This is not legal advice. You should always seek the advice of an attorney who is qualified in Veterans' law before you make any decisions about your own benefits. Visit Stateside Legal (below) for assistance with legal issues.

NOTE:  Letters in my Q&A columns are reprinted just as they come to me. Spelling and grammar are left as is and only small corrections are made to improve readability, ensure anonymity or delete expletives that may offend some readers. This is not legal advice. You should always seek the advice of an attorney who is qualified in Veterans' law before you make any decisions about your own benefits.




                         July 2011 Mailbag



Vet centers are provided for veterans who suffer PTSD from events in combat

Jim,

I truly trust this E-mail finds you and yours in the best of health and spirits. I had called the VET Center upon more than one occasion. I was informed: (1) that they do not provide transportation or travel pay and 2) they do provide free counseling. Long story short, I was finally able to get a way to the Colton, CA VET Center last week. To my chagrin, I was informed (by a one Mr. Austin) that one must have served inside a combat theater to qualify for one on one counseling at their center. Are you aware of this prerequisite? Please advise. I really don't feel comfortable at the VAMC (which is even farther and their travel situation changed 3/1/11-per a letter I received). I am in pursuit of a pill-less solution, if at all possible. AGAIN, I thank you in advance for any insight you can provide. Please do have a very pleasant and productive day.

Reply:

The information you received is true. Vet centers are provided for veterans who suffer PTSD from events in combat. There is no travel pay provided.  More on travel pay here

PTSD Treatment

Jim,

I have been receiving alprozolam through the VA system for the past 7 years. The original prescription was written by a private psychiatrist. I took the "script" to the local VA clinic and MD's have been renewing my prescription. My primary Dr. Left and when my prescription ran out a different MD, whom I have never seen refused to renew it until I saw the VA psychiatrist. Saw him this morning. My VA rating is 70% for general anxiety and 100% for TDIU. The psychiatrist I saw this AM told me that there was no doubt in his mind that I have PTSD.

What boggles my mind is that he told me he could cure me of PTSD by my slowly cutting back on my medicine and suggesting prolonged exposure therapy. I did what he asked me to do and researched this on the Internet. Now this is my own personal opinion. This type of therapy (to me) sounds like throwing gasoline on a raging fire. Your advice in the past has always been right on the mark and I honestly believe I have more faith in you than any Dr. What is your opinion on Prolonged exposure therapy and the fact that this psychiatrist stated he could cure me from PTSD. I am 75 years old and have had this problem (PTSD or General Anxiety) for over 30 years.

Reply:

I rarely offer treatment or therapy suggestions to veteran patients. If I do offer such advice, it will be in some area of knowledge where I have a bit of expertise or personal experience.

I make it a policy that I never offer advice for such questions as yours that are related to psychiatric treatments. PTSD (battle fatigue, shell shock, etc.) has been around a long time and to my knowledge it still isn't a well understood problem.

I've observed dozens of suggested therapies in the few years I've been writing about advocacy and benefits topics. I've heard from veterans who have been helped by all the treatments available and I hear from vets who are helped by none of the treatments.

I wish I knew the answer. I can only suggest that you keep your mind open and give it a try. If the doc has something that works, great...if not, at least you'll know you tried.












Fiduciary considerations


Jim,

I just got the following message from a Vet Advocate. Could please give me your take on this, or is it even now at this point in time.

"IMHO, a fiduciary case is way, way, beyond any VSO or "free advisor". I dont think you can possibly underestimate the devestating financial effect of a bad fiduciary would have on your family, and this is not something I would leave to either "chance" or even a lawyer with less than significant experience with VA law. I would go with a pro, and I doubt that you would regret it. At a very minimum, you can almost always discuss your issue with a VA attorney, and, even if you decide not to enlist his or her services, they will often point you in the right direction.

Frankly, I would highly consider (Attorneys). These are all highly regarded VA law experienced attorneys that have won significant benefits for their (Veteran) clients. You can even do your homework and do a search, at the CAVC website, and type in an attorneys name and find out how he has done with other Vets.

