hypertension Death Certificate

[Charleese]

Hi everyone,

My brother-in-law passed away last year and my sister applied for DIC. He was service connected for non-Hodgkin's lymphoma even though he was treated by them for several other conditions. He had been going to the VA for years but just got service connected in May 2004 and died in June 2004. My sister sent VA in Ohio a letter after his death to reopen his case but has not heard from them concerning it. They just recently sent her a letter in April denying her DIC stating the following:

1. We granted death pension benefits effective June 2, 2005

2. We couldn't approve your claim for accrued benefits

3. We have denied your claim for service connected death benefits, called dependency and indemnity compensation (DIC).

It goes on to state: How Did We Make Our Decision? We have enclosed a copy of your Rating Decision for your review. The reasons for our decision can be found in the section titled "Reasons for Decision" or Reasons and Bases."

My questions are the following:

1. There was no Rating Decision attached to the decision sent to her. She called VA in Cleveland, Ohio who issued her this decision and they stated that they do not have a rating decision. Can she appeal on this?

2. Therre was no Reasons for Decision or Reasons and Bases attached to the decision sent to her. Also can she appeal on this?

3. The death certificate states that immediate cause of death was Arteriosclerotic Cardiovascular Disease. Is this heart failure of some type. Please let us know what this is? One of the medication that VA was giving him was Atenolol for Heart/Blood Pressure. This leaves her to believe that this was solely for the Heart because he was taking Felodipine for his Blood Pressure. Also, Death Certificate states other significant conditions contributing to death, but not resulting in the underlying cause, etc. is Hypertension, B-Cell Lymphoma, Hyperlipidemix, and Lupus. Can someone tell us how we can connect Lymphoma to his death?

I realize this is a long e-mail, but I had to put all of the above for you to understand.

Thank in advance for your reply.

[Guest jangrin]

Charleese,

I'm sorry I can't respond to your questions about VA DIC benefits, as my husband and I are new to the process of claims with the VA ourselves. However, artherosclorosis is a condition of the coronary arteries. It is also known in laymans terms as (hardening of the arteries). This is when cholester0l and calcium build up in the heart arteries and cause blockages and the blood flow into and out of the heart and vessels is blocked. The doctors believe that part of the build up in the viens and arteries breaks away from the wall lining , thus causes a "blockage" which keeps the blood from flowing and the end result is a heart attack.

Artherosclorosis is also known as caronary artery disease or CAD, ischemic heart disease. These are all very closely related. Major causes of these conditions are Diabetes, high blood pressure, hyperlipidemia, lupus, and various other ailments, the list is quite long. I recently read some articles that stated, that the remedies or treatment use to aid patients with lymphoma are connected to artherosclorosis. You will need to find a doctor that can take your brother-in-laws medical records and autopsy report and link all these medical problems together. Run a search on the web for artherosclorosis and lymphoma, I'm sure you will be able to see the connection. Hope this helps some, good luck to your family.

Jangrin

[Charleese]

Charleese,

I'm sorry I can't respond to your questions about VA DIC benefits, as my husband and I are new to the process of claims with the VA ourselves. However, artherosclorosis is a condition of the coronary arteries. It is also known in laymans terms as (hardening of the arteries). This is when cholester0l and calcium build up in the heart arteries and cause blockages and the blood flow into and out of the heart and vessels is blocked. The doctors believe that part of the build up in the viens and arteries breaks away from the wall lining , thus causes a "blockage" which keeps the blood from flowing and the end result is a heart attack.

Artherosclorosis is also known as caronary artery disease or CAD, ischemic heart disease. These are all very closely related. Major causes of these conditions are Diabetes, high blood pressure, hyperlipidemia, lupus, and various other ailments, the list is quite long. I recently read some articles that stated, that the remedies or treatment use to aid patients with lymphoma are connected to artherosclorosis. You will need to find a doctor that can take your brother-in-laws medical records and autopsy report and link all these medical problems together. Run a search on the web for artherosclorosis and lymphoma, I'm sure you will be able to see the connection. Hope this helps some, good luck to your family.

Jangrin

Thanks! We appreciate you taking the time to answer. I will contact a doctor for her to try and tie in his Lupus, high blood pressure, hyperlipidemia that they were treating him for. Once again we are grateful for your answer.

Charleese

[Guest elizabeth]

Hi everyone,

My brother-in-law passed away last year and my sister applied for DIC. He was service connected for non-Hodgkin's lymphoma even though he was treated by them for several other conditions. He had been going to the VA for years but just got service connected in May 2004 and died in June 2004. My sister sent VA in Ohio a letter after his death to reopen his case but has not heard from them concerning it. They just recently sent her a letter in April denying her DIC stating the following:

1. We granted death pension benefits effective June 2, 2005

2. We couldn't approve your claim for accrued benefits

3. We have denied your claim for service connected death benefits, called dependency and indemnity compensation (DIC).

It goes on to state: How Did We Make Our Decision? We have enclosed a copy of your Rating Decision for your review. The reasons for our decision can be found in the section titled "Reasons for Decision" or Reasons and Bases."

