ptsd Need Your Suggestions On Dic Appeal...

[dubsnpugs]

Hello, I have spent quite a bit of time on here the last couple of days reading and reading and then researching and researching. You all are a wealth of information, thank you so much for the guidance. I feel like I am at the point where I need guidance and reassurance that I’m not fighting a losing battle with the VA to determine if my Fathers untimely death was service related or not…

My Father served 3 tours in Vietnam (USN) from August 1965 to January 1968 (He was in Vietnam just 10 days after his 17 birthday, thanks to his loving mother who sent him off to war (insert sarcasm)). After 1968, he was discharged to deal with 2 knee injuries that he suffered, one in war (66’) and one while in Japan waiting for orders on his next tour (67’). He re-enlisted in the USAF and served with them from February 1974 to September 1979. He was discharged due to his medical needs (knees and back) and psychiatric needs. After his discharge my father spent many years in a dark bedroom, went from job to job, struggled with drug use off and on, and sometimes we would not see him for days (or even weeks). My mother stood by his side the entire time. Trying to seek help and time after time, he was pushed off as a "druggie".

Time line of events:

1990’s: In 1991 my father began to suffer severe nerve issues in his hands, legs, and back. After numerous trips to the emergency room, and several surgeries later, he was approved for SSD in early 1994. He also began seeing VA Dr.’s around that time as he was in need of knee surgery and had limited funds as Medicaid would only cover 80%.

1998: His application for disability benefits was received on September 27, 1998 for Agent Orange exposure, PTSD, Knee & back disorders.

2001: Started receiving 60% V.A. benefits and was solely under the care of the V.A.. VA denied claims of Agent Orange as part of the disability, even though he showed neurological signs of exposure. From what I can see my father never fought that ruling.

September 25, 2006 received 100% V.A. disability for his service related injuries, which according to the V.A was PTSD with secondary major depression disorder, degenerative changes status post fusion at T7-8-9, thoracic spine, degenerative arthritis left knee, and degenerative joint disease right knee.

2009: He was provided a motorized wheel chair as his back was too weak and his knees could no longer support his 160lb body. My parents lived in an old farm house that was not wheelchair friendly and this caused many issues for my father trying to get to and from the bathroom with very narrow door ways. It was suggested by his physical therapist that he should have leg braces to help him get in and out of the door ways. My mother was there to help care for him, however she has M.S. and didn’t have the physical strength to get him to the restroom and back.

2009-2012: He had a spinal fusion surgery and another knee surgery and was hospitalized several times for severe falls, one breaking 2 ribs.

9/3/2012: Saw N.P at a V.A. Clinic. Complained of headaches and had a huge bump on his forehead from a fall and she ordered blood work to be done, and sent him home as there was nothing she felt she could do for him. (Currently waiting on a copy of these reports, will have it next week some time).

9/8/2012: 64 years old, passed away shortly after a fall in the bathroom, when his knees and back gave out. The EMT arrived and he was pronounced dead on arrival. He was taken to the corners office. This EMT service had been to the house over 25 times since 2008, and I’m currently waiting on those reports indicating his numerous falls and ambulance rides to the ER, as the VA never requested them, even though we signed release forms. It was suggested by one EMT that was on scene that evening that most like was a blood clot or aneurism due to the falls and the bruises on his head from pervious falls the prior weeks, I’m not sure if that was documented in the report.

9/11/2012-End of Sept.: Death certificated signed by NP on 9/11 who saw him 5 days prior complaining of headaches. She did not see or examine my father’s body. She listed his cause of death as: A. Immediate cause: unknown, uncertain and B. (due to of as a consequence of) COPD. She also didn’t suggest an autopsy and during this time my mother was literally in shock and was not mentally capable of asking for such, he was cremated on the 12^th, as my mom didn’t have the money for a burial, and I paid for the cremation. I arrived to their home the evening of the 11^th (It’s a long way from Florida to Oregon) and my mother didn’t know her address, important information, etc. She was literally in shock. With the help of her family members I was able to step in and take control and begin making arrangements with the National Cemetery in Portland as well as filing the necessary V.A. claims and dealing with SS. I was there for 4 weeks handling it all, and eventually I had to go back and deal with my life that was on hold.

10/19/2012-VA received application for burial benefits, DIC, and pension.

10/31/2012-Received confirmation that they are processing claim.

