VA Priority Groups - Page 2

cheesecake · 01-20-2012, 06:48 AM

Quote:

Originally Posted by SCI-Nurse

This is not difficult. I am disappointed your PVA NSO did not take care of this paperwork for you when helping you with eligiblity applications.

A VA physician must see him and complete the form for priority group category 4. It is not difficult, and is a 1 page form. Insist that the local SCI clinic physician get this done for you. The SCI Coordinator (Social worker) at the clinic should be taking care of this. Tell her Dr. Hammond's office (Chief Consultant for SCI for the whole VA) has instructed all SCI coordinators to be sure that those veterans with SCI get correctly rated as category 4. It makes a big difference in a number of benefits, including travel and co-payments.

(KLD)

Ugh, Linda I am sorry for this SNAFU. Yes, he should be a catagory 4!!! I had this occur with another veteran and the NSO took care of correcting it. Both KLD and Skippy have given you excellent advice, follow it and good luck.

LindaT · 01-20-2012, 12:37 PM

I spoke with our local coordinator this morning and she is working on it. We were impressed with her when we met her last week, so will start there.
I'm unsure if she knew exactly what I was talking about, but I was armed with the info you all have given me and relayed it to her in a tactful manner.

cheesecake · 01-20-2012, 01:10 PM

Quote:

Originally Posted by LindaT

I spoke with our local coordinator this morning and she is working on it. We were impressed with her when we met her last week, so will start there.
I'm unsure if she knew exactly what I was talking about, but I was armed with the info you all have given me and relayed it to her in a tactful manner.

Keep us posted Linda. Every co-pay saved helps.

airart1 · 01-20-2012, 02:04 PM

i got that book, thanks anyway, skippy........

POPO367 · 01-21-2012, 03:34 AM

Linda,
If your husband is a patient in SCI he will be placed in either Priority Group 1 or 4. Every SCI center has been mandated to switch over all their non service connected SCI/D patients to Group 4. If you are service connected for SCI/D you will be in Priority Group 1 which doesn't have co-pays either. Priority Group 1 is higher on the pecking order than Group 4.

Each center is doing it different. Here in Long Beach we switched most of our patients a couple of months after we were mandated. Other SCI centers have been switching them as the Vets have come into the center for their annual physical. If the Vet was switched over late then they will get a refund of all the co-pays they paid after the switch was mandated last year.

I believe when I first applied through the VA, 5 years ago I was denied treatment and the SCI Coordinator had told me that was going to happen. Soon after I was denied they were able to get me into the SCI center, the denial was part of the process to get me into the system since I wasn't service connected. Your facility might have a different way of getting Vets into their facility. Don't be surprised if it takes a couple of months to kick in as far as you switching over to Group 4, so you might have to pay a few copays which will be refunded once the switch occurs.

skippy13 · 01-26-2012, 01:48 PM

So, I made some calls on the 20th of this month to get more info about the priority groups.

I only heard back from them today. 6 days later. Wow. Too long in my opinion to wait for critical information.

How is it going Linda? Any Progress?

LindaT · 02-03-2012, 08:04 PM

GREAT NEWS!
I got a call today from the business office of the local VA telling me the doctor's form came through and Dave will definitely be changed from Priority 5 to Priority 4.
She was sending a letter out and wanted to make sure we knew what it meant.

Thank you everyone for all of the info.

SCI-Nurse · 02-03-2012, 10:40 PM

Quote:

Originally Posted by LindaT

GREAT NEWS!
I got a call today from the business office of the local VA telling me the doctor's form came through and Dave will definitely be changed from Priority 5 to Priority 4.
She was sending a letter out and wanted to make sure we knew what it meant.

Thank you everyone for all of the info.

Great, and thank your husband for his service for us all. He earned this.

(KLD)

t8burst · 02-03-2012, 10:49 PM

Quote:

Originally Posted by LindaT

GREAT NEWS!
I got a call today from the business office of the local VA telling me the doctor's form came through and Dave will definitely be changed from Priority 5 to Priority 4.
She was sending a letter out and wanted to make sure we knew what it meant.

Thank you everyone for all of the info.

That is awesome news Linda! Plus it is friday so Lockup is on. As the saying goes "the sun shines on a dogs ass every once in a while".

01-26-2012, 01:48 PM	#16
skippy13 Senior Member Join Date: Mar 2008 Location: in a handbasket Posts: 2,459	So, I made some calls on the 20th of this month to get more info about the priority groups. I only heard back from them today. 6 days later. Wow. Too long in my opinion to wait for critical information. How is it going Linda? Any Progress? __________________ Anything worth doing, is worth doing to excess

Thread Tools
Show Printable Version Email this Page
Display Modes
Linear Mode Switch to Hybrid Mode Switch to Threaded Mode

Similar Threads
Thread	Thread Starter	Forum	Replies	Last Post
Is Pain a Priority?	dejerine	Pain	31	03-08-2011 12:18 AM
NIH priority	giambjj	Cure	0	09-07-2010 04:29 PM
How to make a priority?	cypresss	Cure	6	12-17-2009 09:57 AM
Article: Priority Setting at the NIH	wildwilly	Cure	0	01-07-2009 10:21 AM
Priority?	duceno1	Cure	1	02-16-2003 11:19 AM

01-20-2012, 12:37 PM	#12
LindaT Senior Member Join Date: Jan 2010 Location: MN Posts: 7,747	I spoke with our local coordinator this morning and she is working on it. We were impressed with her when we met her last week, so will start there. I'm unsure if she knew exactly what I was talking about, but I was armed with the info you all have given me and relayed it to her in a tactful manner.

01-20-2012, 02:04 PM	#14
airart1 Senior Member Join Date: Oct 2003 Location: usa Posts: 699	i got that book, thanks anyway, skippy........

01-21-2012, 03:34 AM	#15
POPO367 Senior Member Join Date: Nov 2006 Location: anaheim, ca Posts: 242	Linda, If your husband is a patient in SCI he will be placed in either Priority Group 1 or 4. Every SCI center has been mandated to switch over all their non service connected SCI/D patients to Group 4. If you are service connected for SCI/D you will be in Priority Group 1 which doesn't have co-pays either. Priority Group 1 is higher on the pecking order than Group 4. Each center is doing it different. Here in Long Beach we switched most of our patients a couple of months after we were mandated. Other SCI centers have been switching them as the Vets have come into the center for their annual physical. If the Vet was switched over late then they will get a refund of all the co-pays they paid after the switch was mandated last year. I believe when I first applied through the VA, 5 years ago I was denied treatment and the SCI Coordinator had told me that was going to happen. Soon after I was denied they were able to get me into the SCI center, the denial was part of the process to get me into the system since I wasn't service connected. Your facility might have a different way of getting Vets into their facility. Don't be surprised if it takes a couple of months to kick in as far as you switching over to Group 4, so you might have to pay a few copays which will be refunded once the switch occurs.

02-03-2012, 08:04 PM	#17
LindaT Senior Member Join Date: Jan 2010 Location: MN Posts: 7,747	GREAT NEWS! I got a call today from the business office of the local VA telling me the doctor's form came through and Dave will definitely be changed from Priority 5 to Priority 4. She was sending a letter out and wanted to make sure we knew what it meant. Thank you everyone for all of the info.