Re: Neperologist Appt. Update

[Guest guest]

My point is if you try to go through the VA with a claim that they missed Dx you

it isn't likely to succeed. Since many of your Sx have improved it would be hard

to say they have caused a permanent disability. VA will only gave rating if

disability permanent.

The VA treats Mis Dx as a service connected disability so same laws apply.

Now you can sue the VA in court and maybe win.

> > > > > > >

> > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA,

> > > > > > doctors have to think + have attended class that day.

> > > > > > >

> > > > > > > Val

> > > > > > >

> > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > ] On Behalf Of Clarence Grim

> > > > > > >

> > > > > > > On the check the box robot dr my guess most would not be here

> > > > > > soars in the process if the boxes had been checked years ago. But

> > > > > > hey we do not want to interfere with a Drs right to do what s/he

> > > > > > wants without being a boxer.

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

You may of missed my point. Money, while nice is not my primary goal.

You raise a question on permanence and I'm not sure it is 100% corrected. Does

LVH weaken the heart? Does COPD and OSA have long term effects on Lungs? Does

T2DM cause your toes to tingle and feet to ache forever or does that go away

(providing you still have them) even if you are lucky enough to resolve the DM?

Speaking of lungs, what about acidosis (I believe that is what the doctor was

talking about when he said I had excess acid.) I believe there are atleast two

types, metabolic and respiratory. Primary organs affected being the kidneys and

lungs.

I found the following statement: " Treatments for respiratory acidosis target the

lungs to improve efficiency so you can exhale carbon dioxide more effectively.

Treatment for metabolic acidosis targets the underlying cause, though agents

that decrease acidity may be given "

He told me my kidneys looked fine (some different from the last Nepr who labeled

me CKD Stage III!) Now, knowing I was on Oxygen for over a year do you think I

should just take that pill he is offering or should we check the lungs out a

little more? Does anyone know if a bi-pap machine set too high might cause

shallow breathing hence not clearing CO2 correctly?

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > > > > > >

> > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA,

> > > > > > > doctors have to think + have attended class that day.

> > > > > > > >

> > > > > > > > Val

> > > > > > > >

> > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > >

> > > > > > > > On the check the box robot dr my guess most would not be here

> > > > > > > soars in the process if the boxes had been checked years ago. But

> > > > > > > hey we do not want to interfere with a Drs right to do what s/he

> > > > > > > wants without being a boxer.

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Your DM is service connected and what ever can be linked to this will then be

given a % rating. Over time DM can cause more disabilities. You will then be

able to file for the new disability.

Any thing related to mis DX PA you would be better off to sue the then to go

through the VA system.

Here is the the Reg that if you go the through the VA have to show.

Sec. 3.361 Benefits under 38 U.S.C. 1151(a) for additional disability

or death due to hospital care, medical or surgical treatment,

examination, training and rehabilitation services, or

compensated work therapy program.

(a) Claims subject to this section--(1) General. Except as provided

in paragraph (2), this section applies to claims received by VA on or

after October 1,

[[Page 272]]

1997. This includes original claims and claims to reopen or otherwise

readjudicate a previous claim for benefits under 38 U.S.C. 1151 or its

predecessors. The effective date of benefits is subject to the

provisions of Sec. 3.400(i). For claims received by VA before October

1, 1997, see Sec. 3.358.

(2) Compensated Work Therapy. With respect to claims alleging

disability or death due to compensated work therapy, this section

applies to claims that were pending before VA on November 1, 2000, or

that were received by VA after that date. The effective date of benefits

is subject to the provisions of Sec. Sec. 3.114(a) and 3.400(i), and

shall not be earlier than November 1, 2000.

( Determining whether a veteran has an additional disability. To

determine whether a veteran has an additional disability, VA compares

the veteran's condition immediately before the beginning of the hospital

care, medical or surgical treatment, examination, training and

rehabilitation services, or compensated work therapy (CWT) program upon

which the claim is based to the veteran's condition after such care,

treatment, examination, services, or program has stopped. VA considers

each involved body part or system separately.

© Establishing the cause of additional disability or death. Claims

based on additional disability or death due to hospital care, medical or

surgical treatment, or examination must meet the causation requirements

of this paragraph and paragraph (d)(1) or (d)(2) of this section. Claims

based on additional disability or death due to training and

rehabilitation services or compensated work therapy program must meet

the causation requirements of paragraph (d)(3) of this section.

