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

[atomicwidow]

thanks, PR. I'll pursue getting my husband's claim file ASAP.

As for the rest of my appeal of DIC denial:

- lung cancer (not a specific type) is a presumptive condition from military exposure to atmospheric ionizing radiation;

- the VA conceded his participation in active duty atmospheric nuclear testing.

- my husband's death certificate lists "probable lung cancer" under the heading "significant condition contributing to death";

- so I'm getting the pulmonologist (lung cancer specialist) who diagnosed my husband to write an evidence-based opinion that "probable lung cancer" was "more likely than not" lung cancer and why it couldn't be biopsied for 100% certainty. I'm also asking her to provide evidence-based medical research and her opinion supporting lung cancer contributing to death.

I expect to receive that documentation from the MD in March when she returns from maternity leave.

Once I have it in hand, do I just attach a cover letter, form 21-4138 (Statement in Support of Claim) to the medical records and send a copy of all to VA certified mail?

thanks for the wisdom.

Jo

[free_spirit_etc]

Hang in there atomic widow!

I had many people tell me that I would not get service connection granted for my husband's death, as his lung cancer was not diagnosed until after service and he didn't have boots on the ground in Vietnam. Luckily his treating physician on base told him -- that based on the nature of his cancer -- it had started a long time before he retired. Unfortunately, the physician said the base attorney told him he couldn't write a medical opinion for a VA claim. Fortunately private doctors would write such an opinion and were in utter amazement that an opinion was even needed as "ANY doctor should know his cancer could not have grown that fast..."

Research other claims at the BVA and see what reasoning was used for both the grants and denials. That will give you some ideas on how to craft your argument.

Also... the word probable bothers me for some reason. I guess because they might try to "re-characterize" it to the word possible. In fact, it looks like they did that. The denial stated "The death certificate recorded the Veteran's cause of death as Larynx cancer with possible lung cancer." The word probable means most likely. They downgraded it to "possible" to make it a maybe.

The thing I would still need to research is whether a probable diagnoses is sufficient for presumptive connection.

Keep in mind that presumptive is only one way to win a claim. The VA also has a list of conditions that are possibly linked to lung cancer. http://www.publichealth.va.gov/exposures/radiation/diseases.asp

A strong IMO linking either or both of the cancers to your husband's radiation exposure would be very helpful.

I am so sorry for your loss.

Keep up the good fight!

[free_spirit_etc]

i just did some research on BVA decisions. It looks like connecting the larynx cancer (or any cancer that is not on the presumptive list) would require dose estimates. Even if an IMO stated it was more likely then not, if the IMO isn't based on the actual dosage the veteran was estimated to have been exposed to, the claims are most generally denied.

[atomicwidow]

Free Spirit,

Thank you for your thoughts and for catching the VA's wording change from "probable" to "possible".

The MD clarification I'm seeking isn't truly an IMO because it's the pulmonologist who diagnosed him. I just asked her to reference and clarify her own medical records in what I've been advised here are VA terms (to define probable as "more likely than not..." and clarify other points in the records). I'm going with the lung CA diagnosis because it's on the atomic vet presumptive list and his death certificate lists "probable lung cancer" as a contributing cause of death. The VA has already conceded his radiation exposure in his Navy years; he enrolled in the Ionizing Radiation Registry years before his death.

What I need to figure out now is how to write up my appeal on their denial of DIC. I need to establish the probable lung cancer as "entitlement to service connection as the cause of the veteran's death". Can anyone advise me if there's a sample format to follow in word-smithing appeals?

thanks.

Jo

[Berta]

Presumptive regulations can lock a claimant into one theory of entitlement, when an additional theory could garner service connection.

As Free-spirit said, the dosage info is a big part of these radiation claims.

but since this has already been a RECA award, I assume the DTRA dose info has already been established, and is in the VA records.

is it? was that an issue in the denial?

In this remand the BVA opened the door for more evidence. They did not rule out this veteran's larynx cancer :
( same Operation I think your husband was in)

"2. Thereafter, the veteran's claims
folder, including the articles regarding
the radiation fall-out after Operation
CASTLE and the negative health effects on
the native population, and any dose
estimates received from DTRA, should be
referred to the Under Secretary for
Health for an opinion to the Under
Secretary for Benefits as to whether it
is likely, unlikely, or at least as
likely as not, or that there is no
reasonable possibility, that the
veteran's lung and larynx cancer are due
to exposure to ionizing radiation in
service."
http://www.va.gov/vetapp08/Files4/0829859.txt

The Radiation exposed regulations are here:

http://www.publichealth.va.gov/exposures/radiation/diseases.asp

We call these "presumptive diseases."

Cancers of the bile ducts, bone, brain, breast, colon, esophagus, gall bladder, liver (primary site, but not if cirrhosis or hepatitis B is indicated), lung (including bronchiolo-alveolar cancer), pancreas, pharynx, ovary, salivary gland, small intestine, stomach, thyroid, urinary tract (kidney/renal, pelvis, urinary bladder, and urethra)
Leukemia (except chronic lymphocytic leukemia)
Lymphomas (except Hodgkin’s disease)
Multiple myeloma (cancer of plasma cells)

These Veterans don't have to prove a connection between these diseases and their service to be eligible for disability compensation. Their survivors also may be eligible for survivors' benefits if the Veteran dies as the result of one of these diseases.
Other diseases associated with radiation exposure

VA recognizes that the following diseases are possibly caused by exposure to ionizing radiation during service:

All cancers
Non-malignant thyroid nodular disease
Parathyroid adenoma
Posterior subcapsular cataracts
Tumors of the brain and central nervous system

- See more at: http://www.publichealth.va.gov/exposures/radiation/diseases.asp#sthash.XYnG6Cdm.dpuf

------------------
Note the codicil to the presumptives:

"VA recognizes that the following diseases are possibly caused by exposure to ionizing radiation during service:

All cancers"

That means that a strong IMO ( which does NOT use the word possibly, but instead " as likely as not" could help to render a direct (Not presumptive ) award of SC if the IMO has a strong medical rationale and also states, the veteran had no other know etiology but for the inservice radiation exposure, for his larynx cancer.

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

One other point........ I often see the acronym IMO here in many posts but if the IMO ,obtained by the claimant, does not conform to the IMO criteria here in our IMO forum ( I just bumped it up again) the claim will probably fail.

[free_spirit_etc]

Scanned Image 143190004.pdfOK, here's the scanned letter, thanks for the review.

A few facts:

- My husband was diagnosed with two primary cancers on the same day, larynx and lung. The MD reports state they were two different primary cancers, not one metastasized from the other.

This is VERY important! Does the VA have a copy of this medical report that specifically states the lung cancer is a primary cancer?

Lung cancer is a presumptive condition from ionizing radiation exposure. They conceded radiation exposure during his service.

- The Dept of Justice RECA award was granted on the same medical records and death certificate sent with the DIC application.

When DOJ approves a RECA award, doesn't it establish service connection? I'm confused how the VA can denied service connection for the cause of death when DOJ has adjudicated the cancer as service connected. I received the RECA settlement in March.

Do you have a copy of the RECA decision for this? I also think it is interesting that they conceded radiation exposure, but did not concede that your husband had the type of cancer needed for the award. They are not actually bound by a decision of another agency, but knowing any reasoning involved in the RECA decision might help build your argument.

I understand there's a DIC offset when awarded the RECA amount, so there's about a 60 month wait til DIC payments would kick in. But if DIC is awarded, I presume ChampVA and other surviving spouse benefits would begin right away....am I correct?

I appreciate your wisdom and opinion.

Jo

Edited January 28, 2015 by free_spirit_etc