Cue Claim?

[jlshand]

Because, apparently its impossible to be TOO petty for the VAROs, would this fact qualify for a CUE claim?

After only one privately done OGTT diagnosing DM11, the P.A at the VA clinic filled a private prescription for Metformin and has been refilling ever since.

If my claim comes to taking another DM2 diagnostic and they insist it be the cheaper glucose tolerance test which has not shown my DM11 (very common thing), would I have grounds for a Cue claim?

Based upon agree ment to treat (the Metformin) implying agreement with diagnosis?

Opinions please? Just trying to cover all the bases since the VA will do ANYTHING! By the way, I realize I could/should just as easily pay for another OGTT myself but....... I'm just getting in warfare mode

Thanks :(

[Guest Berta]

A CUE claim can only be filed on a final claim decision that was never appealed-

There is more CUE info at my hadit blog-

I dont quite understand your question-

The VA can diagnose diabetes with the Glucose Tolerance test, the Blood chem reports, and/or the HB1AC test.

Under Glucose -in your VA blood chem records or under HB1AC they should have values there as to what your readings were.

From: http://www.fpnotebook.com/END11.htm

"Diagnostic Criteria

Random Serum Glucose

Serum Glucose over 200 mg/dl with symptoms

Fasting Serum Glucose

Serum Glucose exceeds 126 mg/dl on 2 different days

Cutoff Reduced from 140 cutoff by ADA (1997)

Postprandial Glucose (2 hours post meal)

Serum Glucose over 200 mg/dl

Precedes fasting glucose increase

More predictive of Diabetes Mellitus Complications

Casual Plasma Glucose (random glucose)

Same criteria as postprandial glucose

Oral Glucose Tolerance Test (OGGT)

Two hour Glucose Tolerance Test (75 gram) >200 mg/dl

[jlshand]

Hi Berta!

Sorry for the confusion.

I'm trying to anticipate the expected denial and covering all my bases, looks like prematurely.

I have one private MD diagnosis of DM11 via OGTT. I am assuming the VA will require another DM test no matter what. and that they wont want to pay for the OGTT but rather the cheaper and less proficient fasting glucose test. I have previously passed this This is apparently quite a recurring happening but of course the VA will "nothing" about the movement to the OGTT as a more definitive diagnostic of DM 2! Since they had already agreed to treat via the metformin, thought I might have an implied agreement with the OGTT diagnosis .....or a case for mistreatment. Guess I thought wrongly that that was what a CUE is for

Edited March 11, 2006 by jlshand

[Guest Berta]

You think like me- always hope for the best but assume the worst!

"or a case for mistreatment" yeah-

If the VA medical records reveal anything that strongly suggested diabetes but they did not follow up on it- that sure might be a Sec 1151 claim.

[jlshand]

Berta,

Well, after reading all the stuff on this and other Vets nets it really is hard to give the VA any benefit of the doubt. I mean, are any claims automatic? Or do they scratch and fight you even for the obvious? Seems so!

Anyway, my VA / service records aren't going to show any indication of DM2. First of all, I'm the guy who was told by NARA they had loaned my service records to the VARO which then told me they had no idea where those records are and havent gotten them from the DEPARTMENT OF DEFENSE???? Don't all the sites tell everyone the old DOD records were all sent to NARA???

My DM2 was diagnosed by my private internist, nothing in any of the VA records. I was just using them for lower cost meds. If I left it to the VA alone of course they would totally deny service connection for the heart problems that have developed ,my internist and cardiologist believe, from the undiagnosed DM2

The thrust of my original ? in this thread really showed my mis- understanding of the CUE. I thought I might use it to show they made a clear error giving me Metformin based on only the OGTT from my private MD.

Guess I'm trying to avoid another unpleasant OGTT test!!! But cant be sure the cheapo test they will proscribe may not confirm DM2 . I think I read that tests on two different occasions are required for definitive diagnosis.

[Guest Namvet6567]

I frequently use the term "grievous error" and the VA seems to accept it. I recently assisted a vet w/a claim for DM-II, AO related and called their error "grievous, possibly reaching the level of CUE." It was under the Nehmer decision and the VA awarded the retro, stating they'd made a "grievous error." I don't care what they call it as long as we win!!!!