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Vync

Filing a claim for a heart attack due to NSAIDs

Question

During the process of recovering from a major heart attack, I have begun collecting and reviewing my medical records and exploring risk factors. The most obvious factor is long-term NSAID use. The Army prescribed Ibuprofen almost daily. The VA and other doctors have prescribed various NSAID medications daily for about the past 20 years to treat my SC musculoskeletal and TMJ disabilities.

The heart attack was a STEMI (aka "widowmaker") with numerous blockages ranging from 10-20% to 99%. The angioplasty began about two hours after the heart attack started, lasted over two hours, and several stints were inserted. I have some cognitive issues like short term memory loss, difficulty making decisions, and greatly reduced physical stamina since the event occurred which has made things much more difficult. I only partially remember visiting the VA cardiologist last week, but do remember him saying the NSAID use is a major factor in having a heart attack. He also said he could tell I had a heart attack by just looking at my EKG.

I am considering filing the claim via Ebenefits this week and just letting the VA handle the C&P. I am already SC at 100% P&T (more than 10 years in effect). If things go downhill, the additional rating might make it easier to qualify for some level of SMC, A&A, or even SSDI.

Any advice or guidance is greatly appreciated.

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Posted (edited)

There is plenty of  recent news on the association of long term NSAIDs use and heart attacks:

 

https://www.health.harvard.edu/blog/fda-strengthens-warning-that-nsaids-increase-heart-attack-and-stroke-risk-201507138138

https://www.mayoclinic.org/diseases-conditions/heart-attack/expert-answers/nsaids-heart-attack-stroke/faq-20147557

and I guess the VA has to issue this warning on every Prescription for NSAIDS:

https://www.pbm.va.gov/PBM/vacenterformedicationsafety/nationalpbmbulletin/NSAIDS_and_CV_Safety_NATIONAL_PBM_BULLETIN_080415_FINAL.pdf

"I only partially remember visiting the VA cardiologist last week, but do remember him saying the NSAID use is a major factor in having a heart attack. He also said he could tell I had a heart attack by just looking at my EKG."

Did he take a notation of that fact in your medical records?

In any event this is a strong basis for a Section 1151 claim.

Or a claim for disability due to treatment of a SC condition,like what you have- maybe best to file both ways.

My husband's initial heart attack,evident when I learned how to read his EKG, was diagnosed as a heart attack

by me. The VA called it a sinus infection.

It was the prime cause of his death ( under 1151, and FTCA) and a ECHO revealed more damage,  but VA never acknowledged it or rated it until I filed CUE in 2004 and then the Nehmer AO RO awarded it, 21 years after he died.

Vync said:

If things go downhill, the additional rating might make it easier to qualify for some level of SMC, A&A, or even SSDI."

Yes!  When you got the 100% did you apply for SSDI at that time?

Even though you are recovering, you are being proactive and it is amazing what a medical record review can find.

I must have reviewed my husband's VA med recs dozens of times, before I filed SF95 and 1151( he had filed the originl 1151 claim himself)

I had to learn all sorts of medical ancronyms and how to decifer handwritten entries, EKGs and ECHOs, as well as to determine the day the malpractice began (Aug 13, 1988 ) and to prove it continued until he died in October 1994.My FTCA involved 3 other malpracticed issues, transcient ischemia , Stroke, and HBP,and then my daughter while still in the Military kept asking me to file for DMII due to AO.

I didnt think he could have  had DMII until she mentioned a few things to me-that seemed to be symptomatic of diabetes.

Finally (I did not want to deal with VA again) I opened the stack of medical records, reviewing them again, many times---and I kept overlooking a crossed out entry. When I realised I might be able to deficer it, it did, it was an entry to" confirm diabetes".The neuro doctor's entry was crossed out by the head cardio doctor at Syracuse-who lied to me about my husband's condition.They had just done an ECHO a few days prior so I asked the cardio doc about it , and he said = after an odd pause= that there was "nothing" wrong with his heart.

That pause always bothered me because now I know they were already covering up all the misdiagnosed conditions that occurred at the Bath VAMC.

The Echo revealed significant heart disease.

It sure pays to make sure you have copies of ,as they are done, your medical records.

In my case my daughter's insistence is why I re opened my claim.

I won. It was a BVA decision because my RO refused to consider my evidence.I should have cued them( my RO) but I had just started AMU to finish my degree and I knew the BVA would award the claim. 

Even a family member can often help with reading medical records. Sometimes if something does not seem right- there might be something drastically wrong.

Watch your meds as well. They gave my husband contraindicated medications.

