Crew Chief Tony

10/16/2026

PALLIATIVE CARE CAN SUPPORT VETERANS THROUGH SERIOUS ILLNESS

Some veterans and families hear “palliative care” and assume it means hospice, that the doctors are giving up, or that treatment has to stop. That is not what palliative care automatically means. Palliative care focuses on easing symptoms, reducing suffering, and helping a person maintain the best possible quality of life while living with a serious or chronic illness.

Palliative care can be appropriate at different stages of an illness, including while a veteran is receiving treatment intended to cure or control the condition. It may help with pain, shortness of breath, nausea, fatigue, anxiety, or other symptoms that make daily life harder. The care team can also help veterans and families talk through treatment choices, personal goals, and the kind of support that would make day-to-day life more manageable.

This care is often provided by a team. Depending on the veteran’s needs, that team may include medical providers, nurses, social workers, chaplains, mental health professionals, and others. They can address physical symptoms as well as emotional, spiritual, family, and practical concerns. Palliative care works alongside a veteran’s existing health care team and treatment plan.

Hospice is related to palliative care, but they are not interchangeable. Hospice is generally intended for people with a terminal illness who are nearing the end of life and whose care is focused on comfort. Palliative care can begin earlier and may be provided while other treatment continues. Asking about palliative care does not, by itself, mean a veteran is choosing hospice, stopping treatment, or signing a do-not-resuscitate order.

Veterans enrolled in VA health care may qualify for palliative care when they have a clinical need for it. The services available can depend on the veteran’s needs and the VA facility. Copays may apply for palliative care, so ask the VA team what services are available and whether any costs apply to your situation.

If you think palliative care could help you or a family member, bring it up with the VA primary care provider or social worker. Explain which symptoms or concerns are affecting daily life and ask whether a palliative care consultation or referral is appropriate. You can also ask how the palliative care team would coordinate with current doctors and treatment.

BOTTOM LINE: Palliative care is another layer of support for veterans living with serious illness. It can focus on comfort and quality of life while other treatment continues. It is not the same as hospice, and asking about it does not mean you are giving up.

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10/16/2026

I made the first cut and am in the top 20! I am actually in 3rd place while I am typing this! And here is your daily reminder. Sorry if you are getting tired of seeing this.

Thank you to everyone who has been voting! You can vote once a day, and every vote makes a difference!

Here is the link for you to vote today! Please share it so others can also vote if they wish to!

***Apparently, the link is not working in the post for some reason, so I will include it in the comments.

Will Tony Cossey be a guest on an episode of On Air with Ryan Seacrest, win $25,000, and lead a podcast produced by iHeartRadio?

10/16/2026

APPLYING FOR AID AND ATTENDANCE DOES NOT AUTOMATICALLY REOPEN EVERY VA RATING

Some veterans worry that asking VA for Aid and Attendance will automatically put all their current ratings at risk. Filing for this benefit does not, by itself, automatically reopen every rating. VA reviews the benefit being requested and the evidence related to it. VA may request an examination or review other issues when the evidence or circumstances warrant it, so no one can guarantee that other ratings will never be looked at.

For a veteran receiving disability compensation, Aid and Attendance may be considered as Special Monthly Compensation when service-connected conditions create a need for regular personal assistance. This is different from Aid and Attendance through VA pension, which has separate eligibility requirements.

The evidence should describe what help the veteran actually needs because of service-connected conditions. That can include help dressing, bathing, keeping clean, eating, using the bathroom, adjusting certain appliances, or staying safe from everyday hazards. The need does not have to be constant, and a veteran does not have to meet every listed factor. VA considers the veteran’s overall condition and whether regular assistance from another person is actually needed.

A medical opinion is important, but it should be supported by clear details about daily functioning. VA Form 21-2680 is commonly used to document the need for regular Aid and Attendance. Statements from the veteran or someone who provides care can also explain what assistance is needed, how often it is provided, and which service-connected conditions contribute to that need.

Do not file based only on fear that every rating will be reopened, and do not assume approval is automatic. Understand what benefit you are requesting, provide relevant evidence, and read any VA decision or examination notice carefully.

BOTTOM LINE: An Aid and Attendance request does not automatically reopen every VA rating. VA evaluates the benefit requested and the relevant evidence, but related issues may be reviewed when warranted. The strongest evidence explains the actual assistance needed and how service-connected conditions contribute to that need.

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10/15/2026

REPORTING DEPENDENT CHANGES CAN HELP PREVENT A VA OVERPAYMENT

If you receive additional VA disability compensation for a spouse, child, or dependent parent, changes in your family may affect the amount you are entitled to receive. VA records do not always update when your family situation changes, so it is important to report changes that may affect a dependent’s eligibility.

