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R2 but no advanced home care


rustysilverwings

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I've had two C&P 2102168 exams, both times docs recommended nursing homes. I declined, and I refuse most "advanced home care" as well. I argue the word in the reg is "need," not acceptance of any care that is unwanted. BVA in ten days to argue...advice? I've drafted a ten page argument. Am R1 now, terminal, age 75

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So the question is? If you're R1 currently, then is it R2 you desire on appeal to the BVA or the VHA PCAFC entitlement? If R2, you will need to meet the requirements of §3.352(b). My trick is always to get a doctor/nurse outfit to give my clients PT in the home. That qualifies in §3.352(b) as acceptable home txment of disabilities. It may be a little late to begin creating this path to entitlement.

I'm sure there are a lot of Vets on SMC R2 here at Hadit who can also contribute some good advice.

Best of luck, sir.

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Alex..Im unaware of any "R2" Vets on hadit, but maybe that indicates I didnt get your sarcasm. (likely). 

In other areas of Va law, the term "need" often suggests "medical need".  And, that often means "documented" medical need.  In other words, some medical professional, such as your doctor, would need to opine that, in his professional opinion, you need some advanced care. 

The higher levels of Aid and Attendance turn on "the level of skill" required.  In other words, if you simply need a lay person to help you put your shoes and socks on, that can be done by an unskilled professional, such as your 8 year old grand daughter. 

However, if you require continious IV's, well that can not be done with unskiled people..A nurse is required to start an IV, at least officially.  Of course, a loving wife, for example, could be shown how to insert an IV, but medical regulations would suggest a minimum of a nurse to start an IV. 

At the highest levels, it could even require even more extensive training than "just" being a nurse.  A "nurse" may well not have the skills, for example, needed to deal with chemotherapy, at least without additional post nursing training. 

Higher levels of medical intervention increases the cost, and, supposedly the compensation.  "Advanced" care suggests a high level of training is "needed". (medically). 

You indicated you are "terminal", but refusing "advanced medical care" may not help your position that you need R2. 

As a hypothetical example, I may have been diagnosed with sleep apnea, been prescribed a CPAP, but if I refuse to use the CPAP, I wont be compensated the classic 50 percent for OSA.  Modern Cpap's record the use, and the sleep doc can easily tell if you are actually using it or not.  The VA wont "require" you to use a cpap, even if prescribed by a doctor.  Mostly, "forcing medical treatment" is not permitted, except, perhaps in special cases.  Patients get to chose whether or not to comply with the doc's orders.  Some patients simply choose non compliance to some degree, and, of course, if the doctor prescribes a cpap, you refuse to use it, then dont try to sue your doctor for getting an unsatisfactory outcome, when you refused the medically recommended treatment.  

 

Back to your case, my unqualified opinion, would be that if you refuse "advanced treatment", it would be more than a little bit difficult for you to get compensated for treatment that you refuse.  I say "unqualified" because, I am not a certified Veterans advocate, nor am I a VSO, nor do I have any training on Veterans law.  But, I have read "a little" bit, and have offered "a few" Veterans some advice on hadit here, that they reported helped them.  

 

 

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I dont know if "Kevin" is a hadit member but this 2016 link from Alex might help:

https://community.hadit.com/topic/66557-how-to-get-from-smc-l-to-r2-in-six-months/

I thought Dolphin was R 2 but maybe I am wrong.

 

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Dolphin25 said he was waiting for a BVA remand for R-2 but I dont know how he made out:

https://community.hadit.com/topic/66726-awaiting-bva-remand-for-r-2/page/2/#comment-410696

 

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19 hours ago, rustysilverwings said:

I've had two C&P 2102168 exams, both times docs recommended nursing homes.

I would believe this would be all the medical evidence you need.

 

19 hours ago, rustysilverwings said:

refuse most "advanced home care

They will probably try and use this but you are able to choose your care.

You have the evidence that you need advance care.

I would stick to that angle it sound like they are fighting at the court.

19 hours ago, rustysilverwings said:

BVA in ten days to argue...advice? I've drafted a ten page argument. Am R1 now, terminal, age 75

If that is the case it is all about law.

There is also smc tbi r. For veterans 

I am not up in it be there are different rules

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On 2/18/2022 at 1:54 PM, asknod said:

My trick is always to get a doctor/nurse outfit to give my clients PT in the home.

Would that rely on state administered Medicare to get the funding for that, and then seek VA compensation in lieu of state administered Medicare funding?

I'm thinking the protection of one's assets from a state wanting to recover expenses.

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