My husband filed for SC for lung cancer prior to his death Feb. 5, 2007
I filed for DIC and accrued benefits May 2007
I have just been WAY busy and haven't been following up aggressively on the claim - but get a bit of time to work on it from time to time - and it is getting close to moving toward the top of my priority list as soon as I get done wading through everything else that is above it.
I have some questions I can start working on a bit now.
1. I received a denial and SOC on November 8, 2007.
This was prior to the one year I had to submit evidence.
I know I will have to get an IMO to submit.
When I get the IMO should I
a. Submit it and any other evidence I have and ask that make a decision on my claim as I submitted the evidence within the one year time frame (and they made a decision before that)?
b. Just go ahead and accept that their initial denial is a denial - and submit a NOD with my evidence - which would put me a step closer to the appeal I might have to go through.
c. Both - ask them to make a decision based on the new evidence submitted in one year AND file a NOD -
d. Same as c - but WAIT on the NOD (I have until November 2008).
Medical Opinion
Though they actually ACKNOWLEDGED that my husband was requesting consideration on the theory that his cancer must have begun in the service - the reasons they gave did not have anything to do with that theory.(Based on the growth rate - the cancer could NOT have STARTED after retirement).
They specifically said: "To assist in gathering evidence to support the claim, we requested a VA medical opinion. In response to that request, a VA physician reviewed the records and noted that the symptoms noted during the veteran’s treatment in the service suggest manifestations of viral respiratory tract illness, and that none of the episodes can be reasonably linked to an early manifestation of lung cancer. He then provided the medical opinion that the veteran’s signs and symptoms listed in his service medical records are less likely than not early manifestations of the adenocarcinoma of the lung first diagnosed in September 2000.
So they blew off the whole growth rate argument - and just addresed whether any SYMPTOMS in the service were related to the cancer.
I have researched cancer and growth rate at the BVA and come up with TWO distinct patterns.
Those which GRANT service connection because of more likely than not IMOs based on growth rates.
Those who ARGUE growth rates - but do NOT provide an IMO - which then leads the VA to somehow FIND a medical specialist who says something about how the medical community accepts that the ONSET of cancer is when it is DIAGNOSED.
This is completely idiotic - as the medical community knows fully well that cancer STARTS BEFORE it is diagnosed - which is why they keep pushing for earlier and earlier SCREENINGS.
But - it is a BIG lesson on EVIDENCE. No matter what the journals SAY - you need a DOCTOR to SAY that the cancer started before it was diagnosed to get the GRANTED type of decision - because if you leave it to THEM - they will find the doctors who say that cancer starts at diagnosis - and you will get a DENIED type of decision.
Anyway - I am asking for a copy of the VA doctor's opinion.
I am also asking for a copy of the request they sent for that opinion. (Because if they only ASKED him to discuss if the symptomology in service was related to the cancer - they prejudiced the claim by limiting what he discussed. I am not going to ARGUE that right away - because if his report isn't favorable - then I don't want to give them a reason to let him discuss any more - However, I will keep it as a back up.
Anyway - Since we already asked they consider the theory of that the cancer had to have started in the service - and they specifically acknowledged that was the request - and they have ALREADY had their opportunity to GET a medical opinion about that - then if this doctor played around and just discussed the symptoms in service - have they already USED their chip to get an independent medical opinion?
What I am asking - is now that they played their hand in whatever way they played it - if I get a medical opinion that indicates it is more likely than not that the cancer started in the service (regardless of whether there were any symptoms) - can they seek ANOTHER opinion that addresses THAT? Or would that be a "fishing expedition?
The growth rate argument is not unique. The BVA has granted many cases based on that same theory. In fact when I typed in a search at the BVA with Cancer and Doubling Time - I saw GRANTED GRANTED GRANTED.
SO they know EXACTLY what we are talking about - they just have danced around the issue.
Also - my understanding was that the VA doctor was supposed to view the ENTIRE C-file. As my husband has repeatedly stated his cancer began in service - has repeatedly stated his doctors told him that based on growth rates, and the LAST evidence we submitted was all the treatisies that expounded on that - If the doctor didn't even address that - and only discussed symptoms in service - then again, will they be "allowed" to seek ANOTHER opinion after I submit an IMO.
I guess I am looking for a way to prevent that game.
Some GOOD news is that they actually CALLED the evidence we submitted " a bound volume of medical treatises" and NOT "internet printouts."
I consider that a GOOD sign - and the information we sent is from sources such as the National Cancer Institute, Center for Disease Control, FDA, peer-reviewed journals (NOT anything they could question the credibility of).