For disability compensation, you generally must have a combined service-connected rating of at least 30% to receive additional compensation for eligible dependents. Qualifying dependents may include a spouse, an unmarried child under 18, an unmarried child between 18 and 23 who attends school full time, or a child who became permanently disabled before age 18. A parent may also qualify under separate financial and support requirements.

Changes to report may include marriage, divorce, the death of a spouse or dependent, a child getting married, or a child no longer meeting the requirements for dependent status. If a stepchild no longer meets VA’s requirements, that may also affect eligibility.

A child turning 18 requires special attention. VA generally removes a child from disability compensation when they turn 18. If the child will continue attending school and may qualify as a dependent between ages 18 and 23, you must submit the child’s information again. VA Form 21-674 is used to request approval of school attendance. If the child stops attending school or their status changes, report that as well.

VA Form 21-686c is used to request that a dependent be added to or removed from disability benefits. You can submit the request online or use the paper form. Keep a copy of what you submit and any confirmation you receive.

Timing matters when adding a dependent. If you already have a combined rating of at least 30% when you marry or have or adopt a child, filing within one year may allow VA to pay additional compensation back to the date of that life change, if you meet the requirements. If you wait longer, VA may use a later date. Reporting a change promptly can also help prevent an overpayment if VA continues paying an amount that includes someone who is no longer eligible.

Adding a dependent to VA disability compensation does not automatically enroll them in VA health care, CHAMPVA, or TRICARE. Those programs have separate eligibility and enrollment requirements.

BOTTOM LINE: When your family status changes, check whether it affects the dependents listed on your VA compensation award. Report changes promptly, especially divorce, a dependent’s death, or a child’s school status, and keep proof of what you send.

Have you checked that the dependents listed on your VA award still meet the requirements?

If you find my posts useful, you can help me keep this mission going by supporting my work through Buy Me a Coffee. There is never any obligation, but every bit of support helps me continue assisting veterans:
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10/15/2026

Today is the last day of voting for this round. Remember, you can vote once each day. I truly value and appreciate your votes.

I have dropped to 3rd place, but as long as I am still in the top 20 when they make the cut for this week, I am good and will not be cut. Of course, the votes do not reset each week after each cut, so any and all votes are valuable.

Could you also share this post and ask your friends and family to vote? That would be incredibly helpful!

Will Tony Cossey be a guest on an episode of On Air with Ryan Seacrest, win $25,000, and lead a podcast produced by iHeartRadio?

10/15/2026

A DBQ AND A NEXUS OPINION DO DIFFERENT JOBS IN A VA CLAIM

A Disability Benefits Questionnaire, commonly called a DBQ, and a medical nexus opinion are both forms of medical evidence, but they do not necessarily answer the same questions.

A condition-specific DBQ is primarily designed to document the medical facts the VA needs to evaluate a disability. Depending on the condition, it may address the diagnosis, medical history, symptoms, treatment, test results, range-of-motion measurements, flare-ups, functional loss, occupational impact, and other findings that correspond with the VA rating criteria.

That information can help establish how severe a disability is, but a completed DBQ does not automatically prove service-connection. A provider can confirm that a veteran has a diagnosed condition and thoroughly document its severity without explaining whether that condition was caused by military service.

A nexus opinion addresses the medical connection. For a direct claim, the provider should explain whether the current disability is at least as likely as not related to an event, injury, illness, or exposure during service. A diagnosis alone does not establish that connection.

For a secondary claim, the medical opinion should address whether an established service-connected disability caused the new condition. When supported by the facts, it should also address whether the service-connected disability aggravated the new condition beyond its natural progression. Causation and aggravation are separate questions. An opinion that discusses only causation may leave the aggravation theory unanswered.

The words “at least as likely as not” are important, but those words alone do not make an opinion strong. The provider should identify the evidence reviewed, discuss the veteran’s relevant medical and service history, explain the medical reasoning, and connect the facts of the individual case to the conclusion. A copied statement or conclusion without a supporting explanation may carry very little weight.

A nexus opinion does not always provide enough information to determine the correct percentage either. A provider may write a well-supported opinion connecting a back condition to service but fail to document range of motion, flare-ups, repeated use, neurological symptoms, or functional loss. The opinion may help establish service-connection while leaving the VA without enough information to assign the proper rating.

The reverse can also happen. A DBQ may thoroughly document severe symptoms and functional limitations but contain no opinion connecting the condition to service. That evidence may support the rating level if service-connection is established, but it may not prove that the condition should be service-connected in the first place.

