Benefits

Question:

Jim, Is it possible to win a housing grant with bad knees and the need for a walker? Or is this grant generally reserved for amputees or paralyzed individuals?

Jim's Reply:

Housing and other grants for adaptive devices generally require that you are unable to accomplish all or most of the Activities of Daily Living. 
 

I too use a walker or a cane for my worn out hips and lower back and the fact is that if we can still get around and care for ourselves, VA doesn't see where we need such grants.
 

You can apply but I have my doubts. Good luck sir.

Question:

I've contacted you before and you are really helpful. My question is how to proceed with a claim for depression as secondary to prostate cancer. My local VSO is not much help and I don't know where to turn next. My doctor is not much help either. What would be the steps to be taken? Should I contact an attorney, get an IMO, or what? I developed my cancer claim myself but this is going to be beyond me.

Jim's Reply:

Thanks for your kind words.
 

Your VA makes no case for the disabling mental health effects of treatments that can be devastating. Depression, sleeplessness, erectile dysfunction, suicidal ideation and more are all part of cancer treatment. A fast growing prostate cancer and the surgery, radiation and other treatments leave lasting impressions in so many ways. All VA recognizes is that you may pee a lot but there are no ratings for the psychological effects.
 

You'll need an Independent Medical Opinion or IMO. An IMO is a professional review of your records and an opinion about whether or not and why your depression is secondary to your cancer. Good luck sir.

Question:

If you have VA disability for bulging disk from direct service connection, then you go and have surgery will they take away your disability cause your "cured"? Even though statistically once one goes out it starts a domino affect?

Jim's Reply:

A service connected disability rating should reflect the state of the disability at a given moment in time. If you're having surgery for a disabling condition the intent and purpose of that procedure is to measurably improve the disabling condition. 
 

Once you have a corrective surgery you'll get a few months of 100% as a temporary rating as your recuperate. Then you'll have a C & P exam to determine just how successful the procedure was.
 

In theory, if the surgery was 100% successful, you'd be cured and your rating would drop to 0%. That doesn't ever happen that I'm aware of though and what usually happens is that the rating will stay the same or maybe even rise a bit. 
 

While a corrective surgery may fix one problem, it can cause others. There's scarring and often loss of sensation and so on that has to be considered as the C & P examiner makes the record. It'll be up to you to make sure the examiner understands all the things that trouble you.
 

In the end your rating isn't a reason to consider whether or not you should have a recommended procedure. There are a lot of factors to be weighed when you contemplate a serious operation and the end result of your rating shouldn't be one of them. Good luck sir.

Question:

Rated at 100% with SMC.  Can one qualify for mobility scooter and will this open up the opportunity for the VA to reevaluate you?

Jim's Reply:

SMC rules and regs seem to be applied differently depending on where you are. I've heard stories of instant approval or denials for pretty much the same ratings. In any case, SMC is one of the more challenging benefits to understand and I use this site as my go to reference. 
 

To be eligible for mobility devices in general you need service connected loss, or permanent loss of use, of at least one foot or loss, or permanent loss of use of at least one hand or permanent impairment of vision of both eyes to a certain degree. There are other less common qualifying conditions as well.
 

The simplest way to determine whether you're eligible or not is to go ahead and apply for the devices or services you believe you need and that you're likely eligible for. To have VA proceed with your application will get you started and if you should be denied, you'll know what's up and you can begin the appeal process.
 

Does this open up the opportunity for a reevaluation? Of course it does. VA will review all the data they need to so as to make a reasonable and fair adjudication of your claim. If you're worried that you may lose some benefits, that's possible but a fairly rare occurrence in this setting.
 

Good luck sir.

Question:

Thanks for your service to veterans, I always tell any veteran I meet to check out Jim's mailbag. I'm TDIU, 100% P & T for 13 years. I heard that if a veteran has a rating over 70% the VA will pay for nursing home care. Is that true? If it is, is it a big deal to get that benefit? Thank you for your help.

Jim's Reply:

Thanks so much for your kind words. That means a lot to everyone here who puts this all together to help our audience of veterans, active duty and of course, their dependents.
 

GREAT question! Yes and no is the only answer I can come up with. Nursing home care is in such turmoil today it's hard to know which way to turn. Many nursing homes are private, a bit more upscale ($$$) and will usually work with veterans, others are run by the state with contributions by a county or city government. In other words, whatever we think of our future in an extended care facility, we need to start planning today. If you have a local facility in mind it won't hurt to visit them right now. 
 

Extended care facilities have been in the news lately because of the pandemic. These are the places that were first hit and where so many deaths happened. Because of all this and more, the extended care facility is changing how it will operate in the future and it's a guess how all that will be paid for.
 

Is it a big deal to get the benefit that will provide you with extended care at a facility? It's a very big huge deal. This can be one of the more challenging benefits to receive depending on where you are. Using your federal benefits to help pay for care at a state run facility gets mind boggling complex just thinking about it. But some regions seem to have plentiful high quality care so a lot will depend on where you are.
 

Personally, I'm making plans for in-home care when it comes to that. With appropriate planning and a little help we boomers are staying home a lot longer these days. In-home care is recognized as not only cost efficient but seniors are happier and healthier than when they're closeted into semi-sterile cubes at a facility.
 

These are the sort of decisions where we must weigh your locale, your family status (so we can identify potential caregivers), how near you are to a VA medical center and a dozen other factors. The sooner we begin that decision process, the better our more fragile senior years will be.
 

