Help with VA healthcare

[alishape]

I am a nine year navy veteran from 1997-2006. When I received my first MS diagnosis, I went to the VA hospital in Baltimore to enroll. We have a VA MS Center of Excellence here. I was frightened because I had been hospitalized twice in a little over a month. One of those times I ended up in a wheelchair. They told me I made too much money and wouldn't enroll me in the system. Everything I read online tells me that any veteran with MS, service connected or not, can be seen at the VA if they have an honorable discharge. I do have an honorable.

I have insurance and I am working. I don't want anything from the VA right now, except to get on the books, just in case. I tried again and called the center directly. The receptionist told me that I need a referral from my neuro. It just so happens my neuro is the head of the MCoE, and he called them for me. They called me back and said that I was denied in the system because of my income. They also told me that the referral is supposed to come from my PC, who would be a VA doctor.

I feel like I am banging my head against a wall. Is it really true that any vet with MS can be seen? I can't figure out where to go from here. Any help would be totally appreciated.

[Scooter24]

Contact a service organization to see if they will get some action for you, I used PVA but some have had no luck with them as others have not had any luck with other S/O. I assume you told them you have MS when they denied you.
I would also have the S/O put in a service connection claim for you, you are entitled to alot of benefits other than just $ even though that doesn't hurt any either. It would be a good idea to get S/C before you need the other things so if you suddenly find that you can no longer work due to MS you have health coverage and at least some income until you get approved for SSDand they also provide some things that insurance will not.

[Bob698]

I'd also recommend talking to a service officer.
Explain up front that you're presently covered for health care but you want to keep your options open just in case.
Also let them know right up front what your financials are like.
You may or may not like the answer but at least you'll know where you stand.

[gomer]

alishape....

Scooter is spot on ..

I would like to add, looks like you are well within the 7 yr window for automatic Service Connection for your MS.

DO file for service connection, then there will be no question or problem with getting your MS care at the VA.

Gomer Sir Falls-a-lot

[Bob698]

Jeez, I also need to stop posting just before I go to bed.

You have a seven year "window" after your EAOS to prove your MS is service connected. You don't have to be rated now, but you should be in their system.

SAVE EVERYTHING THE VA SENDS YOU!

Keep it in a file somewhere so you'll be able to find it later if you need it. Now would also be a good time to put your DD214 in the same secure file along with several notarized copies. The same goes for any paperwork from your medical files (military and civilian).

With the VA, MS is MS is MS. As long as you can prove later on that you were diagnosed (or even had symtoms that were later shown to be due to MS) within the window and you were asking them for help (also within the 7 year window) that's going to make things a LOT easier later on should you need their services.

Now would also be a good time to find a good service officer to represent you. You don't have to use a VA service officer, many Vet "clubs"* have a VA trained SO on their staff. Many city gov'ts also can have an SO on staff (usually in the DHS dept.). You can also check the "blue pages" in your phone book.
Try to find an SO who fits your needs. As I wrote earlier, lay all of your cards on the table with them. DO NOT embellish or avoid any of the facts. Explain that you were diagnosed within the window but you're still able to work.

I'm hoping your MS stays a nuicance at best for a very long time, but you can't afford to plan on that.


*- Vet's clubs can include the obvious places like the good 'ole VFW and American Legion. Other orgs like the PVA have SO's on staff. Other "clubs" may not sound like you would be eligible (Viet Nam Vet's Association or VVA also has trained SO's on staff) but you wouldn't be going there to join, you're just looking for a rep.

[Scooter24]

Bob- what is the purpose of multiple copies of dd214, I have sent them copies and that suficed for them and the PVA

[Bob698]

Sometimes you can run into people who are looking to shoot you down. Most times its not an issue but a notary seal says your copy is legit.

A DD214 copy can also be handy if you're applying for a state or fed job. I'd never hand anybody the original (the one printed on that onion-skin like paper from your service jacket) unless I was positive I was getting it back.

[gomer]

Scooter.... When I filed my SC claim for hearing loss I had to provide CERTIFIED COPIES of my DD214.

Gomer Sir Falls-a-lot

[dustersc]

Yes Gomer, Scooter and Bod are dead on with regards to filing a claim for service connection. It’s better to have it done now, so that way if the VA drags there feet and takes there sweet time it will be completed if and when you need the VA’s assistance. They are also correct about the organizations that can help with this. Get your dd214 in a safe stage, one tid bit I could add is you can go to your local courthouse and have the registry of deeds make a copy and have archived there. That way, it is almost never going to get lost or damaged there, so if for any reason you lose the original it’s an easy and quick way to get a certified copy without having to wait for the VA to send you a copy

[Bob698]

Jeez, I also need to stop posting just before I go to bed.

