Chuck75

You might expect this from a VA doc. I would think that the "vitamin deficiency" would have to be quite severe for some time, or there is some other problem involved. (diabetes, for example) Lab tests should show additional data that would tend to confirm or deny the dr's guess. From what I've found as a result of my diabetes research, is that blood surgar levels can be a late rather than an early sign of diabetes. Diabetes can cause the problems you mention, even before the sugar levels get anywhere near those used to diagnose diabetes.

This is quite common in a case against the state government. Although I think that the director might also be named, as well as the individuals who were directly involved. State laws vary concerning this sort of thing. In some states (mine) the state employees cannot normally be sued directly. They are responsible to the system, and you must sue the system, which has "sovereign immunity". The exception is when a felony is committed, and the actions cannot be said to be under the duties of the state employee. This is a useful area, since, at least in theory, following the various laws and regulations properly does not result in a crime. Malfeasance in office may apply to the director. This whole thing about libility was of major concern to me during my working days. I commonly did the same tasks as a GS-10 or 12. The GS'ers were protected by the "sovereign immunity" bit, and I was not, since my services were contracted to the government. "By the way does anyone know why their director (also named in my VA OGC complaint) was suddenly replaced by the Governor?"

Do you have a copy of the "contract" C&P results? Can you obtain the C&P doctors credentials? I'd be tempted to take the view that the sole purpose of the C&P was to refute the opinions of record (Making it illegal), and that in any event it has no standing, due to the lack of the doctor's qualifications (specialty) to preform the exam, and that it was not done to the VA's own standards. A lawyer may be needed for this case. It involves possible fraud on the part of the contract doctor, and on the surface, possible illegal action on the part of the VA. I don't know if it crosses the line into a "CUE" situation.

Find out if you can charge the VA with attempted fraud? (At least the charge might get someone's attention!) Actually, I'd see my Senator and Representative, and see if I could get them to query the VA as to why they have not ruled or considered the original claim. The likely answer is that the original claim implied issues that they did rule on. (And forgot to deal with issues raised in the original claim!) "How do I get them to straighten my claim and quit altering it?!"

It's interesting that it took them six months to read your claim, and send out the requests for information that were likely included in your original claim. To your advantage is that there was a push to get out as many claims as possible before March 08. Remember that there is no time based penalty, just political "oversight".

By now, after a history of multiple decades of denial, it should be obvious to all that DOD, industry, VA, and the government in general will try to avoid, deny, and failing that, minimize any responsibility, liability, blame, or costs involved. A part of this was to destroy, hide, and deny that events occurred, or were hidden by falsifying records. Over classification of records was a favorite ploy.

YOU REALLY REALLY NEED TO SEE A WELL QUALIFIED CARDIOLOGIST ASAP! This is nothing to fool with. I have no idea what tests were made by the VA, and suggest that you obtain copies and take them to a non VA doctor for an outside evaluation/opinion. Those symptoms (without any others) are of very very serious concern. Age 54 is an age where this set of symptoms often indicates potentially life threatening conditions. "Just getting old" is a cop out. "Chest pains along with Numbness an aches on my left side"

I hate to say this-- First, the recent practice of charging for medical records is a government (read political) sop to the medical records operations. Next, and more important, depending upon VA doctors without another doctor as a check/counterbalance is less than ideal, and should only be the case due to a lack of other options. A once or twice a year visit to a private physician is not very expensive, and, in the case of $1800 records, can have quite a return on the cost(~10:1). A dissenting medical opinion is often quite useful to have when it comes to evaluating medical treatment by the VA. The real problem with the VA is "cost management", which can be to the veteran's detriment when it comes to "quality of care", and even the drugs prescribed. ========================================

You will need to obtain a copy of Dr. Richardson's statements that the VA mentions as the VA has them. In fact you should obtain a copy of your entire VA "C" file. This Dr's statement is the key, and is what the endocrinologist must refute if you are to be successful. You likely will need the endocrinologist's curriculum vitae along with his refuting opinion. It also may be that the VA misread or misquoted the Dr's statement in some manner. "Precipitation or aggravation of diabetes mellitus (high blood sugar)" is a documented possible side effect of high steroid dosage. You are going to have to go the aggravation route and somehow convince the VA that DB 2 was a prexisting condition when you started taking the steroids. There is a conflict between Dr Richardson's "very high dosage" and your "low dosage" statements. This is a specific area that must be addressed by the endcrinologist. "Dr. Richardson notes that at that time you carried a diagnosis of both diabetes insipidus and type I1 diabetes mellitus, whch he related was probably due to your high steroid dose, as it was noted that you were on a very high steroid dose at that time."

