Can Someone Help Keep Me On Track?

[Guest morgan]

I have come to Hadit this time with a broken heart. My kind and sweet husband of 27 years died last Friday. He was rated at SMC M and was enrolled in the VA Home Based Primary Care program. He had a visit with the VA nurse on Thursday, a week before his death. She found a 101.7 fever but didn't follow up with us about it. He had had recurrent UTIs and had been on three rounds of antibiotics, so I assumed the fever was related to the UTI. The third round of antibiotic was to end the next day after the nurse visit. When I didn't hear back from the nurse, I thought the UA must have been clear. But he was still very weak and sick. I took him to a private doctor and he sent him to the hospital. We found out that he had pneumonia so advanced, on top of severe lung disease, and he just couldn't fight it off. I am devastated. I know I need to file a claim for DIC, but I just can't get my head together to find the application or know what else I need. Or how much DIC pays now. Anything anyone might remind me of, I would greatly appreciate, as I have been at home taking care of him and can't seem to think outside the caregiver box. I'm sure my good sense will come back soon, but I just can't think right now. All of our income is gone, of course, and since he was so sick, he had little life insurance.

Any help to keep me on track would be greatly appreciated. I'm just not used to not being able to think. I'm trying to find a job, too, but as crazy as I am right now, I'm sure no one would hire me. I just have to settle my heart and mind. I would appreciate your prayers.

Edited December 26, 2008 by morgan

[Berta]

I just spent some time reading the VBM on this issue.

It does appear that -even if VA Nursing Home Care was negligent -the vet has the right to file FTCA and/or 1151 claims.

I was confused by this:

"VA Home Based Primary Care program"

The VBM makes the point that there are 3 types of NH care available to vets-

2 are contracual situations but the main one is what we have near me- a VA Nursing Home, sole VA medical treatment, right on the Bath VAMC grounds.

In this situation - which I got wrong understanding it- it seems that VA care - not contractual nursing home care-even in the veteran's home by a VA employee would be basis for 1151 claim.I have never seen that type of claim before.

But a lot happened to this vet directly due to being a VAMC patient I am sure -that could have been negligent leading up to this.

These types of claims need a strong Independent Medical Opinion that can fully identify any malpractice and associate that with the resultng death.

FTCAs should have a lawyers help and a good lawyer could use the IMO for the FTCA claim.

What might look like malpractice at first-might not be at all.

I sure am not a doctor either- just interpreting the post here in which it does appear something went wrong in this vets care.

FTCA claims and 1151 claims should always have an IMO for support and FTCA lawyers can be found on the net.

[Guest morgan]

My deepest thanks to all of you who responded to my desperation. I've had the worst day today, I'm just not handling it well. I'm a very strong person, but I've never faced anything like this. The hurt is so deep it's hard to breathe. Most of the time I wish I didn't have to. I guess I'll get over that. I'm so exhausted from fighting the VA on every turn, that I have little reserve to cope with his death. He was my everything. His love and support--always there, even in his sickness--was my backbone. I took care of him 24 hrs every day and I'm so thankful I could do that. Now I'm finding it hard to think outside the caregiver box. Like Berta said, every move I made was based on what was going on with him. Now he's gone. I hadn't had more than four hours sleep at night for four years, now I have way too much time to sleep. Way too much time to do nothing even.

Let me see if I can clear up some of the needful details. My husband was not in a nursing home. Mags is right, he was at home and his VA primary care team came to our home to care for him. In 2004, after the worst incident of poor VA medical care, he was enrolled in the Home Based Primary Care program. We had the funeral last Monday, and we will have a memorial in South Carolina next week, as he was a pastor in the Carolinas for 35 years. He spent 11 years in the USAF, then left service to answer God's call to ministry.

