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#201 jhilly

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Posted 17 March 2010 - 02:00 AM

great stuff, thx...

#202 Michellee

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Posted 25 March 2010 - 09:10 AM

Could "contaminated items" be brought back stateside from the Persian Gulf area by US military personnel and possibly have affected family members or other soldiers/sailors/marines/airforce they may they have traded clothing/equipment with?


This is interesting because when I left for Kuwait I had 20/20 vision and when I came back after about a year I was wearing bifocals and see grey bodies floating to this day. I've tried to tell this eye doctor at the VA hospital and asked him why had my vision changed so quickly and what was causing all the symptoms I now have like cant see the line in the road at night cant see certain colors, He tried to tell me that it is my age and that these eye changes is a normally part of aging yet I am only 43. I never wore glasses up until I was pulled out of a hole returned home and medically boarded out. So I was just trying to make sense of my eye condition and changes in sight. My military entrance records all show I had 20/20 vision all throught out my 14 year career until I come out of that hole and sent back conus. I would wondered maybe I hit my head some sort of way going down and shook my eyeballs loose :lol: I didn't know what to make of it. Another doc at the VA when I mention it for reasoning all of this told me that this is impossible change and If I think I am going to pin that on the military that its a big jump. I wasn't even trying to do so simply was trying to get answers on what is going on with my sight. It is still gettinging increasingly worse and I am changing perscriptions yearly in the past 3 years. Just got a new one in Feb and was told my eyes had worsen. I can only see 3 feet in front of me with out my glasses. I still wonder what happen to my eyes. I had perfect vision before I left for the Gulf. I dont plan to file a claim or wasnt planning on it then when I was questioning those doctor but they acted like I was trying to get something and made a comment to that affect. I had to actually get their head out of their @#$# and say look I'm not trying to get anything can I get an answer to what you think is cause these problems with my vision. The answer they finally gave me is aging.

#203 Sgt Will Dove USMC

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Posted 25 March 2010 - 01:22 PM

It is funny I found this, My eye sight has gone from 20/15 to 20/40 in my right eye, and is 20/30 in left eye. I just turned 30, and my family eye doctor thought it was very strange that my eyesight changed that much in just 2 years.

I wonder if there is some truth to this article and something we used or was explosed to in Iraq has damaged our eyes.

I think I will call my eye doc back and talk with him about this.

Thanks

#204 carlie

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Posted 31 March 2010 - 01:08 PM

http://www1.va.gov/v...asp?pub_ID=1789

Department of Veterans Affairs

VHA DIRECTIVE 2008-070
Veterans Health Administration
Washington, DC 20420
October 28, 2008

PRESCRIBING HEARING AIDS AND EYEGLASSES

1. PURPOSE: This Veterans Health Administration (VHA) Directive provides policy for uniform criteria necessary for prescribing hearing aids and eyeglasses (sensori-neural aids) to veteran patients.

2. BACKGROUND: Public Law 104-262, the Veterans Health Care Eligibility Reform Act of 1996, changed eligibility laws to allow VHA to furnish prosthetic appliances to veterans. However, that law further provided that VHA could not furnish sensori-neural aids (hearing aids and eyeglasses) except in accordance with guidelines that the Department of Veterans Affairs (VA) prescribes. Subsequently, the Department published regulations (Title 38 Code of Federal Regulations (CFR), §17.149) in the Federal Register establishing such guidelines. In 2002,
VHA issued Directive 2002-039 to establish uniform policy for the provision of hearing aids and eyeglasses.

3. POLICY: It is VHA policy that all enrolled veterans and those veterans exempt from enrollment are eligible for medical services that include diagnostic audiology and diagnostic and preventive eye care services, and that the prescription and provision of hearing aids and eyeglasses must be furnished to all eligible veterans in accordance with the parameters and criteria defined in this Directive.

4. ACTION
a. Veterans Integrated Service Network (VISN) Director. The VISN Director is responsible for ensuring that VISN and facility policies on eligibility for and access to diagnostic audiology, diagnostic and preventive eye care services, and the provision of hearing aids and eyeglasses comply with provisions of this Directive.

b. Facility Director. The facility Director is responsible for:
(1) Ensuring access to audiology and eye care services including preventive health (care) services and routine vision testing for all enrolled veterans and those veterans exempt from enrollment. Eyeglasses and hearing aids must be provided to the following veterans:
(a) Those with any compensable service-connected disability.
(b) Those who are former Prisoners of War (POWs).
© Those who were awarded a Purple Heart.
(d) Those in receipt of benefits under Title 38 United States Code (U.S.C.) 1151.

THIS VHA DIRECTIVE EXPIRES OCTOBER 31, 2013
VHA DIRECTIVE 2008-070
October 28, 2008
2
(e) Those in receipt of an increased pension based on being permanently housebound and in need of regular aid and attendance.
(f) Those with vision or hearing impairment resulting from diseases or the existence of another medical condition for which the veteran is receiving care or services from VHA, or which resulted from treatment of that medical condition, e.g., stroke, polytrauma, traumatic brain injury, diabetes, multiple sclerosis, vascular disease, geriatric chronic illnesses, toxicity from drugs, ocular photosensitivity from drugs, cataract surgery, and/or other surgeries performed on the eye, ear, or brain resulting in vision or hearing impairment.
(g) Those with significant functional or cognitive impairment evidenced by deficiencies in the ability to perform activities of daily living.
(h) Those who have vision and/or hearing impairment severe enough that it interferes with their ability to participate actively in their own medical treatment and to reduce the impact of dual sensory impairment (combined hearing and vision loss). NOTE: The term “severe” is to be interpreted as a vision and/or hearing loss that interferes with or restricts access to, involvement in, or active participation in health care services (e.g., communication or reading medication labels). The term is not to be interpreted to mean that a severe hearing or vision loss must exist to be eligible for hearing aids or eyeglasses.
(i) Those veterans who have service-connected vision disabilities rated zero percent or service-connected hearing disabilities rated zero percent if there is organic conductive, mixed, or sensory hearing impairment, and loss of pure tone hearing sensitivity in the low, mid, or high-frequency range or a combination of frequency ranges which contribute to a loss of communication ability; however, hearing aids are to be provided only as needed for the service-connected hearing disability.

(2) Ensuring that hearing aids are provided in accordance with the following policies:
(a) Hearing aids must be issued only to eligible veterans who are otherwise receiving VA care or services in accordance with 38 CFR §17.149 and this Directive.
(b) Veterans meeting the eligibility requirements to receive health care are eligible for diagnostic audiology services. Eligibility rules are the same for both inpatient and outpatient medical services. Veterans must not be denied access to audiology services covered by the Medical Benefits Package (38 CFR §17.38) because they do not meet the eligibility criteria for hearing aids.
© Audiologists must utilize the Remote Order Entry System (ROES) to review and request eligibility for hearing aids; by requesting the hearing aid in ROES, the audiologist stipulates that medical need exists based on the evaluation. Veterans in Priority Groups 1-5 are eligible for hearing aids.
VHA DIRECTIVE 2008-070
October 28, 2008

3
(d) Non-service connected (NSC) veterans (Priority Groups 6, 7, and 8) must receive a hearing aid evaluation (HAE) prior to determining eligibility for hearing aids to establish medical justification for provision of these devices. These veterans must meet the following criteria for eligibility based on medical need:
1. Be enrolled or exempt from enrollment and receiving a vested level of care from a VA medical facility; and
2. Have hearing loss that interferes with or restricts communication to the extent that it affects their active participation in the provision of health care services as determined by the audiologist (see paragraph

4.c).
(e) Prosthetics must approve the ROES request when medical need is established. The cost of hearing aids is not a basis for denying these devices.
(f) In those instances where the veteran presents to the audiology clinic with a hearing aid provided from a non-VA source, the audiologist determines the effectiveness of the device in meeting the veteran’s rehabilitative needs. If the device is sufficient for the veteran’s needs, no device will be prescribed, but the audiologist may register the hearing aids through ROES for battery and repair services. If the device is not sufficient for the veteran’s needs, the audiologist must apply the replacement provisions detailed in this Directive (see subpar. 4c(4)).

(3) Ensuring that eyeglasses are provided in accordance with the following policies:
(a) Eyeglasses are issued only to eligible veterans who are otherwise receiving VA care or services in accordance with 38 CFR §17.149 and this Directive.

(b) In accordance with 38 U.S.C .§1701 and enabling regulations (38 CFR §17.38), all enrolled veterans or those exempt from enrollment are entitled to optometric and ophthalmologic services as well as preventive health (care) services that include routine vision testing and eye care services.

© Veterans meeting the eligibility requirements to receive health care are eligible for eye care services. Eligibility rules are the same for both inpatient and outpatient medical services. Veterans must not be denied access to eye and vision care services covered under the Medical Benefits Package (38 CFR §17.38) because they do not meet the eligibility criteria for eyeglasses. Veterans in Priority Groups 1-5 are eligible for eyeglasses.

(d) NSC veterans (Priority Groups 6, 7, and 8) must receive an appropriate evaluation by an optometrist or ophthalmologist, prior to determining eligibility for eyeglasses, to establish medical justification for provision of these devices. In those instances where the veteran presents to the eye clinic with eyeglasses provided from a VA or non-VA source, the eye care practitioner or provider determines the effectiveness of the device in meeting the veteran’s
VHA DIRECTIVE 2008-070
October 28, 2008
4
rehabilitative needs. If the device is sufficient for the veteran’s needs, no device will be prescribed. If the device is not sufficient for the veteran’s needs, the eye care practitioner or
provider will apply the replacement provisions detailed in this Directive. These veterans must meet the following criteria for eligibility based on medical need:

1. Be enrolled or exempt from enrollment and receiving a vested level of care from a VA medical facility; and
2. Have vision loss that interferes with or restricts communication, quality of life or activities of daily living to the extent that it affects their active participation in the provision of health care services as determined by the eye care practitioner or provider (see subpar. 4d).

(4) Replacing hearing aids and eyeglasses in accordance with VHA Handbooks 1173.7 and 1173.12, to include: NOTE: Hearing aids or eyeglasses are not to be replaced solely for cosmetic purposes.
(a) Hearing aids or eyeglasses are to be replaced when the device proves to be ineffective, irreparable, or the veteran’s medical condition has changed and a different device is needed.
(b) Hearing aids or eyeglasses are to be replaced if the device was destroyed or lost due to circumstances beyond the control of the veteran.
© Hearing aids or eyeglasses are not to be replaced because of availability of newer technology, unless there is evidence that the replacement will significantly benefit the veteran.
(d) For hearing aids, replacement may be based on age of the device, whether they are beyond economical repair, technical performance is reduced, parts or accessories are unavailable, or the device is no longer sufficient for the veteran’s communication needs.
(e) Replacement hearing aids can be prescribed at any time that change of amplification characteristics are required to maintain or improve communication function. Hearing aids have an expected life span of 3 to 4 years depending on the model of the instrument, daily hours of use, wear and tear, frequency of repair and maintenance, ear conditions, and user lifestyle.
(f) For eyeglasses, replacement of corrective eyeglasses necessitated by fair wear and tear, loss, or breakage due to circumstances beyond the control of the veteran, or due to required change of prescription, may be made at any time.
1. When replacement eyeglasses are prescribed because of a change in distance and/or near refractive error, the change must require at least a change in sphere, cylinder and/or axis specified below; or
Sphere power of + or - .25 diopter
Cylinder power of + or - .50 diopter
Axis change of + or - .25 to .75 diopters 5 degrees

VHA DIRECTIVE 2008-070
October 28, 2008
5
+ or - 1.00 to 2.00 diopters 3 degrees
+ or - 2.25 diopters or more 2 degrees
NOTE: Appropriate prescriptions and resultant sphere, cylinder and/or axis changes must be determined by the examining optometrist or ophthalmologist. Replacement eyeglasses are procured and issued in the same manner as the initial prescription when the criteria are met.
2. Replacement eyeglasses can be prescribed at any time due to required refractive change of prescription to improve one line of visual acuity.
3. If one or both lenses are broken and there is any indication that the veteran’s vision has changed, or if it has been more than 1 year since the veteran’s eyes were last examined, the veteran is to be referred to an optometrist or ophthalmologist before replacement eyeglasses are ordered.

