Benefits

Question:

I have Static Ratings that equal 80%. I am 71 years old. Currently being treated for cancer and medication will end soon. My temporary 100% (due to cancer treatment) was in effect for 10 years. Should I keep fighting or wait and see what the VA does with me when they reduce the 100% down to 80% static? I'm hoping they rate me 100% TDIU. I do have more medical conditions I could file for which will be residuals of my cancer. I just don't know if I should file now or wait and see what the VA does with me. I don't see how they could look at me and expect me to return to the work force and earn substantial wages. The VA is a constant fight. I'm tired and worn out from dealing with the VA compensation system.

Jim's Reply:

If your 100% rating has been in effect for 10 years I'd have to predict that your rating will not be lowered. If you want to be rated as TDIU you have to apply for it rather than sitting back and hoping VA will offer it to you.
 

If you're unable to work, you should apply for TDIU. Good luck.

Question:

Hi Jim, Thank you for your service! So if I may get this correct with your recent response to my question, a veterans list of disabilities have to be all static to receive a 100 % permanent and total rating with no future exams scheduled?

Jim's Reply:

That's correct. A static disability is considered by it's very nature to be permanent. The loss of a leg to a land mine would be a static disabling condition. Diseases that are determined to be static or otherwise permanent in nature are those that by medical diagnosis and the record aren't viewed as likely to improve over time.
 

To achieve a permanent rating it seems apparent that none of the conditions that are used to reach 100% can be temporary. A good example of that is the veteran who has a number of physical ratings plus one mental health rating that will add to 100%. That mental health rating is temporary and will not allow the veteran to access the benefits awarded to a 100% P & T veteran. Once the rating is in place 5 or more years and/or the veteran turns 55 years old, the mental health rating is likely to become permanent and the entire rating will then be a true 100% P & T.

Question:

Hello, I’m currently rated at 100% P&T. All but one of my disabilities are static. The one disability is for my lumbosacral rated at 40 and secondary for both legs at 20% a piece. The rating decision for the back states future exam will be scheduled. This rating decision was before I got the P&T status. My VSO noticed that there is a date of 10/2021 next to that rated disability. I spoke to the VA and they said there are no future exams scheduled and that I’m 100 permanent and total. With that said, can the VA still have me come in for a C & P exam for the back even though they say I’m not scheduled for any future exams in the VA letter?

Jim's Reply:

First up...VA makes mistakes. A lot of mistakes. That you have notice of a future exam doesn't necessarily mean that an exam is scheduled, it just means that someone didn't delete that entry. This is a frequent occurrence.
 

However...can VA have you come back in the future for an unannounced exam? Yes they can. However, that too is usually an error and the end result is zip. That happened to me 25 years after a rating I was called in for an exam of that body part. Nobody knew why, the doctor who examined me didn't have any clue. Months after the exam I received a letter telling me my rated condition was static and that there would be no increase.
 

I never did find out why that happened and never will. In the end...if you are ever notified for a C & P exam that you don't understand, don't sweat it. And don't miss it or argue about it...just go get it done and eventually VA will reconcile everything and your ratings won't change. 

Question:

I'm a Gulf war disabled combat vet. I'm 70/30 permanent total and unemployable. I have chronic PTSD, Bipolar, and ADHD. I'm supposed to be in the #1 priority group for healthcare. Can the VA deny me care for disability for any reason at all or are they obligated?

Jim's Reply:

You can't be 'fired' as a patient of the VA. The healthcare priority groups have never had much meaning. The highest rated #1 group is supposed to receive some sort of special treatment when making appointments and such but I've never seen that work well. 
 

VA can flag a patient who is disruptive and require that the veteran have a police escort to appointments or any time he is on campus and a disruptive patient may find he sees different providers but otherwise, VA is obligated to provide your care as long as you are properly registered.

Question:

I was recently enrolled in ChampVA through my husband. I also have OHI through my employer. Can I drop that insurance and just have ChampVA?

Jim's Reply:

Yes, you can drop private pay insurance and save that money. And many do just that...my wife and I did.
 

Whether or not you'll be happy will depend on your tolerance for jumping through hoops. CHAMPVA isn't as easy to work with as your typical BC/BS employer plan. There are preapprovals required, lost paperwork, unanswered phones and don't even think of emailing anyone there. Always remember, it's the VA. We have our best luck hanging on the phone and calling again and again until we get someone who knows what's up. I hear that they have an old school fax machine and that's the only way they communicate with regional offices.
 

If you have an established relationship with a doctor you like, ask her office manager to take a few minutes and talk insurance with you before you drop the private pay. If you don't have an established relationship with a provider, now may be a good time to do that and talk with them about insurance.
 

While you're at it, ask a couple of practice managers or insurance billing clerks to chat with you about how they get paid. They're always happy to do this...it makes their job a lot easier.
 

Having said that, once you are into the plan and your doctors are used to it and you have your mail order pharmacy set up, CHAMPVA works really well and covers most expenses. There are plenty of preventive services just so long as you get that preapproval.
 

Our doctors are perfectly happy with it although my wife has to watch the billing process carefully and she's always prepared to jump on the phone to straighten out a problem. We've started her transition to Medicare so there are more hoops to jump through but overall, it's worth it to have great health care at a very reasonable cost. My stepson has CHAMPVA for his family and the wife and two kids are very well cared for by CHAMPVA while VHA takes good care of him.

It's good, cost effective health insurance. Go for it.