A veteran does not always need two separate documents. A qualified medical provider may complete the appropriate DBQ and provide a separate nexus opinion, or the provider may address both issues within the same medical report. What matters is whether the evidence clearly addresses the medical connection and contains the findings needed to evaluate the disability.

The VA may also obtain both during the claim process. A C&P examiner may complete a condition-specific DBQ and a separate medical-opinion DBQ. In some cases, the VA may request only a medical opinion or records review because it already has enough information about the severity. In other cases, it may request an examination because additional measurements or clinical findings are needed.

Submitting a private DBQ or nexus opinion does not guarantee that the VA will grant the claim or decide the claim without another examination. The VA must consider competent private medical evidence, but it may still order a C&P examination when it determines that more information is needed.

Before submitting either document, check that it identifies the veteran, names the condition being evaluated, is completed by an appropriate medical professional, contains the provider’s credentials, and is signed and dated. Also make sure the provider addressed the correct theory of service-connection instead of answering a question that was never asked.

BOTTOM LINE: A DBQ usually helps document what the disability is and how severe it is. A nexus opinion explains why the disability is connected to military service or to an established service-connected condition. Depending on the evidence already in the record, a strong claim may need one or both.

Have you checked whether your medical evidence addresses both the connection and the severity of your claimed disability?

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10/14/2026

VA HEALTH CARE ENROLLMENT DOES NOT PROVIDE COVERAGE FOR YOUR FAMILY

A veteran’s enrollment in VA health care covers only the veteran. It does not provide medical coverage for a spouse or dependent children. Eligible family members must qualify for and enroll in a separate health care program, such as CHAMPVA or TRICARE.

This remains true even when the veteran receives VA disability compensation. Adding a spouse or child as a dependent for additional monthly compensation does not enroll that family member in VA health care, CHAMPVA, or TRICARE. These are separate benefits with separate eligibility and enrollment requirements.

Some eligible family members may qualify for CHAMPVA. In most cases, the spouse or dependent child must be connected to a veteran who is rated permanently and totally disabled because of a service-connected disability. Certain survivors may also qualify when the veteran died from a service-connected disability or was permanently and totally disabled at the time of death.

A 100% rating by itself does not always establish CHAMPVA eligibility. The veteran generally must be rated both 100% and permanent and total. If the veteran’s rating is temporary or the VA has not determined the disability to be permanent and total, the family may not qualify based on that rating.

CHAMPVA is not the same as VA health care. It is a cost-sharing health care program that helps eligible spouses, dependent children, and survivors pay for covered medical services and supplies. Family members generally receive care from participating community providers. They do not simply use the veteran’s VA medical appointments or become patients of the veteran’s VA primary care team.

CHAMPVA enrollment is not automatic in most cases. An eligible spouse or dependent generally must apply. The usual application is VA Form 10-10d, and supporting documents may be required. Being listed as the veteran’s dependent in the VA compensation system does not replace the CHAMPVA application.

A family member who is eligible for TRICARE cannot receive CHAMPVA. TRICARE eligibility is based on the military sponsor’s status, such as active-duty service, military retirement, or qualifying National Guard or Reserve service. It is not created by a VA disability rating. Eligible spouses and children must also be properly registered in the Defense Enrollment Eligibility Reporting System, commonly called DEERS.

Some families will qualify for TRICARE, some will qualify for CHAMPVA, and others may qualify for neither. A veteran can be enrolled in VA health care while the spouse and children use employer insurance, Medicare, Medicaid, an Affordable Care Act marketplace plan, or another form of coverage.

Medicare can also affect CHAMPVA. A person who becomes eligible for Medicare generally must maintain Medicare Part A and Part B to receive or keep CHAMPVA. Families should review the rules before declining Medicare coverage or making changes to an existing health plan.

Do not wait until a family member needs medical care to determine whether coverage exists. Check the veteran’s permanent and total status, determine whether the family is eligible for TRICARE, submit any required CHAMPVA application, and wait for confirmation of enrollment.

BOTTOM LINE: VA health care enrollment covers only the eligible veteran. It does not provide health care coverage for the veteran’s spouse or children. CHAMPVA and TRICARE are separate programs with their own eligibility and enrollment requirements.

Does your family know which health care program actually covers them?