(1) Actual causation required. To establish causation, the evidence

must show that the hospital care, medical or surgical treatment, or

examination resulted in the veteran's additional disability or death.

Merely showing that a veteran received care, treatment, or examination

and that the veteran has an additional disability or died does not

establish cause.

(2) Continuance or natural progress of a disease or injury. Hospital

care, medical or surgical treatment, or examination cannot cause the

continuance or natural progress of a disease or injury for which the

care, treatment, or examination was furnished unless VA's failure to

timely diagnose and properly treat the disease or injury proximately

caused the continuance or natural progress. The provision of training

and rehabilitation services or CWT program cannot cause the continuance

or natural progress of a disease or injury for which the services were

provided.

(3) Veteran's failure to follow medical instructions. Additional

disability or death caused by a veteran's failure to follow properly

given medical instructions is not caused by hospital care, medical or

surgical treatment, or examination.

(d) Establishing the proximate cause of additional disability or

death. The proximate cause of disability or death is the action or event

that directly caused the disability or death, as distinguished from a

remote contributing cause.

(1) Care, treatment, or examination. To establish that carelessness,

negligence, lack of proper skill, error in judgment, or similar instance

of fault on VA's part in furnishing hospital care, medical or surgical

treatment, or examination proximately caused a veteran's additional

disability or death, it must be shown that the hospital care, medical or

surgical treatment, or examination caused the veteran's additional

disability or death (as explained in paragraph © of this section); and

(i) VA failed to exercise the degree of care that would be expected

of a reasonable health care provider; or

(ii) VA furnished the hospital care, medical or surgical treatment,

or examination without the veteran's or, in appropriate cases, the

veteran's representative's informed consent. To determine whether there

was informed consent, VA will consider whether the health care providers

substantially complied with the requirements of Sec. 17.32 of this

chapter. Minor deviations from the requirements of Sec. 17.32 of this

chapter that are immaterial under the circumstances of a case will not

defeat a finding of informed consent. Consent may be express (i.e.,

given orally or in

[[Page 273]]

writing) or implied under the circumstances specified in Sec. 17.32(

of this chapter, as in emergency situations.

(2) Events not reasonably foreseeable. Whether the proximate cause

of a veteran's additional disability or death was an event not

reasonably foreseeable is in each claim to be determined based on what a

reasonable health care provider would have foreseen. The event need not

be completely unforeseeable or unimaginable but must be one that a

reasonable health care provider would not have considered to be an

ordinary risk of the treatment provided. In determining whether an event

was reasonably foreseeable, VA will consider whether the risk of that

event was the type of risk that a reasonable health care provider would

have disclosed in connection with the informed consent procedures of

Sec. 17.32 of this chapter.

(3) Training and rehabilitation services or compensated work therapy

program. To establish that the provision of training and rehabilitation

services or a CWT program proximately caused a veteran's additional

disability or death, it must be shown that the veteran's participation

in an essential activity or function of the training, services, or CWT

program provided or authorized by VA proximately caused the disability

or death. The veteran must have been participating in such training,

services, or CWT program provided or authorized by VA as part of an

approved rehabilitation program under 38 U.S.C. chapter 31 or as part of

a CWT program under 38 U.S.C. 1718. It need not be shown that VA

approved that specific activity or function, as long as the activity or

function is generally accepted as being a necessary component of the

training, services, or CWT program that VA provided or authorized.

(e) Department employees and facilities. (1) A Department employee

is an individual--

(i) Who is appointed by the Department in the civil service under

title 38, United States Code, or title 5, United States Code, as an

employee as defined in 5 U.S.C. 2105;

(ii) Who is engaged in furnishing hospital care, medical or surgical

treatment, or examinations under authority of law; and

(iii) Whose day-to-day activities are subject to supervision by the

Secretary of Veterans Affairs.

(2) A Department facility is a facility over which the Secretary of

Veterans Affairs has direct jurisdiction.

(f) Activities that are not hospital care, medical or surgical

treatment, or examination furnished by a Department employee or in a

Department facility. The following are not hospital care, medical or

surgical treatment, or examination furnished by a Department employee or

in a Department facility within the meaning of 38 U.S.C. 1151(a):

(1) Hospital care or medical services furnished under a contract

made under 38 U.S.C. 1703.

