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Help Denied Twice

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big jim

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was geting 100% from july 2009 to jan 2010 for ankle fusion. ortho doc gave me off tell july 2010 in dec 2009 this was denied. after the visit with ortho doc in dec my surical wounds started to drain real bad. whent to er was sent to opd clinec. refieled for temp 100% for wounds not heald, denied. doc set in dec wounds were healing, i told him about the dranage he just shafed it off. my wife was there to back me up . now the va keeps denieing me because what the dock said in dec. i have been going to the opd clinec twice a mouth sence dec to get my wounds heald. also i had a little infection sent in that had to be treded. acording to title 38 4.30 i stell am intield to the 100% tell my wounds are heald is this not right. i did a regular requst then a reconsederation, what next, and earer on there part our what. if iam not intieled fine put i dont see how. pleas help me i am at a lose on how to proced.

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Have you seen any private doctor yet?

"i did a regular requst then a reconsederation, what next, and earer on there part our what. if iam not intieled fine put i dont see how. pleas help me i am at a lose on how to proced."

When was the reconsideration request filed?

Make sure-if they do not act on the request -that you file a NOD before the year NOD time frame is over.

You need to stress to them that the healing is very problematic and that the infection has caused you a longer convalescence than normal and is still disabling you.You can add evidence at any time to support the reconsideration request.

I also suggest that you file a Section 1151 claim.

Here is an example of the wording it should have :

http://www.hadit.com/forums/lofiversion/index.php/t1702.html

I dont have my husband's original 1151 in this PC.

Basically he stated he believed that his VA medical records would reveal that they did not give him appropriate care for his stroke and his HBP (and his PTSD) and he believed that they would eventually cause his death due to heart disease and strokes.

He was right. When he died 6 months after filing the claim (it was in rating board the AM of his death)-I re-=opened and then for next 3 years supported the claim with medical evidence.I also filed and supported FTCA wrongful death claim too.

It all took evidence so strong that there could be not doubt whatsoever that the VA cased his death.

I focused continuially on the criteria for Sec 1151 claims in the link:

1. documented disabilities caused by the alleged malpractice

2.documented proof of the malpractice.and how it caused the disabilities and his death.

I didnt have an IMO or a lawyer for these claims.I studied cardiology and neurology for many many months.I had to know everything I could to go against VA Central Strategic Health team. I left almost no stone unturned. The one unturned stone was my 2003 claim.I got 3 IMos for that.In the 10 years since my last award the VA had changed considerably.They read my evidence in 3 months for my FTCA claim and wanted to settle that spring.4 months after filing the SF 95.My 2003 claim- additional malpractice- they didn't read a single bit of my evidence for 7 years.

Much of that was due in great part to my POA.

If you pursue a 1151 claim, I suggest you get a real doctor for an IMO (the criteria for Independent Medical Opinions is in the IMO forum)

but even more importantly I think you need an outside opinion and proper treatment of this condition.ASAP.

Do you have Medicare?

An outside opinion and treatment could help considerably with the temp convalescence claim and -if the infection and treatment has not been proper and has caused you additional disability-an outside specialist could help opine on the 1151 claim as well as treat you appropriately for these problems.

I am not a doctor but it seems to me this is taking a very long time to properly heal.

I suggest you access on the net- this type of surgery- from what I read (I briefly did this the other day) the convalescence period should be much shorter than what you are experiencing.

That tells me something is wrong but I dont know what.

Do you have any type of blood problems that could hinder healing? are you a diabetic? anemic? do you take coumadin? there are factors that might cause prolonged healing but these would be found in your medical records.

What type of infection did you have? what is the medical term they used?

Any outside doctor will need your complete VA med recs, to include all Blood Chem results and your medication list.

I had a friend =a patient at local VA nursing home who developed maggots in an open wound.His story was in the local newspapers.

Oddly enough it wasn't malpractice at all. (long story)

Still - it sounds like the infection was cured in your case yet there is residual edema and I don't think there should be edema at this point.

I feel you need to see a specialist with no ties to the VA at all to see what is really wrong with the ankle problems.

Edited by Berta
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