free_spirit_etc

Okay..I have been in limbo for quite some time about getting my husband's C-file. My husband requested it mid-2006. Hadn't recieved it before he died Feb. 2007. They told me after his death that it was still going to be sent - and I would get it in 30 days...which, of course, only caused a delay of another 30 days - before I called them again and was told I had to RE-REQUEST it. I requested a copy last year - I sent a request to both view the c-file and obtain a copy. I was allowed to view it last JULY - but was told I had to wait for my copy - and I am still waiting - NINE MONTHS after my initial request. They tell you it usually takes 6 months to get your copy from Chicago. When I got the denial - I IRISed them and asked what I would need to do to get a copy of the Doctor's Opinion. They told me to submit a written request; which I did. I asked that my request for a copy of the Doctor Opinion be expediated (i.e. sent during my lifetime) - as this was a LIMITED REQUEST. I didn't recieve a response that they got it - so I did another IRIS asking that they give me a copy of the opinion while I was still WAITING for a copy of the C-fie I requested long ago. They responded and told me that the rquest had been sent to the Privacy officer and that I would get a copy of the opinion FIRST (yippie) and THEN a copy of the C-file (as it is so LARGE). Sooooooooo - I would sure like to request that they toll any deadlines that they have for anything - adding the amount of time it took for them to send me the information I needed for the claim. And here is my major question at this point - When I get the IMO - do I send the C-file to the Dr. - or do I submit a request for the VA to do it. I know I saw a thread where the VA discounted their IMO stating they had not recieved a request to send the doctor the C-file - and though the doctor stated he viewed the file - he only mentioned things that were on the denial letter. (Hmmm - how odd that a doctor would only address the issues the VA had stated were important). Anyway - should I put in a request for THEM to send the doctor a copy of the C-FILE - and if so - does it also take them forever to send it to the doctor - Or do they send those out within the veteran and / or their dependent's lifetime? Free

Good point. Also - since the VA considers you a "lay person unable to issue a medical opinion" they can't really expect you to diagnose yourself. They play that game a lot too. You report symptoms and think it is something - and they deny because it is not what you thought it was. But they need to take it a step further and see if whatever it IS - is caused by the service. I think they make a lot of errors on this. For instance my husband thought his headaches might be caused from Desert Storm. The C&P examiner said they were caused by: 1. Chronic Sinutitis - which was diagnosed in service and treated quite often. 2. From an injury to his neck (which was also the result of service - and he had claimed earlier and been denied because they said there was no current injury. But they DID find a SLIGHT separation of disks RIGHT AT THE SAME PLACE the C&P doctor showed had worsened - and was causing his headaches.) But the RO totally disregarded that the C&P doctor gave TWO service related causes for his headaches - and denied the claim because they weren't a "Desert Storm illness." They made the profound statement that he wasn't entitled to SC "because your headaches have been diagnosed as headaches." My husband never got his C&P reports back then. We discovered this much later when working on his cancer claim. So lesson #1 1. Get your records - and see if the doctor actually said what the VA says they said. (That would have been an EASY appeal to win - Well, yeah - they were not a Desert Storm illness - but caused by conditions apparent in service) (Of course the RO said that he had only been treated a couple times in service (untrue) for the Sinus and so it wasn't chronic - and they failed to mention that the C&P doctor had said that the condition was diagnosed as chronic IN the service by Xrays and tissue changes) 2. Don't get so stuck on one theory or one illness that you miss the ones that are there. My husband totally missed to notice (wait a minute - I had sinus problems in service - and I claimed te neck injury at discharge and they said nothing was wrong with my neck). Sometimes - even within the denials - they give you the keys to a different claim, or the same claim under a different theory of entitlement. However, the RO SHOULD have went ahead and granted it based on the C&P doc stating they were service related (but from a different CAUSE than my husband had thought.) But the RO doesn't always do what the RO SHOULD do. If the vet isn't qualified to issue medical opinions - they cannot expect them to diagnose themselves or issue an opinion on causation. The RO played the causation game with my husband, instead of acknowledging they were service related from a different cause. Free

Yep. Free helps when she is around - and then disappears - and then reappears. But I agree that so many people really stepped up to the plate - and really helped Betty so much. And I also think Betty needs to really give credit to herself. I am amazed at your skills and ability to get what you needed. Getting old records that were locked in boxes (records that were supposed to have been destroyed) - getting statements from doctors from years ago - getting the VA to actually give you valid information on your claim sometimes. Calling, writing, and calling again - calling anyone and everyone who could help you. I has been amazing. I am so happy you won your claim. But last night, after I read this - I went to bed and just started crying - for what you had to go through to get it - and how they tried to destroy you in the process. And then I was MAD! Just totally mad that they would ever DARE put you thorough that. TO them it is a game. TO you - it is your life. They dang well had all they needed long ago. Dr. Crolwey's report should not have been neccessary. The first C&P should have done it. But they decided they had to send you for one more exam. The exam where even the nurse told you strange things always seem to happen in that room. They humiliated you, they terrorized you, the lied about you, and tried to destroy you. You were strong enough to perservere - and yo became stronger and stronger. But as a citizen of the United States, I apologize on behalf of my country, that any vet should have to be put through that in order to get the benefits they so richly deserve. Free (a civilian - and a bit ashamed of my country right now)

