JusticeforLt.Col.Sutton.

Berta "Probably 95-99% of us here have received denials, and we just kept fighting back. " Yes, I am so fiercely ready for this fight. "I think they would have to send you a copy of it now because the claim was denied." Do you have any ideas on who to contact to request this Peer Review. Should I call the Chief of the Spinal Cord Center at the VAMC of Memphis, ???? I would like to point out a few issues I have initially after going over the decision letter. Any guidance would be very appreciated. Under the evidence: 1. The Peer Review is not listed. (Though I gave my POA to the State Veterans Office last week thus I am suppose to view my C File on Wed. 3rd. and am hopeful it might be in there) 2. They listed " VA medical records, Memphis VA Medical Center, received March 25 2019 for the period of March 13, 2018 to September 13, 2018". This is not the accurate time of hospital admission nor what was submitted to them. The correct dates in which were submitted by me should be March 12 2018 to September 13, 2018. (The reason the medical records dated to Sept 13, 2018 (date of death March 22, 2018) is the VA providers continued to make late entries into his medical record). 3. Listed as evidence was "VHA Residents and Trainees and Extraordinary Circumstances submitted by Claimant received October 18, 2019". "VHA Residents and Trainees and Extraordinary Circumstances" does not exist. There is not a VHA publication nor one I submitted. In addition, I did submit multiple VHA publications in which were violated during this admission. I submitted the following as evidence: VHA Handbook 1176.01 Spinal Cord Injury and Disorder System of Care VHA Directive 1352 Prevention and Management of Pressure Injuries VHA Directive 1232 (2) Consult Processes and Procedures VHA Handbook 1401.01 Resident Supervision VHA Directive 2009-058 Pain Management VHA Directive 1400.01 Informed Consent VHA Directive 1004.03 Life Sustaining Treatment Decisions: Eliciting. Documenting, and Honoring Patients Values, Goals, and Preferences VHA Directive 1177 Cardiopulmonary Resuscitation VHA Directive 1157 Out of Operating Room Airway Management I also submitted the all of the below as evidence. All of which are pertinent to establishing they there medical malpractice. I do not see any of the below listed on the Decision Letters Evidence. Therapeutic Monitoring of Vancomycin: A revised consensus guidelines and review Vancomycin Drug Insert Meropenem Drug Insert Sepsis Clinical Practice Guidelines Order Summary Medication Administration Record (MAR) Surviving Sepsis 1 Hour Bundle Clinical Practice Guidelines Morphine Drug Insert Bumetanide (Bumex) Drug Insert Versed Drug Insert Etomidate Drug Insert Diprovan (Propofol) Drug Insert Blue Alert Record American Society of Anesthesiology Difficult Airway Algorithm Department of Veteran Affairs Emergency Airway Management Initiative Vancomycin Administration, Vancomycin blood levels, BUN, and Creatine Chart Echocardiogram on 21 March 2018 Advanced Cardiac Life Support (ACLS) Guidelines, 2015 Karen Curtis, MD late entry to medical record on 5 May 2018 at 11:40 from Blue Button Health Record State of Tennessee Board of Nursing Rules and Regulations State of Tennessee Board of Respiratory Care Rules and Regulations

Berta, "t says they had VA medical records from March 18, 2018 to September 13, 2018 ,but he died on March 22,2018- " They listed " VA medical records, Memphis VA Medical Center, received March 25 2019 for the period of March 13, 2018 to September 13, 2018". This is not the accurate time of hospital admission nor what was submitted to them. The correct dates in which were submitted by me should be March 12 2018 to September 13, 2018. (The reason the medical records dated to Sept 13, 2018 (date of death March 22, 2018) is the VA providers continued to make late entries into his medical record). "We had no idea the cause of death was MRSA , but the decision clearly states he was admitted at a routine exam, with ulcers and infection- I assume the ulcers he means are from the pyoderma-gangrenosum, which causes ulcers on the skin.. " The autopsy copied the cause of death word for word from the discharge diagnosis of the VA Providers. The VA Providers failed to document many things in there efforts to cover up the true events that my husband endured. With that being said it was true that he had MRSA. However, I can absolutely prove they give him MRSA. On second day of admission he was taken to surgery where wound cultures were collected. They were negative for MRSA (March 13, 2018). On March 15 2018 a second set of wound cultures were collected at bedside. These were also negative for MRSA. On March 17 2018 a third set of wound cultures were collected. The wound cultures collected on March 17 2018 were positive for MRSA. Thus, the VAMC give him MRSA. In addition, Yes he had the wounds for three weeks prior to admission. We had this exam set up already and he did not want to leave our autistic son so he waited for the annual admission. However, upon admission the wounds had zero infection. (Per the wound cultures collected twice). Pyoderma Gangrenosum is a rapid progressive wound with an over production of white blood cells. There was no infection until he got MRSA. Yes vancomycin does treat MRSA. They did not start the vancomycin until the fifth day of admission.

