Benefits

Question:

Does ChampVA provide the same coverage if I'm traveling to Nigeria?  If I fall sick while visiting there, will ChampVA pay my claims?

Jim's Reply:

Foreign travel and any health insurance can get overwhelmingly complex in a heartbeat even if you're insured with an insurance company you're paying high premiums to. CHAMPVA is great health insurance but obtaining it can be sketchy and a cumbersome burden to deal with even when you're in a state next door to a VA facility. If you're sick in Nigeria and you need the support of the folks at CHAMPVA all I can see are problems and then more problems.
 

Were I stepping anywhere outside our borders today I'd want to double-check that I have robust health insurance. The VA has a Foreign Medical Program that provides a lot of help for eligible veterans. This seems a good place for you to start and learn how CHAMPVA may help. Good luck.

Question:

I was in Vietnam in 1969 and 1970. I have terminal prostate cancer. Will the VA consider this a presumptive disability for Agent Orange? If so, how long after filing does it take to receive compensation? Thanks for your help.

Jim's Reply:

Yes, prostate cancer is a service connected condition for the Vietnam veteran. Once you've properly filed the process should take 3 to 6 months on average. Since this is a presumptive disease there isn't as much paper that must be verified. Good luck sir.

Question:

My father was stationed in Germany in the army in the mid sixties. He was told by VA that he isn't eligible for benefits due to he wasn't boots on the ground in Vietnam. Is this true? Would he be eligible for something?

Jim's Reply:

I may have known him. I was stationed in Germany at the 98th General Hospital in the late 60's. You never know who you may have crossed paths with.
 

Not eligible for benefits? He misunderstood or there's more to the story. I never went to Vietnam either and I've used my education benefits, home loan benefits, health care benefits, and disability benefits.
 

The only thing we aren't eligible for would be the wide array of disability benefits attributed to exposure to agent orange. There are plenty of diseases caused or contributed to by agent orange and to receive those benefits you must have been boots on the ground in the RVN or a related category.
 

Disability benefits don't require service in a combat zone. Military life and training is rougher than any other labor and accidents happen so most who seek disability ratings never walked into a combat zone.
 

He is eligible for everything I'm eligible for. Start here https://benefits.va.gov/benefits/ 

Question:

I recently received a letter from the VA stating my conditions were static ( no future exams needed). I want to apply for TPD forgiveness on my student loans but it says you have to be 100% totally and permanent before it can be awarded. Is Static considered permanent? What options do I have?

Jim's Reply:

Your VA is infamous for obtuse phrasing of any and all regulations, awards and instructions. I've often compared dealing with your VA to how Alice must have felt when she fell through that looking glass. Up is down and Cheshire cats speak to you all while tea parties are held in your honor. You have to learn VASpeak or you will never understand them.
 

The term static is used by VA to denote a permanent condition. If you are 100% rated by VA and they're telling you that the condition is static (permanent) and no further exams are scheduled, you may proceed to seek dismissal of your student loans. Good luck.

Question:

Received a Fed X from LHI stating the VBS requested that we coordinate an exam on your behalf. It’s a telephone exam. “An ACE exam will insure that your claim is being expedited and eliminates any need for travel.” I am on 100% temp disability due to non aggressive, watchful waiting prostate cancer. Checks have always been on time.

My first biopsy was in March 2020 and a second one is is scheduled for March 2022. Why the need for this? I am seeing a private sector doctor. My PSA readings at his office was about 10. Here is one thing I noticed. My VA doctor does routing blood work for Cholesterol and does not order PSA but this time they did the Cholesterol blood and it was an 8 which is still high. Are they playing games with me? Trying to reduce my 100%?

LHI said have your medications to list and otherwise I don’t have to do anything. I will be truthful and as I see it there is no issue. Assume my biopsy comes back with no change we will continue watchful waiting and schedule another biopsy for 18-24 months out. I am 75, a Vietnam vet and in good health. Have you had experience with LCI? Again, I thank you for your service and good work on this most necessary cause. 

Jim's Reply:

What you're experiencing is routine, SOP, the way it's done at your VA. There is a process and VA is as process driven an organization as you'll ever find. To be honest, they aren't very good at it but that doesn't matter. They think they are and they have the keys.
 

