Benefits

Question:

I'm currently rated 60% secondary to prostate cancer. If I file a claim for depression as a secondary is my current rating at risk of being lowered?

Jim's Reply:

Any time we ask VA to increase a given benefit, it stands to reason that our entire record is opened and reviewed. In other words, yes...you place your current benefits at risk if you seek to increase a current assigned rating or to add a new rating.
 

This doesn't mean you shouldn't file a new claim, it means that you should go into this prepared with eyes wide open.
 

Depression during and after prostate cancer treatment isn't at all unusual and many vets file for that as a secondary condition following prostatectomy or direct beam radiation therapy because let's face it, prostate cancer treatment is brutal. 
 

When you file you should have taken the time to buff and polish your health care records. If you aren't being actively treated for depression, you should be. You need a record of mental health therapy to prove your eligibility for a mental health benefit.
 

So, look at your medical records. Have you been in mental health care for a year or more? Do your records clearly reflect that you are being treated by a mental health professional for depression? 
 

At the time that you can look at your records and treatment history and you feel like you're ready, file the claim.
 

Good luck sir.

Question:

Can you send me any link/source regarding DIC eligibility that says one must be totally disabled (100%) and be P&T for 10 years? I haven’t seen the P&T portion any where. Thanks!

Jim's Reply:

Sure thing...here you go. https://www.law.cornell.edu/cfr/text/38/3.22  
 

For what it's worth for a surviving eligible dependent to receive DIC the veteran must have died of a service connected condition and that condition must be reflected on the death certificate or the veteran must have been rated at 100% for an uninterrupted period of 10 or more years.
 

After the 10 year period the veteran can get run over by a bus and the surviving dependent is eligible for DIC.

Question:

I have bad tinnutis, can't sleep but 4-5 hrs. I am 75 years old and served in Korea in 1967 & 1968. This problem continues to worsen. I am enrolled in VA health care but the co-pay cost me more than medicare. My retirement is $2500 per month and my wife has a teacher retirement, both incomes equal to less than 70k per year. What might I qualify for from veterans health services other than the Class 8 that I am now?

Jim's Reply:

When we are made eligible for VA health care services we are assigned to a priority group. Your tinnitus rating of 10% (the max for tinnitus) places you at 8 on the priority list and sets certain minimums for copays for health care other than that provided for the tinnitus. A vet with a disability rating of 100% is in priority group 1 with no copays for anything and the scale slides down from there.
 

From what you tell me I'd offer that you should consider filing a claim for the secondary conditions you associate with your tinnitus. Tinnitus is ringing in the ears and most people have a degree of tinnitus that they may or may not ever notice. In some people the ringing is distracting at times but not a real bother unless associated with profound hearing loss when the tinnitus may mask already dulled sounds. 
 

There are those folks who have such a loud tinnitus that they have serious issues with concentration, communication and sleep. VA doesn't compensate tinnitus at more than 10% disabling so to increase your benefits and get you into a better priority group so your copays don't cost as much, you need to file for a higher disability rating.
 

I'd first suggest that you have your hearing tested again and see if you don't suffer a degree of hearing loss. Then you'll need a medical record of the things that you believe are attributable to your tinnitus. Sleep loss is a condition as is depression, anxiety, mood swings, anger, etc. Again, these are secondary conditions to tinnitus that can be rated as such but you need a record of treatment to prove these are things bothering you.
 

As you are able to, take a while to get your records in order and file the claims.
 

Good luck!

Question:

I am a 100% service connected veteran, my disabled stepson is in a residential program where he gets SSI and a portion of my wife's Social Security benefits. I am being billed $65 monthly because I get money from VA. Is this correct? They said the order came from the State or County's DFS. Is that accurate?

Jim's Reply:

I can't speak to rules and regs that are made up by a state or county when you don't tell me what state or county you refer to. Even if I could, it probably wouldn't make a lot of difference since most organizations that provide services to low income and disabled citizens do a means test to determine eligibility for their benefits.
 

Veterans often think their benefits are exempt from such things because our monetary benefits are exempt from taxes. That isn't true, our disability money is treated as income and I have to guess that's what happened here. It's likely that counting your VA income puts you in a position of paying a charge as you note.
 

Good luck.

Question:

I currently receive 40% disability compensation for type 2 diabetes, neuropathy, and erectile dysfunction. I recently filed a claim for my hypothyroidism, related to agent orange. That claim was denied. How should I proceed with an appeal?

