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100% P&T, should I stay in Reserves?


glashutte

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I have been granted 100% P&T and was rated this after I joined the Reserves. 

I am happy with my rating and do NOT want to lose it at all cost. The Reserves however gives my family great Tricare health insurance.

I want to keep Tricare by being in the Reserves, BUT absolutely do not want to lose my 100% P&T by just risking it being in the Reserves. The Reserves does PHA's through LHI and I really don't want to risk anything at all. 

I am truly 100% P&T by having many many separate conditions but am so paranoid and untrusty of the VA because I know they will take it away at any chance they get. 

Basically I want to stay in Reserves for TRICARE for my family but am very paranoid VA will find a window of opportunity through my Reserve service/PHA and take away everything. 

 

2 Other questions:

1. Can VA reduce 100% P&T rating if I don't even see a VA doctor and RARELY see my own primary care doctor?

2. Does the VA have automatic access to things like:

      -Tax returns?

      -Medical records from AFTER military service, when I was seen by private doctors using TRICARE?

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  • HadIt.com Elder

No. You only hear about the ones that do. I see the ones that don’t every day. Just because you have a high MH rating doesn’t preclude you from work, though if you can/could pass the psych eval and get a waiver to re-enlist it might indicate some improvement unless you are under a consistent treatment regimen. We don’t “think” anything, it’s based on your treatment records. 

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  • HadIt.com Elder

The va will know you are in reserves anyway, they share information.. you either waive your disability while you are in on your duty days or you waive your va pay for those days. You have to choose which. Read this

 

https://www.google.com/amp/s/www.military.com/benefits/veteran-benefits/disability/having-va-disability-rating-doesnt-prevent-you-serving-military.html/amp

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Thank you, I'm aware of this. 

My concern is that one of my high ratings is Depression. I am paranoid that the VA will think "Hey if he is depressed but he is now in the Reserves, his depression must be getting better! Let's re evaluate him to see if we can reduce his rating"

 

Is this the right train of thought to be worried about this? Doesn't this happen all the time?

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2 hours ago, brokensoldier244th said:

The va will know you are in reserves anyway, they share information.. you either waive your disability while you are in on your duty days or you waive your va pay for those days. You have to choose which. Read this

 

https://www.google.com/amp/s/www.military.com/benefits/veteran-benefits/disability/having-va-disability-rating-doesnt-prevent-you-serving-military.html/amp

Very helpful, thanks. 

Do you know the answers to these Qs?

1. Can VA reduce 100% P&T rating if I never see a VA doctor and RARELY see my own primary care doctor?

2. Does the VA have access to things like:

      -Tax returns?

      -Medical records from AFTER military service, when I was seen by private doctors using TRICARE?

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  • HadIt.com Elder

If you show sustained improvement, potentially. You can see whomever you want but basing your medical attendance on whether or not your disability comp is going to be affected is irresponsible, at best, and potentially dangerous at worst.
 

Plus, those periodic health assessments you’ll every year or whenever in the reserves will be requested by us anyway if there is a claim, or a request for revaluation, along with tricare, and VA. We are required by law to pull all federal record sources, and any private that is identified. Being 100% is not a shield, it just makes it less likely that there will be a review. 
 

yes, va can pull tax and SS records. Usually it’s only for IU claims, though. I do it regularly for those. 

Edited by brokensoldier244th
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41 minutes ago, brokensoldier244th said:

If you show sustained improvement, potentially. You can see whomever you want but basing your medical attendance on whether or not your disability comp is going to be affected is irresponsible, at best, and potentially dangerous at worst.
 

Plus, those periodic health assessments you’ll every year or whenever in the reserves will be requested by us anyway if there is a claim, or a request for revaluation, along with tricare, and VA. We are required by law to pull all federal record sources, and any private that is identified. Being 100% is not a shield, it just makes it less likely that there will be a review. 
 

yes, va can pull tax and SS records. Usually it’s only for IU claims, though. I do it regularly for those. 

 

42 minutes ago, brokensoldier244th said:

If you show sustained improvement, potentially. You can see whomever you want but basing your medical attendance on whether or not your disability comp is going to be affected is irresponsible, at best, and potentially dangerous at worst.
 

Plus, those periodic health assessments you’ll every year or whenever in the reserves will be requested by us anyway if there is a claim, or a request for revaluation, along with tricare, and VA. We are required by law to pull all federal record sources, and any private that is identified. Being 100% is not a shield, it just makes it less likely that there will be a review. 
 

yes, va can pull tax and SS records. Usually it’s only for IU claims, though. I do it regularly for those. 

If a veteran had a private insurance like Aetna, would the VA know this? I can see how they would know if a veteran had Tricare since that's connected with the VA. 

 

I have not been to any medical doctor since my C&P exams. Is this red flag or has no importance when the VA happens to audit my P&T 100% rating? Also, how often or routinely are these P&T audited?

 

If there is no additional claims made (I have no intention of making another claim), does anything else trigger VA to look into a P&T veteran's file? 

Along with my MH, I am extremely OCD and paranoid  

 

Thank you. 

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  • HadIt.com Elder

Yes. You are required to tell va if you have private insurance. They recoup from private, plus it helps if you do because then you have options for care. 
 

They aren’t “audited” except within the first 3-5 years unless one is unstable or has a condition that can change a lot (post surgical, or MH if it’s volatile). After a P/T rating you are not subject to automatic disability exams. What happens on the medical side is separate, your PCP can schedule you for checkups and stuff. 
 

i would not not see doctors for periodic treatment and/or medications. I have a high MH rating, I take a few just for that. 

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