Benefits

Question:

I just received an increase in my VA rating from 70% to 100%, but it does not state it is P&T. Does this mean its not permanent?

Jim's Reply:

VA has never tried to make an award simple to understand. To know if your 100% (Total) award is Permanent you have to interpret the award notice. If there are future exams scheduled, the award is temporary. If no future exams are scheduled, the award is most likely to be permanent in nature.
 

If there is mention of having established DEA and/or CHAMPVA benefits for your dependents, then the award is permanent.
 

One day I may make a secret decoder ring available to vets so we can better understand the obtuse VA lexicon. 

Question:

I appealed my character of discharge to the BVA. The BCNR informed me of the upgrade but the BVA has not sent me anything to say the matter was closed. I did get notice from the VBA that the appeal was granted. I have claims that were filed but were not adjudicated because of the character of discharge. When I appealed, I included them on the NOD and Form 9 as issues that I was appealing but no SOC was ever issued. Can I ask the BVA to have the RO consider those claims and if denied, issue a SOC as it states in 38 CFR 19.9?

Jim's Reply:

I'm not sure I follow you? You say you appealed your discharge to the BVA but the BVA isn't the place where we appeal our less than honorable paper. In your case the place you appealed your discharge to was the Board For Correction of Naval Records. The VA doesn't have the authority to upgrade a bad discharge paper.
 

If your discharge appeal to BCNR was successful, then your VBA denial could be appealed through the BVA. I'll assume that's the path you've taken and that you're now waiting for the finalized determination of all your paperwork.
 

You'll have to be patient for a bit. The VBA and the BVA are so backed up in records keeping and issuing the proper results of claims and appeals I seriously wonder if they can ever catch up. The pandemic struck a very hard blow to your VA and it's going to take a long while to catch up.
 

I'll assume that your paperwork is delayed in the mess left by the COVID pandemic. You can assume it's going to take weeks or months for VA to sort it out. During the time you're waiting you can file all the things you mention and more. 
 

I wouldn't ordinarily recommend that you do that but in our current state of processing of claims and appeals, you need to timely file and hope VA catches up.
 

Good luck.

Question:

Hi. I was having serious knee pain while I was active but couldn't think of any specific injury that may have caused it. While being seen, I was told I had runners knee and was given an MRI. They noticed I had an Osteochondroma. At the time it wasn't bothering me but I still asked if it could be removed. I understand why they didn't want to (not broke, don't fix it). My question is, if the VA has my knee pain at 10% and they attached my osteochondroma to that 2 years later, what effective date do they use for the osteochondroma? Does the date go back to the initial claim or a new one?

Jim's Reply:

Effective dates begin at the date a claim is made. If another claim is made that is secondary to the first claim, a new effective date for that claim would occur. The secondary claim would not date back to the effective date of the primary claim.

Question:

I’m a Navy veteran. I spent 13 months in Viet Nam 1965-66. I was a storekeeper and worked mostly in Chu-Lai offloading and transporting stuff. In October 2018 I was diagnosed with essential hemorrhagic thrombocytemia and treated accordingly. I filed a claim with VA and was ultimately denied A couple of months ago I had a bone marrow biopsy, and it revealed a firm diagnosis of MDS. I’m 100% P&T and would like my wife to receive part of my pension if it kills me. Any thoughts?

Jim's Reply:

Thoughts? Sure.
 

VA takes some care of dependents of vets who die of service connected conditions. She won't get a part of your pension, DIC is a separate benefit. If you are rated at 100% P & T for 10 uninterrupted years, you can die of anything and your dependent survivor will be eligible for DIC. More is here https://www.vawatchdog.org/dic---survivor-benefits.html  

P.S. from StatesideLegal:

Information on Survivor Pensions might also be useful to you given your wartime service. You can find Survivor Pension information here.

You can also find more information about Dependent and Indemnity Compensation here.

Question:

I was successful on several appeals from the Board of Veterans Appeals. I was then scheduled for exams regarding those granted appeals. I was told that I would see any monetary benefits owed to me within 1 to 2 months. I still have not received any benefits from the awards as yet. Can you tell me if there is a reason I don't have the money yet? Should I be more patient after all these years of waiting so far?  What exactly would you recommend?

Jim's Reply:

Three or four years ago your VA was touting progress that was being made in reducing the backlog of veterans disability claims and appeals. Then it became apparent that not all was well. The BVA was suddenly months and even years behind and the VBA was starting to lag a bit.
 

Then COVID struck. The VA did remarkably well to process anything at all so they get some credit. The NPRC...the place where all paper records are kept has been closed for months and all other normal processes have slowed considerably.
 

Nonetheless, claims and appeals are being processed even though they may be months and months behind schedule. I don't have anything much other than you'll have to continue to be patient. There is another option...call the White House Hotline at (855) 948-2311 and see if they can get it unstuck for you. Good luck.

Question:

Hi Jim, I was wondering if I have both 100% P&T and 100% TDIU am I able to go back to work? How do I navigate having both?

