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  • 14 Questions about VA Disability Compensation Benefits Claims


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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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The Veterans Administration saves countless lives every day.

Their malpractice statistics might be comparable to those of all private US hospitals.

There are very few documented cases whereby a health care professional made a conscious decision to cause harm or death to any patient, veteran or civilian, such as the Michael Swango case.

If a veteran and/or their spouse has major concerns that their VA health care is inappropriate or somehow casing them additional disability due to medical error-they need to question their VA doctor and if that does not resolve their issues, they need to contact their VAMC 's Patient advocate right away.

If these steps do not resolve the issues, they need to get an appointment with the VAMC director and make sure the director has the veteran's records at that meeting so the director can document the meeting and the veteran's concerns in the medical record.

If that does not resolve the medical issue, then it is time to call your Congressman/woman who has a VA liason person to get involved with these concerns if they can potentially help with a resolve.

Sometimes none of above will stave off a serious negligence issue that can get worse by the day.

If a serious misdiagnosis occurred then all subsequent treatments for that improper diagnosis could lead to considerable more medical problems,and even lead to death.

Anyone contemplating filing a Section 1151, 38 USC or a FTCA case , and these are well ecplained in this forum,must obtain copy of the the entire clinical VA record.

Dont tip the VA off that you are considering formal charges.Just ask for a complete copy of the medical records.

Then if the VA has not been able to resolve the issue or assure you that the care is proper-

be willing to get an independent medical opinion.

There is an excellent template here on IMOs under this type of claim (good enough for FTCA as well as 1151 claims.)

The cost of an IMO might be quite high-bt it will either support a Section 1151 and/or FTCA claim or it will give the veteran and their family Peace of Mind if it reveals the care has been proper and was not negligent.

Filing under FTCA does not require having a lawyer but I highly recommend getting one.

If you obtain a strong IMO that reveals serious negligence or malpractice,that has caused the veteran to have documented additional disability, a good malpractice lawyer would be a fool not to take the case.

I hardly ever offer strong opinions here on this type of claim unless I see evidence (from what the veteran has posted or attached) of a strong basis for a valid 1151 or FTCA claim.

But my opinions or medical assessment means nothing to the VA. That is what IMO doctors are for.

There is considerable info here on these types of claims.

My cover letter for IMOs for a non 1151/FTCA claim contained an exhibit list to highlight where- in the med recs, the malpractice occurred and then where the records revealed it was covered up by many VA doctors.

I tabbed those specific medical records with colored tabs in the stack as the entire record will be considered by the IMO doctor.

These IMOs were for a claim involving an additional malpracticed condition that I could not determine for 8 years.It was an undiagnosed AO condition thus I needed to file a new claim.

The IMO doctor had the past FTCA/1151 admissions of malpractice to consider and

was a specialist in the field of the additional new malpracticed condition.

Specialists in the field of the malpracticed disability are the only ones who can really give a strong opinion

that considers all available medical evidence for 1151 and FTCA purposes.

Malpractice lawyers and malpractice doctors can advertise on the internet these days and some will possibly assess your case -to an extent -by email.

The differences between 1151 and FTCA is explained in this topic with all the legal ramifications to consider.

All service orgs (DAV,AL,VFW) have vet reps trained in 1151 claims.

They do not handle FTCA cases.

If you file under both-the level of probative indisputable evidence is the same for both types of claims.

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Excellent information!

Thank you, Berta!

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I just realized Rakk deleted some posts he made in the IMO forum that could have been helpful here.

I thought we had a IMO template for FTCA/1151 claims.

I will dig out my Peer Reviews reports this week (am on vacation) and try to post a more specific criteria for a 1151/FTCA IMO.

(I am sure it was here some time ago but I cant find it yet)

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This is a better idea-

I have asked 2 vets local this past month to come to hadit with their potential 1151 issues.They have not joined yet and I cannot help them until they do.I don't do emails,PMs, phone calls or visits over claims anymore.

Everything a vet needs to know on filing these issues is here at hadit.

If they have anyone medically trained among their friends or family- perhaps that person would be willing to help them assess their evidence.

But the best bet is to get an IMO from a real doctor,who is a specialist in the field of the disability claimed due to the malpractice.

An IMO for Section 1151 claims and FTCA cases

must clearly reveal they(VA) did not adhere to medical principles or treatment as found in the usual and standard medical community, and due that medical error(s) or omissions of proper medical acts)

then the IMO must have a full rationale as to the additional disability you incurred and why it is due to the negligence or malpractice.

Excerpts from treatises and other medical citations can help a lot- but VA only considers them if they come from a medical professional.

Instead of trying to explain this all here again-and FTCA Peer Review info is searchable on the other forums here-as it has come up many times-

it is best to ask your vet rep (who is handling your 1151 claim) if they have a specific criteria for this type of IMO as I believe they might have a template they use.

I thought Rakk posted one from the DAV but I could be wrong.

A vet rep might well have their own template for 1151 claims.The wording can be critical to the outcome.

If the rep doesn't seem to understand the claim-find a new rep.

In regards to how to combat any negative Peer Review report (for FTCA issues) your FTCA lawyer will definitely have a specific form that regards FTCA IMOs and this is what the IMO doctor will need to follow,along with ALL available medical evidence and any other documentation that will help prove your case.

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Berta, I save info in case I need it later. I found a post that you made and it might be what you are looking for or similar to it. Hope you don't mind that I post this for you.