Berta, I expected the denial. I am ready to fight. One of my first concerns about this is the evidence list. It contains only about 1/3 of the evidence I submitted. ???? Should I re submit everything I submitted that is not on the list.

Berta Here's the decision letter and report.

I have gotten my decision letter about an hour ago. Everything was denied. I am still trying to calm down and make it through the letter. I will upload it very soon.

HamSlice, "When was he born, or how old was he, etc." He was born in 1956. He was 62 when he died March 22, 2018. I had to correct my initial post. My husband was in the United States Army for 13 years (entered in 1985 and honorably discharged 1998.) and in the Army Reserves for 12 years ( entered in 1998 and honorably discharged in 2010). My appoligies for my critical error on the initial post. With that being said, did my husband still have reserve retirement coming at age 60? "After twenty years reserve time, which could be more if there is a minimum requirement in the reserves, like the National Guard (last 8 years must be in Guard) however, even with that, your husband would have a reserve retirement coming at his age 60. Now, when he got his, Notice of Eligibility for age sixty retirement, he would have had to elect A, B or C on a DD 1883 or similar. Not sure what the reserve uses and I see this form has changed since I did mine. A, service member only. This means the service member only gets retired pay at age sixty. The spouse has to sign for this option. Not as rare as you would think, I had some chose this when I was a clerk in the NG. If you have a lot of money and are not worried about you spouse if you die, then people select this option as you make more money, as SBP is taken out post retirement pay, i.e., out of you retirement pay. B, when the service member passes, the spouse will get a portion of his retirement when the service member would have turned age 60. C, immediate portion of retirement when service member passes. And then, you can buy (from your retirement when paid) additional percentages. So, I believe the OP, (original poster), needs to find the DD 1883 Survivor Benefit Plan Election Certificate that her husband would have completed. She may be entitled to a portion of his retirement right now. FWIW, Hamslice I selected option C, and selected the highest percentage. So, if I was to pass right now, my wife would get 85% of my retirement immediately, even though, I won't get my retirement for a couple years yet." Thank you for explaining this in such detail for me. I am hopeful that I will be seeing my C File this coming week at the State Veterans Office. I signed a POA this week and they are suppose to go through it with me on Wednesday. I will be looking for the DD 1883 and also be requesting it from the military.

Berta, "I have a concern over the error they might have made in the pension denial You had stated: "My husband served in the United States Army for 18 years followed by 12 years in the Army Reserve. My husband was a skillful, highly sought General Surgeon, a life-saving Trauma Surgeon" That means he surely received a pension from the DOD, in addition to SSA, and if so, was that info included on the VA Pension form? All I could see on the letter regarding the pension was his SSA annual award. It my or may not include the Medicare amount." This is the first time that I have re read my initial post. I am so very sorry. The above is not accurate. I must have made this error talk typing through google. With that being said, to my embarrassment, I must correct my information so hopefully you, Hamslice, Oceanbound and all others will continue to help me. My husband entered the United States Army in 1985. He was honorably discharged in 1998. This is a total of 13 years in the Army. He then entered the Army Reserves in 1998 and was honorably discharged in 2010 for a total of 12 years in the Army Reserves. "That also means , as a retiree, he might have paid into the SBP program, which would have garnered you an annuity payment, monthly." What is the SBP program? Is this still possible given the above accurate facts? "I did not see anything on the one page letter you posted above regarding the pension matter, with any accounting for his Military Retirement Pay." The above accurate information may explain why he did not receive Military Retirement Pay. He received Social Security monthly. This was his only income. He received nothing from the military at all.

Berta "LHI was contracted to give him a C & P exam. I ca hardly read it even when I magnify it- You got it recently, but but what is the date of that exam.? What I see here is that he applied for a Pension ( far different from a service connected claim) If he did not appeal this decision and point out their errors, the date of the decision tells me the only way to get this changed is to file a CUE claim. But I do not know if pension's involve accrued benefits-will try to find out- Was there anyone ( like DAV- VFW- AL ) mentioned as his POA on the pension denial?" Berta Yes it was recently. The letter is dated 10/19/2019. My husband died 17 months prior to letter on 03/22/2018. This is what stumped me when the letter arrived. Yes it appears he had applied for pension on the letter from the Department of Veteran Affairs dated January 18, 2018. It also states on page three, "If you do not agree with our decision, you should write and tell us why. You have one year from the date of this letter to appeal the decision. The enclosed VA form 4107, Your Rights to Appeal Our Decision explains your right to appeal." It is my intention to Appeal the decision very soon. It will be next week before I am able to go to the Social Security Administration Office to obtain all proof I need from them to submit with the appeal. There was no POA listed. I am quite sure he did this himself. He was bound to his wheelchair so if he had gone to a VSO I would have taken him. I am sure we did not do this. Did you find out if pension is involved in accrued benefits?

