Just need advice on what to do?

[Dan1865]

Hi All, 

I filed a claim for benefits on Feb 4, 2020 and am still waiting for a decision! Here is what I claimed and will explain.

1. VA 1151- I was diagnosed with appendicitis at the VA hospital. Then said it was an emergency and surgery needed to happen ASAP. Thirty-four hours later they performed the surgery. The student surgeon was allowed to perform the surgery by himself with no attending surgeon present. The student messed up and almost killed me. He ended up leaving almost 5cm of a 6cm organ in my body. Over a 3 month period I kept on getting sick. Out of the blue, I became very ill with high fever, vomiting, and horrible abdominal pains. Went back to ER and they discovered I had appendicitis again. This is when they found out the organ was leaking and in tack. The surgeons tried to say it was a mistake on the CT exam. 

I went into the OR for a second surgery. They had to abort the surgery due to the lack of instruments. 10 days later I had a 3rd surgery. In the end, I now deal with major problems with my colon and stomach due to the constant infections. I have a rare form of chronic colitis. I have submitted everything imaginable to the VA. I have a nexus letters from 2 doctors who are specialists in surgery and GI. I have a Medical Opinion from a highly regarded Surgeon/Radiologist. The IMO clearly defines the many 1151 violations. The attending surgeon was also investigated by the OIG. He was terminated for allowing students to perform surgery without him present. OIG discovered that during surgeries he would not even be in the hospital, but would sign off on the surgery a day or 2 later like he was there.

2. Non Combat PTSD. 

    Everything is clearly documented. I have multiple buddy statements and records from this time period. They have a boatload of information; including, records from a civilian hospital suicide attempt. 

3. Unemployability: I am on SSDI for the GI Issues, Mental Health, Ischemic Heart Disease. and Paraneoplastic Syndrome associated with tumors in my lungs.

I had all exams before May 20, 2020. I figured they would have given me a decision by December. My doctor told me to write my senator; which I did. They told the senators office they were waiting on employment records. I get a call in Jan telling my claim was about finished and he needed a different address for a previous employer. I explained the employer went bankrupt and there is no address. He said my decision would be completed in 30 days. The very next day I get a call from my VSO stating they scheduled me for more exams. Believe it or not, they scheduled me the same PTSD exam I had in May of 2020. It ended up being with the same doctor as the first. He said in 22 years he has never had to do the same exam on someone during the initial Claim. So, for 3 hours we went over the first exam report. He made changes and submitted it the VA. Then in middle of March I get a call from the same guy at the VA. He told me my claim was done and I should have a decision within a week. My wife and I was super excited. The lady at the senators office received a statement stating a decision was forthcoming very soon. The very next day, my VSO calls me and said they scheduled you for PTSD "rework" exam. The same doctor yet again; 3rd time now I have seen this guy. We were able to do this exam over the computer and it was only 8 mins. Then on March 23,2021 they scheduled a new exam. This exam is a record review only. I received a VES overnight stating my record review was completed on 4/8 and it gave me the Physician Assistants name. So, again I sit here and wait. 

Sorry for the long post and thanks for reading. What else can I possibly due to receive a decision? My health is declining and want to make sure a decision is reached to find out what I need to do next. My ultimate goal is to hold this VA system accountable for what they did to my body. They really jacked up my stomach and colon by doing what they did on a routine surgery. My goal is to make sure that the kids are taken care of in the event something happens to me. 

 

 

 

[Berta]

I am using a Fax for something different re: VA then your issue-

The Senators who sponsored the Bill S 221, might have their own Fax machines and email addys -at their web sites. But Snail mail will be OK.

There is no rush either-Covid is still slowing down everything in DC.

 

 

[Berta]

I read the downloads carefully-Dr. Bash's opinion was Excellent,supported my medical excerpts.

The IG report is devstating- but the IG cannot bring charges against them- only we claimants can via FTCA and/or 1151, as you have done.

You said:

"It just feels like the VA is trying to find one of their terrible physician assistants to write up something in their favor to deny my claim. It seems like they are trying to find one person to agree with them out of the bunch that I have seen that agree with me! "

That is Exactly what they are attempting to do.

In my case  a Peer Review was done within 4 or  5 months after I filed my SF 95.

