Question:
Jim,
Thanks for all you do for us veterans! Without your column and the assistance you provide, I am sure many would be left without or at least a more difficult time in obtaining benefits. I am a 100 percent Vietnam vet. (70 percent PTSD and 30 percent UI). I was recently diagnosed with type II diabetes. Is it worth while to submit a claim for the diabetes? I know (well, assume) I can't be rated more than 100 percent, so what would the benefit be for me to file this?
Again, thanks for all you do!!
Answer:
Thanks for the kind words. I really appreciate it.
Yes, you should file for the diabetes. You won't get more money, correct, but it could protect your future.
Let's say VA decides to reexamine you because your PTSD is better. They do that often, don't believe the P & T stuff...it's a lie. If they tried to lower your PTSD to 50% because you've “improved”, you could lose your IU. If you have your diabetes rated at 20% Service Connected, you're still good to go.
Most important though are future secondary conditions. You have diabetes. Diabetes is known as a precursor to vascular disease. If your diabetes is rated as a service connected condition, any future vascular disease (heart attack, stroke, some kidney problems and so on) may be rated as SC secondary to diabetes.
There is a small risk. You apply for a diabetes rating today and some gung ho employee at the VARO decides it's time to reexamine your PTSD just because he had to go get your file. However, that risk of reexam is there already.
If it were me, I'd file for the diabetes.
Also, I wouldn't complete the long 526 application unless they asked me to. I'd write a letter.."Dear Sir/Madame, I'm currently rated and so on and I just got diagnosed with type 2 diabetes. I'm a VN vet and want my rating increased accordingly."
They will set the start date and notify you. If they need a 526, they'll send one to you.
Jim Strickland's Mailbag: Volume #46 for 2008
NOTE: Letters in my mailbag 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.
06.16.08
Question:
Jim,
How are you doing? I read your mailbag # 40 on the watchdog as I always find you column educational. I was a little surprised by your response to the veteran from a small community who has been authorized fee basis for mental health care or treatments. I fully agree that the VA is well staffed to help combat veterans with PTSD assuming the veteran will have adequate access to care. However, mental illness can present in many different guises, and there are many therapists, counselors, and doctors who are very good at providing treatments.
In my own case, I have weekly sessions in my small town which is about 130 miles from the closest VA facility. I have had care for my PTSD coming up to 20 years now, and the very best counseling / therapy I have ever received is conducted by a local PhD psychologist. As far as I know, I was his first combat PTSD case. However, the numbers have been growing for him over the past year and we may even establish a group session to support our individual weekly sessions. Part of it is that this counselor is also a veteran who has overcome his own disability. So there is a level of rapport that is much deeper than could ever be established with a young, caring, charming VA psychologist who just does not have the life experience to understand our issues.
I would recommend that he simply ask his physician at the VA for a recommendation and then make an appointment to see if he can work with the new provider. This is a highly individual and personal process. One size will not fit all. I would also encourage him to ask for help in identifying local providers by speaking with some of the local physicians. I have noticed a great deal of relief simply because I am saving 2 to 4 trips a month into the VA hospital which takes a whole day to complete. The reduction of overall travel stress may also help the therapy process. Additionally, if the service is provided on a fee basis, the local provider will be evaluated to make sure that VA standards of health care are being delivered. This may be seen as privatizing the VA in one sense, but if he has to drive more than an hour to get to an appointment, it may be a better choice for the veteran.
Also, if the sessions do not help the small town veteran, then he can always return to the VA system for his mental health concerns.
Just another perspective - please pass this on for me to the veteran who asked the question about mental health care on a fee basis.
Answer:
Thanks for writing to me. I appreciate your nice response. I happen to agree with you...to a degree, with caveats.
I write to a broad audience. I must generalize a fair amount.
I stand by my assertion that the vast majority of PTSD vets will be better served by mental health professionals provided through the VA. I say that for a number of reasons, the first of which is that the VA has vast resources and is getting more resources to serve this unique group.
The "group" at the VA is a sort of support system in itself. I know a lot of guys who prefer the VA because of the familiarity of the men and women around them. When you walk in the doors, it often feels like home...I know all those guys and share their experiences.
Beyond all that, I believe you got lucky. Let's think about how many small towns will have a PhD shrink who will accept VA fee basis (many won't, they aren't required to) and who "is also a veteran who has overcome his own disability" and further will "have the life experience to understand our issues".
I'm becoming more open to a fee basis solution modeled on Medicare. I wasn't until I heard this analogy...
When veterans came home after war decades ago, our country wanted to care for them. Two major efforts were put in place to provide education and health care exclusively for vets.
The GI Bill, in one form or another, gave veterans funds to attend approved colleges. The VA health system built hospitals.
Consider if the opposite had happened. What would that system of schools for veterans look like? Attachments to universities with borrowed professors?
In any case, there is plenty of room for debate and thought.
I appreciate your writing and I will share your note (anonymously) with the gentleman who wrote in. I'll also publish your letter in a near future mailbag.
Question:
Jim,
Hi again-Hope all is well with you. Its been over 3 months since my personal hearing with the VA, and I haven't heard anything yet. My last QTC exam was about a month ago, so I'm hoping to hear from them soon. Boy! they can sure screw with a persons life just waiting, hoping, going everyday to the post office, and nothing again.
Anyway I have a question about my military medical records which I have been after for over a year and a half. I keep getting a run around from the VA about having to photo copy them, and will get them to me a.s.a.p., and so on. I was originally told after waiting 8 months that they were sent to my regional office which I'm sure they were. I have been trying to get a copy from them for another year while my appeal is happening.
Someone has told me that the originals would never have been sent to my regional office, and that they would have sent a photo copy. Do you think I'm getting the run around, or is this just standard procedure. I am very curious to know what they say about how I was exposed to HepC. Thanks for all your help in the past, and present from some very grateful Veterans.
Answer:
I know, the waiting is a killer. I firmly believe if VA would look us in the eye and say, "We will be screwing around for at least a year, maybe two. So, go away and we'll get to you when we get to you." we'd all be better off.
You ask, "Do you think I'm getting the run around, or is this just standard procedure?"
I believe the run around *is* the standard procedure.
It's really hard to grasp how poorly organized the VA is. It isn't that the left hand doesn't know what the right hand is doing, often the left has no idea the right exists. And when discovered, they don't like each other and interfere with everything just because.
If VA were a civilian business it would be out of business in weeks due to the massive incompetence. I really hate to say that because I've come to know some guys who work there and they're good people. The best employees at VBA are as frustrated as we are.
The most powerful weapon you have is a clear, concise, brief letter stating exactly what you want. Only use certified mail, return receipt requested. It may not get you what you want but it's great evidence for an appeal. As you appeal a denial, your folder climbs up from the
bottom of the food chain to a level where some human intelligence resides.
Evidence in your folder of your repeated attempts to have the VA follow their "Duty To Assist" always works in your favor on appeal.
I'm advising veterans that what most of us are doing today is no more than buffing our folder for appeal. Your application for benefits may not reach a knowledgeable decision maker until you get to a DRO or the BVA.
Sad, isn't it?
So...write letters and keep at it. Never let the bastards get you down.
