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NOD for deceased husbands claims

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Poopsy Woopsy

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i am in an NOD for TDIU  thus asking accrued thru PTSD. The more work I do the more I find out the more I should have done or I guess my VSO. As in earlier posts, I have said that the only reason they denied the TDIU (which to me was obvious), is they denied it because of an old SSI claim for his back. I will "state" in my NOD that it should not supersede the TDIU/PTSD because I can add some presumptive info that started "Before" the back claim.. (I don't know if it will be as determinative to them, as PTSD can be elusive) Again I'm not sure thats what they even want. It seems they just want me to put in "Words" that it is not predicated on the back situation, which by the way back issues are in his VA med records as a condition as well, but I found where VA stated the back was stable. In doing all this (thru good info like you get here) I realized my husband should have been 100% for DMII. He met all the requirements for 100%. DMII it was originally claimed thru A.0. (along w CHF, ED, PN,) which I hope the new ruling as of Feb will change that. (we could not prove in country  because he was on ship, (did what you said Berta, got records asking for info stating ship etc, but they stated because of PII, I wouldn't receive such info. I do have his ship listed on the presumptive list so it all seems obvious. Do "I" have to Resubmit or do they just re-rule on the claim.  ANYWAY, back to my original point! Can and "Should" I add evidence stating proof he fits the 100% criteria for DMII. and ask for Re-consideration of DMII on presumptive or secondary grounds on the NOD??. (Or do I have the right to, (or shoud I)  resubmit it seperately, even though it was previously part of a closed claim) The AO is closed because of "No further proof" but should I not be able to re-direct his DMII on the NOD as a secondary to his PTSD instead? or even presumptive because of so much medical evidence in his VA med files. I am so determined to make them pay for what he "deserves" but I get lost with emotion, and then get lost with where I should go with all the information. What I don't understand is there is a huge amount of medical files all positive for everything claimed, so don't they have a "Duty to assist"  in getting it and figuring it out?  "Some" of the medical evidence but not much in respect to how much evidence there is, is in his C-files, so "is it" really as easy as sending "more" medical evidence that sits their right in his medical files for them to see?     I read where Berta stated not to re-state things that are obvious, so as not to assume "Ignorance" on their part or that they are not doing their job. (I realize they are just "Pawns" in the game) so some more direction would be very helpful to me. Been away for a bit because it takes such consentration with so much information,  realizing the more I find out the more work I have to do.   SOOOO afraid of making a mistake.  AND NO!!! I am too committed to this to hand it over to someone else at this point.. Except for asking verification from my VSO.

P.S. got a new printer so I could send receive or copy info now to help with any info received or replied to. Thanks everyone.. You are what grounds me!!    

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  " I didn't know it was possible to get more than one DIC.. So should he have gotten another DIC then for heart etc.. all I suppose too late for any such thing. "

I believe what I said was that I get DIC "awards" on 4 different basis- only One check however-----

a member here who I have knew from the older board , suggested to me by phone ( years ago when I was fighting them over something else) he suggested they might try to take away my DIC. That is when I realized they ,by now, would have to take away 4 separate awards of DIC. I was not concerned at all with what he said.

I have an issue before the VA that might rectify  the one DIC check scenario -Might- no one has ever challenged the DIC regs with OGC Pres Op 08-97 before. I hope that clarifies what I said.

I suggested filing for AO under Nehmer because you have proof his ship is on the AO list....filing separately from the TDIU claim.

This would be like my AO IHD claim as well as my AO DMII death claim- under Nehmer, your husband had disabilities that "should have been coded", but I do not understand why they do not appear on any rating sheet-

was he formally diagnosed and treated by VA or cardiac condition as well as diabetes mellitus?

If he was formally diagnosed and treated for these conditions by a private doctor, does the VA have those private records?

I am a little lost here because :

 "Then I find this letter:: to the dept of veterans affairs: (Skipped some parts)  it is my opinion that Mr. Hudgeons is totally and permanently disabled due to the conditions discussed below and that they are related to his military service.  Evidence of his medical diagnosis is: Interstitial PF.    specifically pages A,B, C, D. ( I don't know what that means and dont seem to have those pgs.) He then mentions I have reviewed his history on board the ships and is also my opinion "more likely than not"  PF was caused by exposure to AO including causation of secondary conditions of IHD, DMII, PN, aggrivated by said primary condition..    Problem being it is not physically signed just typed; Signed; Dr. Hescamp. Really wondering if He wrote it or not.."

