DIC Denied Wrong Death Certificate

[Pansy Peacock]

My DIC claim was denied saying that I failed to respond to a request for a "long death certificate"

I never received a letter from the V.A. requesting a different death certificate.

I received two different forms of my husbands death certificate.  One was 8 x 10 other was 8 x 14. I had included the long form in a clear vinyl sleeve and I'm assuming the person deciding my claim did not remove it, unfold it and look at it.

When I received notification April 5, I went to my DAV rep and he sent them another long form of my husbands death certificate, a SOC stating I had not received the request from the V.A. and a NOD for just in case.

I have asked IRIS two weeks ago for any info with no response. Called Peggy a couple of times to be told they had denied my claim, checked eben's and vets.gov numerous times with the only information being my name.

Does anyone here have thoughts on if my claim goes to the end of the line again or if someone will see the SOC and just do the right thing and follow through.  He was service connected BOG Vietnam and his death was secondary to his IHD.

Thank you folks for your time and this board.

 

[Pansy Peacock]

Thank you for your responses.

BOG was term my husband used for Boots on the Ground, Vietnam.

Only wording on death certificate is in part I stating cause of death:   Multi-compartmental hemorrhage with midline shift. (I researched this and one of the main worries for physicians prescribing blood thinners is hemorrhaging).  I also included this research in the claim citing 5 separate medical resources and included 3 different VETAPP citations where cause of death was secondary to IHD related blood thinners.

My claim, I believed, was bullet proof. I had a 4" binder with a table of contents, chapters marked, at least 3 citations from VETAPP tabbed with medical references for each disease and included a CD and a thumb drive with the same information so they would be able to use whatever means was easiest for them.  I hadn't counted on someone looking at a folded piece of paper and deciding what size it is without unfolding it. I probably should have put instructions.

To be very honest, I feel they were quick to resolve my claim even tho they erroneously denied it. 60 days. My husbands appeal was close to 5 years when he passed, and pwrslm, you are correct. My husband was a hero.

Called White House, thank you guys for that, I didn't know it existed. Gentleman took my info but really seemed more concerned that IRIS didn't respond.  Also, emailed IRIS with the info Mrs. Bertha gave me (thank you for that).

Again, Thank you folks for being here. I've been reading the hadit forums for years and it has given me some very valuable information and at times was just good company

[Berta]

"Only wording on death certificate is in part I stating cause of death:   Multi-compartmental hemorrhage with midline shift." (I researched this and one of the main worries for physicians prescribing blood thinners is hemorrhaging).  I also included this research in the claim citing 5 separate medical resources and included 3 different VETAPP citations where cause of death was secondary to IHD related blood thinners.

So in Part 2 they did not  put anything as a contributing factor?

I will look up those citations-hope I can find them unless you have the Docket #s....and can post here....

Dud you file under Section 1151 DIC or for death due to medication for a service connected condition?

Was he on coumadin?

"My husbands appeal was close to 5 years when he passed, and pwrslm, you are correct. My husband was a hero."

Indeed he was. Have you substituted yourself as the claimant on the appeal?

Has any doctor  ,in documentation, stated that the medication he was on for his AO IHD,  contributed substantially to his death?

How soon prior to his death did he get a CT scan or MRI?

Was that done at the VA?

You need copies of all of his VA Medical records. The VAMC he went to might have a short form you can fill out to get them. You could contact their Records Access officer ( sometimes called FOIA officer)but you dont neeed FOIA tyo get the copies.

I am unaware that any blood thinner would be prescribed for IHD.....

Then again my husband died due to IHD with CVAs contributing.

VA provided no diagnosis or treatment for his IHD. 

Did the VA prepare the death certificate?

Did he have another other conditions that could have warranted the blood thinners?

If this is all the death cert revealed (and I assume no autosy was done) I think the VA, even with the death certificate, might still deny the claim.Obviously the 3 BVA decision you found were because a claim had been denied, and by then( BVA decision) years had passed.

Are you prepared to seek an independent medical opinion if the VA denies the claim again?

That can be costly. I did that myself because although I proved VA wrongful death of my husband without any IMO-5 years later I found he had also been mamalpracticed on due to AO DMII and I filed that claim for direct S C and not  under 1151  and got 4 thousand worth of IMOs from real doctors to succeed.

Have you contacted anyone ( Coroner ,ME , or whoever filled out the death certificate) to see if IHD could be added as #2 a contributing factor to death?

