Non VA medical bills

[JohnsWidow]

My husband was 100% service connected disabled USMC veteran. He passed away Oct.22, 2016. He had gone to 2 seperate non VA hospitals via ambulance before his passing. The hospitals were aware he was 100% service connected disabled. They have been sending bills for hospital services and he had told their billing departments to send the bills to VISN 16 Consolidated fee unit PO box 320164 Flowood, MS. 39232 several times. Now that he has passed and the same bills are still coming I decided to just enclose a note in all bills stating to remit all bills for payment to the VISN address. They still don't get it. What am I doing wrong? Can anyone suggest a better alternative? Thank you for your time.

Edited January 2, 2017 by JohnsWidow

[SonOfJohn]

10 hours ago, Berta said:

Was he receiving VA compensation at the 100% Rate since that date?

Do you have a copy of the actual award letter that specifically stated how they decided the award and the 100% P & T?

If the VA in 2012 had determined he was 100% P & T due to cancer from AO exposure, why did he file a claim in 2016 for VA compensation for the same AO  lung cancer ?

Many lung cancers are not AO presumptive. I just read a denial to a widow at the BVA –the veteran ( incountry Vietnam)died with the same non small cell metasizing lung cancer but it was a carcinoma and not on the AO Presumptive list.

I thought the Texas Veterans Commission held your mother’s POA,but now a law firm does?

Do you have his private medical records up to the point in 2012 that the VA was treating him?

 

Yes, My father was getting 100% since Nov 2012. This was for PTSD/Bi-polar Psych. 

He was declared incompetent Oct 2010, and stopped on July 2011 when he was found competent.

The Texas Vet Commission assistant told my mother and I (very confidently) that Lung Cancer was on the AO presumptive List and showed is so that is one of the claims still pending

I do not have VA records pre-2012.

Would it be wise to wait for the lung cancer/AO claim to go through before pressing other wrongful death claims? I'm not exactly sure how to go about filing multiple claims. My main concerns are 3 things:

- AO compensation as presumptive cause for lung cancer

- Wrongful death due to malpractice in finding cancer. My father was put on "Harvoni" to clear up Hep C prior to getting Bi-polar meds. Due to the cost of Harvoni, he was put through a battery of tests to determine his health in early 2015. The fact that NO issues were found and yet he suffered a Aortic dissection in Sept 2015, then was suddenly diagnosed with Stage 4 cancer a few months later is HIGHLY suspect

- Wrongful death due to malpractice in cancer treatment. My father was NEVER given chemotherapy and did not even get an appointment with the VA oncologest before he died. We tried for months to get the VA to clear "Choice" care to pay for a private care oncologest who said he should be on chemo immediately, but we were denied by the VA chief of staff.

Any thoughts (also I"m not familiar with a few of the acronyms you use)

 

10 hours ago, Berta said:

 

 

 

 

 

 

 

Edited January 6, 2017 by SonOfJohn

[Berta]

"The Texas Vet Commission assistant told my mother and I (very confidently) that Lung Cancer was on the AO presumptive List and showed is so that is one of the claims still pending."

If it is lung cancer as defined as respiratory, they will service connect it to Agent Orange:

"Under 38 C.F.R. § 3.309(e), certain diseases may be presumed

to have resulted from exposure to certain herbicide agents

such as Agent Orange.  The list includes chloracne or other

acneform disease consistent with chloracne, Type 2 (adult

onset) diabetes, Hodgkin's disease, multiple myeloma, non-

Hodgkin's lymphoma, acute and subacute peripheral neuropathy,

porphyria cutanea tarda, prostate cancer, respiratory cancers

(cancer of the lung, bronchus, larynx, or trachea) and soft-

tissue sarcoma (other than osteosarcoma, chondrosarcoma,

Kaposi's sarcoma, or mesothelioma)".  See 38 C.F.R. §

3.309(e). 

 

There are different types of lung cancer.

 

If this was a “respiratory” cancer, the VA should service connect it.