I'm not sure how well I "know my stuff" - but I do explore the options. I think that is important in dealing with the VA - It is like tiptoeing through a mine field - where if you step one way - they have another trap waiting for you there. So I think it is important to not just read one case or regulation and think "Yeah. This fits" - but explore FARTHER down that path and see where that can take you. Otherwise - they can let you argue the wrong argument for a long time - knowing that you will lose it at the end. For instance, arguing a CUE when it is a pending claim. Instead of the VA just saying - it is a pending claim; not a CUE - here is our decision and here is your money ---- They can spend years arguing with you denying that it is a CUE. Then if you are persistent enough, and LIVE long enough - you can finally get to Court (maybe even all the way to Federal Court) to have them decide it is not a CUE, but it IS a pending claim. You get your money (I guess) after they remand it back to the BVA - but lots of years have gone by in the mean time. So I do think it is important to not just take a Regulation - Or case, but explore that farther and see where it might lead. For instance, there is a post in another thread about asking the VA to pay for an IMO - I also saw that regulation. It looked good. Wow! THEY will PAY for this. But before I moved in that direction, I looked up the BVA cases on cancer - and checked out some of the IMOs they paid for. I was not impressed enough to want to risk my husband's case on their choice. In some cases they used the people who said that Cancer's onset is the time it is diagnosed. What a bunch of *&*&(. I cannot see how they can justify that opinion - but unchallenged - it will stand. And they know if you are asking them to PAY for an IMO, you are less likely to challenge it. I imagine they do get some good IMO's just like they get some good C&P's. And by good - I don't mean favorable - as much as an adequate one. I think it is horrid that the VA has to rely on inadequate exams to be able to deny benefits. The same with IMOs. I don't trust them enough to ask them to pay for my husband's. They have already sought flimsy opinions from doctors who don't even address the issue. Asknig them to pay for one more would just give them the chance to stack their own deck so they can say 3 of a kind beats an Ace. I don't know how many errors I made in judgement on Betty's claim. I would tell her to do one thing - search a little deeper - and say NOOOOOOOOOO - Do NOT do THAT!!!!!!!! I've never seen as system as full of booby traps as the VA. They have them at every term. So I do think it is important to look 80 steps ahead and see the biggest "lay of the land" you can get - before you take off in any one direction. And I also think it is important to anticipate whatever objections they might raise - and try to address them before they use them. Hopefully, that might knowck a few years off the process (sometimes). Free

Glad to hear you had a good experience getting an IMO from the VA. I was concerned about that. We considered asking them for one - but then when I read some of the cases - I wasn't sure. I did see quite a few positive results from the Armed Forces Institute of Pathology. I think for MANY vets - if they actually get a real expert who will tell the truth - it works in the vets favor. But if they get one of their flunkies to do it - forget it. I was thinking that they are allowed to pick the agency but NOT the person who issues the opinion. Of course, if the VA is paying the agency for quite a few opinions - the agency will pick whomever keeps that money flowing sometimes. But I HAVE seen some favorable opinions - again, if they get Good doctor's and the vet really does have an SC condition...it should be easy. I have seen some where the C&P says one thing - and the vet's doctor says another - and they seek a third opinion through IMO. I am not sure why? With both opinions - if they can't decide between them - the benefit of the doubt should kick in. I contacted the Armed Forces Institute of Pathology last year - but they informed me they only take cases if referred by the VA. Free

The answer to the Personality Disorder is No. They usually do not resolve themselves - though they can improve with treatment. I am with Pete though - I think you will need an IMO. You will need a doctor to say that. If they gave you the diagnosis with no testing. And your testing does not indicate you have it - it will help with an IMO immensely. AND if you have the MHC doc putting in your notes that you were tested for PD and did not have it, and an IMO that says what you do not have it - the two support each other. (i.e. stronger case). A doctor who won't write an actual "opinion" can still be part of a strong chain of evidence. I have even seen the BVA give MUCH weight to what they do write in your favor...and remark that they find it credible because it is your medical records - and NOT an opinion. Of course the IMO you submit is going to be in your favor. But the facts that are in your medical records also HELP alot. You have one doctor who spells it out - and another doctor whose documentation supports that. Free

I wonder if we could get some stats showing that a the number of veterans entering the service just fine, and ending up leaving with "personality disorders" is so out of proportion to the incidence of personality disorders in the general population - that there must be something in the service causing these personality disorders that are SO military specific that they can only be recognized by VA doctors. Wouldn't that make a good case for making them a presumptive illness? Do it kind of like a blend between the AO presumption and the "undiagnosed illness" of Desert Storm. If you were ever in the military and end up with a personality disorder that is undiagnosed by a civilian doctor, and only apparent to the VA doctors - automatic SC. Double SC You get one SC for the personality disorder thay only appears in military related settings. And one SC for the anxiety that is secondary to your VA induced personality disorder. FREE