 

 

 

Edited April 20, 2018 by Berta
lots of problems due to wind

[Pansy Peacock]

WOW! I wish the VA was as quick as you

While the cases aren't exactly like his, the information to grant them for service connect would be relevant.

Here are the citations

a.    VETAPP Citations Service Connect Granted Blood Thinner related deaths

                                          i.   Citation Nr: 1625367 IHD leading cause of death in Stroke (CAH) Patients

                                         ii.   Citation Nr: 1022184 IHD with anticoagulation caused fatal cerebral hemorrhage

                                        iii.    Citation Nr: 1454619 Cerebral Hemorrhage Death, Warfarin Coagulant

I'm in Florida and looked into what I would need to add to the wording on his death certificate as contributing cause and spoke with his cardiologist who said he would confirm that one of his blood thinners was prescribed by him if I needed it. His vascular surgeon also agreed because he was also on another one because he had artificial veins from his COPD caused by his service connected PTSD related smoking and inability to quit.

So, I also included the following: VAOPGCPREC 6-03 (Service Connection for Cause of Disability or Death, 69 Fed. Reg. 25178 (2004)

With respect to tobacco-related disability, for claims filed after June 9, 1998, Congress has prohibited the grant of service connection for disability due to the use of tobacco products during active service.  38 U.S.C.A. § 1103(a) (West 2002 and Supp. 2009).  However, the VA General Counsel has held that neither 38 U.S.CA. § 1103(a), nor its implementing regulations at 38 C.F.R. § 3.300, bar a finding of secondary service connection for a disability related to use of tobacco products after service.  VAOPGCPREC 6-03 (Service Connection for Cause of Disability or Death, 69 Fed. Reg. 25178 (2004)).

According to the VA General Counsel opinion, where secondary service connection for disability due to smoking is at issue, adjudicators must resolve (1) whether the service-connected disability caused the Veteran to use tobacco products after service; (2) if so, whether the use of tobacco products as a result of the service-connected disability was a substantial factor in causing a secondary disability; and (3) whether the secondary disability would not have occurred but for the use of tobacco products caused by the service-connected disability.  If these questions are answered in the affirmative, the secondary disability may be service connected.  Id.

And then I included these.

      I.       

a.    Citation Nr: 1741745 Veteran’s COPD due to PTSD-related cigarette smoking

b.    Citation Nr; 1632854 Veteran’s COPD due to PTSD-related cigarette smoking

c.    Citation Nr; 1635253 Veteran’s COPD due to PTSD-related cigarette smoking

Medical Research regarding smoking and PTSD

                                          i.    Prevalence and correlates of heavy smoking in Vietnam Veterans with Chronic Posttraumatic Stress Disorder – abstract- Beckham, Kirby, Feldman

                                         ii.    Improving Functional Outcome of Veteran Smokers w PTSD VA Study.docx – Improving Functional Outcomes of Veterans with PTSD and Tobacco Dependence

                                        iii.    Clinical Psychology Review – Smoking, Traumatic Event Exposure and post-traumatic stress. Feldner, Babson and Zvolensky

                                        iv.    Combat, PTSD and Smoking Trajectory in a Cohort of Male Austrailian Army Vietnam Veterans. O’toole, Kirk, Bittoun, Catts.

                                         v.    Factors associated with smoking behavior change in UK military personnel – Occupational Medicine, Thandi and Fear

e.    EXTRA CITATIONS ALL GRANTING SECONDARY TO PTSD, SMOKING

                                          i.    Citation Nr; 1511796 Veteran’s COPD due to PTSD-related cigarette smoking

                                         ii.    Citation Nr; 1550139 Veteran’s COPD due to PTSD-related cigarette smoking

                                        iii.    Citation Nr  1444646 Veteran self-medicating PTSD with smoking

                                       iv.    Citation Nr, 1413894 Veteran’s COPD due to PTSD-related cigarette smoking

                                        v.    Citation Nr; 1401524 Veteran’s COPD due to PTSD-related tobacco usage smoking

                                       vi.    Citation Nr; 1313313 Veteran’s COPD due to PTSD-related cigarette smoking

He also had Stage 4 Parkinson's, which really,really sucked when he had his PTSD episodes, and vice/versa!

When I was going thru all the VETAPP citations I was amazed at how many men had exactly the same maladies as him. And stories. Tough read.

Thank you again for you time and expertise.

 

[Pansy Peacock]

I should have said my husband also had peripheral vascular disease and had artificial veins in his leg and had blood thinners for that, also, which was secondary to his COPD caused by his service connected PTSD related smoking and inability to quit.