 

Also: http://www.publichealth.va.gov/exposures/agentorange/conditions/respiratory_cancers.Asp

 

“And:

In addition, in a statement, received by VA in August 2010, V. C., M. D. opined that the Veteran's primary lesion was in the oropharynx, throat, as opposed to his tongue.  Once again, the Board notes that only respiratory cancers, which include cancers of the lungs, bronchus, larynx and trachea, are presumed to have resulted from exposure to an herbicide agent such as Agent Orange.  The Veteran's squamous cell cancer of the tongue cancer cannot be presumptively service connected on the basis of herbicide exposure.  38 C.F.R. §§ 3.307, 3.309.  Significantly, where a cancer is not the primary cancer, but is merely the location where a primary cancer has metastasized, the secondary cancer cannot be considered presumptively related to herbicide exposure.  See VAOPGCPREC 18-97 (May 2, 1997) (metastasis represents the progress of the nonservice-connected primary cancer, and is affirmative evidence that the secondary cancer was not the result of some other cause, such as herbicide exposure).”

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp15/Files6/1550972.txt

 

But I assume you have medical evidence that the law firm and the woman from TVC  have  seen, and  that indicates your father’s lung cancer was a “respiratory” form of cancer.

 

I ,however,do not see anything here in your posts to indicate that it ,in fact, falls into the above regulation, as a "respiratory cancer."

 

 

You stated:

“I have sent the records to a law firm my father was working with (Rawls Mcneils) prior to his passing in an attempt to get compensation for AO and now wrongful death. They have been going through it for months and I"m hoping they find something they can use.”

This seemed to suggest to me that your father had already filed for the lung cancer but had been denied and had contacted the law firm.

Had he been denied by VA for AO lung cancer?...

as the above quote from you seems to indicate....

 

 

 

 

 

 

 

 

 

 

[Berta]

To add:

I have posted the controlling VA regulations as to Agent orange presumptives., and the fact that lung cancer must be of a respiratory nature,with proven exposure for an AO Award.

I have also spent Considerable time at the BVA web site trying to find any case at all that granted comp or DIC for Metastatic non Small Cell Lung cancer....under the Agent Orange presumptive Regulations.

Others here are welcome to search the BVA too in case I missed something.

http://www.index.va.gov/search/va/bva.jsp

I have also posted here all the info on FTCA/and 1151 claims with links, all based on years of research I had to do for those claims, when I had them.

Section 1151 ,38 USC has not changed since the Gardner decision ( 1997) and FTCA laws have only changed in respect to specific state court caps on settlements.

I strongly suggest that you contact the law firm you mentioned, via email,to obtain a hard copy response of what their status is on anything they were helping your father with. They would have a copy of any past AO denial, if he was denied in the past.

I also suggest that you copy my posts here as to the Agent Orange Presumptives and the recent BVA clarification link, and send that to the TVC person who is apparently on your mother’s POA….to confirm that TVC has found -in your father’s medical records,- that he died from a “respiratory” Agent Orange cancer.

I would like to know of their response.

There are certainly confines to the Vast internet and we can only opine here on what documentation we see here  , that is attached.

You said:

“We tried for months to get the VA to clear "Choice" care to pay for a private care oncologest who said he should be on chemo immediately, but we were denied by the VA chief of staff.”

Do you have documented proof of what the private oncologist said?

Do you have documented proof of the denial of the Choice card by the VA Chief of Staff, with a full reason he/she gave?

“The fact that NO issues were found and yet he suffered a Aortic dissection in Sept 2015, then was suddenly diagnosed with Stage 4 cancer a few months later is HIGHLY suspect.”

Yes it seems to be. The medical records, if reviewed by a private oncologist willing to do an IMO, will reveal if malpractice did occur.

Perhaps that  private oncologist would be will to prepare an IMO for the DIC  claim....if it is filed or has been filed, raising the malpractice issue as a Section  1151 claim.

