free_spirit_etc

I am not seeing any way around this two year requirement. So I guess the thing to do is that if the veteran had a claim for SC pending at the time of his / her death, it would be best to go ahead and apply for the insurance within the two year time frame, even if SC hasn't been granted yet. It is ironic that it looks like you still must show the veteran was incompetent at some point before their death - as a reason they didn't apply. They didn't apply because they did not have SC yet. It isn't easy to find out a lot of information about this. I guess it is a well kept secret. http://www.benefits.va.gov/INSURANCE/docs/2014_VALifeBook.pdf Application For Gratuitous S-DVI Benefits VA must receive an application for payment of Gratuitous S-DVI within two years from the date of the Veteran’s death. However, if the person making the claim is mentally or legally incompetent at the time the right to apply for Gratuitous S-DVI expires, they may apply within one year after their incompetency ends. Payment Of Gratuitous S-DVI Gratuitous S-DVI is granted in an amount that, together with any other United States Government Life Insurance or National Service Life Insurance in force, totals $10,000. Gratuitous S-DVI is payable to the beneficiary only as a lump sum payment.

That's great on getting some movement from Chicago! It wouldn't surprise me if there are some records missing. They lost some of my husband's. I had to send in the burial claim several times.

Classic!!!!

There is a Court case here http://search.uscourts.cavc.gov/isysquery/2b823686-e861-4d32-b187-21bbf3834544/1/doc/ and a BVA case here http://www.va.gov/vetapp10/Files1/1004323.txt on the issue of probable lung cancer diagnosis. On the BVA case, they are saying that probable is not a definitive diagnosis - and, in fact, once stated it is not an "actual" diagnosis. On the court case, they did say that the claimant was entitled to the benefit of the doubt on whether the veteran had lung cancer, but then they upheld the BVA on saying it couldn't be determined if it was primary or metastatic. What is odd is that the physician asked on the remand said it was not possible to tell without a biopsy or autopsy. But he said it was at least as likely as not that it was metastatic. That would follow that it was at least as likely as not that it wasn't. I am not seeing any mention of the widow submitting an independent opinion in that case. I need to go over these again when I have a little more time to dig. They aren't real promising, but you have to look at all sides of the issue to make the best case that you can.

I am so happy for you!!! One more for the good guys!

