Month: February 2016

Guest Post: Applying for VA Disability at Military Retirement

Today we have a guest post about one veteran’s experience applying for VA disability in conjunction with retirement from the military:

“I recently retired from the military. I was fortunate to have some people knowledgeable in VA procedures to help me find my way through the little known avenues of applying for VA benefits. For starters, I was in a career field that discouraged complaining to the military doctors about physical ailments. That does a great disservice to the military member when it comes time to separate. If the ailment is not in your records, then it is difficult to prove to the VA that it was service connected. Fortunately, again, my last assignment was not as operational and I used that time to get to the doctor and get all of my problems written into my medical records. That did require many trips to the base/post hospital, but those trips were worth the effort, even if they did not resolve the issue. As I got close to my retirement date, I began the process of getting into the VA system.

The second thing I did was to attend the Transition Assistance seminar offered by the military. While not everything in this seminar may be relevant to you, the visit from the VSO (Veteran’s Service Organization) representative (if he or she is any good) WILL be worth your time. If you cannot attend the TA seminar, please contact a VSO representative BEFORE separating from the military. They are often found at VA hospitals and military hospitals, or a list can be found on the VA website. They will help you fill out the proper forms and get started. Applying before you separate makes things easier.

Well in advance of retiring, I went to medical records at my installation and had them make two copies of my complete medical record: one for me and one for the VA. This can often take a few months. I suggest you never give up your copy of your medical records. I went over my complete record and made a list of everything I ever saw a medical professional about while on active duty. The VSO representative will want a copy of your medical records to review as well, so be sure to give them a copy. My VSO found things to apply for that I would have completely ignored. I was surprised at what I got disability for and what I did not get disability for. I also highly recommend reviewing the e-CFR, Title 38, Chapter 1, Part 4 available on-line to see what the VA can give you disability for. I did this around the time that I applied for my appeal to the VA’s initial decision and wish I had reviewed them sooner. They are available here.

Even if the VA only gives you a zero compensable disability for something, it is in your records as service connected and can be upgraded later if the problem gets worse. The important thing is having proof that you had the condition while you were on active duty. If you have it in your VA medical records from your separation exam, then it is, as I understand it, by definition, service connected.

Eventually, the VA set up an appointment to review my case with a VA Physician’s Assistant (PA) but you may see a doctor there. This is where they assessed the degree of my physical ailments. This doctor or PA will not assign any disability. They fill out paperwork and send it off to others who will decide your VA fate. The doctor/PA will probably be very friendly (as mine was) and you can be friendly as well, but remember, they are there to assess you and you are there to convince them that you actually are impaired. (I am, of course, assuming that you are impaired and not trying to game the system. Please do not try to apply for things that are not actually wrong with you. Fraud is dealt with harshly by Uncle Sam.)

A few months later I got the results from my appointment with all the data on my 70% disability and information on disability pay. As I mentioned, I did appeal the decision on basically everything that the VA turned me down for that I knew gave me trouble. After going through the same process a second time, I was finally awarded a 100% disability. They had neglected to assess one of my biggest disabilities, plus I was awarded a few smaller percentage disabilities that had been zeros previously. Overall, because I started early and was knowledgeable on the process, the entire ordeal, although long (7 months for initial rating plus another 7 months for the appeal), was not as difficult as I had been expecting.

If you are eligible to be seen at the VA, I recommend going at least annually to get a check-up just to keep your file current even if you get your primary care somewhere else. I do this and feel a bit out of place due to my age. If you are newly retired or separated, you may feel a bit out of place at the VA as well, but don’t let that scare you into avoiding it.

Finally, there are lawyers out there listed on the VA website who specialize in dealing with the VA. I thought that seeing one early in the process would help. It did not. Remember, they work for a fee, while the VSO representative works for the organization they represent, and there is no charge to you. I am not disparaging the lawyers, but as the lawyer I saw told me, there was nothing he could do until the VA had rejected my claim. If you feel the VA is not giving you the disability you deserve and the VSO representative is at the end of his ability, then by all means consider one of those lawyers, but do not waste money on a consultation before you need it.” – Die Fledermaus

Thanks, Die Fledermaus, for sharing your experience with us.

***I (Crew Dog) STRONGLY recommend that you consult with a VSO BEFORE filing your initial claim – they have the experience to make the claim stronger and the process smoother.***  For example:

Filing a VA claim – AMVETS

Filing a VA claim – VFW

VSOs for benefits claims assistance, career guidance, and more

Advice from a lawyer: 8 ways to improve your disability claim

Here are some additional resources that may help you if you are applying for VA disability compensation benefits:

What is all this, anyway? A thorough explanation provided by MOAA

Understanding the VA disability application process

Getting started (pre-discharge from service)

Applying for benefits (all benefits)

Compensation

VA service-connected disability compensation rates

38 CFR Book C, Schedule for Rating Disabilities

Legal presumption of disability

Another Vet’s experience: Lessons I learned filing for disability benefits

How do veterans file a PTSD claim?