(5) Issuing spares or second pairs only as determined by the audiologist or eye care practitioner or provider (optometrist or ophthalmologist) in accordance with VHA Handbooks 1173.7 and 1173.12.

NOTE: When providing spare or a second pair of eyeglasses from any existing prescription, the prescription must be current and appropriate for the visual needs of the veteran. Two pairs of single vision eyeglasses, one for reading and one for distance, are to be provided in cases where bifocal lenses are contraindicated.
c. Audiologist. The audiologist is responsible for applying all the following in prescribing hearing aids:

(1) To mitigate the impact of hearing impairment on quality of life and participation, the following degree of impairment is considered disabling and establishes the basis for consideration of hearing aid candidacy, subject to evaluation by an audiologist: hearing thresholds 40 decibels (dB) HL or greater at 500, 1000, 2000, 3000, or 4000 hertz (Hz); or hearing thresholds 26 dB HL or greater at three of these frequencies; or speech recognition less than 94 percent (38 CFR §3.385). This degree of impairment is disabling is considered justification for hearing aids.

(2) When determining candidacy for amplification, audiologists must consider the effect of impairment (i.e., activity and participation) using well-established, patient-centered clinical practices. It is the effect of impairment, specifically participation restrictions (e.g., access to health care), that is the justification for eligibility based on medical need. In making decisions about candidacy for amplification, audiologists must apply evidence-based clinical practices guidelines and recommendations including, but not limited to:

(a) Audiology Clinical Practice Algorithms and Statements. Joint Committee on Clinical Practice Algorithms and Statements. Statement 3 and Algorithm 3. Joint Audiology Committee Statements on Hearing Aid Selection and Fitting (Audiology Today, Special Issue, August 2000). See http://www.audiology...eAlgorithms.pdf.
VHA DIRECTIVE 2008-070
October 28, 2008
6

(b) Guidelines for the Audiologic Management of Adult Hearing Impairment, American Academy of Audiology. See http://www.audiology...aguidelines.pdf.
© Joint Audiology Committee on Clinical Practice. (1999). Clinical practice statements and algorithms. Rockville, MD: American Speech-Language-Hearing Association. See http://www.asha.org/...-AF53-40A2-91CE 9D9124FDA8B5/0/18871_1.pdf.
d. Eye Care Practitioner or Provider. Since visual disorders requiring eyeglasses are so varied and complex that in some cases, a combination of acuity level and clinical practice guidelines does not address all possible prescribing indications, the eye care practitioner or provider, an optometrist or ophthalmologist, is responsible for applying all the following in prescribing eyeglasses:

(1) Visual Acuity and Visual Field. To mitigate the impact of vision impairment on quality of life and activities of daily living, eyeglasses must be provided to veterans who meet the following minimum criteria:
(a) 20/50 visual acuity or worse uncorrected refractive error at distance or near while using both eyes. NOTE: For the purposes of this Directive, 20/50 visual acuity or 40 degree average visual field radius corresponds to the 80th percentile of function and is considered justification for eyeglasses.
(b) Average visual field radius of 40 degrees or less when assessed monocularly conducted using Goldmann’s equivalent III/4e (e.g., altitudinal field loss; homonymous hemianopsia; generalized constriction or other significant visual field defects from eye and/or brain injuries, diseases or disorders, etc.) to ensure proper orientation and safe ambulation in the environment.

(2) Literature-based Clinical Practice Guidelines and Recommendations. Literature-based Clinical Practice Guidelines and Recommendations for optometrists and ophthalmologists. These include, but are not limited to:
(a) Optometric Clinical Practice Guidelines, American Optometric Association. See http://www.aoa.org/x4813.xml .
(b) Optometric Clinical Practice Recommendations, American Optometric Association. See
http://www.aoa.org/x5495.xml .
© Preferred Practice Patterns, American Academy of Ophthalmology. See
http://one.aao.org/C...elines/PPP.aspx.
VHA DIRECTIVE 2008-070
October 28, 2008
7

(3) Special Circumstances. Special circumstances for prescription eyeglasses are evaluated on an as-needed basis subject to review by the Section or Service Chief of Optometry or Ophthalmology, or other designated official, as appropriate. Not withstanding the visual acuity
and visual field criteria in this Directive, the eye care practitioner or provider must prescribe eyeglasses in the following special circumstances:
(a) Ophthalmic prescriptions are filled for veterans receiving medical care when determined medically necessary for the veteran’s care by an optometrist or ophthalmologist.
(b) Special eyeglasses or frames required for cosmetic facial restorations may be procured upon the recommendation and approval of an optometrist or ophthalmologist. In such cases, corrective lenses are authorized for any refractive error present.
© Veterans with a service-connected disability for the loss of vision in an eye (or the enucleation or evisceration of one eye) are eligible for eyeglasses for defective vision in the remaining eye or to protect the vision in the remaining eye (safety eyeglasses or polycarbonate lenses, as appropriate).
(d) Prescriptions by optometrists or ophthalmologists of safety eyeglasses or polycarbonate lenses and/or eyeglasses with photochromic or tinted lenses are filled for veterans who are monocular, and those with post-cataract surgery, chronic uveitis, severe corneal disease, clinically-significant macular degeneration, clinically-significant cataract, ocular toxicity from drugs, ocular photosensitivity from drugs, significant visual field loss, significant amblyopia or visual acuity loss in the fellow eye (worse than 20/40 correctable visual acuity by conventional spectacle lenses), traumatic brain injury, photophobia, and/or retinal or other medical eye conditions, as appropriate.
(e) The need for photochromic or tinted lenses must be documented by an optometrist or ophthalmologist; this need may include the need for ocular protection from undesirable incident radiations, such as ultra violet radiation, etc. Tinted lenses will not be provided solely for comfort;
(f) Progressive addition lenses may be procured for eligible veterans when prescribed by an optometrist or ophthalmologist.
(g) Eligible veterans may be furnished an initial pair of corrective eyeglasses when prescribed by an optometrist or ophthalmologist. Two pairs of single-vision eyeglasses, one for reading and one for distance, will be provided if prescribed by an optometrist or ophthalmologist in cases where bifocal lenses are contraindicated. Post-surgical aphakic cataract patients may also be provided two pairs of eyeglasses (in addition to contact lenses): a pair of cataract eyeglasses (aspheric lenticular), and a pair of eyeglasses for use over contact lenses when prescribed by an optometrist or ophthalmologist.
(4) By request, the veteran may obtain a copy of the prescription from the examining optometrist or ophthalmologist.

VHA DIRECTIVE 2008-070
October 28, 2008
8

5. REFERENCES
a. Title 38 CFR, Section 3.385, Determination of service-connection for impaired hearing.
b. Title 38 CFR, Section 17.149, Sensorineural Aids.
c. Title 38 CFR, Section 17.30, Definitions.
d. Title 38 CFR, Section 17.38, Medical Benefits Package.
e. Guidelines for the Audiologic Management of Adult Hearing Impairment, American Academy of Audiology.
f. Optometric Clinical Practice Guidelines, American Optometric Association (http://www.aoa.org/x4813.xml).
g. Optometric Clinical Practice Recommendations, American Optometric Association (http://www.aoa.org/x5495.xml).
h. Preferred Practice Patterns, American Academy of Ophthalmology (http://one.aao.org/C...elines/PPP.aspx).
i. Title 38 U.S.C. Section 1701(6)(A).
j. Title 38 U.S.C. Section 1701(6)(A)(i).
k. Title 38 U.S.C. Section 1701(6)©.
l. Title 38 U.S.C. Section 1701(9)(I).
m. VHA Handbook 1173.1.
n. VHA Handbook 1173.7.
o. VHA Handbook 1173.12.

6. FOLLOW-UP RESPONSIBILITY: The Chief Consultant, Prosthetic and Sensory Aids Service (113), is responsible for the contents of this Directive. Questions may be addressed to
202-461-1800.
VHA DIRECTIVE 2008-070
October 28, 2008
9

7. RESCISSIONS: VHA Directive 2002-039, Prescribing Hearing Aids and Eyeglasses, dated July 5, 2002, is rescinded. This VHA Directive expires on October 31, 2013.
Michael J. Kussman, MD, MS, MACP
Under Secretary for Health
DISTRIBUTION:
CO:
E-mailed 10/29/08
FLD:
VISN, MA, DO, OC, OCRO, and 200 – E-mailed 10/29/08

#205 carlie

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Posted 31 March 2010 - 01:25 PM

http://www1.va.gov/v...asp?pub_ID=1641

Veterans Health Administration
Transmittal Sheet
Washington, DC 20420
May 17, 2007

CLOTHING ALLOWANCE BENEFIT

1. REASON FOR ISSUE. This Veterans Health Administration (VHA) Handbook updates Department of Veterans Affairs (VA) procedures for governing the clothing allowance benefit to veteran beneficiaries.

2. SUMMARY OF CHANGES. This VHA Handbook revises the procedures for the issuance of clothing allowance benefit to veteran beneficiaries.

3. RELATED ISSUES. VHA Directive 1173 and VHA Handbooks 1173.01 through 1173.14.

4. RESPONSIBLE OFFICE. The Chief Prosthetic and Clinical Logistics Officer (10FP) is responsible for the contents of this VHA Handbook. Questions may be referred to
202-254-0440.

5. RESCISSIONS. VHA Handbook 1173.15, dated November 1, 2000, is rescinded.

6. RECERTIFICATION: This VHA Handbook is scheduled for recertification on or before the last working day of May 2012.
Michael J. Kussman, MD, MS, MACP
Acting Under Secretary for Health
DISTRIBUTION:
CO:
E-mailed 5/22/07
FLD:
VISN, MA, DO, OC, OCRO, and 200 – E-mailed 5/22/07
T-1

May 17, 2007 VHA HANDBOOK 1173.15
i
CONTENTS
CLOTHING ALLOWANCE
PARAGRAPH PAGE
1. Purpose ................................................................................
..................................................... 1
2. Authority ................................................................................
.................................................. 1
3. Scope ................................................................................
........................................................ 1
4. Procedures ................................................................................
................................................ 2

May 17, 2007 VHA HANDBOOK 1173.15
1

CLOTHING ALLOWANCE BENEFIT

1. PURPOSE
This Veterans Health Administration (VHA) Handbook establishes uniform and consistent procedures for governing the clothing allowance benefit to veteran beneficiaries.

