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1151 Claim for DM 2


jackjack37

Question

I submitted a claim to service connect my diabetes mellitus II because my doctor never diagnosed my diabetes. I found out I was diabetic when I went to an urgent care and they did lab work and found my blood glucose over 400, A1c 13.4. I was transported to a local hospital by ambulance and spent 2 days in ICU and another day on the regular floor. I was diagnosed with diabetic ketoacidosis with acute kidney injury on May 19, 2019.

I found note in my medical records where it said I was prediabetic on 9 Apr 2018, I don't remember ever having a conversation with my doctor telling me I was prediabetic. My A1c was 6.0 and blood glucose was 143. My A1c was never checked again in that whole year and I had blood glucose readings on 6/25/2018 (103), 10/10/2018 (186) and 3/20/2019 (285), I didn't know about these elevated numbers until I looked thru my records when I was filing my claim. My doctor never contacted me about them. I now know I was getting sick when I had the 285 reading. I had diabetes at this point. Let me also mention I had other risk factors: obesity, family history, age, race, inactive lifestyle, high blood pressure and high cholesterol all of which is documented in my records. She also has been my doctor for over 2 years at that point. I sent her a secure message complaining  I was losing weight and feeling dizzy, unsteady on my feet, pins/needles in my feet. She sent a message back saying it probably was because I was a picky eater (I told her this before) and that I was taking topiramate for headaches. 

My claim keeps getting denied. Is this a winnable claim? 

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  • HadIt.com Elder

Yes this might well be a "winning" claim.

I proved my husband had undiagnosed and untreated DMII and that it contributed to his death.

I filed it a direct SC ( he was a Vietnam Vet and DMII is presumptive to Agent Orange) because I had l ready won FTCA/1151 (DIC)on a few of his other VA malpracticed  conditions, and could not file another DIC claim ( until Nehmer) . 

Please scan and attach the denial here, as we need to see the Evidence list, and their rationale for the denial.

Cover your C file #, name, address prior to scanning it.

Your "doctor"- I would suggest filing a FTCA claim but that depends on many factors ( explained in our FTCA forum here) and if your doctor is a federal contractor ,they are not technically a VA employee and FTCA does not apply to them.

I posted a link here searchable as to VA Providers,because VAMCs are full of them, and they are not liable under FTCA. 

VA; malpractice stats have been so high ( for decades s) that they hire these contractors so they (VA) cannot be sued if the contractor malpractices on a veteran.

I have been a VA claimant for over 2 decades and in this case -my DMII death claim) I obtained 3 IMO ( Independent medical opinions) to support the extensive evidence I had found in 6 years of VA health care my husband got, all of which revealed malpractice and even a VA attempt to cover that all up but they failed.

VA fights these claims aggressively.

You stated:

 "I sent her a secure message complaining  I was losing weight and feeling dizzy, unsteady on my feet, pins/needles in my feet. She sent a message back saying it probably was because I was a picky eater (I told her this before) and that I was taking topiramate for headaches. "

You might have peripheral neuropathy in your feet due to the DMII, and the headaches and dizzyness could be something more serious- caused by the high cholestrol- 

you seem very willing to go over your VA medical records.....that is great- and that is the way I found my husband had multiple misdiagnosed conditions, heart attack treated as sinus infection, HBP due to contraindicated meds, multiple transcient ischemias , mini strokes) and a full blown stroke, and a fatal heart attack. ( SC under Nehmer)

He had very high tryglycerides as well and this was a strong factor in my claim.

The VA's Endocrinologist gave ridiculous statements that denied the 1151 death claim at first- I knew more about DMII than she did-but they kep ignoring my medical evidence, and I was in military school  at that time and I patiently waiting for a BVA award..which I got.

We need more info and the scanned denial will help ( to include the evidence list)

 

What did the VA give you for the cholesterol problems?

A simple HB1AC test could have saved my husband's  life- ( maybe) or maybe they would just have continued the malpractice.)

Do you have a good source of medical acronyms?

I used Merck because the VA used Merck when I filed my claim.

This is funny now but one of the obtacles I had to overcome.

I found a medical entry of DVD in the med recs- Merck said that meant Diabetic Vascular Disease. The VA endocrinologist said it meant the veteran "denies having  venereal disease".

What a crock- he had VD in Vietnam (treated incountry per his SMRs)and that was on all of his VA rating sheets.

I had to decifer a crossed out entry that i ignored when I filed FTCA.- a VA doctor had told him his problems were due to diabetes  but there was nothing more in the med recs on that,except the decifered entry which mentioned diabetes . The doctor , a Neurologist left the VA and it took me 8 months to find him in private practice. He remembered my husband and wrote a very brief email to me, that Dr Bash incorporated into his IMOs, after calling the doctor. asking him to put that email to me on his letterhead, which he did, and the BVA gave that brief neuro opinion as much weight as all of my other evidence.

 

 

 

 

 

 

 

 

 

 

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Thank you for replying back so quickly. I already have a diagnosis for peripheral neuropathy documented in my records. I was only put on medicine for high cholesterol after my diabetes diagnosis. My primary care doctor put me on simvastatin. My doctor is from the VA. I never saw an endocrinologist at the VA. I also believe a simple follow-up HBA1c test could have saved me from ending up in the hospital. Can someone walk me thru the steps to link my denial letter to post.

 

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  • HadIt.com Elder

Cover your C file, name address prior to scanning it.

Save the scan and go down to the "choose files" thingy at bottom of the reply area, your PC files should pop up and you should see the new scan under  jpg.,or doc  etc depending on how you saved it- I had to attach something below to see if I told you the best way to do it.

Recently I had to send many scans of Thanksgiving cards out for my church but instead of using jpg to save them I copied and pasted  and the scans into  in Word and from there I copied and pasted them into the emails I sent- so I guess both ways might work for you.

#3 deck cushions Fran.jpg

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  • HadIt.com Elder

I forgot to add- diabetes does not kill anyone, it's complications do,if not properly treated.

My husband's complications from DMII were heart disease, multiple TIAs ( mini stokes,) a 100% P & T full blown stroke, visual problems, peripheral neuropathy, peripherial arterial disease, odd low body temperatures, oral  candidiasis, etc etc etc  and they all needed a strong link to his DMII.

I used the 1997 VA Diabetes Training letter but I think that is on the older hadit board. There shoud be a newer version somewhere here under a search.

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