BRAC makes recommendations to congress as to which bases should be closed and remain open. It, as I understand, was created by congress to help isolate the decison process from very strong political considerations. (HaH!) Originally, Congress was supposedly to vote up or down on the recommendations as a whole. The community I live in has had several major "scares" involving BRAC. It seems that the largest employeer in Mid Georgia is the Robins AFB. Anyway, the information about contamination with Dioxin at Treasure Island Navy Base is of serious concern. The majority of Vietnam era USN sailors sent overseas to the Far East, 7th Fleet, and Vietnam were routed via Treasure Island. A large number of those returning from Vietnam and the Far East were also outprocessed for Discharge/Seperation at Treasure Island. Many of the sailors may have attended at least the Fire Fighting School, one of the Dioxin contaminated sites at T.I. This information may also have some effect on the "Blue Water" claims. NAVAL STATION TREASURE ISLAND 529 ACRES; BETWN SAN FRANCISCO & OAKLAND SAN FRANCISCO, CA 94130 SAN FRANCISCO COUNTY SITE TYPE: CLOSED BASE ACRES: 550 ACRES APN: NONE SPECIFIED NATIONAL PRIORITIES LIST: NO CLEANUP OVERSIGHT AGENCIES: DTSC - SITE MITIGATION AND BROWNFIELD REUSE PROGRAM - LEAD<B&NBSP;< FONT> PROJECT MANAGER: RYAN MIYA SUPERVISOR: DANIEL MURPHY DIVISION / BRANCH: OMF - NO (BERKELEY) ENVIROSTOR ID: 38370044 SITE CODE: 201210 ASSEMBLY DISTRICT: 13 SENATE DISTRICT: 03 SPECIAL PROGRAM: FUNDING: BRAC 93 PUBLIC PARTICIPATION SPECIALIST: RICHARD PERRY PRESS CONTACT: ANGELA BLANCHETTE COMMUNITY INVOLVEMENT Cleanup Status ACTIVE AS OF 1/1/1991 Regulatory Profile VIEW DETAILED AREA / SUB-AREA REPORT PAST USE(S) THAT CAUSED CONTAMINATION DRY CLEANING, FIRE TRAINING AREAS, FUEL - AIRCRAFT STORAGE/ REFUELING, FUEL - VEHICLE STORAGE/ REFUELING, FUEL TERMINALS, ILLEGAL DUMPING, LAUNDRY SERVICES, OIL/WATER SEPARATORS, PAINT/DEPAINT FACILITY, SCHOOL - OTHER, WASTE - SEWAGE TREATMENT PLANT POTENTIAL CONTAMINANTS OF CONCERN SLUDGE - PAINT - CONFIRMED UNSPECIFIED OIL CONTAINING WASTE - CONFIRMED BENZENE - CONFIRMED DIOXIN (AS 2,3,7,8-TCDD TEQ) - CONFIRMED LEAD - CONFIRMED METHANE - CONFIRMED POLYCHLORINATED BIPHENYLS (PCBS) - CONFIRMED POLYNUCLEAR AROMATIC HYDROCARBONS (PAHS) - CONFIRMED RADIOACTIVE ISOTOPES - CONFIRMED TETRACHLOROETHYLENE (PCE) - CONFIRMED TPH-DIESEL - CONFIRMED TPH-GAS - CONFIRMED TPH-MOTOR OIL - CONFIRMED TRICHLOROETHYLENE (TCE) - CONFIRMED VINYL CHLORIDE - CONFIRMED CUMENE (ISOPROPYLBENZENE) - CONFIRMED<B&NBSP;< FONT> POTENTIAL MEDIA AFFECTED INDOOR AIR, OTHER GROUNDWATER AFFECTED (USES OTHER THAN DRINKING WATER), SEDIMENTS, SOIL, SOIL VAPOR Source: http://www.envirostor.dtsc.ca.gov/public/p...bal_id=38370044

You should read it. The language looks like it may be a back door into making a C&P mandatory. "VA -2008 VACO 0003-0024 (seems to involve C & P exams -have not read it yet"

Virtually everyone that uses the #$%& automated menus changes them in order to reduce the number of successful calls and route more callers to the waiting line. Even worse, it seems deregulation has removed the requirement for the systems to be rotary dial compatable. (wait and a live person picks up.)

Sounds like you will need to get an attorney and a VSO that knows what is what, then go to the next step in the process. What evidence did they use to ignore or refute Dr. Bash's IMO? If there is no countering evidence, the VA failed to follow it's own regs and law.

Given that you have service connected the Heart disease, I'd suggest that you use that, since the C&P tied them together. Depending on a lot of "gotchas", you may be able to even get an earlier effective date for compensation. Actually, the evidence was already in the VA's hands, and they should have automatically connected the two when you were given SC for the Heart condition. They after all are interrelated, in that one can exacerbate the other.

