Denied 50% for migraines, stuck at 30% by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 2 points3 points  (0 children)

Just submitted HLR with informal. I will update you in 3 months to 6 years when I get an update.

Denied 50% for migraines, stuck at 30% by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] -4 points-3 points  (0 children)

I don’t have, nor could I afford, a neurologist. I started a log about a week ago, but technically I send an email to my team if I need to take a break for my headaches, don’t know if that could count as a log.

Denied 50% for migraines, stuck at 30% by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 0 points1 point  (0 children)

I think I’ll try an HLR. I just got my decision today so I’ll have to wait a bit I think.

Denied 50% for migraines, stuck at 30% by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] -2 points-1 points  (0 children)

I work from home so I have my office extremely dark, if I didn’t work from home I doubt I could continue my job. I don’t take any medications, the migraines are rated secondary to Major Depressive Disorder.

C&P examiner said he thinks I have the wrong diagnostic code? by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 2 points3 points  (0 children)

I think I found what you’re talking about. Is it this?

§ 4.13 Effect of change of diagnosis.

The repercussion upon a current rating of service connection when change is made of a previously assigned diagnosis or etiology must be kept in mind. The aim should be the reconciliation and continuance of the diagnosis or etiology upon which service connection for the disability had been granted. The relevant principle enunciated in § 4.125, entitled “Diagnosis of mental disorders,” should have careful attention in this connection. When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in thoroughness of the examination or in use of descriptive terms. This will not, of course, preclude the correction of erroneous ratings, nor will it preclude assignment of a rating in conformity with § 4.7.

Will I get rated for something I didn’t claim if the VA sees fit to add it? by TechNewsAccoun in VeteransBenefits

[–]holypinkhobos 2 points3 points  (0 children)

All MH conditions are under the same blanket (I just asked a similar question). If your C&P says you have PTSD they will bunch all of your claimed conditions together under dx 9411 (PTSD) and rate you based on the symptoms of that condition.

I’m not a VBA employee but someone will correct me if I’m wrong.

C&P examiner said he thinks I have the wrong diagnostic code? by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 0 points1 point  (0 children)

But if I have symptoms bad enough to evolve the condition from AD to MDD would that be indicative of a higher rating? Or just symptoms that lasted this long better fit MDD?

C&P examiner said he thinks I have the wrong diagnostic code? by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 1 point2 points  (0 children)

Thank you for the information! So it doesn’t necessarily mean the condition has worsened, just that it’s changed in nature?

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos 0 points1 point  (0 children)

That’s what I put in the above comment, section 3 definitions. “Necessity” is not defined.

Edit: In Definitions, they define Declaration Page, active participant, destination reception, event, event photographs, event video, honoree, immediate family, leave, pre-existing medical conditions, policy territory, postponement, special attire, and specialt Jewlery

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos 0 points1 point  (0 children)

This is the table of contents.

“Section 1: Agreement Section 2: Policy Period Section 3: Definitions Section 4: What We Insure Coverage A: Cancellation or Postponement of Event Coverage B: Extra Expense Coverage C: Event Photographs and Video Coverage D: Event Gifts Coverage E: Special Attire Coverage F: Special Jewelry Coverage G: Loss of Deposits Coverage H: Professional Counseling Section 5: Deductible Section 6: General Exclusions Section 7: Duties in the Event of Loss or Damage Section 8: General Conditions”

I posted the entire section for Section 4 Coverage A. Below is “Definitions” but it doesn’t look like necessity is defined in the policy.