There is no reason to complain or to try and change the process. Once you become a member of Congress you can work on that but until then, it's a lot easier to do the little inconvenient senseless things as they come up. 
 

I'm actually pleasantly surprised that they're talking about using the ACE process. The fact that you're being subjected to the exam is pretty pointless but at least you aren't being told to come in for a face to face...as it were.
 

The VA process to manage watchful waiting in a service connected prostate cancer isn't outmoded, it was never put in place. Every cancer, according to 1950s VA philosophy, will be treated aggressively and every cancer will be cured. Until the cancer is treated and cured the veteran is rated at 100% disabled on a temporary award. Once the treatments are completed and the veteran is free of cancer, there are C & P exams (future exams) that are mandated to evaluate any residual disabling conditions from the treatments. VA anticipates treatments will be immediate and you'll be all better soon.
 

With the prostate cancer patient the residuals are usually incontinence and frequency of urination. The veteran may also file for erectile dysfunction, a common residual effect of prostate cancer treatment.
 

The process is so deeply ingrained in the VA DNA that you can't escape it no matter how inane it may be. 
 

Are they trying to reduce your 100% rating? Yes, of course they are. I've worked with veterans who were taking blood pressure drugs and VA decided that was a cancer treatment and reduced the prostate cancer rating. Anticipate that no matter what you do you will get a notice telling you your rating is being reduced. This is annoying but simple to appeal with no interruption to your benefits.
 

Don't buck the system. There is no point in trying to change things for the better, you're wasting your time. In your spare time, write to your representatives, for now stick to the script.
 

When you speak with the LHI examiner be courteous, friendly and precise. Only answer questions posed to you, don't go rogue with all your problems and concerns. Stick to your script that nothing has changed, there have been no treatments and that you still have cancer. You will be asked about symptoms like incontinence and you should answer accurately and truthfully.
 

This is a perfect example of why VA doesn't work. The inefficiency of the C & P process is astounding and of course, there's a profit motive...money is being made on your back. The C & P examiners are contract employees, many are former VA employees.
 

They are paid piecemeal so every nonsensical examination earns them a fee. The more the merrier.
 

No matter who you are or what is happening with your claim, there will be unnecessary and redundant C & P exams built in along the way. It's VA tradition and not likely to change.
 

Good luck sir.

Question:

In the past I was able to have my blood work done at my family doctor's office and I brought a copy of it to my VA yearly exam. My problem is that the VA has a hard time taking my blood without trying several times. My old VA doctor has retired and now my new doctor says that I have to have my blood work done by the VA or I'll lose my all my prescriptions.

Jim's Reply:

There are 2 reasons that VA doctors want you to have your labs done at the VA. 
 

They'll tell you that different labs have different standards that 'values' are measured by. The doctor wants to see what he or she is used to seeing and trusts. This is sort of legit, sort of bogus. Although one lab may have a different range of values for a given test, the report clearly states what those values are and it gives you the normal and abnormal limits. Any competent caregiver can look at any lab's work and figure it out with no problems.
 

The real reason is that they want to be sure you're drug tested. The VA screens everyone who walks through the doors for substance use and abuse. If you pop positive on a drug test nothing will happen to your benefits but some of your prescriptions may be altered. If you currently take any opioid or other drugs that are prescribed by a mental health provider VA may stop filling those prescriptions for you.
 

I support VA treating substance abuse as a health problem rather than a criminal matter. I do not support the clandestine approach that VA typically takes with every encounter. 
 

So far as VA having trouble drawing your blood...that isn't VA, that's the person drawing it. It can happen anywhere to anyone...former phlebotomist speaking. I was one who could draw blood from a stone and I occasionally missed. After 2 unsuccessful sticks, politely ask for another phlebotomist.
 

Don't use that as an excuse to avoid VA. Good luck!

Question:

Hi Jim, I am currently 100% disabled veteran, I want to file for either Aid and Attendance or House Bound. I spend most of my time in bed due to my disabilities and requires some aid for my daily activities. Which of the two should I pursue? Thank you.