Jim's Reply:

You don't have both. That isn't possible. If a mistake has been made and you're collecting the money for both 100% ratings, don't spend it whatever you do. VA will want it back.
 

It happens often enough that because of changing circumstances the rating may change from 100% TDIU to 100% Schedular. Because of the significant lag time involved in processing paperwork when a veteran has a change to a rating that shifts a 100% TDIU rating to a 100% Schedular rating it may often appear that you have both ratings. It's rare that the vet actually receives both monthly payments but again, a mistake has been made and VA will want their money back so don't spend it.
 

Disability ratings over the 100% level enter Special Monthly Compensation territory and a whole new ratings schedule opens up.
 

Study your award notices a bit longer and I imagine this will work itself out. If I've missed some special circumstance, feel free to let me know.

Question:

I am 100%service connected. My VA doctor is 4hrs away. So I am going to take Part B. My concern is pharmacy. How long do you wait for your meds to come if it's a new prescription? What if I don't have a set VA doctor? Mine leave every six months.

Jim's Reply:

You and I are in the same situation. I use Part B for much of my health care and I rely on VA pharmacy for all my meds. You're in luck. The VA pharmacy service is probably the best benefit we're offered.  It works really well once you get used to the timing and your own role in keeping up. For many of us who are fortunate enough to be getting older, the VA pharmacy benefit saves thousands upon thousands of dollars...the financial bonus shouldn't be underestimated.
 

You usually have to visit your VA primary care provider to initiate any prescription. If an outside or civilian provider writes you a prescription and if it isn't urgent, you can copy that to your VA provider using "secure messaging" on the HealthEvet service and most often that provider will authorize it and it'll be mailed out to you.
 

You're required to see your VA provider once each year to remain active in the VA program. At that visit all your chronic (blood pressure, diabetes, etc.) prescriptions will be refilled for a year, usually in 30 to 90 day increments. From that point it's up to you to stay on top of it and use the medication refill services on the HealthEvet site. 
 

Staying ahead of your prescription refills is now up to you. I suggest that you get familiar with both the secure messaging and the refill services as each has it's quirks, depending on whether you're using a desktop, your smartphone or a pad to navigate the site. Practice and get familiar with how it works well before you need it...it can be frustrating until you do this. Don't wait until you need a medicine to reorder it, the site is often down a day or two for maintenance.
 

The trick is that as soon as you get a refill of a medicine in the mail, go to the web site and tic the box to request your next refill. Once you do that you'll learn that the pharm service will mail it to you a couple days ahead of time so you'll always have a supply in case of emergency. I try to stock up at least 30 days of everything and I keep it ready to go. I live in a region prone to hurricanes and we evacuate to avoid the storms every couple years and I like knowing I have a cushion of my prescription medications should bad things happen.
 

If you need adjustments during all this, using secure messaging to tell your provider usually gets a quick response. Even if your provider has changed your records will be there for any new provider and any problems can usually be resolved in quick email (secure) messages.
 

If you visit a civilian provider and you are prescribed a medicine that you need right now (an antibiotic for example) you can seek a local pharmacy or find another solution by following the guidelines here.
 

I'm thinking that between Part B and the VA pharmacy benefit that I'm fortunate to have access to the great majority of health care that I need at a very low out of pocket cost. This becomes more important every year.
 

Good luck!

Question:

Hello Jim, You have directed me in the past and would like your opinion. I'm 100% PT, over 10 yrs, age over 60. My doctor accepts my VA and I have Tricare as a back-up. Do I need to have Medicare Part B with both VA and Tricare for life when I reach 65? If so why would you recommend all 3 vs just VA and Tricare? 

Jim's Reply:

I hear you...Interestingly, only a veteran will be questioning whether we have too many health care choices. Our options are plentiful as a result of our honorable military service and that's a good thing. I was a military brat and never understood why my young civlian peers didn't enjoy the Navy hospitals and doctors and medics I got to see.
 

I've advised for a long while now that the amount of health insurance one carries has to be tailored to the individual. If you are eligible for VA care and you live within reasonable distance of a reliable VA facility, and you're happy with your care, you're done. If you aren't sure that your VA facility will meet your personal needs over time, then you look at your options. 
 

Emergency care is a big concern. Yeah, sure...VA is supposed to take care of any civilian emergency bills but a lot of vets are being sued by bill collectors right now so I wouldn't count on that. Part B covers a ton of the costs associated with emergency care so if a VA medical center isn't nearby, Part B may be wise.
 

Tricare always introduces a few curves by not being accepted by all providers. OK, right...that's true of any insurance but there have been a lot of changes to Tricare over the years so before you rely on it be sure it'll work for you where you are. If it works for you, you're done.
 

VA health care offers a pharmacy service (Meds By Mail) that is outstanding. Part B offers zilch for pharmacy and I'm unsure of how your particular Tricare coverage responds to prescriptions.
 

In a nutshell, your tolerance to risks (availability, financial, emergency care) and your own assessment of your current and future needs will be what will guide your choices. I get along really well with Medicare Part A & B and I use my VA care mostly for medicines. 
 

Making all the choices is a pain...of a good kind. Good luck.