Benefits

Question:

I have a 100% permanent rating. If I get the cochlear implants, will it effect that rating?

Jim's Reply:

I wish I could give you a definitive answer, but I can't. There's a fair amount of discussion about conditions rated at 100% permanent that are cured by treatments that didn't exist when the rating was awarded.
 

The best example of this is HepC. HepC has been a problem in the military since the beginning and when the disease is bad, it's very bad and often rated at 100% if it's service connected. A few years ago a cure came about in pill form. These are very expensive treatments and there was debate about how much it would cost and VA went ahead in the face of the financial impact and began treating and curing vets.
 

The treatment for HepC is pretty much absolute...you either have the disease or you don't. So...what to do?
 

Residuals of the disease and the treatment are always considered if there is such a dramatic cure. In the case of cochlear implants, the cure isn't always that dramatic. Your hearing may not return to 100% but there may be improvements of varying degrees. 
 

If you'll click here https://search.usa.gov/search?affiliate=bvadecisions and enter the search term <cochlear implant> you'll see how the BVA views different situations with appeals and decisions like this https://www.va.gov/vetapp15/Files3/1526552.txt .

I have a history of advising vets that they should consider the improvements to their overall health before they worry about the final rating. Take care of yourself first!  Good luck sir.

Question:

Hello Jim, I'm a 100% disabled Veteran and on Medicare part A. I stopped part B around 6 years ago because I never used it for medical reasons. I'm turning 65 soon and am getting correspondence from Medicare to pick up part B again but pay late penalties. What's your take on getting Medicare parts A and B? I appreciate your guidance and help with this matter. They want me to sign the notice card to opt out of Medicare part B by July. If I don't sign the card and mail it in they'll make the penalty adjustments and place me on Medicare A and B again.

Jim's Reply:

Medicare A is required when you begin taking your SSA retirement or SSDI, opting out is very difficult. Medicare B is optional but as you've learned, if you don't take it when first offered the penalty for that can be brutal depending on how many years you delayed.
 

Health insurance is a very personal decision. If you live within easy reach of a VA medical center, that's likely all you need. If you aren't within an easy drive to your clinic, you may want Part B so you can visit civilian physicians at very low cost.
 

I have it all...VA care, Medicare A & B because I'm 3 hours away from my VA hospital and I'm 1 1/2 hours away from my VA primary care clinic. My small community has a very nice and highly rated hospital and a bunch of doctors offices that are less than 10 minutes from my house.
 

You see where I'm going with this. It's a lot more convenient for me to use my Medicare even if it costs me a little more. I do stay connected to VA health care because I like my VA primary care guy a lot and I have all prescriptions filled through VA.
 

You'll have to decide for yourself how much money you want to spend protecting your health and how comfortable you are relying on VA if you do without the extra insurance. Good luck sir.

Question:

Can a Vietnam Vet get disability for ATTR cardiac amyloidosis?

Jim's Reply:

ATTR-CM is thought to be a largely hereditary disease where proteins with unstable structures misfold and aggregate into amyloid fibrils, which deposit in the heart and other organs. 
 

I don't see any way to service connect the condition other than if you were diagnosed on active duty or you can claim that your active duty service somehow aggravated the condition. It is not a presumptive condition so service connection won't be automatic. Good luck.

Question:

I hold a 100% P&T rating from an Agent Orange related cancer. I applied over a year ago for an extra SMC benefit, due to prostate and bladder cancer. I had both the bladder and prostate removed and now wear an appliance. I received a favorable rating concerning the prostate and the appliance, but nothing concerning the bladder cancer. Is this the norm?

Jim's Reply:

If what you tell me is accurate, no...I don't believe that your rating is correct. However, I can't be sure that there isn't a typo that excludes mention of the bladder cancer but doesn't affect the overall rating. That's a frequent happening at your VA.
 

I think that were I in your spot I'd seek a higher level review just to be sure. This won't require a lot of effort for you and it should get you an answer eventually. Keep in mind that your VA is way behind in appeals since they're making so many mistakes during the first try.
 

More info is here https://www.va.gov/decision-reviews/  Good luck sir.

Question:

Can I see if I am schedular or TDIU on my eBenifits? And if so, where can I see it?

If not, where can I go to find out if I'm schedular or TDIU? I'm 100% VA Disability, 30% Navy, where I'm medically retired, not separated. I need to work.

Jim's Reply:

Determining details of ratings can be a challenge. If you are TDIU, in your eBenefits account you'll see language like a 'base rate of 80% paid at 100%' and so on. When you print a benefits letter that same language will insert itself if you are TDIU.

It's all in there but you may have to be persistent to sort it out in your account. Good luck sir.

Question:

Does VA pay any benefit for non service related pacemakers? Thank you.

Jim's Reply:

VHA may take over monitoring your non-service connected pacemaker and providing battery replacements and so on...or they may not. There is no monetary disability benefit for a non-service connected pacemaker device as all rated disability benefits must have a service connection.
 

If you are an active and registered patient who receives VHA services because of a service connected and rated (0%-100%) disabling condition you are likely eligible to be referred to the VHA cardiology service near you.
 

It sounds as if you have been receiving civilian cardiology care, probably paid for by Medicare and/or your private insurer. The copays can be a challenge when we're talking about these high end medical devices and the procedures necessary to get them in our bodies. Checkups and maintenance in the future can also be expensive so it may be worth your while to talk directly with your local or regional VA clinic or hospital to learn if they can accept you as a patient. 
 

