VA Medical Record(s) Sharing

[maknon31]

I’ve got questions about the 5-10-15-20 Rule.  I am going on 8 years (so far) since my 100% Total & Permanent disability findings and rulings in 2016.  I am worse now.  However, recently, the VA has gotten VERY aggressive and are trying to get ahold of my medical records (from Medicare) from my non-VA private doctors--after 8 years.  I don’t go to the VA for healthcare.  They are trying to find away how to access my private doctors’ records since I disabled record(s) sharing.

I went into my online VA portal about 9 months ago, and I noticed in the medical records section, they had “sharing” with non-VA providers enabled.  However, I changed it to “opt out of sharing.”  That way, they cannot scrutinize me with non-VA doctors and violate my privacy.   They no longer have my permission to access and/or share my medical records to anyone. 

However, the VA sent my insurance (Medicare) a VA Form 10-5345 to send me.  It was a REQUEST to fill out and send that form back to my insurance about my health.  It didn’t say “required.” I declined and refused to fill it out and send it back.  The VA Form 10-5345, as far as I know, is permission for the VA to gain access to your non-VA records and/or share such records.   Does anyone else know about VA Form 10-5345? It’s voluntary, right? 

So…what might the VA try next to get ahold of my private records?  I thought that I have pretty much shutdown their ability to gain access to my non-VA providers.  But I’d like to know if the VA would try a different tactic for access to those privileged records.

Thanks in advance...

[brokensoldier244th]

No. If you don't authorize it the providers won't share it. The control is on the providers' side, and yours. 

Edited April 6 by brokensoldier244th

[pacmanx1]

Since you are rated P & T, it is not likely that the VA would try to reduce your rating.  As for the rules I have only heard of a 5 - 10- and 20 years rule. I have never heard of a 15-years rule. Once again since you are already past the five (5) year rule, I really doubt the VA would try to reduce any veteran's rating. Unless the VA would claim fraud, the veteran's rating would be protected. No, I am not referring to you or your particular situation. 

 

 

[broncovet]

I will give this one a shot.  

First, I will provide a link to the so called "5-10-20 year rule".  

https://www.law.cornell.edu/cfr/text/38/3.344

If you notice, there is no "10" year rule in the above.  That is because the "10" year rule is for serverance of Service connection, the above are for Reduction.  

One of the best sources for reductions/severance was published by NVLSP:

https://www.tn.gov/content/dam/tn/veteranservices/learning/powerpoints/annual-training-2019/Tue 2 - Rating Reductions & Severance.pdf

If you take the time to read over the link, above, you will see that its very difficult for VA to reduce your rating unless you "actually improve under ordinary conditions of life" or, of course, if you committed fraud in obtaining beneefits.  

Its my opinion that VA "probably wont" contact your private providers for the purpose of trying to reduce your benefits, "unless" they had a compelling reason to do so.  When you signed up for VA benefits, to apply, you signed a release form to release information.  (You may not remember it, because you probably signed a bunch of papers, but you would not have gotten your benefits without sufficient medical documentation of a disability). 

For most Veterans, "fears of reduction of benefits" is unfounded.  This is generally true, espeically if you have not returned to work full time.  IF you have returned to work full time, then, remember, VA benefits are designed to compensate you for your loss of earnings capacity and, if you are earning a living, well, maybe you did improve.  

The regulation states something to the effect that "it renders the average person unable to maintain SGE (substantial full time employment)."  Note the word average.  THATS because SOME exceptional people CAN overcome their disabilities and earn a full time income.  Tammy Duckworth is a notable example of a 100 percent disabled Veteran who overcame disabiities to earn a full time income.  She used to work at VA, now she is a Senator :  https://www.duckworth.senate.gov/

My advice:  Dont worry about a reduction.  "If you do get a proposed reduction letter" contact hadit right away for help.  I got 2 of them and beat them right away.  

[Tbird]

@broncovet, great post I took the links you gave and added them to our article