Hi all-

I am new to this forum and in need of any assistance. Here is the deal, my father had been rated 100% disabled by the VA off an on for years. He then had his 100% rating for about 6 consecutive years when he passed away. They listed NC on the death certificate. My mother took care of him the entire time and did not work. Now she has been denied benefits because he was not rated 100% disabled for I think 8 consecutive years is what they said.(how can this really be a law?) So now she has no income and no health insurance. The VA is saying tuff. I dont know what I can do... Any ideas?

Any responses very much appreciated

Is there any possibility his death was due to any SC condition- causing or contributing to death?

Can you tell us what his SC % was for and what he died from?

Even though VA denied on direct SC death- perhaps there is something they overlooked?

That is the reg in 38 USCS 1318- it is ten continuous years at 100% SC - then VA awards the survivor DIC benefits, unless they can succeed in a direct SC death claim.( meaning proving death was caused or contributed to by SC disability.

I assume they denied her a pension?

If he was wartime veteran and her income met the income limits guidelines, they should have awarded her a pension.

Does she have his complete SMRs and medical records?

A long time ago the VA denied my direct SC claim many times. They did award me DIC under 1151 (malpractice causing death). But I continued with the direct SC death claim and was recently awarded direct SC death.

This goes to show that persistence pays off in gathering all medical evidence possible and in my case I had 3 strong independent medical opinions as well as other significant evidence.

It took 14 years all in all but this is my point- that there might be something the VA overlooked -evidence wise.And something that you or your mom overlooked in his medical records.

But there also might be no possibility at all of DIC but I am concerned as to the pension-if they denied it-and why.

Is there any way your mom could prove by medical evidence that he should have been SC at 10% for ten years?

"Here is the deal, my father had been rated 100% disabled by the VA off an on for years. He then had his 100% rating for about 6 consecutive years when he passed away."

Off and on? I think that could be the key in getting a ten year rating. What did the VA say regarding the prior awards?
when the 100% was not on-going-why not ?

How could a vet be 100% on and off? Did VA reduce him or just cut off his comp?

Berta-
Thanks so much for the reply. My dad had PTSD and was on a ton of medications. He was rated a 100% then he would have a hearing and if he said he was feeling ok they would take it away.. it was such a mess. They denied because they put natural causes on the death certificate and my mom did not have an autopsy done. Since it wasnt SC related and he wasnt 100% for 10 consecutive years then denied it. I wrote a letter stating my father should have been rated 100% all along and of course they responded that I "allege" that. They wanted medical proof.. We have alot of his medical paperwork, I am just not sure how to prove he should have been rate 100% all along. My father really died from a heart attack which could have been caused by the medication he was taking, also he couldnt exercise due to that medication and his condition.

What are SMRS?

SMRs Service Medical Records

They can be obtained by your mother with a SF 180 form- Google the NARA web site (National Archives) and the form is under the Military Records Section.

PTSD has been associated as contributing to death in some cases.

I had a claim like that myself after I filed a Section 1151 claim.

That type of claim would take a strong independent medical opinion (you might even need one from both a psychiatrist and a cardiologist) to show with full medical rationale that his SC PTSD contributed to his death.

If the medcication he took for PTSD contributed to his death -that too would be a possible way to get DIC under Section 1151 regs.
That too would need medical evidence.

It can be done. I proved the VA made errors in medication that contributed to my husband's death.

Also -I hope your mother has all of his past rating decisions- I suggest she write to VA for a copy of his C file
as she also has potential to prove DIC under the ten year rule.

She would have to prove (and this might need to be a CUE claim-if he didnt appeal some of these decisions)that the medical evidence of record proved that he should have been 100% continuously for ten years prior to death.

Was he an incountry Vietnam veteran?
Was he ever diagnosed with diabetes?
Did the Death certificate give more details such as atherosclerotic heart disease?

Was the VA treating him for heart disease?

