atomicwidow

I'm a surviving spouse of a Navy vet who was exposed to atmospheric ionizing radiation in his active duty years. My husband developed a "presumed" cancer long after his exposure. He kept excellent records; he applied for the IRR (Ionizing Radiation Registry http://www.publichealth.va.gov/exposures/radiation/benefits/registry-exam.asp)to verify his military radiation exposure. When he died, I finally received adjudication that his death was 100% service connected. That brought several benefits including an award from Dept of Justice, VA DIC, DEA and CHAMPVA. Sad why I get them, grateful for the VA honoring the service. My point is, there is a precedent for service connected disability (a long list of presumptive conditions) for atmospheric radiation exposure http://www.publichealth.va.gov/exposures/radiation/diseases.asp. The VA may not yet have those rules clear for Operation Tomodachi, but if you were there, save all records, get medical documentation now and in the future.

BIG mail received today...."full grant on appeal", including rating decision by DRO with DIC, DEA, eligibility to apply for CHAMPVA. I'm elated, relieved, sad for what my husband went thru to make this happen, hopeful for my future. Thank you, thank you, thank you for the advice and support on this site.

BIG mail received today...."full grant on appeal", including rating decision by DRO: "1. service connection for the cause of death is granted. 2. Basic eligibility to Dependents' Educational Assistance is established." DIC was granted with effective date 10/13, the month after my husband's death. I'm elated, relieved, sad for what my husband went thru to make this happen, hopeful for my future. Thank you, thank you, thank you for the advice and support on this site. Jo

9 July 2015 update: I got a letter from the VA service center dated 6/30/15 notifying me that burial benefits were granted and I'd receive a check in the near future. Listed as evidence used to decide my claim is "evidence establishing that the veteran's death was related to his service". I've received nothing else about my notice of disagreement or DIC claim, but approval of burial benefits for service connected death seems hopeful. Jo

I'm hoping for a shorter wait time than Berta's :-) I learn so much from you all - thank you.

Hi Berta, I haven't received a Statement of Case. It appears that a SOC is part of the Traditional Appeal process, but not the Decision Review Officer process. I selected the latter. The VARO letter explains that after the Decision Review Officer reviews the claims file, evidence, arguments & statements, they may request additional evidence or an informal conference with me to discuss the case. "The DRO will then make a new decision. You will be notified of the decision and your appeal rights." So I'm now awaiting the DRO process.

I thought I'd share a brief update. I received the letter of clarification from the diagnosing MD. I mailed my Notice of Disagreement with this letter; I received the Regional Office's letter asking whether I wanted to go with the Decision Review Officer process or Traditional Appeal Process. I selected the DRO. That was in early April. So now I wait, again. Any guess how long? I'm expecting 4-6 month minimum?

We think alike, Berta. I'll begin wordsmithing my Notice of Disagreement as I await the doctor's clarification. I understand medical lingo and I'm succinct, these skills will help. In my professional writing, I try to say as much as necessary and as little as possible. Thanks!

I just read Berta's 2/3/15 post.....I'm blushing. I truly hope my knowledge of DIC application for atomic vets helps another vet or widow down the road. Today I received a letter from VA regional office/claims telling me they corrected my husband's social security number in his file. It only took them 7 months and my follow up. Argh. I'm waiting for the diagnosing MD's written support in IMO terms. I expect it in March. I'm also waiting for a copy of my husband's claim file from the VA. I won't hold my breath. My next step is to submit a NOD (Notification of Disagreement) with a cover letter connecting the dots, referencing the CFRs (Code of Federal Regulations), including all the documents/medical records to support "probable" lung cancer. I have until August, so I'm okay on the timeframe. My sister said this is a bit like writing her doctoral thesis.....I agree. Jo