12/1/2012-I moved Mom to Florida as she has all of $700 SS income to live off of. Tried to get her a VSO here in Tampa, and no such luck. The gentleman she spoke to said he can’t help her as it was out of his area. So basically she communicated back and forth with the Salem Oregon office from this point forward.

3/1/2012-Per the request of the VA we sent additional documentation for his Dr.’s that he saw for the past 20 years along with a claimant response letter.

3/27/2013-Received confirmation that they got the 3/1.

5/5/2013-Called Salem office to follow up and our case worker was no long employed and they could not locate his file. V.A. at its finest.

5/30/2013-Faxed all documents and previous confirmations to new case worker.

6/19/2013-I received a call from the case worker that we should have a decision soon and wanted to know how things were going??? REALLY???

8/15/2013-Received denial letter.

8/20/13-Sent medical records from a hospital that the V.A. could not seem to get, that I got in about 3 hours. Also sent a release form for them to get the EMT/EMS records from the night of his death.

Between August and December of 2013, we made close to 15 calls and could not get a single person to call us back.

1/23/2014-Received yet another denial letter and stating that they stand by their original ruling, as COPD as cause of death. (More on that in a moment).

Since that date in January (knowing that I have a year for an appeal), I have spent that time building our case, collecting medical records, reading and researching and I feel like I am about ready to submit the appeal (waiting on EMS records and missing VA records).

Here are some of my questions and thoughts….

Like many vets my father was a smoker and did have stage 2 COPD. From my understanding of COPD, there are 4 stages of it. My father was NOT on oxygen nor was he on anything but a simple inhaler. He was never hospitalized for this condition and was not treated for it on a regular basis. He didn’t have cancer or heart issue (ruling out heart attack). How can they say that the cause of death was not service related, when the cause is listed as unknown? How can they say COPD was the cause of his unknown death? Is that even possible? Can you die instantly from COPD (my findings is that most die with COPD, not from it).

Why did it take 8 years (1998-2006) for my father to be 100% disabled when it is very clear he suffered from his PTSD for decades that totally affected every part of his life and his symptoms were first noted in 1968? He has been using a cane to walk since the mid 1990’s and why did it take 10 years to get him a wheelchair and how come he was never given the leg braces to support his legs when he was trying to get from his chair to the toilet or shower? If COPD is really the cause of death wouldn’t that be service related since it was the service who provided him cigarettes in his daily rations in Vietnam? and wouldn’t it be service related if his nicotine addiction was contributed to his PTSD and his other secondary major depression issues (whatever that means)? I’m not convinced that my father died from complications of COPD, considering his issues were not breathing related, they were related from a fall that evening and probably many falls prior. How do I get the V.A. to see that? Also the NP that saw him a few days before his death and completed the death certificate was a total %$&^# when we questioned her findings and asked to have his records updated to reflect just unknown cases/undetermined and list from complications of a fall in the second line, as that is what all the medical reports lead too. She refused to take our calls on that and never responded to our written requests.

What do I need to submit to the VA to get them to see what I see? Apparently they reviewed all his records (minus the EMT records). Is there another angle that I can approach as far as him not being 100% from the start (or even from 2001) when there was no doubt that he was not employable or really even mentally functioning? I’m open to your thoughts, suggestions and opinions. Sorry for such a long post, but at this point I could literally write a book on this case as his records are endless.

Respectfully,

S. Foster

[Berta]

This is a BVA CUE award for nicotine dependence contributing to hypertension and heart disease.

The veteran had already been service connected for COPD.Apparently smoking was not a major factor when the VA made that award.

:

" As the Board specifically found in the
March 2002 decision which effectively granted service
connection for nicotine dependence, the medical evidence
shows that the Veteran started smoking and became addicted to
nicotine in service and supports the finding that the
Veteran's hypertension and coronary artery disease were
aggravated by his cigarette smoking. Given the 2002 Board
decision, the June 9, 1998 prohibition against tobacco-
related claims is not applicable to this case. "


http://www4.va.gov/vetapp09/files4/0930736.txt

But it would take a very strong independent medical opinion (and they can be costly) to attempt to get his COPD service connected due to smoking.

I do not see the COPD as a cause of his death.

