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Author Topic: VA Disability Ratings & HIV  (Read 7948 times)

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Offline dpb

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  • Posts: 89
VA Disability Ratings & HIV
« on: November 30, 2011, 03:14:26 PM »
Are there any veterans here who were diagnosed with HIV either while on active-duty or after?  I was infected and diagnosed while on active-duty and I believe it's considered a service-connected disability.  I will be seperating from the service in one year, and the VA pre-seperation benefits representative explained that the application process begins 6 months prior to your ETS (estimated time of seperation).

Has anyone received a disability rating from the VA for HIV, and if so, what was your rating? 
Date        CD4    %    VL
1/15/11    Diagnosed
3/1/11    525    18    168,518
5/12/11    558    16    331,791
5/16/11    Started Atripla
5/31/11    NA    NA    1,200
6/15/11    721    21    330
7/15/11    649    23    231
8/15/11    569    25    UD
11/17/11  752    26    UD
3/1/12    634    27    UD
7/2/12    594    26    UD
2/13       676    30    UD
9/13       662    31    UD

Offline vaboi

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Re: VA Disability Ratings & HIV
« Reply #1 on: February 27, 2012, 04:43:41 AM »
I'm a veteran and am 30% disabled by the VA, though not for HIV.  I acquired HIV after separation so getting a service-connected disability rating for it would be very difficult unless I can prove the infection was somehow linked to one of my other service-connected disabilities.

That being said, since you were infected while on active duty, it is almost a given they will service-connect your HIV disability, assuming you were in for 2 years, no dishonorable discharge, etc.  However, given your numbers, you'll probably only get 0% for it, with no monthly compensation... maybe 10% if you are on meds and say they have an effect on your work.  But even at 0%, all your meds, tests, and doc visits if associated with your HIV condition will be paid by the VA (and/or your reg insurance).  Once you apply, get your rating and enroll at your local VA hospital, ask the first doc you see to refer you to an ID doc.  Request that ID doc to be your primary care doctor and you should be all set.

Should your HIV condition ever get worse, you can at any time apply for a higher rating.  With HIV this can go on up to a full 100% if you are really bad with AIDS.

I've seen both civilian doctors under my company health care plans and government doctors working at the VA, and I must say, I prefer the doctors at the VA (at least the ones at my VA hospital).  They seem more thorough and caring about my health, whereas civilian docs seemed more worried about how much money they're going to make (or risk loosing) off your insurance if a certain test or med is given.  I'm very honest here.  The difference is shocking, and I could cite numerous examples.
« Last Edit: February 27, 2012, 04:52:31 AM by vaboi »

Offline JR Gabbard

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Re: VA Disability Ratings & HIV
« Reply #2 on: February 27, 2012, 02:55:18 PM »
0% service-connected disability puts you in priority group 5, with a pharmacy co-pay of $8.00 per prescription, unless you (as a single vet) have an annual income of less than $11,830.  If you are rated more than 50% SC disability, you go into priority group 1, with no pharmacy co-pay.
Your percentage rating will depend on the state of your health, but since you are currently on active duty it will be seen as service-connected.
There is no charge for outpatient care or for hospitalizations at VA facilities.
I only enrolled myself a few months ago, and have only seen my primary once.  So I can't really pass an opinion on how good the care is.  The VA clinic was very respectful though.  I have also gotten care under Medicare.  I decided to change because I relocated away from my former docs, and because I have heard really good things about the VA and HIV care.
You could also be eligible for VA disability compensation, depending again on your percentage rating.  Definitely start the process before you ETS.
Any other vets who read this thread, please chime in about your experience!!
It goes like this
The fourth, the fifth,
The minor fall, the major lift,
The baffled king composing Hallelujah!

L. Cohen

Offline denb45

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  • "1987 Classic Old School POZ+"
Re: VA Disability Ratings & HIV
« Reply #3 on: February 27, 2012, 04:59:01 PM »
@ JR Gabbard, I did some digging & asking around, and after a few phone calls to my local VA, I found out that I'm a Category 7 or group 7, my hubby is a Category 4 or group 4, not really sure what this means, but was told we make more than 11,830 each per yr. so we aren't really eligible for the VA health care service system
 they said we made too much and were already on Medicare......is this correct?  anyone else know what this means , neither of us have a service related injury :-\
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline J.R.E.

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  • Joined Dec-2003 Living positive, since 1985.
Re: VA Disability Ratings & HIV
« Reply #4 on: February 28, 2012, 11:15:28 AM »

0% service-connected disability puts you in priority group 5, with a pharmacy co-pay of $8.00 per prescription, unless you (as a single vet) have an annual income of less than $11,830.  If you are rated more than 50% SC disability, you go into priority group 1, with no pharmacy co-pay.
Your percentage rating will depend on the state of your health, but since you are currently on active duty it will be seen as service-connected.