If my posts are helping your family understand benefits before a problem occurs, you can support my mission to continue assisting veterans through Buy Me a Coffee. Donations are appreciated, but they are never required:
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10/14/2026

THE 2027 COLA INCREASE IS 3.6% - HERE IS WHEN IT WILL SHOW UP

The Social Security Administration announced a 3.6% cost-of-living adjustment for 2027. The increase applies to Social Security retirement, survivor, and disability benefits. VA disability compensation rates will also increase by 3.6%.

You do not have to apply for either increase. The adjustments are automatic for people receiving eligible benefits.

You can estimate the increase by multiplying your current monthly benefit by 0.036. For example, $1,239 multiplied by 0.036 equals about $44.60. Adding that to $1,239 gives an estimated amount of $1,283.60 before Social Security’s final payment rounding.

Social Security does not round that amount to the nearest dollar. Its rules round the monthly amount payable down to the next whole dollar. For example, $1,283.60 would be payable as $1,283.00. This is an estimate only. Social Security calculates COLAs using the underlying benefit rate, and deductions such as Medicare premiums can affect the amount deposited. Your official benefit notice will give you the exact amount.

For VA disability compensation, the new rate is effective December 1, 2026. VA pays benefits after the month they cover, so the December benefit at the new rate is scheduled for December 31, 2026. The payment is early because January 1 is a federal holiday.

Social Security’s increased benefits begin with the January 2027 benefit. The arrival date depends on your benefit type and payment schedule. SSI recipients and some Social Security beneficiaries will receive their January payment on December 31, 2026, because January 1 is a holiday. Other recipients will receive the increase on their regular January payment date.

If you receive both Social Security and VA disability compensation, each program applies its own increase to its own benefit. Check each payment separately when the new rates take effect.

BOTTOM LINE: The 3.6% increase is automatic. You can estimate it by multiplying your current benefit by 0.036, but the final amount may differ because of Social Security’s rounding rules, benefit calculations, or deductions. VA disability compensation should reflect the new rate in the December benefit paid December 31, 2026. Social Security’s January 2027 benefit will arrive on your scheduled payment date.

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10/14/2026

THE BILATERAL FACTOR CAN INCREASE YOUR COMBINED VA RATING

When a veteran has compensable service-connected disabilities affecting both arms, both legs, or paired skeletal muscles, the VA may be required to apply the bilateral factor. This is meant to recognize the additional functional difficulty that may result when disabilities affect both sides of the body.

The disabilities do not have to involve the exact same joint or carry the same diagnosis. For example, a compensable right-knee disability and a compensable left-ankle disability may qualify because both affect the lower extremities. A disability affecting the right hand and one affecting the left shoulder may also qualify because both affect the upper extremities.

The disabilities must affect opposite sides of a paired set. Two disabilities involving only the right leg would not qualify by themselves. A noncompensable 0% rating in one extremity also generally does not satisfy the requirement because each paired extremity must have a disability evaluated at a compensable level.

The VA does not simply add 10 percentage points to each rating or to the veteran’s final combined rating. The qualifying right-side and left-side ratings are first combined using VA math. The VA then adds 10% of that combined value before continuing with the remaining disability calculations.

For example, a 10% right-knee rating and a 10% left-knee rating combine to 19%. Ten percent of 19 is 1.9, which is added to the 19 for a bilateral value of 20.9. That value is rounded to 21 and then combined with the veteran’s other ratings. It does not automatically produce a final combined rating of 30%.

When disabilities affect both upper extremities and both lower extremities, the qualifying ratings are combined in order of severity before the bilateral factor is applied. The resulting bilateral value is then treated as one disability when the VA continues calculating the overall combined rating.

The bilateral factor does not always change the veteran’s final monthly payment. It may increase the underlying combined value without moving the final rounded rating to the next 10% level. However, even a small increase can become important when additional disabilities are later granted or increased.

The VA is also required to use the calculation that is most favorable to the veteran. If including a particular disability in the bilateral-factor calculation would produce a lower combined evaluation, the VA should remove it from that calculation and combine it separately.

Veterans do not normally file a separate claim for the bilateral factor. The VA should apply it automatically when the ratings qualify. Still, do not assume the calculation was completed correctly. Review the individual ratings, the affected extremities, the combined-rating calculation, and the rating code sheet if one is available.

BOTTOM LINE: The bilateral factor is part of VA math, not an additional disability rating. It can increase the combined value when compensable service-connected disabilities affect both sides of paired extremities, but it does not mean the VA simply adds another 10% to the final rating.

Have you checked whether the VA applied the bilateral factor to your service-connected arm or leg disabilities?

If the information on my Page has helped you better understand your VA benefits, you can help me continue assisting veterans through Buy Me a Coffee. Support is always appreciated, but never required:
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