Benefits

Question:

My husband was in Vietnam. Because of Agent Orange exposure he has a 100% temporary disability for non-hodgkin's lymphoma. Recently he had a heart attack, and applied for expanded rating due to an implanted defibrillator (100% left ventricle closed, about a 35% overall heart rating). The VA approved 60% disability for heart. It doesn't say whether this is permanent on his paperwork. There is no plan to remove the ICD. Prior to his cancer he had a 30% disability for hearing loss. My question is when would he be rated Permanent and Total?

Jim's Reply:

You'll have to file an appeal, an error has occurred. The AICD-defibrillator alone is a 100% rating. That should stack on top of the 100% & 60% rating already in place. Yes, the AICD should be rated as permanent. It's likely that because of his age the n-Hl should be a permanent rating.
 

You'll need to file a formal appeal to get anything done. I'd like for you to speak with a veterans law attorney to help you with sorting this out. This will not cost you any money out of your pocket and no money at all until you prevail and get retroactive pay.
 

The only way to resolve this and to insure that he gets all he earned by his honorable service is to formally appeal and the case is complex enough to require the services of an accredited veterans law attorney. He has enough going on with his health that he should be cautious that VA doesn't leave out a substantial payment.
 

Please click here https://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html and contact any or all of the attorneys you'll meet on that page. Good luck.

Question:

We were Denied our appeal for care givers benefits and wish to pursue it to the next level, as my husband needs supervision due to a brain injury. He was rated at 70 percent associated with PTSD and received a rating of 100 percent due to unemployability. While in a facility addressing PTSD and depression, he was given ECT and he contracted encyclopedias which caused a stroke. The stroke left him with impaired cognitive abilities. The VA made me his fiduciary, however they determined he doesn’t need supervision. Please explain the next steps to appeal this decision.

Jim's Reply:

The decision to deny caregiver benefits is made within the medical facility. Your must appeal to the director of the facility. That VA would appoint a fiduciary because he needs supervision and then deny the caregiver role because he's capable of caring for himself is no surprise. VA contradicts itself all the time...old habits are hard to break.
 

This is all explained in detail here. 
 

I also think that you may benefit by discussing the fiduciary appointment with a veterans law attorney. The VA fidu program doesn't function very well and is often unnecessary and burdensome to you for any number of reasons. To appeal the appointment of a fiduciary is complex and often requires the skill of an experienced lawyer. You can speak to the veterans law attorneys who I refer most to here and it won't cost you any money out of your pocket. Please make contact with any or all of them to get the help you deserve.
 

I also hear you saying that he was caused a stroke by VA medical care. You really need to discuss medical malpractice with an experienced attorney.
 

In fact, developing a relationship with a veterans law attorney today is a pretty good plan for the future. You have a complex scenario on your hands as the caregiver of a seriously injured veteran. You should prepare today for the inevitable uphill battles you'll face.
 

Thank you for caring for your injured and disabled veteran husband. It takes courage to be a wartime wife and care for a soldier who gave so much. Good luck.

Question:

I qualify for CHAMPVA the effective date will be my effective date of my 100% P&T rating. Once I get my card I want to cancel my employer  provided insurance to save some money. The problem is they are saying it has to be canceled within 30 days of a life event. But I won't have coverage or a card for a few months. CHAMPVA will backdate coverage but I could not afford if something happened between now and then. Do you have any suggestions how to get around the 30 day IRS rule? Thank you.

Jim's Reply:

I'm not sure which IRS rule you're speaking of? To be clear, I'm not expert on IRS rules and regs, far from it. But I don't know of any such rule. Over the years many veterans I know (including my wife) have stopped paying for civilian insurance and switched to CHAMPVA with no issues. I recommend that the beneficiary visit with the primary care physician one wants to be associated with and talk with their insurance and billing folks and then go for it.

CHAMPVA is great insurance if you're patient and be sure to get preapprovals and so on.

Many will keep their civilian insurance for weeks or even months as they transition...a personal choice depending on individual circumstances and finances.

I'd suggest that you review whatever policy it is you're looking at and then make a decision whether to invest more money into being assured of any emergency care or just diving right in. Good luck.

Question:

I am a Vietnam vet. Service connected due to conditions related to agent orange. In 2019, I was diagnosed with hypothyroidism, which I take meds to control. If I file a claim, is this treated same as the 14 presumptive condition? If so how do I get started?

Jim's Reply:

Hypothyroidism is not an agent orange presumptive condition. However, it's my experience that many Vietnam veterans who have a service connected diabetes rating also have hypothyroidism. I've known veterans who claimed hypothyroidism as a secondary condition to their service connected diabetes and prevailed.
 

I'll also take a moment to comment that it's my experience that there is a sort of interaction between hypothyroidism and diabetes that can make each disease worse over time. Please be sure to recognize the connection and take care of yourself.
 

You can learn more about how VA views these diseases by going to the BVA search engine here.   Use key words like <hypothyroidism diabetes> and you'll have dozens of appeals to review. Appeals do not establish precedence in the VA system so when you find a favorable outcome, you should plan to repeat the successful processes you see there.
 

Since hypothyroidism isn't a presumptive condition there isn't a sure-fire way to file for it. It's been my habit to suggest filing for the condition as secondary to service connected DMII and waiting for a denial and then seeking an IMO for an appeal.
 

An IMO is the surest way to prevail. If you obtain a favorable, professional IMO as you file the claim, it's likely that you can avoid the lengthy appeals process.
 

The IMO is explained here.   Any of the doctors you'll meet there will be happy to speak with you about your claim.
 

To get started I'd recommend that you file an 'Intent To File' here so that the effective date of your claim is set. Then proceed to file the claim as usual, see how here.
 

Good luck.