Question:

My father was found to be incompetent by the Va without a medical exam. My sister was helping him file for aid and attendance and wrote in detail what she was doing to assist our dad. She wrote that she prepared his bills, wrote checks for him to sign and balanced his checkbook. This is all it took for the Va to determine him Incompetent. No medical or psychology exams. Is this even legal? Also if he did not spiral in 60 days can he appeal layer?

Jim's Reply:

Yes, this is legal and standard operating procedure. During a C & P exam for benefits the veteran may be asked who takes care of his or her finances. If the veteran isn't capable of managing his own money a fiduciary may be appointed by VA. Often enough there is a lot of money involved and the VA has a lawful duty to ensure that the veteran is protected...even from himself or his own family.
 

An exam was conducted. That was during a C & P exam or review of records or the evidence you say was submitted telling VA that he is not able to manage his finances. That's all the exam necessary. Rating a veteran as incompetent to manage his finances doesn't require a lot of legal juggling so there is no hearing or anything like that. https://www.vawatchdog.org/fiduciary-appointments.html 
 

Your sister made an error volunteering information in such detail...that's one reason no hearing is necessary...she's already told them he was incompetent. That wraps that up. 
 

As soon as she described how much she did for him it became very apparent he couldn't do that for himself...thus he is incompetent to manage his finances. When dealing with VA we never answer questions that aren't asked and we never provide extra information because this is what happens. Blunt, brief, yes or no answers without elaborating extemporaneously is always best.
 

Often enough a family member is appointed as fiduciary. If a family member isn't eligible (credit or criminal history) to serve as a fiduciary the VA will appoint a professional fidu who will work with VA to manage his money.
 

If he objects to this it's best to appeal before the fidu is appointed. It's much easier to show competence prior to an appointment being made. Once the fidu is in the role it can be very difficult to have them removed. So you understand...when  a fidu is appointed that individual is given a budget by VA for that veteran. Any amount of retro money and so on is not freely available to the veteran, every dime must be approved by VA and they approve basic living expenses and not much more. When the veteran passes, any remaining money is returned to the government. There is no disbursement of remaining funds to heirs.
 

You'll need some help...a veterans law attorney may be able to fix this so your father can manage his own benefits. https://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html 

Question:

I was granted TDIU on appeal and the judge put the date as the same date as my SSDI date. Will I get back pay to that date or can the RO change that date?

Jim's Reply:

Yes, your TDIU effective date will be the date that the judge says. The RO can't change that order.

Question:

I was discharged from the army back in the 1990s, two months into basic training, because of a preexisting curvature of the spine. What would my discharge be and do I have a chance for VA assistance?

Jim's Reply:

I'm not sure how you think I would know about your discharge? I'd have to guess it was your responsibility to keep up with important documents that reference your brief time in service. Much the same applies so far as any 'assistance' or benefits would go. I'll assume you're looking for health care and there are a wide variety of variables that can affect your eligibility for care. Click this link and go through the application process https://www.va.gov/health-care/how-to-apply/  Good luck.

Question:

Hi. My husband passed years ago. It took 4 years to receive a spouse pension. Last year, March, 2020, I received Social Security and his retirement pension. I notified them immediately.  Every month they continue to deposit the VA check?  I called three times. The first tine I called, they were working from home because of COVID. I don't know what happened to information I provided. I called again. They finally sent papers stating my income and information. Then it took 60 days for them to reply back. I faxed everything in after I received the papers. They continue to deposit pension. I don't know if this will affect taxes. It's now over $25,000 . I would appreciate any help. I don't know what to do. Thank you. God bless you.

Jim's Reply:

I understand what a frustrating problem this can be. You aren't the first who has received money from the VA that they weren't supposed to be receiving and they can't seem to cut off the flow. I advocated for a young veteran on the east coast a decade ago who had a single misplaced $350,000.00 deposit made by VA and it took us a couple of weeks to straighten that out. VA didn't want the money back at first...I had to convince them and then they drained his entire account so we had to make an effort to get his rightful money back. 
 

VA will eventually figure out that those deposits to you were made in error and they will immediately take that money back. Until that happens you've done all you are able to and you aren't obligated to do any more. Do keep accurate records of any activity where you've notified VA and so on.

Most importantly...don't spend a dime of that money. If you were to spend it VA will want it back and they'll go to great lengths to recover their money. If you are able to it's best that you leave that particular bank account alone and use another account for your day to day transactions. If you can't do that, be sure to keep good records of where all that money is and how much is rightfully yours.

You're correct that all this is made worse by the pandemic. VA and many other government as well as civilian institutions are a mess right now and it's going to be a long while before they recover. While this is happening the best we can do is to protect ourselves and do what we can to help our service providers do their jobs.

I can't speak to taxes since I don't know your overall situation but I'd make a bet that this won't affect your taxes because VA will take care of it sooner than that. Don't spend the money, be patient and it'll all work out. Good luck.

Question:

Hi Jim, I have a 100% Schedular Rating P&T. I have several conditions- but I actually have 100% for insomnia w/depressed moods. I have been contemplating attending a trade school and utilizing my Post 911 GI Bill, it will require that I attend class twice a week. I honestly think this could be great therapy for me because the training/class is hands on. I am only hesitant to attempt attending class for fear of losing my rating. Will I be at risk of losing my disability if I attend class or if I take a class online? Thanks!

Jim's Reply:

Mainstreaming, or returning to activities that you would do had you not been injured during your military service, is a good idea. You are allowed to do whatever it is you feel capable of doing and there is no limit and no penalty for returning to a more active life.
 

I'm one who believes that returning to work and school is the best thing we can do for ourselves. Start slow, do what you can and let it develop over time. Good luck.