Benefits

Question:

Hi, Jim. Is there a VA regulation that says when a veteran must file a convalescent claim? Is it 6 months after the convalescent event took place, or is there no time limit such as 10 or more years later? If there is a regulation, can you give me the regulation number? Thanks!

Jim's Reply:

A convalescent or recuperative rating must be filed at the time of discharge from surgery or other treatment modality that necessitates a period of convalescence. Periods of convalescence are covered at each diagnostic code here https://www.benefits.va.gov/WARMS/bookc.asp  Once the need for convalescence or recuperation has passed you are no longer eligible for the benefit. There is no retro pay like you mention.
 

The specific topic of convalescence ratings can be found at: 4.30 Convalescent Ratings. 

Question:

Can a spouse with CHAMPVA be seen and treated at a military (naval) hospital? Thank you.

Jim's Reply:

No. Military hospitals these days are overwhelmed caring for active duty personnel. There are some few VA facilities that will care for CHAMPVA beneficiaries but for the most part you're expected to use the benefit with civilian providers.

Question:

I am filing for Sleep Apnea secondary to Hypothyroidism for which I am approved. My ENT wrote a nexus letter, but it was not good enough. It seems they want more details on how he got to the nexus. Do you know of any references I can use to justify the connection? Thanks.

Jim's Reply:

Whenever a provider writes a nexus letter to help us establish service connection and an appropriate rating that person must provide a rationale for their opinion that is based in current science. If your doctor says that your OSA is more likely than not secondary to your hypothyroidism, the doctor must then state how and why he or she arrived at that conclusion. It isn't your task to sort out the science and that you're trying to isn't a great sign.
 

I can think of a couple of options that may help. First, go to the Board of Veterans Appeals site and use their search engine to learn how cases similar to yours have done in an appeal. Enter your key words and choose 1 or 2 years to search and read some cases. You'll learn a lot about how VA views cases similar to your own.
 

The other option...and the one most likely to prevail...is to retain a disability medicine professional to provide the nexus you need to prevail. You can learn more about the Independent Medical Opinion (IMO) here.
 

Good luck!

Question:

I am a Camp Lejeune contaminated water survivor. In Feb. 2022 I was diagnosed with bladder cancer, which is on the CLCW presumptive illness list for compensation. I meet the requirements as set forth by the VA. My VSO filed a claim in the middle of March. Now a week ago the VA notified me I will have to attend a C&P exam. My question is: since I qualify as a contaminated water survivor and have a diagnosis, which is the 2 requirements for this to be service connected, why is the VA requiring me to attend a C&P exam? Thank you for your time. 

Jim's Reply:

As you read through this keep in mind that I'm a professional cynic, a curmudgeon by nature. I'm also a Lejeune survivor, I was a child when dad was stationed there...we lived at Tawara Terrace so we had the full benefit of the contamination. Both parents passed with bladder and kidney diseases, I'm being worked up for mine in the coming weeks.
 

There is no good reason for you to have a C & P exam. Nada, zip, zero...not a single good reason for you to show up for an exam, period.
 

However, the businesses that make up the providers for those exams are owned by retired VA executives. Their businesses are paid by the exam so if they can schedule you for 2 unnecessary exams, so much the better.
 

Believe it or not, VA even has thought this through and they have a process in place that will keep most of us from needing an exam. The ACE process makes a lot of sense and would reduce processing time and save a lot of taxpayer dollars so you can bet you'll never hear of it!
 

In the end there's not a thing you can do about it. If you fuss or choose to skip an exam, VA will default to denial and call you a no-show. Once that happens your records will forever reflect that you're a no-show and thus not profitable to the company.
 

Yes, you're correct, this is an outrage and shouldn't happen. However, it is what it is and the best I can tell you is that this time you embrace the suck and enjoy your visit with your examiner. Good luck sir.

Question:

I am rated as a 100% permanent and total disabled veteran. My base rating is 80%, but am rated as TDIU, so I have a total of 100% rating. Do I qualify for Space A flights?

Jim's Reply:

Yes, you are a 100% permanently and totally disabled veteran. That there is a TDIU rating in there doesn't make any difference, you are Category VI
 

On a personal note, I've never known anyone who was successful in getting a free flight anywhere. The real issue comes into play when you're trying to return from wherever you found a flight to.
 