2. AUTHORITY

a. Under Title 38 United States Code (U.S.C.) 1162, the Department of Veterans Affairs (VA) must pay an annual clothing allowance to veterans if the veteran has a service-connected disability or condition, or a disability compensable under 38 U.S.C. 1151 that requires the veteran to wear or use a prosthetic or orthopedic device that wears out or tears clothing, e.g., pants, shirts, etc. (see Title 38 Code of Federal Regulations (CFR) 3.810).

b. The clothing allowance may also be paid if the veteran uses, for a service-connected skin condition, medication prescribed by a physician, which causes irreparable damage to the veteran’s outer garments. NOTE: Irreparable damage does not include stains that are removable through regular laundering or dry cleaning. Approval of a claim based on use of medication requires a medical determination. A skin condition requiring use of a medication is not considered static, and a re-determination is required each year.

3. SCOPE

a. Veterans Service Center officials in the Veterans Benefits Administration (VBA) refer applications for the clothing allowance benefit to VHA in all cases, with the exception of a clothing allowance benefit as an accrued benefit after the veteran’s death.

b. Certain clothing allowance claims require a determination by a Prosthetic Representative, or designated physician, when the veteran's disability appears temporary in nature or when, for other reasons, a review of the record and/or physical examination of the veteran is necessary.

c. In all cases where a review is determined to be necessary, the Prosthetic Representative, and/or designated physician, must determine that:
(1) Use of the device or skin medication is medically prescribed; and
(2) In the case of a device, such device qualifies as a prosthetic or orthopedic appliance;
(3) The device or skin medication tends to wear out, tear, or cause irreparable damage to the veteran's clothing; and
(4) The veteran actually uses the device or skin medication with sufficient consistency to wear out, tear, or cause irreparable damage to clothing. If it cannot be determined from the veteran’s records that all preceding conditions have been met, an examination and/or evaluation is required.
VHA HANDBOOK 1173.15 May 17, 2007
2

d. The clothing allowance may be authorized for veterans who wear braces, rigid spinal braces, rigid cervical braces, or who use wheelchairs, crutches, rigid orthotics and/or ankle and/or foot orthosis (AFOs), ileostomy and colostomy appliances or similar devices, or who use certain skin medications and/or ointments.

e. Payment of the clothing allowance is made in a lump sum annually to those for whom entitlement is established as of August 1. Future annual payments are made to those who are on the rolls with established permanent or temporary entitlement on August 1 of subsequent years. These annual payments are not related to specific periods and prorated payments are not made. For example, if a veteran establishes eligibility for the clothing allowance as of any date after August 1 of any year, the claimant is not entitled to any payment for that year. No amount is payable until the annual payment becomes due on the following August 1. Likewise, a partial refund is not required should the veteran's entitlement be terminated during a period after the annual clothing allowance has been furnished, which is prior to the succeeding August 1.

4. PROCEDURES

a. When a rating decision is processed which initially establishes service connection, and the patient, because of a service-connected disability, wears or uses a prosthetic or orthotic appliance, the veteran must be informed of potential eligibility for the clothing allowance by the Veterans Service Center. The veteran is instructed to apply for the clothing allowance benefit at a VHA health care facility utilizing VA Form 10-8678, Application for Annual Clothing Allowance, and submitting it to the nearest VHA health care facility.

b. When other veterans with potential eligibility are identified by Prosthetic Representatives at VHA health care facilities, assistance must be provided to the claimant after VA Form 10-8678 is completed. The completed application will be processed at the health care facility. Documentation of all actions, favorable or unfavorable, will be recorded in the patient’s Computerized Patient Record System (CPRS) record.

c. Annotate VA Form 10-2319 (ADP), Record of Prosthetic Service, on page 3 to reflect receipt of VA Form 10-8678, as follows:
(1) Access the Add/Edit Clothing Allowance option under the PSC/Entitlement Records section of the Prosthetic official's menu.
(2) Enter the patient's name at the prompt, and then complete the remainder of the fields beginning with the date the claim was processed by the Prosthetic activity.
(3) Enter the name of the person performing the clothing allowance examination.
(4) Enter appropriate identifying information at the “Clothing Allowance Description” prompt, including the appliance for which the claim was made.
May 17, 2007 VHA HANDBOOK 1173.15
3

(5) When entitlement is not recommended, indicate one or more of the following at the “Clothing Allowance Description” prompt:

(a) Appliance causing wear or tear is not worn, or medication causing damage is not used;

(b) Appliance not worn for service connected condition, or medication not used for service connected condition;

© Appliance worn, not medically prescribed, or medication used not medically prescribed.

d. Notification letters for all determinations made must be sent to each veteran and their designated power of attorney. This includes denials.

e. When the veteran certifies use of an appliance and/or medication which damages clothing and there is no record of VA issue, a physical examination needs to be scheduled prior to a recommendation for denial of entitlement. In determining whether these devices and/or medications tend to damage clothing, each individual application is to be considered on the objective findings of the case; this may include a medical examination and an inspection and evaluation of the device(s) claimed to cause damage to the clothing. Staff must ensure that they do not routinely require the production of worn or torn clothing. NOTE: Reasonable doubt should be resolved in favor of the veteran.

f. Appeals must be handled according to the official appeals process administered by the facility Chief Business Officer.

g. VHA Prosthetic and Sensory Aids Service is responsible for the award action on the annual re-certification portion of the Clothing Allowance benefit. However, the funding for the Clothing Allowance remains in the VBA benefit appropriation. The Veterans Integrated Service Network (VISN) Prosthetic Representative (VPR) coordinates the award action at the facility level and ensures all appropriate staffs have been trained in the procedures of processing payment for clothing allowance benefits in VBA’s Benefits Delivery Network (BDN). NOTE: All training and user manuals can be located on the prosthetic website at: http://vaww.va.gov/prosthetics .

h. Authorization of a clothing allowance to a veteran, who is in receipt of military retired pay and for whom an active master record does not exist, must be made each year for the current annual payment. If continuing eligibility has been established, payment of the next and succeeding annual clothing allowance payment may be made without re-determination of eligibility. For non-static disabilities, reapplication, using VA Form 10-8678, is required for each subsequent annual payment. NOTE: Veterans Service Center officials have been instructed to verify addresses in cases involving continuing eligibility on, or about, August 1 of each year through individual communication.

i. Veterans rated as service connected and determined to be eligible on a continuing basis (per 38 CFR 3.810(a)(1)) for loss of use (at a rate specified in 38 CFR 3.350(a),(b),©,(d), or (f)(1)), are not required to reapply. Their clothing allowance is included in the automated
VHA HANDBOOK 1173.15 May 17, 2007
4
payment process; this, however, does not preclude the possibility of future recertification as to the wear or use of the appliance.

j. Veterans whose determination, completed at a VHA facility, states "the condition requiring use of such device is not static," are required to reapply at the local VHA facility on an annual basis prior to August 1 of each year

#206 carlie

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Posted 01 April 2010 - 08:25 PM

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#207 carlie

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Posted 07 April 2010 - 08:34 AM

M21-1MR, Part I, Chapter 4, Table of Contents
Chapter 4. Hearings
Table of Contents

1. General Information on Hearings 4-1
2. General Conduct for Hearings 4-5
3. Scheduling and Preparing for the Hearing 4-7
4. Conducting the Hearing 4-9
5. Additional Issues Raised During the Hearing 4-15
6. Transcribing the Hearing 4-16
7. Reviewing the Evidence of Record 4-18


Chapter 4. Hearings
1. General Information on Hearings

IntroductionThis topic contains information on

· the purpose of a hearing
· regional office (RO) responsibility for hearings
· requesting, canceling or rescheduling hearings
· who conducts
- pre-decisional hearings
- post-decisional hearings, and
- hearings for employee-claimants
· the end product code for formal hearings
· where to hold a hearing
· attendance at hearings, and
· presenting evidence and testimony.
Change DateMay 6, 2005
a. Purpose of a HearingA hearing is a formal procedure that VA must provide at the request of the claimant or his/her representative. Its purpose is to allow the claimant to present testimony. A claimant or his/her representative can request a hearing at any time and on any issue.

A hearing can be conducted

· by video conference, or
· in person.

Reference: For more information on the purpose of a hearing, see 38 CFR 3.103©.Continued on next page
styleref "Map Title" 1. General Information on Hearings, Continued

b. RO Responsibility for HearingsEach RO designates a person responsible for

· scheduling the hearing
· contacting the claimant and his/her representative
· maintaining records on the hearing, and
· coordinating the hearing schedule with the Decision Review Officer (DRO) or Veteran Service Center Manager (VSCM) designee.

Note: Maintain all scheduling records under RCS VB-1, Part I, Item 13-004.000.
c. Requesting, Canceling, or Rescheduling HearingsA claimant may request, cancel or reschedule a hearing in writing, by e-mail, by fax, by telephone, or in person. If this is done by telephone or in person, the DRO or VA employee receiving the request should promptly complete a VA Form 119, Report of Contact, to document the request.
d. Who Conducts Pre-Decisional HearingsPre-decisional hearings are conducted before one or more Veterans Service Center (VSC) employees who have decision-making authority over the issue(s) involved.
e. Who Conducts Post-Decisional HearingsThe DRO is empowered to hold post-decisional hearings on VBA benefit issues. The duties and authorities of the DRO may also be exercised by the VSCM.

The DRO serves as an integral member of the Appeals Team, reporting to its Coach.

Note: If the DRO participated in the original decision, another DRO or acting DRO must hold the hearing.Continued on next page
styleref "Map Title" 1. General Information on Hearings, Continued

f. Who Conducts Hearings for Employee-ClaimantsIn some situations, an employee of VA or a veterans service organization (VSO) is also the claimant in the hearing.

Use the table below to determine who conducts hearings for employee-claimants and service officer-claimants.
If the hearing is requested by a …Then the …RO employee-claimant· DRO or other VSC employee at that RO
- conducts the hearing, and
- sends the transcript and any evidence to the RO of jurisdiction, and
· DRO or other VSC employee at the RO of jurisdiction makes the decision.
Note: Employee-claimants may request a video conference hearing or travel to the RO of jurisdiction for their hearing. Travel is conducted at their own expense.VSO representative (service officer)-claimant· DRO or other VSC employee at the VSO representative’s RO
- conducts the hearing, and
- transfers the claims folder to the RO of jurisdiction, and
· DRO or other VSC employee at the RO of jurisdiction makes the decision.

Note: Service officer-claimants may request a video conference hearing or travel to the RO of jurisdiction for their hearing. Travel is conducted at their own expense.
Reference: For more information on jurisdiction and transfer, see M21-1MR, Part III, Subpart ii, 5.Continued on next page
styleref "Map Title" 1. General Information on Hearings, Continued

g. End Product Code for Formal HearingsUse EP 174 for formal hearings. Do not clear the EP 174 until

· a decision is issued
· the appeal is withdrawn, or
· the appellant
- dies
- fails to appear, or
- cancels the hearing request.
h. Where to Hold a HearingHold hearings at the

· RO of jurisdiction, or
· RO nearest to the claimant’s residence.

Do not conduct hearings in the VSC work area.

The hearing is part of VA’s duty to assist and, as such, it is non-adversarial in nature. Avoid the appearance and atmosphere of a formal trial or any similar proceeding.

Note: Subject to available resources, and at the option of VA, a formal hearing may be held at any other VA facility or Federal building where suitable hearing facilities are available. Display the United States flag appropriately.
i. Attendance at HearingsThe person requesting the hearing and witnesses are expected to appear in person at the hearing. An exception may be made for extenuating circumstances that prevent him/her from attending, such as incarceration or a serious medical condition.

