Champva And Survivors

[john999]

What happens when the ChampVA sponsor dies and before the surviving spouse has their DIC approved? Does ChampVA stop until the survivor gets their DIC claim approved? If my wife were to be on Medicare as primary and ChampVA as the secondary medigap coverage and I croak then what? I know the money from my compensation stops, but do all the other benefits to the spouse stop as well until she/he has DIC approved? My wife is entitled to three survivor pensions so to speak. She would be eligible for my SSA, my Civil Service survivor pension and to DIC. The thing is how long does it take for all this to kick in after she applies? Not many survivors just snap out of it in a week and then claim their life insurance and all their survivor pensions. They have to bury their vet and deal with all that plus they might be in grief for a while. The way I see it the survivor can't afford to grieve if they want to keep paying their bills. Now I have some of this taken care of but the insurance thing worries me. One thing I do know is that the vet and the spouse need an emergency fund that will carry them at least 6 months while all this stuff gets worked out. I have the disabled vet insurance which is enough to bury me, but do undertakers extend credit based on the VA insurance? Even if a vet has the grave and headstone paid for by the VA the service and all the extras can come out to $5000-6000. I did take a course in financial planning but I did not get to that specific section I guess. My wife always avoids my talking about what she will have to do if I leave this world before her. She says " John, you worry too much!" Yeah, I have been dealing with the VA for 40 odd years, so I do worry. I think it would behoove her to get one of those medicare advantage plans so she would not be high and dry if I croak and she has to wait for DIC claim.

John

[free_spirit_etc]

http://www.ca4.uscourts.gov/Opinions/Published/991622.P.pdf

"2 The phrases "more likely than not" and "more probable than not" havethe same meaning. See Black's Law Dictionary, supra at 1201 (equating"probable" with "likely"). The court therefore uses the term "probability"and the phrases "more likely than not" and"more probable than not"interchangeably."

Edited January 29, 2015 by free_spirit_etc

[free_spirit_etc]

This explains that a lung cancer diagnosis is lung cancer; not another cancer that has spread to the lung. So the ROs statement "We have not received information that lung cancer is direct site" is a bit untrue. The doctors called it lung cancer. That equals direct site.

National Cancer Institute:

http://www.cancer.gov/cancertopics/pdq/treatment/laryngeal/Patient/page2

The metastatic tumor is the same type of cancer as the primary tumor. For example, if laryngeal cancer spreads to the lung, the cancer cells in the lung are actually laryngeal cancer cells. The disease is metastatic laryngeal cancer, not lung cancer."

Edited January 29, 2015 by free_spirit_etc

[free_spirit_etc]

http://www.va.gov/vetapp04/files4/0431865.txt

"The above medical statements are made by a competent medical

experts and the Board is not free to substitute its own
judgment for these experts. See Colvin v. Derwinski, 1 Vet.
App. 171, 175 (1991)."

https://veteranclaims.wordpress.com/2009/03/21/cue-liberal-reading-chisem-v-principi-no-90-1540/

"The Court has further held that “the conclusion

of an examining psychiatrist is a medical conclusion, one which the BVA
is not free to ignore or disregard.” Hanson, 1 Vet.App. at 516 (quoting
Willis, 1 Vet.App. at 70). “Nor may the Board substitute its own medical
judgment.” Willis, 1 Vet.App. at 70 (citing Colvin v. Derwinski, 1 Vet.
App. at 175 (Board cannot provide its own medical judgment; rather, it
must consider only independent medical evidence))"

Edited January 29, 2015 by free_spirit_etc

[atomicwidow]

Whew! I go to work for 2 days and come back to your research. Thank you.

I have a lot to learn about VA acronyms and the appeal process. What's the difference between RO and BVA in the appeal?

"Twisted words....from probable to possible"....understanding that as a tactic helps.

I'm in the process of creating irrefutable documentation around my husband's lung cancer (not the larynx cancer) because lung cancer is presumptive for VA documented radiation exposed vets, which he was. That's why I've asked the pulmonologist at the major medical center who diagnosed my husband's lung cancer in 2013 to use the IMO words "more likely than not" (I gave her the reference). I've asked her to state he "more likely than not" had lung cancer, the cancers were more likely than not two different primary cancers and NOT metastasis, and to explain why she couldn't biopsy the lung for a definitive diagnosis. Her assistant already told me they're happy to do it but the MD is having a baby and won't be back til next month. I'm confident I'll get it....I crafted the draft letter for her review.

