ptsd Dro Timeline?

[Prospector]

I served from '68 to '72. I filed for severe hearing loss, tinnitus, and PTSD in 2007. I received 30% on the hearing and tinnitus. They denied the PTSD for lack of proving stressor incident. At that time I had no idea where to get copies of my ships logs as I had assumed they would get them. I did not file a NOD. I continued to be treated for PTSD by the VA for the next few years. As my condition seemed to be worsening, my Dr. asked why I was not receiving compensation so I could retire and alleviate some stress? In June 2012, I found the official logs of the incidents and re-filed. After a C&P exam they awarded 50% PTSD for a combined rating of 60% in September 2012. I filed a NOD immediately and had another C&P in June 2013. In July they raised the percentage to 70% PTSD and a total of 80%.I then filed for IU and also another NOD on the original claim. In Jan 2014 they denied the IU. They also showed I had withdrawn my NOD to the original claim. (I contested this and in August they put the NOD back as active) I also have a rare cancer that was stage 4 when found in 2010 by the VA (not Service connected) Unlike most cancers, this is very slow growing but has no FDA approved treatment here in the US. (When found the VA told me to go home and get my affairs in order as they had no treatment for it)

I went to Germany for 3 treatments in 2012 which halted the progression of the cancer. It did not cure it, but bought me some time.

When I filed with SS for disability retirement, I filed for PTSD and when asked did I have any other conditions, I told them about the cancer. They looked it up and told me this cancer was on their automatic list and they could grant it immediately.

The VA in their IU denial stated that I was IU, however since SS granted disability on the cancer, it was not service connected so they had to deny. I filed a NOD explaining I did not file with them or SS for disability on the cancer, but for PTSD. Along with the NOD I submitted a letter from the chief VA psychologist who was treating me who explained the severity of my PTSD and the added depression from the cancer diagnosis aggravated my PTSD symptoms and according to his treatment notes he advised retiring to alleviate stress for the last year before I actually retired. October 8th, I received a phone call from the DRO. She asked if I would take another C&P exam and then a hearing. I agreed. I had the C&P exam on Monday October 27th and the DRO hearing was scheduled for the following Thursday October 30.

The C&P examiner volunteered at the end of my exam "you have taught me something today. I had an earlier exam today claiming depression and I could not see it. Yours is real. I feel it."

Her words, I seen no reason the VA to deny you benefits.

When I met with the VSO prior to the hearing, he was not even aware the DRO had scheduled another C&P exam. He tried to see if they had received it yet. They had not. We explained what the current exam Doctor had quoted and pointed out on the prior C&P exam June 2013 which raised it to 70% the Dr. had said I had already retired due to the Cancer at the time of the exam.

This was incorrect. I did not retire until the month after that exam and retired due to my service connected disability PTSD.

He went next door and spoke with the DRO and came back and asked would I settle for an informal hearing. I agreed.

The VSO introduced us to the DRO and then went mute. My wife presented the case to the DRO explaining the above info and showing her the letter (which was supposed to have been in my file along with the NOD) to the DRO. She asked who this Dr. was that wrote the letter (It was on official VA letterhead and showed his official capacity with the VA and his credentials)

My wife explained who he was. It was obvious she had not reviewed my file prior to the hearing.

She said this would depend on what the C&P report said (we did not tell her what the C&P exam doctor had quoted to us)

She also stated it was good this hearing was informal as she could move forward with her decision and notification should be forthcoming sooner since she would not have to wait for a transcription of the hearing.

Does any of this mean anything?

[Prospector]

Berta thanks for taking the time to read my post. I can attach my C&P but I don't think it will come out correctly on this. (scanned as jpeg - converted to pdf.) I would be glad to send this direct to you, but you have to open each page as individual attachments.

My cancer is neuroendocrine tumors with unknown primary. (formerly called Carcinoid - it is the same cancer Steve Jobs of Apple had).

In 2010 the VA did a biopsy of a mole. It came back melanoma. They did a CT scan and MRI in 10/2010. They found multiple lesions on the liver, one on the lung, two in the mesentery.

3 biopsy's later they still did not know what kind of cancer it was, but ruled out melanoma (they have to do a special test to find Carcinoid). In January, 2011 the primary care doc suggested doing a Petscan. I agreed.

In May, 2011 (4 months later) at another primary care visit she suggested doing a Petscan. I reminded her she was going to order one in January. She checked the records and said "I forgot".

In July 2011 they did the Pet scan. The next week the young doc I met with was all excited when he showed me the scan. His words, I would class you as stage 4. I asked stage 4 what.