The VA denied my disability claim. Now what?

 

Dealing with a Health Condition or Disability that Others Can’t See

Unseen disabilitiesSome disabilities are visible, and others are not. They each have their own challenges. I can’t personally speak about what it’s like to have a disability that is obvious to others. If someone who has experience with that would like to write a guest post for this blog about their experiences, please contact me.

My disability is chronic and debilitating, but it is not visible. When it is flaring up, people sometimes notice symptoms. But most of the time, it is not obvious. While that means I don’t always have to deal with other people’s biases or awkwardness, it also means that other people typically don’t understand or respect my limitations.

It can be difficult for others to accept or remember your restrictions when “you don’t look sick” – especially if they have never personally experienced a chronic illness or disability. They may become offended when you cancel plans you had made with them, or don’t keep in touch as often as you used to. Or, because they don’t understand your limitations, they may try to convince you to do things you know would be detrimental to your health.  They may even imply that you are lazy or “faking.”

Before my condition became debilitating, I didn’t understand when someone with a chronic health condition told me that sometimes it was just too exhausting to go to church because so many well-meaning people would come up and ask how they were doing. I didn’t understand when I read on a blog that a person with a chronic health condition had gotten divorced because they just didn’t have the energy to cope with their health *and* try to sustain a relationship. Now I understand.

If you have an unseen illness or disability, and you have people in your life that you would like to have a better understanding of your reality, I highly recommend this post by Christine Miserandino.  (You can also download it from that website as a pdf.) It’s called The Spoon Theory, and it’s the best explanation I’ve seen of what it’s like to live with a chronic, debilitating condition.  Even if they still don’t really get what it’s like to be you after reading the article, at least it will give you a common vocabulary to explain things to them.  I find it very helpful to be able to say, “I don’t have enough spoons for that,” or “If I do this with you, it will take all of my spoons, or nearly all of my spoons, and then I won’t be able to do x, y, or z.  Is that how you would like me to spend my spoons today/ this week?”  It helps make my reality a little more tangible for others.

P.S. – If you’re wondering what the people at church “should” have said to the person with the health condition – if you’re wondering what the “right” thing is to say to someone you know is coping with an illness or disability – I recommend “It’s nice/good to see you.”  It acknowledges that you noticed I haven’t been around, and you noticed I am here today, but it doesn’t require me to spend my limited energy talking about my health.  If I’m feeling well enough to be here today, I probably don’t want to be reminded that I frequently *don’t* feel well enough to attend, and I don’t want to feel defensive about my limitations.  Just say “hi” – it’s enough.

Proposed Health Care Hikes in Pentagon’s 2017 Budget Proposal

Another good reason to embrace preventive health and self-care: retiree health care benefits continue to erode.  Recent proposals would make health care significantly more expensive for retirees and their families.

According to this article in Military Times, the Pentagon’s proposed 2017 budget includes several changes to the existing Tricare system and to the fee structure.  The most significant price change is the proposed implementation of an annual healthcare fee for “working-age retirees” – retirees (and family members) who are not yet eligible for Medicare.

Under the proposed plan, Tricare would be re-structured into two choices: Tricare Select, which provides care through military treatment facilities (MTFs) and is similar to the current Tricare Prime option, and Tricare Choice, which provides care through civilian providers and is a hybrid of the current Tricare Extra and Tricare Standard options.  Tricare Select would cost $350 for an individual or $700 for a family (per year).  Tricare Choice would cost $450 for an individual or $900 for a family (per year).  Please see the Military Times article for proposed co-payment rates and other proposed fees, which would be in addition to the annual enrollment fee.  What’s the bottom line?  According to MOAA’s president, retired Air Force Lt. Gen. Dana Atkins, “the full array of fee changes would mean about a $500 to $600 annual increase for retired families under 65 who use in-network providers and an increase of more than $1,000 a year for those using out-of-network providers” (MOAA article on the proposed changes here).

The proposed budget also includes increases to the catastrophic caps for beneficiaries.  For retirees, the cap would increase from $3,000 to $4,000, and participation fees would not count toward the caps.

Military Times states, “According to budget documents, the changes are designed to entice more beneficiaries to use military hospitals and clinics by continuing to offer care at these facilities at no cost to patients and curb the rising costs to DoD of private care.”  As has previously been pointed out on this blog, this places patients in a very difficult position when MTFs in their area are at capacity and not accepting new patients.

Furthermore, MOAA is concerned about the robustness of the non-military network of providers.  In the MOAA article, Lt. Gen. Atkins asserts, “One of the main access problems is that many doctors don’t want to be in the current network.  We’d like some assurance that will be fixed.”