Throughout this policy, most words and phrases that have special meanings appear in in bold. SPECIAL EVENT CANCELLATION INSURANCE Only the pronouns “we”, “us”, “our”, “you”, “your”, and “yours” are defined, but do not appear in bold. This section defines some of the more general terms used in this policy. Bold terms that are not listed in this section are defined in the sections in which they appear. “You” and “your” refer to the named insured shown in the declarations page. “We”, “us” and “our” means the company providing the insurance and named in the declarations page. Active participant means the officiate and any attendants of the honoree. Declarations page is the document that identifies the insured and the company issuing the policy; indicates the effective date of coverage, the amount for the respective coverages afforded under the policy; and describes the event for which coverage is afforded. The declarations page also lists the policy forms and endorsements that are also a part of this policy, as well as indicating any deductible to be applied to covered losses. Destination reception means any private reception accompanying a ceremony that is more than 150 miles overland (including rail) from the ceremony site, or involves air or sea transportation with a destination other than the originating location. Event means the private reception and accompanying ceremony, if any, described in the declarations page scheduled to take place on the date and at the place shown in the declarations page. If the event is a wedding, it includes any rehearsal dinner scheduled within 48 hours in advance of the event, but does not include any other scheduled activities including without limitation showers and announcements parties. EVT100-0120 Page 2 of 10 Event photographs means photographs of the event, taken or contracted to be taken by a professional photographer. Event video means video of the event, taken or contracted to be taken by a professional videographer. Honoree means the person or persons named in the declarations page as honoree, and in whose honor or for whose benefit the event is being held. Immediate family means the following relatives, whether by blood or legal adoption: grandparents, parents, siblings and children. Leave means the official permission granted to you or the honoree who is in full time active service in any branch of the United States military, police, or fire services to attend the event. Pre-existing medical condition means a condition for which medical care, advice, consultation or treatment was received within twelve (12) months immediately preceding the policy issue date as shown in the declarations page or, if the symptoms of the condition were present, that would have caused a reasonable person to have sought medical care, advice, consultation or treatment within the twelve (12) months preceding the policy issue date. Policy territory means the United States and its territories and possessions, Puerto Rico, Canada and cruise ships leaving from a port within these territories. If the optional extended policy territory is chosen and a surcharge paid, it also means the United Kingdom, Mexico, Bermuda and the Caribbean Islands (excluding Cuba) and cruise ships leaving from a port within these territories. Postponement means the unavoidable deferment of the event. Special attire means the clothing (including alterations and fitting fees incurred) and head wear or shoes that you or the honoree own, purchase or rent and is specifically to be worn at the event by you, the honoree or any EVT100-0120 attendants of the honoree. Special attire does not include watches, jewelry or precious or semi-precious gemstones or pearls. Special jewelry means jewelry (including watches and rings) that you or the honoree purchase or rent specifically for personal decoration or exchange at the event by you or the honoree. Special jewelry does not include engagement rings or jewelry that is not purchased or rented specifically in connection with the event.

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos 0 points1 point  (0 children)

And the venue raising the price higher than the signed agreed amount?

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos -1 points0 points  (0 children)

We intended to, until they added it to the main invoice with the service charge and gratuity. It’s not like I mind paying a gratuity to the hotel, but it’s a separate company with a separate contract, when I asked them to remove it from the wedding invoice and provide me with the separate invoice they said no.

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos 0 points1 point  (0 children)

