Knock Me Over With A Feather

[johnjjr]

I posted on wed. I was unsure about filing a NOD on my Jan '09 decision. Well, I did. Hand delivered the papers to the RO wed. afternoon,got a signature and came home. 150 miles round trip but worth it. Out of curiosity, I called the 800 # this morning at 11:15 AM to see if it was in the system yet.I was told that this morning a DRO had requested a hearing on my NOD. I couldn't believe it, so I called again and was told the exact same thing. I was told on the second call that it will be after the first of the year before a hearing can be scheduled. Talk about the speed of light. I didn't know the VA could move so fast.

Do you think there is a legit reason for this or am I just being shuffled to meet someone's quota?

[Berta]

John the new VBM page 202 lists cataracts as having strong association to diabetes and gives a link.

Yes you should claim the cataracts and see what other excuse the VA could find for you having them.

I had vet whose BVA CAVC BVA CAVC BVA VARO ordeal was in progress for over a decade before I was asked by his rep for help.

Claim was inservice diabetes.

BVA mentioned he had a drusen in his SMRs regarding an eye exam.

Neither the vet rep nor the vet ever looked up what a drusen was. I couldnt wait till they left to research that word.

It means macular degeneration- a familiar symptom of diabetes. I had a beauty of a claim and 3 days later prepared a great rebuttal for the vet to the most recent denial.

He had developed cataracts by time I met him.

With my help and 2 IMOs from his doc he won his diabetes claim- it took 2 IMos because the doc did the first one all wrong.

They need to use the criteria here.

An IMo could certainly help you if VA has not linked the cataracts to DMII.

There could be some other reason for this problem and not DMII- but I am sure it is worth while pursuing this.

DMII can cause glaucoma, retinopathy, cataracts, and macular degeneration (drusen formation)

Early on visual problems (blurred or double vision, an odd glare sensitively to sunlight) could indicate diabetes.

Even my husband's documented vision problems were part of my evidence for his untreated and undiagnosed diabetes.

The VA would have to have full strong medical rationale to go against a strong IMO John on this-

and they dont usually have much medical rationale that makes sense.

Their docs know how to save them comp money.

Edited November 21, 2009 by Berta

[johnjjr]

You might find that they could make a favorable decision without the hearing-

that is a possibility here- if they have the evidence I am mentioned below-and they actually read it-

"denied CAD as diagnosed prior to DMII, "

Do you have medical statement that the CAD is as likely as not due to the DMII?

(which it most surely is in MOST cases)

(denied ED as part and partial to DMII) other more than likely-in my opinion- but I am not doctor-

so any of your meds have ED as side effect of the meds?

"denied eyesight as not caused by DMII."

Do you have atherosclerotic heart disease-

meaning did you ever get ECHO that gave low ejection fraction?

any high cholestrol problems?

any hyperlipedemia?

Is your vision problem due to cataracts?

Can you possibly scan and attach the decision? (cover the personal stuff)

Berta,

Didn't do it right but attach 3081 is decision, 3082 statements from C & P exams and 3083

is a list of DX problems as of Oct '09.

Yes I have been DX'ed with AHD.

MUGA scan in '01 at 48%, left heart cath in '09 at 50%.

I take simvastatin for high cholestorol.

yes to cataracts.

As I see it, everything hinges on proving I was diabetic prior to cath in '01. I have 2 hospital lab reports from '01 prior to cath showing glucose levels of 163 and 149.

do you think I have a chance with the NOD?

[Berta]

I will ask a moderator to get this post into the CLaims Research forum up top- as we need the experts

here- more who will read the scanned stuff-

I think you have basis for Section 1151 claim-the VA could have diagnosed and treated DMII with the evidence (glucose readings in March and December 2001 ) in 2001 and that failure to treat caused you multiple additional disabilites.

I also feel you have basis for direct service connection on most of the disabilities as well as 1151 SC. You can only get one type of SC but you have 2 ways to go here.

This stuff crops up more and more with DMII and AO veterans.My claim had same premise as what I see in your claim.