My questions are the following:

1. There was no Rating Decision attached to the decision sent to her. She called VA in Cleveland, Ohio who issued her this decision and they stated that they do not have a rating decision. Can she appeal on this?

2. Therre was no Reasons for Decision or Reasons and Bases attached to the decision sent to her. Also can she appeal on this?

3. The death certificate states that immediate cause of death was Arteriosclerotic Cardiovascular Disease. Is this heart failure of some type. Please let us know what this is? One of the medication that VA was giving him was Atenolol for Heart/Blood Pressure. This leaves her to believe that this was solely for the Heart because he was taking Felodipine for his Blood Pressure. Also, Death Certificate states other significant conditions contributing to death, but not resulting in the underlying cause, etc. is Hypertension, B-Cell Lymphoma, Hyperlipidemix, and Lupus. Can someone tell us how we can connect Lymphoma to his death?

I realize this is a long e-mail, but I had to put all of the above for you to understand.

Thank in advance for your reply.

I don;t understand if you a asking about penson or compensatiom? atenool is a bata blocker used to slow the heart you might be able to prove this brought on his heart disease you could open a appesl under benifit of doubt i think you would have a good case because why give felodipine for high blood pressure then give a beta blocker Elizabeth

[Berta]

Was this question posted in another forum a few days ago?

I gave a detailed answer-

I cannot find it-

If the veteran received a retroactive payment due to the May decision prior to his death in June- there are no accrued benefits due the spouse.

This is what I mean-I am a widow and filed the 21-534- it covers burial expenses, REPS, etc and the whole thing should be filled out.

Rod's claim was awarded 3 years after he died- he was dead so they could not send him retro- they sent me the amount as accrued-

If his award came in his lifetime the retro would have went to him and I would have not had a claim for anything accrued.

I believe the last check due the veteran in month of death has to be applied for-

I gave a link as to the B cell and NHL- that is only way that his death can be service connected-

Was this question first posted elsewhere?

I cannot find it and hope I dont have to repeat the whole thing again.

The B cell- as my post stated has a definite medical association to the SC NHL-

as a contributory affect to death- as listed on the death certificate-

this is the key to this claim for service connected death.

The coroner could be asked to change the death certificate- it should have mention NHL as a contributory cause-

a real doctor would get the B cell involvement- a VARO employee will not have a clue-

this claim will take an Independent medical statement (if the coroner will not alter the certificate)

to show that the B cell listed as contributing was in fact evendence of the NHL as a substantially contributing factor to death--

therefore a SC death-

if a service connected disability materially "contributes" to death, the death can be service connected.

"The surviving spouse of a veteran who had a service-connected

disability that was the principal or contributory cause of

his death, which occurred after December 31, 1956, may be

eligible for VA death benefits. See 38 U.S.C.A. § 1310(a);

38 C.F.R. § 3.312(a). In order to establish service

connection for the cause of the veteran's death, the evidence

must establish that the service-connected disability was

either the principal or a contributory cause of death."

In this case there are many conditions listed on the death certificate-

the B cell lymphoma ( due to the NHL most likely) is but one of them-

only if any of the other conditions can be associated also to his SC NHL- will the VA grant grant DIC-the NHL is the strong point unless other conditions can also be associated to the NHL.

This claim can succeed for DIC with a strong medical statement showing that the NHL was a materially and significant contributing cause of death and a review of the med records might even reveal that the HBP and heart disease somehow were also due to the NHL- that might be difficult however- I dont know what the B cell involvement to the heart is-

The SC condition is NHL- if you can prove with medical evidence that the contribution of the veteran's SC NHL contributed substantially to his death , the VA would have to award the claim.

My prior post had a link to a B cell-NHL abstract- there are many at google.

I also suggested that she send the Director of this VARO an inquery via the VA web site immediately-

the VA cannot send a decision without Reasons and Bases and expect the claimant to be able to appeal- this is against VA regulations-

I would push them for this- right away-

Also this veteran had some symptoms of diabetes- as I review the causes of death-

was he ever treated for diabetes ? was it ever diagnosed or was it definitely ruled out?

Edited May 10, 2006 by Berta

[Charleese]

Was this question posted in another forum a few days ago?

I gave a detailed answer-

I cannot find it-

If the veteran received a retroactive payment due to the May decision prior to his death in June- there are no accrued benefits due the spouse.

This is what I mean-I am a widow and filed the 21-534- it covers burial expenses, REPS, etc and the whole thing should be filled out.

Rod's claim was awarded 3 years after he died- he was dead so they could not send him retro- they sent me the amount as accrued-

If his award came in his lifetime the retro would have went to him and I would have not had a claim for anything accrued.

I believe the last check due the veteran in month of death has to be applied for-

I gave a link as to the B cell and NHL- that is only way that his death can be service connected-

Was this question first posted elsewhere?

I cannot find it and hope I dont have to repeat the whole thing again.

The B cell- as my post stated has a definite medical association to the SC NHL-

as a contributory affect to death- as listed on the death certificate-

this is the key to this claim for service connected death.