Question
free_spirit_etc
My husband filed for SC for lung cancer prior to his death Feb. 5, 2007
I filed for DIC and accrued benefits May 2007
I have just been WAY busy and haven't been following up aggressively on the claim - but get a bit of time to work on it from time to time - and it is getting close to moving toward the top of my priority list as soon as I get done wading through everything else that is above it.
I have some questions I can start working on a bit now.
1. I received a denial and SOC on November 8, 2007.
This was prior to the one year I had to submit evidence.
I know I will have to get an IMO to submit.
When I get the IMO should I
a. Submit it and any other evidence I have and ask that make a decision on my claim as I submitted the evidence within the one year time frame (and they made a decision before that)?
b. Just go ahead and accept that their initial denial is a denial - and submit a NOD with my evidence - which would put me a step closer to the appeal I might have to go through.
c. Both - ask them to make a decision based on the new evidence submitted in one year AND file a NOD -
d. Same as c - but WAIT on the NOD (I have until November 2008).
Medical Opinion
Though they actually ACKNOWLEDGED that my husband was requesting consideration on the theory that his cancer must have begun in the service - the reasons they gave did not have anything to do with that theory.(Based on the growth rate - the cancer could NOT have STARTED after retirement).
They specifically said: "To assist in gathering evidence to support the claim, we requested a VA medical opinion. In response to that request, a VA physician reviewed the records and noted that the symptoms noted during the veteran’s treatment in the service suggest manifestations of viral respiratory tract illness, and that none of the episodes can be reasonably linked to an early manifestation of lung cancer. He then provided the medical opinion that the veteran’s signs and symptoms listed in his service medical records are less likely than not early manifestations of the adenocarcinoma of the lung first diagnosed in September 2000.
So they blew off the whole growth rate argument - and just addresed whether any SYMPTOMS in the service were related to the cancer.
I have researched cancer and growth rate at the BVA and come up with TWO distinct patterns.
Those which GRANT service connection because of more likely than not IMOs based on growth rates.
Those who ARGUE growth rates - but do NOT provide an IMO - which then leads the VA to somehow FIND a medical specialist who says something about how the medical community accepts that the ONSET of cancer is when it is DIAGNOSED.
This is completely idiotic - as the medical community knows fully well that cancer STARTS BEFORE it is diagnosed - which is why they keep pushing for earlier and earlier SCREENINGS.
But - it is a BIG lesson on EVIDENCE. No matter what the journals SAY - you need a DOCTOR to SAY that the cancer started before it was diagnosed to get the GRANTED type of decision - because if you leave it to THEM - they will find the doctors who say that cancer starts at diagnosis - and you will get a DENIED type of decision.
Anyway - I am asking for a copy of the VA doctor's opinion.
I am also asking for a copy of the request they sent for that opinion. (Because if they only ASKED him to discuss if the symptomology in service was related to the cancer - they prejudiced the claim by limiting what he discussed. I am not going to ARGUE that right away - because if his report isn't favorable - then I don't want to give them a reason to let him discuss any more - However, I will keep it as a back up.
Anyway - Since we already asked they consider the theory of that the cancer had to have started in the service - and they specifically acknowledged that was the request - and they have ALREADY had their opportunity to GET a medical opinion about that - then if this doctor played around and just discussed the symptoms in service - have they already USED their chip to get an independent medical opinion?
What I am asking - is now that they played their hand in whatever way they played it - if I get a medical opinion that indicates it is more likely than not that the cancer started in the service (regardless of whether there were any symptoms) - can they seek ANOTHER opinion that addresses THAT? Or would that be a "fishing expedition?
The growth rate argument is not unique. The BVA has granted many cases based on that same theory. In fact when I typed in a search at the BVA with Cancer and Doubling Time - I saw GRANTED GRANTED GRANTED.
SO they know EXACTLY what we are talking about - they just have danced around the issue.
Also - my understanding was that the VA doctor was supposed to view the ENTIRE C-file. As my husband has repeatedly stated his cancer began in service - has repeatedly stated his doctors told him that based on growth rates, and the LAST evidence we submitted was all the treatisies that expounded on that - If the doctor didn't even address that - and only discussed symptoms in service - then again, will they be "allowed" to seek ANOTHER opinion after I submit an IMO.
I guess I am looking for a way to prevent that game.
Some GOOD news is that they actually CALLED the evidence we submitted " a bound volume of medical treatises" and NOT "internet printouts."
I consider that a GOOD sign - and the information we sent is from sources such as the National Cancer Institute, Center for Disease Control, FDA, peer-reviewed journals (NOT anything they could question the credibility of).
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