Okay -- Here is the case I saw that gives more information about it. In this case, the widow lost the appeal in getting the supplemental insurance, but she was granted the initial policy. The veteran didn't apply during his lifetime, as they didn't receive the decision on his pancreatic cancer until a couple days after he died. The decision was made before he died though. What seems odd about this case is that it says that the veteran's doctor wrote a letter to the VA about his pancreatic cancer, and the next day they granted him 100% for the cancer. The next day? It doesn't seem like any RO I know. Anyway -- as far as the law on the life insurance, the case states: "The Court holds that in accordance with the plain language of the statute, the grant of insurance under 38 U.S.C. § 1922(b) is treated, by operation of law, as an award under 38 U.S.C. § 1922(a)." And this looks like the factor that met the standard of not competent: On February 22, 2006, the veteran died from his pancreatic cancer. R. at 53. According to the appellant, she did not receive the rating decision in the mail until "four or five days" after the veteran's death. R. at 19. A triage nurse at the veteran's hospice later explained that the veteran was "unable to conduct his daily affairs in the last few days of his life due to high doses of medication." R. at 96." And it goes on to state: "In March 2006, the RO sent the appellant a letter explaining that they were unable to accept her application for S-DVI because it had to be "signed by the veteran and received by the VA Insurance Service before the veteran's death." R. at 315. In April 2006, the RO determined that the veteran's cause of death was service connected. R. at 112-15. On June 30, 2006, the RO awarded the appellant gratuitous S-DVI under 38 U.S.C. § 1922(b).2 R. at 92-95. In its decision, the RO found that the veteran had been mentally incompetent at death as a result of his service-connected disability and that this prevented him from applying for S-DVI. Id." I don't know if it matters in the case that the SC was granted during the veteran's lifetime. But it does seem to take SC granted after death in account: The law 38 U.S.C. § 1922(b) specifically states: "(b) (1) Any person who, on or after April 25, 1951, was otherwise qualified for insurance under the provisions of section 620 of the National Service Life Insurance Act of 1940, or under subsection (a) of this section, but who did not apply for such insurance and who is shown by evidence satisfactory to the Secretary (A) to have been mentally incompetent from a service-connected disability, (i) at the time of release from active service, or (ii) during any part of the two-year period from the date the service connection of a disability is first determined by the Secretary, or (iii) after release from active service but is not rated service-connected disabled by the Secretary until after death; and (B) to have remained continuously so mentally incompetent until date of death; and © to have died before the appointment of a guardian, or within two years after the appointment of a guardian; shall be deemed to have applied for and to have been granted such insurance, as of the date of death, in an amount which, together with any other United States Government or National Service life insurance in force, shall aggregate $10,000. The date to be used for determining whether such person was insurable according to the standards of good health established by the Secretary, except for the service-connected disability, shall be the date of release from active service or the date the person became mentally incompetent, whichever is the later. But 3 states: (3) "No application for insurance payments under this subsection shall be valid unless filed with the Secretary within two years after the date of death of the insured" or before January 1, 1961, whichever is the later, and the relationship of the applicant shall be proved as of the date of death of the insured by evidence satisfactory to the Secretary. Persons shown by evidence satisfactory to the Secretary to have been mentally or legally incompetent at the time the right to apply for death benefits expires, may make such application at any time within one year after the removal of such disability. So there is a provision that someone who is mentally incompetent can have additional time -- up to one year after the disability it removed. But otherwise, it looks like there is a two year limit. But then, this footnote in the case http://www.veteranslawlibrary.com/files/CAVC_cases/2014/Martin_11-3814.pdfstates "See http://benefits.va.gov/insurance/s-dvi.asp(last visited Feb. 11, 2014). 1922(b) provides that "[a]ny person who . . . was otherwise qualified for insurance under . . . subsection (a) of this section," but who is found to have been mentally incompetent from a serviceconnected disability at the time of his or her death, "shall be deemed to have applied for and to have been granted such insurance, as of the date of death." (which I also underlined in the regulations). So that is a bit puzzling. If they are deemed to have applied and been granted benefits, does that meet the two year requirement? I am not sure because #3 is talking about applying for insurance payments. I apologize if I am entering confusing information in the thread that is supposed to be giving survivors an overview of what to do. I can edit the posts if I am muddying up the thread. But I am trying to get clear on this issue, and also think it is an issue that might effect other widows / widowers.

I am throwing this out there without having all the information to post, in case someone is reading this who is still within the time frame. I had a bunch of information pulled up and then had to reboot my computer. I have been puzzled about the disabled veteran's life insurance. How do you apply if you die before SC is granted? It would seem like once SC is granted, the widow would be able to file, under the provisions where you can be deemed to have applied as of the date of death. But in researching this it looks like -- even if you couldn't apply because you weren't SCed yet, there still needs to be a showing that you were at some point not competent for 38 U.S. Code § 1922 (b) to apply. http://www.law.cornell.edu/uscode/text/38/1922 It seems like that provision can be met even with a doctor's statement that immediately prior to your death you were not capable of managing your affairs because of the illness or medication. BUT -- what I am also running across is that it looks like the widow has to apply within two years after your death, even if SC has not been granted for the condition / death yet. They don't seem to have any provision to file after SC has been granted, if it was granted more than 2 years after the veteran's death. The VA is also not obligated to tell the widow she may be eligible. So what I am finding is that if the veteran does not have the insurance, and dies before receiving SC for the condition, the widow needs to file a claim within two years, even if SC has not been granted yet. I read a BVA case where a widow appealed a Gratuitous Service-Disabled Veterans Insurance claim, and the BVA stated it was inextricably intertwined with the accrued benefits claim and remanded it until the accrued benefits claim was adjudicated. http://www.va.gov/vetapp10/Files4/1039840.txt So I think I missed this one. I didn't realize I could apply until Service Connection was granted. Unfortunately, it took the VA almost 8 years to grant that. So I am not seeing where I can meet the two year deadline. If this is true, we need to add filing for Gratuitous Service-Disabled Veterans Insurance (S-DVI) (ARH) within two years of the veteran's death, regardless of whether SC has been granted yet, to the list of thing widows might need to do. http://www.benefits.gov/benefits/benefit-details/4757