"9/3/2012: Saw N.P at a V.A. Clinic. Complained of headaches and had a huge bump on his forehead from a fall and she ordered blood work to be done, and sent him home as there was nothing she felt she could do for him. (Currently waiting on a copy of these reports, will have it next week some time).



9/8/2012: 64 years old, passed away shortly after a fall in the bathroom, when his knees and back gave out. The EMT arrived and he was pronounced dead on arrival. He was taken to the corners office. This EMT service had been to the house over 25 times since 2008, and I’m currently waiting on those reports indicating his numerous falls and ambulance rides to the ER, as the VA never requested them, even though we signed release forms. It was suggested by one EMT that was on scene that evening that most like was a blood clot or aneurism due to the falls and the bruises on his head from pervious falls the prior weeks, I’m not sure if that was documented in the report."

I suggest you get a complete copy of his VA medical records ( that is your mother will have to request them) and get an IMO doctor to focus on whether his VA medical care was appropriate,in addition to finding if his COPD contributed to his due to a nicotine dependence from his SC PTSD..
Did he have diabetes or any other medical conditions ?

It is very unfortunate that no autopsy was done.

The VA caused my husband's death. I could have never proven that without an autopsy.

The only reason I even got an autopsy was because my husband was an organ donor, and they have to autopsy organ donors..

"It was suggested by one EMT that was on scene that evening that most like was a blood clot or aneurism due to the falls and the bruises on his head from pervious falls the prior weeks, I’m not sure if that was documented in the report."
EMTs do fabulous work but they are not doctors.

Something seems dratically wrong here. An IMO doctor will study all of his medical records carefully, looking for evidence of potential strokes , chronic hypotension (BP too low), medication side affects, etc etc,to see why he died so suddenly.

Also the IMo doctor could make a determination as to how his SC physical disabilities had caused these multiple documented falls,that ultimately caused his death.

That is one other possible way to garner DIC.

I am astonished however that the coroner didnt consider an autopsy and left the prime cause of death as unknown.{A. Immediate cause: unknown)

I agree that he would not die so suddenly from COPD. And I dont think these falls were contributing to death, something else was causing them to.

what were the ratings for each of these conditions?

.
"September 25, 2006 received 100% V.A. disability for his service related injuries, which according to the V.A was PTSD with secondary major depression disorder, degenerative changes status post fusion at T7-8-9, thoracic spine, degenerative arthritis left knee, and degenerative joint disease right knee."



You need to make sure the VA ER certificates come with the complete medical records.And his complete medication profile and all blood chem reports.

You can get Ambulance service records by writing to the ambulance service (that is your mother can as the surviving spouse), and also ALS reporrts too.

My husband died of sudden death syndrome.I gave him CPR until the ambulance came but I knew he was dead.
VA had failed to properly diagnose and treat his AO IHD, AO DMII, and many strokes he had , and he also had 100% SC for PTSD.

I found the evidence of their malpractice in his VA med recs to prove my FTCA and 1151 claims but I paid for 2 IMOs for the DMII death claim.

I didnt need an IMO to prove my AO IHD claim.

Your mother might have basis for a wrongful death case that would garner DIC but that would take a very strong IMO.

Vets I have said this before and it bears repeating....and I always mention this at our radio shows when I get a chance to...

Tell your spouses you want to be autopsied when you die....

Consider being an organ donor too. As bad off as my husband was they harvested a lot he had left as donations to the organ bank.(he gave enough skin for 4 burn victims ,, eyes for sight in two living blind people , and bones for replants in cancer patients.)

Tell the spouse you know the autopsy wont hurt a bit and also tell them that, without an autopsy, the spouse might never see any DIC at all.

This spouse's DIC case will be difficult. But nothing is impossible.

I suggest contacting Dr. Bash if you consider getting an IMO.

Print off my suggestions here and tell him Berta Simmons.wrote this reply

His contact info is here under a search.

Edited July 17, 2014 by Berta

[Berta]

In this blog radio show I did as co host with host Jbasser, John Dorley (a former VSO and right hand man for Dr. Bash,) and also Dr. Bash gave out their contact info.

Also I think this show involved a PTSD IMO doctor too.....

http://www.blogtalkradio.com/haditcom/2014/06/11/dr-bash-imos

You could see if John Dorley could possibly begin to assess your mother's claim in email....

but Dr Bash, or any other IMO doc you contact,will need the complete VA med recs, etc, as well as a copy of the VA denial letters, and the actual death certificate copy too.