[Berta]

You certainy did a lot of work on the DIC claim.

But I can see the pitfalls........The main one is the death certificate and they can often be amended.

The death certificate must show that an established Service Connected condition was a contributing factor to death.

You said he was BOG Vietnam ( Gee- I forgot that acronyn-thanks) with IHD. I assume this was AO IHD.

If so statements from his doctors, as you mentioned above, should tie in the cerebral hemmorhage  directly to the IHD via the blood thinners. This should take the form of a Brief IMO- and the criteria for IMOs is here in the IMO forum.

The death certificate only needs to have any SC condition he had as contributing to his death.

However VA will need to see that the contribution of the SC due to the  blood thinner ,was substantial and ,with documentation from these doctors, that could award the DIC claim.

Was the PVD also service connected? If so that could bolster any medical opinion as well.

Parkinsons is a AO presumptive disability- was he awarded for that as well?

Was the COPD service connected?

Was the PTSD service connectd?

What was on appeal and have you been formally substituted as the claimant on that.?

PS whe I proved my husband had DMII , undiagnosed and untreated, and that it contributed to his death- the ME (Medical Examiner told me they could not amend the death Certificate. However some years after that I called someone ,possibly through our county surrogate's office and she said they had a form  for that and it could be done. But I never pursed that because my DMII claim had been granted. I had 2 IMOs and one short freebee to prove he had DMII and also the BVA award letter. It is best to know exactly what your ME or  county Coroner would need to amend the Death Certificate.

Did the VA deny his Parkinsons claim? If it was before Parkinsons beame a presumptive, you might have a chance to fight the denial ( Nehmer Footnote Oe 2010)

 

 

 

 

 

 

 

 

 

[Berta]

Citation Nr: 1625367

The widow had a strong IMO to rebut the VA opinion.

The claim was granted 10 years after the veteran’s death

Citation Nr: 1022184

This case came from a 2005 rating decision and was awarded in 2010.

The BVA asked for 2 VHA opinions, which supported the DIC claim.

VHA opinions are ,in my opinion because I had a VACO opinion from VHA once,

Far more thorough that any opinion from a C & P examiner, asked by a VARO, to do a posthumous  C& P exam.One denial I got was because a C & P examiner stated my husband had died from Cocaine.

I was so furious ( my husband did not take drugs-just VA meds ( which were the wrong meds- FTCA/1151 award) and he didn’t even drink. I called the doctor up only to find that the VA has ever given him the 6 page autopsy, revealing he was drug and alcohol free and was an organ donor- the reason the ME did an autopsy. VA also sent to VACO ( for th3e VHA opinion) the whole medical record -leaving out again, the autopsy. The OGC said they had denied the claim again. I called the Cardio VHA doctor- I still hear this doctor shouting into the phone WHAT AUTOPSY!-I immediately faxed it to her and OGC called me up to settle the malpractice claim. Her actual report is devastating and she is still their head cardio expert at VHA.

My point is that VA can aggressively fight DIC claims.

The widow above was very fortunate to get the VHA referral by the BVA.

Citation Nr: 1454619

“FINDINGS OF FACT

 

1.       The Veteran died in August 2010; the death certificate lists his cause of death as cerebral hemorrhage, warfarin anticoagulant; other significant conditions noted were hypertension and diabetes mellitus.”

(I believe , as I did, the widow or someone in the family told the coroner of the veteran’s medical situation,prior to the death certificate being written.)

As you can see, the VARO fished around for negative opinions but the BVA granted due to Relative Equipoise. It is unusual to see how a VA doctor in this case, who had treated the veteran, gave a superb opinion that outweighed the other VA opinions.

I mentioned the C & P doc I called and raised Hell with due to his cocaine statement in the SOC. He told me if he had been given the autopsy his opinin would have drastically changed.

Years later I asked him if he would be willing to do an IMO for my DMII claim. He reminded me that I had knocked down not one but two negative  opinions he had done for my claim.We had certainlu made up when he realised what the RO had withheld from him . He told me without a doubt my husband presented a picture of full blown untreated diabetes mellitus, based on some medical info I found in his VA med recs. That was all I needed to hear and I  promptly contacted Dr. Craig Bash for an IMO. DMII AO death granted 2010.

You might not have any problems at all with your VARO.

If the death certificate cannot be amended, it might take a strong IMO to grant DIC.

Was an MRI or CT done prior to his death?

Those MRI assessments in the medical records can often reveal a lot.