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Ihd Earlier Effective Date Denied!

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stillhere

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Well got the letter today from VA in a small white envelope and it said denied for an earlier effective date based on all the evidence in my folder....

While I agree that the tests the VA and C&P ran in 2003 and 2005 did not show heart disease I believe it was because of the sub-standard testing preformed at the 2 C&P's.

I am at 100% P&T with SMC-s so I guess I should be grateful and just walk away from this now before it really does kill me! I guess I might.

Then again I may contact a lawyer and get some advise on how to precede. Berta always said that I might have a better chance at a FTCA claim or a 1151 but I just don't know now.

How the VA can say that a vet that comes to them with angina and hyperlipdemia should not be tested appropriately by echo or angio is just beyond me. My blockages of 100%/90% and 50% THAT DAMAGED 40% OF MY HEART DID NOT JUST OCCUR ON OCT.05!! They were there and nobody detected them and it almost killed me!!

Sorry I am running on and yes ranting... I need to clam down. Let me know what you all think.

Happy Holidays!

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"While I agree that the tests the VA and C&P ran in 2003 and 2005 did not show heart disease I believe it was because of the sub-standard testing preformed at the 2 C&P's"

What tests did they give you?

If I were you- you might consider getting an IMO.

Then again this could be costly and maybe would not reveal any VA negligence....but

"How the VA can say that a vet that comes to them with angina and hyperlipdemia should not be tested appropriately by echo or angio is just beyond me. My blockages of 100%/90% and 50% THAT DAMAGED 40% OF MY HEART DID NOT JUST OCCUR ON OCT.05!! They were there and nobody detected them and it almost killed me!!"

This is beyond me too but this is how they caused my husband's death.He was rushed to VA ER from his job at VA as he had collapsed.

The VA treated him with sudafed (said he collapsed from sinus condition) did EKG and sent him home.

When he suddenly died 6 years later I re-opened his 1151 claim and when I fully understood all the notations on the VA ER certificate-and the EKG - I filed FTCA right away.

You might be beyond the FTCA Statute of limits- 2 years from date of knowledge of potential negligence.

I began to build my case with considerable more evidence and the VA RC wanted to settle with me in mere months as they had obtained a Peer review right away that agreed with my charges.

The Peer Review report, the RC and the VA doctor who did the report disappeared and it took me almost 3 more years to succeed.

If I had a lawyer for FTCA this would not have happened.

Luckily I had developed a medical background in cardio and neuro enough to make my charges quite valid by time this went to the General COunsel and I proved them to the GC and the Cardio med team in DC. However VA is VERY reluctant these days to give any credibility to medical evidence that comes from a lay person.My evidence was overwhelming and I presented it carefully.They did give me a hard time but once I dealt directly with OGC lawyers- things began to go smoothly.VA Lawyers can read. The FTCA case I had was far easy to succeed in then all of my past claims... because I dealt with VA lawyers who knew I had presented a claim they could nt deny (they tried twice but it didnt work)

This is how a potential 1151 claim has to be presented to them.

You could send the a ballpark open end statement at first- (I did this for local vet -only a few sentences- bingo 1151 award of 100% in 5 months.

Just say

this is a claim under auspices of Section 1151, 38 USC.

I believe my VA medical records will reveal my heart condition was not properly assessed,diagnosed and treated when it first presented itself in ( date of first documented VA visit for angina or first time they SHOULD have ordered more tests)and that ,due to VA negligence,I have incurred additional disability with my heart condition.

When VA gets something like this they might respond with something you can use against them. This protects your EED by iling this statement and gives you time to support it.

You could refer to-and enclose copy of the first med rec that showed their was potential heart problem and then med rec that reveals your current condition.

C & P doctors are not supposed to really diagnose and order further testings so this would probably rest on records that occurred before and after the C & P exam.

Hyperlipedimia? do you have diabetes ?

Hyperlipedimia was a marker for my husband's also malpracticed and undiagnosed diabetes mellitus.

I didnt even knw he had this. A VA doctor in a SSOC for the 1151 claim mentioned it.

I immediately went to a medical library to find out what that was.

No internet when I did these claims.

The SSOC was an awful denial at the time but worth it's weight in gold when I found that term in it.

VA will aggressively fight against 1151 claims if they can. However they will often put their medical foots in their mouths when they do it.

I have certainly used their documented erroneous medical statements in SSOCs against them.

The 1151-if you file it-will open a bag of worms they must respond to.

The notations that tipped me off on the ER certificate were "R/O CAD" "W/U for CAD" "dysphagia" and then clearly abnormal EKG.and of course the sufdafed (which the VA agreed I had proven also was instrumental in his sudden death)

Malpractice has a paper trail. It can be well hidden in the med recs.

For my present claim I sent them a record from 1992 that referred back to this ER certificate.

I testified that I had spoken to the cardiogist who made the entry- he and the head neuro were confused as to the origin of Rod's CVA.

I told him I felt this might have had something to do with the prior ER situation (I didnt have any med recs then) and asked him if he had the complete clinical records.He said he did and put the phone down to search them and then suddenly said "Oh my God, I see it, thank you very much!!!"

What he saw, which I did not quite understand at that point was the first manifestation of IHD presented by a heart attack which they treated with sudafed.That is when, as I stated in my case, the cover up in one VAMC began to cover up the initial malpractice in a different VA.

If the VA had sigivifant fdocumented reason to consider you for cardiac testing and they failed to do that- it is obvious they caused you to have considerable additional disablity.

There are malpractice lawyers on thre net who handle claims against the VA. Mayve Robb Graham could help you or direct you to an attorney. He is always overwhelmed with cases.