I don't know if this is malpractice, but his SMC M rating included one type of lung disease rating. I'm going to try to go on Monday to get his medical records from the VA and the private hospital where he was before he died. It still amazes me how upset I get when I even look at VA records, after what we went through to get his claims approved. In fact, if I see anything from the VA, I start shaking. It must be VARO-induced PTSD. (I don't say that in disrespect or to minimize any veteran's PTSD from military service, I truly mean that I think dealing with the VA claims system affected me in a similar way. I had nightmares about the VARO when I worked through my husband's claims. The system was truly traumatic for me.). The VA nurse came on an unscheduled visit about two weeks ago because I kept telling them I wasn't happy with the "protocol" they planned for his Coumadin treatment. He ALWAYS had interaction with Coumadin and antibiotics, other than Macrobid. A private doctor put him on daily Macrobid to try to control UTIs, then the VA decided that was a good idea. A private doctor decided that an ultrasound was advised to check out why so many UTIs, then the VA decided an ultrasound was a good idea. Despite chronic antibiotics, he had breakthrough UTIs. He would have to stop the Macrobid and start a different antibiotic. The VA doctor said he didn't want him to have his PT/INR checked more than once monthly. I insisted that that was not often enough when he was on antibiotics, especially when adjustments were needed. The adjustments needed to be followed too. They weren't happy with me, but I didn't care. Once before, the VA had failed to monitor his blood thinner and make appropriate adjustments, and he ended up in the ER with overanticoagulation, almost three times more than therapeutic (which was already high by necessity). That time I took him to a private doctor, and he was bleeding in his lungs and bladder, and his VA labs showed out of range for two months (I got a copy of them later), and by that time he was into the third month out of range, yet VA didn't notify him to adjust downward. He was going to an OPC then. Two weeks ago, the nurse came to do labs for PT/INR and she found a fever at 101.7. I was shocked that he was running a fever that high, as he rarely had done that, if ever. She also took an UA sample, and said she would let me know if the sensitivity culture showed anything. I still haven't heard anything from them. In the meantime, I saw that he was having greater difficulty breathing and was getting weaker, so I took him to a private doctor who ordered a chest x-ray and found pneumonia almost covering his right lung, plus his BNP was 1177! Normal is 6-67. Serious problems were way ahead of us by then, and soon the doctor said he just wasn't strong enough to fight it. I was so hopeful that he was turning for better last Friday morning, as his white count was down somewhat and his blood gases were bad, but no worse, he was talking and joking. Then the doctor took me to a room and told me he wasn't going to make it. I couldn't believe my ears. He had to go on 15L of O2 by mask, and still had saturation in the 70s and 80s. He had said no resuscitation, after the doctor told us it would be unlikely that they could get him off the vent successfully because of his lung function. So I asked if we could take him home if they could do nothing else at the hospital. He was home in his bed for about two hours when he could breathe no more. I'm so glad he knew he was at home in his bed. I realize that didn't matter in the whole scheme of things, but it mattered to me.

I think if the VA doctor had ordered a chest X-ray as soon as the nurse found the fever (about a week earlier than when he went to the hospital), then with appropriate antibiotics, he would have had a better chance of overcoming the pneumonia. He had pulmonary fibrosis (likely associated with medication and radiation for prostate cancer) and the added stress of pneumonia was more than his diseased lungs could handle. He always fought so hard to stay with me. He knew how much I loved him.

Life is just one big blur now. I hope one day it will be better. I realize I'm not the first person to lose a beloved husband, but it's my first time. And I'm finding out what a baby I really am. I miss him more than words can say. (Sorry this post is so long.)

Edited December 27, 2008 by morgan

[Josephine]

Morgan,

I am so sorry for you loss. It will be some time before you can make rational decisions, but remember we are all here for you.

Betty

[Berta]

Morgan- Josephine is right-

It would be best to get all of his medical records and then discuss the claim with a rep before you file it.

There is too much for you to deal with as it is at this point.

I didnt file for DIC formally until I had a copy of Rods VA med recs.His Section 1151 -word for word as he had prepared it-was the basis of my re-open and I felt I had to prove exactly what negligence he charged VA with in that claim.

I couldnt even think about all that for many many weeks after his death and would have probably worded the claim wrong if I had done it too soon.

If there is not a possibility of direct SC death- any Sec 1151 claim will sure take time and will probably need an independent medical opinion anyhow.My 1151 took over 3 years for award.

We are here to offer our support and help with any questions you have and the DIC claim can wait until you have the records and are better able to deal with that.

It is hard to feel any sense of closure however- when a DIC claim lingers at the VA without resolve.

My present claim is almost 6 years old and only a few weeks ago- was the medical evidence finally read.

It is set for s decision but who knows what that outcome will be and how long the decision will take?

The endless waiting drains widows and vets of the energy they need to continue to fight if the decisions are wrong.

A claim has to be out into proper perspective -otherwise a VA claim will control us day and night.

[Commander Bob]

I am profoundly saddened to hear of your husbands passing. I am moved beyond words by your loss. I weep for you and my fellow veteran brother. May he rest in peace.

[vmo]

I might still have this wrong.

This decision shows what I mean- some nursing homes are not under the Secretary's Jurisdiction.

I would think a VA Nursing home would be.

http://www.va.gov/vetapp08/files2/0809862.txt

Also if any negligent care came from a VAMC employee at a VA Nursing Home I still believe this falls under their FTCA liability.

I need to find out more info and we dont know if there is any FTCA basis at all.

I do suggest that you obtain a service rep and get copies of every medical record he had from private hosp, docs, and the VA before preparing a DIC claim with a 21-526 form.

I did that to make sure that when I stated reopen of my husband;s 1151 claim- that I already had some of the evidence of malpractice that I found in Rod's VA med recs.

I also learned that VA writes FTCA and 1151 all over the C file for these types of claims and would probably stall on any records release unless the survivor got the med recs first before tipping them off to any negligence claims.

##Morgan: Sorry to hear of your tragic loss this Christmas. My prayer's are with you and your family.

*The VA Form for a DIC application by a widow should be VA FORM 21-534 "Application for Dependency and Indemnity Compensation or Death Pension by Surviving Spouse or Child". Effective 12-01-2008, the monthly rate of DIC for surviving spouse (widow) is $1154 plus $286 for each dependent child under age 18. Also, I believe there is possibility of an additional allowance added on if the veteran was rated totally disabled for at least 8 years immediately preceding death, add $246 monthly. In addition add another $286 monthly if widow is entitled to Aid & Attendance or $135 if housebound.