You may also have good luck with some of the "national" law firms who do pro bono work for Vets. You see, a large well known law firm is NOT going to want one of their attorney's on staff to do pro bono work, and then say...ok we represented you and you lost..now have a nice day...NO! Those law firms have BIG EGO's and would not want their good name attached and associated with failure! Those big name law firms have excellent research teams and software to "dig out" those loopholes and exploit them to the max.

While I am not an expert at all, I have read enough about this issue to know this is not childs play! The VA has been burned and burned badly, and those VA employee lawyers want revenge and would love to take a case to "weaken" or even reverse Freeman, so you need a "heavy hammer" to counter the VA huge resources...some 400 or so lawyers.

Do not even think of showing up at a gunfight with the VA with a knife or any thing less than HEAVY artillery...such as a very experienced, big name law firm in the category of those I mentioned. You need every advantage you can muster, so the sooner a lawyer enters your case, the more likely you are to have a positive outcome. It is high time to call in the "heavy hitters" to help you. The VA has made their position known: They plan on taking advantage of every Vet and family they can to the max on the issue of fiduciary.....that fishy smell coming from the fiduciary department at the VA is NOT dinner!!"

Am I even at this level yet. I know the seriousness of the matter, but I also know the passion you have for this fiduciary mess. If the retro wasn't so large, I doubt that they would even be putting me through this mess. A wrong decision would actually ruin my family.

Reply:

The advice is really pretty good. However, as you've guessed...you aren't at that level yet. Few attorneys would bother trying to take your case as there is no abuse to be noted. So far your case is routine.

The proposal to you by VA to appoint a fiduciary isn't an offense. In your case, I believe there may be a reason to resist. You aren't happy with the idea and so far you seem very bright, you're a good communicator and based on that limited evidence I wonder if you need a fiduciary?

There are many who do need a fiduciary and not every professional fiduciary is a bad thing. Out of every 100 veterans who ask me about the arrangement, I tell maybe 75 or 80 of them to stick with it. One recent one had seen the spouse appointed and the veteran wanted his money under HIS control, not his wife's. He told me that he did not have a gambling problem, he just enjoyed gambling. The wife and others found that pissing away your check in a weekend every month was a problem. Another female vet had some serious drug issues and confessed to giving her money to a dealer and hoping for the best. Her older sister was fiduciary and when I told her to stay with that, she ultimately agreed.

To use a lawyer you must have some documented abuse by VA. Read Freeman (it's on my site) to understand that. Give your vet advocate my best. That's good advice although just a bit off the mark.



Prostate Cancer

Jim,

Viet Nam 1969-70 I was diagnosed with prostate cancer on June 9, emailed disability application to VA on June 15. On June 16 received email that application was received at Detroit office.

I an thinking of watchful waiting as treatment. I expect not to hear from VA for many months. Will I get 100% disability from June 9 if I chose this treatment option? I am not sure VA will consider this a ongoing treatment.

Reply:

Thanks for dropping me a note. VA does consider "watchful waiting" as therapy. It's interesting to note that if you choose this route, your 100% benefit will stay with you and not be lowered in the near future. As you may have guessed, I get a lot of mail about this so I've written up some stuff that may help you understand it all.  Here
If you have questions after you've had the chance to absorb all this, you may write to me at <jim912@gmail.com> and I'll be happy to chat with you. 


Applying for Disability

Jim,

hi, i am a Vietnam veteran, i have a claim for ischemic heart disease, my claim dates back to 1996 i served aboard the uss Jamestown agtr3, basically a spy ship, i was able to get a hold of an updated list of navy ships that fall under agent orange it's dated may 4 2011 the were only a hand full of these ships operating around the world, they were classified as agtr's the uss oxford which was our sister ship is listed in the up date we have not been as of yet our mission was the same and one of us (our ship) was always on station up and down the vietnam coast, we took liberty in vung tau, an thoi ect. I am trying to find out how i get my ship added to the list . also i landed in Saigon at ton son nute aiport and stayed at the annapolis hotel while in transit four different times and i can't find any of my travel info from st.louis i served in vietnam from sept 1967 untill dec 1969 i extended once, if there is any help you could offer would be greatly appreciated

Reply:

You can begin the process by writing a letter to your VA Regional Office. You must make this letter very brief and to the point. This letter must be sent by certified mail with return receipt requested.

