Benefits

Question:

Jim, I retired from the U.S. Army in November 1988. Currently I am rated at 80%. Part of my 80% rating was Coronary Artery Disease (rated at 30% individually) in August 2014. In December of last year (2020) I was admitted to the Hospital for Triple by-pass surgery, and am currently still recovering. My question is, do I have a possible claim to request an increase of my individual 30% rating to a higher rating?  Thank you for your assistance.

Jim's Reply:

Yes, absolutely. In fact once you have that surgery you should be rated at 100% on a temporary basis as you recover. You must notify VA that you've had the surgery...in a nutshell, you must make a claim and tell them what's up. You should be receiving 100% from the day of surgery.
 

When you recover you'll have another C & P exam and then a more appropriate and permanent rating will be evaluated. Good luck.

Question:

I have applied for SSDI 3 times since 2011 only to be denied twice and finally approved. I put the most recent app in on 5/2020 and was eventually approved on 1/1/21. My letter of approval states my benefit amount and other items but also gives me a disability onset date of 11/2015. Crazy thing is, my second app was submitted to Social Security on 06/09/2015. Back then, as far as I know, I was denied and never heard anything until I filed again in 05/20.

Of course I was paid 12 months of back pay but they used the 05/20 application date to figure that . My question is: why, since they have given me a onset date of 2015, isn't that the back pay date since I had an app in during that time? This makes no sense to me. I can show my application and the notice of receipt from SS dated in 05/2015.
 

Jim's Reply:

I'm sorry but I'm sure you'll understand when I tell you I don't know why that decision was made...not a clue. As a rule there will be an explanation of why the decision was made the way it was somewhere in your papers.
 

When we run into decisions like this, particularly decisions about effective dates of claims, we may have to dig really deep to learn what the decision maker was thinking.
 

You'll have to gather every record you can and do some studying to see if you can learn why? If not, you may have to query the SSA office to see if they can help. Good luck!

Question:

When I'm passed away does my spouse get anything from my medically retired benefits? I also get SS disability.

Jim's Reply:

Your spouse may get some benefits. Or not. If you die of a rated disability your spouse may be eligible for DIC benefits. Or not. Now is the time to plan.
 

The benefits that will be available are varied and depend a lot on the circumstances of your death and so on. I urge vets to plan now and have a will as well as all the VA documents your survivors will need. Your local funeral home will be able to provide you with a lot of free counseling and materials to guide you through the process. Most funeral directors are familiar with all the VA regs and processes for getting you into a national cemetery or one close to home.
 

Wills and other probate discussions can be a challenge but this is a necessary part of being a veteran...you're responsible for getting this done. Start here https://www.vawatchdog.org/dic---survivor-benefits.html and get your will done. Good luck!

Question:

Is there a VA FACILITY that encompasses a hospital/rehabilitation/job placement or disability benefits all in one place for veterans? If so, what are the ratings and where are they located? Thank you for your service and your continued service in this!!

Jim's Reply:

The short answer is no, there is no such centralized service.
 

Ratings? The VA has it's own internal rating system and according to that everything they do is peachy-keen, fist rate, couldn't be better. Many veterans disagree with that. The VA has an Inspector General function that may offer some insight to the various failings and successes of your VA.
 

The Department of Veterans Affairs is the 2nd largest federal agency in America, the largest health care provider in America and is made up of 3 main divisions, the Veterans Benefits Administration, The Veterans Health Administration and the National Cemetery Administration.
 

These divisions operate independently of each other, reporting through their command structures to a Central Office in DC  (VACO) and they work together to properly serve veterans. Since each of these 3 divisions of the VA are as large as they are, each one will have internal programs that often enough will overlap or compliment similar programs in another division.
 

Thus...most (disability, pension, family, education) benefits issues are managed through the VBA at regional offices, health (primary, emergency, specialty, rehab) care is managed via the VHA at hospitals and clinics everywhere and job placement programs, legal aid, homeless vet help and such are scattered about through the individual agencies. 
 

The cemetery folk will bury us after everyone else is finished. They're pretty dependable if you are...timing is everything.
 

Programs to benefit dependents like CHAMPVA & DEA often seem to be in a world of their own...nobody is quite sure who they work for? Education benefits and fiduciary programs are also sometimes wild cards. As if that weren't enough we now have a civilian health care program that ties into the VHA and keeping track of that is its own task.
 

Navigating the VA takes patience and persistence.
 

The VA has some terrific benefits for those who are willing to take time to learn about them. Good luck.

Question:

Can a veteran be 100% T&P and also receive individual unemployment?  I was just rated at 100% T&P and live in Southern California. $3100 ish per month is not enough for me to live on.

Jim's Reply:

Yes. The Permanent and Total (P & T) tag only means that the rating is total (T=100%) and that no future exams are scheduled (Permanent). The individual unemployability (TDIU) benefit is total (100%) and it may or may not be permanent (The P part of the equation.)
 

If you are rated as TDIU and it is permanent, (P & T) you are allowed to earn income up to your regions federal poverty wage. Often enough that's enough to live reasonably well although I understand your SoCal life is a bit pricier than most.
 

If you are capable of returning to work and you can earn an income that would make you much more comfortable, you can give up the TDIU, keep your base rating and do well for yourself. All you have to do is to do it...VA will figure it out eventually and you can go from there. Good luck.

Question:

I had ulcerative colitis (sc), then had surgery, and now have ileostomy. I also now have a hernia around it. Does that qualify me for VA disability?  After my C & P for ileostomy, they gave me 10 percent more for my colitis, but I don't know why. 