Wow Berta, you dig deep....that's a compliment! Yes, my husband has a Defense Threat Reduction Agency exposure record. I have a copy of his dose exposure estimates. We requested those records as soon as they were declassified, long before the cancer diagnosis and death. Veteran groups at that time advised that vets radiation exposure numbers would appear small, perhaps not representative of their true exposure. DOJ, via their RECA (Radiation Exposure Compensation Act) award concedes his presence, so with a presumptive cancer, I believe the dosage is not important. My husband also registered in the IRR: Ionizing Radiation Registry. I have that documentation. That also was long before his cancer diagnosis and death. Again, the fact that the feds acknowledged Fred's radiation exposure via the IRR long before his cancer hopefully connects the dots. His Navy radiation exposure was during Operation Castle, including Castle Bravo: http://www.pbs.org/wgbh/amex/bomb/peopleevents/pandeAMEX51.html I'm in and out of this site...sometimes I may not reply timely. Just so you know, I work full time, take care of aging parents, recently (8 weeks ago) survived a rollover car accident on ice on my way to work and I'm pretty achy but mostly ok & grateful. Tenaciously, Jo

I have a few things in process: 1. the pulmonologist who diagnosed the lung cancer's clarification....I drafted the suggested wording (subject to her approval/changes) including "more likely than not" primary lung CA and that it significantly contributed to his death (using IMO language and reinforcing the death certificate) 2. a call this AM with VA regional office; they have my husband's soc security # wrong despite me mailing them corrections in July 2014. She read my correspondence with correction documents, so we know they received it, just didn't yet update/correct the file. Correction is now in process. 3. request to the VA RO for copy of the claim file. Waiting on that. Free Spirit, yes, the MD who diagnosed the cancer is a different MD than who signed the death certificate. So you're right, there are 2 MDs who state "probable". If the VA has my husband's SSN wrong and has not corrected it in the 6 months since I sent the documentation they need to correct it, I wonder if they also missed medical evidence sent? Getting the claim file contents will be telling. 2 more questions: - at what point should I sent the Notice of Disagreement......now or wait til I get more evidence? I have until August (12 months) to appeal. - as I read recent posts, it seems BVA gets involved at some point. Is there a link or tutorial to explain the steps & timeframes bumping it up the legal ladder? Thanks, all. Jo

Whew! I go to work for 2 days and come back to your research. Thank you. I have a lot to learn about VA acronyms and the appeal process. What's the difference between RO and BVA in the appeal? "Twisted words....from probable to possible"....understanding that as a tactic helps. I'm in the process of creating irrefutable documentation around my husband's lung cancer (not the larynx cancer) because lung cancer is presumptive for VA documented radiation exposed vets, which he was. That's why I've asked the pulmonologist at the major medical center who diagnosed my husband's lung cancer in 2013 to use the IMO words "more likely than not" (I gave her the reference). I've asked her to state he "more likely than not" had lung cancer, the cancers were more likely than not two different primary cancers and NOT metastasis, and to explain why she couldn't biopsy the lung for a definitive diagnosis. Her assistant already told me they're happy to do it but the MD is having a baby and won't be back til next month. I'm confident I'll get it....I crafted the draft letter for her review. My husband died 7 weeks after cancer diagnosis in 2013. His Operation Castle radiation exposure was in 1954. He was a "registered Atomic Veteran" so I believe timeline isn't important in my claim, nor was his dose exposure. I've narrowed down the crucial medical records to 2 reports from 2013. The pulmonologist I referenced above is helping me make those reports tight. As I understand the medical documentation I need to submit, those 2 reports plus the pending doctor's letter will be all I need. What I'd appreciate input on is how to write the appeal letter and where do I send it. My words of advise to readers: If you are a vet or love a vet who was exposed to radiation, do your homework NOW. Get your records organized. Get registered as an atomic veteran: http://www.publichealth.va.gov/exposures/radiation/benefits/registry-exam.asp Know what you may qualify for in advance. Get yours ducks in a row. We did as much as we could in advance of my husband's death. It's still a lot of work for the surviving spouse. Grief is hard enough. You all help me feel tenacious. It would be easy for me to fold because I have no experience in the VA system. You'll chuckle....when you mention a new acronym I have to Google it. I average 2-3 acronym definition checks with each message here. So maybe help me and others here by explaining acronyms such as SMR = service medical records or RO = regional office. I still don't know what BVA means in my case :-) I'm worldly, but just not in the VA system. I DO appreciate your help, Jo

