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Oh So Many Questions!

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Bigred122

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I swear I would go crazy without this site. I can never seem to get answers from the VA any more. Is anyone else having problems getting files from Our Government lately? NPRC does nothing but give me the run around. I have tried getting just regular records thru Ebenefits site( DPRIS) and get the run around.I have requested my C File 3 times now in the last 2 1/2 months and no response. I can not get the RO to acknowledge my NOD, DRO Hearing or anything relating to my claim. The site shows receipt of my letters, but no one has responded to any of my request. Is this common practice from them. I just received my nexus letter today for my 1151 claim. Everyone says it should be short and sweet and that is what is was.The Dr is a specialist in his field and has been writing these for years for Hep C Veterans. I just expected more I guess. Maybe that was part of my problem was over killing my claims. Anyway my question on this is, Should I save my nexus letter and info and give it to the DRO at the hearing or should I send it early so that they can dispute it prior to the hearing. My RO is in Portland, Or but I'm thinking that my DRO hearing will be at Boise Id since they are only 60 miles vs 500 miles.They are the offending hospital on the 1151, but I think they will send someone from Portland since the originated my claim. Or at least do a teleconference with them in Portland and me in Boise. I don't know how you DIYers do it without any guidance instructions. I can't believe how little of info there is out there on how to do it yourself. I couldn't tell you how many times I've gone thru the Warms Library to find the info on DROs I was looking for. Has anyone found out if there is a site where one can find stats on claim approvals per disability. The BVA and CAVC sites are good on claims that have gone that far. What I'm looking for are the stats of claims like Hep C or other disabilities that were approved without going to the courts. The generalize data doesn't help me with what I'm looking for. Data I'm looking for is like how many claims for Hep C from transfusions or surgeries each year were filed,granted or denied without going to court. The government is Data freaks, so it is somewhere. I'm afraid it falls under we don't want you to know category. They act like parents when they say you are denied because we say so. I say show me the proof or prove to me how I got(whatever) don't just use the old because you say so. Well I better finish this before my computer dies again.The next time it might be fatal for it. Mike

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Just to add, someone asked if Benefit of Doubt applies to Sec 1151 claims.I pulled out my 1151 award letter and there is no mention of BOD at all but they used the FTCA info as evidence and maybe that is why.

I found very few 1151 claims at the BVA awarded under Benefit of Doubt.

The weight of the evidence for 1151s as well as regular claims has to be equal but, in my opinion, knowing how aggressively VA fought me and I fought back on my 1151 FTCA issues, I feel these 1151 claims sure need a lot of evidence to get them 'weighed' properly by the VA for Benefit of Doubt to kick in.

The devil is in the details in many 1151 claims.Medical records need to be thoroughly reviewed.I think I reviewed my husbands Med recs dozens of times before I filed 1151 and FTCA.

But even though I took the VA step by step on my FTCA and 1151 issues, by solely relying on the specific medical records that revealed malpractice, I missed the DMII malpractice and this caused me to reopen my 2003 AO claim.Which took more then twice as long as my 1151 claim did to succeed.(Actually my daughter made me reopen it because some things regarding Rods death still didn't make sense.)

I reluctantly reviewed his entire med recs again looking at them in a different point of view as he had never been diagnosed or treated for diabetes and I didn't want to reopen a claim that had no merit or medical basis I could not prove.

Suddenly the proof I needed for my DMII claim appeared by figuring out a very small notation that had been crossed out in the med recs.I had disregarded it completely for my past claims because it had been crossed out.

Then I remembered the very day this notation was made and why-something I had forgotten about for years.

Then I tried to find the doctor who made the notation.VA said he didnt exist. They were right as I was spelling his name wrong based on a few scribbled signatures in the med recs.

Finally I found his name typed out clearly in the MRI report.

It took me at least 8 months to find him, as he had left the VA for private practice.

Long story short -I contacted him and sent him some of the med recs and his crossed out notation. His brief email response to me was given as much weight by the BVA as my 2 formal IMOs.He remembered the veteran and confirmed what he had written in the med recs -which someone on the VA medical team had crossed out.

One cannot overlook a single thing in medical records when they file 1151 claims.

And then Research ,as well, can become the key to the claim.

Did your IMO doctor fully assess your blood chem reports as to before and after the surgery?

