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Asbestos Related Lung Disease, Denied!


Old 5311

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My diagnosis was for asbestos related lung desease; emphysema. Maybe I went wrong using the word "asbestosis". Who knows? The damage is located in the upper lobes vs lower. This is what the RO emphasized.

Quote from my Rep:

For VA purposes any post drug predicted FEV1 reading above 80% are considered normal, your's was 108%, this is one of the reasons the VA Dr says your breathing problrems are un related to asbestos, he also says you have dammage to the upper lobes of the lungs and asbestos always effects the lower lobes first, so if you have asbestos exposure related lung disease and show effects to the upper lobe, you should also see it in the lower lobes, again according to the scans you submitted, you only have involvement in the upper lobes - and none in the lower lobes.

My VAMC test results:

FEC: PREDICTED-4.95. PRE DRUG REPORTED% 3.90. PRE DRUG PREDICTED 79 <. POST DRUG PREDICTED 95. %CHANGE 20.

FE1: PREDICTED 3.42 PRE DRUG REPORTED% 3.24 PRE DRUG PREDICTED 95 POST DRUG REPORTED % 3.71. POST DRUG PREDICTED 108. %CHANGE 14.

I was also exposed to Sodasorb and Barylyme while diving..

Any thoughts out there regarding this?

Thanks and MERRY CHRISTMAS!

Edited by Old 5311
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M21-1, Part VI February 5, 2004

Change 110

in some respects. Chrysotile products have their initial effects on the small airways of the lung, cause asbestosis more slowly, but result in lung cancer more often. The African fibers have more initial effects on the small blood vessels of the lung, the alveolar walls and the pleura, and result in more mesothelioma. True chrysotile fibers are hollow and extremely thin. All the other varieties of asbestos fibers are solid.

(3) Persons with asbestos exposure have an increased incidence of bronchial, lung, pharyngolaryngeal, gastrointestinal and urogenital cancer. The risk of developing bronchial cancer is increased in current cigarette smokers who have had asbestos exposure. Mesotheliomas are not associated with cigarette smoking. Lung cancer associated with asbestos exposure originates in the lung parenchyma rather than the bronchi. About 50 percent of persons with asbestosis eventually develop lung cancer, about 17 percent develop mesothelioma, and about 10 percent develop gastrointestinal and urogenital cancers.

All persons with significant asbestosis develop cor pulmonale and those who do not die from cancer often die from heart failure secondary to cor pulmonale.

b. Occupational Exposure etc

This is the significant part of asbestos claims within M21-1 -

do you have your complete medical records from VA? as well as the actual results of any asbestos C & P exams?

I am concerned that VA is talking about "lobes" yet they might not be fully considering that you could have affects in

"Lung cancer associated with asbestos exposure originates in the lung parenchyma rather than the bronchi."

They seem to be looking at lung cancer regs rather than any other lung disease-

This vet was denied but it shows what the VA is looking for in order to service connect asbestos-

http://www.va.gov/vetapp05/files3/0515258.txt

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PS- if I were you I would absolutley file a claim on the affects of the

sodasorb and barylyme as one other reason you have lung disease.

This is one report I just found but there might be more on the web as to the negative affects of these chemicals:

http://66.102.7.104/search?q=cache:KRXbLQh...&hl=en&ie=UTF-8

When you handled this were you issued protective gear?

Or was it part of the diving breathing apparatus?

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Thanks for your reply and link to MSDS and the 2nd link. I used sodasorb and barylyme as a CO2 absorbant extensively while deep, mixed gas diving. While handling these chemicals no PPE was advised or required to be used. As a Machinist Mate I had extensive exposure to asbestos in the 60's and 70's so all the private physicians determined AB must be the cause of the emphysema.

The damage is detected in the upper lobes just as if I were a heavy smoker. In fact I am a life long non-smoker. The upper lobes seem to be the deciding factor in the denial. In addition I have above average lung capacity 6 1/2 L, perhaps this is a factor why I did so well on the pulmonary function test. I have a referral with a pulmonary specialist so soon I may have enough information for a well founded NOD.

Thanks again.

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  • HadIt.com Elder

Old5311

Persistence is the key. The VA just hopes you will give up and walk away. Those who have persisted here on Hadit have most often won their claims. We have some great examples here in Berta and others.