I typed the phrase into a search - it looks like when used by a doctor it means that the TEST RESULTS were not normal. Hope the VA knows this! ;) http://www.medhelp.org/forums/NeuroSupport...sages/1034.html EMG Conclusions: This is an abnormal study revealing the presence of the following: 1.Minimal sensory neuropathy . 2.Questionable mild S1 radiculopathy on the right side, given and absent H-reflex . http://www.medhelp.org/posts/show/364855 Impression: This is an abnormal study. Conclusion: This study is suggestive of mild C5radiculopathyand severe median neuropathy at wristconsistent with the diagnosis of carpal tunnel syndrome on right side. Further clinical correlation is advised. http://potsramblings.blogspot.com/2008_01_01_archive.html So I went into the doc's office today to discuss my tilt table results. I got a copy of the results (hell yeah! Concrete proof!) and under the section where it summarizes this called "Impression" it says: "This is an abnormal study. This is borderline evidence for postural orthostatic tachycardia syndrome. This was no orthostatic hypotension. This is borderline post ganglionic sympathetic sudomotor dysfunction as well. http://gamma.wustl.edu/division/NM-Std-Reports-10-4-06.htm FINDINGS: The 48-hour urinary excretion of Co-57 cyanocobalamin is ____% of the administered dose. Normally over 9% of the orally administered dose should be excreted in the first 48 hours. This is an abnormal study indicative of inadequate intestinal absorption of vitamin B12. If clinically indicated, a repeat examination with simultaneous administration of Co-57 cyanocobalamin and intrinsic factor would be useful to distinguish intrinsic factor deficiency (e.g., pernicious anemia) from primary intestinal malabsorption of vitamin B12.

Maybe to the VA abnormal means they couldn't find anything to twist around and deny you with... ;) Free

Awwwwwwwwwww, come on....... I heard from a very reliable source (the woman who can't find my husband's discharge physical and then said it must be because he didn't get one - though his C&P talks about his discharge physical - and then decided it must be my husband's fault because he must not have sent it to them - like he had sent the mutiple copies of his DD-214 every time they lost theirs, but the didn't send it to the BVA anyway, so it held up his claim a year) - ANYWAY - SHE said that they read EVERY SINGLE PAGE we send - COMPLETELY - and that's why it takes so long to do our claims... ;) ;) :) Free

Can you do it kind of that way - but a bit different. Keep it ALL in the NOD - but add a SUMMARY at the beginning. Like journal articles have abstracts. That way - you have the Big guns up front - but you also have EVERYTHING you WANT in the NOD. So they can top sheet it and get the important stuff right up front - but they can't later say you didn't mention something in your NOD. NODs are different than statements - and I have read cases where they fault the vet for not bringing something up in their NOD. Almost like if they didn't say it in the NOD - they didn't say it. So - though I am not real experienced with NODs (and thus do not know what I am talking about) - I am throwing out the idea to write the NOD in a way that leaves EVERYTHING in it - but summarizes it at the beginning to simplify it. I have a couple of appeals on other issues -with other agencies going on now. I went back and looked at my old drafts of appeals - and said "oh good! I DID say this or that back then." But then I look at my edited copy that I SENT (trying to shorten it for those who don't read) and think "DANG! I took THAT part out! I WISH I would have left it in." So - just a thought... been thinkin' a lot.. Free

Maybe we should send a copy to your RO - so they can read it too. The we would all be on the same page! ;) It never hurts to be prepared when dealing with scoundrels. ;) Free

If we are starting a pool to bet on what day Betty gets her letter - put me in for a $5 bet for her getting it on a SATURDAY!" Put it on my tab. My credit is good. The VA OWES me! ACKKKKKKKKKKKKKKKKKK Free

It has only been a little over a year for me - and much shorter for you (I think Berta has the most seniority on the widow list - heck! Berta was a widow before I was even married!) - and it takes time before the bittersweetness of the memories loses some of the bitter and gains more sweetness. It helps when some of the "could of done's" "Should of done's" and "wish I'd done's" fade more into the background. One moment I would be blissfully remembering a touching moment - and the next moment I would be berating myself for the time he wanted to go get ice cream and I didn't go along. How could I have MISSED that moment? Or the time I said this to him or that to him. How could I have ruined that moment? Or the times I have missed him so horribly. I do feel that he is still with me - Love doesn't die - It just changes form. But, as you know - it is not the same as them being HERE. I still love him tremendously. And I always will. At this point I would say that I am happier with his love for me and my love for him than most women I know whose husband's are still alive. (sad to say). Some people would take this as a "not good" sign. They think you should "let go - move on - live your life - yadayada" I am letting go of the pain and holding onto the love. I am moving forward (but maybe not "on"). And I am living my life - the life of a woman who was fully loved by her husband....and is happy enough in that love to not trade it in. I am not about to go find a living male to make me miserable to prove to people I am "moving on..." You also have strength and courage - I can tell. How wonderful that you put what you knew was most important first. I know what you mean by wishing to go along though. Though we did not use "til death do us part" in our wedding vows - We said "completely and forever...." (I told him he was not going to use a little inconvenience like death as an excuse to get out of the commitment ;) ) it was still so very hard to "lose" him - I remember sitting there that last day saying "You know this is kind of sucky. If there is such a thing as reincarnation - I'll let YOU go first next time... Or maybe we could just go together at the same time, in a plane crash or something... I know, 100's of people would have to die in order for us to do that - but that's their problem; not mine.." ;) And YES, your Robert DESERVES the money. And YES, he would want you to have it. I see it in post after post here - vets fighting so hard for benefits, not always for themselves, but to make sure their wives and children are taken care of. And Robert deserves it for the price he paid for serving our country. And you deserve it because Robert loved you and does not want you to have to pay any bigger of a price than you have already paid. I wish for you that this process will go smoothly for you. You have been through enough. And you deserve it. :) Free

