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VA Claim under PACT act

Posted by Dick Williams on 7/24/2024, 14:28:43

I made application under the PACT Act using the VFW's VOS at the VA hospital in Kansas City on June 1st 2023. Since then I see some status reports via the online portal. Mostly code numbers that don't mean anything to me. My VFW VOS isn't replying to emails and the app seems to be stalled.

I know a year and a month isn't long compared to the long wait many of you have had. I do have one question.

I have not been contacted to report for any screening exams. Is that always a part of a VA claim - being examined by one of their contract examination clinics? They have my records from the VA physicals and an outside provider but no requests for specifc exams for the claim.

The claims are for Type II diabetes and high blood pressure - both covered under the PACT act.

Dick Williams
Takhli Base Weather 69-70
Kansas City MO

Re: VA Claim under PACT act

Posted by Gary Williams on 7/25/2024, 10:49:04, in reply to "VA Claim under PACT act"

I applied in August of 2023 for hearing loss, tinnitus and sleep apnea. In Feb of this year I was contacted to have a hearing exam at a third party facility. One week after the exam I was awarded 10% for tinnitus. Within the next few weeks I was denied for hearing and sleep apnea. I appealed the sleep apnea, was given a phone interview and am awaiting appeal results.

Re: VA Claim under PACT act

Posted by Rich on 7/27/2024, 12:35:15, in reply to "VA Claim under PACT act"

To answer your question: under normal circumstances, yes. C&P medical exams are par for the course during a VA medical compensation claim.

I also have Type II diabetes and high blood pressure along with quite a few other issues as well and I would say I that have gone through 8 or maybe 10 different C&P medical exams at different VA contracted medical facilities over the 10 year life of my claim.

I also submitted copies of my medical records to support my claim but the reality is that the VA much prefers to have original copies of medical records sent directly to them from your medical provider (if not part of your military records). I had to submit a notarized release of medical records to the VA on more than one occasion during the life of my claim.

Have you ever received (directly) any land based mail from the VA Evidence Intake Center in Janesville, WI acknowledging receipt of your claim or claim status reports of any kind?

It sounds like your claim may be stalled for some reason. VFW VOS reps come and go, it is possible that your rep is no longer there and either forgot or could not pass your torch for some reason or another? That happened to me during the 2nd year of my claim.

I would like to help you if I can Dick. I first would like to suggest that you give the VA a call at 1-800-827-1000 Monday through Friday, 8:00 a.m. to 9:00 p.m. ET and inquire about your claim. If they can't help you they should know where you can get the help you need.

Good Luck in the pursuit of your claim.

Re: VA Claim under PACT act

Posted by Dick Williams on 11/21/2024, 10:28:36, in reply to "VA Claim under PACT act"

An update to my July posting on my PACT act claim. Things continued to go nowhere and after svral email and voicemails to my VFW VOS at the Kansas City VA Med Center I learned that the VOS had left and there are currently no VOS personnel at that VA facility. One of my voicemails apparently got to the VOS office in Jefferson City and I had a call from Troy Williams with VFW National who works out of Jeff City.

He confirmed that the 526-EZ was not in the system - so nothing has happened on the claim since I thought it was filed on 1 Jun 2023. Troy took my info over the phone, completed a new 526-EZ and also contact info for my civilian provider and all was submitted this week but with date of 1 Jun 2023. They did have records of the attempt to file on that date so my place in line should be preserved. May be important if a rating and compensation are granted in order to get the retroactive benefit.

I had been checking all along at about a 2 month interval and there some notatinon in the online status section about pending issues but if a claim seems to stall out be pro-active and make sure it was submitted and isn't in limbo as mine was for 17 months. THe new VOS did more in 3 hours by phone that all prior had done in a year and a half. And if your VOS stops responding -follow up with another VOS in another facility if need be.

Previous Message

I made application under the PACT Act using the VFW's VOS at the VA hospital in Kansas City on June 1st 2023. Since then I see some status reports via the online portal.

Re: VA Claim under PACT act

Posted by Gary Williams on 11/22/2024, 9:07:00, in reply to "Re: VA Claim under PACT act"

Update to this message. I was requested by third party to do a home sleep study. Equipment was sent to my home and an instructional phone call was provided. Equipment was then returned to third party . In August I was awarded a 50% disability for sleep apnea, my overall rating now being 60%.

Previous Message

I applied in August of 2023 for hearing loss, tinnitus and sleep apnea. In Feb of this year I was contacted to have a hearing exam at a third party facility. One week after the exam I was awarded 10% for tinnitus. Within th next few weeks I was denied for hearing and sleep apnea. I appealed the sleep apnea, was given a phone interview and am awaiting appeal results.

Re: VA Claim under PACT act

Posted by DENNIS WOLVERTON on 12/4/2024, 12:06:11, in reply to "Re: VA Claim under PACT act"

I also have ten percent for tinnitus, and zero for sleep apnea. I'm currently at 80% due to Parkinson's and other issues of agent orange.

Re: VA Claim under PACT act

Posted by Rich on 12/5/2024, 9:31:08, in reply to "Re: VA Claim under PACT act"

Gary,

Congrats on your VA award of a 60% rating for Tinnitus and Sleep Apnea.

I am reaching out to you today in hopes that I can provide some information that you my find helpful to you and perhaps supportive to your VA claim.

Question: Have you had an 'A1C'blood test recently?

You may already know this but the reason I am asking this is because AFAIK Sleep Apnea can greatly increase your chances to contract Diabetes.

Also AFAIK the VA will recognize Diabetes as a Secondary Condition to Sleep Apnea.

Therefore, if your 3rd consecutive (on record) A1C blood test result is 6.5% or higher I then think you have the bases for an additional claim. If your test results are less than 6.5% continue your quarterly testing of your A1C levels. Perhaps ask your health care provider if he/she can slip in a "standing order" for A1C testing as you are now at higher risk of developing diabetes due to your sleep aponia condition.

The VA awards diabetes in increments of 10% 20% 40% 60% and 100% depending on the level of severity and life's inconvenience that the Diabetes condition causes a claimant.

I hope this information proves to be helpful to you. Best of luck and thank you for your service.

Re: VA Claim under PACT act

Posted by Dick Williams on 1/28/2025, 22:29:04, in reply to "VA Claim under PACT act"

Follow up number two to claim under PACT Act submitted 1 Jun 2023.

My resubmitted claim did get fairly fast turnaround after the VSO for the State of Missouri got involved. I attend two contract exam sessions on Dec 5th and on Jan 7th, 2025 received a Decision granting 40% disability. The monthly payments won't start till 1 March but the retroactive came right awat - about a week after the decision letter. So favorable outcome in my case after the claim languished for a year and a half due to some glitch in the original submission .

Keep inquiring and if things seem to have died - make sure the claim was submitted properly even if you're having help from a VSO. Everyone can make mistakes and apparently that was what happened in my case -the the original VSO didn't fully submit the claim and left that post and looks like her clients were not assigned to someone else. Later the State VSO got involved and put a layo layo on it or somehow got quick action and favorable finding.

Between original submission and now I developed Kidney Disease which was not part of the submissions - we have submitted a secondary for the kidney involvement. I had exam and blood draw for that aspect on Jan 23rd and awaiting a decision. Kidney disease is not a PACT act covered condition unless it was caused by a covered condition - in my case Diabetes II and Hypertension. Many kidney claims get a yes for Service Connected but 0% rating so no additional compensation

I did get a new VA ID showing "Service Connected" and today up at Fort Leavenworth registered for Post Access and made a trip thru the Commissary and Post Exchange - a privilege granted to any vet with any rating.

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