When there are extenuating circumstances, an individual holding power of attorney may represent this person.
j. Presenting Evidence and TestimonyThe claimant or his/her representative can

· present documentary evidence as well as oral testimony at the hearing, and
· bring witnesses to the hearing to provide testimony, or
· make arguments and contentions with respect to the facts and applicable law.
2. General Conduct for Hearings

IntroductionThere are general guidelines for VA personnel’s conduct during hearings.

This topic contains information on

· the non-adversarial nature of hearings
· the obligation to assist in developing facts
· the decorum and appearance of VA personnel
· the prohibition against conveying an “expected’ decision during a hearing.
Change DateAugust 24, 2004
a. Non-Adversarial Nature of HearingsProceedings before VA are non-adversarial in nature. Questions by VA employees in the nature of cross-examination are inappropriate. Structure all questions to fully explore the basis for claimed entitlement rather than with intent to refute evidence or discredit the claimant’s statements.
b. Obligation to Assist in Developing FactsVA is obligated to assist the claimant in developing facts pertinent to the claim. Make suggestions to the claimant as to the submission of evidence

· that the claimant may have overlooked, and
· that would be advantageous to his/her position.
c. Decorum of VA PersonnelThe VA hearing may be the only personal contact a claimant may have with VA. The claimant’s opinion of VA is influenced by

· proper hearing facilities, and
· the appearance and conduct of VA personnel, including
- courteous treatment of the claimant and his/her witnesses
- paying close attention to the proceedings, and
- expressing an openly positive interest in assisting the claimant.Continued on next page
styleref "Map Title" 2. General Conduct for Hearings, Continued

d. Prohibition Against Conveying an “Expected” Decision during a HearingUnder no circumstances may the DRO or other authorized personnel convey the “expected” decision to the claimant or his/her representative during a hearing until the formal decision has been signed and, if necessary, approved.
3. Scheduling and Preparing for the Hearing

IntroductionSchedule the hearing and prepare for it by reviewing the evidence.

This topic contains information on

· scheduling a hearing
· scheduling a hearing when a request is received without a notice of disagreement (NOD), and
· preparing for the hearing.
Change DateMay 6, 2005
a. Scheduling a HearingSchedule hearings within a reasonable amount of time from the date the request is received.
b. Scheduling a Hearing Request Without a NODSchedule a post-decisional hearing when a hearing request is received but a NOD has not been filed.
c. Preparing for the HearingTo prepare for the hearing, review all of the issues and evidence.

Use the table below to determine how to conduct the review.
If …Then …the review disclosed a need for additional evidence from a third-party or another issue that should be considered· request the additional evidence
· address the other issue, and
· refer the issue to the appropriate activity for development.

Continued on next page
styleref "Map Title" 3. Scheduling and Preparing for the Hearing, Continued

styleref "Block Label" c. Preparing for the Hearing (continued)
If …Then …you did not receive the third- party evidence you requested provide the claimant with the standard notification that the evidence was not received.

Reference: For more information on providing standard notification to the claimant, see M21-1MR, Part I, 1.B.3.
4. Conducting the Hearing

IntroductionThis topic contains information on

· explaining the proceedings
· the presence of an attorney
· advising the claimant of his/her right to a representative
· the statement of the issues
· administering the oath or affirmation
· starting the hearing
· gathering testimony and asking questions
· an alternate order of testimony and questioning
· conduct during the hearing, and
· ending the hearing.
Change DateAugust 24, 2004
a. Explaining the ProceedingsFollow the steps in the table below to greet the appellant and explain the proceedings.
StepAction1· Escort the claimant, witnesses, and his/her representative to the hearing room or appropriate waiting area
· introduce yourself and other VA personnel present, and
· begin the hearing without delay.

2Explain the

· nature and purpose of the hearing, and
· necessity for and use of recording equipment.3Tell the claimant that a copy of the transcript is

· placed in the claims folder, and
· sent to the claimant, if requested.Continued on next page
styleref "Map Title" 4. Conducting the Hearing, Continued

styleref "Block Label" a. Explaining the Proceedings (continued)
StepAction4Tell the claimant and witnesses that they may “go off the record” to

· collect their thoughts, or
· clarify any matter.5Explain the necessity of an oath or affirmation.
b. Presence of an AttorneyWhen the claimant’s representative is an attorney, emphasize

· the informality of the hearing
· that the rules of evidence do not apply, and
· that leading questions are permissible.
c. Advising the Claimant of His/Her Right to a RepresentativeFollow the steps in the table below when the claimant is not represented by an attorney, veteran service organization (VSO), agent, or other third party.

Reference: For more information on requesting representation by a power of attorney, see M21-1MR, Part I, 3.A.
StepAction1Explain the availability of

· a representative, or
· assistance by a member of the VSC.2· Inform the claimant that there is
- no obligation to join a VSO
- no charge for representation, and
· advise the claimant that representation is not mandatory.Continued on next page
styleref "Map Title" 4. Conducting the Hearing, Continued

styleref "Block Label" c. Advising the Claimant of His/Her Right to a Representative (continued)
StepAction3Did the claimant request a representative?

· If yes
- take the claimant and his/her witnesses to the chosen representative
- explain the situation to the representative, and
- go to Step 4.
· If no, proceed with the hearing.4· Set a new time for the hearing to begin, and
· allow adequate time for the representative to review the evidence.
d. Statement of the Issue(s)State the issue(s) in detail before testimony begins. This will not be used to limit the scope of the relevant issue(s) or indicate to the claimant that testimony is to be curtailed.

Ask the claimant and his/her representative if this is their understanding of the issue(s) and clarify any misunderstandings at this time.
e. Administering the Oath or AffirmationAll hearing testimony is to be given under oath or affirmation. Administer the oath or affirmation before recording begins.

Note: The DRO or presiding member of the hearing panel has the authority to administer oaths and certify documents as evidenced by VA Form 4505 series.
Follow the steps in the table below to administer the oath or affirmation.
StepAction1Ask the claimant and his/her witnesses to stand and raise their right hand.Continued on next page
styleref "Map Title" 4. Conducting the Hearing, Continued

styleref "Block Label" e. Administering the Oath or Affirmation (continued)
StepAction2
“Do you swear (or affirm) the testimony you are about to give will be the truth and nothing but the truth?”

Note: If the claimant or any witnesses refuse to take the oath or affirmation, request a solemn declaration using words the person considers binding on his/her conscience.
f. Starting the HearingThe DRO or VSCM designee starts recording the hearing with the opening statement which includes the

· fact that a hearing is being held
· date and time of commencement of the hearing
· name of the authorized individual before which the hearing is being held
· the name of either the veteran or claimant (if not the veteran)
· file number
· fact that the claimant and any witnesses have been duly sworn, and
· brief statement of issue(s).
g. Gathering Testimony and Asking QuestionsThe table below describes how to gather testimony and ask questions.
StageWho is ResponsibleAction1· DRO, or
· VSCM designee· Asks the representative, if present, if he/she desires to make an opening statement, and
· gives the claimant this same opportunity.

Continued on next page
styleref "Map Title" 4. Conducting the Hearing, Continued

styleref "Block Label" g. Gathering Testimony and Asking Questions (continued)
StageWho is ResponsibleAction2ClaimantProvides testimony.3· DRO, or
· VSCM designeeAsks questions that

· are consistent with the non-adversarial nature of the hearing, and
· elicit all relevant testimony.4Witness(es)Provides testimony.

Note: Repeat stages three and four for any additional witnesses.
h. Alternate Order of Testimony and QuestioningSome representatives may ask that the witness testify immediately after the claimant and before questioning. In this circumstance, question the claimant and witness after completion of all testimony.

Before questioning the claimant

· ask if he/she objects to any of the witnesses being present, and
· if so, excuse the witness(es).Continued on next page
styleref "Map Title" 4. Conducting the Hearing, Continued

i. Conduct During TestimonyInterrupting the Claimant
The appropriateness of interrupting the claimant or the witness(es), or suggesting areas that should be further developed during the course of testimony, depends on the individual hearing.

Limiting the Witness(es)
Exercise care and tact in limiting the witness(es) and guard against any suggestion that the testimony is not important.

Cross-examination
While cross-examination should be avoided, it is important that the claimant be questioned sufficiently to elicit all relevant testimony.
j. Ending the HearingFollow the steps in the table below to end the hearing.
StepAction1· Give the claimant and his/her representative an opportunity to make a final statement when
- testimony is complete
- discussion of any area raised by questioning has been concluded
· ask if anyone wishes to add anything, and
· identify any evidence referenced in the hearing testimony that
- the claimant has agreed to furnish, and/or
- VA will attempt to acquire.2Explain

· VA’s procedures regarding notification, and
· that the claimant will not be provided with oral or written notification of the formal decision until it has been signed and, if necessary, approved.3· Note the time the hearing concludes for the record
· have the claimant complete any medical release forms needed to obtain private treatment records, and
· escort the claimant and/or witness(es) from the hearing area.
5. Additional Issues Raised During the Hearing

IntroductionThis topic contains information on

· handling additional issues raised during the hearing, and
· what to do when the claimant
- requests to file a NOD or substantive appeal during the hearing, or
- disagrees with a previous decision.
Change DateAugust 24, 2004
a. Handling Additional IssuesProperly consider additional issues raised by the claimant or his/her representative during or after the hearing.
b. Claimant Requests to File NOD or AppealIf a NOD or substantive appeal was not filed, but the claimant or his/her representative indicates during the hearing that he/she wishes to file one, provide the claimant with either
· VA Form 21-4138 to prepare a written NOD, or
· VA Form 9 to file a substantive appeal.

Note: Encourage the claimant to complete the appropriate form prior to leaving the hearing.
c. Claimant Disagrees with the Previous DecisionIf the claimant expresses disagreement with a previously rendered decision during the course of the hearing, the DRO is responsible for preparing

· his/her decision on the issue specifically under consideration at the hearing, and
· a statement of the case concerning the other issue newly raised at the hearing, if the benefit sought is not fully granted.
6. Transcribing the Hearing

IntroductionIn most cases, when the hearing has concluded, transcribe the hearing.

This topic contains information on

· preparing the hearing transcript
· soliciting the claimant’s permission to not transcribe the hearing
· handling the claimant’s waiver of a hearing transcript, and
· preparing the transcript for Board of Veterans’ Appeals (BVA) transfer.
Change DateAugust 24, 2004
a. Preparing the Hearing TranscriptIf the case will be forwarded to BVA, transcribe the hearing, clearly labeling each tape with the date and issue and store the tapes until the transcript is verified.
b. Soliciting Claimant’s Permission Not to Transcribe HearingIn some situations, the DRO, or other appointed VA employee who conducted the hearing, determines with reasonable certainty that particular cases will not be referred to BVA.

Examples:
· Cases involving a complete grant of benefits.
· Instances in which the claimant is considered likely to withdraw the appeal.