Also - if they do the "right thing" on Betty's claim - they can pretend like they don't use these bogus discharges as often as they do. Free

I think I would stay away from the CUE on this one - at least until I knew more. Because they could turn that into a CUE hide and seek game. I was just reading the Hayre decision - http://www.ll.georgetown.edu/federal/judic...ons/98-7046.pdf This veteran claimed a CUE - and took it to Federal Court - because the VA did not get the SMRs or notify the vet that they were not recieved - prior to issuing a decision. The GOOD thing is that the Court decided that because of the VA error - that the claim was STILL PENDING and NOT final - because of the regs in effect at that time. (following court decisions have decided that this case can be applied in VERY limited circumstances - so WATCH trying to use it without a lot of research). Anyway - the Hayre case was ALSO a case that had originally been denied in 1992. So I would think - that in this instance - if Betty called it a CUE too quickly - she could spend a lot of years fighting that it WAS a CUE - and the VA would insist it was NOT a CUE (because it was actually a pending claim). Now the RIGHT thing to do in that case, would be for the VA to SAY - No it is not a CUE, it is a nonFinal decision - therefore we will pay you back to the date of filing. But what the VA - as WE know the VA - MIGHT do - is spend YEARS proving it is not an ACTUAL CUE - so that Betty could finally get to court - so that the court could say - No, it is not a Cue - it is a pending claim - and send it back to the BVA who would send it back to the RO. Years wasted arguing over words, rather than truth (which the VA has been known to do on more than one ocassion. I am not for SURE if it is a CUE or a pending claim - I lean toward pending claim. Because basically the regs say that if the SMRs are not of record - and discovered - the case has to be RE-decided - and paid back to the date of claim. And as Betty said - the BVA said the military discharged her knowing full well that she was suffering from chronic anxiety - but putting the pseudo-PD tag on her. If they put THAT in the decision - there just might be the possibility that they will pay her back to her discharge. I don't know the regs on this - but she might have a case that the one year deadline to file a claim and be paid back to date of discharge be equitably tolled - because she was intentionally misled - the military had information in it's possession - which though they didn't actually "keep" from her (as she KNEW she had been treated) - they denied her the due process of being ABLE to claim within that period - because they gave her the type of discharge that prevented her from doing so. So I think the BVA was trying to make SOME ammends for what she went through. She was traumatized in the military, choked by a doctor until she wet her pants - and when she couldn't take it - they KNEW she had chronic anxiety (CAUSED by them) and they let her out - on the condition that she accept the tag that THEY knew would prevent her from being adequately compensated for the harm they had caused. And the BVA could see how the game continued for MOST of her life - Odd that they didn't accept the first C&P in the first place - Well not odd really... But when Dr. Crowley stepped up to the plate and said "Game's over - I CAUGHT you!" - the game suddenly changed. They know that he knows - and they know that he is a doctor that provides expert testimony in court. I don't think they want him going to court in Betty's behalf - and exposing the horror she was put through - all in the name of "caring for the veteran." Again, I am not sure of the exact laws on paying all the way back to discharge. But since the VA brought that point up (about her being discharged with the wrong label when they knew fully well what she was doing) there could be a possibility that she would be paid to that time. As Dr. Crowley said - "The Game is OVER!" Maybe they will stop playing games - and start playing by their own rules - on this case. Free

