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Dazed and Confused Caregiver Denied


Cavscout1977

Question

I've been 100% TDIU  for the past 13 years I am SMC with most the alphabets.  But primarily loss use of both feet and hands. When the Caregivers program opened for my wife we applied of course we were denied. The reason was my records do not indicate a need for a caregiver. Plus I guess the interview my wife and I did they did not feel I needed enough help. I can't drive. I can't wash my legs or feet. I can't put on my socks. So I'm going to see my PCP but not sure what needs to be done and not sure if it needs to be for a period of time. Any suggestions? comments. 

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Read my post on the PCAFC caregivers benefits here at hadit. Also read more about what I have to say about the CPAFC caregiver program at my website. 

vatheredneckway.wordpress.com

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Also, if you do indeed have service connected loss of use of both hands and both feet you might benefit by reading the entire threads posted here at hadit on SMC "M" and "R"1 and "R-2".

With your loss of use it sounds like you should be in the neighborhood of R-1 or R-2, instead of lingering around at TDIU.

I am rated loss of use of upper extremities at 100% P&T. A&A 1 was granted for LOU of upper extremities.

Also Loss of use of lower extremities. A&A 2 was granted for LOU of lower extremities.

The two A&A awards L-1 and L-2 warrant the SMC "O", 

Granting of he "O" award automatically advances the A&A to either R-1 or R-2, depending on your individual circumstances. You may have the makings of a CUE claim for an Earlier SMC effective date.

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22 hours ago, jamescripps2 said:

Also, if you do indeed have service connected loss of use of both hands and both feet you might benefit by reading the entire threads posted here at hadit on SMC "M" and "R"1 and "R-2".

With your loss of use it sounds like you should be in the neighborhood of R-1 or R-2, instead of lingering around at TDIU.

I am rated loss of use of upper extremities at 100% P&T. A&A 1 was granted for LOU of upper extremities.

Also Loss of use of lower extremities. A&A 2 was granted for LOU of lower extremities.

The two A&A awards L-1 and L-2 warrant the SMC "O", 

Granting of he "O" award automatically advances the A&A to either R-1 or R-2, depending on your individual circumstances. You may have the makings of a CUE claim for an Earlier SMC effective date.

SORRY for the misunderstanding on my part I use TDIU as the catch all. I am rated K-1, L-1, M-1, 0-3, R-1 since 2010. I did go to the Wordpress site you provided will do a deep dive into that. I have an appointment with my PCP on 1 March. What I am not sure of is what they want t see in my records. The answer my be in the link you provided hopefully so.  

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 38 CFR 3.352 contains all tou need to know about the qualifications for R-2, To fully understand, you will need to read it a few times.

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I would suggest that you appeal the PCAFC caregivers denial directly to the BVA. Ask that your case be advanced on the docket for the reason that you are a R-1 veteran.

 

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As always, when denied, file a timely NOD to dispute the denial.  Critically important:  Be able to refute the VA's "reasons and bases for denial".  

An example may suffice to explain.  (hypothetical example only..I have not read your file)

VA decision states:

    

Quote

The Veteran is denied benefits for a caregiver because there is no evidence in the file to show that a caregiver is needed.

Sample NOD:

    I disagree with the above decision, dated Jan. 14, 20xx.  Specifically the statement disputed is above.  Instead, the Veteran medical record dated, 11-14-2012 states:  "The Veteran is unable to use his hands or feet".  

    Logic suggests that a Veteran can not provide for himself or his spouse, if he is unable to use his hands or feet, as he is unable to hold a fork under his chin, and cut it with a knife with unusable hands at the same time.  The c and p exam dated xx-xx-xxx was incomplete or inadequate and needs to be redone.  (now state why exam was inadequate.  Did the examiner ask you how you are able to care for yourself lacking use of your hands and feet?  If not, perhaps this exam was inadequate.  )

     Cite exam dates, statements made by doc, to refute the docs claim.  You may have a 38 CFR 3.156 claim (new evidence) if another exam supports your position you need a caregiver.  

      If you are unable to make such a NOD, then consider getting some help, probably an attorney experienced in VA law.  

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