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AO UPDATE -our last chance

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Berta

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As all here know, if and when the Secretary adds any new AO presumptives due to the NAM ( formerly IOM) 2014 report it will be the last possible chance to have any other AO conditions added.

Yesterday I got two updates:

https://www.stripes.com/news/us/shulkin-says-he-would-if-he-could-expand-agent-orange-related-health-care-1.518135

http://www.thenewstribune.com/latest-news/article206376404.html

Possible additions still include bladder cancer, hypothyroidism, and Parkinsonian symptoms ( as compared to full flown Parkinson -already a AO presumptive.

However, the VA has stated in the past that hypertension and stroke could be potential AO disabilities too.I guess the Secretary ,in this artcle forgot about the "limited -suggestive" association that the IOM found in it's 2010 Update, not that this limited suggestive category also has applied to hypertension, in the IOM Updates of 2006,2008, and 2010 .

The second article brings up the cost factor found in the Philpott article.

What cost factor?  Vietnam veterans are dying and that also means their spouses and survivors are elderly and dying too!

My position  is that any veteran who has ischemic heart disease, awarded by VA do to AO exposure, and who also has suffered a stroke, ischemic in nature, should be awarded for the stroke , as due to AO.

I am writing to the Secretary to get his full medicale rationale ( since he is a doctor) as to how an ischemic stroke that occurs in a veteran who also has documentd AO IHD, could Not be an obvious AO presumptive.

It would cost a veteran in that case thousands to get an acceptable IMO to prove the CVA is secondary to the IHD, yet it just makes common sense that an ischemic heart would cause an ischemic stroke of the brain.

I am not considering Hemmorhagic stroke as that could have other causes not related tyo IHD.

Has anyone here with any disability that could possibly be related to their AO exposure, and that has been found to have ( per IOM /NAM reports ) a limited but suggestive association to Agent Orange, written to the Secretary to make their case as to why their disability should become an AO Presumptive?

"Limited" and " suggestive evidence"  is why we have most if not all of the AO presumptives we have now, per past IOM and now NAM reports.

If anyone wants Secretary Shulkin's address  ( I always send President Trump a copy of any letter to the Sec, with a brief cover letter)

They are here under a search or I can post those addresses again. Some input and pressure from veterans themselves might get this whole thing moving.

I never saw new presumptives take this long to be considered by the VA. And time is our enemy.

 

 

 

 

 

 

 

 

 

 

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Even though this is the last VA Mandated IOM based AO Presumptive update. I believe that the possibility of additional future Presumptive Conditions will be possible.

As for Hypertension, I never thought it would make the cut as a Presumptive. Just way too many individual lifestyle factors to be considered, especially for Old Dogs.

I haven't reviewed the 2017 IMO Report regarding Hypertension in Male Civilian Population Vs Nam AO Vet population. were the Vet population numbers significantly higher than the civilian cohort?  With the $$$ involved, I believe the Vet Numbers would have to be significantly higher than the Civy population.

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Unfortunately, its mostly "always about the money".  

Vets benefits are akin to an old bill from when we were broke...many of us simply dont want to pay it unless we have to.  The "bill" is due to Veterans from old wars, mostly Vietnam.  People talk about being Pro Veteran, but they are not speaking with their mouth, and not their wallet.  

And, Vets are largely disorganized and not united like the AARP, who gets benefits for seniors.  The VSO's, in my opinion, represent their own interests more than Veterans.  Their platform is to maintain status quo..they are largely against any type of privatization, even tho I am convinced that private industry is more efficient than VA in providing health care.  

The reason is clear.  There is an economic principal called "economies of scale" and "optimal interceptor allocation".  These principals explain how a mom and pop operation does not run efficiently, as it is too small.  As a company grows, it becomes more efficient as its able to get "bulk" quantity discounts.  However, when a company grows too large, its efficiency suffers for many reasons.  

The federal government is too large to be efficient.  The waste in VA is enormous, and VA officials either cant or wont do anything about it, with some actually in favor of that waste as they are the beneficiaries.  

The solution is to turn some of it over to private care..that is, Vets could choose whether to go to VA or get some type of private insurance paid by the VA.  The VSO's are adamantly opposed to this as they point out some VA facilities would likely close if Vets had a private insurance alternative.  I say that would be good..if inefficient and corrupt VAMC's close..and Vets go to private clinics..this is VA's own fault and I dont see Vets suffering..they would have private insurance paid for by VA.  

Its kind of the same thing with schools.  If students had a choice of going to school A, school B, or private school C, then the poor schools would close and competition would enter the school system.  

I think we need competition..and VA hospitals would have to compete with private care.  I think they would either up their game or get shut down.  

I really dont understand why so many are opposed to this..it happens in industry with companies all the time.  I cant see a downside to some competition and privatization at VA except that some people would lose their jobs at inefficient, corrupt VAMC's.  Ok, Im off my platform, now.  