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Just to add, someone asked if Benefit of Doubt applies to Sec 1151 claims.I pulled out my 1151 award letter and there is no mention of BOD at all but they used the FTCA info as evidence and maybe that is why.

I found very few 1151 claims at the BVA awarded under Benefit of Doubt.

The weight of the evidence for 1151s as well as regular claims has to be equal but, in my opinion, knowing how aggressively VA fought me and I fought back on my 1151 FTCA issues, I feel these 1151 claims sure need a lot of evidence to get them 'weighed' properly by the VA for Benefit of Doubt to kick in.

The devil is in the details in many 1151 claims.Medical records need to be thoroughly reviewed.I think I reviewed my husbands Med recs dozens of times before I filed 1151 and FTCA.

But even though I took the VA step by step on my FTCA and 1151 issues, by solely relying on the specific medical records that revealed malpractice, I missed the DMII malpractice and this caused me to reopen my 2003 AO claim.Which took more then twice as long as my 1151 claim did to succeed.(Actually my daughter made me reopen it because some things regarding Rods death still didn't make sense.)

I reluctantly reviewed his entire med recs again looking at them in a different point of view as he had never been diagnosed or treated for diabetes and I didn't want to reopen a claim that had no merit or medical basis I could not prove.

Suddenly the proof I needed for my DMII claim appeared by figuring out a very small notation that had been crossed out in the med recs.I had disregarded it completely for my past claims because it had been crossed out.

Then I remembered the very day this notation was made and why-something I had forgotten about for years.

Then I tried to find the doctor who made the notation.VA said he didnt exist. They were right as I was spelling his name wrong based on a few scribbled signatures in the med recs.

Finally I found his name typed out clearly in the MRI report.

It took me at least 8 months to find him, as he had left the VA for private practice.

Long story short -I contacted him and sent him some of the med recs and his crossed out notation. His brief email response to me was given as much weight by the BVA as my 2 formal IMOs.He remembered the veteran and confirmed what he had written in the med recs -which someone on the VA medical team had crossed out.

One cannot overlook a single thing in medical records when they file 1151 claims.

And then Research ,as well, can become the key to the claim.

Did your IMO doctor fully assess your blood chem reports as to before and after the surgery?

I have all my lab tests from 1994(when I came back to VA for medical problems) to 1999 post surgery.My Dr looked at those closely. They showed that the VA had tested me for the usual Hep A,B,C and HIV in 1995 and all those test were neg. My next blood screen was done before my colonoscopy in 1997 and my ALT levels were elevated while AST levels were well in the normal range.Still neg for Hep C. They were treating me for a growth on thyroid as well as Graves disease as well as 4 medications they were giving me for various reasons are all known to raise ALT levels while leaving the others normal.Dr confirmed what I had found. I don't have the case study handy, but as you know with a 1151 claim all the veteran has to do is show that a unforseen event happened that either injured or killed the veteran to win. No fault has to be proven by Dr or hospital to win your claim.(They wouldn't admit to it it you did prove fault.) The surgeon is still practicing at my VAMC and is just as arrogant as he has always been.I am almost positive he was the one who altered my authorization form.All tho he is 100% American, his use of the english language is unique. His surgery report seems to recall a event from a different place and time. It came no where close to nurses notes,ER notes or any official record. Example: His notes stated he went home early because I was not bleeding and I was only hold for observation.(Truth per record: I went to hospital because I was bleeding heavily and ER notes me losing around 550cc of blood per hour.)

