Approved DEC and lost some medical coverage

Page 1 of 2 1, 2  Next

View previous topic View next topic Go down

Approved DEC and lost some medical coverage

Post by robleggett on Wed 08 Nov 2017, 11:03

Just wanted to see if this has happened to anyone else.

I was on the rehabilitation plan and was getting some coverage for travel to medical appointments for some medical problems that I was not pensioned for, but were part of the reason I was medically released. One example, durolane injections in my left knee, they would pay for the injection and for the travel to the Dr to get the injection.

Well now that I have been moved/classified DEC, they are telling me no more coverage for the injections or the travel to get the injections.

Its almost like your being punished for being classed as DEC???

robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by johnny211 on Wed 08 Nov 2017, 13:16

Iím thinking someone gave you the wrong info. I canít see what one has to do with the other. But itís VAC, what do we know..Out...VVV...
avatar
johnny211
CSAT Member

Number of posts : 548
Location : Down East
Registration date : 2014-12-26

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by Vet1234 on Wed 08 Nov 2017, 14:57

have you ended rehabilitation?
that can change coverage
avatar
Vet1234
CSAT Member

Number of posts : 471
Location : Ontario
Registration date : 2016-07-27

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by robleggett on Wed 08 Nov 2017, 15:36

johnny211 wrote:Iím thinking someone gave you the wrong info. I canít see what one has to do with the other. But itís VAC, what do we know..Out...VVV...

part of the email they sent through my account

You are not covered anymore
for the Left Knee as you are no longer on the Rehab program but
you can appeal the unfavourable decision on the Left Knee if
you have not exercised all levels of appeals. You can contact
the Bureau of Pensions Adocate at 1-877-228-2250.

robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by robleggett on Wed 08 Nov 2017, 15:38

Vet1234 wrote:have you ended rehabilitation?
that can change coverage

yes they have ended my rehabilitation and put me as DEC, but I still don't understand why they would take away the medical coverage they gave me while on the rehab??

robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by robleggett on Wed 08 Nov 2017, 15:43

Sorry should of included the whole paragraph in the email

You are not covered anymore
for the Left Knee as you are no longer on the Rehab program but
you can appeal the unfavourable decision on the Left Knee if
you have not exercised all levels of appeals. You can contact
the Bureau of Pensions Adocate at 1-877-228-2250.

I can appeal, that's a good one, already submitted a claim, they said no, did an appeal, they said no. So whats the sense of trying a third time and that would take what, about 2 years to hear them say NO AGAIN.

robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by Vet1234 on Wed 08 Nov 2017, 16:25

im on rehab still and DEC. im not sure what the differences are in coverage but i want to know. its not very clear. i have dental coverage but i didnt until u was approved CIA.
avatar
Vet1234
CSAT Member

Number of posts : 471
Location : Ontario
Registration date : 2016-07-27

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by BinRat on Thu 09 Nov 2017, 00:24

Yes happened to me, under the medical rehab I had problems I had no pension/awards for covered under the medical
rehab, as this condition was or could effect my medical rehab.

And Once it was determined that I wouldn't be able to gain suitable employment, being the 66 2/3 no matter what was
done in the medical rehab program I was given Made DEC.

Now under the medical rehab, if you decide to miss appointments, and or not going to your appointments, VAC can cancel
your rehab program because they can say your non compliant with the rehab program.

But if you go to all appointments and test and everything, and you won't get the full improvement enough to gain
suitable gainful employment then your classified as DEC.

And under the DEC you are only now entitled to Pensioned/Awarded treatment Conditions for coverage.

Anything that is not covered from a Pension/Award is removed. So now if ya say, screw it, I ain't going to any more
of these appointments they are crap and aren't working, well it's not held against you.

As for travel expense, you are covered for travel for any condition that you have been awarded a pension/Award for
http://www.veterans.gc.ca/eng/services/health/treatment-benefits/tb-coverage-travel

Now with all that said, my back which was the added to my medical rehab to be covered that I DO NOT have a Award
or Pensioned condition on, during the Medical rehab part, I was allowed 20 visits to see an Osteopath. Even tho it was removed when I had like 5 visits into my Osteopath visits, I could still go another 15 times till I used them up, even tho it's as in my Back is no longer covered.

So, my question is how many visits have you had for your knee, like how many visits were authorized. if for example they said you can get 10 visits, and have only done 3 visits, the remaining 7 visits you should still be able to go to and be covered. Cause that was or had been already Authorized.

But if you have used all the authorized visits you were given for you knee's that were added while on medical rehab, ya VAC won't Allow no more, since now all your covered for are for conditions you have been pensioned, or received an award for sadly...


Note:
Just did some research and I see that durolane requires special authorization under POC 10, so there wouldn't per say be a authorization letter that I was looking or thinking off, so ya it would have to be like a prescription saying something like 10 refills, Hmmm now I am at a lost of what to say or what you could do.. getting Brain Farts now


Last edited by BinRat on Thu 09 Nov 2017, 00:48; edited 1 time in total (Reason for editing : cause I added some things)

BinRat
CSAT Member

Number of posts : 217
Location : Komoka
Registration date : 2008-09-18

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by robleggett on Thu 09 Nov 2017, 08:02

binrat, thanks for reply and you are right I have a letter of approval for 24 injections of Durolane and I have only used 7 as far as I can see so far, but as per usual, they have covered themselves, I just read the letter of approval and notice this line

"The approval will be in effect for the duration of your Rehabilitation Case Plan"

So even though I have 17 injections left on the approval letter, they are taking them away!!!

robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by Vet1234 on Thu 09 Nov 2017, 08:20

here's something, not sure if anyone is in the same boat.
i am DEC CIA2 and my VIP gets reviewed every 6 months. i have heard that if i stop psycho rehab the reviews will stop?
also, will my dental be covered if i stop rehab?
avatar
Vet1234
CSAT Member

Number of posts : 471
Location : Ontario
Registration date : 2016-07-27

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by Rustytheviking on Fri 10 Nov 2017, 17:38

I havenít had any issues, yet. I was approved dec in July, and thatís the last time I did a travel claim. I do my claims every six months since I donít have to travel 700km round trip anymore

Rustytheviking
CSAT Member

Number of posts : 39
Location : Sask
Registration date : 2017-01-17

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by robleggett on Sat 11 Nov 2017, 07:18

Rusty as far as I can tell, if you have any pensioned conditions, then no problem claiming health related travel and any medical procedures for those conditions.

Its the other medical problems that they will stop covering once your rehab plan ends and you are classed DEC


robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by Vet1234 on Sat 11 Nov 2017, 07:47

what about Dental?
avatar
Vet1234
CSAT Member

Number of posts : 471
Location : Ontario
Registration date : 2016-07-27

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by robleggett on Sat 11 Nov 2017, 07:53

Vet1234, I have no idea on that question, better to send an email using my account to VAC and ask.

I don't think you see many pers with dental coverage due to pensioned conditions.

robleggett
CSAT Member

Number of posts : 21
Location : Bolton, Ontario, Canada
Registration date : 2013-03-19

Back to top Go down

Re: Approved DEC and lost some medical coverage

Post by Vet1234 on Sat 11 Nov 2017, 07:55

ok thanks. i have dental right now, i didnt when i wasnt DEC.
or if i did, noone told me
avatar
Vet1234
CSAT Member

Number of posts : 471
Location : Ontario
Registration date : 2016-07-27

Back to top Go down

Page 1 of 2 1, 2  Next

View previous topic View next topic Back to top

- Similar topics

 
Permissions in this forum:
You cannot reply to topics in this forum