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Absurd 1151 Denial


Berta

Question

As someone said contacting Ms Hickey might mean haste makes waste.....

This is one of the most ludicrous decisions I have gotten yet.

I just got a decision on my pending 1151 accrued claim.

They went against findings I sent them for my FTCA claim,that came from VACO Strategic health team.... a team of VA doctors who try to deny FTCA issues,if they can.

In my FTCA case they couldnt deny me at all..

They didnt base this on any posthumous C & P exam, they stated the 1151 hypertension claim was denied because
tjhey say Sudafed was prescribed to my husband beginning 6 months prior to his death WRONG

I guess those dopes dont understand that sudafed and pseudoephedrine are the same thing.

In answers to questions from the OGC for my successful Tort claim, the Cardio doctor stated in a document the listed as evidence.:

"The pseudoenphedrine prescription should have never been prescribed."

She had agreed with my X ray findings in his medical records. that the veteran 'sinus cavity X rays revealed no sinus condition at all.

She stated

"It is my professional opinion that it is liklier than not that this dose pf pseudoepherine Would (she underlined this)raise his poorly controlled BP, and did contribute to his death."

(it had been prescribed to my husband for 6 years....they had misdiagnosed a heart attack ( proven via the FTCA claim) as a sinus infection and prescribed the sudafed 4 times a dayfor 6 years.

This FTCA evidence document also ends with the fact that there were multiple deviations from the usual standard of care and that ALL of these deviations hastened the veteran's death.

ABSURD!!!!!!!!!!!

Howe can the RO go against this finding from the Stratetic Health Team, VA Central Office, and do it without even a posthumous C & P exam?

They are trying to say the veteran started taking sudafed on March 30 1994.(VA prescribed Pseudoephedrine)

His medical records that the VACO doctor based her opinion on show he was prescribed this med by VA for 6 years to take 4 times a day (for something he didnt even have.)

I have plenty to work with, with this ridiculous denial,,,but I onky asked an assurance from MS Hickey that my evidence be properly consider under 38 CFR 4.6.

It was not.

I got tough with VA in the past with this crap but they have not seen anything yet.

The director emailed me from her blackberry on Sat that my claims had been denied.

This is the only decision I got. so far. and I certainly expect some bogus crap on the next decision.

I had the impression when VA called me to review what evidence they had, that a decision had already been made.

It is another CUE under 38 CFR 4.6 but I think I will file a Mandamus writ on this and the next one.

I am a little ticked off but have no fath in my ROs ability to read at all anyhow, after these past 20 years.

And I sure don't mind making a stink when something as ludicrous as this comes my way.

PS They tried to deny my DIC claim many years ago by saying the veteran might have died from a cocaine overdose.

Of course they completely ignored info from the Organ Donor place and a complete autopsy with a full toxicology report, with only VA meds in my husband's blood, stomach etc. that I had sent them 12 times.

If anyone is interested in the Writ idea I will post here...otherwise this will take me some time to figure out what to do next. (A new war plan is in order.)

And who to do it with.......

and it will be lots of FUN to prove them wrong again.

How can VA raters go against documentation from a top honcho VA cardio doc from VACO????

Because they think they can get away with this shit.

God knows how they screwed up my other pending CUE claim.....

I cant wait to send this decision to Ms Hickey.along with evidence directly from the VA itself that proves them wrong,.with a CC to the Director of Buffalo NY.

I was a little ticked off but also I am Thrilled at the evidence I have collected for 20 years that proves how

incompetent my RO is.

Either this is SOP for many claimants there or I am an isolated case.

Maybe that billboard really exists.

This is funny...my husband used to say there must be a Big Billboard the VARO could see out their windows at Buffalo, that said " F--k this veteran , Rod Simmons"

....

For a few weeks I thought they put my daughter's name on it (major CHAP 35 screw up that they fixed)

And then I guess they put my name on it......too...for the last 20 years....

Of course that billboard never existed..... but it is the only thing I could blame their downright incompetence on.

My war with the VA begins again. And I will prevail!

Edited by Berta (see edit history)
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You know how this stuff gets Free_Spirit......but I am a civilian warrior......

I asked the director via email to CUE the decision and then stated to her:

"I will advise Ms Hickey of the denial, and send her the VACO medical report,
and also ask her , the UnderSecretary of the VA, what NEW VA regulation in 38 CFR now allows VA raters to opine on medical issues,
in the face of prime facie evidence from real medical professionals employed by the VA , in order to deny a claim.

