CHAMPVA Deep Dive

Jason Perry said:
I personally have no experience using CHAMPVA, so hopefully others with direct experience will chime in.
However, with a 0% DoD rating, I wanted to make sure that it was actually a 0% rating for an unfitting condition OR if it was deemed non-compensable because the PEB stated that your unfitting condition Existed Prior to Service and was not Service Aggravated.
Can you confirm the situation? It matters for the appeal options (likely a VARR vice challenging the EPTS issue). I have come across a high volume of EPTS cases that I am confident are being decided indirectly.
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What do you mean Sir by “decided indirectly”? How so?
 
Provis said:
Wow! I have a feeling that if you consult a good attorney that you have decent chance of getting that changed. Getting a zero percent unfitting rating is an oxymoron for most situations. I bet you could request a FPEB and get mental health added as unfitting to bump up from 0% to 70%. A 70% rating for mental health is by definition unfitting lol since work impairment is alleged.
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My lawyer says I have a strong case. He thinks dod rated it as 0% as a "hook up" so I didn't have to pay the severance back.
 
jwm88 said:
Nevermind. I just reread your post. Basically, it sounds like if I go with CHAMPVA for my family they would have to use express scripts to reduce cost?
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Yes, the med was cosyntyx and was 350 through a regular pharmacy now she pays far less like 60 through meds by mail.
 
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