He replied Cancer. I told him they had done 3 biopsy's and had not identified what kind of Cancer. I asked how we could treat it. He responded at this stage you may just want to go home and get your affairs in order. My words to him, "Get your boss in here". He complied. The senior doc said they could do another biopsy on another of the liver tumors. I said Ok and had it done 2 weeks later. Someone finally stained the biopsy for carcinoid." Wow they finally knew what I had". I asked for 2 weeks the result of that biopsy and no one would answer. When I called the Dallas VAMC all they would say is my Primary Care Doc should give it to me. She said she did not have it I would have to get it from the Dallas VAMC. Finally one of the nurses in Hematology/Oncology, once I explained what was going on, said she would read me the report. That is how I found out what I had. I asked about an appointment with Oncology, she said they would not give me an appointment until November 2011 another 3 1/2 months. I complained to my Congressman. He wrote letters. They still refused to see me until November.

I could write another 30 pages of what all transpired but thru it all the VA never offered any treatment and refused to send me to specialists. Suffice to say, I battled them this year March to May 2014 to send me to one of the clinical trials in Houston, of the same treatment I received in Germany which had stabilized the cancer and shrunk most of the tumors. They totally refused to send me. (there was a cost of the trial of $46k). In June 2014 I appealed their decision at the OKC VAMC with the VISN office with the same medical info I had presented to OKC. They actually investigated the treatment (it has been used successfully for over 20 years at major med facilities in Europe and many countries throughout the world) They overturned OKC's denial and agreed to send me to the treatments. I will complete my 4th and last treatment Dec. 2nd. BTW it has stabilized the cancer, no new progression and existing tumors are continuing to shrink. ( the affects of this treatment can continue for up to 30 months)

I continued to call my VSO this week to find out my status. (He has never returned a message left for him) I got him on the phone Monday, but as usual he did not have a clue who I was, even though he just went through a DRO hearing with me. On Monday he messaged the DRO to check status. Since I had not heard back from him by yesterday, I kept calling until I got him to answer. After refreshing him again on why I was calling he went into his emails and said the DRO had answered that my file was still in her stack of things to work. I said to him it appears her statement at the hearing that it was good this was an informal hearing so she did not have to wait on a transcription did not mean anything as far as time. He responded the DRO's do not always get to work the files they want as sometimes they are told which ones they have to work first.

And in answer to the filing question: When I filed in 2007 and they denied the PTSD because they claimed I did not prove the stressor (was in the ships logs which I thought if they sent for them and could not get them, what chance did I have). I did not file an NOD. In 2012 someone told me of someone who could possibly find the logs. I called him and he had them to me in 48hrs. I sent in another claim with a letter asking them to re-open the original claim (knowing they probably would not) I sent in the original treatment notes and diagnosis from the VA (the same ones I had sent the first claim 5 yrs earlier) They just started a new claim and within 3 months sent me for a C&P. I was awarded 50% PTSD (retro only 3 months - I already had 30% hearing and tinnitus)

I filed a NOD to the decision 9/2012. June 2013 I had another C&P exam; They increased the PTSD to 70% for a total SC of 80%. I filed for SSID In July 2013. SS asked if I had any other disabilities other than hearing, tinnitus and PTSD. I told them about the Cancer. They looked it up and said you only need one and this cancer is on our 100 list of automatics.

In January 2014 the VA denied my TDIU claim with the statement my cancer was not service connected and since SS granted on it, they had to deny my claim.

I immediately filed a NOD along with a letter from my treating VA Physiologist stating the depression in dealing with the Cancer compounded my PTSD symptoms.

I was not in country in Vietnam.

I don't mind telling you between fighting with the VA for treatment and PTSD, I have wanted to give up. My wife won't let me. If I complain she uses her favorite saying "Suck it up cookie, your not dead yet!"

[Berta]

It sounds to me like VA smelled FTCA/1151 potential and mitigated the damages by paying for the treatment.

You might still have a 1151 claim potential here.(failure to timely diagnose and treat) It if gets worse, I would suggest to file 1151.We have a template here on that type of claim and other info on them in our FTCA/1151 forum.

There is a lot of the net as to this type of cancer but little on potential causes

This vet had Merkel cell cancer , not technically an AO cancer but he got it service connected to AO:

http://www.va.gov/vetapp04/files/0406967.txt

That is an unusual case and you did say you are not a Vietnam vet.

So maybe no way to SC it directly but the secondary claim sounds very good.

"In 2010 the VA did a biopsy of a mole. It came back melanoma. They did a CT scan and MRI in 10/2010. They found multiple lesions on the liver, one on the lung, two in the mesentery."

"In June 2014 I appealed their decision at the OKC VAMC with the VISN office with the same medical info I had presented to OKC. :" Then you got the treatment you needed.