Question:

I have been drawing a non-service related pension and SSDI for nine years. Can I buy a home through the V.A. with that income without being penalized by the VA? Thanks Jim!

Jim's Reply:

Hmm. Well, in theory...yes. To use your VA loan certificate you need an honorable discharge and that's pretty much all. However, that is the tip of the huge iceberg. Once you have your certificate in hand you must find a lender. VA doesn't lend money, you have to find a bank or mortgage lending service who will loan you money based on your income, past income and creditworthiness. 
 

You tell me that you have a VA pension and SSDI as your only income. That you're drawing VA pension tells me that you're very low income and I'll assume that the SSDI offsets much of the pension payment. Whatever a home costs where you are is what you must borrow and you must show that you're a good risk to get that much money.
 

Homes today are expensive, very expensive. Lenders are often free with the money so long as you're a good risk. Having said that, I'm having a hard time with thinking of a lender who would accept your income as adequate to make a purchase even with the VA certificate in support. You can try but be aware of the hurdles you face.
 

Good luck.

Question:

My ex-wife filed for an apportionment of my VA Disability years ago and was awarded $170.00 per month for her and our children (she also has received child support from my employer). My children are all grown now and out of school, and she was remarried over 10 years ago. What do I need to do to get the apportionment stopped? My service connected rating is only 30%.

Jim's Reply:

There are a couple of considerations. Are you paying alimony or child support or both? If you're paying alimony and you're consistently caught up and always pay on time, you can provide proof of that to VA and ask that your apportionment end. 
 

If you had been paying child support without alimony and that child support has ended, you need to show VA that the children are no longer dependents and that you have no further child support obligation.
 

If you aren't sure about your obligations you really should speak with a lawyer in your region who is expert in family law. I can see a situation that may require you to return to a court that holds jurisdiction today and have a formal record that your obligations have ended before VA will do anything. Anything you may pay a local family lawyer will be worth it over the long run. Good luck.

Question:

My 6 year contract was October 1974 thru October 1980. I was inactive reserve from October 1974 until June 1975 when I started my active duty enlistment. I ended my service as inactive reserves again until October 1980. Though I didn’t start active duty until June 1975, does the inactive reserve period of October 1974 to June 1975 qualify me for Vietnam era vet? In total, I was USN 4 years active, 2 years inactive reserve.

Jim's Reply:

For VA purposes, in accordance with the Code of Federal Regulations Chapter 38 Paragraph 3.2 (f), the Vietnam Era is "The period beginning on February 28, 1961, and ending on May 7, 1975, inclusive, in the case of a veteran who served in the Republic of Vietnam during that period. The period beginning on August 5, 1964, and ending on May 7, 1975, inclusive, in all other cases."
 

 - Source: https://en.wikipedia.org/wiki/Vietnam_Era
 

Inactive reserve doesn't count for anything in particular in reference to benefits. Your time in the military is measured in terms of active duty for other than training. If your active duty began in June 1975 you are not a Vietnam era veteran.
 

Question:

If a veteran has already started drawing social security, and then becomes permanently and totally disabled due to military service, can the veteran then get an additional amount from social security due to their disability status?

Jim's Reply:

Disabled folk often qualify for SSDI...Social Security Disability Insurance. It's a bit of a laborious process to get though but if the applicant is eligible he or she will receive benefits equal to their SSA full retirement age...the maximum benefit. When the beneficiary is old enough to begin to collect SSA retirement benefits the SSDI will quietly convert to the full retirement age benefit.
 

The SSA even makes a few allowances to speed processing for the veteran who is rated 100% P & T disabled by the VA on the application for SSDI.
 

Beyond that there is no other benefit. You tell me that you're collecting your SSA retirement so you aren't eligible to apply for SSDI. The good news is that there is no offset when you receive both benefits. Good luck.

Question:

My uncle suffers a significant hearing loss that his VA physician suggests may be caused by his service in an artillery unit during the Vietnam War. We need a local doctor (Atlanta GA) who can provide him a nexus letter so that he can seek disability benefits.

Jim's Reply:

He doesn't need another opinion, he needs to file the claim. His service in an artillery unit will be recognized in his records, likely on his DD-214. When he files the claim for hearing loss he'll be examined by an audiologist to determine the degree of hearing loss he has. He may be prescribed hearing aids during this process. If he is prescribed and receives hearing aids that will not affect his claim.
 

Once the hearing exam is complete the results will be dispatched to a rater at a regional office who will adjudicate and close the claim. That he served in an artillery unit during the Vietnam war is all the evidence necessary to receive a rating.
 

Only if he is denied, an unlikely option, should he consider paying for an opinion. This shouldn't be any problem. And...don't forget to file for tinnitus, ringing in the ears. That is usually connected to hearing loss and is a separate rating that must be claimed.
 

Thanks for helping your uncle! Good luck.

Question:

I’m a Gulf War vet and after 8 years of appeals, the VA recently service connected NHL at 100% due to exposures to environmental hazards. I’m currently in remission so I know the 100% rating is temp. I want to file for secondary conditions or residuals. I've already experienced and continue to deal with anxiety, depression, chronic fatigue, dental replacement surgery (I have full dentures now), insomnia, body aches & pains, etc. These are all things common for cancer survivors. Do I need a nexus letter from both my oncologist and dentist?? Thanks for your time! 

Jim's Reply:

Yes. However, it's not likely that your VA providers will do what you need them to do. Even civilian providers who aren't experienced with the VA won't know the language that needs to be used or the process that VA goes by to adjudicate your claim.
 

You'll need an Independent Medical Opinion (IMO) done by a physician who is expert in VA disability medicine. The physician you choose will be able to address the dental conditions...I doubt you'll need a dentist opinion. 
 

Click here to meet the doctors I have referred to for many years. Good luck.