And if you have a strong IMO that reveals malpractice any malpractice attorney would be foolish not to handle your case.

My case was like yours in this respect.

Proper testing was never done even though the ER cert and the EKG warranted it.

At no time when other manifestations of heart and brain Ischemia occurred and were documented by VA was anything done medically until 1992.

Then when VA had a chance to alter their negligence, they failed to and covered up the past negligence.

The result was that my husband -who had seemed to be improving , suddenly dropped dead.

I took them step by step - med rec by med rec -from their initial misdiagnosis in 1988 up to his death in 1994.

You need to look over all of your medical records very carefully.

If you feel that they did not give you pro[per care, you certainly should file a Section 1151 claim (dont know as to the FTCA

and a lawyer could advise you better on that.Those 2 years after knowledge of potential malpractice can go by fast and the OGC holds to that statute with no execptions. A good lawyer can manipulate the statute limits sometimes.

Do you have a vet rep?

They are trained in 1151 claims.

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Thanks Berta I was hoping you would reply, From reading about your husbands murder I felt we have some common areas.

*First applied in 2003 Dxed with DM2/Hypertension/PN/ED denied heart pain after walking treadmill and ekg. But started drug treatment with lipitor and zocor by PCP.

In c-folder was report from private heart evaluation center (echo) that showed 50% LVE calculated from 2002.

*Appealed 2004 after still having angina and given a C&P in 05 Sept. denied again after walking treadmill and ekg but in SOC mentions Hyperlipdemia.

*Oct. 24th 05 Heart attack over weekend (doctor said I had 2) ignored went to private doc on Monday and rushed to ER for emergency angio after EKG at his office. 2 stents placed and blockages noted of 100%/90%/50%.

Heart disease granted secondary to DM2/hypertension only back to date of heart attack. Listed as MI/with CAD secondary to DM2.

*Filed for IHD for EED on Oct. 09 when added to Presumatives asking for earlier date and 60% Denied on Nov.30th 2010.

That pretty much sums it up and I hope (think) I answered all the questions. Please let me know what you and anyone else thinks. Would appreciate it!

By the way they did not change my current 100% any and noted that in my denial.

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"Denied on Nov.30th 2010." Can you scan and attach the denial here?

"First applied in 2003 Dxed with DM2/Hypertension/PN/ED denied heart pain after walking treadmill and ekg"

Was the narrative at top of the EKG tape indicative of anything abnormal?

"private heart evaluation center (echo) that showed 50% LVE calculated from 2002."

The ECHO results would show any atherosclerotic involvement.

I assume this was the estimated left ventricular ejection fraction? LVE ?

ECHOS are hard to interpret and there are sites on the net that explain them.

Was there hypertrophy listed on the ECHO results?

I see there were 2 EKGS, do you have copies of both of them?

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Lorraine said:

"He filed for hypertension and heart disease back in 1979 when he retired from the AF, but they say because he never received TREATMENT for hypertension or evidenced any heart disease on chest x-ray and electrocardiogram at that time"

Was there any evidence in SMRs, por VA or private records that they were wrong in the old decision?

and

"I think it borders on malpractice for you guys to be sent out the door and told you are fine and then end up with heart damage from a MI that maybe could have been avoided! "

You are right. It is a Disgrace! The OGC doctor said my husband's care was "indefensible"- it was that horrible. And it only takes one incident of misdiagnosis or lack of treatable proper diagnosis to start a snowball effect of continuous medical damage to the veteran.

I used to have faith in anyone who had sheepskin from a medical school on the wall of their office.But I sure learned to get and read all of my medical records.The internet has made it so much easier to comprehend what they mean

The VA saves lives everyday. I think they saved my life a few years ago.

They have Many exemplary doctors and nurses who know what they are doing.

They also have some downright dopes with MD after their names.

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Berta asked if there were any SMR's or VA or private records . Yes, when he was stationed on active duty at Boeing aircraft, he broke his ankle and had to be seen at a US Public Health hosital(no longer exists) and they noted that he had hypertension on his clinic visits(but, not at a compensable level for VA). We had our own copies and provided copies to VA iwth his claim. Then his retirement physical showed hypertension and they were the ones who told him to file with VA, he did and they said he was fine. Ultimately, his IHD would have been the same, but the extensive heart muscle damage could have been avoided.

Now that his claim has been awarded, we're going to get copies of his C-file because we've never seen a copy of his C & P back in 1979. Heck, we were ignorant to the whole thing, they said he didnt have a problem, we believed them. I am still so angry, but try not to dwell on the fact that there could/should have been intervention then.

I'm a retired RN(wasn't back then) and know this kind of thing happens elsewhere within the medical community, but the VA is a huge training facility for doctors and I personally think they are not closely enough supervised. We've heard too many stories here on Hadit and in the media to discount these fiasco's as being rare!

Gosh, Berta, you've been through a lot and here you are working diligently every day to help Vets with their claims and sharing your knowledge. I really admire you and appreciate all that you do for the folks here on Hadit. Even though my knowledge is very limited, I still am wanting to be able to help other Vets through this claim process whether it simply be filling out paperwork, providing transportation, making some phone calls. I'm going to find a way.

Lorraine

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Berta, And all tomorrow AM I will be going to the heart evaluation company that did my 2002 echo and ask them after a discussion to elaborate on their findings in 2002.

I am hoping a letter from them would help establish the fact that CAD/IHD was indeed present then.

I also plan to see the DM2 that first sent me to that exam and their position on my heart risks under their care. I am hoping with these two letters and one my from current cardio doc explaining how the progression of my blockages.

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