tinnitus Dic Question

[Guest terrysturgis]

I hijacked a thread the other day, sometimes it happens. I appoligize.

The question posted was, I am 100% P&T with DMII, PN, and tinnitus. If I die as a result of HBP (heart) problems does my wife get her DIC? I understand the 10 year rule. My 100% effective date is April 2004.

I had a NOD for HBP that I dropped after receiving 100% P&T. The VA says my HBP was diagnosed before DMII so it is a pre existing condition. Thanks. Terry Sturgis

[Berta]

Terry dont die or if you have too- make sure it is after April 2014.

"If I die as a result of HBP (heart) problems does my wife get her DIC? I understand the 10 year rule"

If you die and the Death Certificate states the disabilities that you stated are SC- (Coroners dont like to put PTSD on death certificates) and your service connected disabilities of DMII, PN, and tinnitus contribute or cause your death (per medical evidence on death certificate or in autopsy findings)-

you wife will get DIC - however what I mean by that is that

if medical evidence shows that any or all of these contributed to your death- she will get DIC.

Diabetes does not cause death -it can contribute to death by causing heart disease-which only involves specific types of LVH -Left Ventricular hypertrophy of heart-and also can involve atherosclerosis of heart and brain.Also it can cause renal (liver) disease.

This can be established by ECHO and MRI.

One does not ever know what they will die of-

always best to tell the spouse to get an autopsy done-county coroners like ours here are paramedics but not doctors.They state on the Cdeath certificate what disabilities they are aware of- they dont care about PTSD.(unless suicide or other factors) I dont even know if that would trigger a coronoe to list PTSD on Death cert. I have seen plent of PTSD vets death certs-I have never seen this done by the coroner.

diabetes -as all ADA commercials on TV show- can be fatal due to its complications.

The complications or cause of death or any contributing factors , with SC established for DMII

can produce DIC.

Still these could take years.

How did the VA possibly give competent medical rationale to say the HBP came before the DMII?

They could have misdiagnosed the DMII for many years, thus the DMII undiagnosed, caused the HBP.

If your Med recs indicate high glucose values ,hyperlipedimic hypothesis, or any other symptoms of diabetes (recurrent blurred vision, burning mouth pain, PN, sore that didnt heal etc etc -all in the VA's Diabetes Mellitus trainging letter I posted here many times-

prior to the date VA gave you for established DMII- that could well mean they failed to diagnose it early then they did and thus they can claim that the HBP is not due to the DMII and if you died of HBP involvement they wont have to pay your spouse DIC if death occurs prior to 2014.

This might be well worth your time to look over all of your VA med recs real good and even consider getting an IMO.

[Berta]

PS- you withdrew the HBP claim? just re-read this---

do you still have time to NOD this and give VA some excuse for the prior NOD withdrawal?

I guess I mean the 100% decision- how much time to you have left to NOD it?

If the HBP drop was due to a discussion with a DRO-

NOD it anyhow if you still have time.

If you have medical evidence of heart disease- claim that too as due to the SC DMII.

Has VA ever ruled in or out cardiovascular disease due to your diabetes?

Edited March 6, 2007 by Berta

[Guest terrysturgis]

Berta, The decision for 100% P&T is date stamped May 25, 2006. My DAV SO is who advised me to drop the claim.

The decision is based on De Novo review by a decision review officer.

Deecision: Service connection for hypertension is denied.

Reason and bases: The service medical records do not show any hypertension, so service connection as directly incurred in service is not estabilished. You have requested service connection for hypertension due to diabetes. Service connection on that basis is not established either.

Dr. F_______ stated (IMO) that your hypertension has been more dificult to control since you've had diabetes, but he did not state that the diabetes was the cause of the hypertension.

The VA examiner stated in the exam of January 18, 2005, that she could not state that the diabetes caused the hypertension. Your blood pressure at the exam was 160/80. (I am on three blood pressure medications) You take medications for your hypertension. The VA examiner in the exam of March 27, 2006, stated that since there is no diabetic neuropathy from your diabetes, the hypertension is not aggravated by or related to the diabetes. That finding is most consistant with general VA policy that hypertension is not related to diabetes unless there is diabetis neuropathy. Therefore, based on that opinion, service connection for hypertension is not established. The copy of the Board of Veterans Appeals decision does not change this result, because the VA examiner conclusively stated that the hypertension is not due to the diabetes.

What I have posted is the SOC. The main thing that has changed is now the VA has rated me 40% bilaterial lower body PN and 20% bilaterial upper body PN. Any suggestions greatly appreciated. THANKS! Terry Sturgis

[Berta]

Say what?

