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HERE'S THE LATEST EDITION OF JIM STRICKLAND'S MAIL BAG --

Veterans' Advocate Jim Strickland answers questions

from VA Watchdog readers.

Veterans' Advocate Jim Strickland provides regular columns for VA Watchdog dot Org.

If you would like to contact Jim about his columns, you can email him here...

The archive of Jim's articles is here...

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Jim;

Thanks for the great advice (provided in your columns). I actually found this just before sending the paperwork to the VA. I didn't use a VSO, my wife did my claim. She made some mistakes, was very vague about the problem, but it did not matter. She called the VA whenever she had a question, and they would walk her through the forms. They told her exactly what they needed for proof and how the process worked.

I did consult a VSO at my local veterans post and when he told me to file one of their boilerplate claims I said "no thanks" and my wife filed her claim.

What really got me my 40% was the C&P examiner. I took my wife as suggested by someone on this site because I tend to downplay my medical problems. But the C&P examiner was helpful. He gave me advice about the process. He actually seemed refreshed by the fact that we had a simple claim. He commented, "I don't see many of these" and I asked him to elaborate. The fact was that I didn't show up with braces and walking devices or a briefcase full of records and that we did the claim and it was just a simple claim, not a pile of boilerplate conditions that the VSO's pump out.

Also I told him exactly what I needed from the VA. I needed to get into the vocational rehab program, and that i needed 30%. I kept asking him if he thought that was possible, he finally said, "you are looking at 20 maybe 30%" then before i left he said he would put together a report that should help me. well he got me 40% which is the max i could have gotten for my medical problems, to get any higher I would have needed hospitalization for it within the past year. the c&p examiner even told me I should try to file for back compensation, that i should at least be able to get it for the last 2 years.

VSO's really have a place. If they are trained. But most local veterans posts just hand out the title to whoever. and there is no oversight by the national offices or the departments. sorry to ramble but thanks and have a great holiday.

Answer;

I agree that VSO's “have a place”. I often recommend that Vets seek out the assistance of a State or County Veterans Service Officer (CVSO) if they have a complex claim. The CVSO is usually much better prepared to assist a Veteran than other VSO's from the usual Veterans Service Organizations. You can find a CVSO close to you by looking in your telephone book or clicking here http://www.nacvso.org/  to visit this web site .
 

Jim:

My service connected disability is at 70% being paid at 100% . I am 73 years old and been collecting payment for about ten years, about 5 years at this rate. What do I do to get it changed to 100% total and permanent?

Answer:

I'd advise that you don't do anything. If you are 70% schedular and paid at 100% IU and you haven't been subjected to yearly C & P examinations, you are already considered P & T. It's the same category I'm in and it's a perfect place to be. As you're over 55 years old and you've held that rating for a while, it's very unlikely that anyone at VA will try to make any changes. Even if you had a letter stating P & T, you wouldn't be "protected" from change until you've been rated 100% for 20 years.

Asking VA to change anything would require a review of your file and that may stir up a hornet's nest.

Enjoy the benefits you have today and don't worry about it. If you ever should get a notice from VA that they want to change your rating, contact either Larry or myself and we'll advocate for you.
 

Jim:

I read your article on VAWatchdog. I'm not sure if my experience with my VARO qualifies as cryptic. I would rather use the terms trickery, dishonesty and lying. My questions first: Can my VARO office reduce my benefits for failing to return an Employment Questionnaire in the prescribed 60 days? Do only veterans with IU's have to do the Employment Questionnaire?

Now the facts: My combined rating is 70% disabled (Effective August 2002). I was granted the 100% rate because of IU. In the decision it said that there would be no examinations scheduled in the future. It also said that I have a permanent and total service connected disability.

On December 03, 2007 I received an Employment Questionnaire from my VARO. As with all correspondence from their office in came in an envelope with no post mark and no way of telling when it was mailed. I have received these questionnaire's in years past and except for the one I received in 2004, I never paid any attention to the date mailed vs. the date received. That one (2004) was date mailed October 1, 2004 and I received it on September 30, 2004. On the questionnaire, instead of having a date, it had a "date mailed" box. In the box was October 1, 2007.

In the instructions it said that the required items must be filled in fully and accurately, which I did (Section II). The instructions goes on to say that the completed form must be filled out and returned to the VARO within 60 days or my benefits MAY be reduced. I received it three days after it was due back at the VARO. I live in Fayetteville, NC. Winston Salem, NC is only about 115 miles away. I rubber stamped it "RECEIVED DEC 03 2007" and returned it in the same day mail. I also faxed a copy to my VSO, also located in Winston Salem, NC. As of this writing I haven't heard back from my VSO (MOPH).

I believe that it was either mailed on December 1, 2007 and not on October 1, 2007 or the date box should have read December 1, 2007. I tend to believe that it was mailed late on purpose. This would be more consistent with the VA's reputation and their SOP. It would be in my interest to get the form back to them ASAP and it would be in their interest to mail it late on purpose. Maybe their way of reducing my (and other veterans) benefits with the promise of reinstating them if I agree to more examinations, that I must pass, and probably with new guidelines since my case was adjudicated. I'm sure it's a trick in there somewhere, I just can't figure out where. Your thoughts would be appreciated.