In this situation, solicit the claimant’s permission not to prepare a typed transcript of the hearing.Continued on next page
styleref "Map Title" 6. Transcribing the Hearing, Continued

c. Handling the Claimant’s Waiver of a Hearing TranscriptIf the claimant gives his/her permission not to prepare a typed transcript of the hearing,

· ask the claimant to sign the following statement at the hearing: “I hereby waive any requirement that the record of my hearing will be transcribed. A hearing transcript will be prepared if my records are eventually referred to the Board of Veterans’ Appeals for a decision on this issue,” and
· secure the tape recording or other electronic record in the claims folder for a period of at least two years after the hearing, at which time it will be recycled or destroyed.
d. Preparing the Transcript for BVA TransferIf the case is transferred to BVA for consideration of the issue(s) that was the subject of the hearing, place a transcription of the recording in the claims folder.
7. Reviewing the Evidence of Record

IntroductionReview the evidence of record after the hearing.

This topic contains information on
· types of testimony
· a definition of argument
· analyzing the testimony for credibility and value
· competency of witnesses
· requesting corroborative evidence
· handling new issues, and
· when to request VA exams.
Change DateAugust 24, 2004
a. Types of TestimonyTestimony is evidence presented as either

· written testimony
- in the form of affidavits, or
- certified statements, or
· oral testimony which consists of evidence sworn under oath.

Example: Testimony, as evidence, may include statements relating to
· history
· symptoms
· etiology
· employment, and
· treatment.
b. Definition: ArgumentArgument is an effort to establish a point by a course of reasoning.

Example: Contentions, inferences, or explanations offered by the claimant or representative as to why the evidence supports granting the benefit sought.Continued on next page
styleref "Map Title" 7. Reviewing the Evidence of Record, Continued

c. Analyzing the Testimony for Credibility and ValueAnalyze the credibility and value of testimony presented by the claimant and others who testify on the claimant’s behalf.

Note: Take care to distinguish between testimony and argument.
d. Competency of WitnessesOnly a witness qualified as a medical expert can provide medical determinations. A medical expert must have education, training, and knowledge in medicine.

Lay testimony concerning etiology or diagnosis of a medical condition is generally of no probative value. However, lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. (38 CFR 3.159(a)(2))
e. Requesting Corroborative EvidenceUnder the Veterans Claims Assistance Act of 2000, the hearing official has a duty to assist the claimant in obtaining evidence to support his/her claim.

If the claimant identified sources of information or evidence while testifying that corroborates the claim
· attempt to obtain the additional evidence, and
· do not make a final decision on the claim until development has been completed.

Example: The claimant states that he was treated by Dr. John Smith, and Dr. Smith’s report is not in the file. Reasonable efforts must be made to obtain that report before making a decision.Continued on next page
styleref "Map Title" 7. Reviewing the Evidence of Record, Continued

f. Handling New IssuesIf the claimant raises a new issue(s) separate from the decision being appealed

· resolve the new issue(s) at the same time as the decision on appeal, if possible, or
· refer the issue(s) to the appropriate VSC activity for development and decision.

Note: Do not delay making a decision on the issue(s) that was the subject of the hearing pending a decision on the new issue(s).
g. When to Request VA ExamsIf, during the course of a hearing or review of the claims folder, it is determined that an exam should have been or should now be ordered based on new evidence, request a VA examination if the claimant agrees to report for the exam.

#208 carlie

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Posted 07 April 2010 - 09:58 AM

http://www1.va.gov/v...asp?pub_ID=1790

Department of Veterans Affairs VHA DIRECTIVE 2008-071 Veterans Health Administration Washington, DC 20420

October 29, 2008


PROVISION OF MEDICAL STATEMENTS AND COMPLETION OF FORMS BY VA HEALTH CARE PROVIDERS

1. PURPOSE: This Veterans Health Administration (VHA) Directive establishes policy requiring VHA health care providers, when requested, to assist veteran patients in completing non-Department of Veterans Affairs (VA) medical forms (with the exception of the completion of examination forms if a third party customarily pays health care practitioners for the examination, but does not pay VA) by providing the veteran patients with medical statements with respect to their medical condition(s) and functionality. NOTE: Attachment A identifies a process to assist VHA providers in honoring requests by veterans to complete those forms.

2. BACKGROUND: VHA strives to be the provider of choice for all enrolled veterans. Completion of medical forms by health care professionals based on an examination or knowledge of the veteran’s conditions, is required under Title 38 Code of Federal Regulations (CFR) 17.38(a)(1)(xiv) as part of the medical benefits package (with the exception of the completion of examination forms if a third party customarily pays health care practitioners for the examination, but does not pay VA). This regulation requires VHA providers to honor requests by veterans for assistance in completing non-VA forms regarding their current health conditions and functional impairment.

3. POLICY: It is VHA policy that clinicians must honor all requests by patients for completion of non-VHA medical forms (with the exception of the completion of examination forms if a third party customarily pays health care practitioners for the examination, but does not pay VA); clinicians must honor all requests for the provision of medical statements, following procedures established by the local facility Release of Information (ROI) Office.

4. ACTION: Each medical facility Director is responsible for establishing and implementing a written facility policy addressing:

a. Non-VA Medical Forms. Veterans may ask VA health care professionals, including primary care and specialty practitioners, to complete forms that require a medical professional’s assistance.

(1) Although the primary care provider typically receives the form from the veteran, when completion of the form extends beyond the scope of the primary care provider, additional input from appropriate specialty services may be considered (e.g., functional assessments from Physical Medicine and Rehabilitation (PM&R), Occupational Therapy, etc.). The practitioner completes these forms at the time of the visit, or requests the veteran return to pick up these forms at another time, especially if not all information is available to the practitioner, or the form is lengthy and may cause an undue delay in the provider’s schedule.
THIS VHA DIRECTIVE EXPIRES OCTOBER 31, 2013
VHA DIRECTIVE 2008-071 October 29, 2008


(2) All medical forms completed on behalf of the veteran require that the individual sign VA Form 10-5345a, Individuals Request for a Copy of Their Own Health Information, and local procedures must be followed for obtaining this authorization. Examples of these non-VA forms include, but are not limited to:

(a) Family Medical Leave Act forms. (b) Life insurance application forms. © Non-VA disability retirement forms. (d) State workers’ compensation forms. (e) State driver’s license or handicap parking forms. (f) Social Security Administration (SSA) examination forms.

b. Non-VA Medical Statements. Veterans may request a descriptive statement be put into their electronic health record regarding the current status of an existing medical condition, disease, or injury, that includes a statement of diagnosis, prognosis, and assessment of function for purposes other than VA disability claims.

(1) The veteran must sign VA Form 10-5345a, and then be responsible for forwarding the veteran's own information to the requesting entity.

(2) If the veteran requests that the form be sent directly to the requester (e.g., insurance company, etc.) then the veteran must sign VA Form 10-5345, Request for an Authorization to Release Medical Records of Health Information. NOTE: The local ROI Office is available for additional guidance.

c. ROI Procedures. In all cases, prior to releasing any statements or forms, the veteran is required to sign either VA Form 10-5345a or VA Form 10-5345 (see Att. A for a suggested algorithm that may be used by facilities in establishing local procedures).

d. Medical Statements to Support VA Benefits Claims.

When honoring requests for medical statements by veterans for VA claims adjudication, care must be taken to avoid conflict of interest or ambiguity.

(1) Determination of causality and disability ratings for VA benefits is exclusively a function of the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. As a result, they may not feel comfortable in stating causality of a current condition. However, this does not preclude VHA providers from
recording any observations on the current medical status of the veteran found in the medical record,
including their current functional status. All pertinent medical records must be available for review by VBA. NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process.

(2) Requests by a veteran for assistance in completing a VA disability claim are to be referred to VBA through official channels; however, the clinician, if requested by the veteran, must place a descriptive statement in the veteran’s medical record regarding the current status of the veteran’s existing medical condition, disease, or injury, including prognosis and degree of function. This may then be requested by VBA for the purposes of making a claim determination.


5. REFERENCE

a. VHA Handbook, 1605.1.

b. Title 38, CFR 17.38 (a) (1) (xiv) “Medical Benefits.”

6. FOLLOW-UP RESPONSIBILITY: The Office of Primary Care, Patient Care Services (11PC) is responsible for the contents of this Directive. Questions may be addressed to 202-461- 7182.

7. RECISSIONS: VHA Directive 2007-024 is rescinded. This VHA Directive expires October 31, 2013.
DISTRIBUTION: CO: FLD:
Michael J. Kussman, MD, MS, MACP Under Secretary for Health
E-mailed 10/30/08 VISN, MA, DO, OC, OCRO, and 200 – E-mailed 10/30/08



ATTACHMENT A
SUGGESTED ALGORITHM THAT MAY BE USED IN ESTABLISHING LOCAL PROCEDURES
Process Flow Chart for Non-VA Forms.pdf

#209 carlie

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Posted 28 April 2010 - 12:37 PM

DATE: 02-13-91



CITATION: VAOPGCPREC 04-91  
Vet. Aff. Op. Gen. Couns. Prec. 04-91  


TEXT: 
 

Failure to Submit to Medical Examination--Insistence on the Presence of an Attorney and Use of a Recording Device
 


QUESTION PRESENTED: 

 
Has a veteran failed to report for a scheduled examination for purposes of 38 C.F.R. § 3.655 if he or she appears but refuses to be examined unless accompanied by a private attorney and allowed to record the evaluation? 
 


COMMENTS:
  
 1. This is in response to your request for an opinion concerning the possible "right" of Department of Veterans Affairs' (VA) beneficiaries to be accompanied by an attorney during scheduled VA medical examinations.  The veteran appeared for a scheduled psychiatric examination but refused to be examined unless the veteran's attorney was present and the veteran was permitted to use a tape recorder during the evaluation.  Section 3.329 of title 38, Code of Federal Regulations, provides that every person applying for or in receipt of compensation or pension shall submit to examinations when required by VA under proper authority.  Section 3.655 of that title provides for discontinuance of benefits when a veteran fails "without adequate reason" to report for examination. Determination of the facts surrounding a claimant's failure to report is a factual matter which rests with VA adjudication and appellate personnel.  See 38 C.F.R. §§ 3.100 and 19.111.  This opinion addresses the legal issue of whether denial of assistance of counsel and use of a recording device in connection with a VA-required examination constitutes adequate reason for failure to submit to examination for purposes of section 3.655.

 2. A "right to counsel" in administrative proceedings does not exist unless it can be found in some constitutional clause, statutory measure, or regulation.  Barker v. Hardway, 283 F.Supp. 228 (S.D.W.Va.), aff'd, 399 F.2d 638 (4th Cir.1968), cert.  denied, 394 U.S. 905 (1969);  Suess v. Pugh, 245 F.Supp. 661 (N.D.W.Va.1965) (proceeding before Professional Standards Board of Veterans Administration).  Turning first to the United States Constitution, we note that the sixth amendment provides for the assistance of counsel " i n all criminal prosecutions."  It has no bearing on the question of assistance of counsel in civil matters before administrative agencies.  Hannah v. Larche, 363 U.S. 420 (1960); Smith v. United States, 250 F.Supp. 803 (D.N.J.1966), appeal dismissed, 377 F.2d 739 (3d Cir.1967); Suess, 245 F.Supp. at 665.  The fifth amendment is less specific than the sixth and contains a very powerful guarantee, requiring  that one not be "deprived of life, liberty, or property, without due process of law."  U.S. Const. amendment V.  However, in interpreting that clause, the courts have been reluctant to find that "due process" includes a right to representation by counsel in administrative activities of an investigatory or preliminary nature.  E.g., In Re Groban, 352 U.S. 330, 335 (1957) (no right to assistance of counsel in testifying at an investigatory proceeding); Bowles v. Baer, 142 F.2d 787, 789 (7th Cir.1944)  (investigations held in private, without representation by counsel-- held no provision of the Constitution required public hearing); see also Hannah, 363 U.S. at 440-51 (no right to cross-examine witnesses before commission performing investigative function).  See generally Torras v. Stradley, 103 F.Supp. 737, 739 (N.D.Ga.1951) (noting cases recognizing distinction between fact-finding functions and those involving determination of legal rights). 