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Berta and Old5311,

What do you make of this part of the appeal?

The United States Court of Appeals for the Federal

Circuit (Federal Circuit) has recognized the Board's

"authority to discount the weight and probity of evidence in

light of its own inherent characteristics and its

relationship to other items of evidence..."

First, does "in light of its own inherent characteristics" give the VA a broad license to deny if a VA exam contradicts private medical evidence?

Second, Old5311, who diagnosed "asbestos related lung disease; emphysema"?

I read "asbestos related lung disease; emphysema" as two lung conditions--obstructive and restrictive (the semicolon reasonably taking the place of the coordinating conjunction "and"). So you do have a diagnosis of asbestosis (which simply means lung disease caused by exposure to asbestos particles), and the RO is without cause to discount the weight and probity of that evidence.

I think an appeal point would be just that--the VA failed to give weight and probity to your competent medical evidence... in light of its relationship to other items of evidence, such as "asbestos-related lung disease" clearly being diagnosed, and because being a lifelong nonsmoker and having no known occupational exposure to harmful elements (I'm assuming here) allows no other plausible etiology for lung disease.

What gets me on this denial is basing it on no lower lobe involvement when the diagnosis of "asbestos-related lung disease" by VA's own admission means the lower lobes are involved. Maybe the scans you provided were not specific to asbestos exposure. Besides that, some are technically difficult and don't show everything. I think a good IMO could box this denial in and win this claim. (And a more positive and helpful SO wouldn't hurt either.)

Carrie

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MMC that decision does not weigh evenly. Asbestos can effect any part of the lung. There are diseases of lower Lung. It may be helpful to actually go to the VA and get a copy of the Xray and the report they used for your exam.

There is pulmonary Fribrosis, Rounded atelectasis( Top part of the Lung) Interstiatal Lung Disease.

Did you have a high resolution cat scan or HRCT,A chest Xray is not worth anything when it is associated with asbestos. The only true diagnosis are from a HRCT. Any VA Radiologist will tell you the exact same. If you did not have a HRCT, I am advising you to use your insurance and get your primary Doc to get you one. Try this site: http://www.radiologyinfo.org/content/chestct.htm.

Now for your asbestos exposure: You were a Machinest Mate Chef Petty officer and you served during wartime. You served on the Shangri La. You also served on 2 submarines. These boats had steam piping and they underwent a rigorous Quality control as a Result of the Thresher SSN 593. Went Down. This included Steam and Water Pipe inspectiuon that resulted in the removing All of the insulation for inspection and Replacement. The Welds were then Xrayed to ensure there were no deefects.A Submarine has no Rating for Repair personnel and the Crew have to go through a Training process to learn every station on the Boat in order to receive their Dolfins. That is where the SS relates to Sub Sailors. A machinestmate is the engineering rating that would be constantly exposed to asbestos Due to the Insulation aroung Reduction Gear,Steam Piping, Floor Tiles, ECT. Asbestos also may have been used in acoustical dampening insulation on Submarines.

What these Guys get away with and they are protected by law.

I have a C and P on Monday 12-19-05 for 5 things 1Pulmonary Asbestos related.

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Make sure- if your DD 214 does not reflect your actual Navy duties that exposed you to asbestos-

that the VA knows exactly what your duties and MOS was while inservice-

I cant seem to be able to post the VA PIES list-of occupational exposure-

Machinist Mate is listed as "probable" exposure-but you might have had other duties that put you into the higher probability of exposure-

If anyone gives me their two letter Navy job-I can look it up on the VA asbestos PIES list-

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j999, MorGan, jstacy and Berta: All good well thought out replies. You'all are awesome! I have an appointment Jan. 11 with a pulmonary specialist, NASJAX hospital. He will determine a fresh diagnosis and I will use his notes for my NOD remarks. The disease was discovered in the ER after I was found unconscious. The hospital gave me a chest x-ray and a Nuclear mist lung scan and immediately asked me how long I've been smoking. Their diagnosis was Emphysema. BTW the x-ray showed nothing. Our discussion led to asbestos after my informing the Dr. that I am a lifelong non smoker and spent years exposed to AB. This discussion resulted in a diagnosis of Asbestos related lung disease; Emphysema. I have also been exposed to large amounts of Sodasorb and Barylime. Soon I'll get another opinion. My large lung capacity unfortunately makes for good PFT results. Glad to hear about the HRCT and will try to get one. Soon I'll have more data and new diagnosis to support a well founded NOD. Thanks for all your efforts and advice!

