VETERAN Discussion Rating increase R1 to R2

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Jhettinger

Distinguished member
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Joined
Sep 22, 2016
Messages
156
Reason
PALS
Diagnosis
4/2016
Country
US
State
GA
City
Roswell
Looking for specific information on going from R1 to R2

Getting R1 was not hard, just told PVA rep and done

R2 seems an struggle. Sent VA Dr Support Form VA FORM 21-2680 Examination for Regular Aid and Attendance, PVA requested letter 2. Got that, put in packet. VA sends me one inch thick bundle of Claims info with a 38USC 5103- Do you have more info.

So do I spend 15 more hours getting a full blown claim together or just send it?

What info did you include ?

I am not housebound or bedridden. yet
 
Generally a R2 rating means the veteran requires skilled care or bowel/bladder assistance. Sometimes a R2 increase is requested it initiates a fiduciary inquiry.

"Category R2: For this category, the person helping the veteran must be a licensed medical professional or someone working on behalf of a licensed medical professional. In addition, the VA must judge that the veteran would have to be hospitalized, put in a nursing home, or otherwise institutionalized if he did not have this professional-level care at home." (What is Special Monthly Compensation? Do you qualify?)
 
Moving to Veterans forum.
 
I don't recall this being any problem at all. Maybe someone else filled our our paper work for us, or there was a shortcut.


I remember just sending a typed letter where I requested the SMC in accordance with reg X based on the following criteria. The patient requires 1.2.3.4.5. And my PALS made a mark for a signature, which I witnessed.
 
Steve's VA pulmonologist filed the paperwork each time he saw him, any time he was at clinic, etc. Basic ally our VA used outside dba for info and notes but the VA docs and their notes, lab tests etc were the backbone of the rating documentation. Everyone who saw Steve, from the nurses, to can, etc would document what they witnessed. When va needed anything it was in his electronic medical record. E Benefits saved us.
 
How have you all been able to get R1? My social worker asks me every time I go to clinic if I am r1. I have asked my pva rep to file for an increase but he always says that the notes don't have any thing to show.
 
Good luck getting R1. I am in the process now of trying to get it. The PVA rep started the ball rolling by applying for R1 on June 29, 2018 and I am still playing games. The VA social worker filled out a form for aid and attendance really fast in July 2018. I then sought help from the Mayo Clinic in Jacksonville, FL for them to fill out the ALS Disability Benefits Questionnaire (DBQ) in July 2018 after my attending their ALS clinic. Unfortunately the DBQ that the Mayo Clinic sent to the PVA rep had no information of any use on it. I did not see a doctor at the July 2018 ALS clinic at Mayo but a doctor signed the DBQ and said basically I had no issues. I saw an RN that just talked to me. I did see the OT, PT, speech, RT and more and they all documented their work thank God and it was load to my patient account I have at Mayo. I now have been playing screw around with a male RN at Mayo trying to get a new DBQ submitted by them to the PVA. The VA sent me for a C&P exam and that data is in the system. I also uploaded my report from the July 2018 ALS clinic at Mayo with the info from the specialist that I saw. The PVA rep wants to wait for the DBQ from Mayo but I am about to call the VA and tell them to make their decision based on the information they now have on file. I was told by the VA that if they denied the R1 SMC rating and the Mayo Clinic does send the new DBQ I can have the case reopened. The PVA rep does not want to do that so I am stuck at this point. On the VA e-Benefiters site I see the VA has my projected date for review as June 29, 2019. I will be dead by then.
 
One thing that really helped us was using both the VA system and private sector. I have to say, in Tampa, the Va did a better job than private sector.
 
I am sorry about the R1 Rating, I am getting an L Level payment

Sorry about any issues I started
 
I kept my own notes of things I saw that Steve wouldnt admit to unless asked. Holding the wall when walking for example...multiple attempts to stand, etc. Then I brought the notes with me. I was trained to use his breathing machines, check stats, etc. I worked with the dietician on food, smoothies, etc. I learned all of Steve's gadgets and gizmos...how they work, trouble shooting, etc.
 
What symptom takes you to the next levels?

Also there is a new dbq form on the street
 
VBA-21-2680-ARE Is now obsolete / expired

a more detailed 4 pages is the replacement

Question - In the new world of IPAD/TABLET how do we fill this out? Has anybody working with the VA been measured ??
 

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  • VBA-21-0960C-2-ARE BLANK.pdf
    1.6 MB · Views: 444
The Mayo Clinic in Jacksonville, FL tried and failed two times in the last 60 days to fill this form out for me. Both times they left out vital information and had areas totally blank. The PVA rep stated that I will be denied R1 and will need to start this process all over again. I see why veterans give up.
 
So a suggestion to bring a DRAFT form with most things filled out. Check mark agreements , take it home fill it out, then mail original to a person requesting a return copy

Thoughts
 
Adobe fill and sign will let you fill in a pdf
 
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