Thanks TS. I will keep that in mind. In my mind - Internet sources are kind of the generic term used for not so much "unreputable" websites - but sites that do not fall into the realm of academic, scientific journals, etc. Personally, I think there is much misunderstanding about this right now. Not so much with the VA - but with most people. For instance, I teach. And many teachers get aggravated when the only research students do it online. But I think that the idea comes from a time when you DID "real" research at the library - and looked up whatever kind of information online. But that time is rapidly fading. Student no longer need to be taught that the information they find on the internet is not valid. They need to be taught to discern the valid information from the not-so-reliable information - how to look for the source of the information - and if it is a typical internet webpage - how to look for the source of where THAT information come from - and to go back to the source before deciding: 1. If the information is being presented accurately. 2. If the information is reliable. (If you get information on smoking from "IWANTTOSMOKEDANGIT.COM" - it MIGHT not be as accurate and reliable as information from a more reputable source. But it MIGHT be -- track it to the original source.) But most teachers still restrict the students to only being able to use one or two internet sources for information. I don't think that this is, in itself, bad. As students do need to get familiar with other sources. However, the time has come that the Internet has TONS of reliable information. And the time is approachig (if it is not already here) that the Internet will be THE place to FIND that information. So instead of passing on our archaic belief that information may not be reliable ONLY BECAUSE it was found on the internet - we need to start teaching students how to DISCERN how reliable the information is REGARDLESS of the source. (ALL internet info is NOT UNreliable - and ALL NON-internet sources are not necessarily reliable. But instead, many professors still express outrage at students doing research on the Net. I laugh at that one - because my husband did probably over 90% of his research for his Master's Thesis on the Internet. He mostly just needed to use his books to aply some of the theories. But we used the heck out of google scholar to find journal articles. His Thesis, by the way, was called : A Personal Journey Through a Bureaucratic Maze: The Department of Veterans' Affairs. Or: How Words and Actions are Often at Odds," Hadit, by the way, made it into his Thesis. "The idea of a routinized front, impression management, and a possible failure to perform the tasks at hand in order to maintain that impression, may apply to the VA. While the motto of the VA may be “to care,” the impression left with the author and other veterans (see “hadit.com” for examples) is that the personnel within the VA are unwilling or unable to perform the tasks they purport to perform." Anyway - the whole idea of internet sources being unreliable - is a mistaken belief - shared by many, apparently the VA. On the question of a case about internet printouts going through court - I do believe that if the BVA dismissed evidence because it was an "internet printout" - AND that case was taken to court - the veteran would prevail. Peer reviewed journal articles are peer reviewed journal articles - regardless of whether you print them at the library of off the internet. The information doesn't change with the medium. Any information that would have been found reliable had it been printed at the library would have to be reliable if printed elsewhere. §3.159 Department of Veterans Affairs assistance in developing claims: (a) Definitions. For purposes of this section, the following definitions apply: (1) Competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also mean statements conveying sound medical principles found in medical treatises. It would also include statements contained in authoritative writings such as medical and scientific articles and research reports or analyses. Regardless of the medium where these were found - the medium shouldn't matter. The Court would not make a ruling as to whether the specific article was competent - or whether it applied to the veteran's specific case - But I believe the Federal Court would rule that the BVA could not merely dismiss an article because the vet printed it on the Internet, instead of running to the library to get a hard copy of a hard copy. Then they would remand it back for the VA to find a different reason and basis for finding it unreliable. With that said - I DO agree that I would much rather have the VA accept my evidence - and let someone else have the job of taking it through the courts. However, the VA did not call our evidence Internet Printouts. They called our evidence medical treatises. I think that might be because we used lots of journal articles (peer reviewed) - and because they were each making small points and reporting common knowledge. They will NOT "Make" our case - they merely SUPPORT it. Now when we get the IMO that bases their opinion on actual MEDICALLY ACCEPTED standards - about the known growth rates of different types of cancers - it will be hard for their paid doc to rebut that - with the standard "we do don't for sure how fast any specific person's cancer grows..." Yes. You can't know the DAY it started - but there is enough known - and published in article after article - ALL of them reporting the SAME medically established standards - that you can state without speculating - that it is not very likely that a cancer that typically would have taken 15 - 17 years to grow to a certain size would have grown to that size in TWO years. The journal articles will back our IMO - and rebut their rebuttal. And I actually submitted them in anticipation of the appeal. If the VA doctor read the entire C-file - they SHOULD reconcile their opinion that there is no way to know without speculating - with all the treatesis info that says there IS a way to be reasonably assured. Their experts - even after reading the C-file - which has article after article ALL agreeing that lung cancer is MOST OFTEN asymptomatic (has NO symptoms) until it is in the LATE stages. (That is one reason it is so deadly - because by the time you know you have it - it has a LONG head start on you) - but their experts tend to IGNORE the question of when it most likely STARTED - and choose to focus on the idea that it can't be service connected because there were no symptoms experienced in the service. My husband, like MOST people, still didn't have ANY symptoms when the tumor was discovered - at 3 cm. two years post retirement. Okay. Yeah. Their doctor gives an opinion that my husband didn't have any symptoms in the service. Big deal. The VERY NATURE of lung cancer is that you will NOT have symptoms until the very end. So the lack of symptoms proves nothing. And to require someone to have symptoms for a disease that is known to be asymptomatic is AGAINST medically established standards. So if we have our IMO stating it most likely DID start in service - and their IMO that says he had no symptoms - and lots of journal articles pointing out that it is COMMON KNOWLEDGE that it is asymptomatic -- how much credibility should THEIR opinion be given? The RO might buy into it - but I don't think the BVA will. And I want to have this set up where it is granted AT LEAST on the first appeal. The reason we used so many articles was to point out the fact that this is not some obscure idea that you might find somewhere. Every peer reviewed journal article says the same thing. It is taught in medical schools. It is on traning sites. It is on the government sites. ANYONE with ANY knowledge of cancer SHOULD know the information. It is THE STANDARD for lung cancer. So if their doc issues their flimsy opinions - without so much as giving any reasons for why they are going AGAINST everything that IS KNOWN about cancer - I am HOPING the journal articles will be what pushes the case over to my favor. My doctor vs. their doctor = remand. My doctor and his PEERS (through the treatises) vs. their doctor SHOULD = granted (unless their doctor is pretty dang good at explaining away all the established medical standards.) And again - on both sides of the fence - just because you can find a couple articles to support you does NOT mean you are using ESTABLISHED medical standards. You may be using information that, though researched, has NOT been established. Just trying to set myself up for the ultimate win. Free

