ptsd Runaround -delay Or Just Sluffing It Off?

[Guest jangrin]

Berta,

I moved this topic to a new post so we didn't hi-jack Jim's PTSD post....

Also, I took some snipets of your post and pasted it here.

Berta stated, This is another thing I dont understand Jangrin-

In the beginning of 2006 my AO claim went through numerous hands at the VARO-

from January to July- appeals team, predetermination team, in and out of rating board, Dro to coach, back to adjudication, 3 authorizations on three different days- supervisor ,coach, and then rating again- and then to my POA----at one point in March an 800 vet rep who always seems on the ball told me it looked like I would have a decision in days-he said the 3 signatures showed it had not been denied.But then more action took place for 4 more months-

How can -in some cases- a claim isn't stagnant but is getting some sort of attention as it goes from person to person- yet the evidence still remains unread?

The only way this can happen is if the VA employees are passing this claim from desk to desk and from department to department just to avoid having to work on the claim. This could be intentional or it could be because it is percieved to be a difficult case on no-one wants to tackle it.

When the claim came back they immediately appeared to start working on it again-appeals team, rating, coach, regional counsel, rating, RC, rating board, appeals team- sameo sameo-

The case finally got farmed out but then was immediately back on the road again going from desk to desk.???

In all this time I supplied more evidence and now have 3 IMOs to support the AO claim yet have no idea whether any of it has actually been read yet. By Feb it will be 4 years since they got this claim.

Still no one has read or rated or done anything of substance with this claim. ummm?

Berta,

Four (4) years is a very long time time to wait for a determination on a claim. I can't help but think the problem here is not the "meat" or "substance" of your claim. I am sure you have provided ample evidense to support every aspect of this claim in order for a rightful determination to be made.

I believe that there is a problem with "sorting through some cases". Either the cases are too complex for the adjustor, who is over loaded with claims and he doesn't have time to sort through the evidense or,

the files are full of too many very old records and the adjustors don't want to work the file sorting through the SMRs for service connection, or the file is percieved as being just toooo difficult.

The idea of having a file float from office to office so it is percieved as being worked on, with an ocasional computer notation, does not seem too far fetched to me. With everyone hopeing like crazy someone else will finally work that darn claim.

There is no penalty to these people, employees, adjusters, raters, file clerks, government benefit job types ,

for not doing their job. This file is perceived as being too complex and too difficult to rate with too many secondarys for the claims people to sort out. It is far easier to shuffle the file.

If you remember back a few years, I'm not sure if you would have heard about this or not. But the same thing happened in the California court system. There were somany filed law suits that would never be brought to court, because the people involved just kept postphoning the trial date, or asking the court to put off discovery, or for a bunch of different reasons. The cases just never got through the system and it was clogging up the whole legal system in the state.

What happened is the state filed some new admistration laws for the court system and we ended up with what was called FAST TRACT. This made the court cases move through the system whether the attorneys were ready or not. By implementing Fast Tract, the court calenders started to clear out and there were openings for scheduling trials and criminals were once again being prosecuted and trials began proceeding through the courts.

I believe that is the problem with your claim and many others. There are so many difficult cases that they are clogging up the system. The claims people are afraid to try and work the file, or it's easier to bury the file on a desk than to work it, or move it around so it looks like it is being worked. Ask any lawyer how they build a case or work a file. Someone is ultimately responsible for maintaining the file and logging the information so the file can be prepared for trial or settlement.

It seems that there are a lot of people in the file but no one who is ultimately responsible to answer for the condition of the information or the status of its readiness to proceed for rating.

THERE NEEDS TO BE EITHER A PENALTY FOR NOT PROCESSING THE CLAIMS WITHIN A SPECIFIC TIME PERIOD OR THERE NEEDS TO BE AN IMPLEMENTATION OF FAST TRACT TO START MOVING THESE CLAIMS THROUGH THE SYSTEM

I think your claim is too difficult and the people are afraid to rate it. They keep hopeing someone else will work your file. There has got to be some way to make the VA work the claim?

Is there anything that we are missing??? Any laws or regulation with time limits??? I have never heard of a system that does not have time limitations for making decisions.

Jangrin

Edited November 30, 2006 by jangrin

[Guest jangrin]

Berta, I don't mean to bring up memories. I hope you are OK with this.

