Benefits

Question:

Jim, I am a retired Army CSM. I served 27 plus years and deployed to combat on 5 occasions. I was awarded 100% P&T in 2015. I was initially notified that I had a high PSA level at the VA in February 2020. Doctor prescribed antibiotics and nothing happened with the VA, so I decided to use Tricare to get get this checked again in August 2020. The Urologist found I had Prostate cancer. I told the VA doctor about the diagnosis and nothing happened, so I filed for Prostate cancer on 13 Oct 2020. I was apparently awarded a temporary 100% on the 23d of Nov 2020. I have Prostate removal surgery on 25 Nov 2020. If I’m already 100% what benefits will my family receive from this temporary rating? I had COVID in October, pneumonia in early November, and now this prostate removal. Your advice is respected.

Jim's Reply:

The veteran who has served in the country of Vietnam and who is diagnosed with prostate cancer is presumed to have been exposed to agent orange, a chemical thought to cause or contribute to the development of the cancer.

When the diagnosis is made and a claim is filed, the veteran is awarded a 100% temporary rating. The rating is temporary as the VA assumes every veteran will seek treatment for a cancer and that every treatment will cure the cancer.

If the veteran chooses 'watchful waiting', a popular alternative to prostate cancer surgery or radiation therapies, the rating will remain at 100% in a temporary status until treatment is sought and accomplished.

If and when the veteran chooses treatment there will be an exam scheduled about 6 months after treatment to evaluate the residuals of the disease and any therapy that has happened. The usual residuals are a loss of control of the flow of urine that requires wearing absorbent pads and erectile dysfunction. 

A final rating will be determined by the degree of loss of control of the flow of urine...if you use 2 pads each day you'll get a 20% rating, 4 pads each day you'll likely get a 40% rating, 6 pads equal 60%. The rating for erectile dysfunction is separate from others and is a max of 10%.

There are no family or dependent benefits for the temporary 100% rating. The benefits of CHAMPVA and Chapter 35 DEA only occur when the 100% rating is permanent.

Question:

A friend's husband served in Vietnam in the late 60's and was exposed to Agent Orange. A few years later he was diagnosed with Gregory's disease and then just this year he passed away with lung cancer. She is looking for an approved attorney to assist her with this case.

Jim's Reply:

Please click here to meet the veterans law attorneys who I refer to. https://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html  

Question:

I have a 100 percent VA disability rating and I have medicare part A and part B. Am I eligible to get a medicare advantage plan with dental? I am 56 years old.

Jim's Reply:

Sure...if you're willing to pay for it. I'm also 100% rated and eligible for dental care at VA. I choose to pay for a plan and use civilian dentists at my own expense. My plan is made available through VA  and is similar to every other plan out there. It pays for routine stuff, it costs too much and there are steep copays for everything else. 

I'm sure Medicare offers similar and I'd suggest that you use Google search to discover helpful articles like this one. In the end we will pay a steep price for our dental and vision services no matter which way we go.

Question:

Jim,

I am 65, have been on TDIU P&T for 10 years, and am considering getting married. I know the 10 year and married thing for DIC, my question is does my spouse rate my 100% or not in the event of my death? Thanks a lot!

Jim's Reply:

A surviving spouse does not receive a 100% rated veterans benefits at the time of his death. Depending on the circumstances the surviving spouse may be eligible for the DIC benefit. 

For your spouse to be eligible you'll need to have been married at least one year. Since you've been rated as 100% for over ten years you can die of any cause and she'll be eligible.

P.S. From StatesideLegal:

Here is a great page on StatesideLegal that explains eligibility for DIC.  We hope this helps and wish you the best of luck!

Question:

Jim, I have a friend who died of a heart attack a few years ago. I believe he was a Blue Water vet. If that's the case, can his wife apply for any kind of VA benefits? Thanks for your help.

Jim's Reply:

Maybe, maybe not. If there is proof your friend was Blue Water Navy and if you can produce documentation that the cause of death was a heart attack caused by ischemic heart disease then there is a very slight possibility of a claim developing from that. But I'd have to give the chances of something coming together at this late date as very slim indeed. There's never any harm in trying so go for it.

Good luck.

Question:

Greetings Jim, I actually suffered from depression and anxiety under PTSD. I often get very anxious from ringing in my hear or not being able to hear my family at times. How do I get checked for tinnitus?

Jim's Reply:

There is no exam for tinnitus. You simply state that you have it as you make the claim. VA will review your records to learn if it is a reasonable assumption that you were exposed to acoustic trauma and rate you with tinnitus at a max of 10% if they agree that it is more likely than not that your hearing was damaged during service.

For example, if you worked on a flight line or if you have been awarded the Combat Infantry Badge or equivalent VA will cede that you were exposed to acoustic trauma. In other circumstances you may have to offer more evidence and all too often this claim is won on appeal...be prepared. Good luck.

Question:

Jim, as you may know, urinary stress incontinence is ongoing with leakage throughout the day and minor or little to no leakage at night during sleeping hours. However, the VA will use the same eligibility criteria "number of pads usage during the course of the day" and "number time you wake during the night to void", as the eligibility criteria for veterans with no prostate and veterans with a functioning prostate. Do you feel these eligibility criteria should be amended within the code of federal regulations?

Jim's Reply:

"Do you feel these eligibility criteria should be amended within the code of federal regulations?"

Yes. Absolutely. But Congress has shown no interest in tackling this as the Congress continues to meet the dictionary definition of dysfunctional. The Dole-Shalala Commission was the best attempt to correct how veterans are cared for in my memory and if a recall correctly not one single item was ever adopted for use by the VA.

More on that is here. 

Question:

Jim, to treat my prostate cancer the prostate was removed in 1997. In 2004, I underwent 6 weeks of external beam radiation. Stress urinary incontinence followed and in 2011 my sphincter had weakened to the extent of my having an artificial sphincter implant. Nine years later (11/10/20), I had my second artificial sphincter implant. Currently I'm 60% rated and convalescing at home for a period of 8 to 10 weeks. Do you feel the complete (Loss of Sphincter) is a secondary condition directly related to my primary condition of Prostate Cancer and Erectile Dysfunction?

Jim's Reply:

Yes. Your rating should be higher than 60% for all of the residual complications you're suffering. You should file a claim that says all those problems are secondary to the original cancer and each problem should receive it's own rating to add to your overall final rating. Good luck.

Question:

Good Evening, Jim I would like to know, How does the VA use percentage when rounding up or down when assigning ratings. Thanks.

Jim's Reply:

I'm not sure I understand? Rounding up or down is just a part of the overall process used to determine a final rating.

If you'll click this link https://www.benefits.va.gov/WARMS/bookc.asp  and scroll down to 'Subpart A - General Policy in Rating', you'll find all you ever wanted to know about how ratings are calculated and much more.

Question:

Hi Jim. Can i qualify for a unemployability claim if I receive a city/state retirement pension?

Jim's Reply:

Maybe, maybe not. The pension probably won't interfere but there are plenty of other factors. Applying for TDIU is the only sure way of knowing your eligibility.