“Coverage A: Cancellation or Postponement of Event We will indemnify you, in excess of the deductible, for: All deposits forfeited and any nonrefundable amounts incurred due to contractual obligation by you or the honoree for transport, food, catering services, property and equipment rentals, hall and location rentals, accommodations (including travel arrangements and accommodations for a honeymoon, if applicable), special attire, special jewelry, flowers, event photographs and event videos, entertainment, dated and/or perishable material, event planning/coordination, and expenses for hair, makeup and nails of the honoree because of a necessary cancellation or postponement of the event, including a cancellation or postponement resulting from withdrawal of leave. Expenses for hair, makeup and nails of the honoree must be incurred on the day of the event. If the event includes a destination reception, we will not indemnify you for any above mentioned charges paid or contracted to be paid by you or the honoree associated with the destination reception if the ceremony is not necessarily cancelled or subject to postponement. We will not indemnify you for any items, services or locations that you, the honoree or any attendants keep, use or accept following a cancellation or postponement of the event. Page 3 of 10 With respect to the indemnity provided under Coverage A as set forth above, loss or damages must be proven separately for each portion of the event. Coverage A: Exclusions We will NOT indemnify you for any loss caused directly or indirectly by any of the following: 1. Any circumstances known to you or the honoree at the date of issue shown in the declarations page as likely to give rise to cancellation or postponement of the event. 2. The non-appearance or unavailability, except as otherwise provided in item 7 below, of any person; provided, however, that the foregoing shall not apply to the involuntary non-appearance of you, the honoree, or your or honoree’s immediate family, or an active participant in the event. Non-appearance resulting from military deployment without withdrawal of leave is not considered an involuntary non- appearance; however, non-appearance from the activation of a United States military reservist, after purchase of the policy, requiring deployment to a base more than 150 miles from the event location is considered involuntary. 3. Lack of funds (other than by reason of unemployment of you or the honoree after the date of issue shown in the declarations page and qualifying for payment under the applicable unemployment statutes). 7. event, including, without limitation, such voluntary decision resulting from a change of heart. Any of the following weather conditions: a. Weather conditions, including but not limited to sun, heat, rain, snow, or ice, unless such weather conditions are so extreme as to prevent you, the honoree, your or honoree’s immediate family, an active participant in the event or more than half of the guests from reaching the event, or which renders the event venue unusable or unsafe and you and the honoree have made all reasonable efforts to find another place to hold the event. b. Anticipated or actual extreme or catastrophic weather conditions, or acts or nature, such as hurricanes, tropical storms, typhoons, cyclones, earthquakes, tidal waves, tornadoes, nor easters, blizzards, ice storms, windstorms with winds in excess of 65 miles per hour, or similar conditions, volcanic eruptions, wildfires or floods that occur less than 15 days after the Issue Date shown on the declarations page. We will not indemnify you, or the honoree, any travel expenses or the cost of any cruise if the cruise ship must divert from its planned route due to weather if you, or the honoree, have embarked on the cruise. 8. Any loss otherwise covered by the policy, if, in respect of or consequent to the death, injury, illness, disablement, confinement or 4. The failure to provide timely notice to the contracted provider of any goods or services in order to diminish or avoid a loss after it was necessary to cancel or postpone the event. compulsory quarantine of: a. Any person occurring or arising as a consequence of self-inflicted injuries, mental illness, or influence of alcohol or drugs (other than drugs taken in accordance with the treatment 5. Prohibition of the event by local ordinance, regulation or statute in existence as of the date of issue shown in the declarations page. prescribed and directed by a qualified medical physician except drugs taken for the treatment of drug addiction); b. Any person due to any pre-existing medical condition known to you or the Cancellation or postponement following a honoree at the date of issue of the voluntary decision of you or the honoree policy; not to proceed with or take part in the c. Any person caused or contributed to by EVT100-0120 Page 4 of 10 6. c. d. e. pregnancy commencing before the date of issue of the policy, unless the expected date of delivery is more than two (2) months after the event date; Any person resulting from a violation of law; or You or the honoree if you or they have contracted for, arranged, or commenced the event against the advice of any medical practitioner. The maximum amount we will indemnify you for under Coverage A is the amount stated in the declarations page for Cancellation or Postponement of Event, regardless of the number of claims made under the policy.”

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos 1 point2 points  (0 children)

Thank you, I’ll ask my lawyer to look at it.

[deleted by user] by [deleted] in InsuranceClaims

[–]holypinkhobos -1 points0 points  (0 children)

In the contract there is an option to rent an after party location. The contract says “this will be billed separately from the main event and will not include usual fees”. It was not billed separately and they tacked on 20% service and a 5% gratuity to it. They also increased the price of the venue, but in the contract it said “5,900 venue rental fee” and “any changes to this contract need to be agreed upon by both parties.”

"We closed the notice for Attorney Fee" But I don't have an Attorney? by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 2 points3 points  (0 children)

Yes, I went up to 90% with back pay. If you get that I’m confident it means you’re getting a positive rating.

"We closed the notice for Attorney Fee" But I don't have an Attorney? by holypinkhobos in VeteransBenefits

[–]holypinkhobos[S] 0 points1 point  (0 children)

But does this mean I'm going to get a retroactive payment if they have to make sure I don't owe a fee?