I have not received the CUE claim denial yet.I am sure that was not done properly either."

This is the crap that any veterans can expect his/her spouse might get when they die.

And Particularly if they die directly due to VA health care itself.

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I am not sure your RO is actually incompetent. They seem to be very good at doing exactly what they seem to be trying to do -- ignore evidence in support of your claim, sift through to find something they can misconstrue, and then misconstruing it in order to deny.

And yes, it makes no sense that they can ignore the Veteran's Administration's own doctors - that said multiple standards of care were violated, including misdiagnosing your husband's condition and causing his death by not only not giving him appropriate treatment, but actually giving him treatment for an extended period of time that actually substantially contributed to his death - and decide own their own that the treatment did not contribute to his death.

So they just decided on their own to say he only took sudefed for 6 months - and that it didn't matter - despite substantial evidence on both counts to the contrary?

I'd say they are never going to hit their 98% accuracy mark this way.

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I think they were poed to find out that I won my past CUE claims,they sat on for 8 years, in my Nehmer award.2012....

They also found out that I succeeded in my AO IHD death claim at Phila VARO and also they are poed that General counsel had to order them to refund my FTCA offset.when I won my AO DMII claim.

I am going to Cue them under 38 CFR 4.6 and also I think it is Colvin V Derwinski???I need to find the case that says VA adjudicators and/or BVA cannot substitute their own medical opinions for those of independent doctors opinions.

Whoever wrote up this decision was not a doctor and went against an established VA medical opinion.with no medical or legal rationale at all, in addition to the fact that they were a GS12 (I assume) rater and not a doctor at all.

I was surprised to even get notice of my denials from the director via email sent by her blackberry on Saturday and I was upset at that yesterday for a while, not even having the denials to even read.

But now , after reading this ridiculous decision I just got ,I am absolutely THRILLED!

That might not make sense to most here , but Asknod knows what I mean.

This will probably take time away from me being at hadit ,to resolve this crap but there are plenty of very smart people here ,like you Free_ Spirit and the good hadit ship will always stay afloat.

Edited by Berta (see edit history)
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http://www.va.gov/vetapp12/Files2/1213467.txt

The Board also notes that VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. See Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991).

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I think Berta is preparing for battle!

Before my husband started chemo, we read about this:

http://www.ishopsouthwest.com/story_history_war_pony.html

'The plains indians custom was to tie up a horse's tail when preparing for battle. The Indian would knot up the horse's tail to prevent the enemy from taking hold of it and using it to dismount him from his horse and to prevent it from getting entangled in his bow and arrow during the combat. Fringes and feathers were added for a more spectacular effect."

So he decided to "tie up the tail of a horse" before going into battle. He went out to a local stable and asked if he could have some hair from their horses tails, and he weaved them into a bracelet to wear before he started chemo. The important idea was preparing for the battle can often be as important as the battle itself.

If I had a horse's tail -- I would send it to you!

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Whoever wrote up this decision was not a doctor and went against an established VA medical opinion.with no medical or legal rationale at all, in addition to the fact that they were a GS12 (I assume) rater and not a doctor at all.

I agree Ms Berta

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Berta, sorry to hear of the bad news. You have done so much for us on Hadit, just cant believe the crap the VA has put you thru over the years. God Bless and keep us posted

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You have done so much for us on Hadit, just cant believe the crap the VA has put you thru over the years.

That might be why they do this...to hinder my credibility here. The director of my VARO has been well aware for years ,that I am a veteran''s advocate.

THANK YOU Free_spirit...that was what I needed.Colvin and Willis!

Coincidence-

My relatives are from Europe, I am a first born American but another family relative had came from England in the 1800s and married an Indian from the Mashpee Wampanoag tribe . This was recorded by Harvard University when my uncle was faculty there in a detailed family tree they did for him. The Indian's last name is my maiden name ...they registered white to Indian marriages with the white person's last name. Indians didnt have last names in those days.Maybe I have that warrior blood by proxy.

I sure will post the writ here .if I think I need it.............this is going to get very interesting.next week..

Dont forget to set your clocks ahead tonight everyone!.If you live in Eastern Daylight Savings time zone.

I set mine ahead hours ago but I almost missed Man of Steel on TV. It was fabulous.

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