When you ultimately prevail and the SC is made for Diabetes and SC the CAD & CVAs, will that be retro to the date of the 1151 filing, settlement/decision/date you filed for SC?

When you prevail-will they off set your DIC again? Which to me seems rather stinky!!

Also on the last post I asked- Why isn't Rod's death directly SCd when they admit that they caused his death. If they admit malpractice and cause of his death as misdiagnosed aren't they admitting that he actually had the ailments that caused his death?

Berta have you ever provided a chronological synopsis of yours and Rods claims, cue, the whole thing.

I know you have for yourself, but have you ever, been asked or approacheed by the VA to aid in filtering the file in an attempt to resolve this? Are there laws against the VA claims representatives talking to a claimant? Somethings are just not jiving with me. The VA is suppose to aid the veterans in developement and eventual granting of a SC ailment. Why do they keep themselves and the process at arms length from the people they are trying to help.

What is going on here???? It's like talking out of both sides of their mouth, double speak.

Jangrin

Edited December 2, 2006 by jangrin

[Berta]

Jangrin , the DRO , my vet rep at the VARO, any rater or adjudicator could have contacted me at any time.

I provided a clear one page outline of my claims and all of the evidence I submitted for 3 vet reps, the DRO, the VSM and the VARO director.

Unon direct SC award they will send my the FTCA offset and process my REPS, Chap 35 reimbursements and the entire funeral bill.

Then the fun begins- I will say they have made an error in Finance and I will ask for 12 years of direct SC DIC under Nehmer.These are two distinctly different awards for death.

One of the vet reps -the one who had the DRO conference-

understood very clearly the predicament this claim has put the VA in.

How many vets die due to direct service connection and also due to the fact that the VA killed them too-

He was stunned at the ramifications of this claim.

NVLSP was surprised too-that this situation existed.

I really should write to them as they do not know I have IMOs.

A Section 1151 award is called an "as if service connected award".

It is by far not the same thing as a direct SC award. It does not give a survivor the VA loan guaranty, nor Champva, nor Chap 35.

It does not give a living veteran any benefits other than SMC if eligible.

If a Sec 1151 vet dies the spouse still has to prove the Sec 1151 situation caused their death.

I get CHAMPVA due to Rod's 100% P & T PTSD. I was talking to the CHAMPVA people one day-

and the woman said I would be surprised at how many widows with Sec 1151 DIC think they get CHAMPVA and find they are not eligible. The CHAMPVA woman said it was heartbreaking to tell them that.

I said it is heartbreaking that you said 'many widows' with Sec 1151 DIC.

I have no idea how many vets die due to VA care.

Between you and me- something sure went down up there between my 2 former vet reps,another vet rep at the VARO, and the RO-itself---

I raised Hell with their main office about the documentation I have that shows something very odd went on.

They could not explain it.

I requested a different local vet rep and got him but they still would not support my remand request.When the remand came they were shocked and the main office gave me a different more senior vet rep at the VARO level.

This has been a parallel war for me-

VARO doesnt read the evidence

and the POA stands by as the VA breaks the law and violates my rights.

I am a civilian in a military university.I have studied warfare.

If you find you are presented with two apparent different enemies approaching you on the battlefield at the same time,you immediately protect your flanks, build up the fire lines, cause mass confusion, deflect your intent,use their intelligence, and then turn them against each other.

When I filed a new FTCA claim against this VARO for restitution ($4,500)for property destruction of my IMOs- I think that helped to accomplish that goal. Either VA actually has them or the vet rep up there -when he checked my c file-took them out and 'accidentally' never put them back-all 12 copies sent by priority mail and tracked and received by the VA.

The FTCA claim result will be interesting.It is an example of principles of manuever warfare on a different level than a real battle.

Maybe the VA is ticked that they have paid thousands so far to send me to a military school.

When they asked me what goal I had for going to a military school I stated my volunteer experience with veterans claims and said the VA claims process can be a battlefield so I needed to go to a war school.

Edited December 2, 2006 by Berta

[Guest jangrin]

Oh MAN

you mean you didn't get DIC benefits when you won the 1151 case. You got a settlement but not DIC.