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no need to search...

President Donald J. Trump                                              

The White House

1600 Pennsylvania  Avenue NW

Washington, DC. 20500

--------------------------------------------------------

Secretary David Shulkin                                                                                      

Veterans Administration 

810 Vermont Ave. NW
Washington, DC 20420

------------------------------------------------------

You can access on line any IOM or NAM report and copy their 'limited or suggestive' statements as to your disabiity -if it has been considered by the IOM/NAM already and paste that excerpt from them into your letter and cite the hyperlink it is from.

This is all based on a 1,100 page report done that was finished in 2016.

All IOM /NAM reports are on line.

 

Edited by Berta
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If a vet has SC heart condition is there any doubt that HBP has some serious interaction with existing heart problems.   I go 60% for AO heart condition and I take meds for HBP.  Which came first I do not know.  How in the world can VA separate out AO effects for vet with heart and blood pressure problems?  Where you have one you usually have the other because factors causing HBP also cause heart disease/heart failure.  How can VA treat or rate vets for AO conditions as if person were living in outer space and all conditions impact each other?

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I fully know what you mean John.

I will not be here much next few days.....I have prepared a letter to Shulkin as to Stroke and HBP but  my  request isthat he consider ischemic stroke to be AO presumptive in any Vietnam vet who already has an AO IHD rating and then suffered an ischemic stroke.I gave a lay medical opinion based on lots of research but I think I can add more to persuade him- or at least I asked him to give all AO vets who have IHD and then had an  ischemic  stroke , a full medical rationale for not adding stroke to the presumprtives.Both of these disabilities come from atherosclerosis that causes clots from heart to go to the brain,if not properly treated...sometimes even if they are.I can make a strong argument- will see how that goes ----my last letter got a call from his office-

But I got into one more issue and mentioned that POTUS will get a copy of my letter too-

I hope the VA is aware that MANY vets and their survivors are forced to spend THOUSANDS to get IMO/IMEs that offer the first concise reading of their SMRS and VA med recs, that many never get from the VA, and their C & P result might definitely deny the claim. And unfortunately Many veterans and their survivors cannot even afford an IMO.

 

This is often the only way a veteran or survivor with a fully probative claim can ever get service connected.

 

 

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I also asked for the Sec to make stroke presumptive to AO vets, whether they have AO IHD or not and raised the HBP issue as well.

John as you said:

 "How in the world can VA separate out AO effects for vet with heart and blood pressure problems?  Where you have one you usually have the other because factors causing HBP also cause heart disease/heart failure.  How can VA treat or rate vets for AO conditions as if person were living in outer space and all conditions impact each other?"

You are correct. There is also the issue of vets trying to get secondaries from HBP or IHD and they almost always need a strong IMO for that, as they wont get a cardio expert for any C & P unless theu get real lucky.

I griped about that too-to Shulkin"

"I also am sending this to the President to let him know how MANY veterans are forced to pay thousands of dollars (and some can never come up with that cash) to obtain independent medical opinions, based on their medical evidence, in order to overcome deficient C & P exam results that are geared to deny their claims. This is often the only recourse a veteran or a surviving spouse has, to get a full reading of the SMRs and complete medical picture of the veteran."

and added:

"It is heartbreaking to me to realize that our enormous claims backlog is due in great part to the fact that many C & P examiners do not give a full reading to medical records and SMRs, and deny what could be a completely valid claim, yet might well be in the appeal status for YEARS.

I am at the BVA web site daily- the BVA decisions are proof that many denials have been overcome – only when the claimant has been able to come up with the cash to get a substantial independent medical opinion- which often includes an in-person exam, as well as the most concise reading of their VA medical records they will ever get, and they will have a full medical rationale supported by current abstracts or treatises, from an expert in the field of their disability.. .and someone who is not paid by the VA to do C & P exams- a major conflict of interest that can have a negative impact on many veterans."

cant post the whole letter ---much there about how they caused my husband's death and some other personal stuff.....and what they withheld from a C & P examiner ,and what the director of my VARO wanted me to accept about a year ago. BS to that.  I am not an isolated case by any means. 

I listed all awards letters I got ( husband never lived to see any of them) and enclosed my  initial 1151 award.

It is still horrifying to me to read after the past 20 years and I added the subsequent 1151 awards as well so I wonder what they will think about it. They can access my C file (Trump's people did via the vet White House hot line ) so they can readily see how many bogus posthumous C & P exams I got, that denied the claims,that they

did eventually have to award. This personal rendition all supported exactly what C & P crap most of us have  had to put up with. It is the C & P exam that holds the denial or the award.

C & Ps should be paid for under the Choice program- we chose the examiner  ( an outstanding real doctor with expertise in the field of disability in our claims and the VA pays them via Choice.....to do a concise  fair IMO/IME.

yeah right..that is a fantasy and the Choice program is already screwed up anyhow. 

 

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