In your letter you should say "This is in support of my claim" and give any numbers (c-file, SSN) that will identify your claim. Go on to say "I have evidence that my ship (name the ship) was in these waters (name the waters) on or about these dates (name the dates). This ship should be added to the list of vessels that are approved for the presumption of exposure to herbicides in Vietnam. Further, I have evidence that many of us assigned to that ship set foot on land as we took our authorized leave in the areas of (name the regions you visited)."

Then make good copies of any evidence or documents you may have and enclose those with your letter. This will become a part of your claim and will also begin to have your statement and such forwarded to the appropriate people to have the ship added to any future updates. Latest Blue Water Navy List Here.



Benefits Status: VA Toll free number of no use

Jim,

My claim for IHD has been at the Ratings Board for about 90 days+. I call 2 twice a week and they tell me I should hear very soon. They have all the medical info they need to determine my case. I feel the longer they take --the result will be disappointing and they will turn my claim down. I had 2 heart attack (sting installed) 2nd h.attack (quad by pass). Should I keep calling or just wait for the brown envelope?

Reply:

I rant daily that veterans should not call the toll free number. VA cases are taking 12 to 24 months to adjudicate these days...VA has about one million claims along with yours that are pending and running way behind. Your case will be decided when it gets decided and not a moment sooner. That toll free number is just a diversion and there is no information of any value to be found there.



Agent Orange Question

Jim,

IS THERE A RELATIONSHIP TO AGENT ORANGE AND LOSS OF IRON OR NO IRON IN THE BODY. 1965-66 VIET NAM VET. THANKS IN ADVANCE - BEING READING YOU FOR A GOOD WHILE.

Reply:

I'm not aware of any such thing associated with agent orange. The loss of iron in your blood counts when tested is often related to blood loss. Internal blood loss can occur very slowly over weeks and months to become debilitating. This may be the result of a tumor or other problem. Beyond that there are dozens of other causes for anemia. Often enough you only need to adjust your diet to eat more iron rich foods. Your doctor will guide you.



Agent Orange, HCV cases, getting a lawyer

Jim,

I need some reliable information about agent orange condemnations. I served in Bindlach-Bayreuth Germany 74-75. My mos was 63C20. I was in a heavy maintenance co with numerous repairs of 4 wheel-half tracks-jeeps-2 1/2-. There was a chopper base there and lots of 55 gal drums of numerous chemicals and jp. This place was nicknamed "the rock" because it was very high up. The place had underground airports-unexplored caves-chemical-biological stores that was never fully disclosed to the troops.

My question? A social worker at my clinic interviewed me some time ago. She told me that guys (other vets) had filed for agent orange benefits because of contamination on army hardware, wheeled vehicles, and more. She has helped other vets with their claims and was severely reprimanded by the RO in Los Angeles. She was summarily fired but got her job back. She will not discuss this matter with me any further.

Is there any truth to this? Or any way I can research agent orange contamination without viet nam duty?

Currently I completed my second C&P examination regarding appeal for service connection for HCV. I was denied in 2001 because of mal practice of the ca dept of veteran affairs in Los Angeles. Was granted NSC pension in 2005. What happens now that the RO has it's doctor reports? I also have 4 very strong CUE claims that was denied with this appeal. I have studied these va laws for years now. I am prepared to argue them and prove the board erred.