My husband died 7 weeks after cancer diagnosis in 2013. His Operation Castle radiation exposure was in 1954. He was a "registered Atomic Veteran" so I believe timeline isn't important in my claim, nor was his dose exposure.

I've narrowed down the crucial medical records to 2 reports from 2013. The pulmonologist I referenced above is helping me make those reports tight. As I understand the medical documentation I need to submit, those 2 reports plus the pending doctor's letter will be all I need.

What I'd appreciate input on is how to write the appeal letter and where do I send it.

My words of advise to readers:

If you are a vet or love a vet who was exposed to radiation, do your homework NOW. Get your records organized.

Get registered as an atomic veteran: http://www.publichealth.va.gov/exposures/radiation/benefits/registry-exam.asp

Know what you may qualify for in advance. Get yours ducks in a row.

We did as much as we could in advance of my husband's death. It's still a lot of work for the surviving spouse. Grief is hard enough.

You all help me feel tenacious. It would be easy for me to fold because I have no experience in the VA system.

You'll chuckle....when you mention a new acronym I have to Google it. I average 2-3 acronym definition checks with each message here. So maybe help me and others here by explaining acronyms such as SMR = service medical records or RO = regional office. I still don't know what BVA means in my case :-)

I'm worldly, but just not in the VA system.

I DO appreciate your help,

Jo

[Berta]

I went back to your older post here:



The decision states:


"DECISION
Service connection for the cause of death is denied.
EVIDENCE
• VA Fonn 21-534EZ, Application for DIC, Death Pension, and/or Accrued Benefits, received
April 2, 2014
• Death Certificate, Dated September 20, 2013
• Review of the Veteran's claims file to include Service Treatment Records, Received August 6,
2014
• Data Match VA Medical Center Records, no record found, dated August 6,2014"

"REASONS FOR DECISION
Service connection for the cause of death as a result of exposure to ionizing radiation.
Service connection may be granted for a condition diagnosed after military discharge provided
evidence establishes that the condition was caused by service or it is presumed by law to be
service connected. If service connection is granted on the basis of a relationship to radiation
exposure during military service, available evidence must demonstrate that the veteran was
exposed to radiation during the course of his service, and that a disease associated with such
exposure resulted.
RECA has confinned the veteran's participation in Operation Castle during atmospheric testing.
Radiation exposure is conceded.
The cause of death, Larynx cancer with possible lung cancer, does not qualify for service
connection under these provisions. Under VA regulation, Larynx cancer is not associated as a
condition related to radiation exposure. VA has detennined that a positive association exists
between exposure to radiation and the subsequent development of lung cancer. We have not
received evidence that lung cancer is direct site. For lung cancer to be considered as service
connected based on presumption to radiation exposure, lung cancer would need to be shown as
the primary site of the disease.
The Veteran passed away on September 7,2013. The death certificate recorded the Veteran's
cause of death as Larynx cancer with possible lung cancer. As Larynx cancer with possible lung
cancer is not a condition recognized as presumptive to radiation exposure, entitlement to service
connection for the cause of the Veteran's death is denied.
REFERENCES:
Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains
the regulations of the Department of Veterans Affairs which govern entitlement to all veteran
benefits. For additional information regarding applicable laws and regulations, please consult
your local library, or visit us at our web site, www.va.gov."

Was this prior to your receipt of the VCAA letter or after it?

Except for the death certificate, and his STRs, no other medical evidence was used.

Was there more to this decision?

At time of the posted pdf above I asked you some more questions but cannot find the answers to them here.

I mentioned the VCAA letter .

You stated:
"It appears I never received a VCAA letter. Is that a big deal?

YES IT IS!

In the older thread I posted an example of what the VCAA letter looks like and should state.

The VA, as I also mentioned somewhere here to you MUST refer to the CAVC HUPP decision..regarding DIC claims..

My AO DMII death claim took over 6 years because, not only did I not get a legal VCAA letter, I had multiple reps from my state org, to include their former director, telling me it WAS legal. The director even made a fatal error by telling me that in a long letter under the state letterhead. ALL of those reps are gone and one was still there a few years ago but was demoted. I raised hell over that fiasco.