The coroner could be asked to change the death certificate- it should have mention NHL as a contributory cause-

a real doctor would get the B cell involvement- a VARO employee will not have a clue-

this claim will take an Independent medical statement (if the coroner will not alter the certificate)

to show that the B cell listed as contributing was in fact evendence of the NHL as a substantially contributing factor to death--

therefore a SC death-

if a service connected disability materially "contributes" to death, the death can be service connected.

"The surviving spouse of a veteran who had a service-connected

disability that was the principal or contributory cause of

his death, which occurred after December 31, 1956, may be

eligible for VA death benefits. See 38 U.S.C.A. § 1310(a);

38 C.F.R. § 3.312(a). In order to establish service

connection for the cause of the veteran's death, the evidence

must establish that the service-connected disability was

either the principal or a contributory cause of death."

In this case there are many conditions listed on the death certificate-

the B cell lymphoma ( due to the NHL most likely) is but one of them-

only if any of the other conditions can be associated also to his SC NHL- will the VA grant grant DIC-the NHL is the strong point unless other conditions can also be associated to the NHL.

This claim can succeed for DIC with a strong medical statement showing that the NHL was a materially and significant contributing cause of death and a review of the med records might even reveal that the HBP and heart disease somehow were also due to the NHL- that might be difficult however- I dont know what the B cell involvement to the heart is-

The SC condition is NHL- if you can prove with medical evidence that the contribution of the veteran's SC NHL contributed substantially to his death , the VA would have to award the claim.

My prior post had a link to a B cell-NHL abstract- there are many at google.

I also suggested that she send the Director of this VARO an inquery via the VA web site immediately-

the VA cannot send a decision without Reasons and Bases and expect the claimant to be able to appeal- this is against VA regulations-

I would push them for this- right away-

Also this veteran had some symptoms of diabetes- as I review the causes of death-

was he ever treated for diabetes ? was it ever diagnosed or was it definitely ruled out?

Hi Berta, thanks for responding:

Yes you did respond in Social Chat.

She's going to go online and let them know that both Reasons and Bases as well as Rating Decision was not sent. She contacted RO and they said that both Reasons and Bases and Rating Decision were never done. How they issue a deniel without these two, ever being done is beyond us. No he never was diagnosed or treated for diabetes. If he had diabetes and they failed to treat him for it, then we will have to look into that also. As you said evidently whoever wrote descion didn't understand B-cell involvement, nor rating decision and reasons and bases needed to be done. Also, I did have her reopen his case in her name in June. She stated that this re-opened claim refers to the Notice of Disagreement (enclosed) as to his earliest effective date. I'm hoping that eventually she can get his other medical conditions service connected or secondary to it.

He did receive back pay from the time he applied. Why she wasn't approve for accrued benefits, she does not know, maybe it will be stated in reasons and bases.

Once we get rating decision and reasons and bases, I will help her file a NOD immediately letting them know that they did err in their interpretation of the B cells and send them the attachment you graiously supplied.

I will also point out in NOD that atenolol is a bata blocker used to slow the heart, and to say that this also brought on his heart disease. Why they would give him felodipine for high blood pressure then give him a beta blocker as well is beyond me. I probably will tell her to use Relative Expose since this is medical instead of reasonable doubt or to use both. What do you think?

She has a call into the corner to ask him to issue or amend death certificate adding NHL as cause of death.

Hopefully, we can get them to change their decision after receiving NOD without having to contact a NHL doctor. However, if they don't then she will contact NHL doctor.

Thanks!

[Berta]

Charleese-by "accrued" does she mean the retroactive pension amount?

Once the veteran is deceased and they have received any retro due them- then there are no more 'accrued ' benefits- but the VA should have made her pension award retroactive-if she filed the 21-534 within one year after his death.

Even if she did file this within that year- a wartime pension is based on income and they probably looked at the fact that she might have had money left from his retro and then they might have offset that from her pension amount.

When she gets the Reason and Bases that will tell her more-

The VBM makes the point that only if an accrued claim is filed within one year of the veterans death- only then can accrued benefits be determined if they should have been awarded to the veteran in his/her lifetime.

Also the DIC application- it must be filed within one year after death- this goes for the pension part of the DIC 21-534 application too-for benefits to be paid back to date of death. Otherwise they will use the date of application filed as the date they determine the retro from.

Ex: vet dies on August 8th, 2004 ,and spouse files DIC 21-534 app on Nov 7, 2005.

Vet had claim in progress for TDIU which was awarded posthumously in Dec 2005.

The VA does not owe the widow any accrued benefits per 38 CFR 3.1000© 2005

(38 USC 5121 ©

The VA also -whether they award DIC or pension -in this case-does not owe the widow any retro DIC or NCS pension

except for what goes back to the Nov 2005 filing date.

We had a widow here whose date of filing her DIC claim was decades after her husband's death.She won a lot of retro but it could not go back to his date of death- only to the date she filed the claim.

I believe you mean that she did obviously file within the year after death and maybe the VARO had misinterpreted her filing date ???

The Reasons and bases will tell much more.