Over 100% ratings in VA Disability Claims (General) Forum

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Over 100% ratings

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scs	Over 100% ratings		Lead	[-]
Posts: 160 Aug 15 11 11:58 PM	Tags : None Maybe I am being Obtuse, but what is the point of filing new claims when you are already 100% T&P. I thought the VA would cover everything once you are 100%, Or does the VA only cover service connected problems regardless of your overall rating. If that is the case then it makes sense to try and get everything possible service connected.
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namwife2		#1	[url]	[-]
Posts: 314 Aug 16 11 12:13 AM	My husband started in 1975 trying to get the VA to acknowledge his back injury from Vietnam but they would not do so, saying there was no proof. He injured his ankle also and they won't acknowledge it. Instead, they gave him 100% for PTSD. With a new rating, we were able to replace a small portion of my lost income and with a new rating he will be able to apply for life insurance (which he didn't have when I married him 14 years ago and very expensive at our age). But mostly for him, he wants the VA to acknowledge that he hurt his back in Vietnam from a 30 foot fall and also injured his ankle (which is now fused). He was flown out to the hospital, but of course there are no records to be found and the VA just says, we know you were in the hospital but we don't know what for. Still looking for those records.
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71infantry		#2	[url]	[-]
Posts: 4990 Aug 16 11 12:32 AM	scs wrote: Maybe I am being Obtuse, but what is the point of filing new claims when you are already 100% T&P. I thought the VA would cover everything once you are 100%, Or does the VA only cover service connected problems regardless of your overall rating. If that is the case then it makes sense to try and get everything possible service connected. I am rated over 100%.. even thought technically there is no rating over 100%. If your talking about medical care .. thats true or I thought it was untill I leaned the va can bill fo non-service connected care even if your rated 100%. But going over 100% really hasn't anything to do with medical care.. it is more to do with money...... anytime someone tells you they have a SMC ( special monthly compensation) that means they are being paid over the normal compensation rate for their disability. For example; I receive an extra $96 a month because I have been rated loss of use for my foot. In addition I was awarded the one time auto grant, and lifetime auto adapted equipment, auto adapted equipment is worth from $3000-$5000 for each vehicle I purchase. That means if I want I can purchase a more expensive than I normally would because I am going to get this extra cash, by the same token.. I can use this cash as part of my down payment, and save so finance charges.. either way it .. I get these funds for two vehicles every four years if I decide to purchase a new vehicle every four years.... Lot of talk on here about SMC S Housebound,,, which is paid when ever a veteran has a 100% rating and a seperate 60% rating the difference between 100% or 100% +60+ is $320.00 for a single veteran. For aid and attendance SMC L, for a single veteran the difference between 100% or 100% A&A ... is $654... a month Or if a veteran is rated 100% and has a seperate 50% rating his A&A rate is L 1/2 and the difference is now $826.00 for a single veteran.. These are just the three more common examples... so If I told you that I have rating that add up too 250 ( and I do) one rating is 100% by itself... and I get a K award for loss of use of a foot, and becaue I also need A&A and have a seperate 50%+ rating over 100% I get A&A at L 1/2... this means my total compensation is $3745.00 monthly since I am married.. so that is $922.00 more that a straight 100% rating..... many other veterans have far serious problems than me for example loss of eyes, loss of feet, loss of legs, loss of hands etc... receive compensaton much higher than the normal 100% rate.. See teh compensation tables here and compare the differences: http://www.vba.va.gov/bln/21/Rates/#BM01 So when someone tells you it isn't worth the trouble trying to get that extra rating think again... it could be the difference between $3745 and $2823 a month.. which would you rather have?" Hope this answes your question...
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sailor4eva		#3	[url]	[-]
Posts: 93 Aug 16 11 6:00 AM	I would say that even if a 100% for one condition and the other at less. you should always put in all the disabilities you have because they get worse with time so asking for an increase doesnt just say money to me it means damn I am getting worst. for example my back is killing me more now than when I put in my first claim and my sleep apena machine needs more pressure than before too. now the VA tells me that my liver is in really bad shape cause of the pills they give me since I dont drink alcohol at all cant get better without messing something else up just have to laugh about it.