 
3. In applying this case law to the situation under consideration, we note that medical examinations conducted by VA are investigative in nature. Within VA, there is a clear delineation between the role of the Veterans Health Services and Research Administration (VHS & RA) and that of the Veterans Benefits Administration (VBA).  Compare the Department of Veterans Affairs Act, Pub.L. No. 100-527, § 7, 102 Stat. 2635, 2640 (1988), with 38 U.S.C. § 4101(a).  As set out in 38 C.F.R. ss 2.67 and 3.100(a), authority is delegated to VBA personnel to make findings and decisions as to entitlement of claimants to monetary benefits under laws administered by VA.  Thus, even though medical examinations conducted by VHS & RA provide important information relevant to claims for benefits, the  examinations are not conducted by the same individuals who  
participate in benefit decisions, and the reports of those examinations represent only one piece of information which will be considered by adjudication personnel in determining eligibility for benefits.  Given the nature of the examination function, there is thus, in our view, no constitutional right to the presence of an attorney at a VA medical examination. 

 
4. With regard to pertinent statutory provisions, assistance of counsel for persons appearing before administrative agencies is addressed in the Administrative Procedure Act (APA) in the first two sentences of 5 U.S.C. § 555(b).  The first sentence provides that " a person compelled to appear in person before an agency or representative thereof is entitled to be accompanied, represented, and advised by counsel or, if permitted by the agency, by other qualified representative."  The second sentence adds that " a party is entitled to appear in person or by or with counsel or other duly qualified representative in an agency proceeding."  The legislative history of the predecessor to this provision indicates that the second sentence was intended to supplement the first sentence by providing a rule to govern situations where appearance of an individual is not compelled.
92 Cong.Rec. 2156 (1946) (statement of Senator McCarran).  Since the veteran in this case was required to appear for examination at the risk of termination of benefits, we believe that only the first sentence of section 555(b) is for consideration here. 

 
5. The predecessor to section 555 was described in congressional committee reports as prescribing "the rights of private parties in a number of miscellaneous respects which may be incidental to rulemaking, adjudication, or the exercise of any other agency authority."  H.R.Rep. No. 1980, 79th Cong., 2d Sess. 18, reprinted in 1946 U.S.Code Cong.Service 1195, 1206;  S.Rep. No. 752, 79th Cong., 1st Sess. 8 (1945).  The reference to "any other agency authority" suggests a broad application of the section.  Further, a section-by-section analysis in the House report on the measure stated broadly " t he section is a statement of statutory and mandatory right of interested persons to appear themselves or through or with counsel before any agency in connection with any function, matter, or process whether formal, informal, public, or private." H.R.Rep. No. 1980, supra, at 31. 

 
6. Given that Congress intended the provision to apply to a broad range of agency functions, the question remains as to whether Congress intended that any limitations apply with respect to the scope of representation activities. This issue was addressed in House floor debate on the measure by Congressman Walter of the Committee on the Judiciary, who stated " t he representation of counsel contemplated by the bill means full representation as the term is understood in the courts of law." 92 Cong.Rec. 5652 (1946).  Thus, it appears that the scope of 
representation was intended to be consistent with that recognized in judicial proceedings.  A review of analogous situations in judicial proceedings reveals that medical examinations in both adversarial and nonadversarial settings are almost uniformly conducted without the presence of attorneys.  For example, parties do not have the right, under discovery rules, to have an attorney present during mental or physical examinations conducted by physicians pursuant to Rule 35(a) of the Federal Rules of Civil Procedure. E.g., Wheat v. Biesecker, 125 F.R.D. 479 (N.D.Ind.1989) (by attending the examination the attorney might have to choose between participating at trial as a litigator of as a witness);  Cline v. Firestone Tire & Rubber Co., 118 F.R.D. 588 (S.D.W.Va.1988) (nature of psychological examination  particularly dictates against allowing the attorney to be present). 

 
7. Courts considering the issue of assistance of counsel in administrative proceedings have frequently ignored the possible applicability of the APA. Wasson v. Trowbridge, 382 F.2d 807, 812 (2d Cir.1967) (APA not mentioned in discussion of right of military academy cadet to counsel during expulsion hearing); Schawartzberg v. United States Board of Parole, 399 F.2d 297 (10th Cir.1968) (upheld regulation excluding counsel from parole hearings without mentioning APA).  In F.C.C. v. Schreiber, 329 F.2d 517 (9th Cir.1964), modified on other grounds, 381 U.S. 279   (1965), the Ninth Circuit held that application of the "right to counsel" as provided in the APA varies with the circumstances of the case.  In its turn, the Supreme Court noted, in F.C.C. v. Schreiber, 381 U.S. 279, 290 (1965), that administrative agencies should be free to fashion their own procedures and pursue methods of inquiry capable of permitting them to discharge their "multitudinous duties." 

 
8. Significantly, it has been held that, under the social security statutes, a claimant for social security benefits may not insist on the presence of an attorney during disability examinations conducted by the Department of Health, Education, and Welfare.  Neumerski v. Califano, 513 F.Supp. 1011 
(E.D.Pa.1981).  The reasoning in Neumerski is illuminating.  The court rejected the plaintiff's argument that the presence of counsel was justified because the proceedings had been given an adversarial taint by the agency's request for further examination.  Consistent with the legislative history of the APA the court pointed out that attorneys have no right to be present at medical or psychological examinations in truly adversarial civil litigation.  513 F.Supp. at 1016.  Quoting from Brandenberg v. El Al Airlines, 79 F.R.D. 543, 546 (S.D.N.Y.1978), which labeled as "frivolous" the claim that an attorney should be present at such an examination, the court indicated that " t his is especially true in psychological examinations which depend on 'unimpeded one- on-one communication between doctor and patient.' "  513 F.Supp. at 1017.  In addition to the concern that the presence of an attorney would undermine the communication process of an examination, courts have also recognized that there is very little an attorney can contribute in certain settings.  Cf. Cruz v. Skelton, 543 F.2d 86, 96 (5th Cir.1976), cert. denied, 433 U.S. 911 (1977) (parole board hearing does "not present a forum in which the special analytical, research or forensic skills of the lawyer are necessary, nor even likely to prove particularly helpful").  In light of these considerations, we cannot conclude that the APA provides a right to be represented by counsel at the examination itself. 

 
9. Turning to relevant VA statutes and regulations, we note that there is no provision in title 38, United States Code, or in VA regulations, specifically granting a claimant the right to have his or her attorney, or other representative, present during a medical evaluation.  Further, the involvement of claimants' representatives in VA proceedings is clearly not without limits. For example, while the provisions of 38 C.F.R. § 3.103(e) state that claimants "are entitled to representation of their choice at every stage in the prosecution of a claim," this provision is specifically made subject to the general provisions governing representation by attorneys and other representatives of claimants and beneficiaries in the "preparation, presentation, and prosecution" of matters affecting veterans' benefits.  See 38 U.S.C. § 3404(a);  38 C.F.R. § 14.626, et seq.  See also 38  
U.S.C. § 4005(a) (representation rights to be accorded in  administrative appeals pursuant to VA regulations);  38 C.F.R. § 19.150 (full right to representation by "authorized" individuals in all stages of an appeal).  Even assuming that a regularly scheduled medical examination represents a "stage in the prosecution of a claim" for purposes of section 3.103(e), the  scope of representation must be considered in light of the generally recognized limitations on the role of attorneys in judicial and administrative proceedings.  Such limitations, as discussed above, generally preclude the presence of attorneys at medical examinations, particularly those of a psychiatric nature. Thus, the provisions of titles 38 of the United States Code and the Code of Federal Regulations cannot be read to grant attorneys authority to participate in such activities. In view of the foregoing, we conclude that a veteran does not have a right to be accompanied by counsel at a scheduled VA examination and cannot justifiably refuse to submit to examination on the basis of denial of counsel. 

 
10. Similarly, there is no constitutional, statutory, or regulatory requirement that would allow beneficiaries to use recording devices during VA medical examinations.  Again, it must  be noted that the examinations at issue are investigative and preliminary in nature.  Further, while case law on the subject is not extensive, it supports the conclusion that one has no "right" to record such activities.  See, e.g., Baer, 142 F.2d at 788-89  (no constitutional infirmity where court reporter ordered to leave investigative-hearing room); In Re Neil, 209 F.Supp. 76, 77  (S.D.W.Va.1962) (APA does not extend to any party the right to bring a stenographer to report the proceedings at an agency hearing); Torras, 103 F.Supp. at 740 (witness in investigative proceeding did not have right under the APA to the presence of a personal stenographer).  As discussed above with respect to the presence of an attorney, use of a recording device would threaten to impede free communication between the examinee and the examining physician.  VA regulations do not authorize the use of recording devices at medical examinations, and we find that their use is not otherwise required by law.  Thus, denial of the use of such a device would not be an adequate reason to refuse to submit to examination.


HELD:  

Neither the Constitution, the Administrative Procedure Act, nor VA statutes and regulations provide a right to counsel at medical examinations scheduled by VA for evaluation of beneficiaries, including psychiatric evaluation.  
As, under the relevant constitutional, statutory, and regulatory provisions, there is no "right" to be accompanied by an attorney to this type of agency activity, refusal to participate unless accompanied by an attorney may be considered a failure to report for purposes of VA regulations at 38 C.F.R. § 3.655 providing for discontinuance of benefits for failure to report for examination.  

Similarly, a beneficiary may not insist on using a recording device at a VA medical examination, and refusal to participate due to absence of such a device may be considered a failure to report for purposes of VA regulations governing termination of benefits. 
  


VETERANS ADMINISTRATION GENERAL COUNSEL  
Vet. Aff. Op. Gen. Couns. Prec. 04-91 



#210 Pete53

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Posted 28 April 2010 - 01:25 PM

But the VARO tapes Hearings and at same time denies the Veteran the right to record our exams. At first I thought that it may have ruled other way but it was a typical VA set up to close the door at the end. They were right the whole thing is tainted.

#211 john999

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Posted 28 April 2010 - 03:20 PM

If vets were allowed to tape or have counsel at these exams most of the exams would be found to be inadequate just on the basis of what was said and what was witnessed. I mean we all have had the ten minute exam from the hostile doctor. You know you are being screwed and disrepected in the first three minutes.

#212 Wings

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Posted 28 April 2010 - 07:01 PM

x
x
x


Maybe times/laws have changed? ~Wings

#213 carlie

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Posted 28 April 2010 - 07:13 PM

M21-1MR - still shows veteran has no right to attorney being present
or recording device at C&P examination.

carlie

#214 jbasser

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Posted 03 May 2010 - 06:39 AM

Here is the link to the SVR Radio Show.
SVR is now affiliated with Hadit.com.
We provide open communications involving Veterans issues.
Jerrel Cook is the Host, Berta Simmons, Carlie and Pete53 and J Basser are the CO hosts.
Show times are 6:30 to 7:30'EDT 5:30 to 6:30 CDT,4:30 to 5:30 MDT,3:30 to 4:30 PDT.