Jim's Reply:

It sounds as if the A & A benefit may fit your circumstances best. However, I can tell you that either benefit can be an uphill climb to get to.
 

The key to a smooth application process is attention to detail when completing the VA Form 21-2680 https://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf 
 

Attention must be paid to each and every activity of daily living (ADL) even when the VA doesn't emphasize the importance of a particular activity. If someone must remind you each day to floss and brush your teeth, that small detail should be mentioned. You'll see that the form asks that you use extra paper if necessary and I can only comment that you should have plenty of attachments documenting your daily challenges and struggles.
 

As a rule I like to open a claim with VA by providing them with overwhelming evidence right from the start. If we do that then our chances of prevailing in short order are a lot better than if we leave anything to doubt.
 

So...go for it but do your homework up front. Provide the rater who will make the decision with so much supporting documentation that he or she has no choice but to grant your application.
 

Good luck!

Question:

Hi Jim, I am a disabled vet rated by the VA at 90%, yet paid at 100% IU. My family and I would like to start a bee farm and, due to other circumstances, would only be able to do so if the business was established in my name as this would allow us to utilize USDA and SBA funding resources granted to veterans. My concern is that the VA will then view me as employable, despite the fact that I would have very limited ability to actively participate in the business. I do not want to jeopardize my VA benefits, so I'm thinking the solution might be to request the VA review my case and transition my rating to 100% P&T, as all of my conditions have worsened since my medical discharge in 2002. Is this even possible? Am I on the right track or is there another way to try and help my family build a future without losing my benefits? Thank you!!

Jim's Reply:

You do not ever want to ask VA to review your TDIU. Never. You have to be careful what you ask VA, you never know what you'll receive. Think of what you'll tell them with such a request..."I can work but I don't want to lose my 100% benefits for not being able to work so please rate me at 100% even though I'm technically not eligible. Please."
 

You are allowed to work and earn under the amount of the federal poverty line. This may come in the form of marginal employment (under the poverty wage line) or 'sheltered employment'. The term sheltered employment often refers to family run businesses.
 

There is so much varying information about how all this works available that I'm hesitant to link you to a single source. So that you see all that's available from dozens of source, do a search for <TDIU sheltered marginal employment> and learn all there is to know about your options.
 

In a nutshell, when you incorporate your business in your state VA will track the SSA and IRS filings to see how much you earn over time. If it appears you're making too much money, you'll receive a VA form 4140 which will begin a Q & A to ensure that you aren't earning megabucks. 
 

I'm enthused about your choice of a bee farm. That's an industry that needs some attention and I'm glad to know you're on it.
 

Good luck.

Question:

If the purpose of a COLA is to maintain the buying power of a previously determined value, under what theory does the VA decrease my caretaker's benefit based on my Social Security Retirement COLA?

Jim's Reply:

Hmm...that's an interesting definition of why there is a COLA .
 

However, since it's well known to those around me that I'm no financial wizard I'll just say many social welfare benefits are offset by other social welfare benefits to prevent what is often called concurrent receipt or double dipping. 
 

When social welfare benefits are awarded for a similar cause there are often dollar limits that restrict the overall dollar amount that the beneficiary receives. This is very common with all sorts of state and federal benefit awards. If you receive a benefit for a low income situation and that situation changes, the benefit will adjust accordingly.
 

Is this palatable for everyone? No, I guess it isn't. Is it legal? Sure it is...you just have to read the fine print for the benefits you receive.
 

I can't address your situation directly since I don't know the authority that provides your benefits but in the end, offsets are routine to prevent concurrent receipt of benefits.

Question:

Hello Jim,

I am 100 percent disabled Vietnam vet. My heart valve was bad. No one in my family has heart disease. Now my 34 year old son had to have a pacemaker put in. My question is: Does this qualify him for VA compensation and healthcare benefits? thank you.

Jim's Reply:

No, your son isn't eligible for benefits for having a pacemaker implanted. I don't see any way to link your military service to his current illness. In fact, I'm not sure what you're rated at 100% for? Heart valve problems aren't linked to agent orange so I'm having a difficult time understanding how you're rated.
 

I'm sorry to hear all of this going on but I don't see any additional benefits. Good luck sir.