Advice on Filing a Agent Orange/Prostrate Claim

[peakgolf]

I am a USMC Vietnam Veteran rated 100% P&T PTSD, 10% Hearing Loss, 10%Tinnitus.....I had  my yearly VA Physical in March of 2018 and found my PSA had risen from 4.1 in 2017 to 6.8, my primary care Dr at the VA  said she was concerned and would get a Referral for me to see a VA Urologist....  2 months went by and no Referral. I contacted my Private Family Dr and he referred me to a Private Urologist who did a biopsy and and was diagnosed with Prostrate Cancer.  Incidentally 4 days after this diagnoses came back I received my long awaited Appointment with the VA Urologist finally came through and I see him next week.

My questions are: 1.  Should I file a Agent Orange/Prostrate Cancer Claim with the VA and risk having my 100% P&T being reduced after my Prostrate Cancer is in remission  or should I go ahead and continue with the Treatment Plan my Private Urologist recommends and keep the VA out of the equation (I have fairly good Private Insurance).  2.  Should I keep my appointment with my VA Urologist and try and get him to Refer me to the Private Dr. who is going to be administering the Radiation Treatment for my Prostrate Cancer so the VA picks up Treatment Cost.....

Thanks in advance for any advice on this matter, Peakgolf

[broncovet]

Maybe Berta will chime in here, BUT it is medical malpractice (1151 claim) when VA fails to diagnose and treat you.  (I beleive it may be called treatment delay.  You were apparently referred for treatment, and "somebody" dropped the ball).  

While my crystal ball is currently on the blink, if I had a choice I would take private treatment over the VA, mainly for 2 reasons:

1.  You get faster treatment in private care than you do VA. 

2.  "Fear" is a big motivator, and private care docs fear a malpractice lawsuit, so they do everything in their power to prevent it.  VA docs dont care..if the Vet does file an 1151 claim, the worst that would happen is they are transferred to another VAMC.  

[Gastone]

I think you have more pressing concerns regarding which treatment for PC to use than worrying about future SC Reductions.  A recent Major Medical Report indicates that a 10+- years PC Study results showed that there was no significant benefit to any of the current PC treatments over Watchful Waiting. Survival Stats were equal. Remember, Surgeons like to cut, Radiologists like to Radiate, both procedures have extreme side effects.                         Start the PC Claim on E-Ben to establish your File Date for Retro, just don't jump on the Submit Claim Button right away. A PC DX for a Nam Vet would possibly qualify you for a Statutory SMC S (Housebound) Award during the Watchful Waiting Period.

[Berta]

 

All of the prostate cancer ratings are found within this 2018 BVA decision:

https://www.va.gov/vetapp18/files1/1800828.txt

Bronco vet is right as to the SMC S award- but that would only last as long as the  prostate cancer is at 100% or residuals are at 60%, in addition to the 100% P & T for PTSD.

This BVA case shows what I mean:

https://www.va.gov/vetapp17/files8/1752468.txt

Broncovet said:

"Maybe Berta will chime in here, BUT it is medical malpractice (1151 claim) when VA fails to diagnose and treat you.  (I beleive it may be called treatment delay.  You were apparently referred for treatment, and "somebody" dropped the ball).  "

That was my first thought too when I read all this.

  "2.  Should I keep my appointment with my VA Urologist and try and get him to Refer me to the Private Dr. who is going to be administering the Radiation Treatment for my Prostrate Cancer so the VA picks up Treatment Cost....."

I dont know how the cost factor would work-but what if the VA doctor does Not diagnose prostate cancer- that would be the basis of a 1151 claim, at that point-yet you do have ability to get good private care. And the SC rating for this disability is far better than 1151 awards.

I was a 1151er  survivor for many years but reopened my claim to prove that, although VA admitted they caused my husband's death, it was 2 Agent Orange disabilities that caused his death, an untimely death- because VA did not diagnose or treat either one of them ( AO IHD/ AO DMII). 

VA almost killed a local Vietnam Vet friend of mine by failing  to diagnose and treat colon cancer- this is a differet situation here- VA had allowed his cancer to get to Stage 4 before they realized his "hemmoroids"-they had diagnosed and treated him for, for many years, were actually evidence of colon cancer.

In the 1151 claim I wrote for him I just referred them to all of his VA medical records that would reveal the malpractice, and they awarded 100% P & T under 1151- but in this vet's case-

 "my primary care Dr at the VA  said she was concerned and would get a Referral for me to see a VA Urologist....  2 months went by and no Referral. "  Technically the VA PCP did the right thing-

Only a urologist could determine if maybe something prior to that referral involved a "failure to treat" which is different that a "delay" in treatment that might not be as serious as it seemed.

Yesterday on Fox News the  young Congressman who lost both of his legs in Afganistan (forget his name) told how he waited for 5 hours to get treatment at a VAMC recently , their delay in proper  referrals is plaguing probably the whole VA system.

 

 

 

 

Edited May 14, 2018 by Berta

[Gastone]

Nam Vets are all Old Dogs now and who knows when OUR Expiration Date will hit. Time is not our FRIEND.

Once you have the Official PC DX, hit the Submit Button on E-Ben to file the AO Secondary Claim as an FDC Attaching the testing Results and the Private or VA Dr's DX and Treatment notes. The 100% PC SC would take effect almost immediately, with Retro back to File Date or 06/01/18 and continue as long as the PC hasn't been removed or successfully Radiated.

Scheduler SMC S (Housebound) should be Awarded simultaneously.

[Buck52]

I agree with Gastone   submit the claim asap and let the VA Figure it all out.

[peakgolf]

Thank you guys for the prompt replys!!  I am just trying to get some advice on the best way to approach this....Semper fi, peakgolf