Free Spirit, Thank you for your thoughts and for catching the VA's wording change from "probable" to "possible". The MD clarification I'm seeking isn't truly an IMO because it's the pulmonologist who diagnosed him. I just asked her to reference and clarify her own medical records in what I've been advised here are VA terms (to define probable as "more likely than not..." and clarify other points in the records). I'm going with the lung CA diagnosis because it's on the atomic vet presumptive list and his death certificate lists "probable lung cancer" as a contributing cause of death. The VA has already conceded his radiation exposure in his Navy years; he enrolled in the Ionizing Radiation Registry years before his death. What I need to figure out now is how to write up my appeal on their denial of DIC. I need to establish the probable lung cancer as "entitlement to service connection as the cause of the veteran's death". Can anyone advise me if there's a sample format to follow in word-smithing appeals? thanks. Jo

thanks, PR. I'll pursue getting my husband's claim file ASAP. As for the rest of my appeal of DIC denial: - lung cancer (not a specific type) is a presumptive condition from military exposure to atmospheric ionizing radiation; - the VA conceded his participation in active duty atmospheric nuclear testing. - my husband's death certificate lists "probable lung cancer" under the heading "significant condition contributing to death"; - 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. I expect to receive that documentation from the MD in March when she returns from maternity leave. Once I have it in hand, do I just attach a cover letter, form 21-4138 (Statement in Support of Claim) to the medical records and send a copy of all to VA certified mail? thanks for the wisdom. Jo

Can a surviving spouse request the deceased Vet's c file? Wondering if I can sign his name or my name then "surviving spouse". In reviewing VA form 3288 (request for release of information from individual's records) there's a section heading: INFORMATION REQUESTED (Number each item requested and give the dates or approximate dates - period from and to - covered by each.) Can I ask "entire claim file" and leave it at that? or better to request from date of service to present? There's also a section heading: PURPOSE(S) FOR WHICH THE INFORMATION IS TO BE USED. I presume I state "DIC appeal".....?

Berta & all, thanks for the ongoing thoughts and support. I'm in a bit of a holding pattern; the pulmonologist who diagnosed my husband's lung cancer is out on maternity leave for another 6 weeks. Her office asked me to wait til she returns. I plan to ask her to write clarifying documentation about her lung cancer diagnosis that I can submit with my appeal. I have not followed up with my veteran's service officer rep (is that the same as POA rep?) as when we last spoke about the denial last autumn, she seemed resigned and disinterested. I was thinking of appealing on my own. Is that unwise? Jo

what I see that they still need is medical evidence of the two primaries and/or a strong statement that the lung cancer contributed substantially to death. Or the Death certificate could be changed to reflect that. Hello Berta, a few questions: I'm following up with the pulmonologist who diagnosed my husband's lung cancer to ask for written clarification to submit with my appeal. In your experience, are there phrases/statements to include? I plan to ask her to clearly document that she diagnosed lung cancer (vs "probable" or "possible" lung cancer) and that it was a separate primary site, not metastasized from another cancer. Do you know how easy it is to have a death certificate changed? Does that come from the MD who signed it or from the state? How strongly do you recommend that for my appeal? It appears I never received a VCAA letter. Is that a big deal? When DOJ approves a RECA award, doesn't it establish service connection? I'm confused how the VA can denied service connection for the cause of death when DOJ has adjudicated the cancer as service connected. Working my way through this, trying to get all my ducks in a row. Thank you again for your advice. Jo

Thanks, Berta, for your suggestions. It'll take me a bit of time to think this all thru, look up/understand some of the acronyms you referenced and come up with a game plan. Jo

Berta, Thanks for your work. Answers to your questions: - All medical records are from private providers, he had no VA care. Local doc sent us to Seattle to a major medical center for definitive diagnosis. Diagnostic imaging (PET scan) found the 2 cancers. 2 MD specialists there were involved: an ENT (head and neck specialist) and a pulmonologist (lung specialist). - Date of rating decision/denial is 8/6/14; the cover letter with the decision is dated 8/11/14. - There was no claim for accrued VA benefits pending; we had only 5 weeks from diagnosis to death. We did get the RECA claim going in that short time. - I filed the DIC application dated 3/27/14 via a local Vet Service Officer/advocate; that office mailed it. I have a copy. Attached was the DOJ letter approving the RECA claim. No medical records were attached to the DIC application. BTW, that VSO's response to the denial was, "they got you on a technicality" and felt it unlikely that sending medical records in an appeal would help, but offered to support me if I wanted to try. Regarding the VCAA letter: this confuses me. I've saved copies of all correspondence sent and received. It appears I've never received a VCAA letter asking for additional evidence. I got brief form letters dated 4/10/14 and 4/13/14 stating: "We are now in the process of deciding whether additional information or evidence is needed. If we need anything else from you, we will contact you, so there is no need to contact us in the meantime." I'd heard nothing for 2 months so I inquired online. A letter dated 7/3/14 from the IRIS Response Center said they couldn't access the records with the social security number I provided. They directed me to the VA Pension Management Center. I spoke with a rep at the Pension Mgmt Center who advised me to send them official documents verifying my husband's SSN. I got those from our local social security office and faxed them on 7/25/14. Then I got the DIC denial dated 8/11/14. That's my story so far.....ugh. I'm not yet resilient from grief but I am tenacious :-)

