Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • hohomepage-banner-2024-2.png

  • 27-year-anniversary-leaderboard.png

    advice-disclaimer.jpg

  • donate-be-a-hero.png

  • 0

Is This Neglect?

Rate this question


khensonb52

Question

My va doc ordered a sleep apnea test in 2003. The study showed i had sleep apnea and my o2 sat level dropped to 88% while asleep. The doc says she ordered a cpap machine but the order was cancelled,didn't know why ,never followed up on this since 2003 until now. I am rated at 100%, part of which is cardiac related and previous lung cancer with removal of part of r lung in 2001, due to agent orange. I had asked her on follow up apts with her in 03 and 04 about my test results, she said she could not find them. Two different cardiologist and my private family doc have asked me in the past if i had been tested for sleep apnea, i told them yes by the va but i must not have sleep apnea because i never recieved a cpap machine .I recently seen my va doc and for some reason i asked her again about my sleep apnea test results from 03.This time she did find the results on the computer, and said i need another test done immediately, which is now being set up. This va doc is the only one i've had at the va . In the past few months i have had increased angina, even waking me up with left arm pain. My cardio doc has recently increased angina meds, still having angina. I told him about the va doc mishap, and now before he does an arteriogram he needs to see if cpap resolves angina at night.,Is this gross neglect by the va doc,that never followed up on my need for a cpap,and if test showed i needed one, why i never was told, or recieved a machine?Cardiac disease has prrogressed,and angina has increased since 2003,possibly caused by not being treated for sleep apnea. Thanks

Link to comment
  • Answers 16
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Recommended Posts

I sure am glad this topic as to OSA and heart problems came up here.

It might be a very good subject for Dr. Bash to discuss on a future SVR show.I will mention that to Jerrel Cook.

I am stunned at the association of OSA to heart conditions.

This vet, on remand from the BVA, has a similiar type of claim.

“In this case, the Board finds that the medical opinions of record are not adequate to make a determination in this case. Dr. Karim has opined that the Veteran's hypoxemia was likely secondary to sleep apnea; however, this contradicts the April 2008 VA polysomnogram that showed no need for oxygen supplementation. Dr. Karim also opined that the Veteran's congestive heart failure was due to sleep apnea, but provided no rationale or explanation for this opinion. Dr. Zuriqat also opined that the Veteran's OSA "may worse congestive heart failure"; however, this opinion is equivocal and was provided without any rationale or explanation. On the other hand, the June 2008 and April 2009 VA examiners opined that the Veteran's hypoxemia and heart conditions were not caused by OSA, but additional evidence has been submitted since then which has not been considered by VA examiners. Additionally, neither VA opinion addressed the question of aggravation. Therefore, a remand is necessary to obtain another VA medical opinion. “”

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp12/Files5/1231494.txt

Unfortunately the IMO docs did not follow an adequate IMO criteria as to a medical rationale to excpaion their opinions.

This too is an interesting statement BVA made:

"Additionally, neither VA opinion addressed the question of aggravation."

-----------------------------------------------------------

Some OSA info on assocaition of heart disease:

http://www.sleepfoundation.org/article/ask-the-expert/sleep-apnea-and-heart-disease

https://www.cardiosmart.org/~/media/Documents/Fact%20Sheets/en/tb1479.ashx

http://www.mayoclinic.com/health/sleep-apnea/DS00148/DSECTION=complications

================================================================

In this BVA case ,filed under1151 ,OSA-heart ,the BVA stated:

“The Veteran and his wife, a registered nurse, testified at a personal hearing before the undersigned Veterans Law Judge in March 2009 that the VA clinic at which the Veteran was seen in 1988 ignored the early signs of OSA, hypertension, and angina, which led to his cardiomyopathy; that he was sent to a VA psychiatrist, who prescribed medication for PTSD that made the conditions worse; and that his hypertension was not treated until Dr. Stuart gave him medication in 1994. The Veteran's wife confirmed that a VA doctor essentially told the Veteran when he was subsequently treated at a different VA facility that the VA clinic should have treated him for his hypertension in 1988 and that the lack of treatment had adversely affected his health. “

BUT:

“Non-ischemic cardiomyopathy with congestive heart failure and heart block was diagnosed. According to this evaluation, the Veteran had been treated by Dr. Stuart, a private physician, for disabilities such as hypertension and OSA beginning before he was seen by VA in 1988. Consequently, it was noted by the examiner that the Veteran's contention that he did not receive private care for his hypertension until the 1990's is incorrect. Moreover, it was reported that even though the Veteran had contended that VA had ignored his medical problems, the record shows that he was noncompliant with his prescribed medications and had failed to appear for scheduled VA appointments. For example, it was noted by the VA examiner that, in 1989, the Veteran was counseled by VA social workers because he had "missed recent appts."

