I had an ankle reconstructive surgery on 6 June, it's my 4th surgery on that ankle total(3 while in the Army and this one). I was rated at total of 60% before this surgery, only 20% was for ankle, I think. After I had this surgery I applied for the temporary 100% convalescent pay.
I just got a reply back from the VA saying they approved "a 100% evaluation is assigned from June 6, the date of surgery, and it is based on a need for a splint in a non-weight bearing status which will continue through July", 2 months. But they have listed that my pay starts on 1 July and ends 1August, only one month of 100% pay...
I sent with my claim, a letter signed from the Chief Doctor of Ortho at the VA hospital I had my surgery saying I need to be off work for 6-12 months for rehab and recovery.
I'm out of the original cast and in one of those boots and still on crutches. I should be off the crutches at the end of this month but will still be in a boot for another 2 months or so.
The claims process is confusing to me but I really need the financial help, especially since I can't work and cant go to school either. Can somebody please give me some advice on what I can do?
They approved me for two months but only pay for one month.. How do I get the pay for the other month? Is there a way to get the temporary 100% for 6-12 months like the doctor wrote???
Are you working with a VSO, if not go and start working with one. The VSO will ask you to go to your Doctor and have him write a letter stating that your surgical procedure has not healed yet and you need an additional six to twelve months of convelecence time. The VSO will submit that and once it goes through you should receive the payment.
Yes 100% can be continued on the bases of not recovered to full status. You need medical evidence to continue 100% Sounds like you did that already when you submitted for it in June but non the less get your surgeon/doctor to write letter.Also, VA pay is a month behind. So if you filed in June the first pay start date is July 1. After August 1. it goes back to your 60%. Are you sure your decision says 2 months? Further more being that your ankle is at 20% before surgery the VA can ask for a re-evaluation on your ankle after surgery because possiblity of improvement. The purpose of most surgeries is to improve the condition they operated on. If condition of ankle improved they can reduce the 20% to a 10% or even 0%. If you do not get a re-evalution mandate by the VA medical then you have lucked out. way to go.
VSO? There is a DAV office in the hospital but the guy who works there is very old and hardly ever there.
The letter says that I am approved for temporary 100% from 6June, day of surgery, thru July. Almost two months. The pay schedule that came with it says 100% on 1 July, which I haven't gotten and 1August back to normal.
I called the 800 VA number and the guy said I only get paid for one month, July. Even though my surgery was in beginning of June. He said this is normal but still doesnt make sence.. I'm approved basicly 2 months but only get paid for one?
Is this normal? I'm trying to get as much info on this crazy process so I can appeal it the right way if necessary..
|Moderator, Veterans Issues |
YOu can call the regional DAV office or the veterans group of your choice. They all offer free services to all vets. Counties have Veterns offices that offer the same services.
Yes this is normal. I suspected it would be for one month. Most are. But you can ask for more months like I said before.
Just thought I would relate my story on this subject.
After my retirement from the USAF in July 2000, I was VA rated 30% total; lumbar spine was rated at 10% for degenerative changes, rated 10% for thoracic spine degenerative changes, and rated 10% for right knee due to MCL tears and reconstructive surgery done in 1989.
After reirement, I was fully employed as a DoD contractor and was fat, dumb and happy with a 30% rating from the VA, never pursuing or researching any increase in compensation. I wish I had known about the 1 year after retirement presumptive period too.
Due to increasing problems over the years, such as herniated disks, along with severe pain and numbness in my legs and back, I was eventually diagnosed with lumbar spinal stenosis which required surgery.
I had lumbar fusion surgery on 14 May 2007. I was fused at the L4-L5 and L5-S1 levels, with rods, screws and cadaver bone to form the fusion. My orthopedic doctor has not released me to work since my surgery.
Until I found this forum I was unaware that I was possibly eligible for a temporary 100% rating while in recovery from surgery.
I went to the county VSO as soon as I was released by my doctor to go anywhere other than doctor appointments, which was in September 2007. I applied for an increase in rating due to severe limitations in motion due to the fusion. I also applied for temporary 100% for the time period of the surgery and recovery.
As of today, 29 July 2008, I have received ZERO in temporary compensation and ZERO in an increase in compensation. I have received the form letters from the Decatur, Ga VA office informing me they are still evaluating my claim. In June 2008 I sent an inquiry through IRIS and got back a response that my claim is now with the rating board.
Fortunately, I am receiving long term disability insurance payments from my previous employer or I would have lost pretty much everything while waiting for a decision from the VA. I realize they are very busy.
I have also been denied SSDI. I have now retained a lawyer for the SSDI appeal.
Anyway, to those that have received timely convalescent compensation, I am glad for you.
Also a big THANKS to all those that keep this forum going. It is extrememly informative and a lifeline to many of us when our patience with the bureaucracy is strained.
It has been explained to me by my Regional VA Office that they no longer give seperate decision when you have 2 or more issues claimed. Basically you filed for increase and for 100% due to post surgery. The VA will send you a rating decision for all of it. it happened to me too. Filed in August 2007 did not get my decision until April 2008 with the one month of 100% included with decision. I have seen the 100% granted within 2 months or so when that is all the veteran is asking them to do.
|Moderator, Veterans Issues |
SSDI is not meant for temporary disability. If you are not able to go back to work, then you qualify for SSDI. To be eligible for the SSDI program, Social Security's definition of disability must be met. To meet medical eligibility requirements of SSDI, an individual must be unable to engage in any Substantial Gainful Activity for at least 12 months.
"To be considered medically disabled according to Social Security rules, an individual must be unable to engage in any "Substantial Gainful Activity" (SGA) due to any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. In addition to being unable to perform his or her previous work, the person cannot, considering age, education, and work experience, engage in any other kind of SGA that exists in the national economy (1967 Amendments)."
Dave_M: Yes, I understand that SSDI is for permanent, not temporary, disabilty. I am continuing to pursue SSDI since I have been kept out of work 14 months, so far, by my orthopedic doctor. At this point I cannot engage in any "Substantial Gainful Activity" and my doctor is suggesting I will probably have to have more surgery soon.
By coincidence I received my claim decision letter today from the VA. Under the heading, What Did We Decide, it states, "A temporary evaluation of 100% has been assigned effective 14 May 2007 based on surgical or other treatment necessitating convalescence. A 10% evaluation is assigned from September 1, 2007. Your overall or combined rating is 100% from June 1, 2007 to September 1, 2007 then 30% from September 1, 2007."
Under the Reasons For Decision section in the Rating Decision, it states, "We have assigned an evaluation of 10% because we do not have the current status of this disability. We will set up an immediate examination for this condition." I had a C&P exam at the Dublin, GA VAMC in December 2007. It appears they do not have that information from the December 2007 C&P exam. Otherwise, why set up another exam so soon??
Bottom line, I was given 3 months convalescent pay at 100% for June, July and August 2007. As of 1 September 2007 I was reverted back to my original 30% overall rating.
I was expecting some increase of my overall percentage due to the reduced range of motion I now have. Needless to say, I am disappointed with being reverted back to my original rating but I am glad to have received the 100%, even if only for 3 months.
You're almost right. I think the VA is saying exactly that "No CURRENT" status of this disability. They are not saying they do not have that C&P exam. You can certainly find out quickly with a call to the VARO
|Powered by Social Strata|