(2) Nursing home care furnished under 38 U.S.C. 1720.

(3) Hospital care or medical services, including examination,

provided under 38 U.S.C. 8153 in a facility over which the Secretary

does not have direct jurisdiction.

(g) Benefits payable under 38 U.S.C. 1151 for a veteran's death. (1)

Death before January 1, 1957. The benefit payable under 38 U.S.C.

1151(a) to an eligible survivor for a veteran's death occurring before

January 1, 1957, is death compensation. See Sec. Sec. 3.5((2) and

3.702 for the right to elect dependency and indemnity compensation.

(2) Death after December 31, 1956. The benefit payable under 38

U.S.C. 1151(a) to an eligible survivor for a veteran's death occurring

after December 31, 1956, is dependency and indemnity compensation.

(Authority: 38 U.S.C. 1151)

[69 FR 46433, Aug. 3, 2004]

Sec. 3.362 Offsets under 38 U.S.C. 1151( of benefits awarded under

38 U.S.C. 1151(a).

(a) Claims subject to this section. This section applies to claims

received by VA on or after October 1, 1997. This includes original

claims and claims to reopen or otherwise readjudicate a previous claim

for benefits under 38 U.S.C. 1151 or its predecessors.

( Offset of veterans' awards of compensation. If a veteran's

disability is the basis of a judgment under 28 U.S.C. 1346( awarded,

or a settlement or compromise under 28 U.S.C. 2672 or 2677 entered, on

or after December 1, 1962,

[[Page 274]]

the amount to be offset under 38 U.S.C. 1151( from any compensation

awarded under 38 U.S.C. 1151(a) is the entire amount of the veteran's

share of the judgment, settlement, or compromise, including the

veteran's proportional share of attorney fees.

© Offset of survivors' awards of dependency and indemnity

compensation. If a veteran's death is the basis of a judgment under 28

U.S.C. 1346( awarded, or a settlement or compromise under 28 U.S.C.

2672 or 2677 entered, on or after December 1, 1962, the amount to be

offset under 38 U.S.C. 1151( from any dependency and indemnity

compensation awarded under 38 U.S.C. 1151(a) to a survivor is only the

amount of the judgment, settlement, or compromise representing damages

for the veteran's death the survivor receives in an individual capacity

or as distribution from the decedent veteran's estate of sums included

in the judgment, settlement, or compromise to compensate for harm

suffered by the survivor, plus the survivor's proportional share of

attorney fees.

(d) Offset of structured settlements. This paragraph applies if a

veteran's disability or death is the basis of a structured settlement or

structured compromise under 28 U.S.C. 2672 or 2677 entered on or after

December 1, 1962.

(1) The amount to be offset. The amount to be offset under 38 U.S.C.

1151( from benefits awarded under 38 U.S.C. 1151(a) is the veteran's

or survivor's proportional share of the cost to the United States of the

settlement or compromise, including the veteran's or survivor's

proportional share of attorney fees.

(2) When the offset begins. The offset of benefits awarded under 38

U.S.C. 1151(a) begins the first month after the structured settlement or

structured compromise has become final that such benefits would

otherwise be paid.

> > > > > > > > >

> > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA,

> > > > > > > > doctors have to think + have attended class that day.

> > > > > > > > >

> > > > > > > > > Val

> > > > > > > > >

> > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > >

> > > > > > > > > On the check the box robot dr my guess most would not be here

> > > > > > > > soars in the process if the boxes had been checked years ago.

But

> > > > > > > > hey we do not want to interfere with a Drs right to do what s/he

> > > > > > > > wants without being a boxer.

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I understand that re. DM although I have yet to receive that ruling from them.

Not sure what you base your suit recommendation on but I am not far enough along

to even seriously consider, say nothing about make a decision. But then, many

good lawyers look like they are well fed so I'm sure I can find one or two that

would make their opinions known!

> > > > > > > > > >

> > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx

PA,

> > > > > > > > > doctors have to think + have attended class that day.

> > > > > > > > > >

> > > > > > > > > > Val

> > > > > > > > > >

> > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > > >

> > > > > > > > > > On the check the box robot dr my guess most would not be

here

> > > > > > > > > soars in the process if the boxes had been checked years ago.

