Are disclosure of severe adverse events, and concomitant referral to the benefits application process, mandatory? - 1151 Claims - VA Disability Claims Community Forums - Hadit.com Jump to content
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Are disclosure of severe adverse events, and concomitant referral to the benefits application process, mandatory?


UpToHere

Question

My VAMC providers never disclosed to me adverse events in my care, or  referred me to the benefits claim process.

A VA employee told me I was not eligible for VA disability benefits in connection with VAMC delayed cancer dx.

My VAMC then referred me - all at my expense (including ~ 8,000 miles transportation), to a civilian medical center for ~ 40 corrective surgery & radiation therapy treatments.

Pain & scarring, depression, homelessness, bankruptcy soon followed.

Eventually (2 years later) I came to know I was eligible for 1151 benefits, applied, and, after 2 more years,  “won.”  

Currently rated 80% for pain & scarring, SC-MDD, but receive 100% due to TDIU.

Subsequently I came to hear about equitable relief (38 U.SC. § 503(a)(b)(c), submitted my petition, got turned down on the basis of “such & such.”

However, my VAMC medical records & c-file made clear that “such & such” was not remotely applicable to my case.

I wrote VA a rebuttal > VA came up with new denial rationales.> I wrote VA a rebuttal > VA came up with new denial rationales …

This pattern has continued for 10 (!) years.

Calls to the White House Veterans Hot Line got me more of the same.

Last year, a law school veterans legal clinic exhaustively went through my file, took on my case, prepared a petition for equitable relief for me, and sent it to VA Central Office.

In response, I got a letter from way down the VA totem pole (my VARO) telling me they had turned down my petition, on the basis: “As multiple arms of the VA have already told you, you are not eligible for equitable relief.

Q: How do I get a meeting with an upper-echelon VA official to go over the record/my actual file, from a-z, not merely glance at a distorted “top sheet” view.

Thank you.

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Being granted an 1151 is a plus because the VA has already admitted fault.

I'm not an expert on equitable relief, but it sounds like you have tried taking this up through the appropriate usual channels. In the latest denial letter, did they happen to include a page containing instructions should you disagree and wish to file for review or appeal?

What did the law school veteran's clinic say after the denial?

What were the "such and such" reasons for denial of equitable relief? I'm not sure if there are specific requirements for it like a certain time frame, etc... You don't have to be specific, but someone else here should be more knowledgeable and might be able to help.

Have you engaged your congressional representative? When I requested help, they simply referred it over. However, it sounds like you have a good story to tell them.

Given the adverse event and the fallout, perhaps the VA Inspector General might be able to look into it.

 

I hope this information is helpful. I would hope the VA would be disclosing adverse events to patients. For example, there's nothing worse than learning they left a sponge in your abdomen and have to have another surgery - or finding out the hard way after you get really sick. As far as referring you for benefits, I only had one VAMC specialist ever do that proactively. Most providers try to dodge referral.

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In the year 2000 or 2001 I filed on my own a Petition For Equitable Relief and Administrative Review directly to the Secretary of Veterans affairs that also included a copy of Section 1151 VA Injury claim that I filed about the same time along with a 3rd claim for CUE and a 4th claim for P&T 100%.  Copies of my 1151 injury claim was also sent to many many U.S. Senators and Congressman describing the deliberate drug abuse against me and a few other vets on my psychiatric ward at Temple, Texas VA hospital in 85 and 86 causing the suicide of a Korean War veteran and extreme distress to me and others who were given the drug Scopolamine secretly and telling us it was Tylenol. We were then put on display in front of room full of A&M medical students (VA Fascism).

In short order I received a direct reply from Sec of VA that the VARO was adjudicating me for TDIU with 70% PTSD rating and about 4 months later I received another Sec of VA letter confirming I was P&T TDIU.  Not long after that I received the VARO official decision for the P&T TDIU rating.  They never actually acknowledge my injury claim as I fully expected but I did receive what I wanted with some years back pay.  Also received many letters of acknowledgement from senators and congressman and several letters of apology from Directors of Temple/Central Texas VAMC, Reno and Waco Regional offices directors.  I made clear I would send copies of the injury claim to many news media outlets if no favorable response from VA.

I have always thrown everything on to the wall to see what sticks since 1991 to present day and the overkill works greatly for me.  Some have no guts or patience to do this but it has worked for me 90% of time.  It has been both fun and satisfying payback.  

P&T 100% with SMC-S

70% PTSD, 60% GERD, 50% OSA Sleep Apnea, 30% AO IHD/CAD heart disease and 10% Tinnitus with everything due to Vietnam combat.  Also Vietnam PH, CMB, Air Medals, etc.

Edited by Dustoff 11 (see edit history)
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Winning an 1151 is an accomplishment, I know I filed and lost my 1151 claim got  a lawyer and lost again. If I had won I would have been happy because the VA would have admitted they screwed up my eye. Instead I was awarded service connection on a secondary basis, and was given a 30% rating that did nothing to increase my compensation.Today the rating is 60% and  I still feel I was cheated. But equatible relief ? No.. I just want acknowledge they damaged the eye.  I  don't understnd why you feel your owed equtable relief. Frankly getting a service connected award, and then TDIU seems to me anyway that you received all that your entitled too. Why am I wrong?  

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Q: I  don't understnd why you feel you are owed equitable relief.

A: Because: “tip of the iceberg”: an outcome other than expected (13-month delayed diagnosis of soft tissue sarcoma) that necessitated corrective surgery; failure to disclose adverse event(s); failure to refer to the benefits application process; 1 provider’s note in medical file that he hadn’t discussed case with me, because of concern over legal action; referral by VAMC Tumor Board to civilian corrective surgery + radiation therapy at my expense; as well as to VA social worker for financial counseling (who “counseled” I was not eligible for VA disability benefits); all of which led to SC-MDD, bankruptcy, homelessness; years-delayed application for 1151 benefits due to believing VA social worker’s erroneous counsel; date of claim years past date of injury; lost years of 1151 benefits are statutorily barred; equitable relief is the only possible path to redress.

There’s more.

 

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12 hours ago, UpToHere said:

: Because: “tip of the iceberg”: an outcome other than expected

Look, I understand what your are saying.. I am not against you getting equitable relief but I think its going to be hard to acheive.

I was damaged by the VA doctors in 2008, they removed a cataract from my left eye, During the surgery something went wrong, They do not put you under during cataract surgery, so I could hear everything. The resident was pushed out of the way by the attending  surgeon who took over the surgery. It was not until a month later, when I lost my eyesight that I was told that they had damaged the "strings" that keep the original lens in place and is used for the replacement lens. In my case they placed the lens too close to my iris, and for years I would lose my sight off and on, due to pressur spikes, finally in Nov 2000, I had emergency surgery to remove the lens because it continued to rub on the iris, and it caused serious internal bleeding. So now I have no lens in the left eye, and they will not insert another lens for fear of the same problem.  I am fighting with the va for a K award for loss of use which they continue to deny. My claim just went to the BVA.

Who knows maybe I would get some satificationf if I  filed for equitable relief, the raters keep playing games with my claim, ( I am rated 60% for the eye) but because I was already 100% when I received the rating, I don't actually get compensated for it. 

Edited by Richard1954 (see edit history)
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