I had no IMO. The Regional COunsel called me yp and said we would begin negotiates very soon, as the Peer Review Doctor had agree with some of my charges-specifically the main charge-

undiagnosed and untreated heart disease,with full knowledge of an abnormal EKG.

My evidence for that was an ER certificate and the subsequent additional VA medical records.

I had studied cardiology, from th day I filed SF 95 up to this phone call.

Then everything changed- the peer review disappeared, the RC retired suddenly and so did the Peer Review VA cardiologist.I had to start all over again with the Office of General Counsel.

Their Peer Reviewer had expertise in Cardio and the other charges I had made and they agreed with every charge. However my most probative evidence, a 6 page  autopsy with toxicology report ,was withheld from the OGC an when I found out I immediatey faxed it to them.

I am thinking maybe you should hold off on the submissions, until you get a decision.

My issue re: S 221 was to prevent further malpractice by forcing VA to honor the NPDB mandate.

Your issue could reveal to the H/S VAC the deliberate way the VA will attempt to get out of 1151 and FTCA. And how you had to spend money for an IMO/IME as that is the only way many 1151 claimants can get a fair and accurate medical opinion on their 1151 issues.

You can also give testimony by mail to any Sub Committee at the H VAC. I sure did.

BUT there is no way a PA or nurse's opinion could ever overcome Dr. Bash's opinion- unless they do what they did to me for my AO DMII direct SC death claim.

My daughter , still in Military then, started to urge me to file the claim. I didnt ant to deal with ifiots again. Finally I did go through the medical records- she was right and I studied Neuroloy and Endocrinology and I knew Dr Bash would prepare an excellent IMO- he did, he even prepared two IM0s and the RO completely ignored them.

That was a CUE and even my daughter knew it but I was in military school (AMU) at the time (I am a former Phi Theta Kappa in another college -All A's))and did not want to have a long drawn out fight with the RO ,that could affect my grades, so I was wiling to wait for the BVA. They awarded the claim.

I hope all of you here realize that someday your spouse will be grief stricken if you die, and the VA will take advantage of that,also VA will hope  they cannot find a decent POA, whether you die from SC or under 1151. Get your spouses up to speed on our disability and how to use a PC because without getting the solid DIC advice here, their claim will be doomed.

If you have any life insurance at all, make sure the spouse knows ,in the event of your death, that they might need some of the proceeds, to get a costly IMO to attain DIC.

 

 

 

 

 

 

[Berta]

sorry for typos- I am still angry and grief stricken- my husband should be alive and here at hadit, like he was on Prodigy Veteran  BBS, before they malpracticed on him , and eventually killed him.

I can forgive the doctors who did that, but I cannot forgive a system that continues to cause harm and death to the very men and women , and all veterans, for decades, whose service created the VA.

 

[Dan1865]

Berta, 

First you are awesome and I am so glad I found this site. You are definitely an amazing woman for fighting for your husband. 

I have been telling my wife for a long time that the VA needs to be held accountable. We all know that these individuals can walk around and do what they want. The VA employees within the hospital system are so protected by multiple unions and legal departments its absurd. I am not against unions. What I am against is when employees commit negligence and are able to walk to do it again. That's what needs to stop!

The VA has investigated my claim to a point of redundancy. How many times can you review the same information and come to the same conclusion; before you realize there is no other way possible to review the information! 

Dr Bash was able to write this medical opinion with very few records and these records were from the Detroit VA. When I submitted the 1151 claim, I organized every VA record from these surgeries in one file. It only required a click on a PDF and you had it all. No need to search for it. 

[Berta]

GOOD!- Organization is a great asset! But it takes time to organize VAOLA while the RO claims people often  can just spin on their thumbs.

Regarding Dr Bash - or anyone who needs an IMO/IME-

I emailed Dr Bash with a few statements regarding my AO DMII death claim- he responded , if you have that you have a good case, or words to that affect.

The DMII had never been diagnosed or treated by the VA. The evidence showed clearly that he had DMII.It took me 8 months to find a VA Neuro who had gone into private practice and had treated my husband. I sent him a few records and he gave a brief IMO in support of my claim.His diabetes diagnosis had been crossed out by the doctors who were trying to cover up their other malpractice on my husband but I managed to figure out what the entry said.

