Health & Safety

Question:

Do you know of a good doctor in Oregon who helps veterans write Nexus letters?

Jim's Reply:

No, darn it...I don't know of anyone in Oregon who writes nexus letters. In fact, we don't talk of nexus letters these days, rather we talk about the independent medical opinion or IMO. You don't want the doctor closest to you, you want the doctor who will do the task you need done as professionally as it can be done.

I refer to a small handful of professionals across America who will be able to help you. Have a look here and talk to any one of these doctors or talk with each one https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html  

Question:

Jim: I've recently earned 100% P/T. Of course, this benefit opens many more doors within the state and the VA. My question is about CHAMPVA's pros/cons. I've searched many websites but there is not a lot of info or references that does a deep-dive into the program. Some say it's a great program while others say it's a bad program due to many doctors, hospitals, etc., being unaware of the program (payments scheduler, etc). Can you please elaborate a bit on what you might know concerning CHAMPVA (pros/cons) to include providing any veteran dependent stories about their care via CHAMPVA online? Thank you for your time and assistance.

Jim's Reply:

I'm not at all sure what you're reading or where but CHAMPVA is insurance, nothing more, nothing less. Like all insurances the program requires that you learn how it works. Dealing with the offices of CHAMPVA is a very typical VA experience with lost paperwork, unanswered calls, voice mailboxes that are full and all the administrative bungling we know and love at our VA. Patience and an eternal cuppa are the secret to working with CHAMPVA.

Of course that can be said for almost any insurer today, they're all a pain to deal with and figure out what the rules are that they play by. I've not come across any hospital that doesn't readily accept CHAMPVA and most doctors who accept Medicare (most doctors) are happy to see the CHAMPVA patient.

My wife has used CHAMPVA for over 15 years as her only insurance and we think it's the best insurance she's ever had. She's currently melding her new Medicare benefit into the fold with CHAMPVA and doesn't seem to have hit any bumps in the road.

My stepson's family (spouse, 2 kids) all use CHAMPVA and everyone is happy and healthy.

The disabled veteran is assigned a primary caregiver who may or may not timely refer you to specialists that you might have to travel hours to see. You have little choice in how your care is doled out. The CHAMPVA beneficiary is able to choose their provider and seek out specialty care without a referral. Medicines come in the mail, copays are low, preventive care is included and...it's free.

That a given doctor's office may not be familiar with CHAMPVA isn't surprising. With the ACA small and unheard of insurance companies are everywhere and the people who deal with the insurance for the doctor are always happy to talk with you up front. My wife has educated some doctors offices and everyone is happy...they get paid, she gets good care.

If you can find a better deal, take it. Once you're set with a doc or two, it's seriously good insurance. I'd like to have CHAMPVA for myself but all I get is this VA care thing...

Question:

Hello: After a long battle (8 years) with the VA, I finally was awarded 100% P/T. During this long battle, I became proactive and returned to school to earn several degrees. I have always yearned to return to the military as an officer. I now have that opportunity. However, what will happen to my 100% P/T? I've read different options in numerous online website, blogs, etc., including a recruiter. The options include losing my disability, suspension of my disability pay but not losing my disability as a whole, not being able to refile for disability, etc.... Do you have any advice or information that might be more helpful in making such an impactful decision. Thank you.

Jim's Reply:

Many people with disability ratings do return to active duty. These are mostly lesser (<50%) ratings for conditions that will not have a negative effect on the returning member's ability to perform the requirements of the elected MOS.

The service member who is accepted to return to active duty will give up the VA disability ratings while active and more or less be required to adjudicate the claim(s) once again at the end of this term of service. Realistically, no matter how you slice and dice it, being labeled as 100% disabled and living the rigorous life of an active soldier is incongruous at best.

At ETS you'll have a blank slate with VA.

I question whether you will be viewed as fit for duty with your 100% P & T rating. If you were successful, that's a lot to give up for a dream. Were I you, I'd probably take a pass on the whole thing and find another way to fulfill my yearning to be back in uniform.

Good luck.

Question:

I was awarded TDIU P&T earlier this year, with an effective date of August 2011. My question pertains to the S-DVI insurance policy that is available to 100% disabled veterans where the premium is waived. I understand that eligibility ends at 65. I am currently 72, however based on the effective date of my award, I am 63-64. Under these circumstances, am I eligible? I did call the appropriate department and was told no, which makes no sense. Looking for your opinion. Thank you.

Jim's Reply:

You must have an award of a new service-connected disability to be eligible for S-DVI. 

Ratings of Individual Unemployability are not considered grants of “new” service-connected conditions under S-DVI. You must receive a rating for a new condition not previously rated by VA.

In my opinion you're not only not eligible for a waiver, you aren't eligible for S-DVI.

Question:

Were Vietnam veterans on the USS Ranger, during 1962, exposed to agent orange?

Jim's Reply:

See:

https://www.va.gov/disability/eligibility/hazardous-materials-exposure/agent-orange/

and

https://www.va.gov/vetapp12/Files2/1212750.txt 

Question:

Hi Jim, First I like to thank you for all you do. I am a Vietnam vet with prostate cancer. I have been awarded 100% for over 10 years under watchful waiting. I was also awarded 60% for IHD at the same time. Since the award for IHD I have undergone a quintuple by-pass, defibrillator, and pace maker. I am now about to get a cow valve as they have indicated further by-passes may not go well, I would like to attempt to have the 60% increased to 100% P&T. I guess I would like to get your opinion.

Jim's Reply:

Your rating should be 100% P & T now because of the defibrillator device...the AICD. If the IHD caused the electrical malfunctions in your heart that led to the AICD, that's a 100% rating.

You need to file the claim.

Question:

Greetings. I am 90% but 100% with TDIU. I have been diagnosed with Parkinson’s. I was at Camp Lejeune in 68’ for more than 30 days. Is it worth my while to file for my Parkinson’s with the VA? Will I damage my current status if I do?

Jim's Reply:

Yes, you should go ahead and file the claim for Parkinson's Disease as associated with contaminated water at Lejeune. 

Since I don't know the specific ratings that brought you to your 100% TDIU I'm not sure of how this might affect current ratings other than to say they won't be reduced. Your ratings could remain as they are or you could experience a change from the TDIU status to a 100% schedular rating. 

Filing the claim now may also help protect you in the future should your physical conditions deteriorate over time with age. The time you'll spend filing this claim will be well spent. Good luck.

Question:

Please direct me to a link for Blue Water Navy. I was on two Westpac tour in the Gulf of Tonkin '70 - '74. I never stepped foot on Vietnam Shores. I remained just off the coast for two 6-month tours. I have Non-Hodgkins Lymphoma. I was told that I may qualify for Agent Orange. If this is true how do I find out?  Thank you.

Jim's Reply:

It's likely that you are eligible for a VA disability benefit...probably 100%, Start here: https://www.va.gov/disability/eligibility/hazardous-materials-exposure/agent-orange/

Now...don't ask more questions, don't talk with others, file the claim. https://www.va.gov/disability/how-to-file-claim/ 

The longer you delay, the more you lose. Too many vets try to go into way too much detail when their claim is most likely to be won on the face of it. You really don't need help or representation, follow the instructions and file the claim. Good luck.