Any other vets who read this thread, please chime in about your experience!!

I am receiving my healthcare through the VA. My HIV is non-service related I am in category/ group-5 , and pay $8.00 per med. I currently have no other co-pays. I have no complaints, at this point, and probably should have gone through the VA years ago.

I am still employed full time, and receive no group healthcare insurance through the workplace. ( It got too damn expensive, and the co-pays, and out of pocket were too much.  If I had insurance, the VA would bill the insurance company first. I've never been on medicare, or disability. I used my group insurance at work from 2003-2009 for my primary and HIV care, and to purchase medications. We had good insurance, through work, but that all changed, for 2010.

I enrolled into the VA in November of 2009, and I made sure that I told them, I would have no insurance coverage effective January 1, 2010. There was no problem with that. ( in fact, she was very glad I told her that)  Shortly, after enrolling into the VA, I met with the Ryan white coordinator( at the VA) and was placed into the Ryan white program. I still get dental and vision through the workplace, and that's through Humana. 

I am still receiving blood tests every 3 months. As I explained in the LTS forum I will become part of the MVP Veteran program, and have my first meeting with them on March 5th, 2012  This is for research study.


I have been very pleased with the care I am receiving. I've had quite a few tests done, including a colonascopy, which was scheduled by my primary care of the VA.

  My primary care takes care of my general health issues, and I go to the clinic for that. She will also schedule any appointments with the dermatologist. For the HIV care, I go to Bay Pines in St. Pete,  There, I meet with the specialists, and discuss any other possible needs and future tests.

 The VA was the first place to discover that I had several heart murmurs.  I was never told that, by any doctor previously.

I like my  primary care doctor, ( heck I like all the doctors), but my primary care is very sharp, but she leaves the HIV portion of that to the specialists.  I still don't have any problem discussing anything related to HIV with her.

It did take a little getting used to in navigating, through the system,  But I think at this point I have it figured out. !



Ray







Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline J.R.E.

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  • Posts: 7,161
  • Joined Dec-2003 Living positive, since 1985.
Re: VA Disability Ratings & HIV
« Reply #5 on: February 28, 2012, 11:28:16 AM »

I only enrolled myself a few months ago, and have only seen my primary once.  So I can't really pass an opinion on how good the care is.  !

That's about how often I see my primary care.  She will still schedule blood tests, and will consult with me when those results are available and If something comes up, there is no problem getting in there to see her. All I have to do is make the appointment, I can get in there, the next morning. She also informed , that if anything serious comes up, to not hesitate to get to the emergency room at the VA. I will be seeing her again in April, where we will most likely discuss lipids...,  weight, blood pressure, overall health     :-X




Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline denb45

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  • "1987 Classic Old School POZ+"
Re: VA Disability Ratings & HIV
« Reply #6 on: February 28, 2012, 12:01:27 PM »
Wow Ray, sounds like your VA health care is way better than what I'm getting in the private sector w/ Medicare & Ryan White , hubby & I might be moving to Upstate NY,

and all we'll have available to us way up there will be the VA, I'm guessing they will take us, ( since were both Vets) if there isn't anything else..

funny every-time I talk to the VA ( when ever we move to another City, State) I always get very different answers about eligibility , it can get very confusing  :-[



"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline JR Gabbard

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  • Posts: 257
  • Union Jacks
Re: VA Disability Ratings & HIV
« Reply #7 on: February 28, 2012, 05:16:49 PM »
denb45--
In practical terms, group 7 means you would have a pharmacy co-pay of $9 per prescription, and would have co-pays for medical services.  VA also sometimes won't provide care for those in groups 7 or 8 depending on their budget.  I think group 7 is receiving care now, but I'm not sure.
Group 4 means the VA has determined the vet (your hubby) to be catastrophically disabled, which probably would apply to anyone whose has been sick (HIV-related).  He would have either an $8 or $9 pharmacy co-pay, and might have a medical co-pay as well.
VA will bill private insurance if you have it, but will not bill Medicare.
It goes like this
The fourth, the fifth,
The minor fall, the major lift,
The baffled king composing Hallelujah!

L. Cohen

Offline denb45

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  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: VA Disability Ratings & HIV
« Reply #8 on: February 28, 2012, 06:44:57 PM »
denb45--
In practical terms, group 7 means you would have a pharmacy co-pay of $9 per prescription, and would have co-pays for medical services.  VA also sometimes won't provide care for those in groups 7 or 8 depending on their budget.  I think group 7 is receiving care now, but I'm not sure.
Group 4 means the VA has determined the vet (your hubby) to be catastrophically disabled, which probably would apply to anyone whose has been sick (HIV-related).  He would have either an $8 or $9 pharmacy co-pay, and might have a medical co-pay as well.
VA will bill private insurance if you have it, but will not bill Medicare.