YOu get DIC because ROD had been Diagnosed with PTSD but not because the VA killed him. Man this is really messed up. All the women who file for 1151 and it not SC'd are screwed. And they are probably pressured to accept whatever 1151 settlement amount the VA can weasel them to accept.

I'm sitting here with my mounth hanging open.

No wonder you are fighting for the SC not only for ROD's honor which I agree is really important--now that I see the bigger picture-- but you are entitled to the benefits when your spouse is killed by the same entity that is supposed to be caring for him.

Berta, please correct me if I am wrong, but I think I see the big picture, finally.

1. 1151 granted- but you have a cue for SMC-that should have been compensated under the

That should have been included and compensation for, but they dropped the ball.

2. You filed a claim to SC misdiagnosed (conditions that casued Rod's death) but they have

never been service connected. When they are awarded then there will be possible retro and benefits that

you should have as a spouse of a SC'd veteran. These claims have been remanded by the BVA for lack of a VCAA letter and work up? And this case will be four years old in February.

3. You filed a law suit for distructsion of property against the VARO (?) but this is a federal case

not under any jurisdiction of the VA they are listed as, the defendent?

Dr. Bash has SC’d the AO diabetes and in addition he has linked the secondarys as the cause of Rods death thus the CAD and CVAs will be SC’d when your claim is approved and rated. Award for service connection makes Rods death SCd not dealth from malpractice/misdiagnosis. And that is what you are after, RIGHT? I think I get it now.

Or at least I think I get it and the big picture.

You have just done a lesson in VA claims 101, thank you. I am printing all this out for future reference.

Jangrin

[john999]

Jangrin

I did not mean to disrespect the dog species comparing them to our leardership.

[Guest jangrin]

Oh John999,

You are so funny. When I start my new job this coming MONDAY morning I am going to go through withdrawels from mising my Hadit buddies.

I just got a new puppy. His name is Copper and he is very cute and loving, only problem is he will probably be about 80 pounds. So we will be going to doggie school so we can learn how to be a good dog. Which is what some claims people should be doing, going to VA employee school so they learn how to be good claims raters.

[Berta]

That is basically it- I do get DIC but never saw a check until a few years ago as the offset had been recovered.

My husband deserved much much better than what he got-the second time I studied the med recs for this AO claim I realised just how many times they could have done tests or something to change it all-

The head cardiologist at the Syracuse VA told me he had nothing wrong with his heart and here this jerk had just read the ECHO and could see Rod was in terrible shape.

One of my IMO doctors -the freeby- was the VA doctor who wanted to give him a fingerstick test for diabetes but he was overruled.His IMO is very brief but states very clearly that Rod's glucose was way too high=especially when you consider he had no food for 28 days as his throat was paralysed.

They sent him home expecting him to die and no one would find out what they did.And we thought he was going to recover.

I can pinpoint exactly when -in the med recs-they began a cover up-

funny that when I filed the FTCA claim-in 1995 there was a lot I missed then.I found a lot more in 2003.

I named three VA employees in my recent FTCA claim and named them as witnesses to property destruction of my IMOs-

the DRO, the VSM, and the Director of this VARO.

They all were sent the IMOs so they are all liable to my way of thinking. However it remains that the IMOs

still should have ended up in the c file anyhow.

I think they will all blame my vet rep.But he could be canned for destroying evidence.

If they blame him and there is any documented basis for that- I can sue the state of New York.

However-the whole point of this new FTCA claim is not for money- I filed it to get the RO to acknowledge my IMOs.

It is basic VA law that they must fully consider probative and competent medical evidence.

PS I just got in the mail- another letter saying "Mrs. Simmons We are still working on your compensation claim blah blah blah"thank you for your patience."

the standard generic VARO thing

I could wall paper my bathroom with all those letters-from over the years-

It would make more sense it they just said the truth -"Mrs Simmons we are still farting around with your compensation claim and we don't have a clue as to how to decide it.Although we do have your IMos and really didnt destroy them, there is no one at the VA medically competent enough to read and understand them.As you well know we dont have many competent doctors. We asked the C & P doctors to read them but of course they know nothing about medicine and usually make something up anyhow in their reports to make sure we deny a lot of claims. However we assure you that your evidence has all been carefully considered- not actually read- just considered-

we considered reading it as it is all stated in very simple terms but we don't know what it says anyhow.Thank you for your patience."