diabetes Diabetes Mellitus Help?

[chiefhouse00]

Greetings

C&P statement, "VETERAN WAS DIAGNOSED WITH DIABETES MELLITUS IN 2006. THE DIABETES MELLITUS HAS BEEN DIFFICULT TO CONTROL WITH LARGE DOSES OF INSULIN. THERE HAVE BEEN NOTED DEVELOPMENT OF TYPE I DM DUE TO ISLET CELL DESTRUCTION AFTER TREATMENT WITH RIBAVARIN AND PEGALATED INTERFERON WHICH THE VETERAN DID RECEIVE. NOTEWORTHY THAT THE VETERAN'S DIABETES HAS BEEN VERY DIFFICULT TO CONTROL WITH LARGER AND MULTIPLE DOSES OF INSULIN SUGGESTING ISLET CELL DYSFUNCTION. THEREFORE VETERAN'S DIABETES MAY HAVE EVOLVED FROM SOME DAMAGE TO THE ISLET CELLS RATHER THAN THE USUAL ETIOLOGY ASSOCIATED WITH GRADUAL PANCREATIC INSUFFICIENCY. THEREFORE IT IS AT LEAST LIKELY AS NOT THAT VETERAN'S DIABETES WAS DUE TO TREATMENT INCLUDING THE USE OF INTERFERON FOR HEPATITIS C."

The VA rated me 20% for DM Type 2 but now I have symptoms of DM Type 1. I put in for an increase for regulation of activities and hospitalization for episodes of ketoacidosis and hypoglycemic reactions requiring one hospitalization in 2012,2013, and 2014.

Can I claim this as Type 1 or Type 2? Or does it matter?

Best Regards

Chiefhouse

Edited September 24, 2014 by chiefhouse00

[Berta]

Chiefhouse, after thinking about this again, I think you should pursue the claim for a higher rating of DMII, which I feel the C & P will garner for you.

But I also think you should file a Sectuion 1151 claim for the DM Type One and attach to the claim a copy of the C & P exan with this part highlighted:

"THEREFORE IT IS AT LEAST LIKELY AS NOT THAT VETERAN'S DIABETES WAS DUE TO TREATMENT INCLUDING THE USE OF INTERFERON FOR HEPATITIS C"

(If the VA gave you the interferon and IF this was not a reasonably expected result'.)

I dont think this is a 'secondary' condition, but can stand on it's own and be rated separately.

Section 1151 is briefly explained here at the VA's main web site:

The disability was:

The direct result of VA fault such as carelessness, negligence, lack of proper skill, or error in judgment, OR
Not a reasonably expected result or complication of the VA care or treatment OR
The direct result of participation in a VA Vocational Rehabilitation and Employment or compensated work therapy program.
http://www.benefits.va.gov/COMPENSATION/claims-special-1151.asp

We have much more on this type of claim under our FTCA/1151 forums here.

And/or you could file for this condition as secondary to the Hep C if that is SCed, and even file that the DMII was "aggravated by" treatment for a SC condition ( if the Hep C was SC):

In determining whether such additional disability resulted
from a disease or injury or an aggravation of an existing
disease or injury suffered as a result of VA hospitalization,
medical or surgical treatment, or examination, it will be
necessary to show that the additional disability is actually
the result of such disease or injury or an aggravation of an
existing disease or injury, and not merely coincidental
therewith. 38 C.F.R. § 3.358©(1).

However, if the interferon caused this secondary condition(which the C & P also supports) and the VA stated this WAS a potential outcome of the interferion treatment,you could claim the DM Type One as secondary:

Service connection may be granted for a disability that is
proximately due to or the result of a service-connected
disability. 38 C.F.R. § 3.310(a). To establish entitlement to
service connection on a secondary basis, there must be competent
medical evidence of record establishing that a current disability
is proximately due to or the result of a service-connected
disability. See Lathan v. Brown, 7 Vet. App. 359, 365 (1995).

Additional disability resulting from the aggravation of a non-
service-connected condition by a service-connected condition is
also compensable under 38 C.F.R. § 3.310(a). See Allen v. Brown,
7 Vet. App. 439, 448 (1995). In order to prevail on the issue of
entitlement to secondary service connection, there must be (1)
evidence of a current disability; (2) evidence of a service-
connected disability; and (3) medical nexus evidence establishing
a connection between the service-connected disability and the
current disability. See Wallin v. West, 11 Vet. App. 509, 512
(1998).