Of course this claim was denied.

This case also reflects an important fact........

if a veteran ( or any witness such as the veteran's wife in this case), makes a statement that is found to be untrue, then ,just as within a court of law , one can assume all other statements they make might not be based in fact.

That is why we sign an oath statement on initial VA claims forms.

I have typed in the oath many times and signed it on subsequent other claims I have made too.

I dont feel this veteran in this BVA case was trying to deceive the VA, in my opinion, but it pays to get one's facts straight whenever a claimant makes lay statements.

Link to comment

My va doc ordered a sleep apnea test in 2003. The study showed i had sleep apnea and my o2 sat level dropped to 88% while asleep. The doc says she ordered a cpap machine but the order was cancelled,didn't know why ,never followed up on this since 2003 until now. I am already rated at 100%, part of which is cardiac related+ diabetes diagnosed in 2002 and previous lung cancer with removal of part of lung in 2001, due to agent orange.That cancer was missed by the va on a physical with xray and just 4 weeks later the tumor was found by private doc on xray.I just forgave the va for that.. Two different cardiologist and my private family doc have asked me in the past if i had been tested for sleep apnea,., i told them yes by the va but i must not have sleep apnea because i never recieved a cpap machine. 6 months ago i seen a new va doc, my regular doc was sick, and she asked if i had been tested for sleep apnea. I said yes but years ago by the va. she could not find the test results,but she would mention it to my regular doc when my doc gets back to work.

On my recent visit a few days ago, i mentioned this to my reg va doc. This time she did find the results on the computer, and said i need another test done immediately, which is now being set up. This va doc is the only one i've had at the va . In the past few months i have had increased angina, even waking me up with left arm pain in the night. My cardio doc has recently increased angina meds,and wants to see me again in 3 months to see if the angina has decreased with the doubling of angina meds. still having angina.i called him and mentioned the angina and the va sleep apnea,, and now before he does an arteriogram he needs to see if cpap resolves angina at night.,Is this gross neglect by the va doc,that never followed up on my need for a cpap?, test showed i needed one, why i never was told, or recieved a machine?Cardiac disease has prrogressed,and angina has increased since 2003,possibly caused by not being treated for sleep apnea. Do i need a lawyer to file a sf95 and ftca claim.I seen the apnea test, and my need for a machine for treatment. and the cancelled machine order. by whom? The va doc has finally torqued me off.Any suggestions on how to proceed

Link to comment

I responded yesterday to some of your questions under this topic:

Regarding the SF 95.....

YES I always recommend getting a lawyer to handle FTCA issues.

A lawyer can best prepare the SF95 for you.

You certainly have the right to prepare and file the SF 95 yourself and even proceed to sue VA without an attorney.

I did and I won...however I had to become a pro se lawyer and pseudo medical doctor to do that.

It would have been easier to have a lawyer but none of the lawyers I contacted saw any merit in my case so I FTCAed myself as we do have the right to do that.

A few years ago I was BSing with the OGC lawyer who handled my FTCA settlement, over another matter, and this lawyer told me how many FTCAers,if they fill the SF 95 themselves, make errors in a critical part of the form and OGC must reject the SF 95.

Also, the initial wording of the charges must be worded a certain legal way...I have posted in our FTCA forum here how I prepared my SF 95 ,as to the proper wording of the charges, also what I did as to the Witness question, on the form, and also what the critical error he mentioned was.

Lots of info here on FTCA.

A malpractice lawyer would be foolish to turn down any FTCA claim that has a strong IMO already prepared, that reveals a medical rationale for a documented determination of negligence, so great that the negligence caused additionl documented disability.

An IMO doctor will need to see copies of all medical records you have.

There are IMO doctors as well as malpract6ice lawyers on the net, and many have experience with FTCA cases against the VA.

Many, if you send them a brief email saying what you told us here, can possibly assess your FTCA potential right away...but thy would still need to see proof of malpractice and malpractice always has a paper trail.

When I hired Dr. Bash for my additional malpractice issue (I could NOT file this issue under 1151 or FTCA again and filed for direct SC death due to AO),I emailed him a very brief rendition of some of my evidence. He responded ,if you have that, you have a good case. Within days I sent him the whole 9 yards and within a few more days he prepared my initial IMO that fully supported my claim.

IMOs can be costly but I consider them as an investment , if the medical evidence warrants the claim to be awarded, and the fees are easily absorbed by some future comp checks .that the veteran might never get without the IMO..

