The term P & T is sometimes a little confusing. The T is for Total and simply indicates a rating of at least 100%. The P is, of course, for Permanent and in VA lingo, that doesn't really mean permanent, it means that additional benefits are opened up for the permanently rated veteran and family.
A permanent 100% rating brings with it Chapter 35 Education benefits and CHAMPVA. To receive the permanent label isn't always easy, many vets have a 100% rating but it's temporary.
Those vets should wait for a future C & P exam and ask the examiner to note that the conditions are stable with little or no chance of improvement and the rater is likely to then make your 100% benefit permanent.
Ratings lower than 100% are generally considered as permanent so only a 100% rating can be "P & T".
Whether a given rating is permanent and/or total can get really complex really quickly. It's usually worth the time spent to study your own rating situation to be sure you're maximizing your benefits.
M21-1, Part IX, Subpart ii, Chapter 2 - Ratings for Special Purposes
M21-1, Part III, Subpart iv, Chapter 8, Section C - Protected Ratings
M21-1, Part III, Subpart iv, Chapter 6, Section B - Determining the Issues
Question: I am 60 yrs old and just received comp for PTSD @ 50%. Someone said they will not re-exam you to reduce the benefit after age 55. Is this true?
Reply: No, that's not true. VA may reexamine a veteran at any time for any reason. The "Permanent" rating isn't ever permanent at VA. This is particularly true of mental health issues like PTSD .
Having said that, the 50% rating is rarely on the VA radar. The focus of the VA is the 100% rating because that's where the money is. While VA can reexamine you, it's very unlikely that they will. Enjoy your benefit, seek as much treatment as you can get and don't worry about it.
Citation Nr: A21011271 DOCKET NO. 201116-120262
FINDING OF FACT The rating criteria for the Veteran's service-connected prostate cancer (currently at
100 percent) contemplate remission and therefore precludes the assignment of a permanent and total disability rating.
CONCLUSION OF LAW The criteria for a permanent and total rating for prostate cancer have not been met.
38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 4.115b, Diagnostic Code 7528.
Discharge Upgrade?
Question:
If an Airman failed tech school and received an uncharacterized discharge because they separated under 180 days, can they apply to have the discharge upgraded to an honorable one and if so how can one go about doing it?
Jim's Reply:
You'll need to get in touch with these folks The Veterans Consortium. If you'll go ahead and click that link you'll find all the intel you'll need to get in touch with them. Their experts will evaluate what you've got and help you as you go along. Good luck!
Effective Date
Question:
I applied for disability in April 2021. It was approved and I received 100% in July 2021. I want to know if I’m entitled to payments when the cancer was finally confirmed - approx. 2 years earlier. I also have 3 Purple Hearts, nothing major, which why I didn’t apply earlier.
Jim's Reply:
The date that a claim begins payments is known as the effective date of the claim. If you file on January of 2020 and your claim is awarded in July of 2021, your effective date is the date that you filed, January 2020.
To establish the effective date you must file a claim. There are rare circumstances that an earlier effective date may be filed back to the dates of a diagnosis but that's an unusual event often as a result of a clear and unmistakable error on the part of VA when processing a claim.
In the end, if you didn't file a claim back then, I don't see any way to claim retroactive payments.
Permanent and Total (P & T) Disability Ratings
Jim Strickland is a Vietnam era Army veteran and nationally recognized expert on VA disability benefits.
Jim writes extensively about VA and Social Security disability benefits.
Jim's Mailbag is a regular column featured at Stateside Legal where veterans, servicemembers, and family members can ask Jim their questions about VA and Social Security disability benefits.
Question:
I am curious and can't seem to find an answer about my anxiety meds and marijuana. I don't live in a legal state, but am curious to try some marijuana to help with pain and other issues. I'm curious if my psychologist would stop my anxiety and sleep meds if I brought it up to them. Thanks for any guidance you can provide!
Reply:
The use of marijuana to treat medical conditions is controversial even in the states where it's legal. The VA doesn't care if you use illicit substances so far as your benefits go, no benefit will be interrupted because of substance abuse.
But...marijuana and other similar substances are psychoactive drugs and your mental health providers for the most part don't want you mixing any medicines with the ones they prescribe for you. That might even include alcohol and some over the counter medicines, anything that may skew the effect of the prescribed drugs is a concern.
The person who prescribes your mental health medications will have authority over whether or not your prescribed medications would continue if you added marijuana to the regimen. Each case would be decided individually and there isn't really any policy one way or the other except that everyone will remind you that marijuana is illegal. In your case it isn't just illegal at the federal level, you say you're in a state where it's still illegal so you have a steep uphill climb to convince anyone that it's a good idea to use something illegal.
So, what to do? It's a very personal decision and a lot of veterans decide to toss their prescribed medications in favor of using THC to control their anxiety and pain and to aid their sleep. VA tests everyone for drugs at almost every visit so be aware that you won't be able to hide the use of marijuana.
I'd offer that you should approach your provider and ask. If you aren't testing positive for marijuana at that time, if the provider says "no" to your using weed, you probably won't lose the prescriptions.
I'm in a state where medical marijuana is legal and relatively simple to get to. As I've said, a lot of older veterans I know in particular have decided to toss the pills and replace those with THC in one form or another and they are happier for it. It's your decision to make...remember that where you are, you can get in trouble and nobody from VA will be there to bail you out.
