Benefits

Information on VA benefits, Social Security benefits, how to files claims, and how to appeal denials.

TDIU

Question:

Hi Jim I'm 90% but rated unemployable and permanent and total. Would I be able to start a business without it affecting my benefits?

 

Jim's Reply:

You're rated as unemployable. If you start a business and earn income that is classed as gainful employment, you'll be self employed and no longer viewed as unemployable. In other words, you'll be employable.
 

If you are successful, you'll lose the TDIU benefit. Good luck.

 

Medical malpractice

Question:

If the VA caused the loss of my leg, after a mrsa infection, that led to three amputations. Why am I not considered a disabled veteran? 7 years have passed and the recovery is still ongoing. I'm still unable to walk or work. There's no help available. Any ideas?

 

Jim's Reply:

A disabled veteran is one who has service connected disabling conditions. You aren't active duty so what's happening to you can't be service connected.

However, it doesn't sound as if your care has been appropriate so it's time to talk with the lawyers. Click https://verdictvictory.com/medical-malpractice/va-malpractice/  Good luck!

 

Effective Date

Question:

I applied for disability in April 2021. It was approved and I received 100% in July 2021. I want to know if I’m entitled to payments when the cancer was finally confirmed - approx. 2 years earlier. I also have 3 Purple Hearts, nothing major, which why I didn’t  apply earlier.

 

Jim's Reply:

The date that a claim begins payments is known as the effective date of the claim. If you file on January of 2020 and your claim is awarded in July of 2021, your effective date is the date that you filed, January 2020.
 

To establish the effective date you must file a claim. There are rare circumstances that an earlier effective date may be filed back to the dates of a diagnosis but that's an unusual event often as a result of a clear and unmistakable error on the part of VA when processing a claim.
 

In the end, if you didn't file a claim back then, I don't see any way to claim retroactive payments.

 

Pension?

Question:

I have a TDIU P&T rating, I am 53 and when i turn 55 i can start receiving a small teamster pension of $900 a month. My question can i lose my TDIU if i am collecting a pension?

 

Jim's Reply:

No, you will not lose VA TDIU benefits for receiving a Teamster pension. A pension is not gainful employment and gainful employment is your only restriction. You can win the Lotto, strike gold in your back yard or inherit a fortune from your poor old aunt Gertrude and none of that will affect your benefits. If you return to work, then you may have an issue. Good luck!

 

Prostate Cancer

Question:

I’m currently 100% for Prostate cancer. I received 28 radiation treatments. I’m now on hormone shots for 2 years. Is this considered part of my treatment, and will I continue on 100% till I complete the hormone treatment?

 

Jim's Reply:

The hormone treatment is 'treatment' and while you're being treated your rating should remain at 100%. However, this is an arena where VA makes a lot of mistakes so be prepared to appeal if they drop the rating prematurely. Good luck.

 

Appeal

Question:

My dad is totally blind. He’s been SC for diabetes from agent orange exposure during the Vietnam War. He has some Parkinson’s like symptoms, too. He’s been denied Service Connect for blindness. Any advice?

 

Jim's Reply:

You can help him appeal the decision by contacting a veterans law attorney. This is the only way to fix the disservice you're experiencing and if you follow this advice, he'll likely get the benefits he deserves.
 

The accredited veterans law attorney will work on a contingency fee basis so you'll have no money out of pocket to get this set straight. Please click https://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html 
 

Thanks so much for helping your dad. Good luck!

 

TDIU Going Away?

Question:

If one is rated 70% with IU putting them at 100%, does the rating become protected after 20 years? I’m worried IU will be taken away one day via Congress once I’m over the age of 67. What are your thoughts? I’m 55 now. I worry about this happening. I also receive SSD so this would be a big loss, as would losing the property tax credit and everything else regarding benefits at 100%.
 

Jim's Reply:

You have no worries. There is a rumor that goes around all the time that the feds are planning to take away TDIU when you are able to collect Social Security retirement. That is only a rumor and will not happen.
 

The fact is that benefits are always changing to keep up with the times. Everything changes...look at Tricare and similar benefits like the GI Bill.
 

But in your case, if changes occur in the future the changes will apply to future generations, not you. This happens often with our VA benefits and with guys like you, you're 'grandfathered' in and your benefits are protected.
 

You're losing sleep over a rumor. I hope this helps dispell that. Good luck sir.

 

Added Claims?

Question:

Hi, quick one. Can a C & P examiner add claims? I had GWI C & P and I only put in for IBS, but I have pretty much all the GWI problems. Thank you.

 

Jim's Reply:

As a general rule, no. You are the only one who may initiate a claim. The exception to this is an imputed claim where a rater may see something while processing your claim that is so obvious that the issue must be raised to the level of a formal claim. It's my experience that this is haphazard at best when viewed over the long run. I've seen plenty of claims where a disability like dandruff that was treated on active duty is rated at 0% without a formal claim being filed.
 