As a general rule, you or someone else should accompany Rick, particularly for the PTSD C&P. You may also want to have a copy of the VA reg that states that a veteran is entitled to have someone of their choice present. One of the forum experts (Help! Berta!) can likely locate this for you. If sufficient medical records exist showing blood pressure problems, the other C&P may be solely for the purpose of giving the VA an opportunity to have an examiner say that the blood pressure problem is not connected to an SC'd condition. (So, I'm a paranoid veteran when it comes to the VA!) "So, what do I need to do to prepare him for this? Should I do anything? Should I just let him go and be himself, or warn him that they will try to trip him up?"

Were blood tests and samples taken during your military service? Is there any way that you can obtain the test results, (Request military medical records) and (It's possible in a very limited number of cases that some of the samples still exist.) If the notable symptoms occurred shortly after discharge, there is hope, but given the VA's attitude, it will likely require expert help (Possibly legal and medical) to "prove" the claim. In any event, at the least, you may qualify for a veteran's pension due to TDIU.

Without knowing the details of the first denial and the subsequent award, it's difficult to say for sure. BUT, assuming that the award evidence was sufficient, it seems that you have a good chance of obtaining retroactive payment. A reverse to the reverse would be cause for you to go the political route, and I really doubt that SSI would care for this to occur. "What are the chances of me losing my SSDI benefits. I am 80% VA with TDIU."

To me the VA sees it this way-- Cite evidence used to deny, ignore or don't mention evidence that can be used to grant. "Accentuate the Negative, downplay the positive" --Typical bureaucratic thinking. The VA seems to require that these statements must be made by a "competent" medical person--The VA gets to define competent. "Competent medical evidence may also mean statements conveying sound medical principles found in medical treatises." The VA has a practice of saying that there is nothing that ties an inndividual case to this type of evidence. "It would also include statements contained in authoritative writings such as medical and scientific articles and research reports or analyses." "b. Review of Evidence. Concisely cite and evaluate all evidence that is relevant and necessary to the determination. Rating decisions must evaluate all the evidence, including oral testimony given under oath and certified statements submitted by claimants, and must clearly explain why that evidence is found to be persuasive or unpersuasive. Decisions must address all pertinent evidence and all of the claimant's contentions. “ Source: September 23, 2004 M21-1, Part VI"

You might want the DV rep to see if he can find out.

I'm still waiting, and it will be a year in March 08. All I've seen so far. Perodic "we are working on your claim" letters, which stopped after several months. A request for medical records-- (I had already submitted the necessary forms for them to obtain them from the sources, and given them a copy of the records I had.) I wrote a letter in reply to the request letter, and stated in that letter that in general, the medical records should already be in the VA's hands. If additional records were needed, and can be identified specifically, I will help in obtaining them. It's also interesting that I have never received a valid VCAA letter or a rational and complete SOC letter.

True when it involves medical treatment, not as true when it involves medical opinions. Remember that opinions can be countered by an opposing opinion, which opens another big bag. "med. records are med records"

For whatever its worth. The VA Clinic Doctor can be asked for an opinion as to the relationship between the SC connected problems and those not currently SC'd. There is an internal VA form floating around to use for this. The disadvantages are several. The VA doctor may state that the conditions are not related. (Not what you need!) The VA may disregard the written information on the form if it chooses to do so. (Only likely if the information is in your favor) Some time ago, in a VA Clinic, with a contracted Dr. The Dr. wrote a favorable opinion. The Dr. connected several drugs to the SC condition. Several months later, the drugs went back to Non SC, and copay resumed. The Dr. went on (as did several others of the clinics med staff to bigger and better things) The contractor/company running the clinic changed, and more staff quit. I never did get a rational explanation of how the drugs went from SC back to non sc. Just the you gotta go thru the admin side (compensation claim) to do anything. (Which is really not true when it comes to SC'ing drugs. A VA doctor (real or full contract)could set the flags in the VA program that SC's drugs)(At least when this occurred) (They did get upset when I asked if the electronic file showed who made the change back. and said that I could not have that information) (Not wanting to start a major hassle, I backed off and left stage right!)

Run, do not walk to the patient advocate for the VAMC. Explain your problem, ask to see and obtain a copy of your records in writing, and see what happens.

The VA will very likely attempt to use a future C&P to take advantage of the out given in the regs/law-- It may be useful to have one or more qualified specialists opinion that the medical problems are directly related to military service. "unless clearly attributable to intercurrent causes."

The bright side of this is that the various conditions are now service connected. So, you can ask for higher ratings and TDIU due to the multiple SC conditions. The VA often "low balls" original compensation claims. A notice of disagreement (NOD) is one way, and perhaps the first of several steps. You should, if eligible, also file for SSDI. An SSDI approval for SC connected conditions is extremely useful, and will help substantiate your claim. As for a detailed description of how and why the VA assigned the various 10% ratings, a look at the VA's disability/compensation schedule will provide some idea. You should ask the VA for an "SOC" and the details concerning the way they assigned the 10% ratings. (If they have not already given you that information.) You will need to conduct most of the research and so forth personally. This helps provide a rationale for the NOD.