You will want to write a a specific Notice of Disagreement, listing specific reasons you disagree with their decision, and spelling out the evidence for your claim (i.e. connect the dots for them). As far as "so I'm getting the pulmonologist (lung cancer specialist) who diagnosed my husband to write an evidence-based opinion that "probable lung cancer" was "more likely than not" lung cancer and why it couldn't be biopsied for 100% certainty. I'm also asking her to provide evidence-based medical research and her opinion supporting lung cancer contributing to death." Why she diagnosed it as probable lung cancer is probably more important than why it couldn't be biopsied for 100% certainty. Though why it could not be biopsied might be relevant, it is not as important to getting your claim approved as why she diagnosed it as lung cancer. The important part is "Based on x, y, and z medical evidence it was determined that the ___ was most likely primary lung cancer. I am not sure of your relationship with this doctor, but if she would be willing to provide you with a provisional statement, and write a more complete statement once you can get some feedback on what else might be needed for the VA (after we have seen what she has written) that would be wonderful! It is also great that she is willing to include a statement on how the lung cancer contributed to his death. I know there are some guidelines for that too, where it needs to be shown that it was a significant contribution, and not just a contributing factor. The fact that the Death Certificate actually stated that should be strong evidence. The Death Certificate is a legal document. They should be considered strong evidence. But having a statement that backs that would always help. It is always best to make the evidence as strong as you can, not just as strong as you think is needed. VA claims are not a place to walk the fine line --- get as far above the line as you can and so they have more trouble twisting things around. If possible, it is good to look for places they will argue, and try to head that off by answering the objection before they can make it. I think that objection in your claim is the use of the word "probable" that they have changed to "possible." Unfortunately, once the RO has made an objection, they generally just keep repeating the same phrase, regardless of the amount of evidence they receive. So it is possible you won't get this resolved until the BVA. But hopefully, you can get it resolved sooner. Can I ask? Is the doctor who diagnosed the lung cancer also the attending physician who signed the Death Certificate? Or did a different doctor sign it? If so, that is another doctor who confirmed the probable lung cancer.