MERRY CHRISTMAS!

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old 5311 - I was just thinking of you-

because I was working on my asbestos vets claim all week and found that- even though Machinst mate says "probable" exposure-on the VA PIES LIST of MOS exposure- within an old 1999 CAVC decision, the CAVC clearly held that Machinist's mate-as MOS-

in this specific veteran's claim-"was such that it would place him at high risk for exposure to asbestos." A step up from 'probable'-

It is always good to give some details as to what you actually did within the duty that exposed you.

There is no presumption for asbestos by MOS-yet the asbestos guidelines and MOS criteria are developed to help the adjudicator consider the potential for inservice exposure resulting in after service disability.

The latency factor- which VA recognises , can be 40 year or more after the exposure.

My asbestos vet just told me he has an additional cancer just diagnosed that is quite terminal-

It could be from the claimed asbestos cancer- I dont know yet-

I wrote a letter to his VA doctor asking for an opinion-

(I think the C & P he got was buggered-waiting on that)

I asked the doc to give a "more than likely" statement based on his expertise, and I enclosed with that

the fact that the vet had no other etiology prior to or after service for any exposure-

(in the med recs), I attached a printout from the VA itself regarding VA's own recognition of asbestos and disability from it as it was found in old ships, and that- also -as the VA knows, this veteran is a non smoker.

Also I gave the doc the VA's asbestos regs and also a printout involing a large lawsuit that a non vet had won- he got millions- but the point was it also supported this same type of cancer as due to asbestos exposure (the vet has colon cancer- regs state gastrointestinal cancer - sameo sameo in my way of thinking)

(I thought he had a private doc- found out VA doc after I sent this to the vet for the doctor to read-and I had not asked for potential new cancer as secondary because I didnt know about that yet- I dont know what good it will do-they are checking his NAVY MOS via NPRC or something- but this vet does not have too much more time left and if he gets an IMO that helps- we are asking for immediate expeditious treatment of this claim.)

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Thanks Berta, Very good info! I've been covered in AB while busting in AB off steam piping and valves.

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I attached a printout from the VA itself regarding VA's own recognition of asbestos and disability from it as it was found in old ships.

Berta,

Can you tell me where to find this information from the VA? I'm working on a claim for a veteran with asbestos exposure. He just recently developed bladder cancer, which is also recognized as a higher risk for those with asbestos exposure. He found out about the cancer after we filed his claim, so we are working on more documentation.

Thanks,

Carrie

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Hello Everyone,

I submitted an asbestos exposure claim in 2002 and was awarded 60% right out of the shoot. I had a private pulmonary lung specialist right up some letters "that based on my service in the Navy, this is where the exposure came from" and then I submitted them with my original claim. After the C and P exam, the doctor agreed with my private doctor.

My origian claim reads "service connection is established as the evidence show that you did serve on a ship for more than a year and exposure to asbestos is conceded. Doubt is resolved in favor of the veteran.

My Navy service was from 69 to 73 - so there was plenty of asbestos. Sometime in the mid 70's, they started to rip it out of the ships so your naval service dates are pretty important.

Bob

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  • HadIt.com Elder

DirtDog

Are you still working or have you applied for IU?

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I attached a printout from the VA itself regarding VA's own recognition of asbestos and disability from it as it was found in old ships.

Berta,

Can you tell me where to find this information from the VA? I'm working on a claim for a veteran with asbestos exposure. He just recently developed bladder cancer, which is also recognized as a higher risk for those with asbestos exposure. He found out about the cancer after we filed his claim, so we are working on more documentation.

Thanks,

Carrie

Carrie- this was attached to email some time ago by one of our members here-he hasn't been around lately- I made a pdf out of it and cannot get it to copy, paste, or attach here.

My kid will be home in a few days and she will try to get it to post-

Meantime -if you have his Navy occupation code it would help-

I could see if it is on list- 4 pages-

Dirt Dog is correct however- these had to be older ships- do you know his ship's name?

