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Ptsd Help


SSGmajik
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Question

I'm not sure where to put this question, so I'm posing it here & hopefully someone can help my buddy!

My friend has been struggling with his PTSD & the VA has screwed up his meds several times now & even giving him a combination of meds that could have been lethal! Long story short is that he had 2 events where the police came & he had to be taken to a local hospital where he was admitted in to the mental health hospital & hospitalized for 7 days each time. He now has a large bill that he can't pay! He even had his income tax refund garnished to pay towards it. He was in an appeal process on his claim & just recently won his appeal & now the VA his finally recognizing that he has PTSD, even though they have been treating him for years for it & denied it, he finally got them to recognize it. He is now 60% total (50% PTSD). So my question is since the date of claim goes back to before he was hospitalized should the VA be responsible for paying the bill? He even notified the VA about being hospitalized, but they denied payment because he had no rating for PTSD. Any help guidance would be appreciated! He is currently hospitalized again & I'm worried about him!

Thank You,

SSGmajik

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"He even notified the VA about being hospitalized, but they denied payment because he had no rating for PTSD. "

Can you explain that?

Do you mean they denied a past PTSD claim and gave him no rating at allor did they give him a PTSD NSC rating?

Did they give him a diagnosis in past PTSD claims that was for a different MH disability that they recharacterized as PTSD.

I dont think there is much he can do about the hospital bills but others here will chime in on that.

There is always the possibility he could have a basis for a CUE claim on the older denial but not enough info here.

In cases like this ,I think the best way to recover a hospital expense that VA refuses to pay for, is to find another way to have the VA pay, via compensation......such as maybe a CUE claim.

He even notified the VA about being hospitalized, but they denied payment because he had no rating for PTSD.

"He is currently hospitalized again & I'm worried about him!"

"My friend has been struggling with his PTSD & the VA has screwed up his meds several times now & even giving him a combination of meds that could have been lethal!"

It is quite possible that, if he is on a lethal cocktail of meds, or meds that are contraindicated by each other, they could certainly be affecting his MH issues in a negative way.

How long does he expect to be employed with these hospitalizations ( I assume he is employed because of the IRS situation)

If the VA screwed him up with the wrong meds, and a real doctor can state that with a full medical rationale, showing that this caused his hospitalizatuiions, and aggravated his PTSD, he could potentilly recover some cash under Section 1151, 38 USC, to help recover the hospital bill that VA wont pay.

His medical records, from private hosp, doctors and the VA would be needed for an IMO doctor to develop that type of opinion.To include his entire medication profile.

SInce I assume he has gotten some retro he might want to consider having a real IMO doctor go over his medical records, to see why his PTSD (or the meds he takes for it) is causing these hospitalizations.

What is the 10% for?

How do you know the combo was lethal?

I am not questioning what you are saying....VA gave my husband a combo that was lethal....that is it was a factor in a VACO medical report, that I had proved, had contributed to his death.

.

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Try to visit your friend in the hospital if you can, I've been in the Psyc Ward multiple times and visits from friends and family make a big difference.

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Thank you for your reply Berta & I will try to answer all I can. I do not know everything in detail & I will have to talk to my friend to ask questions in more detail, so we can get him some help.

"He even notified the VA about being hospitalized, but they denied payment because he had no rating for PTSD. "
Can you explain that?

-Once he was released he notified the VA stating he was hospitalized & why he was hospitalized. He received a bill & brought it to the VA to have it reviewed for payment & it was denied, because he did not receive a rating from the VA stating he has PTSD.

Do you mean they denied a past PTSD claim and gave him no rating at allor did they give him a PTSD NSC rating?

​-From my understanding he was completely denied PTSD several times. He was not even given a 0% rating to even acknowledge he has it, even though the VA was treating him for PTSD!

Did they give him a diagnosis in past PTSD claims that was for a different MH disability that they recharacterized as PTSD.

-No, he had no rating or diagnosis for other mental health conditions.