OMG! I bet that was so traumatic! In some ways - dying from a terminal illness brings unexpected blessings at the end. I fought so hard for my husband's life too. Day after day. Though he kept telling him he wanted everything done to save his life - the nurses kept pulling me aside and telling me I wasn't doing my husband any favors by putting him on life support. He never actually had to go on life support - but they didn't like his decision to be put on it if the time came. They kept badgering me - trying to get me to over-ride his decision. I can't see how they thought I was not doing my husband any favors. I was honoring HIS wishes - and HIS wishes were to be kept alive (as HE kept TELLING them). It was HIS life - and HIS right to MAKE THAT DECISION. They kept spouting off about "quality of life.." Who are they to determine that his life had no "quality?" Once again, that was HIS choice to make. And I honored his choice. I remember one night - after the nurses thought his life had "No quality" - we played the tape of our wedding music - and held hands and talked - and I climbed up with him in the hospital bed - and we held each other. Of course, I stayed with him in the hospital - so that night - when we went to sleep (him in the hospital bed and me in the recliner) - still holding hands - I said "No matter what tomorrow brings, I am glad we had tonight." He agreed. The next morning we said "No matter what today brings, we are glad we had yesterday." To us - every MOMENT we had together was VERY MUCH worth fighting for. The nurses didn't seem to understand why would you fight so hard to survive a few more days - if you were probably going to die anyway. I kept telling them - because it is NOT just a few more days - it is THE REST OF HIS LIFE (whatever that may be) that we are fighting for. If he has one year, one month, one week, one day, one hour, one minute LEFT - it is THE REST OF HIS LIFE - and he DESERVES to have it. I remember one nurse that came in and said "If he goes on life support - he will spend the last few days of his life unconscious. Is that a "quality" ending of life?" I said to her - If the time comes that he would HAVE to go on a respirator - that means if he did NOT go on the respirator - he would die, right? She said - "Yes." I said - so then, the last days of his life wouldn't have been spent unconscious - they would have been spent with him telling everyone that he wanted to fight for his life, and everyone telling him that it wasn't worth fighting for. Can you tell me what QUALITY ending THAT would be?" She looked at me and said "I will never mention it again." He got to come home a couple days - and then was back in ICU. I even caught one nurse in there trying to talk him out of his full code - behind my back. She was asking him "Do you want tubes stuck down your throat?" (The obvious answer to THAT question would probably be "No.") I walked in the room and asked what she was trying to do. She said she had only heard ME say he wanted everything done - but she HAD to hear HIM say it. Well - I set her straight (somewhat) on that one. SHE did NOT have to hear HIM say it. It was ON his Living Will - He had said it 7 million times to every doctor, nurse, etc that asked. But she even told his daughter that *I* kept keeping him full code - but she never heard HIM say it. She was telling me that if he did not TELL her he didn't want everything done - she would HAVE to take all measures to preserve his life. But - 1. She was going off duty - so that was an odd time to ask. 2. She was trying to trick him into giving her the answer she wanted (by the "do you want tubes stuck down your throat?" question. I confronted her about that. Though he had repeatedly told them "Yes. I want everything done." They said they had to ask again and again. But I knew if they could get him to say what they wanted to hear (NO) ONE TIME - they would NEVER ask again. So I informed her that he was NOT full code by default - he was full code by CHOICE - and we would let them know if he changed his mind, thank you. The next morning he DID change his mind. We talked - and he told me he still had the will to fight, but didn't think he had the strength any more. And he asked me if it was alright if he would go. I told him it was. He asked if I was sure I would be okay. And I told him I would. I told him, I know where you are going and I know that it is a wonderful place. And then - the part I consider the real blessing. He told me - "I'm really happy though. I'm happy that I got to marry you." And then he touched my nose - and then took my hand and put it on his heart - and let me know he carried his love for me in there. And it was like he GAVE me his heart. And I gave him MY heart to carry with him too. I was so blessed to be able to have that moment. A moment that people who have someone die in a different way never get. I will carry that with me always - to know that my husband, on the last day of his life, knowing it would be his last day said "I'm really happy though. I'm happy I got to marry you." I also believe that both Berta's husband and Kim's husband said that too. If they couldn't say it out loud - they said it in their hearts. I informed the nurses that we wanted to change my husband's status from full code to "comfort measures only." It was a bit scary for awhile - to make such a decision. But just as I honored my husband's choice to fight for his life with every fiber of my being - I honored his choice to surrender the fight equally as strong. It was his life. He was my husband. It was his choice. And I honored him. I applaud all the widows who stood by their husbands every step of the way - even when some of the steps were so damn hard. Free