Atomic Widow In writing your NOD, you will want to address the errors the RO made (such as changing the diagnosis - i.e. disregarding the doctor's diagnosis and substituting their own medical judgement). And you will want to spell out the evidence that supports your claim (i.e. clearly connect the dots for them). It can also help to point out relevant sections of law. I am attaching one of my arguments I sent to the BVA as an example. Well dang... I don't see where to attach it -- so I will paste it in here for the moment: DIC CLAIM LUNG CANCER IN-SERVICE ONSET ARGUMENT 1. My husband was diagnosed with lung cancer, and had a 3.1 cm tumor removed, within a short time after his retirement from a 28-year career in the Air Force. He later died from the disease. 2. §3.303(d) clearly states “Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.” 3. Competent medical evidence in the record is sufficient to establish it is more likely than not that my husband’s lung cancer had its inception during service, and thus was incurred coincident with his service in the Armed Forces. § 3.303 (a) 4. Two independent medical opinions were submitted at the September 3, 2013 Board Hearing. Both opinions are well-articulated and based on pertinent evidence in the medical records. Both opinions were written by specialists who are Board Certified in their respective fields in oncology. Both specialists have the requisite knowledge and experience to opine on the medical issues involved in the claim. Additionally, one of the specialists, Dr. xxxx, reported his experience doing bench research analyzing cell survival curves / growth rates. 5. Both specialists clearly stated that it is more likely than not that my husband’s lung cancer had its onset while he was serving in the Air Force. Their conclusions were based, in part, on the size of my husband’s tumor when it was surgically removed in 2000, the standard established growth rate of my husband’s type of cancer, the actual reported growth rate of my husband’s tumor prior to the start of his chemotherapy, the amount of time it took for my husband’s cancer to once again become detectable by CT and PET scans after his September 2000 surgery, the relatively small size of my husband’s recurrent tumor three years post-surgery, and the fact that it took a significant amount of time for his cancer to become lethal. 6. There is no medical opinion, nor medical evidence in the record, that directly conflicts with the recently submitted medical opinions. 7. Though the Supplemental Statement of Case noted my husband’s 1996 chest x-ray did not show evidence of cancer, both specialists pointed out that it takes a significant amount of time for a tumor to become detectable by x-ray. Dr. xxxx, a radiation oncologist, also pointed out that chest x-rays are known to miss the majority of lung cancers for most of the tumor’s lifespan. Dr. xxxx also indicated that my husband’s tumor would most likley have been discovered prior to his 1998 retirement if a more sensitive instrument would have been used for detection. 8. The Supplemental Statement of Case states the October 2007 VA examiner’s opinion indicated none of my husband’s respiratory problems in service can be linked to the development of adenocarcinoma of the lung. However, the examiner only discussed whether the signs and symptoms of respiratory problems noted in the SMRs could be considered an early manifestation of lung cancer. He did not, as the SSOC stated, opine on whether they could be linked to the development of lung cancer. 9. Additionally, the VA examiner limited the scope of his discussion to only the viral respiratory illness my husband was treated for, and did not discuss the non-viral illnesses diagnosed in service, such as his chronic bronchitis. 10. Most importantly, the VA examiner did not actually refute our claim that my husband’s cancer had its onset in service. 11. The VA examiner documented that he reviewed the C-file. There was ample evidence in the C-file supporting our claim that my husband’s cancer had its onset while he was in the service, including Dr. xxxxx handwritten note, Dr. xxxx June 2006 letter, my husband’s statements, and a wealth of supplemental evidence from medical treatises and journals. 12. The VA examiner did not refute any of this evidence. He merely opined that the signs and symptoms of my husband’s viral respiratory illnesses treated in service could not reasonably be linked to an early manifestation of his lung cancer. 13. §3.303(d) does not require an illness to be diagnosed or treated in service in order to establish service connection. In fact, it specifically addresses post-service initial diagnosis of disease. 14. My husband submitted evidence indicating lung cancer is most often considered asymptomatic until late in its development. The evidence was from the U.S. National Cancer Institute's Surveillance, Epidemiology and End Results Program SEER's Training Modules, U.S. Preventive Services Task Force Guide to Clinical Preventive Services, the American Cancer Society, as well as excerpts from articles in peer reviewed medical journals. (Both recently submitted independent medical opinions further substantiate this information.) 