Posted previously by Berta

Posted 08 February 2011 - 08:35 AM

Template for Section 1151 claims

To VARO etc

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

I believe my VA medical records will reveal that I did not receive a standard of VA medical care comparable with that of the standard medical community, regarding treatment (or non treatment) of my (put disability here that they malpracticed on) and as a result of the VA's medical errors I have incurred an additional disability of ( put the additional documented disability here that you claim is directly due to the malpractice. Add any secondarys to this that also are due to the 1151 disability.)

I have listed and enclosed the following medical records to support this claim:

(Then list the enclosures with date of the medical test or entry and brief description of what they reveal for the 1151 issue. Try to keep the focus solely on medical errors and the results that are documented.In many cases it could be an “omission of an act.”

Then sign it, make copy of it, and mail it with USPS tracking slip to your VARO

For example your med recs reveal need for MRI and ECHO regarding a VA doctor's concern over a carotid artery situation. The med recs note “W/O CAD.”after you complained of neck pain and headaches. But MRI and ECHO is never ordered. Then you have a major stroke with embolic cardiac origin.This “omission “of proper follow up testing that resulted in your additional disability of a stroke is more than likely malpractice and could involve a malpracticed heart condition as well.

Or say the VA diagnoses and treats you for bleeding hemmoroids for years.You develop another condition that involves further testing such as extensive blood work etc and these tests results cause the VA to consider cancer. They diagnose you with stage 4 colon cancer and remove your colon. You didnt get Stage 4 cancer overnight. The VA has most likely committed malpractice.

These are true cases and much more to them than this -this is just a simplified example of malpractice.

Section 1151 claims ,when first filed, should be short and sweet. Focus solely on the evidence of negligence or malpractice in the medical records.It is a good way to state the claim as 'I believe, or I think or I feel '

that VA made medical errors and caused you additional disability but from that statement on- give them documented facts supported by copies of the clinical record.

All NSOs and vet reps are trained with the same training I got on Section 1151 claims.I advise getting a POA for 1151 claims.The Section 1151, 38 UCS regs are not difficult to understand and contain the keys to what evidence you need:

1.documented proof of medical error ,omission, negligence, malpractice that is in your VA medical record file.

2.Documented proof that you have a resulting additional disability directly due to the malpractice.

If VA was negligent to point of causing you harm, this will be in the medical records. This is why it is best to obtain an IMO for these claims.It will be in there but if you don't have a medical background, it could be well hidden and attempts can be made by VA to cover up prior malpractice,

Those attempts to cover it up however will be documented in the med recs.That sounds odd but I found evidence of a VA cover up and can verify it happens. That evidence was also critical to my FTCA/1151 claims.

VA fights 1151 issues aggressively. The initial filed claim will draw them out. They might well put their foot in their mouth in the SOC.But they will try to walk all over you if you do not have an IMO. An IMO for a Section 1151 claim, if it supports the malpractice-will easily be absorbed cost wise by some of the 1151 comp checks you get , that you might never see with the IMO.

FTCAers and 1151ers:

I have alreadly posted in the FTCA forum many important things to consider if you file both types of these claims. The VA will only pay once under either of these regs.That info is detailed here and with the FTCA regs which are googleable.

If you have lawyer preparing your FTCA issue. Ask the lawyer if you can use their exact wording on the SF 95- the part where the claimant states the charges.It is under Number 8 on the SF 95 form:

after stating that this is a claim under Section 1151 , 38 USC.Instead of what I posted here.

Get the lawyer's permission if you use this statement from the SF 95 verbatim for 1151 issues.

For the claim as well as for an IMO you need to thoroughly review your medical records any many times. Get a good medical source to use to help understand the medical acronyms and abbreviations. Try to figure out anything that has line drawn through it or that appears they tried to erase or delete.

Prepare a cover letter for the IMO doctor with your take on how they malpracticed. The IMO doctor will review everything anyhow but nothing should be overlooked.For examle a minor entry on the surface might mean nothing but there could be extenuating circumstances the IMO doc needs to know.

I quoted something a VA doctor told me in Aug 1992in my FTCA/1151s but had no proof of what he said- then I realized the very same day I talked to him, his entries revealed what we had discussed.His handwriting was awful and copies of this entire page of the med rec always comes up very light and hard to read.It took many hours but I could decifer the whole thing and it was critical to my 1151/FTCA issues and my IMO. It was also the day the cover up began. I had asked the wrong question. They started to scramble.

Another entry was very very hard to read and I had the VA contact the doctor and her secretary transcribed it to for me.

On the hard to read entry I couldnt' believe how ridiculous what the VA doctor had written was. .I was sure I was reading it wrong.

The transcribed version was verbatim to my decifered transcription. More proof of VA malpractice.

One cannot overlook a single entry or chart or test results when filng FTCA and/or 1151 against the VA.

GRADUATE ! Nov 2nd 2007 American Military University !

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Thank you Susan.

I was looking for something that could be used both for FTCA cases and 1151 claims.

On a SF 95 form , the charges should be stated a specific way and they can be stated this way for a Section 1151 claim.

They should be worded basically the same way although VA handles these types of claims separately.FTCA through Regional/General counsel and 1151 is filed at the VARO level.

The template you found is basically what I used in the form of a letter but it was a re --re-opend 1151 claim.

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