Now..Now.. I don't think it exploded. I think the VA just sent it to so many C&P exams it was finally worn down to dust. Free

Woo Hoo! If they are considering you a "Special Case" (of which I fully agree) - MAYBE, just MAYBE that means they won't just breeze over the BVA decision - look to see when you re-opened the claim - and pay you back to 2004. Maybe, just maybe they will AT LEAST grant it back to 1992 (or ACTUALLY when the claim the BVA says was DENIED in 1992 was actually FILED) --or maybe even earlier. 1992 would be a GREAT START for a nice tax free chunk of money (but not NEAR enough for all the pain and suffering you experienced at the hands of the military / VA). (If you are ever traumatized again - try to get traumatized by a civilian - it pays better and is much quicker to resolve - because it is not set up in a system designed to "protect" you...ahem...) Maybe they know the really messed up on this one - so they will work a bit more diligently to try to get it semi-right. They definately know that if they try to blow you off - you do not back down. So I am keeping my fingers crossed that they "do the right thing" right off the bat. If not - I hope they "do the semi-right thing." I think awards to the time of discharge are granted if you file for SC within a year of discharge. That is something my husband misunderstood. He filed when he retired - and when he was EVENTUALLY granted SC for a couple of conditions - it went back to his discharge date - so he thought when he got ANY claim granted - it would go back to the date of discharge. Of course, like most normal humans, he didn't spend 800 hours a day reading the laws and regulations. My wish for you is that you will once again be able to join the ranks of normal humans Free

Another thing to consider is that the earlier decisions were made when the standards were different. I have seen some cases where they decided an older case was still pending, because of the standards that were in effect at that time. Free

I am not an expert on the Regs at all. I just read a lot - and keep searching trying to put together the bigger picture. That is why I suggested that she pose the effective date to the VA in more of a question format - than a declarative stance. That way - she has not STATED anything - she has merely ASKED questions... (Please help me understand this. The BVA said my SMRs were material because ___. But they were not in my record until __. I notice the law says ___. Could you tell me if YOU are going to take care of dating my claim back to ___ when I first filed but the SMRS were not of record - or am I supposed to file something for that to occur?) Another important factor is that SHE had to get the SMRs from the record center. I think if the Vet has them in their possession - and doesn't submit them - and the VA can't get them - they don't "count" for some reason (as far as earlier effective date) - I guess because the vet SHOULD have submitted them - and they were NOT available to the VA. But in Betty's case - the VA kept telling her they were not available and she FOUND them at the records center - where the VA should have gotten them from. So this case should be the same regardless of WHO got them from the record center. They WERE in the possession of a government agency. She was TOLD they didn't EXIST. She FOUND that they DID - and she got them in her claim file. Who knows how many copies they shredded before SHE let them know she was aware they existed. Free

TS- VERY good point about waiting to see what rules really apply. Did you notice how you read one rule and another rule counters THAT rule, until it becomes a virtual mine field where you have to watch EVERY step - because ONE misstep can land you on a mine - or take you to a minefield 10 steps down the road. But I think Betty is pretty good at looking before she leaps She just doesn't seem to trust the VA. ACK!!!!!!! I wonder why.(Duh..) Isn't it horrid that even in the celebration of her victory - we have to worry about "okay, how are they going to mess this up now?" Free

We didn't go get the printed article - but instead of saying we got the article at www.com - we reported it as: In fact the article Rapidly growing small peripheral lung cancers detected by screening CT: correlation between radiological appearance and pathological features (The British Journal of Radiology, 73 (2000), 930±937, Wang, et. al) reports: Of course - we haven't won the case yet either - ACK! We also did not use the WHOLE article - but gave enough of an EXCERPT to prove the point. But of course, we were proving pretty simple points. For instance - one point is that lung cancer is most often asymptomatic until it's later stages. That is SO well known - and reported in SO many places - we gave them several reputable sources that said it - and a BIT of the article - rather than gave them the WHOLE articles. Another word of warning is to read the WHOLE article - don't just take a little part out of context. I've seen quite a few cases where people's own articles were held AGAINST them at the BVA. The BVA would say - THey submitted an article that said blah, blah, blah. And at first look it would seem the article supports their claim. But on further reading the article also says ___ and ____ and blank___ - and dang if the BVA doesn't use the claimant's OWN article AGAINST them. So I would read EVERYTHING in the article we were sending - and if ANYTHING was IN that article that looked like it could be TWISTED BACK AROUND AGAINST my husband's claim - we didn't use the article. We just searched until we found enough info that supported the claim - that didn't include something that could be twisted. Our problem was my husband having lung cancer and being a smoker. SO MANY articles have that line that says MOST cancer is caused by smoking. We weren't about to send them tons of articles where they could disregard the point we were making - and focus on the ONE LINE about smoking. Gotta watch your back - real careful like... Free