Link to comment
  • HadIt.com Elder

given the fact that you knew more than a decade ago that they ordered a CPAP machine and then cancelled it and didn't do anything about it until now opens a whole can of worms abandonment for one, the thought I have a 100% I can't get any more it's not worth it now you see why it is worth it, the CPAP will keep your oxygen levels up while you are asleep, I have a BIPAP because of carbon dioxide because of CHF and a very low ejection fraction of 10% I have periods where my O2 is down to 77 that is while I am awake if I don't have an air line hooked up I have been on oxygen 24/7 for more than 2 years if you have any other sc issues you might be eligible for SMC S is you had added the SA back in 2002 a lawyer might see a legal argument for it and an extra 300 a month for 11 or 12 years will add up to a nice little retro

sometimes just giving up is not the right answer you might be mad at the VA right now but you are the one who made the decision to quit the issue in 2002

Link to comment
  • Moderator

You dont have anything to lose by seeking a lawyers input. Many, if not most, VA experienced lawyers are very busy, some of which are not even taking new cases. Its hard to get Mr. Ken Carpenter, for example. He is very selective of his clients. The simple answer is to take your case to a lawyer and see what he says. If he agrees to take your case, then you have a pretty good idea he likes it. You can decide then.

All this being said, I have not changed my opinion that you bear some/all of the responsibility for not following up in 2002 on your CPAP. We dont know why the VA cancelled the CPAP. Maybe your local VAMC did not have setup a sleep department in 2002. Maybe the CPAP's were on backorder. Maybe the contractor could not fill the order. Maybe the UPS man dropped or damaged your CPAP. The doc is not required to confirm that you got your CPAP, and that you are using it. You need to make an appointment with the doc for follow up, they always recommend follow up and if you dont do so, this is not the docs fault. If you read the fine print you sign when you consent to treatment, you will likely see some sort of disclaimer, that "tollow up" is recommend and if you do not do so, then its not the docs fault. If the doc tells you to "see me in 2 weeks" to see how the treatment is going, and you dont make the follow up appt, how is this the docs fault?. If you allege the doc did not ask you to follow up, then you would likely have to have recorded that conversation, as most would simply deny that. The docs always ask you to make a follow up appointment.

The law often uses the "reasonable man" doctrine. If a "reasonable man" was supposed to get a CPAP in 2002, and it did not show up, what would he do? Forgetting about it for 12 years then suing the doctor does not exactly seem reasonable. Most of the laws do give us a chance to "correct" our mistakes. Its when we fail to correct them then they nail us. Of course, there is a point of no return when we make a mistake that we have to pay the penalty.

Edited by broncovet
Link to comment

" If you read the fine print you sign when you consent to treatment, you will likely see some sort of disclaimer, that "tollow up" is recommend and if you do not do so, then its not the docs fault."

I proved to the VA that, although they had done an EKG and noted 'follow up ' and R/O CAD, and other critical notations on an ER certificate, when my husband collapsed on the job at the same VAMC in 1988, that this was the initial instance of VA malpractice.

My point is my husband went to every VA appt scheduled for him and the diagnosis he received that day was completely wrong and contributed to his untimely death.

My husband could not "follow up" on the medical certificate statements nor do his own "R/O for CAD" ...meaning work up to rule out CAD, because he was not a VA doctor.

I suggest you get a copy of your complete medical records and then get an IMO and then, if the IMO supports negligence, file 1151 and get a lawyer if VA denies the claim.

This may be well beyond the Statute of Limits for FTCA.

This was not in the first post you made:

"That cancer was missed by the va on a physical with xray and just 4 weeks later the tumor was found by private doc on xray.I just forgave the va for that ..."

Yeah I forgave the VA when they misdiagnosed my husband's 1151 stroke for 3 weeks and called it labyrhinthitis.

He couldn't swallow and the medical records stated he told the nurses and the doctor he was dying of thirst (he was right)

I figured ,with a transfer at that point (I had to threaten them to give him a CT scan and then I made the CT doc read it to me by phone as my husband's doctor didn't have a clue on how to interpret it and told my husband he needed brain surgery...once transferred to another VAMC, I could overlook that misdiagnosis.

(this all happened right before a nurse actually pulled me aside and asked if I could get him out of there before they killed him)

But the misdiagnosis I forgave them for (sort of) came back to haunt them when I FTCAed them. I have 2 current claims before the VA as they still owe me cash on their malpractice.

We are not doctors or lawyers here. We are all giving our opinions to the best of our knowledge and experience.

An IMO can either reveal the medical evidence of malpractice or give a veteran and their family great piece of mind that the VA didnt bugger them.

I think this :

"This time she did find the results on the computer, and said i need another test done immediately,"

indicates the initial doctor recognized that she screwed up.

Link to comment
×
×
  • Create New...

Important Information

Guidelines and Terms of Use