doesn't look like I attached the file correctly above....trying again. Scanned Image 143190004.pdf

OK, here's the scanned letter, thanks for the review. A few facts: - My husband was diagnosed with two primary cancers on the same day, larynx and lung. The MD reports state they were two different primary cancers, not one metastasized from the other. Lung cancer is a presumptive condition from ionizing radiation exposure. They conceded radiation exposure during his service. - The Dept of Justice RECA award was granted on the same medical records and death certificate sent with the DIC application. When DOJ approves a RECA award, doesn't it establish service connection? I'm confused how the VA can denied service connection for the cause of death when DOJ has adjudicated the cancer as service connected. I received the RECA settlement in March. I understand there's a DIC offset when awarded the RECA amount, so there's about a 60 month wait til DIC payments would kick in. But if DIC is awarded, I presume ChampVA and other surviving spouse benefits would begin right away....am I correct? I appreciate your wisdom and opinion. Jo

thanks for the offer, Berta...I'll take you up on that. It may be a week or two. Shall I post it here...or where? Or email you directly?

I'm back after months away from this site while I awaited determination on DIC and ChampVA as a new widow/surviving spouse of a SC atomic vet. In response to the original question here, it took 6 months from my application to reply, which was a denial. I honestly haven't had the heart to pursue an appeal yet but I have a year from the denial...early grief is weighing me down still.... but I'm gearing up to attack it again. I wholeheartedly agree that we all need to have our end-of-life decisions and survivor benefits organized, discussed with loved ones, documented, paperwork squared away. We did, and it's helping me tremendously. If our loved ones don't want to discuss it, okay, but at least we did our part to ease their burden after we're gone. Warm appreciation on this Veteran's Day to all who served and families who lost loved ones to the cause.

PR & Berta, Thanks for the replies, it's helpful to have the VA M21-1MR reference. He was not 100% SC prior to death; as soon as he was diagnosed with a cancer on the RECA presumptive list in 8/2013 we submitted the RECA application to DoJ. Because he died while that claim was pending, I had to re-submit as surviving spouse; did that in 10/2013. I received the RECA award 2/2014 and applied for DIC & CHAMPVA in 3/2014. In 7/2014, I went on IRIS and requested a status on the claim. I scheduled a phone appt; I was told the SSN on his application I submitted didn't match their records and I needed to send in his SS card and other official documents/statements listing his name and SSN. I went to our local SS office, got the documents (same SSN!) and faxed them to the number I was given during my phone call with the VA rep. I sent that fax on 7/27/14. I figured that since DoJ adjudicated his death as SC and awarded me the RECA payment, that clearly establishes SC for the VA. Perhaps I'm impatient and just need to chill out a while? Any "guesstimate" how long this type of claim may take? thanks.

administrator: can you please start this as a new topic under "specialized claims" not under DIC? Thanks, I can't see where to do that. I'm a widow of an atomic vet (died 9/2013, USN, onsite for several atmospheric nuclear tests in the Marshall Islands, Operation Castle). I'm wading my way through the applications for surviving spouse VA benefits. I'm hoping to learn more and share what I know about RECA (Radiation Exposure Compensation Act). I've already received the RECA award because my husband's cancer was on the the DoJ/RECA "presumptive" list. I believe that will establish his death as 100% service connected for the VA and open the door for DIC, CHAMPVA and other minor benefits. I'm 5 months in to that claim. Anyone know how long this type of claim will take? Anyone have wisdom to share? I know quite a bit about the RECA application process and criteria, so maybe I can be a resource to anyone with RECA questions.