Did VA question it was not signed?

Does the VA actually have that letter?

If so have they ever  conmsidered it as evidence?

That letter might warrant the basis for a section 1151 claim.

I googled Dr Hescamp- but only one doctor, with a different spelling of last name popped up- in Spokane:

https://www.healthgrades.com/physician/dr-daniel-hesskamp-ypbc4

Is this the same doctor who opined on the resulting DIC award?

Was Dr Hescamp'sletter to the VA on his actually medical letterhead?

"They stated "Service connection for cause of death on the claim of PTSD because I had a Cardiologist state the connection between the above heart issues and PTSD. The same  letter that verified his death was caused by the neglect of the VA. So awarding DIC.  Thus deeming PTSD as a cause of death also!"

The Hesskamp doctor I found is not a cardio doc.

I forget and probably asked you before- did any VSO or vet rep ever get involved with these current claims?

If not have you considered getting a vet rep to go over some of this with you?

I suggest filing the AO claim separately from the TDIU issue-I had other claims pending when I filed my AO IHD death claim.

With proof he was on the AO ship's list, regardless of the outcome of any possible VA appeal to Procopio decision, and proof of IHD and DMII, PN, that claim should be easy for any vet rep to prepare.

Would the cardiologist who helped with the DIC claim, be willing to provide an opinion as to his DMII, PN, and IHD, as to what the medical records reveal , for a proper retro rating?

You said:

"One other question! I read something from a lawyer that stated you should give any and all pertinent information on your NOD (like me mentioning stating Secondary stuff that is all connected to his PTSD and his death  and also the DMII which he should have been rated 100% SC or NSC either way."

I would agree on that, depending on the wording of  the denial.

"it was significant and should have been a rating! Is it because somehow while taking care of all his medical needs I should have been aware that I needed to file a ratings paper for all this stuff. thats when I wonder  should not his Dr.s been somehow helping me in this?"

In my case many VA doctords tried to cover up my husband's diabetes and heart disease- only one Neuro knew what was really wrong with him and it took me 8 months to find that neurologist and ask him for his opinion.He had left the VA and opened private practice. His email reply to me was put onto his letterhead - it was very brief , and the BVA gave it great weight as it corroborated 2 IMOs I had from Dr. Bash.

That was the only VA doctor who ever tried to help my husband in his lifetime and his entries in the med recs diagnosing DMII had been crossed out- but I blew up the entries and could read them and used them as evidence .

VA awarded for DMII due to AO contributing to my husband;s death but NEVER rated the DMII at all.

The malpractice on that was so bad I dont know if they even could rate it.

The AO IHD , awared under 1151 , was never rated either until I filed for AO IHD death.I had already supplied the VA with enough evidence for rating. EKGs, ECHO, etc etc. all in VA medical records.

Also it involved a successful CUE on the 1998 decision on lack of rating. for AO IHD.

Have you ever scanned and attached here their last denial? And the evidence list they used?

This has become the most unusual claim I have ever seen, regarding a veteran's death.and potential AO disabilities.

I still feel ( since in some respects this is similar to my AO claims,) that the claims for DMII ,PN,and IHD must be filed under the Nehmer Court Order, with proof of his AO exposure and also medical proof of these specific disabilities- as to their diagnosis and treatment records( or as in my case) their lack of diagnosis and treatment.

This could also be a 1151 claim basis but all the info you need is in our 1151/FTCA forums.

You mentioned someone said the DIC claim could go two different ways- I need to find that post-

maybe they meant under 1151 , but a SC death is far better than a 1151 death, for survivors.It is not too late however to raise any 1151 issues....to be filed separate from any TDIU or AO claims.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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".It is not too late however to raise any 1151 issues....to be filed separate from any TDIU or AO claims."

if the VA misdiagnosed or failed to treat any condition he had, with full knowledge of the condition,or with enough evidence in the medical record to support a proper diagnosis and rating for it, that would warrant a proper diagnosis and treatment.

