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bigred1widow

Ptsd Listed As "significant Contributing Factor" On Death Cert.- Dic Still Denied

Question

My dh was 70% SC for PTSD, had not worked at a full time job for 4-5 years, denied 100% (& IU). Had NOD on file when he was killed in an accident. The coroner listed his PTSD as a "significant contributing factor" to his death due to his increased startle response etc.

VA has denied my DIC saying the coroners determination is "just an opinion" and because the primary cause of death is "blunt force trauma" they do not have to consider the symptoms of his PTSD.

He had been to a scheduled PTSD therapy session the day prior to his death. He scored 72 on his PCL. And expressed "extreme" trouble: concentraiting, sleeping etc.

On top of this the VA still has not sent us his month of death check. Every time I call they tell me it was returned "undeliverable". I live at the same address they mailed all my dh checks, the same address I have included on all my paperwork I have sent them. The last time I called they said a check had been mailed May 6, 2010. It was returned "undeliverable". When I asked what address they were sending it to they said that information was unavailable.

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3 answers to this question

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Sorry for your loss.

Welcome to Hadit.

I am no expert on this but it seems to me if you could get an expert opinion that PTSD could have been a factor in your husbands accident than you should be able to win your DIC Claim.

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"On top of this the VA still has not sent us his month of death check. Every time I call they tell me it was returned "undeliverable". I live at the same address they mailed all my dh checks, the same address I have included on all my paperwork I have sent them. The last time I called they said a check had been mailed May 6, 2010. It was returned "undeliverable". When I asked what address they were sending it to they said that information was unavailable."

Send them an Iris request for the check and mark the request as a Complaint and not a status question.

State in this email to the VA how long you have been waiting and what replies they are giving you as to "undeliverable".

IRIS is the "Contact Us" section of the VA main web site.

"Had NOD on file when he was killed in an accident. " Did you formally re-open that claim and are you pursuing it as well as the DIC claim?

I am a widow of PTSD vet and the coroner,when listing his disabilities for the death certificate, certainly gave me his opinion that PTSD is a serious bonafide disability but he never puts it on death certificates.

Our coroner here in NY is a PA, not an MD nor psychiatrist so that would not give his opinion on the PTSD any credibility with VA.

However I used PTSD as one contributing factor to my husband's death and supported that claim with medical evidence but I had raised two other issues and they awarded DIC on those other Issues.Did you raise any other reasons for death due to his service disability of PTSD as contributing?

I feel that only a strong independent medical opinion from a PTSD expert would possible help this claim to succeed.

Then again it might not. Have you attempted to get an IMO from a doctor outside the VA system?

Was this an auto accident? If so was he driving?

and if he was driving was he under influence of alcohol or drugs?

Or was he on VA medication for PTSD that lowered his ability to concentrate at the wheel?

Was the dosage from the VA an appropriate dosage?

Or was his death due to another form of blunt force trauma?

Can you scan and attach the Reasons and Basis part of the denial?

(Cover personal stuff)

Was an autopsy done and do you have the autopsy results?

If you can prove his PTSD should have been rated at 100% P & T for a ten year period prior to his death (by medical evidence) and this is something an IMO opinion would be needed for- then there is possibility that they would award DIC under the 10 year rule.

(Established total and permanent SC for 10 continuous years prior to death equals DIC.)38 SC 1318

Or if there is possibility of proving that VA itself contributed to his death by administering medications for PTSD that were either contraindicated by other VA meds or profoundly altered his mental state yet he was never told not to drive while taking them- then there is possibility of DIC under Section 1151, 38 USC.

I am assume however this was an auto accident. I could be wrong. He might have been a crime victim. We don't have enough info.

I am sorry for your loss.

We need to read the exact words they used to deny the DIC claim.

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I need to add to this:

"If you can prove his PTSD should have been rated at 100% P & T for a ten year period prior to his death (by medical evidence) and this is something an IMO opinion would be needed for- then there is possibility that they would award DIC under the 10 year rule"

You stated:

"had not worked at a full time job for 4-5 years" and I realize the VA had already rejected the ten year rule as that shows he was not TDIU for 10 years prior to death-

unless-

his prior work experiences during the ten years prior to his death were at jobs that were paying at or below the poverty level.The VA considers "substantial employment"and the ability to attain and retain substantial employment as a factor in TDIU claims.

But unless his claim for TDIU was re-opened by you or you had substituted yourself as the claimant-formally within one year after his death- then the 10 year rule would be a moot issue anyhow.

Still if you did pursue that claim (called a claim for accrued benefits) and could succeed in it, it would provide a payment to you of all accrued benefits for TDIU that were due to him less the actual benefits he received at 70% in his lifetime.

Has any vet rep helped you with this claim?

When was your initial NOD filed?

If on or after June 20 2007-then you could obtain a lawyer.

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