Please join us each and Every Wednesday.

http://www.digout-di...m/svrradio.html



J

#215 carlie

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Posted 14 May 2010 - 10:49 AM

afsrc=1&mid=14795556&url=http://www.warms.vba.va.gov/admin21/m21_1/mr/part1/ch05.doc

Board of Veteran's Appeals http://www.fatwallet...va.gov/vbs/bva/

CARES Commission http://www.va.gov/vbs/bva/


Center for Minority Veterans http://www1.va.gov/c...norityveterans/


Center for Women Veterans http://www1.va.gov/womenvet/


Compensation Rate Tables, 12-1-03 http://www.vba.va.go...ates/comp01.htm

Department of Veterans Affairs Home Page http://www.va.gov/

Directory of Veterans Service Organizations http://www1.va.gov/v...m?template=view

Disability Examination Worksheets Index, Comp http://www.vba.va.go...exams/index.htm


Electronic Code of Federal Regulations http://www.gpoaccess.gov/ecfr/


Environmental Agents http://www1.va.gov/environagents/

Environmental Agents M10 http://www1.va.gov/v.....asp?pub_ID=10...


EVALUATION PROTOCOL FOR GULF WAR AND IRAQI FREEDOM VETERANS WITH POTENTIAL EXPOSURE TO

DEPLETED URANIUM (DU) http://www1.va.gov/g...k1303122304.DOC and http://www1.va.gov/v.....asp?pub_ID=11...
See also, Depleted Uranium Fact Sheet http://www1.va.gov/g...iumFAQSheet.doc

EVALUATION PROTOCOL FOR NON-GULF WAR VETERANS WITH POTENTIAL EXPOSURE TO DEPLETED URANIUM (DU) http://www1.va.gov/g...GW130340304.DOC


Forms and Records Request http://www.va.gov/vaforms/


Geriatrics and Extended Care http://www1.va.gov/geriatricsshg/

Guideline for Chronic Pain and Fatigue MUS-CPG http://www.oqp.med.v...us/mus_base.htm

Guide to Gulf War Veteran's Health http://www1.va.gov/g.../VHIgulfwar.pdf

Gulf War Subject Index http://www1.va.gov/G...a...in&letter=A

Gulf War Veteran's Illnesses Q&As http://www1.va.gov/g...andAsIB1041.pdf

Hearings
http://www.warms.vba.../part1/ch04.doc

Homeless Veterans http://www1.va.gov/homeless/

HSR&D Home http://www.hsrd.research.va.gov/

Index to Disability Examination Worksheets C&P exams http://www.vba.va.go...exams/index.htm

Ionizing Radiation http://www1.va.gov/irad/

Iraqi Freedom/Enduring Freedom Veterans VBA http://www.vba.va.gov/EFIF/

M 10 for spouses and children < http://www1..va.gov/......asp?pub_ID=1...

M10 Part III Change 1 http://www1.va.gov/v.....asp?pub_ID=10...

M21-1 Table of Contents http://www.warms.vba.va.gov/M21_1.html

Mental Disorders, Schedule of Ratings http://www.warms.vba...ART4/S4_130.DOC

Mental Health Program Guidelines http://www1.va.gov/v.....asp?pub_ID=10...

Mental Illness Research, Education and Clinical Centers http://www.mirecc.med.va.gov/

MS (Multiple Sclerosis) Centers of Excellence http://www.va.gov/ms/about.asp

My Health e Vet http://www.myhealth.va.gov/

NASDVA.COM http://nasdva.com/

National Association of State Directors http://www.nasdva.com/

National Center for Health Promotion and Disease Prevention http://www.nchpdp.me...oymentlinks.asp

Neurological Conditions and Convulsive Disorders, Schedule of Ratings http://www.warms.vba.....4/s4_124a.doc

OMI (Office of Medical Inspector) http://www.omi.cio.med.va.gov/

Online VA Form 10-10EZ https://www.1010ez.....sec/vha/1010ez/

Parkinson's Disease and Related Neurodegenerative Disorders http://www1.va.gov/r......s/parkinsons....
and, http://www1.va.gov/padrecc/

Peacetime Disability Compensation http://frwebgate.acc.....dbname=browse...

Pension for Non-Service-Connected Disability or Death http://www.access.gp.....pter15_subcha... and, http://www.access.gp.....pter15_subcha...
and, http://www.access.gp.....pter15_subcha...

Persian Gulf Registry http://www1.va.gov/v.....asp?pub_ID=10...
This program is now referred to as Gulf War Registry Program (to include Operation Iraqi Freedom) as of March 7, 2005: http://www1..va.gov/......asp?pub_ID=1...
Persian Gulf Registry Referral Centers http://www1.va.gov/v.....asp?pub_ID=10...

Persian Gulf Veterans' Illnesses Research 1999, Annual Report To Congress http://www1.va.gov/r.....llnesses_Appe... Persian Gulf Veterans' Illnesses

Research 2002, Annual Report To Congress http://www1.va.gov/r...ulfWarRpt02.pdf

Phase I PGR http://www1.va.gov/v.....asp?pub_ID=10...

Phase II PGR http://www1.va.gov/v.....asp?pub_ID=10...

Policy Manual Index http://www.va.gov/pu.../eds/edsmps.htm

Power of Attorney http://www.warms.vba.../part1/ch03.doc Project 112 (Including Project SHAD) http://www1.va.gov/shad/

Prosthetics Eligibility http://www1.va.gov/v.....asp?pub_ID=33...

Public Health and Environmental Hazards Home Page http://www.vethealth.cio.med.va.gov/

Public Health/SARS http://www..publichealth.va.gov/SARS/

Publications Manuals http://www1.va.gov/v...tions.cfm?Pub=4

Publications and Reports http://www1.va.gov/r.....ebpage=gulf_w...

Records Center and Vault Homepage http://www.aac.va.go...lt/default.html

Records Center and Vault Site Map http://www.aac.va.go...lt/sitemap.html

REQUEST FOR AND CONSENT TO RELEASE OF INFORMATION FROM CLAIMANT'S RECORDS http://www.forms.va......ness.asp?form...

Research Advisory Committee on Gulf War Veterans Illnesses April 11, 2002 http://www1.va.gov/r...April112002.doc

Research Advisory Committee on Gulf War Veterans Illnesses
http://www1.va.gov/r.....ations_2004.p...

Research and Development http://www.appc1.va....ll_programs.cfm

Survivor's and Dependents' Educational Assistance http://www.access.gp...chapter35_.html

Title 38 Index Parts 0-17
http://ecfr.gpoacces.....b0c269b510d31...

Part 18
http://ecfr.gpoacces.....b0c269b510d31...

Title 38 Part 3 Adjudication Subpart A "Pension, Compensation, and Dependency and Indemnity Compensation http://ecfr.gpoacces.....p;sid=1b0c269...

Title 38 Pensions, Bonuses & Veterans Relief (also § 3.317 Compensation for certain disabilities due to undiagnosed illnesses found here) http://ecfr.gpoacces.....p;sid=1b0c269...

Title 38 PART 4--SCHEDULE FOR RATING DISABILITIES Subpart B--DISABILITY RATINGS
http://ecfr.gpoacces.....p;sid=ab7641a...

Title 38§ 4.16 Total disability ratings for compensation based on unemployability of the individual. PART A "SCHEDULE FOR RATING DISABILITIES Subpart à "General Policy in Rating http://ecfr.gpoacces.....p;sid=1b0c269...

U.S. Court of Appeals for Veterans Claims http://www.vetapp.gov/

VA Best Practice Manual for Posttraumatic Stress Disorder (PTSD) http://www.avapl.org...ual final 6.pdf

VA Fact Sheet http://www1.va.gov/opa/fact/gwfs.html

VA Health Care Eligibility http://www.va.gov/he...ome/hecmain.asp

VA INSTITUTING GLOBAL ASSESSMENT OF FUNCTION (GAF) http://www.avapl.org/gaf/gaf.html

VA Life Insurance Handbook ¬" Chapter 3 http://www.insurance.....ook/glibookle...

VA Loan Lending Limits and Jumbo Loans http://valoans.com/va_facts_limits.cfm

VA MS Research http://www.va.gov/ms/about.asp

VA National Hepatitis C Program http://www.hepatitis.va.gov/

VA Office of Research and Development http://www1.va.gov/resdev/

VA Trainee Pocket Card on Gulf War http://www.va.gov/OA...ard/gulfwar.asp

VA WMD EMSHG http://www1.va.gov/emshg/

VA WRIISC-DC http://www.va.gov/WRIISC-DC/

VAOIG Hotline Telephone Number and Address http://www.va.gov/oi...ne/hotline3.htm

Vet Center Eligibility - Readjustment Counseling Service http://www.va.gov/rcs/Eligibility.htm

Veterans Benefits Administration Main Web Page http://www.vba.va.gov/

Veterans Legal and Benefits Information http://valaw.org/

VHA Forms, Publications, Manuals http://www1.va.gov/vhapublications/

VHA Programs - Clinical Programs & Initiatives http://www1.va.gov/h.../page.cfm?pg=13 http://webmaila.juno......dError.aspx>

VHA Public Health Strategic Health Care Group Home Page http: // /www.publichealth.va.gov/">http://www.publichealth.va.gov/" target=_blank fwOldOnClick="null" trackingAdded="true">www.publichealth.va.gov/

VHI Guide to Gulf War Veterans ª Health http://www1.va.gov/v...study/index.asp

Vocational Rehabilitation http://www.vba.va.gov/bln/vre/

Vocational Rehabilitation Subsistence http://www.vba.va.go...istencefy04.doc

VONAPP online http://vabenefits.vb...vonapp/main.asp

WARMS - 38 CFR Book C http://www.warms.vba.va.gov/bookc.html

Wartime Disability Compensation http://frwebgate.acc.....dbname=browse...

War-Related Illness and Injury Study Center - New Jersey http://www.wri.med.va.gov/

Welcome to the GI Bill Web Site http://www.gibill.va.gov/

What VA Social Workers Do http://www1.va.gov/s...k/page.cfm?pg=3

WRIISC Patient Eligibility http://www.illegion.org/va1.html

#216 Tbird

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Posted 15 June 2010 - 05:08 AM

http://www.hadit.com...-use-the-forum/

#217 Cruinthe

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Posted 27 June 2010 - 09:29 PM

I am quite sure the VA has people assigned to this and other webpages in an effort to root out "scammers". If only the VA put as much effort into rooting out scammers within its own ranks, we might actually make some progress. It says right on the back of my buisness cards that I never charge a fee for any service rendered, so what do they hope to accomplish?

On one of my recent trips to the Roanoke VARO, I had a person show up in the lobby about 15 minutes after I did. He was complaining bitterly about the guy that was handling his claim very poorly. Turns out this agent was also MY agent some off years ago, and the VA knew I was deeply dissatisfied with his performance. Could have had something to do with this agent taking $4000 from me, then dissapearing off the map. Regardless, this angry person was loudly proclaiming he was going to get a gun and shoot our mutal agent dead. I immediately knew this was a VA employee or confidential informant trying to entrap me into a murder conspiracy rap, if for no other reason than you dont walk into a federal building screaming that you are going to murder someone without the marshalls cuffing and stuffing you.

It is amazing to think the VA will go to such lenghts to get at people that are actually trying to do good.

