Benefits

Question:

I have prostate cancer. If they remove prostate approximately how much money will I lose in dollars? 

Jim's Reply:

Veterans who are service connected for prostate cancer are rated at 100% on a temporary basis. A veteran alone (no dependents) who is rated at 100% receives $3,332.06 each month while the cancer is active.
 

Once the cancer is treated and you no longer have cancer, you are rated on the residual effects of all the treatments you received...radiation, surgery, etc. That 100% rating will fall to either 60% ($1,214.03), 40% ($673.28) or 20% ($301.74). The final rating is pretty much dependent on how many absorbent pads you use each day to control leakage of urine.
 

I'll let you do the math...good luck sir.

Question:

I am TDIU and 72 years old. Can I now work part time and earn over the poverty level

Jim's Reply:

No. You may lose your TDIU benefit if you earn more than the federal poverty level. TDIU is the unemployable benefit. If you're able to work, you aren't eligible for the benefit.

Question:

I am going to apply for TDIU through my VSO. I am currently rated at 60 percent. I have disabilities that keep me from gainful employment based on my career field law enforcement. I have arthritis in both knees to include total right knee replacement. I am filing for back issues secondary to my knees which are service connected. I have had 3 back surgeries. I want to know if my chances are good. Thanks.

Jim's Reply:

If you are rated at 60% for multiple ratings you aren't eligible for TDIU. You need a single 60% rating or multiple ratings adding to 70% or you must apply for an extra schedular rating. To receive an extra schedular rating isn't a simple process. Proving that a back injury is service connected as a secondary condition to service connected knee conditions isn't easy to prove and will usually require an IMO by a credible physician who has a lot to work with in your medical records. If your medical records are scant and don't have much to support your theory that your back is secondary to your knees VA isn't very likely to accept your claim.
 

I don't usually make predictions of success but in this case you are applying for a benefit you probably aren't technically eligible for and you're making a claim that is very difficult or almost impossible to support. I think you know how I feel about your claim. Good luck sir.

Question:

Just got TDIU and wanted to know if I get an id card?

Jim's Reply:

You should get some paperwork from VA regarding your rating. In a nutshell, you'll take that paperwork to the nearest military base that can provide ID cards and you'll work your way into that office. Of course it's a bit more complex than that depending on where you are and so on. Read more for ID card details. Good luck sir.

Question:

Jim, I have been diagnosed with intermediate prostate cancer and am receiving hormone treatment and will soon start Radiation therapy. I have been awarded SMC-K for ED and temporary 100% for cancer. My question is will the VA consider intestinal issues as a residual of the cancer treatment? There can be damage to the colon from the radiation. Thank you in advance for your response.

Jim's Reply:

Radiation treatments, whether direct beam radiation or implanted 'seeds', can cause damage to nearby delicate tissues as the active components of the radioactive beam or implant may 'scatter' as treatment commences. This is a potential problem and if such a complication should occur, you may file a claim for that residual effect.

Question:

My husband is Vietnam veteran. He has been diagnosed with TTR amyloidosis. His genetic test proves he did not inherit it. Can he get disability from the VA for his condition?

Jim's Reply:

It's questionable whether VA will allow whatever genetic test you have as evidence enough to sway their opinion. This is a good example of just how complex these cases can become...https://www.va.gov/vetapp16/Files5/1636648.txt
 

However, were I you I'd apply for benefits and argue my case because if you don't, you'll never know. Every claim and every decision is different and the only way to be sure is to formally file the claim. Good luck.

Question:

My husband filed for bladder cancer a year ago and it is still in review. He had chemo and had his bladder removed. He now has an ostomy/ stoma. What rating will he receive long term?

Jim's Reply:

I'm sorry but it's not possible for me to accurately predict what his rating may be. Typically the veteran who has a service connected bladder cancer will be rated at 100% for a few months and then evaluated during a 'future exam' to determine what the rating will be going forward.
 

The examiner and the rater will take into account all the treatments he's had for his cancer and any other disabling conditions he may have been rated for in the past to arrive at a final rating.
 

Good luck!

Question:

Hi Jim, I’m scheduled for a tele C&P exam for knee and back problems. How will they be able to do the range of motion? Should I cancel and do in person exam? Should I be worried! Thank you for your reply!

Jim's Reply:

No, there's nothing to be worried about. I wouldn't ever suggest rescheduling a C & P exam, once the examiner has you on the schedule any changes can get you lost in the system.
 

It's the job of the examiner to figure out how to do range of motion (ROM) if it's necessary. That's not your problem unless you're denied and then you can ask about the ROM and use of a goniometer on appeal.
 

Any time we're scheduled for C & P, it's best to go with the flow and don't interrupt the process. Good luck!

Question:

Hello. I am on Medicare and have an AARP supplemental plan that gives me full coverage. I recently qualified for CHAMPVA and I’m wondering if I can drop my expensive AARP coverage and/or my prescription part D plan. Will CHAMPVA cover expenses the same as a Medigap plan? Thank you.

Jim's Reply:

CHAMPVA is outstanding health insurance but it takes a little effort and patience to get used to. My wife uses her Medicare and her CHAMPVA together and it provides her with high quality care and prescriptions both by mail and at a local pharmacy. We're sure that her health benefits are better than mine!
 

There are intricacies and mysteries when you start using CHAMPVA. Yes, it should cover everything but some things need preapproval and that can get confusing. I've never been a believer in any sort of supplemental Medicare insurance as most of those receive terrible ratings in consumer reviews. Rather than a "Medigap" policy, we save the money we'd be paying for that policy and pay out of pocket expenses with no pain.
 

And again, I've viewed Part D as a terrible deal and unless you need some exotic and hugely expensive meds it makes more sense to pay out of pocket. However, your CHAMPVA should pay for all your meds although there are small deductibles on occasion.
 

The best I can tell you is that health insurance is a personal decision that you have to make based on your tolerance for risk and the economics you face in day to day life. A lot of folks are over-insured and they're happy knowing that they'll get care and not take chances with billing and debt. Others, like me, are el-cheapo by design and we look for cost savings at every step.
 

Before you drop your current insurance, get comfortable with CHAMPVA. Talk with your doctor's billing office and listen to what they say. Visit your favorite pharmacist and learn what their experience with all the insurances are. These people are all happy to talk to you about how they get paid because it's in their best interests! 
 

Go for it. Good luck!