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Medicare and medicare advantage plans for Veterans..medicare part B and part D
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broncovet,
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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
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Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
broncovet
Its "about that time", when you will be seeing lots of commercials for medicare, medicare advantage plans, wanting you to call a toll free number. Be cautious.
I use exclusively a local Medicare planning company with a full time office, in my town. Why?
Well certain medicare advantage plans have "networks" and "out of networks" doctors, and they are treated very differently. And a Meidcare advantage sales person in Zimbabwe probably knows very little about doctors, hospitals, etc. IN YOUR TOWN.
My wife, for example, wants to keep her doctor she has had for about 4 decades who knows everything about her history. I cant say as I blame her. So, she took her doctors name there, and we made sure she could keep that doc, that he was "in network" without higher copays, etc.
And, this is a big deal:
Do a good job considering your medicare/medicare advantage situation, and go with the plan that works for you. That of course is different than my situation. My wife and I have "very little" cost out of pocket for doctors, hosptials, prescriptions etc.
I also need to tell you a trick I learned about medicare part D.
We learned the "hard way" about medicare part D (prescriptions) and Champva. My wife pretty much buys all insurance and I basically dont. So, she bought Medicare part D, even tho she had Champva. Bad idea, as we later found out. Here is why. My wife needed a blood thinner and medicare part D wanted "$180 per month" copay on ONE prescription. She takes probably 8 prescriptions. So we made about 50 phone calls to every where, and finally figured out the key here. She needed to, and did, "CAnCEL" her part D. Why? Because champva "meds by mail" wont allow her on the program "if'" she has another prescription drug plan. So, after cancelling her part D, she gets meds by mail and her $180 per month per prescription is reduced to $0 per month via meds by mail on champva.
Now, of course I can not say whether or not this applies to your situation, but it probably would. I forget how much part D was, but Im thinking around $40 per month, so it saved "at least" $220 per month by cancelling her medicare part d plan, and getting meds by mail.
Caveat: Meds by mail, is well, by mail. So, we dont have any prescription coverage for what I call "emergency prescriptions", where she goes to the doc and he writes a perscription for some meds she needs right away and cant wait for the snail mailman. In that case, I have one of those discount coupon things, I think mine is called Good Rx, but there are others. My local pharmacy applies the discount code, and i have paid probably a total out of pocket of $50 in the past 5 years for her emergency prescriptions. But that has saved us thousands by not having a medicare part D, and use champva meds by mail, which do not work together.
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