#218 LarryJ

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Posted 27 June 2010 - 09:52 PM

And, of course, we all know that by law an "individual" can "represent" a veteran only once in their lifetime (by "represent" I mean to act as the veteran's "agent"). After that one time representation, then the person that was acting as the veteran's agent must become a "registered agent or attorney" by taking the courses prescribed by the VA, passing these courses, and being accredited by the Office of General Counsel of the Dept. of Veterans Affairs.

Right?
Right!
:wink:

#219 Notorious Kelly

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Posted 28 June 2010 - 08:34 AM

I have had suspicious veterans ask me what I charged etc for advice and help with their claim. It's kinda hard to believe that some veterans will work one on one with others for free, but some of us do, or have. I did for years, but vets are so slammed by the VA that often they are suspicious of anyone. However no can associate Hadit with anything like a charge or fee for services. If someone represents so, they are lying. What you get from Hadit is free. Donations are accepted, but hadit.com is not a not-for-profit site. Tbird spends a huge amount of money and time on this and I remember a big fuss years ago by a certain individual who tried to write off their donation to Hadit as a charity on their taxes. Hadit is NOT a charity. With that said, Tbird isn't buying a Mercedes or even a Yugo on what she makes. It goes to cover costs. Being a not-for-profit means a huge amount of accounting though and Tbird just cannot do that and run the site. At some point common sense has to enter the picture, and with Tbird and Hadit I think it has.

Bob Smith


I just searched and can't find out how to donate to Hadit.

If there's a way, please let me know.

Edited by Notorious Kelly, 28 June 2010 - 08:36 AM.


#220 Pete53

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Posted 28 June 2010 - 12:13 PM

Tbird has quit taking donations. I think that the few adds embedded and allowed by her are sufficient to support Hadit. Thanks for offering I am sure that she appreciates your inquiry.

If Tbird ever needed help I am sure she would ask. By the way Tbird when she took donations always asked Veterans who had not gotten their benefits or were waiting or had a hard time not making it month to month not to donate.

#221 Cruinthe

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Posted 28 June 2010 - 06:43 PM

I saw a quote from one of our Founding Fathers a few years ago. He was asked a question as to the definition of what single situation defines the beginning of tyranny. He thought about it and replied "When those that make and enforce the rules, exempt themselves from those rules, you have passed into tyranny".

So, the VA records anything they want, for whatever reason they want, yet we the veteran can record nothing. So, I wonder what we have here.

#222 Tbird

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Posted 29 June 2010 - 02:24 AM

thanks for offering to donate, really appreciate it! haven't taken donations in quite a long time, went through a rough patch and with those that did donate it helped us sustain. but we are fine now, donate your time to the board or even helping other veterans locally, if you do that you are giving back in a way that warms my heart.

you take care of you and yours, that is the most important thing!


I just searched and can't find out how to donate to Hadit.

If there's a way, please let me know.



#223 Tbird

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Posted 29 June 2010 - 04:33 AM

Updated 06.29.2010 by Tbird

#224 Vync

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Posted 29 June 2010 - 09:58 AM

Check your yellow pages and look for the local spy gear shop. You'll be surprised when you see the selection of tiny hidden recording devices you can buy.

#225 LarryJ

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Posted 29 June 2010 - 10:07 AM

Check your yellow pages and look for the local spy gear shop. You'll be surprised when you see the selection of tiny hidden recording devices you can buy.


That may be true, but what good would that money you just spent do you? You certainly don't dare try using the "secret" recordings during any kind of appeal process involving the VA, unless you wish to become more familiar with the Office of General Counsel, DeptofThe VA..........

just sayin................

#226 Notorious Kelly

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Posted 29 June 2010 - 08:57 PM

Yeah, for purposes of legality you have to check locally.

I believe in Portland/Oregon you can record telephone conversations where only one party is aware of the recording, but in-person conversations may not be secretly recorded.

Of course- everyone obeys The Law subjectively & might find reason to have a recording that won't be admissible in court, but could convince others in The Process.

Your call ;)

#227 LarryJ

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Posted 29 June 2010 - 09:18 PM

Yeah, for purposes of legality you have to check locally.

I believe in Portland/Oregon you can record telephone conversations where only one party is aware of the recording, but in-person conversations may not be secretly recorded.

Of course- everyone obeys The Law subjectively & might find reason to have a recording that won't be admissible in court, but could convince others in The Process.

Your call ;)



Only problem with your premise is this:

Once you step foot onto the VA property, then "for purposes of legality" you might as well be standing in the Oval Office as far as the law is concerned.
You are on U.S. Government Property and "local" don't mean diddly. Federal law prevails.

just sayin............

Edited by LarryJ, 29 June 2010 - 09:19 PM.


#228 Notorious Kelly

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Posted 30 June 2010 - 08:07 AM

Oh- good point, Larry Posted Image

I'm just so much less-concerned about laws & rules that don't serve the common man. It might not be gracious to pass on this attitude to my fellow vets.

#229 LarryJ

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Posted 30 June 2010 - 09:33 AM

Only problem with your premise is this:

Once you step foot onto the VA property, then "for purposes of legality" you might as well be standing in the Oval Office as far as the law is concerned.
You are on U.S. Government Property and "local" don't mean diddly. Federal law prevails.

just sayin............



This is also why your VA doctor/nurse/physical-therapist/lab-tech, etc. do not have to be licensed in any of the states of the United States. And, why you find soooo many doctors/nurses that speak very limited ENGLISH!

#230 Navy Spook

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Posted 30 June 2010 - 04:22 PM

And, of course, we all know that by law an "individual" can "represent" a veteran only once in their lifetime (by "represent" I mean to act as the veteran's "agent"). After that one time representation, then the person that was acting as the veteran's agent must become a "registered agent or attorney" by taking the courses prescribed by the VA, passing these courses, and being accredited by the Office of General Counsel of the Dept. of Veterans Affairs.


Wouldn't that more properly be stated that an individual can only represent (as an agent) one non-related veteran?

I mean I thought you were always allowed to assist family members at any level, and I thought you could assist a non-related veteran "forever", but no other non-related veterans after the first one.

Don't chew me up here, I'm asking not telling.

#231 LarryJ

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Posted 30 June 2010 - 05:04 PM

Wouldn't that more properly be stated that an individual can only represent (as an agent) one non-related veteran?

I mean I thought you were always allowed to assist family members at any level, and I thought you could assist a non-related veteran "forever", but no other non-related veterans after the first one.

Don't chew me up here, I'm asking not telling.


Well, I don't know if being someone's Brother or Second-cousin or Sister-in-law actually enters into it (in other words, where would you draw the relationship line).
Now, I'm ALSO talking about acting as a veteran's "agent", i.e. as the holder of that veterans POA (as an individual via VA Form 21-22a as opposed to VA Form 21-22).
I am NOT talking about, for example, telling your Brother when and what to file, but, instead, I'm talking about filing documents FOR your Brother, with your signature on the bottom line as their "agent".
That capacity you can only fill once in your lifetime.

#232 Commander Bob

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Posted 30 June 2010 - 05:16 PM

HadIt.com is not associated with solicitations to assist with VA Claims, if someone on the board offers to help with your VA Claim they are doing so as an individual, they are not associated with HadIt.com in any way other than being a member on the board.

HadIt.com does not have service officers, nor does it offer individual assistance with claims.



That is why I donate my time and two cents to Hadit...

Greetings fellow members, I have been on a road trip & it is good to be back home.

C.B.

Attached Files


Edited by Commander Bob, 30 June 2010 - 05:17 PM.


#233 yoggie2

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Posted 12 July 2010 - 11:47 AM

thanks for offering to donate, really appreciate it! haven't taken donations in quite a long time, went through a rough patch and with those that did donate it helped us sustain. but we are fine now, donate your time to the board or even helping other veterans locally, if you do that you are giving back in a way that warms my heart.

you take care of you and yours, that is the most important thing!




man I say its been years 4 or maybe 5...yoggie

#234 allan

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Posted 16 July 2010 - 06:48 PM

Correction: Naval base Treasure Island, California was not a naval air base. It wasn't big enough to get a plane to land on it. It was a training base and a transit center. There were also a few ships stationed there including Coast Guard vessels.

Allan

Edited by allan, 16 July 2010 - 06:50 PM.


#235 Chuck75

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Posted 17 July 2010 - 08:58 PM

Treasure Island started as a world fair site.
During WWII, TI. had Navy patrol blimps and a seaplane ramp in use. In 1968, I was actually in one of the surviving blimp hangers, and saw the seaplane ramp. A Naval Air Station, is a "limited" Navy base more or less for aircraft only.
At one time, TI did have an airstrip. It may have been limited to small propeller driven planes.
By 1968, the large ship wood piers had rotted away. Evidently, there are/were other large ship moorings, perhaps a Mole? that may still be there.
http://en.wikipedia....Alameda#History (Closest NAS)

Correction: Naval base Treasure Island, California was not a naval air base. It wasn't big enough to get a plane to land on it. It was a training base and a transit center. There were also a few ships stationed there including Coast Guard vessels.

Allan


Edited by Chuck75, 04 August 2010 - 09:44 AM.


#236 stillhere

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Posted 18 July 2010 - 01:02 PM

Tbird deaflaw.org looks like it has shut down?

#237 allan

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Posted 18 July 2010 - 05:44 PM

On April 1, 1941, Treasure Island along with its twin Yerba Buena, became Naval Station Treasure Island.
The link you posted was for Alemeda Naval Air Station which was located across from Sanfrancisco & south of Oakland. I spent allot of time there chasing down boiler parts and going to the NCO dance club.

The large ship dock on Naval Station Treasure Island, was still functioning when my ship was decommissioned in 1971, so it must have been in the later 70's, 80's or 90's when it was demolished.
I lived in the Barracks for the first two months of 1968 & worked at the base post office during surgical recovery.
After that, Treasure Island was home port for the heavy destroyer I was stationed on until 1971.
I got to experience the hostility the bay area citizens had towards all military to the point of the base being fire bombed by protesters and constant beatings when off base. It wouldn't surprise me if the bay area still treated military personnel that way.

I can tell you now, Naval Station Treasure Island, never had much to do with being an air base. That was one busy base from what I saw and experienced. Training and transit for naval personnel was it's main function for decades, not an air base. What little air base there was in the late 30’s was made into space for training centers and naval housing in the 40’s.



Historic California Posts: Naval Air Facility, Treasure Island
http://www.militarymuseum.org/NAFTreasureIsland.html


Treasure Island (California) From Wikipedia, the free encyclopedia
http://en.wikipedia....and_(California)

http://www.nps.gov/history/Nr/travel/wwIIbayarea/qua.HTM

http://www.atsdr.cdc.gov/hac/pha/pha.asp?docid=26&pg=0





#238 Tbird

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Posted 19 July 2010 - 02:20 AM

That is possible the site is run by someone else, I worked at the same company with her years ago and this her endeavor, it is not uncommon for us webmaster's to add links that at some point go down or go away. This is one of the challenges a webmaster have, it's hard to keep up.

Tbird deaflaw.org looks like it has shut down?



#239 halos2

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Posted 19 July 2010 - 02:55 AM

It opened fine for me with my slow as molasses dial up. I recently found this site on an internet search and thought it was interesting. Thanks tbird for posting it 4 others too!

#240 Pete53

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Posted 19 July 2010 - 04:47 AM

It works for me right now as we all know sometimes a link won't work for a short time.




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