I sent my civilian Dr,All surgery notes, lab tests and my personal findings such as the medications that elevated ALT.The medical site listed about 10 medications that would do that, my pre-surgery medication list showed 4 of those medications on it.I was taking shark cartillage for my cervical injuries as well as meg doses of vitamins and both of these will also raise one ALT levels. So that and the fact that blood supplies were safer after 1992 was their reasons for my denial.So I believe that when the DRO reviews everything,if they aren't biased, I should be granted.The hospital Chief of Staff(also my PCP), was more guility of what wasn't done such as incident report and failure to give me my "Due Process" as required per VAs SOP. The Chief of Staff is responsible in making sure hospital staff follow that procedure to the T.VAOIG reports show that they had already been notified that this procedure was not being done at this VAMC as well as veterans/families were not being notified in a timely manner of their rights when incidents happened.So their lack of actions on this matter speaks volumes to guilt as more so than the actual events that may have lead to the getting of Hep C. If I was hospital staff, the first thing I would have done was contact blood supply for donor records.Second I would look at records of all veterans who had colonoscopies on the days I had mine as well as the one day between to see if any of them have a record of Hep C. These are easyily checked things that I would bring to the vets attention if they all showed negative. But I have never gotten these results and I had asked for them back in 1999 as well as with a FOIA request during this claim period.Again, no answers speaks louder and clearer than answers.I'm guessing something showed positive.If the VA was smart, they would have tossed blame at the Olympus equipment manufactures who received warning letters stating inferior materials used in equipment that would not properly sterlize, Bad valves that would bleed back into the patient any contaminated materials, and and instructions on cleaning equipment that came with equipment did not meet FDA standards. So with all the problems at the time with civilian manufactures and blood banks and as was testified at the Miami VAMC congressional hearings, that the VA medical staff are slow to make changes as directed by SOP.In the civilian world you don't follow the rules your fired. In VA world they wait for you to adjust at your own pace. And if that doesn't work they promote and transfer you. Then you only have to keep your nose clean for two years and all violations are removed from your file.What a system to work for.

Anyway, I hope I have answered everyones questions. No one says life would be easy(unless your some little mommas boy who pays to make your life easy) so I have always had to fight to get what I earned. So as long as I have a breath, I'll fight them on this. All I can do is hope that somewhere along the journey I find justice who will look at just the facts and make a decision accordingly.Thats all that I can ask for, thats all I want!! Thank you everyone for your posts,encouragement and suggestions. When you take this journey alone without a compass or directions, it can sometimes be frustrating and over whelming.

mike

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I finally received an acknowledgement for my NOD/Request for a DRO hearing last week. So I guess they are running a couple of months to reply to our communications. I have attached a copy of it for your viewing pleasure. I've never seen a reply for a DRO before so I don't know if it is standard or not, but gut tells me something is unusual about it. You fine folks have seen many of these and I am sure if something is funny with it you'll let me know. Also I have attached my cover letter to my 38 USC 1151 DRO Hearing Binder.This is the largest portion of my claim and the most complex.I have tried to use Fanaticbooks Format to try and keep it simple and clear enough for a Fifth grader.My Brain is guilty of rambling, so I must keep hitting my fingers with a ruler to keep to her Format.(I'll ramble in each sections overview and in my final section where I hopefully tie all the pieces to the puzzle together).Any and all suggestions will be gladly appreciated.My other binders will be much simplier to put together. No new evidence to add and hopefully I'll be able to find some CHEAP nexus letters to help with the larger ones(highest disability %). Still haven't received any of my FOIA request and all are way over the supposed 20 work days they are to get information to me or at least a letter stating why I can't have it.Most have now gone 6-9 months with no answer and two levels of Management communications. I guess that will help me once I get to the BVA stage and the Duty to Assist claims.I figure asking for the evidence 4 times is sufficent on my behalf.Ok, I think you are now updated and I will await your suggestions. Mike

IMG.pdf

DROcoverLtr.pdf

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Michael,

Some suggestions for your cover letter. Do with it what you will. They are just suggestions for writing to make it easier and faster to read.

I am not sure how good my transfer from my WORD to this topic will be so watch out for run together words. That's just the way it works.

fanaticbooks

*****************************************

This Cover letter breaks down each section/subsection. It describes the evidence within each part.

Please note: I have previously submitted copies of 11/26/1997 colonoscopy surgery; 11/29/1997 post colonoscopy surgery notes fix bleeder; and all medical notes in between the two surgeries.

Section A: Cover letter

Section B:

- Copy of M21-1MR Part IV, Subpart ii, Chapter 2, Section G. This describes 38 USC Section 1151 claims and all that is needed to have all Disabilities granted as if Service Connected.

Section C: Copy of the VA’s denial of this claim.

Section D:

- Medical notes and medical evidence addressing issues noted in the VA’s denial.

- D1) Lab Tests from 1994-1999 (showing elevated AST levels in 1997, while lab tests show negative for Hep C).

1/1999 First blood test showing positive for Hep C.

- D2) Medication lists prescribed by the VA as of 11/1997.

- D3) Medical article showing that five (5) of the medications that I was taking as of that date would cause my AST levels to be elevated and still be Negative for the Hep C Virus.