Jim's Reply:

If you have a service connection for ulcerative colitis and you had surgery to remove that section of your colon, your condition should be rated at 100% after surgery and then at much the same rate for your lifetime.
 

7323 Colitis, ulcerative:

Pronounced; resulting in marked malnutrition, anemia, and general debility, or with serious complication as liver abscess 100

Severe; with numerous attacks a year and malnutrition, the health only fair during remissions. 60

Moderately severe; with frequent exacerbations 30

Moderate; with infrequent exacerbations 10

Were I you I'd run all this past a veterans law attorney to learn if mistakes have been made. That won't cost you anything and you'll have a professional to help you understand what happened. If mistakes were made your attorney will help you file the necessary appeals to set it straight. Click https://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html

Question:

I have just been VA system for short while, and have some health problems. Upon my death, will my wife get any of my benefits if she still living? If so, what type? I'm a Vietnam combat veteran. Thanks.

Jim's Reply:

When a veteran passes there are some benefits we all share...death benefits such as burial in a National Cemetery and some associated expenses are available.
 

Otherwise, unless the veteran dies of a service connected condition...a rated disability...there really isn't much. 
 

When a veteran dies of a service connected condition the dependents left behind are eligible to apply for the DIC benefit. The DIC benefit is a monthly payment and some other benefits for the survivor, it isn't a part of your benefit.
 

I urge veterans to take the time to develop a will and to discuss all the options if the vet should pass unexpectedly. These aren't always easy discussions to have but having them will be a real plus to survivors.

Question:

I'm a Vietnam vet rated as 100% unemployable, considered totally and permanently disabled. I had an EMG in Oct/2019 which confirmed I have peripheral neuropathy in both upper and lower extremities, which was service connected. However, the VA denied my claim. I sent an appeal for review by a VA law judge. It came back REMANDED. The rating decision included favorable findings, most likely associated with agent orange exposure. However, no rationale was provided for the opinion. No etiology opinion was provided which must be obtained.

The VA said, "The failure to obtain etiology opinion in this case is a pre-decisional duty to assist error". Remanded for following action: Schedule exam by appropriate clinician to determine nature and etiology of peripheral neuropathy. examiner must opine is P.N. is at lest likely as not (at least 50%) related to service connection and address EMG tests.

Jim, I speak English as well as the next guy, but I am at a loss when it comes to VA speak. I do not have a VSO as there is none in my area (NYC). I know it does not affect my monthly compensation or benefits, but I feel that the VA should own up to their responsibility and am not sure what all this means. Thanks for your time and attention.

Jim's Reply:

The language that your VA uses seems designed to obfuscate, mislead and confuse. This is what they said.

The EMG showed that you have peripheral neuropathy or PN. PN is a common finding in the Vietnam veteran who was exposed to agent orange and PN is particularly common in the Vietnam veteran who has Diabetes. While PN is generally rated as a disabling condition in the Vietnam veteran, VA is really into crossing t's and dotting i's. There can be a number of causes for PN so we have to be sure we get it right for the record.
 

"No rationale was provided" means that nobody bothered to note why an opinion was given. In this case it's probably missing a simple statement that PN is known to be associated with the Vietnam veteran. You aren't allowed to just make random statements without some reference in support.
 

The "etiology opinion" is a statement by an expert (usually a physician) that says that your PN is more likely than not associated with your Vietnam service. If you're a diabetic and have that rated, then your opinion could say that your PN is secondary to the service connected DMII.
 

The comment about, "a pre-decisional duty to assist error", is a verbal spanking to tell the regional office they didn't do what they should have to properly decide your claim. You should get another C & P exam that will make specific comments as to why you have PN.
 

I think that this was a good move for you to file the claim. It may not immediately affect your compensation but in the long run, you'll have this resolved just in case. Good luck.

Question:

I have Merkel Cell skin cancer stage IV. I put a claim in September 2020 and got approved 100 percent permanent and total in December 2020. I thought that with cancer they never gave permanent? I submitted my skin cancer claim for sun exposure along with hypertension, ankle, scaring. I got 10 percent for HBP, 20 for ankle and 30 for scaring. My letter for my ID card says no future exams. I get immunotherapy every 6 weeks for cancer. I also work full time and am in good health with stage IV. With rated 100 percent total and per will they call me in later for C&P exam to reduce rating?

Jim's Reply:

That's correct, most cancers will not receive a permanent rating since most cancers are treated and with a high degree of successful treatment, the cancer is in remission or even cured. Your cancer is an aggressive one and the fact that you are receiving a treatment that will essentially last a lifetime has persuaded and examiner to call your condition permanent. Good luck.

Question:

I applied back in 1975 for hypertension and I was denied for it. Later in 1977, I was diagnosed with Diabetes and was given 30%. I have diabetes, which is covered under agent orange. But they will not cover me for hypertension secondary to diabetes. because I applied for hypertension first. I also applied for a increase for diabetes for 40% because I take insulin, also denied. What should I do?

Jim's Reply:

Any time we are denied a benefit that we've applied for we have one year to appeal the denial. If we don't formally appeal within that first year we more or less have to start over with a new claim.
 

There is no guarantee of any claim being awarded, particularly hypertension as it relates to DMII...denied claims are a routine at VA whether justified or not.
 

If you want to get these benefits straight your best bet is to retain a veterans law attorney (at no out of pocket expense) to appeal your denials and to seek an IMO from an expert disability doctor.
 

You can find the attorney you need here https://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html and any one of these doctors will be happy to speak with you about reviewing your medical records https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html 
 

Good luck!