I sent Dr Bash a cover  letter highlighting the specific record entries he needed.within the med rec stack and within a week the IMO as done.

Meantime a vet who my useless former POA had asked me to help with a 10 year plus old diabetes claim, and 2 trips to CAVC and 3 to BVA, ( he also had lawyers who were useless)and 

because I knew by then so much about diabetes, that I could help him and he won the claim.

Knowledge is Power as we say here-I am living proof of that.

The BVA had 2 VA endocrinology opinions against my claim, I had 3 for it to include the brief VA Neuro opinion. but the BVA remanded for a cardio opinion. I was ecstatic because I knew a cardio would agree with my evidence but I also paid for a 4th IMO from a forensic cardio doctor.

But I didnt get a VA cardio opinion, it was from a VA PA and he didnt have a clue,I rebutted the PA opinion immediately and sent my lay medical rebuttal to the BVA.

The BVA gave the PA opinion  no weight at all and I was awarded for direct SC death due to AO DMII.

The forensic firm refunded some of my IMO fee because their opinion had not been finished, prior to the award.

We had a Chapter 35 post here today---I thought back to my Chapter 35 application, the VA wanted a statement as to what my college goals were. I told them I wanted to go to a war college because I work as a volunteer on a battlefield,

known as the VA claims process.

 

 

 

 

 

 

 

Edited April 21, 2021 by Berta
snow in satelitte dish!!!!!!!

[Dan1865]

 

Hi Berta and Company, 

I just wanted to give a quick update. I am not making any of the following up. So here goes, 

1. Jan 25, 2021: rcv'd a call by a gentleman with a question. I answered the question and he said the claim would be done within 30 days. The next day, the VA scheduled more exams.

2. March 18, 2021: rcv'd a call by the same gentleman and told my claim was finished; thanks for the patience, and you will have a decision within 7 days. The very next day, they scheduled more exams. 

3. April 15, 2021: rcv'd a call by the same gentleman. He explained that there was some unanswered questions in some of the reports from the doctor. So, that is what caused the need for more exams. He explained that everything that was needed is finally rcv'd and I should have a decision by the 25th of April. Well, April 20 I rcv'd a call from the VSO. She stated that they scheduled a new exam for surgical scars. The morning of April 21, the VSO sends me an email saying that they requested clarification from the PTSD doctor.

Today, I had a packet sent from VES for my surgical scars exam. Thankfully, that exam is on May 7 at 1130. In the same packet was a "record review only" for the same PTSD doctor. 

What in the world is an exam for surgical scars? The VSO has no clue! The VA call center has no idea! Finally, VES just kept on repeating surgical scars. I asked if there was a medical code within their system to explain and they said no! I asked if the VA attached any notes to explain and they said no. I then asked without and explanation, how is the doctor going to know what is needed. My hope is that doctor measures the scars and gives the results to the VA in MM, CM, and inches. Heck, pull out a micrometer and measure. I do not want any more record reviews, telehealth, medical opinions over surgical scars just to delay this process further!!

If you count all of the different exams for PTSD I have had now with the same doctor, this will be number 7 according to my VSO. I now have had 2 in-person exams, 1 tele-health, 2 medical opinions, and now this will be the second *record review only" exam.

No one understands what in the heck is going on; not even my VSO. The doctor fills out the VA paperwork. It comes directly from the VA. We went over the report he initially wrote from the first exam. It's like a book! I am sure the doctor is getting tired of these games by now; just like I am! 

The guy who keeps calling me and telling me that my claim is done; only to pull the plug again needs to be reprimanded! Making a mistake and telling people something wrong by accident the first time; that's OK. We're human and we all make mistakes. Doing this time and time again, has become just plain wrong! 

The entire process of filing a claim is very frustrating. Especially, when the the information you claim is right there in front of them. Everything I claimed is in either the VA or the Military medical records. I would literally lose sleep if I kept on giving people a false sense of hope. That's what this gentleman is doing to my wife and I when he calls and tells us this. 

Sorry for the long post. It just feels good to find a place to vent to others in the same boat and understand what this process is like. My wife and I definitely love this site! She is a Veteran as well. 

We will be making a contribution to this site very soon as well. The amount of information available on this is worth every penny. We definitely wish this information was found on our end at the very beginning of this long process. 

Thanks, 

Dan