Medical records also showing that at that time I was being treated for Thyroid problems that would also cause my AST levels to be elevated.

- D4) Overview of this section.

Section E:

- Evidence showing Blood supplies and Surgical practices improvement from 1992 until 1997. However, many problems still existed due to lack of the following of procedures and policies by both the FDA and the VA OIG.

- E1) GAO Blood Safety Reports and FDA Blood Bank Warning letters pertaining to failures to follow procedures and policies.

- E2) FDA Warning Letters pertaining to defective materials or parts in the manufacturing of colonoscopy equipment as well as other manufacturers of colonoscopy equipment. This includes the Olympus equipment used in the Miami and other VA medical centers involved in the 2008/2009 problems affecting hundreds of veterans.

-E3) VA OIG reports showing lack of the following of procedures used in the operation as well as sterilizing and reuse of colonoscopy equipment throughout many VAMC’s from mid-1990’s up to and including current time periods.

- E4) Overview of this section and how it applies to the VA’s denial.

Section F: Dr. Bennet Cecil’s nexus letter with his enclosed exhibits.

Section G:

BVA Case #0723873. This is a case where the veteran was granted benefits for a 38 USC 1151 when a transfusion for a 2003 surgery resulted in them getting Hepatitis C.

(NOTE TO MICHAEL---Did you mean “them” above or “him” getting Hep C?)

Section H:

A final overview. This will address previously submitted as well as new evidence and how it pertains to the objections that caused my claim to be denied by the Rating Team.

Edited by fanaticbooks
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Michael,

Some suggestions for your cover letter. Do with it what you will. They are just suggestions for writing to make it easier and faster to read.

I am not sure how good my transfer from my WORD to this topic will be so watch out for run together words. That's just the way it works.

fanaticbooks

*****************************************

This Cover letter breaks down each section/subsection. It describes the evidence within each part.

Please note: I have previously submitted copies of 11/26/1997 colonoscopy surgery; 11/29/1997 post colonoscopy surgery notes fix bleeder; and all medical notes in between the two surgeries.

Section A: Cover letter

Section B:

- Copy of M21-1MR Part IV, Subpart ii, Chapter 2, Section G. This describes 38 USC Section 1151 claims and all that is needed to have all Disabilities granted as if Service Connected.

Section C: Copy of the VA’s denial of this claim.

Section D:

- Medical notes and medical evidence addressing issues noted in the VA’s denial.

- D1) Lab Tests from 1994-1999 (showing elevated AST levels in 1997, while lab tests show negative for Hep C).

1/1999 First blood test showing positive for Hep C.

- D2) Medication lists prescribed by the VA as of 11/1997.

- D3) Medical article showing that five (5) of the medications that I was taking as of that date would cause my AST levels to be elevated and still be Negative for the Hep C Virus.

Medical records also showing that at that time I was being treated for Thyroid problems that would also cause my AST levels to be elevated.

- D4) Overview of this section.

Section E:

- Evidence showing Blood supplies and Surgical practices improvement from 1992 until 1997. However, many problems still existed due to lack of the following of procedures and policies by both the FDA and the VA OIG.

- E1) GAO Blood Safety Reports and FDA Blood Bank Warning letters pertaining to failures to follow procedures and policies.

- E2) FDA Warning Letters pertaining to defective materials or parts in the manufacturing of colonoscopy equipment as well as other manufacturers of colonoscopy equipment. This includes the Olympus equipment used in the Miami and other VA medical centers involved in the 2008/2009 problems affecting hundreds of veterans.

-E3) VA OIG reports showing lack of the following of procedures used in the operation as well as sterilizing and reuse of colonoscopy equipment throughout many VAMC’s from mid-1990’s up to and including current time periods.

- E4) Overview of this section and how it applies to the VA’s denial.

Section F: Dr. Bennet Cecil’s nexus letter with his enclosed exhibits.

Section G:

BVA Case #0723873. This is a case where the veteran was granted benefits for a 38 USC 1151 when a transfusion for a 2003 surgery resulted in them getting Hepatitis C.

(NOTE TO MICHAEL---Did you mean “them” above or “him” getting Hep C?)

Section H:

A final overview. This will address previously submitted as well as new evidence and how it pertains to the objections that caused my claim to be denied by the Rating Team.

Thank You for cleaning that up for me!! Mike

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