Hi I am a 90% disabled veteran and had an emergency medical accident outside of the VA that cost 75k. This was before the va processed my claims and after my tri-care coverage stopped so I only had partial VA coverage. The requirement that is not met and the reason this was denied is because I had not visited the VA for any reason in 24 months prior to accident. All other check boxes are met, and if the accident happened a few months later, they would cover it no problem. Normally this wouldn’t be a problem because the Navy allows vets to continue to receive Tri-care 3 months after separation, and the VA would be done processing by that time to take you in. But Covid made it so the VA didn’t process my claim for 9 months. What I did not know was that there was a time limit to contact community care within a certain point after accident, which if I had met that timeline, they would’ve also covered it. My bill was pushed to the VA and returned denied because I contacted community care too late. I resubmitted multiple times and have failed over and over to get someone to stop looking at the check boxes and listen to the logic and see the problem. They denied me once again and now my bill is with a collection agency and the only way I would continue to survive is filing bankruptcy, with no way to pay the 75k and support two kids and a wife with my only income being disability payments with no job.
1 Answer from Attorneys
This sounds like a terrible problem and we are sorry you are dealing with this, but this is just a question and answer service answering specific legal questions. You need to locate a lawyer in person.