TS - Not that I know of. I sure hope one does though - because it seems to be a way for the VA to act like you got your evidence from a cereal box or something. There is NOTHING wrong with using Internet sources for reputable evidence. Unfortunately, as anyone can put anything on the internet - just because something is printed, doesn't mean it is true. However, information from reputable sources does NOT lose it's reputable status just because it is available on the Internet. My husband and I got MANY of our articles off the internet - but they are STILL peer reviewed journal articles, government traning manuals, military standards, etc. They would also be available in print - we just happened to get them from the Internet. We used Google Scholar a lot - because that leads you to more actual peer reviewed journal articles. Websites we used were FDA, National Cancer Institute, some of the top medical schools, etc. With my husband's first appeal - he just typed in a search and printed whatever he could find - but nothing from what I would considered entirely reputable sources. Look for sources they can't just dismiss. As long as they are actual Journal articles - you don't actually have to state that you found the journal on the Internet - Just list the journal -- If the journal or author has something that makes it VERY credible - list that too. Here is a PORTION of some of the Sources we used - and How we cited them in his argument: Information from U.S. Preventive Services Task Force. Guide to Clinical Preventive Services, published in the Columbia University Medical Center’s Guide to Clinical Preventive Services, Second Edition, Neoplastic Diseases Screening for Lung Cancer states____ An article ZD1839 (IressaTM) in Non-Small Cell Lung Cancer (The Oncologist, Vol. 7, Suppl 4, 9-15, August 15, 2002) reports___ The article A Systematic Review and Lessons Learned From Early Lung Cancer Detection Trials Using Low-Dose Computed Tomography of the Chest, (Cancer Control 10(4):306-314, 2003), H. Lee Moffitt Cancer Center and Research Institute, Inc., Bepler, et. al.) states Excerpts from the AMERICAN CANCER SOCIETY FACT SHEETS (http://www.cancer.org/docroot/home/index.asp) include: Excerpt from Case Western Reserve University School of Medicine’s Electronic Curriculum - Pathology of Lung Cancer (http://mediswww.meds.cwru.edu/ ecSample/yeartwo/pulmonary/carcinoma.html): The article On the Growth Rates of Human Malignant Tumors: Implications for Medical Decision Making (Journal of Surgical Oncology,1997;65:284–297,Friberg & Mattson) states: In the article Reducing Lung Cancer Risk* : Early Detection (Chest – The Cardiopulmonary and Critical Care Journal for Pulmonologists, Cardiologists, Cardiothoractic Surgeons, Critical Care Physicians, and Related Specialists - 1999;116;493-496) the author states: Screening, Early Detection, and Early Intervention Strategies for Lung Cancer (Cancer Control: Journal of the Moffitt Cancer Center, Vol 2, No. 6, November/December 1995) reports: The article Management of solitary pulmonary nodules: How to decide when resection is required (POSTGRADUATE MEDICINE, VOL 101 / NO 3 / MARCH 1997, Glen A. Lillington, MD) reports, The article Volumetric Growth Rate of Stage I Lung Cancer prior to Treatment: Serial CT Scanning (Radiology 2002;223:798-805 Winer-Muram, et al., from the Department of Radiology, Indiana University School of Medicine, Indianapolis; and the Department of Radiology, Richard L. Roudebush, Veterans Administration Medical Center, Indianapolis, IN) reports: The following excerpts from the FDA (Food and Drug Administration) Briefing Document for NDA 21-399 (Documents reviewed EDR Submissions) substantiates that adenocarcinoma has the slowest doubling time of all lung cancers. The article Innovative molecular and imaging approaches for the detection of lung cancer and its precursor lesions (Oncogene 7 October 2002, Volume 21, Number 45, Pages 6949-6959 Annette McWilliams, et. al.) reports: ADENOCARCINOMA - DOUBLING TIME 180 DAYS From the National Cancer Institute SEERS site: (http://www.seer.cancer.gov/) “The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI) is an authoritative source of information on cancer incidence and survival in the United States…The SEER Program is considered the standard for quality among cancer registries around the world. Quality control has been an integral part of SEER since its inception. Every year, studies are conducted in SEER areas to evaluate the quality and completeness of the data being reported.” The National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program Web Based Training Modules (http://www.training.seer.cancer.gov/) reports: These medically established standards are also taught as sound medical principles in Universities, as evidenced by: From the Electronic Curriculum of Salisbury University: Cancer of the Lung Robert L. Joyner, Jr., PhD, RRT Associate Professor and Chair Department of Health Sciences Director, Respiratory Therapy Program Salisbury University --- Maybe that is why they CALLED our info Treatises - rather than "Internet printouts" - I don't know. Notice how we didn't just list the SEERS site - we included the part that is ON the site that tells how it is THE authoritive source for cancer statistics. There ARE quite a bit of rulings that discuss how treatises can be used to SUPPORT a medical opinion. So if you have an opinion from a doctor - and the doctor didn't back it solid with reasons - you CAN use the journal articles to SUPPORT HIS opinion - at least the BVA acknowleges it - (My doctor said ____. This is supported by ___, and ___. Free