But

> > > > > > > > > hey we do not want to interfere with a Drs right to do what

s/he

> > > > > > > > > wants without being a boxer.

> > > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

healthcare related lawsuits tend to have a very short statute ofimitations

>I understand that re. DM although I have yet to receive that ruling from them.

Not sure what you base your suit recommendation on but I am not far enough along

to even seriously consider, say nothing about make a decision. But then, many

good lawyers look like they are well fed so I'm sure I can find one or two that

would make their opinions known!

>

>

>> > > > > > > > > >

>> > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx

PA,

>> > > > > > > > > doctors have to think + have attended class that day.

>> > > > > > > > > >

>> > > > > > > > > > Val

>> > > > > > > > > >

>> > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

>> > > > > > > > > ] On Behalf Of Clarence Grim

>> > > > > > > > > >

>> > > > > > > > > > On the check the box robot dr my guess most would not be

here

>> > > > > > > > > soars in the process if the boxes had been checked years ago.

But

>> > > > > > > > > hey we do not want to interfere with a Drs right to do what

s/he

>> > > > > > > > > wants without being a boxer.

>> > > > > > > > > >

>> > > > > > > > >

>> > > > > > > > >

>> > > > > > > >

>> > > > > > >

>> > > > > >

>> > > > >

>> > > >

>> > >

>> >

>>

>

>

[Guest guest]

Oh, Francis, I've talked to them until I'm blue in the face. All we can do is throw them out next time. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PAIt has been over 10 years since I was dealing with what was covered by Medicare. Was doing this for my mother and father. At that time many things that providers said were not covered in fact were. You should do your own reseach might take some searching but should be able to find reasons why someting is or is not covered.How does one talk to the government? Try writing to who you put in office.>> Do not count on Medicare being any different. It is government and is> erratic. I had to have an EKG before my last surgery. Disallowed. Had I> gone to the hospital to get it (at considerably more cost), it would have> been covered without question. Now, I need some gyn help. Medicare won't> allow it and without it, I will have to have a $200,000 hysterectomy. When> I had private insurance, at least I could appeal decisions. How does one> talk to the government?

[Guest guest]

Let me repeat again. I have talked to practitioner's groups ever since JNC started. I would hold up the latest JNC and ask how many had seen this. If 3 of 20 in the group raised their hands I was pleased. Remember that EVERY practitioner's office likely received at least 4 copies of each JNC from various groups. But my guess is that either it did not get to them as the office manager assumed that they knew everything about HTN because it is so easy and they round filed it or or if it did get to the MD they circle filed it as they already knew all that was needed to treat HTN. I mean everyone knows how easy HTN is to treat mostly. If one reads from cover to cover a JNC it will take about 3-4 hours. I recommend that all here download and read JNC 7. 8 or as some of us call it JNC late should be out in May at the ASH meeting in NYC. I required EVERYONE in my office read it from cover to cover as even the sec must also know the importance of BP in the pts long and short term health. Plus most of them have someone in the family with HTN and so are interested.So a reasonable question is to ask your Dr. (after you have read JNC 7) is: have you read JNC 7 or 8 next spring. If no why not. If yes why did you not make my Dx earlier? CE Grim MD Then, , they have to think enough to go look in the guidelines. PA check boxes are still not on the check-off list. None of the people you dealt with had read the guidelines? No? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham They dont have to think. It's in the guidelines. They just have to read. It's actually very simple. Low K, resistant HTN = red flag. But if no low K and still resistant than check still. They just don't. Looking for a pheo is more exciting Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer. .

[Guest guest]

If I were J amie's Prosecutor I would ask. you are a PA correct? Your learned about PA in PA school right?Have you read JNC X guidelines? If yes what did they say about HTN and low KIf no why did you not read the newest guidelines? Did you google low K and HTN to look for causes? If not why not?Just playing the Devil's advocate. My point is if you try to go through the VA with a claim that they missed Dx you it isn't likely to succeed. Since many of your Sx have improved it would be hard to say they have caused a permanent disability. VA will only gave rating if disability permanent. The VA treats Mis Dx as a service connected disability so same laws apply. Now you can sue the VA in court and maybe win. > > > > > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > > > doctors have to think + have attended class that day. > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > > > soars in the process if the boxes had been checked years ago. But > > > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