15. As evidence in the record reported the asymptomatic nature of lung cancer in its early stages, the VA examiner’s October 2007 opinion does not conflict with the evidence we submitted in support of the claim. Though the VA examiner did not address this well-established medical principle when opining whether my husband’s viral respiratory illness could be early manifestations of lung cancer, he also did not indicate that lung cancer requires obvious respiratory symptoms in order to be present, nor provide any rationale to support such a conclusion. He merely opined that my husband’s viral respiratory illnesses were less likely than not early manifestations of lung cancer. 16. Though the Supplemental Statement of Case stated there is no statement from Dr. xxxx in the file which suggests that my husband’s cancer was present during service, my husband submitted the handwritten note from Dr. xxxx when he filed his initial claim for lung cancer. 17. The handwritten note from Dr. xxxx noted the doubling times of various types of cancer, starred (*) the “Adeno CA,” noted it was 3.1 cm, and noted DT (doubling time) 6 months. He additionally noted “15 yrs till 1 cm.” then noted several more sizes, and then noted “3.25 ß 35.” 18. The 6 month doubling time was further substantiated by the June 27, 2006 letter from Dr. xxxx, who stated that it is accepted as a standard in the field that my husband’s type of cancer has a mean doubling rate of 180 days. 19. Though Dr. xxxxx handwritten note was not a fully-articulated opinion, we submitted a wealth of supporting evidence to show that Dr. xxxxx notations were based on sound medical principles. §3.159 (a) indicates statements conveying sound medical principals found in medical treatises and authoritative writings can be considered competent medical evidence. The Court has held that treatises “can provide important support when combined with the opinion of a medical professional.” (Sacks v. West, 1998). 20. Considering the fact my husband had a 3.1 cm tumor removed 2 years post-retirement, his treating physician noting that it would take this type of cancer 15 years to reach the size of 1 cm certainly suggests that my husband’s cancer was present in service. The two recently submitted medical opinions further substantiate this. 21. The Regional Office was in error to use the October 2007 VA examiner’s opinion as a basis for denying the claim. There was no evidence in the record to suggest that my husband’s cancer grew at a different rate or otherwise fell outside the standard development timeline noted by Dr. xxx and Dr. xxxi, and established in the medical treatises. 22. Additionally, as the Regional Office was aware of the fact that my husband’s discharge physical has disappeared from his file (due to my repeated requests that they look for it), they had a heightened duty to consider the applicability of the benefit of the doubt, to assist in developing the claim, and to evaluate and discuss the evidence favorable to the claimant. See O'Hare v. Derwinski, 1 Vet. App. 365 (1991). 23. The only competent medical evidence in the record that specifically addresses whether it is more likely than not my husband’s cancer had its onset in service clearly establishes that it did. 24. The VA has obtained two VA medical opinions concerning the claim. Neither VA examiner actually refuted the assertion that my husband’s cancer had its onset in service, nor provided any sound medical reasoning for doing so. 25. As there is substantial competent medical evidence establishing my husband’s lung cancer had its onset in service, and no competent medical evidence that actually conflicts with this, I believe that the probative evidence is in favor of the claim. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003) (“The Court has cautioned VA against seeking an additional medical opinion where favorable evidence in the record is unrefuted…).” 26. Entitlement to service connection based on doubling time and / or growth rates of cancer is not uncommon. Service connection has been granted on this basis in various claims. (See BVA Citation Nr: 0932955, BVA Citation Nr: 1132635, BVA Citation Nr: 0202424, BVA Citation Nr: 0905201, BVA Citation Nr: 0022373, BVA Citation Nr: 0521737, BVA Citation Nr: 1308760). A non-precedential decision may be cited "for any persuasiveness or reasoning it contains." See Bethea v. Derwinski, 252, 254 (1992). 27. §3.303(d) also states, “Presumptive periods are not intended to limit service connection to diseases so diagnosed when the evidence warrants direct service connection. The presumptive provisions of the statute and Department of Veterans Affairs regulations implementing them are intended as liberalizations applicable when the evidence would not warrant service connection without their aid.” 28. M21-1MR, Part IV, Subpart ii, Chapter 2, Section B, 3 c. clearly states “Consider whether direct service connection may be established under 38 CFR 3.303(d), even if service connection is claimed for a disease diagnosed after service has ended. Service connection may be granted for a disease diagnosed after discharge when all the evidence establishes that the disease was incurred in service. Do not attempt to establish presumptive service connection for chronic or tropical diseases until the possibility of establishing direct service connection has been ruled out.” 29. When the evidence is in relative equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The preponderance of the evidence must weigh against a claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996). 30. I believe that we have established that it is more likely than not that my husband’s cancer had its inception during the time that he was serving in the Air Force. I respectfully request that service connection be granted for his illness and his death. Respectfully submitted, xxx

