diabetes How Should I File For Dic

[KHJH]

I have been looking over my husbands medical records and I'm not sure how I should file for DIC.

My husband has been on a diabetic diet for probably 2 years and it is even in his medical records that he is on a diabetic diet. He never filed for diabetes because I thought his A1C had to be 7 or higher. His highest one was 6.4. But he was on a diabetic diet so wouldn't this make his A1C lower. His Glucose was 144 right before he died and he hadn't had anything to eat in over 24 hours. It is also in his medical records that he has diabetic feet and that he is a diet controlled diabetic. The third time he was in the hospital in the last month and half his diagnosis was: Chronic renal failure, Depression, Chronic pain and Diabetes.

There was several doctors in the last couple months that said his renal failure was because of his pain medications he was taking for his SC back, hip and knee. Some quotes from his medical records: "Possible drug induced. Should reevaluate and adjust his meds. "On methadone chronically, Methadone levels increase with renal insufficiency." "Possible pain medication toxicity, on methadone & vicodin. "will continue to hold methadone, not a good choice with renal insuffiency continue with vicodin." "The patient has been taking a lot of pain medication was advised to cut down on his pain medication and make sure he drinks a lot of liquids." Hold nephrotoxic meds Lisionopril, colchecine, piroxicam." "He also carries a history of major depression and PTSD, chronic pain for which he is taking numerous pain medications. He was admitted for chronic renal failure and possible drug toxicity. He takes around the clock methadone and vicodin. Pain medications and other sedating medications continue to be on hold. Methadone is not a good choice for him due to his acute on chronic renal failure. Methadone is one that can build up to toxic levels. It was felt that the pain medications were too oversedating and he was not drinking enough fluids. Advised to use routine morphine, and as needed vicodin for pain."

My husband had several different doctors his primary doctor, his renal doctor and 4 different doctors each time he was admitted. They kept switching his pain medications around one would put in on one and the other would take him off and put him on another.

My husband was not abusing his pain medications. When he died he still had 2 bottles of vicodin with 180 pills in each bottle, 2 bottle of piroxicam, 2 bottles of methadone and 3/4 bottle of long acting morphine and 3/4 bottle of fast acting morphine.

His records also states "History of CHF but Echocardiogram done in Oct 06 show EF of 60% and concentric LVH.

"Patient has PTSD and Depression which seems to have an impact on his other medical conditions."

"Major depression, recurrent: patient has been on quietapine: It can cause hypotension and increased creatinine in rare cases: wonder if it is contributing to patient's repeat admissions for ARF."

On 11/5 he had creatinine of 6.47, bun 95, hgb 10.8. Records state "if needed arrange for dyalisis. Dyalisis was never discussed with us. And he was admitted 2 more times after this for renal failure. They were getting ready to send him for dyalisis when he went into cardiac arrest.

The cause of death on his death certificate is: Cardio-Pulmonary Arrest.

Can I file for Death due to renal failure secondary to pain medications,medications for PTSD and Depression and Diabetes. Would this be hard to prove?

Do I need to send in his medical records when I file for DIC.

Do I need to get an IMO before I file for DIC?

Do I get to keep ChampVa?

Any help would be appreciated.

I just received a phone call that my best friends husband died last night of a heart attack he was in his late 40's. She had a stroke about 6 years ago and is partially paralyzed on one side. They have a 9 year old son.

Kathy

[jessejames]

Was he 100% disabled service-connected for 10 years or longer before death? If so, death from "any cause" would make you eligible for DIC. see http://www1.va.gov/opa/IS1/11.asp http://www.vba.va.gov/bln/21/Rates/comp03.htm

Yes, you do get to keep ChampVA.. see http://www.va.gov/hac/forbeneficiaries/cha...k/chandbook.pdf page 12

[Brandy]

On 11/5 he had creatinine of 6.47, bun 95, hgb 10.8. Records state "if needed arrange for dyalisis. Dyalisis was never discussed with us. And he was admitted 2 more times after this for renal failure. They were getting ready to send him for dyalisis when he went into cardiac arrest.

I think you can look at his history of lab work and see how far back his creatine levels were elevated. These numbers are extremely high. My husband has chronic renal failure stage 4 and has been holding his creatine level at just above 3.0. It has been as high as 6 and his kidney doctor said if this did not come down within a day that he would put him on dialysis. It only got this high because of an infection he got from a recent surgery he had. His highest bun level was 80. He has been a type 1 diabetic for 27 years and began showing potential kidney problems about 5-7 years after he was diagnosed with diabetes.

Berta can help you with what and how to file. I would think you should file a 1151 for the fact that they did not discuss this with you after they diagnosed it or when it actually began, based on the medical records. What were these levels on his 3rd or 4th visit? If they were this elevated, they should not have released him from the hospital.

[KHJH]

My husband was 80% IU P&T for only 2 years. He was SC for his back, hip, knee and PTSD.

I'll have to check his labs to see how long his Creatinine levels were high. I know the first time he was in the hospital for renal failure was March 06.