I appreciate your opinion and referrals ASAP Thank you for your service

Reply:

There have been many claims filed regarding agent orange exposure because of contamination of vehicles, caskets, the clothes of wounded or deceased veterans and so on. Recent cases that have come across my desk have involved airmen exposed to aircraft used in Operation Ranch Hand that were "dirty" years after the war ended.

To my knowledge and belief, few, if any, of those cases have been awarded.

Any agent orange exposure case may be won. Much like other cases, you must first prove beyond a reasonable doubt that the exposure occurred. To say "I'm sure I was exposed" or similar isn't enough. You must show the evidence supporting your claim.

I have yet to meet a VA or other type of social worker who understands the claims process. Those people are not trained in the intricate details of claims processing and I wish they wouldn't say anything rather than handing out unfounded opinions.

Consider that your friend can't/won't tell you her secrets, that she was fired from her job for some reason and that because of a strong union and a generous appeals process, she's back in the job...giving you useless info.

I'd estimate that maybe 1 in 1000 veterans who tries a CUE claim without a lawyer helping may prevail. The VA employs 200 to 400 lawyers who have nothing better to do than argue cases against you. To believe that you have skills equal to theirs is a fantasy. I don't pretend to play lawyer myself. I am a very good medic but when I need help I go to a doctor. When dealing with CUE, I go to a lawyer.

HCV claims are also very difficult to prove. The injection gun scandals had mostly phased out by the time you served. Beyond that you need to show a blood transfusion or similar. If you've ever had a tattoo, particulalry after your ETS, VA will point to that for sure.

Many who do prevail in HCV cases are shocked to learn they are awarded 10% or 20%...or even 0% ratings. Many who have HCV aren't disabled by it. Just having a disease doesn't equal a disability rating.

If you do earn a small rating, you also may be shocked to learn that the dollars will be less than your NSC pension.

Unless I've missed a lot about your conditions, I'd probably advise that you drop it all and live your life without worrying about cases that probably can't be won. If you have pension and health care, you're ahead of the game...many out there don't have close to that.

Medicare and VA Benefits

Jim,

My husband sustained a head injury in 1968 in Viet Nam. He is rated 100%. He will turn 65 in August. He doesn't know whether he should apply for medicare or not. Is there anyway that by applying for medicare he would lose his medical benefits with the VA? Do you have any recommendations? I appreciate your help and your love for your fellow veterans with their concerns. Thank you.

Reply:

If he will be collecting his Social Security benefit he will have Medicare as part of the package. Then there is the decision of taking A & B or only A. I've written about this and that's posted here


Getting lost records
Jim,

I have a friend that has an other than honorable discharge and he wants To gets va benefits – how does he start the process. He also lost his dd214

Reply:

Start by getting the 214 here http://www.archives.gov/veterans/military-service-records/

Once he has that in hand he should apply as usual for benefits here http://www.vba.va.gov/bln/21/compensation/

Guys with OTH are not always eligible depending on circumstances. This is particularly true if there are multiple periods of enlistment. It's best to apply, see what VA has to say and then appeal if that seems reasonable.



Permanently and Totally disabled

Jim,

thank you so much for the service you provide, I think I would have gone crazy (crazier) if I hadn't happened across this site when I did. I am an Army veteran of the Reagan, Bush, Clinton Grand Tour (Greneda, Panama, Persian Gulf I, and Somalia).

I recently recieved my VA awards letter; my disability rating was increased from 80% to 90%, I was granted Individual Unemployability, and was awarded Special Monthly Compensation, Category S, because I meet the Housebound Criteria due to "moderately severe symtoms of depression in association with PTSD" and "residuals of cold weather injury, both feet" and persistent migraine headaches.

Those lovely words "no examination will be scheduled in the future" are on the second page. My questions are as follows; am I entitled to PX and Commisary privelages? if so how do I go about obtaining them?; I've applied for SSDI and am waiting on VA medical records to forward to them--do you have any pearls of wisdom to dispense concerning the SSA? and is there a published list of benefits that I'm entitled to somewhere?