On Thursday I was informed by my new legal representation for the FTCA claim that not only would I be filing out the form 95 but that they would be contacting my husbands adult children (whom I have no contact with and my husband had very little contact with) to sign a retainers contract and sign Form 95. It is essential that the FTCA claim be correctly. I am not sure that this above is correct. I have spent the entire weekend searching for the statue, the code, the rule, the regulation as to whom must file the FTCA claim. Can anyone help me find this information?

Berta, would you please give me your opinion on the attached additional letter in which I received recently on October 23, 2019. I have no idea what this is. I called the company. They informed me it was a review of medical records?????

Berta, I believe you guided me to the right track. I now believe my husband did have an ongoing claim. I am not quite sure how the "catastrophically disabled". However I wanted to show you my new discoveries. I discovered two additional letters after sifting through four banker boxes. This time I have slowly read each and every word of all Department of Veteran Affairs letters. The first dated January 2, 2018 (my husband died March 22, 2018). It appears this was the letter from the VA letting my husband know they received his claim. The second dated January 18th, 2018. Is informing my husband that his claim for Veteran's Pension has been denied because he is over the income limit for a "married veteran". When you first read it you would assume it is true and that he did not qualify. I am assuming this is what he must have thought in January when he received the letter. However, there are multiple errors. #1 They used the allowed income limit for a married Veteran (17,241). They should have used income limit for married Veteran with one dependent (17241). Plus one additional dependent (for our minor son) ( 2250 )=19,491. In addition, with the catastrophically disabled" just may mean he qualified for Aid and Attendance (which would put income limit at 26,036+one depend 2,250 =28,286. Or it may mean he qualified for Housebound with one dependent (20,166) plus one dependent (2250)= 20,416. No matter what the case maybe be they calculated the income limit wrong. #2 The VA did not have the correct income per Social Security Administration. My husband reported receiving 2,225 monthly. The VA said SSA reported monthly income as 2,412, thus annually 28,944. I called SSA then went to local office. I obtained proof from SSA that in fact my husband made less than even he reported making, only 2,199 per month or 26,388. Most importantly, thank if you had not continued to tell me that he may have had a claim open I would not pursed this. The letter from the VA said I only had till January 18, 2020 to submit new evidence and appeal the decision. So I did not have much more time. Again thank you.

Berta I believe my husband did have a pending claim though I still am not sure what this means exactly. The entire letter read exactly as follows: "Mr. X Based on a recent review of your records and examination, the Department of Veteran Affairs (VA) has determined that your disability, injury, or condition meets the criteria of a catastrophic disability. As a result you will be you will be immediately enrolled in Priority Group 4, unless you are eligible for enrollment in a higher Priority Group. Official notification of the changes in your enrollment status will be sent by separate letter. Veterans enrolled in Priority Group 4 are eligible for all needed services included in the Medical Benefits Package. Veterans who are determined to be catastrophically disabled are not required to pay inpatient, outpatient or prescription copayments that would otherwise apply. If you have any questions feel free to call the enrollment office at 1-800-636-8262 or 901-523-8990 extension 7972. Putting Veterans First. Michael Harper Chief/Business Office"

Thank you so much. I wish I had found this website much much sooner. I am stunned at the moment. I just check my claim status online and.....a decision was rendered today for my 1151 Claim? Are there any other options for finding out the decision other than waiting for it to arrive by mail?

Oceanbound, You rock. I want to contact Dr. Todd do you by chance know his first name or where I can locate his information. Also, do you know the answer to my 1151 offset question above. Just call me MIKE! Thank you so much for your help.

Berta I used the link to search for all providers involved in the care of my husband. They are all VAMC employees except for the many residents. (I am not sure what the residents fall under). I also emailed a copy of the post to my attorney. In regard to the 1151 offset factor..... My husband and I have a son whom is now 9 together. My husband also has five other adult children from his first wife whom died. It is my understanding in the State of Tennessee any settlement or award recieved who be distributed as follows after attorney fees: 1/3 goes to the surviving spouse, 2/3 would be divided equally between the total of 6 children ( despite my son being a minor and a minor with a disability). In regard to the offset of the 1151, would I be responsible for the entire award/settlement or only what I received.