http://www.va.gov/vetapp04/files4/0431865.txt https://veteranclaims.wordpress.com/2009/03/21/cue-liberal-reading-chisem-v-principi-no-90-1540/

This explains that a lung cancer diagnosis is lung cancer; not another cancer that has spread to the lung. So the ROs statement "We have not received information that lung cancer is direct site" is a bit untrue. The doctors called it lung cancer. That equals direct site. National Cancer Institute: http://www.cancer.gov/cancertopics/pdq/treatment/laryngeal/Patient/page2

http://www.ca4.uscourts.gov/Opinions/Published/991622.P.pdf

Illegitimi non carborundum

The inability to sit for long periods of time can be equally important in determining employability, as it severely limits the types of sedentary jobs a person can do. You can read more about the sit / stand option (and how it relates to SSA) here http://www.ssas.com/selected-issue-topic-sequential-evaluation-process/residual-functional-capacity-and-sit-stand-option/ Basically, they would have to say that there have to be jobs available that allow you to sit or stand at will. If you actually have to lay down between periods of sitting, it is very unlikely that you will find a job that will allow you to sit, stand AND lay down at will. And if I recall correctly, the back condition (which I would think would be the condition in play here) is SCed.

I know you are looking for doctors in your area. This guy is a bit far from you, and I don't know much about him. But he might be able to help. http://www.ellisclinic.com/ Maybe some folks here have had some experience with him.

Not necessarily. Social Security's decision would be based on whether all your disabilities combined prevent you from working, while the VA will consider the SC disabilities. I didn't get from the C&Ps that the doctor was saying the conditions prevented you from working, but that they impacted the types of work you could do. That was one of the reasons I asked if you also had problems with prolonged sitting. I know the C&P stated you had trouble with prolonged walking, and lifting and bending. But a lot of people with back conditions also have trouble sitting for substantial periods - which also rules out many sedentary jobs that someone who is merely unable to walk or stand for long periods can do. Hopefully you can get a good IMO that can connect the left side conditions to the right side conditions. Maybe you could ask the rater to drag his right side around for about 30 years and see if it doesn't affect his left side.

I thought that too, but I ran across this website http://www.veteranslaw.com/content/total-disability-individual-unemployability-tdiuthat said So getting TDIU might not be easy without the 60 or 70 percent service connection -- but it might be possible.

Anyway -- Atomic Widow -- I think the word "probable" will be your key issue to overcome. I have done a little research on the BVA site and found a couple of claims that were denied because the BVA said the individual had a probable diagnosis, and not a definitive one. And I have seen remands where the VA was asking for an opinion on the probable diagnosis. I think you actually can win your claim, but it might not be a walk-in; especially if you are working with an RO that is changing the word probable to possible. It shows intent to deny the claim regardless of whether the claim has merit. I know you were asking about Champva benefits, so I know you would like to the get the claim granted sooner rather than later. In my own case, I stopped expecting the claim to be granted at the RO level. I just started preparing for the BVA. I didn't even submit my IMOs to the RO to consider. When I submitted them, I waived the right to have the RO review them. For one thing, I didn't think the chances were great that they would approve the claim anyway -- and then I would have to wait in line all over again for the review and the hearing. For another thing, I didn't trust that they wouldn't find a doctor who would once again pretend to address the issue, while not addressing it, but write a more extensive opinion for them to deny the claim. So I just let them play their hand first and waited. I was done arguing at that level. They played their high card -- and then I went to the BVA a played my hand. My full house beat their high card. I had strong IMOs that actually discussed the evidence and addressed the issue, and they only had hastily written, weak medical opinions that didn't even address the issue at point. In your case, you might have a chance at the RO. You definitely need to mention in your appeal that the RO changed the word probable to possible. But I think you also need to research claims with probable diagnoses. I can help some in my spare time (which I seem to have little of). What I see as positive in your case is your mention that the medical records list both cancers as primary sites. I think that is strong because it isn't like someone coming in after the fact saying your husband probably had lung cancer. It was noted by his treating physician at the time they were treating him that not only did he most likely have lung cancer, they had enough evidence to determine it was a separate cancer, and not merely metastasized. It is also listed on the death certificate. Once again, that shows the doctors considered it to be a likely diagnosis that contributed to his death. Building the argument will most likely involve building a case that a probable diagnoses meets the "more likely than not" standard, and fighting their tendency to try to say that a definitive diagnosis is required in order to meet the standard for a presumptive illness. Again, I am not entirely clear on this -- but I am sure we can find out with a bit of research. Any medical evidence your doctor has as to why they determined your husband had probable lung cancer will be helpful, as it can strengthen the case, by showing the diagnosis was based on medical evidence. It seems very common for the VA to try to question primary sites for cancer. To me, that is a tendency to substitute their own opinion for a medical opinion. Cancer usually carries the name of the site where it originated; not the site where it is found. So larynx cancer that has spread to the lung is not called lung cancer. It is called larynx cancer. If a cancer is diagnosed as lung cancer, that generally means it originated in the lung. So what the VA should need to know that the lung cancer is a primary site is the fact that the doctor called it lung cancer. Hang in there! We'll keep working on it!

And I think this is one thing Bob needs to address - the underhanded way they twist things around in order to deny a claim. If the VA has to twist the facts and lie in order to deny the claim - the claim should have been granted. If a claim does not have merit - the VA can deny it without twisting the facts and lying.