Thanks not sure if hubby is really a 4, he may be a 5 or a 6 he's a Vietnam Vet, I'm not, I came after he did, but Yeah, that's what I thought, if we should ever need to use the VA, it's nice to know it's there for us if we cannot find anything else  ;)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline J.R.E.

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  • Joined Dec-2003 Living positive, since 1985.
Re: VA Disability Ratings & HIV
« Reply #9 on: February 29, 2012, 01:30:02 AM »
 8)

I'd like to share this letter, which was on the VA website, a couple of months ago. I decided to save it :

In the Spotlight

   

A Veteran's Story: Living 25 Years with HIV
Veteran's Story

I am writing this as a personal testimonial to the excellent care I receive from VA. It is a gift, for which I am profoundly grateful. In 1986, I was diagnosed with HIV. Since that time, I have received all my medical care from the VA Medical System. I have other health concerns unrelated to HIV. However, I remain relatively healthy because of the excellent treatment I have received, which has mitigated the problems associated with my being HIV+. With antiviral medication provided by the VA, as well as continuous monitoring by my primary care provider, I have reduced my viral load to zero and maintained it at this level for many years. I continue to live a very active and highly productive life.

Participating in my own health care and being aware of the importance of my own attitude and actions has enabled me to live with this disease successfully. I have accepted the fact that, in order to maintain my health, I must follow certain rules. These include meticulous adherence to a specific health regimen, continuous monitoring, regular interaction with health care givers, and immediate treatment of symptoms. I have come to understand that if one is not willing to participate in their care, then the quality of care does not make any difference. Thus, the excellent VA care, in conjunction with my personal initiative, has been a lifesaver for me.

I offer my thanks for the services the VA has given me. I know the VA provides the same services to countless other Veterans throughout the country, who are affected by this disease. I am sure that they too feel fortunate to have the VA available to them for care and support.

Charlie

Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline vaboi

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Re: VA Disability Ratings & HIV
« Reply #10 on: March 03, 2012, 01:45:25 AM »
I was in priority 8, even with 0% SC, due to having a high income/networth.  But even at 8, I could still seek healthcare at the VA.  Paying $15 or $50 per doc visit sure beat paying $400+/mo for insurance, and I doubt I'd even qualify for individual insurance now with HIV (unless through a high-risk Obamacare plan).  I requested that my hiv specialist become my primary care provider.  Actually he recommended I do this.  It not only reduced the number of appointments I have to make a year, but also reduced his co-pay from $50 to $15.  It's also faster to get appointments with him even at priority 8 since he's not one of the mainstream PCP's.  But once my rating increased to 30%, I was moved to priority 2 and no longer have to worry about doctor copays or payments of any kind if I'm ever admitted.

As for as whether you qualify for VA benefits, unless you are a special veteran, i.e. former POW, recent combat related, etc, you either need to have a service-connected disability or your income be below certain limits.  Keep in mind, once you enroll and accepted, you are ALWAYS enrolled no matter your income (unless you specifically dis-enroll, but who'd do that?).  If you are a vet, not yet enrolled without a SC disability and your income is too high, chances are your have health insurance with your job and don't really need the VA.  But if not, all you need to do is wait for a year where you might earn less, perhaps one year where you are laid off and didn't make as much, etc.  If your income ever does fall below the limit, you can enroll the following year.  You can then go on to earn as much as you want subsequent years without effecting eligibility..  at worst you'd be dropped to Priority 8 but could still continue to seek full VA heathcare (assuming current laws don't change).
« Last Edit: March 03, 2012, 01:56:57 AM by vaboi »

Offline Married Man

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Re: VA Disability Ratings & HIV
« Reply #11 on: May 03, 2013, 10:13:01 AM »
I am currently Active Duty and recently diagnosed poz. Would appreciate if you contact me as you go through the process. I have several years to retire and understand that HIV is service connected. It should be since this resulted from a sexual assault during a deployment. Any information on how to proceed would be great by anyone. 

Offline vaboi

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Re: VA Disability Ratings & HIV
« Reply #12 on: May 08, 2013, 06:57:03 AM »
As long as you were negative when you entered service, how you obtained HIV while in service is not important, unless perhaps you admit (or it was otherwise determined) that it was the result of drug abuse (ie sharing needles) or intentional.   Short of that, if you have HIV documented upon your separation, service connectivity for it is pretty much automatic.  What isn't automatic is the rating you get for it, which can range from anywhere from 0% to 100%.  But you'd practically have to be almost dying of Aids to get 100%.  60% is possible if you do have an Aids diagnoses from that HIV or history of weight loss or mental problems/depression from it.

I believe there is a rule that anything drug abuse related isn't service connected.  It's kind of like the rule if you get lung cancer years after leaving service from smoking while in service, that can't be service connected.  However, if you can get a doc to sign off that it was just as likely as not that your service-connected HIV could have resulted in the lung cancer, the cancer gets service-connected too (secondary to HIV) regardless if you smoked.

 


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