How long does he expect to be employed with these hospitalizations ( I assume he is employed because of the IRS situation)

-He had to quit his job, because of the PTSD recently.

-If the VA screwed him up with the wrong meds, and a real doctor can state that with a full medical rationale, showing that this caused his hospitalizatuiions, and aggravated his PTSD, he could potentilly recover some cash under -Section 1151, 38 USC, to help recover the hospital bill that VA wont pay.
-His medical records, from private hosp, doctors and the VA would be needed for an IMO doctor to develop that type of opinion.To include his entire medication profile.
-SInce I assume he has gotten some retro he might want to consider having a real IMO doctor go over his medical records, to see why his PTSD (or the meds he takes for it) is causing these hospitalizations.

-Thank you for the info. I will pass it along.

How do you know the combo was lethal?

I am not questioning what you are saying....VA gave my husband a combo that was lethal....that is it was a factor in a VACO medical report, that I had proved, had contributed to his death.

-The private docs stated the meds he was on has a high interaction possibility & can be very lethal at the dose he was taking. He told the VA several times he was getting worse & was even having seizures caused by the meds. All stated in his records from the private physician.

What is the 10% for?

He had surgery on his jaw.

Again, thank you Berta. I am just trying to help him all I can, so he doesn't have more stress to deal with!

Thank you,

SSGmajik

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Try to visit your friend in the hospital if you can, I've been in the Psyc Ward multiple times and visits from friends and family make a big difference.

Mike,

I have already visited him & called him. I have visited him ever time he's been hospitalized. He his my best friend & I will do all I can for him! He will never be alone! I hope things are getting better for you brother!

-SSGmajik

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"The private docs stated the meds he was on has a high interaction possibility & can be very lethal at the dose he was taking. He told the VA several times he was getting worse & was even having seizures caused by the meds. All stated in his records from the private physician."

Did VA obtain his private records for the 50 % SC PTSD award?

Did the private docs make any statement as to the possibility the meds were causing the seizures?

Since he had to quit his job due to the SC PTSD he should file for TDIU:

http://www.vba.va.gov/pubs/forms/vba-21-8940-ARE.pdf

I also suggest that he file a NOD if he still has time to on the award letter.

He should put in the NOD that he has also enclosed a TDIU form and on questuion # 18 he should check Yes an d then under Remarks specify that he intends to apply for SSDI benefits due to his SC PTSD.

And I sure feel he should file, separately a claim under 38 USC, Section 1151 due to medication errors.

We have lots of 1151 info in the FTCA 1151 forums here.

TDIU is paid at the 100% rate.

It is quite possible he could get a SSDI award before the VA handles his TDIU claim and if solely for the PTSD, that would be prime evidence for the TDIU claim.

The private doctors are any of them psychiatrists?

Would they be willing to provide an IMO for him?

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This is an example of a Section 1151 award based on the wrong medication and lack of proper medical treatment:

"

The evidence is evenly balanced as to whether the

veteran died as a result of VA treatment in continuing the

use of Coumadin and not attempting to repair the aneurysm

prior to the terminal event.

With resolution of reasonable doubt in the appellant's

favor, the criteria for an award of dependency and indemnity

compensation pursuant to the provisions of 38 U.S.C.A. §

1151, have been met. 38 U.S.C.A. §§ 1151, 5107(b) (West

1991); 38 C.F.R. § 3.358(a)-©(1)(2) (1994); and interim

final rule, 60 Fed. Reg. 14,223 (1995)."

http://www.va.gov/vetapp95/files5/9523462.TXT

This widow, like me , did not have an independent medical opinion.

But the decision (like mine from my FTCA/1151 cases,) shows how a lack of medical rationale along with treatment, or lack of appropriate treatment, , that is not up to the

same steps the standard medical community would take, will warrant a 1151 award.if it causes additional disability or death of the veteran.

However I don't advise doing 1151 claims without an IMO.

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