DWJ

Hello! You seem to be so well informed perhaps you can help me and my Dad.  My Dad was diagnosed with prostate cancer in March of 2017 by a contracted offsite doctor.  The VA he was a patient of no longer had a urologist.  The doctor tells us that looking at my Dad's previous records he finds hard to believe the cancer wasn't found in previous biopsies done.  I ordered his medical records and found out that my Dad's PSA level was considered high for over 2 years and a biopsy performed at the hospital cleared him of cancer.  However, in my research, I have found that his level warranted pro-active treatment and under those circumstances, his prostate should have been removed before 2017.  Do I think my Dad had cancer and his diagnosis was missed? TOTALLY! However, the Tort claim I filed was in regard to his delay in care.  After being diagnosed NO ONE from the VA contacted him.  No casework, nurse, or oncology team.  His surgery happened in July because the contracted doctor scheduled.  His office staff had been able to contact anyone with the VA and confirm that the operation was approved.  My dad showed up for pre-op and was sent home by the hospital.  I got on the phone with the VA hospital, felt like I was transferred 20 times and finally ended up on the phone with a patient advocate, who pushed surgery through immediately. I submitted a tort claim and was specific in regard to "delay of care".  I received a denial letter this week and blame was laid with a doctor who the VA hospital contracted 2 years previous to his diagnosis. A doctor he saw several times at the VA hospital.  I spoke to the General Counsel today.  He basically told me that my Dad got the surgery and that's why it was denied. In the end, he got what he needs, with me pushing it through. He said proper protocol was followed. What? Is it proper protocol for a family to make sure a life-saving surgery happens? My response silenced him.  I told him to expect my reconsideration letter via certified mail in less than 2 weeks and I expect an answer within 6 months.  

I want to know the proper jargon to really ruffle some feathers. I was told by a patient advocate that is a friend of a friend of the family he for sure thought we had an open and shut case.  He was shocked by the denial.