She needs to follow any time lines on the denial to prepare a NOD and could obtain a lawyer.I assume she still is within the one year NOD filing time frame.She will need copies of all clinical medical records, his SMRs and his complete C file.

She could file claims on all above bases.

She is going to need -in my opinion- a strong medical opinion to succeed- and they can be very costly- but a good IMO could cover one if not all of the above situations that could have caused his death.

The main focus of this all is how did his PTSD cause or contribute to his death-
was his blood pressure poorly controlled -therefore causing additional heart disease?
did he have heart disease from undiagnosed diabetes? which could have been from AO?
If VA gave him medical care and diagnosed and treated his heart disease, were the meds for CAD counterindicated by the PTSD medications?

Without an autopsy this will be difficult but nothing is impossible.
AN IMO is an expensive chance to take sometimes too- as it is good idea to know with little doubt that a costly IMO will support a claim like this.

What NSC rating did he have for his heart disease?

to add- The file and his medical records are more important than obtaining the SMRs-for the DIC-
but always good to have them-

I assume -since most PTSD vets were wartime vets- and you said your mom's income was so limited- did the VA deny the pension claim for her or are they still working on it?

is there any dic a widow can recive when the vet died 20 years ago and was getting retirement? they were getting his retirement pay and after his death she got cut off and started on SS.
altho
the widow is on SS but not enough to make ends meet, However sinse her hubby did not sign up for the insurance while he was living is there any chance for this widow ro get any help from the va? now/ 20 years later.

I forgot to mention the vet died of oat cell cancer...he was in world world war II was hon dis in may of 64 died Jan 89
not any medical records to go check? just death certif ect,,ect,,
any help this widow can get would be greatly appreciated , if its just help with her meds, she is disable with ostroporis bad she is very bad takes most of her SS TO BUY HER MEDS, ALTHO MEDICADE HELPS BUT NOT WITH HER MORPHINE PAIN MEDS WHICH IS HALF OF HER S.S. CHECK.
Any one kow if she can get VA to help her?
Thank you.

Rockytop,
Please repost this info by starting your own topic thread.
Thanks,
carlie

One idea is to look into whether V.A. erroneously reduced his 100% rating in the past or erroneously failed to grant him a 100% rating at an earlier effective date. V.A. reduced his 100% rating on and off. It's possible V.A. could have reduced your dad's 100% rating contrary to 38 CFR 3.343 or 38 CFR 3.344 at an earlier date. If he should have been rated at 100% for 10 years or more perhaps his widow would have entitlement to DIC under 38 USC 1318. I recommend that you immediately send a written request signed by your mother to V.A. Was your dad receiving Social Security Disability when he died? If so did he ever tell V.A. about this in writing and did V.A. ever get copies of his Social Security records and consider those records in support of his claims? Were there any earlier claims for V.A. benefits were an increase was requested and V.A. failed to consider new and material evidence of an increase during an appeal period under 38 CFR 3.400 (q) or failed to consider evidence for an earlier effective date under 38 CFR 3.400 (o)(2)? Did your dad ever file a claim for increase with V.A. within one year of the date of medical evidence showing he had become totally disabled? Another avenue to an earlier effective date could be proving that V.A. failed to notify him of a decision at the latest address of record at the time there was evidence in the file of an increase in disability in the file. Sometimes V.A. ignores a Notice of Disagreement by the veteran and fails to issue a statement of case which leaves the earlier claim pending. I recommend you get a copy of your father's V.A. file and arrange it chronologically to look for the answers to some of these questions. Also don't forget the issue of inferred claims and don't forget the issue of informal claims. You can read more about this on the hadit claims forum and online. Search under inferred claims and veteran. Also search under informal claims and veteran. The regulation on informal claims is 38 CFR 3.155. Earlier hospitalizations or treatment can also trigger an earlier effective date under 38 CFR 3.157 (. I also recommend you read V.A. Office of General Counsel Precedent Opinion 12-98 on earlier effective dates.