I am concerned about the "100% " DMII you stated as what the rating should have been.

This is a long but recent BVA decision and it states the criteria for DMII ratings, about halfway down the decision.

It would take documented medical evidence to support any potential DMII rating, and this also would be the case for a successful AO IHD claim as well.

https://www.va.gov/vetapp18/files12/18160129.txt

If a veteran has a NSC that subsequently becomes a SC.....( same exact disability) , then that decision is ripe for a CUE. That is why Rating info is so important.

It might not be found in any separate formal  rating sheet nowadays- but within the decision itself.

 

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I am still trying to figure all of this out-

you stated:

"ANYWAY, back to my original point! Can and "Should" I add evidence stating proof he fits the 100% criteria for DMII. and ask for Re-consideration of DMII on presumptive or secondary grounds on the NOD??. (Or do I have the right to, (or shoud I)  resubmit it seperately, even though it was previously part of a closed claim) The AO is closed because of "No further proof" but should I not be able to re-direct his DMII on the NOD as a secondary to his PTSD instead? "

Yes if you are within the NOD time frame, you could ask for reconsideration based on new  evidence- under the AO presumptive regulations -that evidence being:

1. he was on an AO ship ( actually two) and seems to fit into the AO ships list date criteria.

VA would need proof from his Service records to show he was on these ships.

2. that you have medical evidence that he had DMII, IHD, PN , all related to his exposure to AO while aboard ships they conceded were exposed to AO ( via the dates on the  AO Ship's list info I posted here before.) and send that evidence as well ( copies of his diagnosis and treatment records that put him into the highest rating category for these AO disabilities. PN is common in diabetics but VA will need diagnosis and possibly more medical proof on that- to associate the PN medically with the Diabetes.

You asked"but should I not be able to re-direct his DMII on the NOD as a secondary to his PTSD instead? "

I sure do not advise filing any claim like that.

You asked :

"What I don't understand is there is a huge amount of medical files all positive for everything claimed, so don't they have a "Duty to assist"  in getting it and figuring it out?  "

No, they do not search through medical records for any proof of anything. It is up to us to do that.

This is one big reason why veterans and survivors obtain IMO/IMEs which can be quite costly but which will provide the first good thorough reading of their medical records by a doctor, unpaid and uninfluenced by the VA.

"They" ,who are supposed to extent Duty to Assist ,are not doctors- Their Duty to assist is limited basically to the VA telling us what evidence they need.

I had to study Neurology, Cardiology, and Endocrinology to win my claims.

I had to review my husband's voluminous medical records multiple times, and learn how to decifer handwritten entries and acronyms and symbols, how to read EKGs, ECHOs and Blood Chem results.I would have never succeeded in my claims ( one being a FTCA settlement) if I had not done that work.

Doctors in those days were not allowed to advertise if they have expertise in malpractice or could do an IMO and no lawyer would even review my evidence for my FTCA case. 20 of them told me I would lose, or didnt even have a case at all. So I did not have to pay a legal fee when I won.I did all of the legal and medical work myself.

These days things are different. If you have time left, a good IMO might  help-it might cost a lot but it would be investing in someone who will thoroughly review your husband's medical records,-or you can do that yourself and send them the most probative parts of those records:

diagnoses, treatment records , meds etc test results , glucose values,blood chem reports, for DMII, PN and IHD.

I only obtain IMos for one claim I had. AO DMII death .

I prepared the evidence carefully , explained a timeline in a cover letter , based on the medical records ,and had no doubt that the $4,000 for 2 IMOs I obtained would definitely award the claim.That 4 thousand was easily absorbed by the retro.

I am assuming your husband  had Ischemic heart disease (IHD) but not all cardio problems are  IHD.Still, you mentioned sudden death , like my husband had ,and DMII from AO can cause sudden Death.

I mentioned 1151 and CUE above ,without really seeing any documented  evidence but feel the best thing you can do is use the AO evidence with the NOD, for reconsideration, -or refer to a new claim in the NOD for direct SC disabilities due to AO, and enclose that newer claim with the NOD.