Edited by Berta
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Posted (edited)
23 minutes ago, Berta said:

"I only partially remember visiting the VA cardiologist last week, but do remember him saying the NSAID use is a major factor in having a heart attack. He also said he could tell I had a heart attack by just looking at my EKG."

Did he take a notation of that fact in your medical records?

He noted that I "have significant anxiety and depression related to the experience" and issued a MH referral, which I have later this week.

I did find one error. He stated I did not have shortness of breath, which is correct if I am not standing or talking for extended periods. Once I get up, I run out of breath pretty quickly.

 

23 minutes ago, Berta said:

When you got the 100% did you apply for SSDI at that time?

No, I was still able to work. Lucky enough to have a desk job as a programmer, but have to talk on the phone a lot with customers and sales people. Despite being a desk job, it can be high stress because they are always pressing for deadlines to be met.

 

23 minutes ago, Berta said:

In any event this is a strong basis for a Section 1151 claim.

Or a claim for disability due to treatment of a SC condition,like what you have- maybe best to file both ways.

How could this be considered a Section 1151 claim?

Can a veteran file both an 1151 and regular/secondary claim for the same issue?

 

I also read that the cardiologist advised me to discontinue one medication. I have no memory of that. When I went to the non-VA hospital, they always give me printouts showing what to begin or discontinue taking, along with the dosage recommendations. I don't think any VA doctor has ever done that for me.

 

Additionally, I was recently diagnosed by a non-VA endocrinologist as having Cushing's. I filed a claim earlier this year for it along with a letter from her stating that is was caused by steroids used to treat my asthma and spine issue (both of which are service connected). I asked the cardiologist if Cushing's could be a factor and he said no. However, I found plenty of articles online showing that is can be a factor.

 

Looking back, I am really glad I bought my house which is located less than two miles from a non-VA hospital which just happened to have a cath lab. My wife literally saved my life by driving me to the ER. If an ambulance was called or if we had to drive into the city to go to the VAMC, I might not have made it.

Edited by Vync

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Posted (edited)

"How could this be considered a Section 1151 claim?"

If it fits into the Section 1151 , 38 USC criteria :

In part:

 

 

38 U.S. Code § 1151.Benefits for persons disabled by treatment or vocational rehabilitation

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(a)Compensation under this chapter and dependency and indemnity compensationunder chapter 13 of this title shall be awarded for a qualifying additional disability or a qualifying death of a veteran in the same manner as if such additional disability or death were service-connected. For purposes of this section, a disability or death is a qualifying additional disability or qualifying death if the disability or death was not the result of the veteran’s willful misconduct and—
(1)the disability or death was caused by hospital care, medical or surgical treatment, or examination furnished the veteran under any law administered by theSecretary, either by a Department employee or in a Department facility as defined in section 1701(3)(A) of this title, and the proximate cause of the disability or death was—
(A)
carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the Department in furnishing the hospital care, medical or surgical treatment, or examination; or
(B)
an event not reasonably foreseeable; or
(2)
the disability or death was proximately caused (A) by the provision of training and rehabilitation services by the Secretary (including by a service-provider used by the Secretary for such purpose under section 3115 of this title) as part of an approved rehabilitation program under chapter 31 of this title, or (B) by participation in a program (known as a “compensated work therapy program”) under section 1718 of this title."
There is more but that involves FTCA offset stuff.
 

"Can a veteran file both an 1151 and regular/secondary claim for the same issue?"

Yes- because we can file under any potential theory of entitlement.One might not work , but another theory of entitlement could. might 

I had a BVA appeal  once that the BVA dismissed as moot.

I had filed under two theories, probably under direct SC and also 1151- I have had 4 main 1151 claims.

The BVA dismissed because I had won that claim at the RO level and didnt know I could have withdrawn the I-9 appeal. It might have been the initial 1151 DIC award I got.

VA fights 1151s aggressively.

I didnt have a lawyer or any IMO when I filed my wrongful death FTCA claim.

My evidence was impeccable- I have a pro se background, but it was heartbreaking to discover how poorly the VA had treated my husband.

He filed a Section 1151 claim before he died. Then Pres Clinton said in a speech that the VA was the best Gov run health care system in the world and my husband thought he better withdraw his claim until I reminded him that Clinton had to be taught to salute- what did he know about the real VA- nothing.

I used the regulations for the basis of the claim he dictated to me, and then I used it for my formal DIC claim. It was the same "cause of action" I used for my FTCA claim.

My VARO, even with a copy of my settlement with the USA (under auspices of VA) ignored that and denied my 1151 claim again. I did have an offset factor but I still needed a formal DIC award under 1151, when the offset factor had been deducted.I called the OGCand told them they owed me more money-they really didnt but it got their attention.