You may of missed my point. Money, while nice is not my primary goal. You raise a question on permanence and I'm not sure it is 100% corrected. Does LVH weaken the heart? Does COPD and OSA have long term effects on Lungs? Does T2DM cause your toes to tingle and feet to ache forever or does that go away (providing you still have them) even if you are lucky enough to resolve the DM? Speaking of lungs, what about acidosis (I believe that is what the doctor was talking about when he said I had excess acid.) I believe there are atleast two types, metabolic and respiratory. Primary organs affected being the kidneys and lungs. I found the following statement: "Treatments for respiratory acidosis target the lungs to improve efficiency so you can exhale carbon dioxide more effectively. Treatment for metabolic acidosis targets the underlying cause, though agents that decrease acidity may be given" He told me my kidneys looked fine (some different from the last Nepr who labeled me CKD Stage III!) Now, knowing I was on Oxygen for over a year do you think I should just take that pill he is offering or should we check the lungs out a little more? Does anyone know if a bi-pap machine set too high might cause shallow breathing hence not clearing CO2 correctly? My guess is not. High paCO2 is a very powerful drive to increase ventilation: breathing faster and deeper. Unless this blocked by drugs being used for other things. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > > > > doctors have to think + have attended class that day. > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > > > > soars in the process if the boxes had been checked years ago. But > > > > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Diabetes, CAD and HTN are not natural human conditions. They happen when you feed your genome wrong. Or maybe the army fed them wrong but if you are fighting in Nam or Iraq in the heat you will need lots of salt so you don't die from sodium depletion. And once you are out it is under your control.CE Grim MD Your DM is service connected and what ever can be linked to this will then be given a % rating. Over time DM can cause more disabilities. You will then be able to file for the new disability. Any thing related to mis DX PA you would be better off to sue the then to go through the VA system. Here is the the Reg that if you go the through the VA have to show. Sec. 3.361 Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical or surgical treatment, examination, training and rehabilitation services, or compensated work therapy program. (a) Claims subject to this section--(1) General. Except as provided in paragraph (2), this section applies to claims received by VA on or after October 1, [[Page 272]] 1997. This includes original claims and claims to reopen or otherwise readjudicate a previous claim for benefits under 38 U.S.C. 1151 or its predecessors. The effective date of benefits is subject to the provisions of Sec. 3.400(i). For claims received by VA before October 1, 1997, see Sec. 3.358. (2) Compensated Work Therapy. With respect to claims alleging disability or death due to compensated work therapy, this section applies to claims that were pending before VA on November 1, 2000, or that were received by VA after that date. The effective date of benefits is subject to the provisions of Sec. Sec. 3.114(a) and 3.400(i), and shall not be earlier than November 1, 2000. ( Determining whether a veteran has an additional disability. To determine whether a veteran has an additional disability, VA compares the veteran's condition immediately before the beginning of the hospital care, medical or surgical treatment, examination, training and rehabilitation services, or compensated work therapy (CWT) program upon which the claim is based to the veteran's condition after such care, treatment, examination, services, or program has stopped. VA considers each involved body part or system separately. © Establishing the cause of additional disability or death. Claims based on additional disability or death due to hospital care, medical or surgical treatment, or examination must meet the causation requirements of this paragraph and paragraph (d)(1) or (d)(2) of this section. Claims based on additional disability or death due to training and rehabilitation services or compensated work therapy program must meet the causation requirements of paragraph (d)(3) of this section. (1) Actual causation required. To establish causation, the evidence must show that the hospital care, medical or surgical treatment, or examination resulted in the veteran's additional disability or death. Merely showing that a veteran received care, treatment, or examination and that the veteran has an additional disability or died does not establish cause. (2) Continuance or natural progress of a disease or injury. Hospital care, medical or surgical treatment, or examination cannot cause the continuance or natural progress of a disease or injury for which the care, treatment, or examination was furnished unless VA's failure to timely diagnose and properly treat the disease or injury proximately caused the continuance or natural progress. The provision of training and rehabilitation services or CWT program cannot cause the continuance or natural progress of a disease or injury for which the services were provided. (3) Veteran's failure to follow medical instructions. Additional disability or death caused