Jim's Reply:

It's well documented that veterans law attorneys win more appeals than any other way of appealing a denied claim. If you'll click through that link you'll learn how to hire a veterans law attorney and you'll meet a few of the lawyers I refer to.
 

Good luck sir.

Question:

I read a question that was asked previously. I, too, served in the Marines between 81-84. I was exposed to excessive diesel fuel and fumes. I am currently being treated for heart disease, endocrine issues, lung issues, hypertension, and dry eye syndrome. I understand that excessive exposure can lead to these type of issues. I was a Bulk Fuel man in that time frame. I was constantly exposed to diesel fuel, when operating 600 gpm pump, 350 gpm pump, and 50 gpm pump on a regular bases, these pumps operate with diesel fuel. I was responsible for establishing a fuel farm, with numerous fuel bladders, dealing with leaks, getting doused with diesel fuel, numerous times. I have three brothers that served in the Marine Corps, I am the only one dealing with these serious issues. What do you think?

Jim's Reply:

I think you have the beginnings of a claim that will be an uphill challenge to prove. However, I believe that you should file a claim that clearly states that you believe that there is a relationship between your HAZMAT exposure and each one of the conditions you named to me.
 

You'll need the opinion of a physician who is well versed in how all this works. The physician will write what is called an Independent Medical Opinion (IMO) that will offer an opinion as to how your HAZMAT exposure has affected you and the physician will offer science to support that opinion.
 

You'll need copies of your medical records, service records and so on...the doctor will let you know what you need to produce.
 

Without the IMO I have doubts that you can prevail unless you have active duty records of medical issues from your service.
 

Good luck sir.

Question:

I was in the Vietnam War, 2 enlistments. I never really followed with heath care since I rarely get sick. However, I'm going to be 70 soon and have 2 young children and a son due in a few months. I've been living in the Philippines since 2015, when I met my wife. Do I qualify for anything from the VA? I do have tinnitus, a sore spot in my lower back since 2009, and I need a colonoscopy follow-up. Old age has also brought on prostate cancer.

Jim's Reply:

VA provides services for you but getting the paperwork done may be a burden. VA moves slow in normal times and the pandemic has caused a lot of backlogs. I'd suggest that you file a disability claim for the tinnitus...you'll probably be better off traveling to Manila and ask for some help with that.
 

If you aren't already registered for VA health care you'll likely need a disability rating to be eligible. Getting the rating for tinnitus (10%) should be relatively simple if you have a CIB from Vietnam. You can also ask for an 'agent orange exam' and if they're able to provide that you should meet with a health care provider who will examine you for any agent orange related disabling conditions.
 

I haven't ever been to the Philippines but I hear from quite a few American Vietnam era veterans who live well there. The most common thing I hear is how difficult the VA regional office and the health care system in Manila can be to deal with. They have limited resources and eligibility for different services can be confusing.
 

So...find someone who is familiar with the Manila VA to buddy up with...a VSO or another RVN vet who has been through the drill at Manila VA. Get that disability rating since that opens doors for you and be patient, very very patient.
 

Good luck sir.

Question:

Hi Sir,

I have appointment with a doctor for a pacemaker. Do I need to complete the entire pacemaker process before I put in for a claim?

Jim's Reply:

If you believe that the pacemaker you may get will be a service connected procedure and that you will get a disability rating, you have to wait until the procedure is scheduled and completed to file a claim. VA won't accept the claim if you say that this will happen sometime in the future, VA wants the procedure to be done before you get your rating.
 

The thing to do is to get all your claims paperwork ready to submit and then immediately after the procedure is completed, you can file that claim.
 

Good luck sir.

Question:

I have 10 percent VA rating for high blood pressure. This turned into AFib with 2 stents, a pacemaker, and a defibrillator. I filed for AFib. Will they consider my pace maker and defibrillator or do I have to make a separate claim.

Jim's Reply:

You should make a separate and distinct claim for each condition you want rated. 

Question:

I recently read a blog of a step daughter using his chapter 35.I have been told by vso that stepchildren are not entitled to any benefits although they are being claimed as a dependent.

Jim's Reply:

Your VSO is wrong. Biological children, adopted children and stepchildren can all qualify as dependents as long as they meet the following criteria: Unmarried and under the age of 18; Between the ages of 18 and 23 and attending school full-time; or. Disabled prior to age 18.