PACT Act presumptives

[GBArmy]

The VA has confirmed that all 23 diseases identified in the PACT Act will be considered to be effective the date of the bill passage, Aug. 10. There will not be a "phase-in" of the effective dates that were staggered over several years! He went on to say that the VA will start to process the new claims Jan 1, 2023, which is the earliest possible date for them to begin.

[Whodat]

13 hours ago, MilvetHD said:

Yes, the idea that it must be diagnosed within even 10 years is a bunch of bull...it's either service connected or it isn't. Our bodies all respond differently and therefore in my opinion shouldn't have some arbitrary cutoff, for years, after multiple combat deployments I spent the first several years after service simply trying to adjust. 

I do agree. Just like covid, some people can catch it in minutes while being exposed while other people may have it and never know it being they display the signs of a common cold and do self treatment but still spreading the virus. Some of us old hard vets don't ride sick call for things like a broken toe nail. 

[Vync]

@brokensoldier244th I know what you mean and it makes sense to a certain extent.

The VA repeated has tended to handle presumptives or denials based on statistics or shortcuts much in the same fashion as manufacturers determine if they should issue a recall. If a very small percentage gets sick, they do as little as possible and deny. Repeatedly, the lawmakers had to get involved and force the VA to handle them.

After receiving a denial, I asked the VA chief of cardiology "why the heart attack happened". They quoted a very low statistical chance of migraine meds causing my heart attack. My non-VA neuro specialist's "more likely than not opinion" scolded the VA for not following FDA instructions to perform certain tests to determine if the med could be continued safely. They went so far as to state that they would not have expected a cardiologist to be familiar with the need to do that. The VA reversed the denial and granted SC.

Another example is when I filed several musculoskeletal pain claims after getting out in the 90s. The VA denied all of them because the x-rays were negative, despite me having limited range of motion. I got some of them SC years later. Recently I had an x-ray which was negative, but my non-VA doc requested an MRI which showed soft tissue damage which would have never showed on an x-ray. It is another case of the VA not being thorough and looking for the quickest way to prevent SC.

[Vync]

@MilvetHD I like your "our bodies all respond differently" comment. When COVID was just starting, my mother got it, but by father never got it. I told him in jest that it was due to his AO exposure. When everyone else in my house recently had COVID, I self-tested every other day (due to high risk health factors), but was always negative. In those cases, he and I were the outliers...

Much of the way they calculate presumptive is based on epidemiological study results. The statistical research gauges risk and likeliness of occurrence in a given population and/or duration. Dismissing very low risk individual or limiting diagnosis durations makes it easy to deny. AO is a great example. By the time they VA was forced to recognize hypothyroidism as a presumptive, it was too late for many vets. Because the VA limited retroactive compensation to vets who were previously denied, it allowed them to exclude thousands of vets with documented medical evidence, but never filed because the VA would was publicly known to refuse SC. Kind of a "why bother" deterrent. Telling people they can't get SC for something prevents many from bothering to apply.

I also just posted details of a couple of non-presumptive examples which I personally experienced which were similar in nature. They are cases where the VA failed to be thorough and denied due to low statistical likelihood or failing to perform additional tests to truly identify the cause. They simply tried to look for the easiest way to deny.

[brokensoldier244th]

23 minutes ago, Vync said:

@brokensoldier244th I know what you mean and it makes sense to a certain extent.

The VA repeated has tended to handle presumptives or denials based on statistics or shortcuts much in the same fashion as manufacturers determine if they should issue a recall. If a very small percentage gets sick, they do as little as possible and deny. Repeatedly, the lawmakers had to get involved and force the VA to handle them.

After receiving a denial, I asked the VA chief of cardiology "why the heart attack happened". They quoted a very low statistical chance of migraine meds causing my heart attack. My non-VA neuro specialist's "more likely than not opinion" scolded the VA for not following FDA instructions to perform certain tests to determine if the med could be continued safely. They went so far as to state that they would not have expected a cardiologist to be familiar with the need to do that. The VA reversed the denial and granted SC.

Another example is when I filed several musculoskeletal pain claims after getting out in the 90s. The VA denied all of them because the x-rays were negative, despite me having limited range of motion. I got some of them SC years later. Recently I had an x-ray which was negative, but my non-VA doc requested an MRI which showed soft tissue damage which would have never showed on an x-ray. It is another case of the VA not being thorough and looking for the quickest way to prevent SC.

Yeah, I know, I see that every day-Im not at all for VA denying etc etc, its just that with as many claims as I see at some point there has to be a line-because I see a lot of claims that are ultimately denied where the veteran literally has nothing - no service treatment, no post treatment, 15 yrs later they file a claim and have nothing to support it- in some cases even their private doctors records don't support any of it. But, they claim it anyway. And those claims are all mixed in with everyone elses that actually have issues that need addressed. 

[Whodat]

4 hours ago, brokensoldier244th said:

Yeah, I know, I see that every day-Im not at all for VA denying etc etc, its just that with as many claims as I see at some point there has to be a line-because I see a lot of claims that are ultimately denied where the veteran literally has nothing - no service treatment, no post treatment, 15 yrs later they file a claim and have nothing to support it- in some cases even their private doctors records don't support any of it. But, they claim it anyway. And those claims are all mixed in with everyone elses that actually have issues that need addressed. 

If I see something to that effect and didn't like it, although I need a job and the money for my bills, I do not think think that I could support an organization that turns their left cheek to my band of brothers or sisters, especially if none of them have or had family members that had never served. 

[Vync]

@brokensoldier244thYep. Despite new presumptives like the PACT act, I often listen to other vets discussing similar issues while in VAMC waiting rooms. 

- Some never sought treatment while in service because they wanted to maintain a tough guy persona.

- Some never sought treatment after service because they were able to manage with over the counter remedies. With no physician documentation, the VA discounts their lay statements and denies.

- I heard one vet tell another to just file for any and every ache and pain regardless. I was mentally facepalming when I heard that advice. The guys were about twice my size, so it was not my business to contradict them.

- And then there are those who did everything right, but don't want to deal with the VA because it reminds them of red tape from while in the service.

It would be interesting if the VA would post metrics showing how many vets files claims without meeting any of the criteria: no in-service issue, no continuity of symptoms and/or care, and no current diagnosis.