Question:
Hi Jim, I was hoping you could give me the link to the VA stand on medical marajuana? I was hoping there might be an updated link. Thank you
Reply: The VA position is that it's not legal and they will not prescribe it even in legal states. There is no penalty for using marijuana or any other substance. VA benefits aren't predicated on being drug free although your VA doctor may withhold other prescription psychoactive drugs. Learn more here https://www.vawatchdog.org/marijuana---va.html
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Permanent and Total Disability Ratings
Question:
I have failed a drug screen at my Dr for meth. I don't take meth but I had sex with a girl that does. I also am prescribed a sleeping medication that I have been told can come up as meth. How do I clear my name with this Dr. I need the medication he prescribed me. Please help. I don't do drugs but seems I'm going to have to suffer as if I do.
Reply:
The VA doesn't really care all that much about veterans and substance abuse. No matter what people say, we don't lose any benefits we earned for abusing or using illicit substances.
That doesn't hold true when we fail the drug tests that VA is conducting on every veteran these days. When we pop a positive drug screen, the VA (as well as all civilian doctors) will cut off any prescription narcotics they've been prescribing to you.
There's a good reason for this action; when you're taking a powerful prescription medicine and it is suddenly obvious that you will take that and an illicit drug at the same time, then it becomes a safety problem and the doctor doesn't want you to OD.
For what it's worth, I support drug screens at every patient encounter. I don't support 'random' screens. I believe every American should be tested for substance abuse as often as we check blood pressure and blood sugar. All are major health problems that are killing Americans and without screening, the problem won't be addressed.
Your pleas of a mysterious medication that could show up as meth and the possibility of somehow transferring it during a sexual encounter are the sorts of recitations the doctor has heard time and again and won't help you to get whatever prescribed drug you want back. In most cases like yours, the prescription drug is gone forever.
What VA would like you to do now is get into rehab. Tell your doctor and arrangements will be made for you.
Making that move will open some doors to alternative treatments for whatever it is that ails you. OK, OK...I hear you 5x5. You don't use drugs and you absolutely do not need rehab. I get it.
But let's think of it this way...the failed drug test isn't going away. Concocting more reasons that the test was wrong will just make it worse, every health care provider has heard them all and if you go there you give up what cred you may have.
Unless you act now, this can haunt you a long while. Sign up for rehab even if you don't need it and you'll be the champ and this will be behind you soon enough. Email me when you sign up. Really.
Good luck.
Question:
Since the VA adopted the new mileage application via the internet, I haven't received any travel money. I checked with my travel clerk and he told me that there is a big back log here in Florida. Have others experienced this problem? Thank you Jim.
Jim's Reply:
I'm in Florida so I feel your pain.
We're supposed to be reimbursed a per mile amount for certain travel to and from medical care. In my time with VHA I've seen long lines and over an hour wait to receive a few dollars gas money. Then we went to a fill-out-the-form system. The check-in kiosks were introduced a few years back and those worked well other than you had to remember to sign out and sign in again to submit the travel voucher.
Not all that long ago I checked in to my small clinic and the kiosks were unplugged and parked in a corner. I was told to check in the old school way and only when I asked, I was given an old form to complete for travel pay. I was told the kiosks were gone forever.
I returned to that clinic 2 weeks later and the check in kiosks were back, plugged in and ready to go. There was no option for travel reimbursement, I was told to go to the Internet and figure it out. I haven't seen any deposits either.
I don't have any answer for you other than...welcome to your VA. They care!
Citation Nr: 21040275 DOCKET NO. 20-06 952
ORDER A 100 percent permanent and total rating for prostate cancer is granted.
FINDING OF FACT The probative evidence of record supports a finding that the Veteran's
prostate cancer is reasonably certain to remain permanently and totally disabling.
Eras?
Question:
Why is there no "era" differentiation for support personnel for WWI, WWII, Korea, Desert Storm, Iraqi Freedom? As a matter if fact, if you joined the service the day before the end of WWII and never stepped foot in theater you were still awarded the WWII Victory Medal. The "era" label is an insult to all the support personnel during the Vietnam conflict.
Jim's Reply:
I'm not at all sure why you're angry? An insult? Seriously? This is what you choose to get upset about? I take it that you're Vietnam era and you didn't get the Vietnam Service Medal and you're all hurt about that?
The term 'era' is used throughout many references to historic events. VA defines eras like the Mexican Border period (May 9, 1916, to April 5, 1917), World War I (April 6, 1917, to November 11, 1918), World War II (December 7, 1941, to December 31, 1946) and so on. Each of those eras is entitled to different benefits and such so there is plenty of differentiation.
Human history is generally divided into eras such as Prehistory, Classical, Middle Ages, Early Modern, and Modern. Humans like to categorize things so our brain better grasps the concepts we're presented. Periods of history are put into boxes where similarities exist. The fact that you're upset about that to a point that you are compelled to write to me is...interesting.
For what it's worth, I'm Vietnam era...one of the 'support personnel' you refer to. Although I served most of my tour in Germany as a hospital medic, I cared for Vietnam combat troops so in a roundabout way I was part of your support personnel. I'm proud of my service and I'm proud that I was able to make some small contribution to help my comrades through difficult times. I did my job well and I'm happy I was able to serve my country during the Vietnam war era.
'A soldier will fight long and hard for a bit of colored ribbon' - Napoleon Bonaparte. I get so much mail about the VSM I fear it proves him right. You're another in a long line of veterans who wonder why they didn't get their 'bit of colored ribbon'.
The WWII Victory medal was awarded for military service, much like the National Defense Medal or a Good Conduct Ribbon. It didn't note any particular region of service (Pacific, European Theatre. etc.) and was criticized for both the timing of the award and the fact that almost everyone got one, even student cadets who never served.
If you're really all that concerned, your Congressional representatives are waiting to hear from you. That's where change of government definitions begins. Good luck.