Thanks

Kathy

[Berta]

I replied with quite a bit of info as to filing for DIC under direct service connection and also under Sec 1151.

I dont know where that post is-a few days back-

I strongly feel that -based on what you have told us-that the VA might well be liable for his death.

But then again- they could have mitigated the damage with the way they were trying to change his meds-

as you mention-

in my case the VA did absolutely nothing to mitigate their damages because they never thought anyone would find out what they did.

This is why -even what appears pbvious as malpractice- might not be- hard to say-a real doctor sure would know.

I did suggest getting a good independent medical opinion to either rule in or out malpractice and the IMO could also support direct SC death.

The cause of death on his death certificate is: Cardio-Pulmonary Arrest.

"Can I file for Death due to renal failure secondary to pain medications,medications for PTSD and Depression and Diabetes. Would this be hard to prove?"

It might be easier to prove they were negligent- however this is another potential way to go and I believe I suggest mentioning this too as potential service connected death.

You can claim any possible reasonable scenario that might have caused his death.

This too would need the support of a strong medical opinion.

"Do I need to send in his medical records when I file for DIC." No.

For the Sec 1151 claim I would just say that "This is a claim under Section 1151 , 38 USC. I believe that the veteran's medical records will reveal that he received care that was not standard care comparable with the usual medical community and that this lack of proper medical care and medical error contributed to his death."

At some point you will need to send them the actual medical records that support the Sec 1151. The discharge certs from the last month and half, the Bood chem reports, autopsy findings- hard to know what at this point.

A IMO doctor will need a complete copy of them to render an opinion.

I found numerous misdiagnoses when I filed Sec 1151. However as a layperson I missed one-the actual cause of my husband's other problems.

Knowing I was a layperson they fought me hard on this all.

If I had gotten a good IMO then , a real doctor would have discovered this additional medical misdiagnosis.

It took me quite some time to find this other medical malpractice error and it was the biggest one of all.I filed another claim but got IMOs to support that claim.

I had a case where they got a letter from me just like this (which the vet signed) and they awarded the vet 100% plus SMC within 4 months under Sec 1151.

It was very obvious what they did.

I also could have had an award in 3-4 months for malpractice based on my layperson's statements and medical evidence (per district VA counsel) but those documents suddenly disappeared.and so did District counsel and the VA doc who supported my claim.

It took 3 more years to get DIC . I found those initial 1995 missing medical documents confirming malpractice

in my c file 2 years ago.

They write 1151 all over the claims file and get nervous over these claims but they do try to fight them and will 'overlook' or temporarily lose the evidence if they can.

"Do I need to get an IMO before I file for DIC?"

I would file the claim first. I think I mentioned this before-as long as you have the med recs.

You might need to send the death certificate with the DIC claim.

I did say to get the med recs first and it sounds like you do have them all-

CHAMPVA- this should not affect your CHAMPVA benefit.

I forget- he was an AO vet ? If so make sure you claim that diabetes contributed to his death also due to exposure to Agent Orange.

On the Death Certificate did they list any contributing conditions?Are any of the conditions they listed service connected ones?

If a service connected disability contributes to or causes death the survivor can get DIC.

VA will probably need a certified copy of the death certificate with a raised seal.

I needed quite a few when Rod died -$10 in those days-it could cost more now.

Edited December 7, 2006 by Berta

[KHJH]

My husband was in vietnam but wasn't service connected for anything to do with agent orange.

He never filed a claim for Diabetes.

He had filed a claim for his kidney's about a month before he died.

I met with my husbands SO today and he is going to try and get renal failure added to his death certificate.

He also said I can't file a claim for diabetes contributing to his death since he had never filed a claim for diabetes.

Kathy

[Berta]

" met with my husbands SO today and he is going to try and get renal failure added to his death certificate."

I have a bridge for sale in Brooklyn- he has absolutely no legal basis to be able do that-unless he is a Medical Examiner too-

You can request this from the Medical Examiner- however the VA does not look too kindly on altered death certificates.

"He also said I can't file a claim for diabetes contributing to his death since he had never filed a claim for diabetes"

Say what? That is the most extraordinary statement I have heard in a long time from a vet rep-

He sounds just like my former vet rep- are you in southern tier New York?

He is WRONG. Ask him if he ever heard of the Nehmer decision and if he says HUH? get a better vet rep ASAP.

Men and women -take note of this- this is the kind of crap and incompetence your spouse might go through in the event of your death.

I went through it with the DAV as well as my present POA.

DAV, AL, VVA and every single major vet org are educated by NVLSP courses in widow and widower claims.I know that because I took the same NVLSP courses they did.

If they cant remember the regs for DIC and Agent Orange, all they have to do is look up what they need.

But some of them would rather lay back in their plush PC chairs, take advantage of the fact that you are grief stricken, probably lost income overnight, and cant hardly think straight and then they play God.

I got a thumpcall remedy for them that cannot be mentioned here.

They should be reported to their main office and a better vet rep should be sought ASAP.

(I only stay with my POAs because I am building a case)

Edited December 7, 2006 by Berta