "sitting on it" for a few days.  Now i pray...

[vetquest]

Please keep us posted.

[GBArmy]

Hi Sheila: This correspondence is from Lynne is from 2014? If it is still the law that they are now enforcing there isn't much you can do. Again, the recommendations to consult your congressman is a long shot along with contacting VFW, A L, etc. for changes in legislation is something that may work. But it takes time. As an alternative to your current situation, there are two things you might look into. First, the Veteran organizations have assistance for medical financial situations, I would contact them for help and at the same time ask them to sponsor changes  in the law as well. And I might add that you have at least 3 congressmen you can ask for help. Do a little research and see who is more likely to help a veteran; they certainly are not equal in that regard. Secondly, the reason I asked how old you were is if you were awarded IU is you can consider increase to 100% as Richard suggested. You are young but if you have been rated at 80% combined for 15 years and not had a reval, it would appear that they agree you aren't really on the path for improvement. So yes, I think it might be worth the risk to ask for TDIU for 100%. They might not get you P&T up front, especially because of your age, but bump it up.