Berta, One thing that really gets me is that they not only won't help and they tell you that you don't have a chance -- they treat you like you are stupid. Everyone kept telling me the cancer needed to be listed in my husband's SMRs, or he needed boots on the ground -- and they kept treating me as if I were stupid to think differently. But taking the information my husband's doctor gave us about the doubling time of his kind of cancer, I started researching. When I typed doubling time and cancer into the Search Decisions box at the BVA site, I kept finding "claim granted" " on many of the decisions. Most of the claims based on that theory, that had solid IMOs, were granted. The claims that were denied, most often did not have IMOs or had very weak, speculative ones. However, a few claims were granted because the VA doctor had the honesty to say, "Yes. It most likely started in service." But still, most people kept trying to tell me I didn't have a case. They could not get out their "It has to be presumptive or diagnosed in service" mind set despite the fact that VA law specifically addresses initial post-service diagnosis of disease. Even at the hearing -- the guy working at the desk asked why I didn't have a VSO. I told him because everyone kept telling me I didn't have a case, despite the fact I had a very strong case. Then I got the "Poor thing. She doesn't even realize she doesn't have a case..." type response. Then he proceeded to get me a VSO to purportedly "help," though the only thing the VSO did was treated me like I was stupid and had no idea what I was talking about. I am glad I had a good judge. I finally found someone in the system that understood exactly what I was talking about and at least treated me with respect. The worst part wasn't even having to fight the claim with the faction of the VA that works to twist your claim around and so they can continually deny it (because they aren't even considering the actual claim as it stands). The worst part was being treated with such utter disrespect by those who pretend they are there to help. The way the VA treated me throughout the years of pretending to adjudicate my claim inspired me to hang in there and not give up the fight. If they were going to deny it, I was bound and determined they would face it head-on and deny it on its actual merits, instead of with their word games of twisting everything around so they could pretend they were actually adjudicating the claim. But the way the way the folks that are supposed to be helping the veterans with their claims treated me reduced me to tears several times.

Atomic Widow -- The previous post includes a portion of my actual BVA decision. That is why I tell you to hang in there and not give up. Berta, and some of the hadit folks offered me a lot of support and encouragement in my claim. But many people told me I would not win. In fact, I even got so tired of the VA "stuff" I tried to find an attorney to represent me. The attorney I contacted told me that if my husband's cancer was not diagnosed in service, and he didn't have boots on the ground in Vietnam, that I was not entitled to benefits. Notice, they didn't tell me the claim might be hard to win; they told me I was not "entitled." The law about post-service diagnosis of disease, and my research of BVA decisions told me different. (And keep in mind my husband didn't even file a claim for his lung cancer until a year after his diagnosis when the treating physician told him it had started long before he retired from the service.) But even the VSO that stepped in to represent me at the BVA hearing (who I subsequently fired) called my IMOs (that helped me win the claim) "theories written by people who had not seen my husband." ( see )He told me the judge didn't have to accept them, and I actually had to argue with the guy as to whether I could present them at the hearing or not. But I hung in there -- and I honored my husband by finishing the fight he had started. Well.. actually.. my husband didn't "start" the fight. He filed a legitimate claim with the VA. The VA twisted things around and started the actual fight.