The OGC sent  my VARO  an order to grant the 1151 DIC.

It is almost impossible to get a 1151 award without a strong medical opinion.

In your case there have been strong studies as to the negative affects of NSAIDs.

"I was recently diagnosed by a non-VA endocrinologist as having Cushing's. I filed a claim earlier this year for it along with a letter from her stating that is was caused by steroids used to treat my asthma and spine issue (both of which are service connected). "

That too sounds like a strong claim, either under 1151 or secondary to the asthma if that is SC.

." I asked the cardiologist if Cushing's could be a factor and he said no. However, I found plenty of articles online showing that is can be a factor."  I am not surprised at that.

One point I need to make as to 1151 claims-there is plenty info here at hadit on them-

I proved that VA took "acts" and caused "Omissions of Acts , " that were not consistent with those of the standard medical community for my FTCA and my 1151 claim.

Acts and Omissions of acts is legalize and it all meant that no real doctor would have taken the steps the VA did, regarding diagnosis or treatment, even though they ( VA) could have,at some point, properly diagnosed and treated my husband. The result of these acts and omissions of acts caused his untimely death at age 47.

The very first peer review they did caused the Regional Counsel to call me up within months of receiving my 1151, to discuss a settlement based on a probative Peer medical review-the doctor who did that agreed with all of my charges on the prime cause of death. But suddenly the RC,the doctor , and the review disappeared and I had to start all over again with the OGC.That was OK- when I found out what the VARO withheld from them I faxed it to them and I won.

When I discovered another disability they had malpracticed on-because my daughter insisted I file another claim, DMII from AO, I filed that as a direct SC claim. No diagnosis and no treatment whatsoever from VA.

I provided Dr Bash with a timeline and with referrals to specific records and I had a freebee brief opinion from a former VA Neurologist who had left the VA. His entry to confirm diabetes had been crossed out.

I could not claim the same death due to 1151 on a different theory than what I had alredy won on.

So I filed it as direct SC death. It was the most important claim I ever filed and brought with it numerous other ancillary benefits- even a Chap 35 refund of my college tuition and also the REPS Benefit.

No diagnosis and no treatment whatsoever. He should still be alive and here with me on line. He tried to help vets on the old Prodigy web site circa 1990.

If you do file either way or both, this will take a strong independent medical opinion.

His malpracticed AO IHD  heart disease as well was never rated by VA until I won my Nehmer claim-that grew out of a CUE I had filed in 2004, still sitting at my VARO in 2012,  set for BVA transfer..... Which should never take 8 years.I call that VARO malpractice.

That's OK.I won that 1151 CUE claim anyhow.

 

 

 

 

 

 

Edited by Berta
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Posted (edited)

@Berta I assume that for 1151's, it is not best to let the VA formulate their own opinion. Or, if I file and win approval for the regular secondary claim, might that suffice?

Could negligence be considered as the VA prescribing me NSAIDs for decades instead of in smaller brief periods?

Edited by Vync

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"Could negligence be considered as the VA prescribing me NSAIDs for decades instead of in smaller brief periods?"

Certainly it the VA knew of the risks of NSAIDS in those links above and how they can cause heart problems.

"I assume that for 1151's, it is not best to let the VA formulate their own opinion. Or, if I file and win approval for the regular secondary claim, might that suffice? "

Yes, filing as secondary might suffice. If not there is no time limit on a 1151 claim.

"I assume that for 1151's, it is not best to let the VA formulate their own opinion. " That's right- they even got a Doctor to opine that my husband died possibly of a cocaine overdose.

He (they named the doctor in the decision)was very upset when I called him up- he had no idea the VA had the full 6 page autopsy which included a toxicology report because he was an organ donor.

My husband didn't even drink- the only meds he took were prescribed by the VA.Psuedoephdrine for sinus problems which the med recs revealed he did not have, which contraindicated the lisinopril for his HBP which was at the wrong dose.I also proved that the Switch and Swallow they sent him by mail for years was not for what they told him it was for,

It was for, as I proved, oral candidiasis ,that he incurred due to high elevates of sugar in his saliva. One more thing to prove he had DMII and the VA knew it.

I am waiting for a C & P in which some quack formulated an opinion that was so ridiculous- and did not even consider the opinion I had, that when I get the actual opinion- thought it would be here by now- I am filing a complaint with the WH Hot Line, and with the firm he/she  came from.

I actually do not even believe a real doctor or anyone with any medical background ,  did the opinion. I mentioned that to 3 or 4 people in the VA system recently and they did not seem shocked when I said that.

 

 

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