You have a seven year "window" after your EAOS to prove your MS is service connected. You don't have to be rated now, but you should be in their system.

SAVE EVERYTHING THE VA SENDS YOU!

Keep it in a file somewhere so you'll be able to find it later if you need it. Now would also be a good time to put your DD214 in the same secure file along with several notarized copies. The same goes for any paperwork from your medical files (military and civilian).

With the VA, MS is MS is MS. As long as you can prove later on that you were diagnosed (or even had symtoms that were later shown to be due to MS) within the window and you were asking them for help (also within the 7 year window) that's going to make things a LOT easier later on should you need their services.

Now would also be a good time to find a good service officer to represent you. You don't have to use a VA service officer, many Vet "clubs"* have a VA trained SO on their staff. Many city gov'ts also can have an SO on staff (usually in the DHS dept.). You can also check the "blue pages" in your phone book.
Try to find an SO who fits your needs. As I wrote earlier, lay all of your cards on the table with them. DO NOT embellish or avoid any of the facts. Explain that you were diagnosed within the window but you're still able to work.

I'm hoping your MS stays a nuicance at best for a very long time, but you can't afford to plan on that.


*- Vet's clubs can include the obvious places like the good 'ole VFW and American Legion. Other orgs like the PVA have SO's on staff. Other "clubs" may not sound like you would be eligible (Viet Nam Vet's Association or VVA also has trained SO's on staff) but you wouldn't be going there to join, you're just looking for a rep.

Dang it, I need to correct something.

You have a seven year window after your EAOS to document that your MS is service connected.
You could file years later, but you would have to show that you were being diagnosed or were being treated within that window.
That still looks confusing, so let's try this...

You got out in 1999. In 2006 you were being diagnosed for symtoms that later turned into a full diagnosis of MS.

You're covered for service connection as long as you saved the paperwork to prove it.

This doesn't mean that if you fell out of the seven year window the VA wouldn't treat you. It only applys to wanting to be service connected.

[alishape]

Thanks all!

Thanks you guys for all your help and understanding, as usual! I called the Baltimore PVA chapter I guess. The Officer guy was not there, but his secretary was very helpful. She said most of the things I knew already, and some more I learned from you all. She seemed very optimistic about my eventual chances for a service connection also. I learned two things I wanted to share with you guys.

1. If you have multiple sclerosis and you are over the income threshold, you have to use personal insurance at the VA hospital. She also told me not to worry too much because if I lost my job and my insurance, I won't have to worry about the threshold anymore anyway. I could just come right in and they'd see me service connection or no.

2. The Baltimore claims office has stopped all work on claims less than one thousand days old by gov't mandate. Everyone else in the region's claim is hold for now. I guess until there is only a certain number of them left or they're all gone. The oldest claims I mean.

[Bob698]

1. If you have multiple sclerosis and you are over the income threshold, you have to use personal insurance at the VA hospital. She also told me not to worry too much because if I lost my job and my insurance, I won't have to worry about the threshold anymore anyway. I could just come right in and they'd see me service connection or no.

You might want to ask the rep about insured co-pays for prescriptions and testing. It might save you some greenbacks if you went with the VA. CRABs and MRIs are NOT cheap but the VA has their own MRI machines and I'm pretty sure they're still the biggest buyer of prescription medicines in north america.

[dustersc]

here is a link explaning the co pays if you have insurence.

http://www.va.gov/healthbenefits/cost/copays.asp

You most provide your privet insurance information as well. They will work with you to meet your deductibles and co-pays if any and see which way is the least expensive for you out of pocket. The VA co-pay for meds is 9$ for a 30 day supply. This is great if you don’t have a prescription plan. Here is an example: Betaseron costs about 2800$ for a 28 day supply at full price. With VA prescription co-pay you only pay 9$ for the same meds

[alishape]

Thanks everyone!

On you alls advice I contacted a service organization to see if I could get a PO. I choose the PVE and the guy called me back. He said to fax him the poa, so that means he'll take me on! I just wanted to thank all my former shipmates and you airheads, jarheads and grunts for all your wonderful assistance. I'll keep you all posted, even though this still might take quite some time!

[Bob698]

The one thing that's important for now is to get on their books.
As long as you have a paper trail it makes it very hard to deny your diagnosis timeline.

Depending on how things shake out for you, you might want to opt for VA care down the road. A lot of this seems to depend more on which state you live in but at least the VA is trying to keep it uniform.

Don't confuse Service Connection with getting treated.

I'm a Priority Group 5 and I get excellent care from both the Neuro unit and my assigned GP Doc.
A lot of folks tend to miss seeing the forest because there's too many trees in the way.