VA Dental Treatment And Agent Orange

Most Vietnam veterans were exposed to Agent Orange in some form.
I had rashes on my upper arms for years after returning from Vietnam,
and for years I wore long sleeve shirts to cover the rashes. It was probably
some form of Chloracne, and it did finally go away.

A Question From The Latest S-2 Report Newsletter

My friend is a temporary 100% from the VA for Agent Orange related cancer. The treatments have caused problems with his teeth according to a civilian doctor, but the VA won’t treat him because temporary 100% veterans do not rate dental treatment. What can he do?

  This is from the Code of Federal Regulations. He should be entitled under section g below. The problem is an outside doctor diagnosed the problem as caused by his treatment. If this is a doctor the VA sent him to, it's not a problem, but if it's a civilian, he would have to go through a service organization and request a determination from the VA and I would also file for unemployability.

  It is a Catch 22 because they may try to wait him out like they do with most people, and he obviously doesn't have the time while in treatment. As it turned out, a VA doctor also diagnosed the dental problem as being related to the service-connected cancer treatment. I would file the claim for dental treatment and unemployability because of a service-connected condition.

   He could also go to the VA outpatient clinic and tell them he is in pain from his teeth due to his cancer treatments. If they diagnose it right there he should be eligible right away. I would try this first. Now, since I’ve learned that VA doctors are involved, the VA is for sure violating their own laws. But as in many cases, adjudicators are willing to wait a veteran out to save money.

  The seriously ill veteran or his spouse or representative should  make sure  he signs all paperwork relevant to the claim. If he dies from the service-connected condition, this is no problem because his spouse or dependent children will be able to keep the claim open.. If he dies from a condition not yet service-connected or not yet proven to be secondary to the service-connected condition, this can be a problem if the paperwork is not signed.

Authority: 38 U.S.C. 1712)
(g) Class III. Those having a dental condition professionally determined to be aggravating disability from an associated service-connected condition or disability may be authorized dental treatment for only those dental conditions which, in sound professional judgment, are having a direct and material detrimental effect upon the associated basic condition or disability.

(h) Class IV. Those whose service-connected disabilities are rated at 100% by schedular evaluation or who are entitled to the 100% rate by reason of individual unemployability may be authorized any needed dental treatment.

  Veterans and their reps and family members must treat the VA as an adversary during the claim process. The VA often says the claim process is not adversarial, but it is and they will turn a veteran down or stall the claim when possible.

  I don’t know why people like the blind Chinese guy several months back can be brought to this country and instantly given food, housing, and money for his entire family because they are persecuted by their government...but veterans who lay their life on the line for this country are treated like unwanted guests when they have  a physical injury.

  I truly believe the VA has many dedicated employees at the medical centers who do everything they can for veterans. My problem has always been with the adjudication system, which is only going to get worse. The White House always strips funding from the VA one way or another, and there is no way any claim should take over 800 days, especially when a veteran is critical.

(The S-2 Report Newsletter has been printed bi-monthly since 1994 to help veterans deal with the VA. If you would like more info about the newsletter contact Dennis Latham at ysgazelle@gmail.com)


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PTSD: I Like To Think I'm Normal, but...

How could any combat veteran ever imagine the problems we would deal with later?

I like to think I’m normal, but then if I have to go out in public, I realize I’m not normal. My wife knows if we go into a restaurant I have to keep my back to the wall. I’m also not very good in traffic, and most times would inflict harm on people who are aggressive in traffic (cut me off or tailgate) if I could get my hands on them. I guess a lot of people feel like that, but I would do it. I’ve never been the kind to threaten or argue with strangers. I attack when threatened. That’s one reason I don’t like to go to large stadiums or other public places where I can be exposed to potential threats. I can’t stand crowds where I have no control. That’s also the reason I never drink anymore. I have to keep iron control of my emotions and anger. I’m also a fanatic on perimeter security in my home. I’m always the last to go to bed, and the first to get up. I have a weapon within reach if needed, and I probably wouldn’t sleep much at all if I didn’t have a dog to take up my slack.

I still never sleep more than two to fours hours at a time. I never just wake up. I jump out of bed fully alert. That drives my wife and visiting family members crazy because they don’t understand how I can be instantly awake. I don’t understand how people can be so unconcerned or trusting when it comes to their own security.

Any treeline takes me right back to Vietnam as I try to figure what kind of ambush I could be walking into, how to get out of it, or how I would construct an ambush. Helicopters will make me freeze when they pass over, and war memories flood my thoughts.