I am suggesting a separate AO claim because when the VA got my AO IHD claim they sent it from NY to Maine, to Seattle, and then finally to Philadelphia where they had trained raters focusing specifcally on Nehmer claims. Your AO claim might be sent to a different VARO, that who you deal with now- so this is why I suggest filing it separate from anything else-but using your evidence to support a reconsideration in the meantime, with a NOD.

If others disagree they will opine here.They might have a better idea than me.

I have exhausted my ability for any other advice I could give to you.

 

 

 

 

 

 

 

 

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Thank you Berta, deeply for your extensive information.. It is very much appreciated. 

I have printed out all your information so I can go over it and see what I need to do. Like you, I have done so much work on this already that I would like to finish with it. Hopefully I wont be my own worst enemy.  I will never be at your caliber of knowledge but your information surely brought me up a notch. I got my husband 70% Ptsd the "First time around" (Some VA people told me I was lying and said that wasn't possible) I hope that is not what is giving me false hope!!  I believe I understand enough to make it hopefully come together, but again the more I learn the more confused I get. I know I am willing to fight and put in the time.. I just remember everything he went through and how the VA treated him so poorly.. He was so young!             

Thank you, and everyone willing to help..    "We are NOTHING if we are not about THEM!!  God Bless all who have given.. You have my utmost respect!!  

 

P.S. I cant find acronym for IMO / IME? and don't know what it is!

 

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IMO  Independent Medical Opinion

IMO  Independent Medical Exam.

It appears you did have a strong IMO for the DIC claim.You did very well on that claim.

You were not dissuaded by negative people - my former rep acted like I didn't have a chance on my AO DMII death claim.  I am encouraged by negativity. It usually comes from someone who does not have a single clue on what they are trying to discourage others about. My former vet reps didnt have a clue on anything regarding DIC- they didnt even understand the AO presumptives. 

I assume the diagnosis of Diabetes Mellitus ( Type Two) -VA does not consider Type One diabetes under Nehmer AO regulations is within his medical records with enough info to rate it.

It is far more difficult to prove DMII if no VA doctor diagnosed it , as in my case.

But it became a puzzle that had to be solved.

Part of my evidence was my husband's blood chem Glucose reports, the lack of any definitive HBIAC test, his driver's licence, his personnel records from the VA,when he worked for them, and even his dental records.

Also in the minimal amount of med he was on ( one was a major medical error that contributed to his death)

I found one of the meds was specifically for diabetes symptoms, symptoms he had while hospitalized, at VA that should have triggered more medical care and a proper diagnosis. He would still be alive if the VA had given him proper diagnoses and proper treatment.

 

 

 

 

 

 

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Hi Berta

Sounds like we have a lot in common!!

your last note made me sad then mad!!     Why oh why are our Vets being treated like "Dirt" at the VA.. It's unconscionable !!!!

I have right now 8 stories I'm sending in to show proof of worsening of his PTSD!! to be able to get TDIU. They are stories of horrible neglect and shameful incidents from Dr's and people at the VA here in Washington State.

I believe they will no longer need that evidence if I just send in the SSI info, (I just spent all morning at the SS office and got a clear answer this time.. So I am pretty sure that it's a given, but I want them to "READ" my horror stories!!! ) Get this,  I found a ratings paper that states:  IHD, BPN, ED, and DMII (denied, not in country) then on the bottom of the letter it states: DEATH  Decision = "Grant" =  SC Death, as contributory Cause of death: for CHF, COPD, PFibrosis,  Coronary Artery Disease, and  [PTSD - Non-Combat/Other stressor Verification]. First of all I just "Luckily"  ran across a medical paper that stated IHD & CHF are THE SAME!! so how can they Service connect one and not the other. The IHD is denied from AO. so how do you SC (Contributory) for the other one as cause of death and not IHD just because they are looking at it from another angle?? (I get it one's under "Contributory" and one is  not in county) should be Granted thru contributory for IHD too. and if all this is SC. How are they NOT Rated??    P.S. I know I have exausted you so I am going to ask: Do you want answers to your last questions?

Thank You!  and all you do to help our vets! My heart is broken for these young men that had to "Give EVERYTHING"  

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