Always pay attention to things they fail to mention and places they twist the words around. This often can give you information on where to focus to win the claim. Since a probable diagnosis is a "most likely" diagnosis, they morphed it into "possible" making it easier to deny the claim. In my husband's claim - we presented two theories of entitlement: 1. That his cancer started while he was in service. 2. That his in service asbestos exposure contributed to the development of his lung cancer. The very first letter from the VA acknowledged the claim was for lung cancer, to include from asbestos exposure. After that they morphed it into "lung cancer due to asbestos exposure." Though that was a slight change, it effectively allowed them to side step the issue of whether my husband's cancer started in service because they pretended my husband's claim was only about the asbestos exposure. I believe that if they could have relied on a VA doctor to say that it was more likely than not that the cancer did not start in service they would have acknowledged that part of the claim. Since it would be hard for a doctor to state that, based on the medical evidence, they just twisted the claim and ignored that part. Even when they finally acknowledged that the claim included our assertion that the cancer began in service (after my husband's death), and they pretended to address the issue, the VA doctor still did not address the issue. He did not offer an opinion as to when the cancer most likely started. He merely stated that most of the treatment in my husband's SMRs was for viral respiratory conditions, and it was less likely than not that those were early manifestations of lung cancer. Luckily, the BVA did not play into that game, and they afforded the VA medical opinions less probative weight, specifically stating: "In consideration of the opinions of the two private oncologists, both of whom opined that the Veteran's fatal lung cancer "certainly" began in service, the Board has determined that the Veteran's lung cancer likely began on active duty and that service connection for the cause of his death is thus warranted. In so finding, the Board accepts the private oncologists' opinions as being the most probative medical evidence on the subject, as such were based on a review of all historical records, and contain detailed rationale for the medical conclusions. See Boggs v. West, 11 Vet. App. 334 (1998). Given the depth of the examination reports, and the fact that the opinions were based on a review of the applicable record, the Board finds such opinions are probative and material to the Appellant's claim. See Owens v. Brown, 7 Vet. App. 429 (1995). The March 2002 VA negative etiological opinion is entitled to less probative weight, as it does not specifically address whether lung cancer had its onset in service. Similarly, the October 2007 VA opinion is entitled to less probative weight, as it concentrated on whether the Veteran's in-service respiratory complaints were an early manifestation of his lung cancer and not the growth rate of the disease and whether the asymptomatic tumor was present in service. To the contrary, both private oncologists reviewed the record and cited extensively to their own expertise in the field as well as the current state of medical knowledge in reasoning that the Veteran's lung cancer likely began while he was in active duty. Thus, in light of the opinions of the private oncologists, which both cite to applicable studies and contain supporting rationale, the Board finds that the Veteran's lung cancer likely began while he was on active duty, and entitlement to service connection for the cause of the Veteran's death is established." So they got caught in their own side-step. I realize your claim is not the same as mine, and the theories of entitlement are a bit different. However, it is my firm belief that you need to pay special attention to what the VA is ignoring, leaving out, side-stepping, and twisting around. Those areas will give you the keys to winning the claim. If the VA could easily deny your claim with the diagnosis of probable lung cancer, they most likely would not have needed to change the word to possible. If they have to twist the claim and change the diagnosis in order to deny the claim, then that is a good indication that the actual untwisted claim has merit.

Are you going for increased ratings also? Some of the ratings seem a bit low in regard to being unemployable. (However, I am not very familiar with TDIU claims). It will definitely help if the doctor states your service connected conditions prevent you from working, or limit you so much that it would be difficult to find a job that you can do. As far as SSDI, all conditions should be considered, regardless of whether they are service connected or not. I wouldn't be completely convinced that your service connected conditions are not related to your other conditions. So I think you are wise to seek the opinion of a private physician. As far as SSDI, you mention a walker and cane. Do you have to use a walker much? Or two canes? You might want to read http://www.socialsecurity.gov/disability/professionals/bluebook/1.00-Musculoskeletal-Adult.htm Also -- You mention you are 49. When do you turn 50? The whole game changes for Social Security when you turn 50. The standards to meet to be considered disabled are not as limited. They start basing it more on whether you can do the work you used to do, rather than whether you can be retrained to do something else. http://www.ssa.gov/OP_Home/cfr20/416/416-0963.htm Sorry I haven't been much help with the TDIU claim. I just know a little bit more about Social Security.

They actually have some massage techniques that help with scars, though they won't completely get rid of them. There is a bit of information here http://www.integrativehealthcare.org/mt/archives/2007/07/six_massage_tec.html You can also look up additional information. Though a lot of the techniques work better on newer scars, I have known a few people who have worked consistently on older scars with some pretty good results. It is probably better to learn to do this yourself, as you can work the scar a bit every day, or several times a day. Paying a massage therapist to do this could get pretty costly. Some people have had pretty good results with Mederma cream. http://www.mederma.com/ There are some before and after pictures here http://medermabeforeandafter.blogspot.com/ I am sorry for your pain and am glad you are doing better. Thank you for your service!