I had to prove my husband had DMII in 1988 and that VA's failure to treat and diagnose caused him ischemic strokes and heart disease and death. That claim gave me a lot of medical knowledge as to DMII claims-

I only found a few glucose readings in his med recs.VA tried to say they were not abnormally high but refused to read my response that these occurred while he was on a Feeding tube-could not eat or swallow for weeks-documented right in the same med recs as the high glucose readings.

I am going to print off the scans here and I hope others here will chime in-

John- your situation here is a prime example of how these people at VA withhold proper retros and

can overlook signficant medical evidence.

It sounds like you have a supportive vet rep- I need to thoroughly so over what you attached--

I believe the VA did to you what they did to my husband-failure to diagnose and treat DMII, until it caused additional complications, and then have the nerve to say these complications had nothing to do with the DMII,and

They are KILLING vets by doing this - by shortening their lives.

As well as saving proper EED money by failure to properly adjudicate the claim.

I will go over the scanned carefully and hope others will too-

The VA diagnosed you with DMII on Oct 28 2005 but I think and You think you already had Diabetes since 2001!!!!!!!!!!!!because the med recs show the elevated Glucose readings in 2001.

It is malpractice!

I have quite a bit of med info here that can help you get the correct EED and hopefully all secondaries properly SCed.

Edited November 22, 2009 by Berta

[johnjjr]

Hate to show my ignorance in these matters but what do you mean by a 1151 claim.

Also, to clarify on the ED, it was denied as part and partial to DMII on my first claim, but on second claim in Apr '08 they re-rated it at 0% and awarded me an SMC K dated back to the original claim.

Any help I can get will be greatly appreciated.

THANKS.

[Berta]

John _ I am going to devote the rest of my day after I get off here to the stuff you attached.

38 USC Section 1151

If the VA fails to diagnose and treat a disability (whether SC or not) and they cause a veteran additional disability due to that failure-

the additional disabilities can be service connected due to the negligence.And compensated.

What I see here is that they will possibly award you direct (secondary) SC for the denied conditions but if they dont that 1151 scenario could get you the same compensation-

Still direct SC is much better then 1151 "as if" SC-

So with Direct SC on this -you have 2 years in which to file a FTCA claim for malpractice.

I would support-if it comes to that - that your knowledge of potential malpractice came to you today,from my post here, Nov 22,2009 and I would prepare a signed and notarized statement to that effect if needed for the Statute of limits on FTCA.

I am known by many FTCA lawyers at the OGC- Douglas Bradshaw last week during a phone conversation asked me to apply for job at the VA-many of them ask me to do that because I know FTCA case law.

I was a successful FTCA litigant without lawyer or IMO and they remember my case.

It is every more important now since I succeeded in April on Direct AO death when prior to that I got DIC because of a successful 1151 claim.

My husband himself filed a Section 1151 claim in 1994 predicting his own death because he feared they were negligent with his conditions

and hours before he suddenly died

he insisted that I re-open it if he died.He had just called the 800# to learn both of his claims were at the rating board- 1151 and higher PTSD rating.

He said 'they are going to kill me and they might try to kill you too'

I figured he just meant the frustration was enough to kill anyone.

He dropped dead a few hours later-

My recent award-

AO death due to undiagnosed DMII, undiagnosed heart disease from DMII, HBP treated improperly medically due to DMII, major cerebral vascular accident rated 100% also misdiagnosed, due to DMII from AO in Vietnam.

If there is any hint of medical negligence here in your case (and I think there is)

your vet rep has to be aware there is potential for awards under 1151 if not under direct SC.

Reps cannot help with FTCA claims however.

Your situation is almost exactly what happened to my husband.

BTW the SMC K award is the same as getting the ED SCed to the DMII.

Feel free to copy my posts and send them to your rep if you wish-

and I will gladly give him or her my contact info if they need it.

Edited November 22, 2009 by Berta

[johnjjr]

Berta,

Will PM my e-mail address to you. Any additional info I have I will supply at your request.

Again, THANKS for your help and support.