When the end nears (at about 6 months) Medicare will pick up 100% of the costs of care end of life care while you're at home. That's right, all your medicines, nursing visits, etc. come free. The Medicare hospice benefit is awesome and allows many of us to have dignity in our death while in our home. Your VA also runs both home and hospital based hospice programs so you'll have options.
 

The best advice I can give anyone is that planning is the key to success in any endeavor and dying is one of those things we don't ever plan well enough for. I get it, it isn't a pleasant topic, as Woody Allen once said, "Death doesn't frighten me, I just don't plan to be there when it happens."  I urge anyone listening to have a will, a free will off the Internet is fine but one drawn up by a lawyer is better, although sometimes costly. Check with hospice programs in your community because they know exactly what's going on in the senior citizen community where you live.
 

Talk with your spouse now. The DIC paperwork should be ready for him/her to date and sign at that moment. If you talk with your chosen funeral home service director, you'll learn a lot about veterans, extended care facilities and veterans deaths. Often enough the funeral home director is the most knowledgeable person around for information about extended care facilities, veterans burials, benefits and so on. You should meet that person early on as you're preparing your extended care and funeral. If you never thought a funeral home director could be your best buddy, think again.
 

Believe it or not, I've done all that. My will is up to date. My wife and other family are aware of my wishes, as I am hers. She has the insurance policies and other papers ready to go as do I for her. My best friend has agreed to quickly clear my Reddit browsing history upon word of my death. (!!!)
 

Everyone knows who will care for my dog. I think I'm packed and ready! Good luck to you sir.

Question:

Can I close my VA fiduciary because I have been found competent?

Jim's Reply:

Yes you can but it's never that simple.
 

In fact, VA is likely to dispute your competence and cause all kinds of fuss.
 

You'll be much better off if you get an expert involved to help you. Get in touch with this fellow https://www.vetadvocates.org/users/chris-attig He knows his way around the VA fiduciary issues as well as anyone I know. Tell him I said hello and that I thought you needed to speak with him. Good luck!

Question:

If you had a lower left lobectomy in 1960, entered service in 1963, and you lung condition worsened so you were medically honorably discharged is the Navy at fault for allowing you to enter service?

Jim's Reply:

No. You were determined to be fit for duty in 1963. The lobectomy apparently hadn't made you any less fit for duty than others. This happens a lot with many preexisting conditions like healed broken bones, hernia repairs, appendectomy scars and other conditions that may suffer under the stress of military service.
 

However, a disability claim may be filed for making a preexisting condition worse. This is called aggravation of a preexisting condition and is the basis for many medical discharges as well as continuing disability benefits as appropriate. If you haven't filed a VA disability claim, you should. Good luck!

Question:

I served as an active Reservist from May 1970 to May 2001. I spent 23 months on active duty, 12 months in Korea from Nov. 1970 thru Nov. 1971. I know I am a Vietnam Era veteran. I recently applied for VA medical benefits, providing my DD Form 214. I was rejected without an explanation. Can you provide me with an explanation as to why I was rejected?

Jim's Reply:

You were rejected because in the 2006-2007 time frame the rules that address eligibility for health care changed. Prior to this, anyone with an honorable discharge was eligible for a full array of health care services. During this time America's "forever wars" were taking a toll on VA health services...we were making too many disabled vets for the system to handle. The Bush administration put a temporary limit on how many vets were eligible for care so as to lighten the load and that is still in effect.
 

The rules changed so that the only folks eligible were those who were already enrolled, those who have VA pensions, those veterans who have rated disabilities and the newer vets as they came home and even they were limited to abbreviated periods of care before their eligibility would run out.
 

If you want to pursue health care benefits as a Vietnam era veteran you'll need to file a claim for a disability benefit and prevail so that you have a rating that insures eligibility.
 

Good luck sir.

Question:

Are there any benefits I should know about when buying a new car? I am a Vietnam veteran rated at 100% both ways. I know I am tax exempt on my home.

Jim's Reply:

There aren't any particular laws that give you tax relief for auto purchases like the relief a totally disabled vet may get from homeowner taxes and so on.
 

I've discovered that we can use our status to get some pretty significant discounts from dealers though. I recall just asking about it at a Honda dealer some years ago and I got $1000.00 off just for asking.
 

This isn't a great time to be buying a vehicle though and you're going to run into the fewest choices and the highest prices we've seen in years. Rather than offering discounts dealers are marking cars up over the MSRP just because they can.
 

Good luck!

Question:

I was just reading "Difference in Benefits - 100% schedular disabled veteran vs. 100% TDIU disabled" written on May 12, 2013 on your blog. I am wondering if this is still correct information? I am 100%TDIU P & T.  Will my wife be able to collect benefits in my passing? We have been told I have to have 100% schedular for this benefit?

Jim's Reply:

The TDIU rated veteran (I'm one so I pay close attention) receives exactly the same array of benefits as the schedular rated veteran. For an eligible dependent to receive DIC benefits the veteran must pass from a service connected and rated condition or the veteran must have held the 100% permanent (TDIU or Schedular) status for 10 or more uninterrupted years.
 

The only difference between the benefits of a 100% TDIU vet and a 100% schedular rated vet is that the TDIU vet can't hold gainful employment without risk of losing the TDIU status.
 

There are no other differences.
 

Your dependent is eligible for the full array of eligible benefits when you're gone. Good luck sir.