Don't laugh. Dandruff or "Helmet Hair" can be a vicious disease in the tropics and cause lifelong infections and scarring. But most of us are dispensed some shampoo and it is gone in a day or two. 
 

In most cases, if you don't make a formal application for a specific benefit, you won't get it.

 

Stroke?

Question:

I’m currently receiving 30% service connected disability for IHD. I recently suffered a stroke affecting my left side. IHD was presumptive due to agent orange exposure. Can I file a secondary medical condition for the stroke against my rating for IHD?

 

Jim's Reply:

No. A stroke is a completely different event than IHD. A stroke often or even usually originates in the carotid artery in your neck. That is far separated from the blood vessels involved in IHD.
 

Carotid Artery Disease (CAD) is the exact same disease as Ischemic Heart Disease (IHD) and it makes no sense at all that the ratings schedule includes one disease but not the other but that's what we're dealing with. Both IHD and CAD are diseases where blood vessels clog up and don't deliver an appropriate amount of oxygenated blood to the target organ. In one case, you have a stroke, in the other, you have a heart attack.
 

In any case, years ago VA made the decision that one event is service connected and the other not. I wish I had better news...good luck sir.

 

Like Molasses

Question:

Good day Jim. Myself and several other 80 year old or older Vietnam veterans would like your opinion on something. We have filed Fully developed VA disability claims for Agent Orange Presumptives. The claims have been sitting and not moving in the system for about 10 months. C & P exams and all appointments have been attended months ago. A lot of the test that they did on me had nothing to do with the new presumptive condition that I claimed but had to do with an Agent Orange condition that I am already rated for(Ischemic Heart Disease). I have personally called the 800 number every month for the past 5 months and have been told the same thing every time I called. I am told “The Veterans Service Representative has recommended a decision, and is preparing required documents detailing that decision”. According to VA.gov the average time for completing a claim, as of this morning, is 117.6 days. That is less than 4 months. We know some Gulf War Veterans who tell us that their claims are taking about 4 months from filing until notification. We are getting very discouraged. Most of us are in bad health due to Agent Orange illnesses and don't have that much time left. The consensus among us is that the Top Brass at the VA have ordered all old Vietnam veterans claims decisions to be held back in hopes that we will die shortly and the claim will die thus saving the VA a lot of money. Is our reasoning wrong? Should we just give up and forget about the whole thing? We value your opinion. Thanks much.

 

Jim's Reply:

The pace that VA ordinarily moves at is slow...slow as molasses, as the old folk say. The pandemic hit all businesses hard and VA was at the top of that list. You know the rest...if you take a dysfunctional organization and throw a wrench into the works, what we see today is what you get.
 

It sounds to me like your claims are processing at just about the right speed for the SNAFU we live in today. I understand how frustrating it is to think you should have seen results and nobody has a clue what's going on. I'm sympathetic right now at this moment! My smartphone bricked Tuesday a week ago. It was old so not unexpected that it would fail. I ordered a new phone that was to be delivered the next day. Last night, a week later, I got my new phone around 10PM. The moral of the story is that America is a mess right now and your VA is a the top of the heap.
 

A bit of advice...the toll free number is worthless. It's a call center with very limited access to your file. They go by scripts and have 3 minutes to get you off the phone. The info you get is likely wrong and they have no input to make your claim move faster. Their only function is to distract you while you wait for your claim to move along. It works, doesn't it?
 

Your claim doesn't have to die with you. If you have a dependent, they can keep your claim alive and if they prevail, they get the money. It's called a substitution of claimant and is usually the spouse.
 

Finally...if you want an answer to what's up with your claim, email the boss at Denis.McDonough@va.gov​. This is legit and it's OK to do...it works
.

Keep your message brief and don't ramble or rant. This is Secretary McDonough you're writing to and although it's not likely he'll see the message, you never know, so strict military courtesy is required.
 

Be brief. Give contact numbers that you can be reached at during the week. Give your full name, address, DOB, last 4, etc. You know the drill.
 

The email will be picked up by executive staff who will source it from the Secretary's office to the appropriate senior management who will respond to you directly. You will get a response although it may not be what you hoped for.
 

It is acceptable to tell the Secretary, "Sir, I'm old and fear I'll die before my claim is resolved." There's not a thing wrong with the truth.
 

For what it's worth, I've never witnessed any sort of favoritism from generation to generation. Nobody is ordering that older vets should be set aside, those rumors are older than I am. VA is budgeted for the living veterans on the roster so keeping you breathing is important.
 

What I have seen is that WWII and Korea vets don't have much in the way of records to work with and that bogs the process down. Old guy illnesses are harder to sort out than young guy illnesses.
 

My Vietnam era brothers and sisters don't fare much better because of the records center fire and other lost files. The more modern generations of vets have accumulated computerized medical records even when a medic is tending to them in the field so their claims are often easier to process. As they age like we have, their claims will become more complex.
 

Try my suggestion, write to the Secretary and let me know what happens. I'll look forward to hearing from you in a couple weeks. Good luck sir.