The BVA agreed with me on the illegal VCAA letter. Luckily I knew what it should have stated and my evidence mitigated the damage. Still, this error on VA's part, with the support of their error from my so called vet rep org, caused this claim to be in the backlog for years, whereas it could have taken far less time to recolve.

As Free Spirit said these vet reps often think us widows are stupid and most of them cannot even assess a VCAA letter for widows.,to see if it violates our rights, let alone, really offer viable help with DIC claims.

What have you received from the VA since getting the above decision?

Is there more to this very short decision?


"I've narrowed down the crucial medical records to 2 reports from 2013. The pulmonologist I referenced above is helping me make those reports tight. As I understand the medical documentation I need to submit, those 2 reports plus the pending doctor's letter will be all I need."

I am not so sure. The IMO from the pulmonary doctor (I thought this was an onocologist....did an onocologist treat your husband at all for the cancer?)
must conform to the IMO criteria here at hadit.

"What I'd appreciate input on is how to write the appeal letter and where do I send it."

I think you mean the NOD (Notice of Disagreement )but I also feel it is critical for you to refer to the IMO you seek and attach a copy of the IMO to the decision or tell them it is forthcoming.

If all you received is the above pdf and nothing else, the VA has violated your rights regarding the VCAA...

I cant tell .......what subsequent evidence have you sent in to them?

Did they give a posthumous C & P exam to your husband, based on any additional medical records you had sent to them?

If so do you have a copy of it?

A NOD means the claimant disagrees with the decision and the claimant should state why it is wrong and refer to and attach to the NOD any medical evidence (such as an IMO) to support their lay contentions.

If you didnt get the VCAA letter, have you checked to see of the rep on your POA got it as well?

I agree with Free Spirit who stated:

"I think the word "probable" will be your key issue to overcome. I have done a little research on the BVA site and found a couple of claims that were denied because the BVA said the individual had a probable diagnosis, and not a definitive one. And I have seen remands where the VA was asking for an opinion on the probable diagnosis."

My AO DMII death had NO diagnosis of DMII.It was not mentioned as a contributing factor on the death certificate nor even in the autopsy. I had 3 IMOs and considerable other evidence (some I never even sent to them) to prove that case.

I laid out my claim with a cover letter to Dr. Bash, supporting my contentions at every step with references to the veteran's VA medical records.
I also studied cardiology and neurology and endocrinology. I had 2 negatirve Endocrinology VA opinions to overcome.
The BVA ordered a cardio opinion and I was overjoyed at that. But I got a PA ioopinion instead and rebutted it right away to the BVA, stating it was speculative and why. I knew more about cardio ,DMII, and the affecty of diabetes on heart and brain than the PA did. BVA agreed that it was too speculative and awarded.

I strongly suggest that anyone seeking an IMO, not only make sure the IMO doctor has all available medical records, (In your case maybe the RECA has more than you know), and copies of all decision and C & P exam results.

They should prepare a cover letter, as I did, directing the doctor to medical entries that support their claim.

Dr. Bash did my IMO in mere days, while he was on vacation because I laid the claim and medical evidence out very carefully and left no stone unturned.

Something is missing here........unless you did get a letter from VA stating what evidence they needed, and you sent it in.

If so, what is the status now ,of that evidence? and the actual status of the claim? Or was the above decision all that you have received?

If I have time I will try to read all of your other posts.....maybe you did answer these questions, but I am confused on what you need to file the NOD on as the pdf only referred to 4 pieces of evidence.....

Did you ever contact the Medical Examiner to see of the wording on death certificate could be changed?

[Berta]

In past post here I mentioned :

"Also ,I have no way of knowing how the above veteran made out in the remanded BVA case.

He either succeeded, or was denied and possibly went to the CAVC.

His BVA lawyer would know:

Daniel Krasnegor, Attorney

434) 817-2180 or (877) 838-1010
Fax

(804) 346-5954
Email

dkrasnegor@goodmanallen.com"

I just conversed with Dan Krasnegor on that. The vet did go to the CAVC and a VA C & P was ordered on remand but the vet died. Apparently with no surviving spouse.

If you get a strong IMO but VA continues to deny ( maybe they could deny if there are no rad dosage values they would accept)

I strongly suggest to contact Dan Krasnegor to represent you.

I asked him if he would be interested in doing a hadit.blog radio show with us sometime.

I will let Jerrel Cook know if he can.