Denial of DIC

[Jmgonzales1966]

My husband passed away 1-7-21 and the death certificate stated Idiopathic interstitial pneumonitis.  He had been at a 100% rating for the past 6 years.  However the rating was for Schizophrenia Paranoid type.  His private doctor wrote a letter stating the pulmonary fibrosis happened in Vietnam.   But the VA dr said no there are no service records showing that and declined the claim.  I included in the claim that the treatment for pulmonary fibrosis are steroids and the medical records show they had to stop the treatment because he became so agitated on multiple occasions.  That was not addressed in their deciison.  I need a veterans group to help with the appeal.. Who should I contact?

[broncovet]

You should file a substitution of claimant.  https://www.vba.va.gov/pubs/forms/VBA-21P-0847-ARE.pdf

This should enable you to continue the claim, to include filing cue on the unadjuricated claim, or, filing a new claim for the one unadjuticated, for your late husband. 

Berta, will chime in, hopefully.  

If you post the reasons for denial, hadit members will be better able to help. you.  

As far as the VSO's, my experience has been they know less about DIC than I do.  

Last, but certainly not least, contact NVLSP and ask them for help.  

NVLSP:

https://www.nvlsp.org/

Edited August 6, 2021 by broncovet

[Berta]

I am so sorry for your loss. I am a widow too (of two disabled vets).

I had many problems with my original DIC claim-long ago- because the VARO refused to consider my most probative evidence.

My VSO and vet reps didn't have a clue on DIC.

Everything I know about DIC is in our DIC forum.

Broncovet is right- can you scan and attach the decision here? Cover your C file #, name, address prior to scanning it.

You said:

 "His private doctor wrote a letter stating the pulmonary fibrosis happened in Vietnam.   But the VA dr said no there are no service records showing that and declined the claim. "

A valid independent medical opinion requires the IMO doctor to have the full SMR records- to include military personnel records as well as all other VA or private medical records, in this type of situation.

Do you have a copy of all of your husband's SMRs ( aka STRs) Service Medical/ Treatment  Records. If so did the doctor have the as well?

Those records are critical to establishing a bonafide " nexus" or service link to his cause of death.

The VARO might still have them and could send you a copy--but they might have been retired to St Louis by now.

You said:

 " I included in the claim that the treatment for pulmonary fibrosis are steroids and the medical records show they had to stop the treatment because he became so agitated on multiple occasions. "

What source are these medical records from-

-----inservice medical records or from the VA or from the private doctor?

"That was not addressed in their deciison. "

The actual letter from VA will tell us why they were not considered.

It might be some bogus reason or a valid reason.

I will find a list of VSOs /Reps- what state are you in-?

 "I need a veterans group to help with the appeal.. Who should I contact?"

You should acquire a rep at this point but the truth is, you are already at the best place in town for DIC help.

You said "the death certificate stated Idiopathic interstitial pneumonitis."

I assume that was listed on the death certificate as # 1. Immediate cause of death.

Did they list anything else as a contributing factor under # 2?

Was an autopsy done? If so have you acquired a copy of it from the Medical Examiner ?

My USMC husband was autopsied and cremated because he was an organ donor.

The autopsy was critical to my DIC claim. They- my RO -ignored 12 copies of it that I sent to them by priority mail.

I had filed FTCA for wrongful death and they failed to send the autopsy to the General Counsel- VA. When I found that out I raised Hell, sent it to their Peer review doctor and the General Counsel VA called me to negotiate a wrongful death settlement.

I tell the vets here to make sure the spouse is up to date on their VA health care and that the spouse can use a PC and come here, if they expire.

Did he have an claims pending at his death- if so that is when you need to formally substitute yourself as the claimant but I assume that is all explain in the new forms.

 

 

 

 

[Berta]

Two questions---

Where did he serve and when? 

Was he ever exposed to asbestos`, or radiation, or any environmental toxins. and where?

Can you tell us what meds he took for the schizophrenia- Paranoid type?

I have some research to do and have found two DIC claims, so far,  granted for Idiopathic interstitial pneumonitis.  

"Idiopathic" often means 'no known cause'- but the BVA awards for DIC have revealed an inservice cause.

BVA decisions are not acceptable as evidence, however they contain a wealth of information----I will search some more.....

[broncovet]

"Idio pathic" means the "path" to our benefits is through idiots, right Berta?  

Berta is great at fighting VA for widows benefits..when you complete the "substitution of claimant form" and its accepted, you can submit evidence in behalf of your late husband "as if" it were him filing it.