I have a article and picture of my asbestos vet's ship if we need it for VA-USS Bordelon- it was sent to Iran as salvage- probably because too much asbestos to remove-

Also the vet cannot have any other known etiology for their disability- like- if they left mil and smoked for 25 years -the VA tries to rule out lung cancer due to this on asbestos claims-

also one BVA decision I read, the vet was probably exposed in service but then as a civilian he removed asbestos for a living-the BVA denied as they felt the post service occupation most likely caused his asbestos-

it isn't presumptive but with MOS of exposure and asbestos disability they have to run these claims through NPRC and determine the probability of asbestos exposure-of course they want to find any other possible cause for the disablity too- to save money.

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Berta,

This vet was a Marine from 1960-1964, but he was onboard Navy ships for over a year, some of it during the Cuban crisis. He was a rifleman, but he said his job onboard was whatever the Navy needed him to do, so he dusted horizontal surfaces that were covered in asbestos dust, cleaned up all the frayed insulation, helped the painters, etc., and he slept top bunk, directly under an insulated pipe that dropped asbestos dust on him every night. He was on several ships: USS Paul Revere, USS Cavalier, USS Pickanay, USS Renville, USS MaGoffin, USS Montrose. Dr. Bash reviewed his films and wrote a great IMO for him. He gets SSD for his lung problems.

He just had surgery for bladder cancer, so they asked the VA to expedite his claim after the news of the cancer. Does the VA ask for dependent's information before it makes a decision? They got a letter last week asking for her divorce decree (this veteran is her second husband). I thought that sounded as if they are trying to confirm her as a dependent to calculate the compensation, which would mean he is approved. What do you think?

Carrie

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John

In May 04, I lost my job of 31 yrs with the gov't because of my asbestos disease - just couldn't breathe so I was unable to due my job. I applied for IU the same month and was awarded IU in June 04. Two weeks later, I received a letter from the Atlanta, GA VARO stating P&T awarded effective June 04.

I know I had it much easier than a lot of vets - the Atlanta GA VARO has been excellent for me as well as all the doctors in the North Florida/South Georgia Vets Health Care Program.

Bob

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  • HadIt.com Elder

Sorry about the AB disability but glad you go IU and are not suffering poverty like some vets.

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j999, MorGan, jstacy and Berta: All good well thought out replies. You'all are awesome! I have an appointment Jan. 11 with a pulmonary specialist, NASJAX hospital. He will determine a fresh diagnosis and I will use his notes for my NOD remarks. The disease was discovered in the ER after I was found unconscious. The hospital gave me a chest x-ray and a Nuclear mist lung scan and immediately asked me how long I've been smoking. Their diagnosis was Emphysema. BTW the x-ray showed nothing. Our discussion led to asbestos after my informing the Dr. that I am a lifelong non smoker and spent years exposed to AB. This discussion resulted in a diagnosis of Asbestos related lung disease; Emphysema. I have also been exposed to large amounts of Sodasorb and Barylime. Soon I'll get another opinion. My large lung capacity unfortunately makes for good PFT results. Glad to hear about the HRCT and will try to get one. Soon I'll have more data and new diagnosis to support a well founded NOD. Thanks for all your efforts and advice!

MERRY CHRISTMAS!

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MMC, I will be thinking about you. When you have your PFT, Keep a copy of the results. Pay close attention to the Diffusion reading percentage. I have a C and P on Monday for Lung conditon. This is leading to a Cue claim when th e VA did not diagnose asbestois related Lung disease in 1994. The RO will tell you anything to get out of awarding a claim. If you need a statement from someone who served on Subs and actually removed asbestos, ( NEC 9583) Submarine repair. I would be happy to assist.

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MMC, I will be thinking about you. When you have your PFT, Keep a copy of the results. Pay close attention to the Diffusion reading percentage. I have a C and P on Monday for Lung conditon. This is leading to a Cue claim when th e VA did not diagnose asbestois related Lung disease in 1994. The RO will tell you anything to get out of awarding a claim. If you need a statement from someone who served on Subs and actually removed asbestos, ( NEC 9583) Submarine repair. I would be happy to assist.
By the way take a look at this BVA decisoon for asbestosis. It explains the veteran had upper lung cancer. Show this to the RO.

http://www.va.gov/vetapp92/files3/9226449.txt

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