You need to determine, with any type of treatment you might have signed something for (in you med files) if VA told you this WAS a potential result of the interferon because 1151 under this basis ( can be a bigger hurdle that claiming 1151 under negligence).

And unfortunately even under a secondary claim or claim for aggravation of a SC DMII existing SC, you might need to obtain an IMO that can associate whioch symptoms and medical conditions are from the DMII and the diabetes Type one.

Personally I would file for all of above.

In my initial DIC claim I filed under three theories. I won under 2 of them and realized recently that one of the theories was completely ignored by thre VA,in light of subsequent awards and by me, almost 20 years after filing that claim.

In any event, we have the right to offer any theory whatsoever for entitlement to SC.

Do you have a vet rep? And are you willing to obrtain am IMO if needed?

And is the Hep C Service Connected ?

If so that would change my opinion here a little and might well be a stronger basis for a Section 1151 or secondary claim.

[Berta]

To add...I hope others chime in a this:

"THEREFORE IT IS AT LEAST LIKELY AS NOT THAT VETERAN'S DIABETES WAS DUE TO TREATMENT INCLUDING THE USE OF INTERFERON FOR HEPATITIS C"

It appears that the examiner stated 'diabetes' in a broad point here . Is it clear to anyone that he means the Diabetes Type One or the DMII?

The word "including" after treatment concerns me as well.

"due to treatment"....."including the use of interferon."

Including what other treatment that led to the diabetes?.......

Did the C & P examiner see something else that caused the diabetes?

This is often why it takes a good reading from an IMO doc to really determine what medical care a vet did or didnt get and

how that care could have caused them additional disabilities.

I squalked with NVLSP over my Nehmer EED., saying a 1988 ER Med cert was the initial presentation of my husband's misdiagnosed heart disease ( AO IHD).

However VA had a C & P exam result dated a few months later (I dont recall him having this exam at all and it was not in the med rec copy I got) for my husband's PTSD a few months after the ER incident that noted heart disease. That is what Nehmer used for the EED.

I had never received this copy of this exam either in the med rec copy or the C file copy.

That single record alone would have made my FTCA/1151 claims definitely go a little easier.

Still, in spite of that omission to the records I got, I read every single word and every page many many times in a large stack of med recs to succeed in my original claims, but when I re opened in 2003 I certainly got IMOs from real doctors for the DMII AO death claim because I knew

by then , the VA would give me problems on my lay medical evidence for my DMII AO death claim.

If the medical evidence is solid (and the service nexus is established or presumptive) then an IMO is always well worth the money invested into it.

.

[chiefhouse00]

Greetings Berta

I'm service connected for Hep C and failed three treatment sessions over an eight year period. My first treatment started before retiring from the military. I'm currently rated 20 percent for Hep C.

Best Regards

Chiefhouse

[Berta]

I wasn't sure about the Hepatitis Chiefhouse ...you could file for the DM type one as secondary to the Hep C.....and that might help separate these two diabetes conditions.Someone mentioned pyramiding here.....

I will post new topic on that....

[chiefhouse00]

Greetings Berta

You made a very good point of maybe connecting my DM Type 1 increase request to my service-connect Hep C instead of DM Type ll, which I'm 20% service-connected for both. I will wait for the BVA judge review/decision on my current increase request for regulation of activities and hospitalization for episodes of ketoacidosis and hypoglycemic reactions which I was hospitalize for in 2012, 2013, and 2014.

Best Regards

Chiefhouse

[chiefhouse00]

Greetings

Still trying to understand how I was rated with diabetes mellitus type II instead of diabetes mellitus type I. This is how the VA rated me, "Service connection for diabetes mellitus type II as secondary to the service-connected disability of hepatitis C. We have granted service connection for diabetes mellitus related to the service-connected disability of hepatitis C. VA examiner opined that your diabetes mellitus is at least as likely as not caused by your service-connected Hepatitis C due to islet cell destruction after treatment with Ribavirin and Interferon for Hepatitis C. The examiner noted difficulty controlling your diabetes
with large and multiple doses of insulin suggesting islet cell dysfunction rather than the usual gradual pancreatic insufficiency."

As mentioned earlier, I want to file a claim for an increase due to DM Type 1 because of issues with ketoacidosis and hypoglycemic. and three ER stays (2012, 2013, and Feb 2014) but I can't under diabetes mellitus type II.

I'm I making to such out of this...can DC 7913 Diabetes Mellitus be used for DM Type ll and Type I? If so, I will try to relax a little.

Best Regards

Chiefhouse