An 1151 claim would rest on their failure to diagnose and treat,even though they mitigated the damages by 2014, yet your MRIs, CTs etc etc, would possible reveal you started out at one level Stage I, and some areas of this cancer but it increased to a higher level and maybe more areas of the lesions, and that would support that even though they attempted to help you , it took time for the cancer to grow even more.

Personal example of what I mean. My good friend Dick (Vietnam, 2 PHs) was diagnosed with hemmoroids for years at the local VAMC until they got worse and he was sent to a different VAMC who diagnosed him with advanced colon cancer...no hemmoroids at all.

I got him 100 % P & T plus SMC under 1151. Even though the VA saved his life,by properly diagnosing and treated the cancer they also shortened his life,via the wrong initial diagnosis and untimely care (failure to timely diagnose and treat).

If you read about my husband;s wrongful death, in the FTCA 1151 forum my FTCA./1151 awards were based on the same premise , failure to timely diagnose and treat. He was only 47 when VA killed him.

The C & P exam might reveal nothing regarding the 1151 issue at all.Or maybe it was for the other claim.

PDFs should come out here as attachments I think....

Lots of 1151 info here in our FTCA 1151 forum.

Your wife sounds like a VERY supportive and proactive spouse !.

[broncovet]

Are you Blue Water Navy?

There are some special things about Navy that was stationed "around" Vietnam, but I can not recall what it is. I do know that if your ship was near Vietnam, the AO probably went all over your boat. Maybe someone else knows more about BWN.

About the only thing I would add to any of this is you need to file an "Advance on the docket" due to hardship. Certainly Stage 4 cancer would be a hardship. Godspeed to you.

Edited November 28, 2014 by broncovet

[broncovet]

You should look here to see if you are BWN.

[Prospector]

I don't know if this C&P will open correctly, but here it is.

C&P 10-27-2014.pdf

[Prospector]

Berta, a "Tort" has a 2 yr time limit. The first delays in treatment and failure to run the correct tests to identify the cancer has been over 2 yrs.

In March 2013, I had my last treatment in Germany (Referred there by 2 seperate Neuroendocrine speacilists here in the US) . They recommended I have an Octreoscan (special scan for this cancer which the VA does) in 3 to 4 months to see if the cancer was still stable or if possibly since the tumors had shrunk even surgery to remove them. I requested this from the VAMC OKC.

They refused to do the scan (they offered a standard FDG Pet scan which is almost useless to show this kind of Cancer and they are aware of this). I let them do the Pet Scan which was basically worthless. I asked them to send me to one of the handful of specialists here in the US. They refused. In March 2014 I applied to the NCI which was doing another clinical trial on a Ga-68 scan which is even more superior than the Octreoscan.(It is like a digital picture of your insides) I had three Ga-68 scans done in Europe as it was part of the treatment I had there. The NCI in Md. performed the Ga-68 scan in March 2014. Results, the large tumors I had previously on the liver had shrunk over 40% from the 3 treatments, but waiting on the VA for a year to give me an Octreoscan, I now had 10 new bone lesions including one in the skull. Had I known this, I could have entered the current treatment 9 to 12 months sooner, most probably stopping that progression. Since the PRRT treatment was under clinical trial here in Houston (with a cost of $46k and I had already spent $52k on treatments in Europe which my BCBS denied paying for) I asked the VAMC in OKC to send me to the Houston trial for treatment. They refused. I made an offical request to the then VAMC director. He never answered. I continued to push the Oncology Department for help. They finally in May said I could see the Chief of Staff. We presented the evidence to him but he still refused to send me. My family got the press involved and they even interviewed the VAMC, but tried to sidestep the issue. I filed an appeal with the VISN office the first week of June. I did not receive an answer from them by the second week of July. I had been able to borrow the money to start the first two treatments. First one week of June 1 and the second was the last week of July. I called the VISN office and spoke with the investigator. They had already prepared a denial letter, based on the Chief of Staff's OKC mis-information. They verified the facts I had sent them with medical firm conducting the Clinical trial for treatment, the NCI on the treatment itself and called me 2 days later and said I had been approved for the treatment and they would pick up the costs of the trial.

The day after the letter came for the approval of treatment (I saw that it was copied to the VAMC OKC director) the VAMC director resigned.

I spoke with 4 different attorneys who practice tort law. Three of the 4 said I should keep trying to find representation as I had a case, but they were not interested. The fourth one to turn me down, I pushed for an answer why they were turning me down for representation. Their explanation: With all the press about the VA right now, they have plenty of cases. They are looking for the ones that most probably will be settled before formal litigation by the VA. If a case goes to court they have to pay a medical specialist to testify and the last one they used on cancer charged them $250k for the testimony. Due to the fact my cancer is so rare (117,000 active cases in the US as of March 2014) it would require a specialists testimony, so would most probably go to litigation. They all encouraged me to keep looking till I found someone to take my case. To date I have not found one.