"That finding is most consistant with general VA policy that hypertension is not related to diabetes unless there is diabetis neuropathy"

Is the VA examiner an endocrinologist with initials of A O'D? If so she doesn't have a clue-

Was this the VA examiners actual statement in the actual C & P results?

What general VA policy? This is not even consistent with the ADA (American Diabetes Foundation)

or the VA's own training letter-

My own former vet rep has DMII and had a heck of time getting his HBP SCed to- he has heart disease from the DM- he had to first get the heart disease secondarily SCed then he had to fight over the HBP which I believe they granted also-

Only suggestion I have is

1. find out where that reg is to support the statement above- it is a new one to me-I think they made it up-

2.access your med recs or have a real doc do it to see if your diabetes could have had etiology and was not properly diagnosed as diabetes, prior to the HBP diagnosis-

Do you have heart disease established by medical fact?

I suggest if so you add this to your claim- and get VA to try to come up with an etiology for that-

why was the CAD -if you have it -not mentioned in your IMO?

Diabetes---

then heart disease can potentially occur due to progressions of diabetes, then renal dysfunction, vision problems, candidiasis, strokes and brain ischemia, heart attack, etc- and at any point of above HBP can occur-

The IMO is bad news- I hope you didnt pay too much cash for that-

then again it is based on what the IMO doctor had in way of medical evidence-

did the heart disease (if you have CAD) get established AFTER the diabetes?

If so- the heck with the HBP stuff- you could focus on the CAD as secondary to the DMII-if the CAD was established AFTER the DMII.

[Guest terrysturgis]

Berta, thanks. The IMO (letter) was provided by my private doctor at my request. No charge and well worth it. Seriously, his point was diabetics have trouble controling HBP and it is a known medical fact.

The good news is that as per my non VA doctor I do not have any heart related issues. I have had a recent cat scan and MRI and everything looks good. You used the abbreviation CAD and I assume it means Cardio something.

The statement I posted is the actual decision. Those are the VA's words. The main difference between the decision and now is they say "general policy states that hypertension is not related to diabetes unless there is diabetic neuropathy". As of the 100% P&T decision I am SC for PN upper and lower body. Should I open a new claim for HBP based on the statement above?

Berta, your posting of the DMII traning letter is the main reason I am at 100% P&T. When I hit the brick wall, I changed. I had no idea that I had PN and it can be a secondary condition of DMII. Thanks to you and T-Bird's HADIT site. If you are diabetic, find it and read it.

I plan on living till 2014. I need to keep up on the adventures of our other Terry, Mr. Higgens. Terry Sturgis

[Berta]

Terry -I hope you are still around in year 3014!

Obviously the VA even by then might be still screwing around with vets-

then again maybe by then the world will be in utter Peace- and no need for military or VA at all-

yeah right-

I am VERY glad there is NO evidence of heart disease Terry-this is good news-

Still the fact remains that the VA statement is absolutley bizarre-

I bet they did not quote ay VA doctor and gave No medical rationale at all to support what they said.

I also bet you can find with some searching on the net some good abstracts or info from ADA,try Diabetologic too- I got a lot of info there to prove the VA doc, in my case, was all wrong.

I am baffled by what they said because-and you could make this point- it goes against established medical principles-

my own former vet rep has DMII (AO) and HBP and NO PN

There is No reg or medical criteria I am aware of in 38 CFR that supports what they said-

they are saying,in essense here, that ALL DMII vets MUST have PN in order to have HBP-

I dont recall that medical statement in the DMII VA trainng letter and never in any diabetes claim at the BVA.

I did significant research myself on diabetes to satisfy mysel that Rod had misdiagnosed DMII- and have 3 IMOs that concur-

In all the many months of medical research I did-nothing I found would even come close to this VA statement.

Sounds to me like a rater was playing doctor ( or playing quack)

Did the VA cite anything whatsoever to support that 'medical' statement?

I just remembered something might help you and others-

When Doctor BAsh knocked down a VA "expert" opinion last year for my claim- he gave treatise references to back up his opinion.

He also-in his second IMO-stated that the VA exemier had failed to provide not only her expertise but also had failed to back up her statements with any medical abstracts, studies or treatises whatsoever.

Unlike the VA examiner-his expertise was within the opining he did as to the veterans MRIs, ECHO autopsy etc which the VA examiner had totally failed to regard.

This was a point here that we all need to use-

if the VA expects our IMOs to fall into their specfic criteria- we can expect that too of their

C & P doctors and their so-called "experts".

Terry -I would sure try to make them eat them words!

It is MOST bizarre-

sounds as bad as some of the stuff they tried to get me to accept years ago-

I question every single and statement word they put down in their decisions.