I'm also eligible and looked at it a few years back and schedules were too dicey for me. Good luck!

Question:

I am receiving disability for prostate cancer. It has been removed and my disability went from 100% to 60%. Now my PSA is .35 and I have submitted a claim. At .35, does the VA consider that a relapse and if so will my rating increase to 100%? Thanks for your consideration on this matter.

Jim's Reply:

That your PSA is that low isn't going to allow a rater to give you a 100% benefit. You'll need a statement in your medical record from your provider that clearly states that you're experiencing a relapse. Get a note from your doctor and all should be well for you. Good luck sir.

Question:

If a disabled Veteran (100%) is earning 3k+ a month, can the vet still get snap? Does it matter what disability % they are or how much they are earning?

Jim's Reply:

Like many low income assistance programs SNAP benefits are means tested. Whether you are eligible is going to depend on your household income when you apply. Your VA benefits count as real income so if you're a veteran alone, you likely have too much income to be eligible for SNAP. If you have a family and the VA benefit is your main or only source of income, you may be eligible. You'll need to apply before you know for sure though. Good luck!

Question:

I am using the Chapter 35 benefits from my husband who is 100 percent PT. I am in school for 12 more months and graduate in the summer of 2023. As of 8.12.22 I will have 6 months of benefit left of my 45 months. Is there a way to get an extension for 2-3 months?

Jim's Reply:

Hmm. I'm not aware of any extensions today. However, the most aware people on the planet are the folks who run the Office of Military Affairs at your school.
 

I almost always refer veterans and dependents straight to the university office that manages military and veterans benefits since they have to pay very close attention. That's what they're paid to do and most do it well.
 

I'd like for you to explore all this with the Office of Military Affairs and ask them if there are any special circumstances related to the pandemic that may give you the extra months you need. I think we're all aware that a lot of schools have struggled the last couple of years and you never know what may be available for you. Good luck!

Question:

Why is there no "era" differentiation for support personnel for WWI, WWII, Korea, Desert Storm, Iraqi Freedom? As a matter if fact, if you joined the service the day before the end of WWII and never stepped foot in theater you were still awarded the WWII Victory Medal. The "era" label is an insult to all the support personnel during the Vietnam conflict.

Jim's Reply:

I'm not at all sure why you're angry? An insult? Seriously? This is what you choose to get upset about? I take it that you're Vietnam era and you didn't get the Vietnam Service Medal and you're all hurt about that?
 

The term 'era' is used throughout many references to historic events. VA defines eras like the Mexican Border period (May 9, 1916, to April 5, 1917), World War I (April 6, 1917, to November 11, 1918), World War II (December 7, 1941, to December 31, 1946) and so on. Each of those eras is entitled to different benefits and such so there is plenty of differentiation.
 

Human history is generally divided into eras such as Prehistory, Classical, Middle Ages, Early Modern, and Modern. Humans like to categorize things so our brain better grasps the concepts we're presented. Periods of history are put into boxes where similarities exist. The fact that you're upset about that to a point that you are compelled to write to me is...interesting.
 

For what it's worth, I'm Vietnam era...one of the 'support personnel' you refer to. Although I served most of my tour in Germany as a hospital medic, I cared for Vietnam combat troops so in a roundabout way I was part of your support personnel. I'm proud of my service and I'm proud that I was able to make some small contribution to help my comrades through difficult times. I did my job well and I'm happy I was able to serve my country during the Vietnam war era.
 

'A soldier will fight long and hard for a bit of colored ribbon' - Napoleon Bonaparte. I get so much mail about the VSM I fear it proves him right. You're another in a long line of veterans who wonder why they didn't get their 'bit of colored ribbon'.
 

The WWII Victory medal was awarded for military service, much like the National Defense Medal or a Good Conduct Ribbon. It didn't note any particular region of service (Pacific, European Theatre. etc.) and was criticized for both the timing of the award and the fact that almost everyone got one, even student cadets who never served. 
 

If you're really all that concerned, your Congressional representatives are waiting to hear from you. That's where change of government definitions begins. Good luck.