Reply:

Yes, you are now "P & T" or Permanently and Totally disabled. In your award letter packet should be a document that tells you how to apply for on-base privileges. It's fairly simple...you take the documents required to the appropriate office on the military base near you and with some computer work and a photo, you'll soon have an ID. You should get stickers for your car(s) so that your entry on to and off base is simpler.

If the appropriate paperwork isn't in the award letter documents, write a brief letter to your VARO to ask that they send the necessary stuff your way.

The SSDI is pretty much a sure thing. There is no requirement that says they have to give it to you but the VA 100% usually will ensure a quick SSDI decision.

With SSDI comes Medicare. You must decide how you want to use that benefit. On my web site you'll find a lot of good info about SSDI and Medicare here Read up and then I'll be around for any other questions that may come up.

Filing for disability

Jim,

I currently have a 20% for my right knee that was injured in basic in 1969.I had knee surgery a couple of months later. My knee never felt stable after that.Over the years my knee has gotten progressively worse,as well as my back problems which now include herniated disc, narrowed joints,and arthritis. The orthos now say I need a knee replacement as I am now bone on bone patella.I also have issues with the left knee which locks and has arthritis. Two years ago I was diagnosed with R tarsal tunnel,and had release surgery.I also have the beginning in the left foot as well.

On top of everything else, in 1980, I had a horrific motorclycle accident.I had a compound fracture of the right ankle,and fractured my right heel bone as well.My podiatrist tells me the arthritis in my heel,as well as my unstable knee could be the cause of the major instability in my gait,which he has measured as 30% static and 40% when striding. He says that my knee could have aggravated the heel fracture and the two combined caused the tarsal tunnel, as well as the left knee issues My osteopath says that I might have sustained a fracture of the vertabra in my neck that went undiagnosed at the time of my accident.I have had tention/migranes stemming from this injury for a number of years that likely as not were aggavated my right leg issues.

I have filed a claim for unemployability, and they tell me that they are close to sending it over for a decision.I am trying to get as many medical reports as possible from all of my new doctors.I also have been awarded social security diability for these same issues. The VA already has all the medicals from them.

I have (talked with an IME doctor) and he says he can help me.My question to you is should I retain a lawyer for this when I file the appeal,which I'm sure I will have to, or can some one like you help me? I could use any advise you could give me.

Reply:

You face many issues. Number one of which is that you don't understand the process of just how all this works. I'll spend a bit of time explaining it to you and then I'll hand you some homework. I want vets to learn the system for themselves rather then me telling them all the details.

You aren't eligible for the TDIU benefit if all you have is a 20% service connected rating. To qualify for IU you must already have at least a 60% single rating or a 70% combo of ratings with at least one of those being 40%. There are some rare instances when a lower rating may make one eligible but I don't see any opportunity there for you. See Here

Beyond that you had a 1980 event that VA will blame your current problems on. To alleviate that you will have to have medical records that date from 1969 to 1980 showing a steady progression of knee, back and hip problems. Those records must confirm that you made frequent visits to qualified physicians seeking treatment such as physical therapy and so on. Unless you have those confirming records you don't have much to support an allegation of progression of the condition.

You quote a podiatrist and the statement of a podiatrist won't carry any weight for diagnosing much. The VA will want to see you being evaluated consistently by an orthopedic surgeon over the years. When VA examines you for C & P you can bet they'll have an opinion by someone who in their eyes is more qualified to do disability evals than a podiatrist.

That IMR doctor will cost a lot of money. He does a good report and all that but if you don't have the foundation of the claim laid, it won't help you at all.

VA and SSA use entirely different methods to rate you. When VA looks at you, they only see service connected conditions. SSA sees all conditions.

Most lawyers won't talk with you unless and until you have a denial in hand. Once that happens you are then able to talk with and possibly retain a lawyer. However, unless I've missed something like a rating that makes you eligible for the IU benefit, I don't know that anyone would take your case because you'll continue to be denied until you meet eligibility requirements.
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