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ChiefT		#4	[url]	[-]
Posts: 310 Aug 16 11 6:53 AM	Just because you are rated at 100% or higher does not mean that your spouse would receive DIC. below is a brief recap of what DIC is and who qualifies. Eligible Survivors: DIC is a monthly benefit paid to eligible survivors of the following: Military service member who died while on active duty, OR Veteran whose death resulted from a service-related injury or disease, OR Veteran whose death resulted from a non service-related injury or disease, and who was receiving, or was entitled to receive, VA Compensation for service-connected disability that was rated as totally disabling for at least 10 years immediately before death, OR since the veteran's release from active duty and for at least five years immediately preceding death, OR for at least one year before death if the veteran was a former prisoner of war who died after September 30, 1999. As you can see if you die from a non-service-related injury or disease and have not had the 100% rating for 10 years then no DIC. So the bottom line is get everything rated as SC as soon as you can and that will protect your eligible survivors. Paul CMSgt, USAF, Ret (66-92) Cam Ranh Bay (Jan 69-Jan 70) NKP Thailand (Jan 70-Jan 71) Desert Storm (Dec 90-May 91) 100% P&T IHD (AO) 10% DM II (AO) 10% PN right foot (AO) 10% PN left foot (AO) CRSC Approved 100% (IHD)(AO)
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The Old Medic		#5	[url]	[-]
Posts: 6039 Aug 16 11 11:17 PM	If you are rated at 100%, there is absolutely NO bill for ANY medical treatment provided by the Department of Veterans Affairs. NONE. absolutely NONE! This includes surgery, hospitalization, prescriptions, therapy (inpatient or outpatient), medical devices (orthotics, braces, wheelchair's, etc.) or for anything else This is true of any veteran rated 50% or higher, for everything except for Dental care (with a very few exceptions). People rated at 100% or IU, are even entitled to free Dental care (as is anyone with a Service Connected Dental disability. If you are rated as 100% S/C, and you are billed for any medical treatment, whether service connected or not, something is wrong and you need to report this to the VA. Of course, if you go outside of the VA System from treatment, they do NOT pay for that, unless they authorize "fee basis" outside treatment. US Army 1959-1969; Germany 1960-63; Medic 1964-69 SFC E-7 MOS: 55G10 (60-63) , 91B40, 91C40, 91F40 (64-69) Registered Nurse, 1968-2005 (Licensed, not practicing after 1975) Ed.D in Rehabilitation Counseling, Certified Rehabilitation Counselor Retired, Licensed Clinical Psychologist, Independent Social Security Contract Vocational Expert 1983-2005, Contract Medical Expert 1987-2005 60% Service Connected Disabled; Life Member of the DAV since 1980
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71infantry		#6	[url]	[-]
Posts: 4990 Aug 17 11 12:11 AM	The Old Medic wrote: If you are rated at 100%, there is absolutely NO bill for ANY medical treatment provided by the Department of Veterans Affairs. NONE. absolutely NONE! This includes surgery, hospitalization, prescriptions, therapy (inpatient or outpatient), medical devices (orthotics, braces, wheelchair's, etc.) or for anything else This is true of any veteran rated 50% or higher, for everything except for Dental care (with a very few exceptions). People rated at 100% or IU, are even entitled to free Dental care (as is anyone with a Service Connected Dental disability. If you are rated as 100% S/C, and you are billed for any medical treatment, whether service connected or not, something is wrong and you need to report this to the VA. Yes until yesterday I though this was true,.. but it isn't... I had to do some homework on this one.. and like I told you the other day in another post you need to do your homework. http://vets.yuku.com/topic/63597/VA-charging-private-insurance-for-services 71infantry wrote: I don't think it is legal for va to charge insurance for veterans rated 50% or more. Of course VA can bill insurance companies for treatment for any condition that is not service connected regardless of the veteran's evaluation. The advantage to those veterans who have to pay a co-pay is that anything that is paid by insurance will go against the VA co-pay; but at the end of the day VA has every legal right in the world to bill insurance when it involves non-service connected conditions. Cruiser http://www.va.gov/opa/publications/benefits_book/benefits_chap01.asp Private Health Insurance Billing VA is required to bill private health insurance providers for medical care, supplies and prescriptions provided for treatment of veterans’ non-service-connected conditions. Generally, VA cannot bill Medicare, but can bill Medicare supplemental health insurance for covered services. VA is not authorized to bill a High Deductible Health Plan (which is usually linked to a Health Savings Account). All veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. Veterans are not responsible for paying any remaining balance of VA’s insurance claim not paid or covered by their health insurance, and any payment received by VA may be used to offset “dollar for dollar” a veteran’s VA copay responsibility. The va can even bill tricare..... http://www.tricare.mil/my...+bill+tricare&=#1200 Using Veterans' Affairs Facilities The VA cannot bill Medicare for treating patients who are entitled to VA care as well as Medicare. When seeking care at the VA you must make a decision to either use your VA benefits or use your TRICARE for Life benefits. If you use your TRICARE for Life benefits, Medicare will not pay anything and TRICARE will be the primary payer. In this case, you are responsible for the TRICARE annual deductible and cost shares.
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