[JT24usn]

Look at 38 cfr 3.300. Also I have attached something.

http://www.law.umaryland.edu/marshall/crsreports/crsdocuments/98-373_EPW.pdf

Berta is right. It will probably take a strong medical opinion

[dubsnpugs]

Thank you both for the information. I am working on this a little more tonight and reading/listening to the links you sent. Im sure I will have some more questions for you, again THANK YOU!!!

[dubsnpugs]

In this blog radio show I did as co host with host Jbasser, John Dorley (a former VSO and right hand man for Dr. Bash,) and also Dr. Bash gave out their contact info.

Also I think this show involved a PTSD IMO doctor too.....

http://www.blogtalkradio.com/haditcom/2014/06/11/dr-bash-imos

You could see if John Dorley could possibly begin to assess your mother's claim in email....

but Dr Bash, or any other IMO doc you contact,will need the complete VA med recs, etc, as well as a copy of the VA denial letters, and the actual death certificate copy too.

Bertha, my deepest gratitude for your advice and comments, I spent more time last night reading everything line by line.

As of yesterday, I have his VA records as well as his outside care records (all 2537 pages, on a CD of course). I have his death certificate as well and the denial letters. I spent about 4 hours last night reading through his records and I'm not even sure what to do at this point!?!? The more I read the more angry I become. I left Oregon 20 years ago and well I had no idea what my mother was dealing with when it came to his illnesses (mentally & physically). One thing I find interesting is that everywhere on his records it lists COPD as "past medical history", HOWEVER, he was literally on 2 inhalers listed for the treatment of asthma (off and on) out of 19 active medications and there are no records of him seeing pulmonary specialists, or being treated for COPD. His radiology reports for his back issues all indicate that his lungs were clear. I must have read several times over and over, that is 02 levels were at 100% (Especially during his hospitalizations). One report from back in 2009 from a stay at the hospital, then mental hospital for (suicide watch) the Dr. even noted "According to Pulm/Critical car, pt did not have any evidence of COPD exacerbation on the am of 10/04/2009". This particular episode my father had landed him in the hospital for 5 days (including a 2 day suicide watch in the mental hospital) as he went into acute respiratory failure as well as delirium. When I read this report, I wonder why it was never assumed that he had a panic/anxiety attack? It also appeared that a shot of epinephrine is what brought him out of the attack, and my father also had numerous allergies. But because he was a smoker they just assumed it was something to do with that, and the reports indicate otherwise. Also the report that was 4 days before his death, his blood work was totally normal, he complained that his headaches were an 8/10 on the pain level, and he discussed getting leg braces per the request of the physical therapist (fee paid). Anyway, I guess I could bore you all with all this stuff, I'm just so overwhelmed by all this, no wonder why my mother gave up. Even after reading the records yesterday it's even more clear to me that COPD didn't cause his death. Some other symptoms he had 24ish months prior to his death were loss of all his hair, Hypo-tension (low blood pressure), weight had dropped down to about 129lbs (2011) was at 148lbs at death however was 250lbs 3 years prior, and some other odd happenings. It obvious that the medication he was on caused major issues as well.

Here is what's listed for his ratings:

Service Connection/Rated Disabilities

SC Percent: 90%

Rated Disabilities: POST-TRAUMATIC STRESS DISORDER (70%)

DEGENERATIVE ARTHRITIS OF THE SPINE (40%)

ARTHRITIS, DEGENERATIVE (10%)

ARTHRITIS, DEGENERATIVE (10%)

I would like to proceed in contacting Mr. Dorley and Dr. Bash, but I want to make sure that I am not wasting their time. Should I start email conversations with Mr. Dorely? I am more than willing to send all the documents I have as nothing is private at this time and any help understanding this before I appeal would be helpful.

[Philip Rogers]

I recommend what Berta stated. Chances are the IMO will cost about $5k or more but I think you'll be able to win. Chances are he never had COPD and the VA is probably in some way responsible for his death. Too bad there wasn't an autopsy but it is what it is. His blood labs will tell a lot. You might try contacting one of the lawyers that have ads here, on Hadit.com, prior to getting an IMO. It could save you the cost of a IMO (jmo).

For your Mom, it'll mean an additional roughly $1250 a month, (and maybe an additional $300 monthly), plus ChampVA medical insurance.

pr