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Help! Another Medical Opinon #5 And Counting!


Gosh, I do not know how long this will go on! Since my last post in March, my claim for Cause of Veterans Death was returned to the AMC and once again it was sent out for another Medical Opinion this month which makes the 5th time they have requested a medical opinon. I have submitted 2 more IMO's from his treating doctors since my last post, both agree that his DM II was a contributing factor in the cause of death and also state that he had IHD. (all the proper VA lingo was included in the IMO's so there would be no speculation when it gets to the raters desk)

The hospital discharge summary on date of death indicates that he had an acute myocardial infarction with left branch bundle block. I have read the new regulations on IHD and the regulations state that it includes acute myocardial infarction. When I sent the last IMO in I pointed this out to the AMC. I also requested to be afforded "Benefit of the doubt" since the prior VA medical opinions were purely speculative with no rationale and did not agree or disagree with the claim and that both treating doctors confirmed without any speculation that DM was a contributing factor in his death supported by lab reports, hospital reports etc.

These reports also indicate that he had End stage renal disease and was on dialysis secondary to the DM, he was on a restricted diet, restricted activities and taking both oral meds & insulin to control the diabetes ( I pointed this out also since he was only rated 20% for the DM but due to the increased problems he would have been rated higher if he had survived).

This claim is driving me crazy and wearing me down now! I wish they would decide one way or the other so I know where I stand it has been with the AMC since August 2008.

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Your vet rep or VSO should have a copy in your POA file of the VCAA letter-

I regret I forgot this was a remand so I feel BVA already checked the VCAA letter-they do that right away- and found it was proper-----or stated something in the remand to make VA correct it- that doesn't seem to be the problem-after I remembered this was on remand-

I wonder if this is the hold up- and maybe your rep would agree-

if they are seeking a cardio opinion-I am thinking that the VA might be doing the right thing and considering if he died from AO IHD contributing and then as an AO vet- this would help the claim for DIC.

The AO IHD regs have not been formally published so they cannot award yet for IHD contributiong but in my opinion this is why they want a heart doc to review the file.

I know that doesn't help during this long wait but -if I was a VA rater and had your claim in front of me-

with proven Vietnam service-I would be anxious to consider and rate any AO IHD if that was a contributing cause of death.

He had DMII too I believe- and they could be considering heart disease as secondary to that.

They have to do what the remand told them to do but I think IHD became presumptive after the remand took place and that is what might be the hold up.

Hope others chime in here with some input as to why VA wants the cardio opinion.

After going back thru my papers, I did receive a VCAA notice in August 09 when the VA informed me that after several attempts they were unable to locate the STR's from his 6 week hospital stay in Nam. They asked me if I had the records and of course I do not.

You are correct this is on a Remand and my IMO's indicate that DM was a cause for his heart problems and that he also had IHD. So hopefully that is what they are trying to connect.

The death certificate states sepsis & multi system organ failure. I pointed out that his kidneys had failed prior to his death and he was on hemodialysis due to the DM. (the doctors also stated this in the opinions).

If they agree that IHD was a cause of death will or should they notify me that there is a stay on my claim until the new regulations are posted?

Thanks again for all the help, I NEED IT!!!

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