 

We have an acronym list here:

http://community.hadit.com/topic/15978-acronyms-initialisms-and-abbreviations/

 

 

 

 

 

Edited January 6, 2017 by Berta

[Berta]

and my final reply:

metastasic lung cancer denied...one of many 

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp99/files3/9924795.txt

 

BUT ,This however is an award under 1151 for metastatic lung cancer.

 

“Therefore, resolving all doubt in favor of the appellant and the Veteran, the Board concludes that service connection under the provisions of 38 U.S.C.A. § 1151 for metastatic lung cancer, the cause of the Veteran's death is warranted.  See

38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).

 

 

ORDER

 

Service connection under the provisions of 38 U.S.C.A. § 1151 for metastatic lung cancer, the cause of the Veteran's death, is granted, subject to the legal criteria governing the payment of monetary benefits.”

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp12/Files1/1202416.txt

Also there is a 30 year rule that I am sure the TVC is aware of:

“Service connection may also be allowed on a presumptive basis

for certain diseases associated with exposure to certain

herbicide agents (“herbicide agent” means a chemical in a

herbicide used in support of the U.S. and allied military

operations in the Republic of Vietnam during the Vietnam era,

including Agent Orange), if the disease becomes manifest to a

compensable degree within a specified period of time after

the veteran’s separation from service.  38 C.F.R.

§§ 3.307(a), 3.309(e) (1998).  The following diseases shall

be service connected if the veteran was exposed to Agent

Orange during service, if the requirements of 38 C.F.R.

§ 3.307(a)(6) are met, even though there is no record of such

disease during service, and provided further that the

requirements of 38 C.F.R. § 3.307(d) are satisfied: chloracne

or other acneform disease consistent with chloracne,

Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma,

acute and subacute peripheral neuropathy, porphyria cutanea

tarda, prostate cancer, respiratory cancers

 

(if the

disability becomes manifest to a compensable degree within 30

years after the last date on which the veteran was last

exposed to an herbicide agent during active service), and

soft-tissue sarcoma.)”  38 C.F.R. §§ 3.307(a)(6)(ii), 3.309(e).

 

I could not find a decision with the 30 year rule yesterday as I searched in many older BVA decisions,but found it today and am sure the TVC had his DD 214 and also are fully aware of the 30 year rule as I have no idea when your father was exposed to AO in Vietnam.

It would be the last date on his DD 214 of overseas service ,aka his DEROS ( Date Eligible to Return from Overseas Duty)

 

 

 

 

[Berta]

I meant "final reply" as of yesterday...with 661 views to this topic ( I sure made probably 20 or more of the view hits myself to determine what the issues were here... it has been confusing)

Because I was hoping others, in addition to Buck ,would chime in.

This statement needs clarification:

“ have sent the records to a law firm my father was working with (Rawls Mcneils) prior to his passing in an attempt to get compensation for AO 

“and now wrongful death. They have been going through it for months and I"m hoping they find something they can use."

Why did he contact this law firm for help with AO compensation?

Had he been denied by VA already?

Or was it about the pdf you attached here….Clearly they got the actual awarded disability confused with AO.

Did your father raise the possible malpractice issue with the law firm? Is that documented by them?

Because that is something that, if documented , can begin the 2 year Statute of limits......did they possibly file a SF 95 for your father.?

I would think many here would be concerned about  this thread. 

It involves Agent Orange, and a major screw up letter (the pdf) ,possible malpractice by VA, and worse of all the veteran is dead.

 

 

 

[SonOfJohn]

It appears I have been inaccurate with regards to the law firm. The Law firm was only looking to get my father Cancer treatment (malpractice with regards to FINDING the cancer) and has not in any way looked to see if there is an AO connection.

I should also clarify that ONLY my mother has a POA.

I'm not sure what you mean by "respiratory" lung cancer (I didn't know if came in any other form) I assume this means that the cancer originated in the lungs and did not come from somewhere else in the body is this correct? what is required to prove this?

My father's last date on his DD214 is 18-Jun 71. I'm not sure if that's his last date in Vietnam,