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Another SMC rate question

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  • HadIt.com Elder

So I got another win today. I have been getting paid at the L 1/2 rate for Aid and Attendance, a single 100% rating plus a separate 70% rating. Today's win gave me another single (separate) 100% rating and SMC K. The award letter shows the pay rate equaling L 1/2 + K. If I'm not mistaken I should have bumped up from L 1/2 to M 1/2 + K. What do the experts say?

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Congratulations!  

   Unfortunately, we dont have any SMC experts.  I have heard someone referred to as an expert, when they are from another town.    An "ex" is a has been, washed up.  A "spert" is a drip gone crazy.  So we dont have any ex crazy drips, from other towns.   

However, since we dont have any experts, I will give it a shot.  

    And, I think you have it spot on.  

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  • HadIt.com Elder
Posted (edited)
13 hours ago, rentalguy1 said:

So I got another win today. I have been getting paid at the L 1/2 rate for Aid and Attendance, a single 100% rating plus a separate 70% rating. Today's win gave me another single (separate) 100% rating and SMC K. The award letter shows the pay rate equaling L 1/2 + K. If I'm not mistaken I should have bumped up from L 1/2 to M 1/2 + K. What do the experts say?

I am asking CCK to do that for me.  I will have to give them 20% of my back pay but that is better than nothing. 

There is a new favorable decision of VAHA medical reports from the CAFC to the CAVC with a class action for veterans and their caregivers under PCAFC.  BeaudetteJandM_20-4961.pdf (cavc.gov)

22-1264.OPINION.2-27-2024_2276809.pdf (uscourts.gov)  These probably apply to veterans receiving SMC.

Edited by Lemuel
correct error
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  • HadIt.com Elder

I have a DRO form ready to be mailed to Janesville on Monday. I have so many ratings (two 100%, a 70%, a 60%, a 50%, a 40%, four 20%, a string of 10% and 0%, A&A, SMC K) that I think they just missed it.

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  • HadIt.com Elder
38 minutes ago, rentalguy1 said:

I have a DRO form ready to be mailed to Janesville on Monday. I have so many ratings (two 100%, a 70%, a 60%, a 50%, a 40%, four 20%, a string of 10% and 0%, A&A, SMC K) that I think they just missed it.

It appears A&A falls under VAHA.  SMC falls under VABA.  The DRO in VABA will not be able to do A&A.  It appears that until the decisions quoted above, Nursing, Doctor Reports and other decisions regarding health care were not reviewable, period.  The decision on A&A still appears unappealable unless totally denied or perhaps if you ask in writing for a certain number of A&A hours and it is denied, then it may be appealable.  But if you ask for too many A&A hours they may order you to a nursing home and unless you are close to one that is not full that is either VA run or a VA contract, you will be moved away from family. 

My sister is the only thing keeping me out of a nursing home now.  I have been ask to sell my properties and move to assisted living with a higher level of care. Or the Nursing home here and let them attach my account as my conservator in order to get in something close to family for family visits. 

My sister is doing the A&A that Home Instead "agency" was supposed to do, promised they could do, but did not do.  I am going to get my sister to write a statement tomorrow and submit the references I made above to the Nursing Director because I have never been able to get a call back from a Patient Advocate, where you are supposed to start, and where  I suspect the denial came from.  Give the Nursing Director a chance to get it to the Director for review before I ask CCK, as my only signed representative to go after the back pay for my sister, from February 8 until paid up to date as one of the class because my denial was 3 days before the CAFC decision and subsequent CAVC Order. 

February 8 was when I ask the employee of the "agency" to go home because I was not getting the care promised by the "agency" when they took over from another "agency" that did not have the staff to do the number of hours required in the manner required.  1 hour in the morning and 1 hour in the evening 7 days a week primarily for safety check and safety watch reasons.

It appears to me they are trying to eliminate PCAFC and make it strictly volunteer.  There is a new program that is run by contractors, called "agencies" that are essentially, "temporary hire agencies" that unlike hiring a temp to come to your home and cook a meal for you, help you bath or do whatever housework is needed, allows you to be your own hire and fire employer.  The problem with it is it also requires a work for free "representative" to do a lot of paperwork.  The new program that they were pushing me towards is not workable for me.  I do not have a family member willing to do the paperwork because of the news of veteran caregiver support like that being charged with crimes, perhaps legitimately but could also be because of making a simple mistake.

If I get SMC-T I will be able to hire an accountant to do the paperwork of being an employer.  My sister could manage hiring help even from agencies and insure that what is needed is done.  For example if the two agencies I had could not provide the staff necessary, she could hire one for the morning and one for the evening.  And insure the work was fairly split. 

My sister has set up cameras to watch me and we would be able to pay for cloud recording so that if she thought she missed something she would be able to back track and see.  Now all she gets are pictures that ding her cell phone 24 hours a day on movement to watch me for falls and seizures from my TBI.  She has a 14-year-old son with special needs that also requires some watching and support in her home.

I may ask a couple to move in for free rent and utilities on the main floor of my home for doing housework and cooking when meals on wheels are not available.  I could also buy the groceries or most of them.  And I think that would work with my sister watching them and stepping in when they want to take a weekend trip or go on vacation.

 

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You posted:

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 may ask a couple to move in for free rent and utilities on the main floor of my home for doing housework and cooking when meals on wheels are not available.  I could also buy the groceries or most of them.  And I think that would work with my sister watching them and stepping in when they want to take a weekend trip or go on vacation.

 

This is a good idea, but pulling it off is not so easy.  You have to carefully select the people you allow to move in.  There are many great people, unfortunately, there are also bad people looking to take advantage of you.  

My wife's sister lived with a (disabled) man and did house work for him for around 10 years, but he passed now, so she has no place to go.  Since she is in California, I think she prefers to stay, and I doubt she would go for Wyoming.  She took great care of him for years.      

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