The new system would require annual enrollment, and families who fail to enroll and pay the enrollment fee will forfeit coverage for the plan year – in other words, coverage would no longer be automatic, and if you don’t sign-up during the enrollment period, or fail to pay the fee, you would have no military healthcare for that year.  While it is suggested that requiring annual enrollment would bring Tricare in line with civilian heath plans, one wonders about ulterior motives.  Research has repeatedly shown that individuals are more likely to participate in benefit plans that are opt-out, rather than opt-in (read more here, here, or here).

These proposed changes are intended to change beneficiary health care behaviors.  In other words, if it costs more to see doctors and specialists, and it costs more to have prescriptions filled, maybe you won’t use them as often.  (Of course, if you miss the sign-up window, you won’t be using them at all that year.)

There are many ways to respond to these proposed changes.  I choose to respond to a future that most-likely includes increased healthcare fees by taking actions to improve my health.  How about you? Why not take control of your health and your finances by practicing informed preventive health and avoiding increasingly more expensive co-pays?  You may find that managing your health through diet, exercise, meditation, or other self-care practices could reduce your need for medications and reduce the frequency of your visits to the doctor.  Why not focus on the part of the equation you can control?

Food, Glorious Food! What’s the Right Diet for You?

Most military members maintain a healthy weight.  But once you’re separated/retired from the military, or if you’re disabled, the pounds can creep on.  And once you reach middle-age, often they’re not creeping anymore – they’re double-timing!

Diets?  Chances are you’ve tried more than one: Cabbage soup; Atkins; Pritikin; Mediterranean; South Beach; Paleo; Juice fasts; etc.  We all know the drill: throw out the “bad” food in your house; buy all new “healthy” food; follow new regimen until you can’t stand it anymore; revert to old eating habits; beat yourself up over “lack of discipline”.

If you have a health condition, it can get more complicated.  Your doctor may recommend a specialized diet, or give you a list of foods to avoid, or send you to an allergist to be tested for food allergies.

For years I tried various diets, read labels to avoid certain ingredients, and was an annoying dinner guest.  I had some success with reducing my symptoms and lost weight a few times, but mostly remained overweight, bordering on obese.

And then a friend recommended a series of three BBC videos called “What’s the Right Diet for You?”  In this series, experts from Oxford & Cambridge universities explain new research that suggests that diets are not one-size-fits-all; instead, personalized diets based on your biological and psychological profile are much more likely to work for you.

The researchers illustrate by dividing volunteers into three groups, which they call “Constant Cravers”, “Emotional Eaters”, and “Feasters.”  According to the researchers, Constant Cravers have a genetic predisposition toward overeating because their genes disrupt the signals to their brains which normally tell someone that their fat stores are sufficient and that they should stop eating.  As a result, Constant Cravers are always hungry, because their brains are constantly trying to store up fat regardless of the actual state of their bodies.

Emotional Eaters, on the other hand, eat in response to stress or unhappiness, and tend to prefer foods that are higher in sugar and fat when stress-eating.  The third group, Feasters, tend to overeat because they have lower than normal levels of the gut hormones that signal to the brain that they are full and should stop eating.

There are short excerpts from the BBC videos that illustrate the three categories.  This is the one for Feasters:

and this one covers both Emotional Eaters and Constant Cravers:

Unfortunately, the actual videos are not available in the US & Canada, and have been pulled from YouTube.  But you can find more information at the BBC website  or the Oxford website.

You can also take an online test to help you determine if you fall into one of these three categories, and you can download diets for each of the three categories: Constant Cravers; Emotional Eaters; or Feasters.  Or you could download a free ebook from the BBC website that is interactive and explains all three categories, as well as techniques for each group for losing weight and maintaining a healthier weight once you’ve reached it.

For me, it was very helpful to learn the science behind why I tend to overeat.  When I failed at previous diets, I assumed it was a willpower problem.  But now I know I was fighting my biochemistry, with inadequate weapons.  I had had some success with previous diets, but this information helped me dial in which aspects of previous diets had been beneficial and why.

Instead of eating or avoiding certain foods because I “should” or “shouldn’t” eat them, I now know if I eat this, I will feel full; but if I eat this, I will keep feeling hungry.  So now I’m much less tempted to eat things that will lead to a negative result.  AND, by sticking to my new eating plan, I don’t have cravings (most of the time).  So I don’t have to fight the urge to eat things I “shouldn’t” because I no longer have the urges.  (Well, except for dark chocolate.  I still eat a few squares of dark chocolate from time to time.)

This research helped me sort through all the noise and conflicting advice (low-fat! low-carb! Paleo! Vegan!), and find a simple way to lose weight.  Perhaps it will help you as well.