Answer:

Yes. Your VARO can and will reduce your benefits if you fail to timely respond to a request of verification or examination.

This applies to those of us who are IU and it's one of the few rules that are reasonable. There are many Vets who would work and earn an income even while taking their IU benefit. I hear from Vets often who ask if it's OK to work "off the books" and receive unreported and untaxed income. Of course, that's illegal. The employment questionnaire isn't all that intrusive, I get one each year too.

If you are IU, you're in the best category of 100%. If a Veteran is 100% schedular rated, the VA may reexamine him at any time and look for improvement in his condition. Even if the rating says "Permanent and Total", it isn't protected until it's been in continuous effect for 20 years. Any Vet can get a re-exam notice and have a proposal generated to lower his rating. If there is improvement, it may drop from 100% to say 60% or even lower. The VA only has to show "improvement" on a Vet with a 100% schedular rating. If a Vet is IU...unemployable...the VA must substantiate not only improvement but also employability. Their burden doubles.

As for a conspiracy to develop some secret plan to misdate letters to force a lowering of your ratings...I only wish it were true.

If that were true, it would indicate to me that the employees of the VA are sharp enough to think of and execute such a plan. To develop a process like that and get away with it would be the product of some people who were thinking ahead and had a goal.

Unfortunately, if your letter was dated incorrectly, mailed later than it should have been, etc., it only confirms more sloppy work by untrained, unskilled and unsupervised VBA employees. They would have to be pretty smart to do what you imply...they aren't. Don't make that mistake of giving them credit for doing something like conspiring to take away your benefits, most lost files and wrong letters are caused by sheer incompetence, not clear thinking and highly motivated people.

Reductions in benefits aren't made because regulations have changed. Regs don't change much, the rating schedule has been in effect since 1945 with no significant changes. There is also a specific regulation that clearly says that no reduction will be made because of any reg change. If you were reexamined, the exam must be compared to the original.

If you are contacted by VA and any attempt is made to lower your rating because you did not timely file your letter, the issue should be simple enough to resolve. Let me know, I'd be happy to help. In the future, you may want to make a note to yourself to expect a letter each year and if you don't get it, either call your VARO and ask about it or simply find the form on-line, complete it and mail it in. That's a preemptive strike for you that will ensure that your benefits are as safe as can be.
 

Jim:

I WILL BE ELIGIBLE FOR MEDICARE IN JULY THIS YEAR. DO YOU RECOMMEND STAYING WITH THE VA OR SWITCHING TO MEDICARE.

Answer:

I use both Medicare and VA health care. It's perfectly acceptable to do just that. Those of us who have both VA Health Care and Medicare have the best of both worlds. I don't bother with a Medicare secondary insurance policy like AARP. If I need local civilian care, I'll pay a small deductible up front for part B (doctors) and then 20% of any allowable. If I'm hospitalized suddenly at a civilian facility and use my Medicare benefit, I may get tagged for almost $900.00 deductible but I'll soon ask to be transferred to a VA facility. If I chose to get a secondary policy such as that offered by AARP, I'd pay about $2000.00 each year, maybe more.

We don't need pharmacy or Part D Medicare...we can usually get civilian prescriptions converted to VA prescriptions. Now that Wal Mart and others are selling a ton of stuff for $4.00, I sometimes don't even bother and just pay the 4 bucks.

There is a caution though. When you go to a civilian provider, be sure to be specific about which coverage you are asking them to bill. If you want them to bill VA, you must have clear pre-approval from VA for "Fee Basis". If you want to use your Medicare, it's best to not even let them know you're covered by VA. If you allow them to have both your cards, confusion can result that is tough to set right.

Read the second part of this article in the link below and you'll see how that can happen.

http://www.vawatchdog.org/07/
nf07/nfSEP07/nf090407-1.htm

Jim;

I have developed adhesive capsulitis (frozen shoulder) as a result of my diabetes. As I am 100% P&T, my PCP has written a referral for physical therapy, which is the only therapy before considering surgery. The only problem is that I will have to drive 2 hours there and 2 hours back. My spouse is housebound with a syncopal disorder and I don't think that I can leave her alone for 5 + hours every day for a couple of months. Also the cost of gasoline will make this trip too cost prohibitive to make. Any suggestions?

Answer:

Stop at your CBOC or VA hospital and speak to the fee basis people. You may have to get the recommendation or approval from your PCP but you have a good case to get local, civilian physical therapy treatment. I'm seeing many more fee basis approvals for all sorts of treatments and physical therapy is one of the busiest. When you are approved, the process works well. Once you have your written authorization, you can usually choose your physical therapy provider from any in your town. Every physical therapy provider who accepts Medicare is required to accept a VA fee basis patient and you'll usually be welcomed and offered good treatment.

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Larry Scott  --

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