I have a lot of nightmares. Most times I don’t remember them or they wake me up. There isn’t a day that passes that I don’t think of the war or my dead friends. I try to keep any depression in check by exercise, though I’ve never been able to quit smoking. I tried a quit smoking group at the VA, but it reminded me too much of rap groups or AA meetings and I never went back after one session. My few friends are Nam vets or other vets I’ve known since childhood. I pretty much remain isolated all the time, and I have never felt comfortable at any job unless it involved helping combat veterans. I have never felt any remorse for anything I saw and did in Vietnam. I never hurt women and children, and everyone I dealt with was an enemy. If anything, I would like to meet some former VC or NVA so we could go at it again. That could possibly give me some form of closure because I still despise them.

I like to feel that I’m a friendly, outgoing person, but others (those who were never in the military) see me as full of rage and I don’t understand how I present myself as being full of rage. My behavior is normal for me. (That’s why it sometimes takes so long for veterans to realize something is wrong.)

I believe a lot of my rage is from dealing with a system that puts combat vets through such hell to obtain benefits. Last night on the news I watched our money rebuilding Iraq. Somebody (Iraqi) comes and asks for money and we give it to them for a business while back home our veterans have to fight to get anything.

It all feeds the rage. I often feel I should have just died in the war and that I could have done more while I was there. I feel guilty for being alive and I feel helpless that I can’t turn things all the way around for myself and others. I know the PTSD will never go away, but I also know that I’ve helped a lot of combat veterans survive to make it this far.

So we all continue to walk a fine line and try to cope the best we can as we live with PTSD.

(Since I've written this article, I did manage to quit smoking after 48 years, and I've been in therapy for my PTSD, as I have been off and on since 1981. I have seen some positive changes, but the PTSD is something that will never go away. All we can do is learn to live with it.)

A PTSD Novel: Michael In Hell

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PTSD Higher Percentage

Paper Viet Cong flag taken from pocket of dead VC in Street Without Joy 1967

Obtaining The Higher Percentage

   I have received many letters from veterans who have received service connection for PTSD, and who are not happy with their percentage. They want to know what to do next. The next step is the appeal, but this can be totally confusing to a veteran who doesn’t have knowledge of how the system works. Ben Franklin said there were two sure things: death and taxes. If he lived today, he would probably add one more: anything involving money and a Federal Agency is going to be complicated...this is a fact of life.

   The appeal is almost automatic anymore. You get a percentage and you appeal to the Regional Office for a higher percentage. If you don’t have additional evidence to offer at this point, the appeal will probably be pointless.  But any current statements from doctors or from another agency such as Social Security (if it already has not been submitted) can be used.

   If the Regional Office turns you down on the disagreement, the next step is an appeal to the BVA (Board of Veterans Appeals). The Regional Office will send you a Statement of the Case including VA Form 9. The statement of case will show your evidence and the reason you were denied an  increase or service connection. This is when you file a Substantive Appeal on the VA Form 9. You should clearly state the benefit you are after (increase in PTSD percentage), and the mistakes you think the VA made in turning you down. You can also use this form to request a personal hearing before the BVA.

  (A hearing is best because you can actually tell a person what is wrong instead of doing everything through the mail).

   If you are turned down by the BVA, you may re-open the claim with new evidence. Or, if it is a matter of law, not diagnosis, then you can appeal to the Veterans Court Of Appeals.

   With PTSD, percentage ratings of 10% to 30% are common on the initial claim. If you disagree with your percentage at the Regional Office level, the odds are good that you will be turned down for an increase. This is because the RO usually does not change a rating no matter what the new evidence. Maybe because they  can get the claim out of their office by letting you appeal to the BVA.

   Since a lot of the PTSD rating stems from your ability to support yourself, veterans who have managed to hold one job for years often suffer when being evaluated for ratings. (I call it being punished for managing to survive a work place).

   I know veterans who have held one job for many years, on a day to day basis. Meaning they just barely hang on, even though they have severe PTSD. They are often miserable, depressed, and ready to explode, but they hang on because they are the sole support of their families and they are survivors. Many have to work alone in complete isolation or are in constant struggles with management due to PTSD. But because they haven’t exploded yet, the rating board often concludes that they operate on no more that a 30% disability level. These veterans should hang tough and work through the entire appeal process.

   Even if you have managed to hold one job, but must be isolated, meaning you can only function while working alone, this would probably  make you eligible for a 50% rating.

   With PTSD, the appeal process can work if the veteran can wait it out without giving up. The main point (95% of the battle) is getting the VA to admit you have PTSD from war. Once that is established you can use the appeal process to obtain a higher percentage. In many cases, it becomes a long, drawn out process, but can be worth the wait because you will win in the end.

 

 

(from the S-2 Report)

ysgazelle@gmail.com