If so, you'll get good care and top shelf medical devices at no or very low cost. VA distributes a great many generic drugs but the medical devices they dispense are always brands you know...Siemens, Medtronic, Pacesetter and such so you'll get great services at a lower price.
 

Good luck sir.

Question:

I reviewed some written legal decisions online but am unable to find the website again. Can you tell me where to find written legal case decisions regarding Veterans' cases who were granted and also denied Veteran disability benefits? Thank you!

Jim's Reply:

Good on you for looking up these decisions. This is hugely important and most vets skip it or hand it off to a 'rep' who they don't know. We have to play by the rules to prevail even though it may feel like VA doesn't. The first step is to know what those rules are.
 

Keep in mind that BVA decisions do not set precedent so you can't cite a case similar to yours and be done. You'll have to do what the veteran who won did all over again and even that doesn't guarantee anything.
 

Go here to search BVA decisions. 
 

That link will take you to the BVA home page and you'll see the search link in your browser. I like to keep my searches there brief so I choose only one year at the time. It can be a bit overwhelming if you seek too much.
 

I also use The Federal Register when I need to learn a bit about how a rule was promulgated or modified way back when. It's (sadly) a part of my daily morning reading fix and you can find a lot of interesting things about VA and the rest of your federal government tucked away in their archives. Go to https://www.federalregister.gov/ and work your way through the menus to see topics about VA. You can filter that for dates and so on.
 

You're correct if you're thinking that anyone who reads The Federal Register with their morning coffee must be a bit...focused. All I can say is that if you're a Tolstoy fan, you'll enjoy our Government Publishing Office. 
 

Finally there is 38 CFR Book C, Schedule for Rating Disabilities This set of documents is usually up to date although it can be complex with a lot of cross referencing. It's an indispensable guide to knowing what your rating should be.
 

You're now as well armed as Sun Tzu and ready to take on VA about your claim. Good luck sir.

SIDE NOTE FROM STATESIDELGEAL: 

Jim has given you some really great resources! If you're still having trouble finding where to search BVA decisions, you can find the BVA "Search Decisions" page here. Once on that page, just type your search words into the search bar and it should pull up any decision with those terms.

Question:

My husband is rated 100% permanent and total from PTSD. We are thinking if he did some kind of work, it would help him. Sitting around is not good. Can he do this and still keep the 100%?

Jim's Reply:

If he is rated as 100% disabled by the schedule, he is allowed to work as much as he is able to with no restrictions. If he is rated as 100% TDIU he is limited to earning no more than the amount of the federal poverty wage.
 

Pro tip: If he isn't able to find a suitable job, he should consider volunteer work. Volunteers can work as much as they want to and it won't interfere with VA disability payments. The next time you go to a VA health care facility and see a volunteer, that may well be a totally disabled veteran who was bored at home but couldn't retain gainful employment. I volunteered at my VA clinic and hospital for years when I lived close enough to do so. It was one of the more rewarding experiences of my life.
 

There are many volunteer opportunities in your community too. Just look around and he'll find something that fits. I also advise that when anyone asks, "So, what do you do for a living?" the answer is always the same, "I spent some time in the military and I'm retired now with a little pension." That's all the info anyone needs to hear, you shouldn't bother explaining any further than that. If someone presses for a conversation it's acceptable to politely decline and walk away.
 

A lot of VA counselors in the mental health arena advise their clients to try volunteering. Returning to meaningful work (and volunteering) in the right environment can't be beat. Give him a salute for me. Good luck.

Question:

I was diagnosed with prostate cancer within one year of when I retired after 34 years in boots. Does the fact that the initial appointment that led to the diagnosis was within a year of retiring generate any presumption of service connection? If not, do you have any suggestions for establishing a service connection? I deployed to AFG twice, but (outside of the burn pits in Kabul and Kandahar) was not (as far as I know) around any of the nuclear/chemical/biological stuff that might be tagged as a cause. Thanks.

Jim's Reply:

34 years active? I hardly know what to say. You're made of sturdier stuff than I was. It was the guys like you who kept guys like me from getting killed. Thanks.
 

Yes, there is a presumption of service connection by Title 38 here. You do not need to prove a cause, you just need to show that the disease was diagnosed within one year of separation. Prostate cancer is a malignant tumor that likely began development long before your discharge and even though it wasn't detected, knowing that prostate cancer is a disease that develops slowly over time, it's very like you had the disease for months or years prior to the end of your obligation.
 

Will VA award you the benefit without a fight? I can't predict that but you should go ahead and apply for the benefit. VA doesn't always interpret the rules correctly and this is one of the occasions they often fail. However I'm confident that even if you were required to appeal an initial denial, you'll eventually get the benefit and that will be worth your time. I'd offer that I believe you should file the claim as soon as you are able, tell them the diagnosis was within one year of separation and leave it at that. Don't muddy the water by claiming some HAZMAT influence, keeping it simple is best. Good luck sir.

Question:

Does VA disability pay count as income for low income housing or for HUD housing?

Jim's Reply:

Yes. Every means tested benefit available for low income families wants to count all income no matter the source.
 

Many veterans believe that their disability check is exempt from all that but the only thing exempt is taxes. The disability pay is used in divorce court and loan applications alike as it is real money. Good luck!