by a veteran's failure to follow properly given medical instructions is not caused by hospital care, medical or surgical treatment, or examination. (d) Establishing the proximate cause of additional disability or death. The proximate cause of disability or death is the action or event that directly caused the disability or death, as distinguished from a remote contributing cause. (1) Care, treatment, or examination. To establish that carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on VA's part in furnishing hospital care, medical or surgical treatment, or examination proximately caused a veteran's additional disability or death, it must be shown that the hospital care, medical or surgical treatment, or examination caused the veteran's additional disability or death (as explained in paragraph © of this section); and (i) VA failed to exercise the degree of care that would be expected of a reasonable health care provider; or (ii) VA furnished the hospital care, medical or surgical treatment, or examination without the veteran's or, in appropriate cases, the veteran's representative's informed consent. To determine whether there was informed consent, VA will consider whether the health care providers substantially complied with the requirements of Sec. 17.32 of this chapter. Minor deviations from the requirements of Sec. 17.32 of this chapter that are immaterial under the circumstances of a case will not defeat a finding of informed consent. Consent may be express (i.e., given orally or in [[Page 273]] writing) or implied under the circumstances specified in Sec. 17.32( of this chapter, as in emergency situations. (2) Events not reasonably foreseeable. Whether the proximate cause of a veteran's additional disability or death was an event not reasonably foreseeable is in each claim to be determined based on what a reasonable health care provider would have foreseen. The event need not be completely unforeseeable or unimaginable but must be one that a reasonable health care provider would not have considered to be an ordinary risk of the treatment provided. In determining whether an event was reasonably foreseeable, VA will consider whether the risk of that event was the type of risk that a reasonable health care provider would have disclosed in connection with the informed consent procedures of Sec. 17.32 of this chapter. (3) Training and rehabilitation services or compensated work therapy program. To establish that the provision of training and rehabilitation services or a CWT program proximately caused a veteran's additional disability or death, it must be shown that the veteran's participation in an essential activity or function of the training, services, or CWT program provided or authorized by VA proximately caused the disability or death. The veteran must have been participating in such training, services, or CWT program provided or authorized by VA as part of an approved rehabilitation program under 38 U.S.C. chapter 31 or as part of a CWT program under 38 U.S.C. 1718. It need not be shown that VA approved that specific activity or function, as long as the activity or function is generally accepted as being a necessary component of the training, services, or CWT program that VA provided or authorized. (e) Department employees and facilities. (1) A Department employee is an individual-- (i) Who is appointed by the Department in the civil service under title 38, United States Code, or title 5, United States Code, as an employee as defined in 5 U.S.C. 2105; (ii) Who is engaged in furnishing hospital care, medical or surgical treatment, or examinations under authority of law; and (iii) Whose day-to-day activities are subject to supervision by the Secretary of Veterans Affairs. (2) A Department facility is a facility over which the Secretary of Veterans Affairs has direct jurisdiction. (f) Activities that are not hospital care, medical or surgical treatment, or examination furnished by a Department employee or in a Department facility. The following are not hospital care, medical or surgical treatment, or examination furnished by a Department employee or in a Department facility within the meaning of 38 U.S.C. 1151(a): (1) Hospital care or medical services furnished under a contract made under 38 U.S.C. 1703. (2) Nursing home care furnished under 38 U.S.C. 1720. (3) Hospital care or medical services, including examination, provided under 38 U.S.C. 8153 in a facility over which the Secretary does not have direct jurisdiction. (g) Benefits payable under 38 U.S.C. 1151 for a veteran's death. (1) Death before January 1, 1957. The benefit payable under 38 U.S.C. 1151(a) to an eligible survivor for a veteran's death occurring before January 1, 1957, is death compensation. See Sec. Sec. 3.5((2) and 3.702 for the right to elect dependency and indemnity compensation. (2) Death after December 31, 1956. The benefit payable under 38 U.S.C. 1151(a) to an eligible survivor for a veteran's death occurring after December 31, 1956, is dependency and indemnity compensation. (Authority: 38 U.S.C. 1151) [69 FR 46433, Aug. 3, 2004] Sec. 3.362 Offsets under 38 U.S.C. 1151( of benefits awarded under 38 U.S.C. 1151(a). (a) Claims subject to this section. This section applies to claims received by VA on or after October 1, 1997. This includes original claims and claims to reopen or otherwise readjudicate a previous claim for benefits under 38 U.S.C. 1151 or its predecessors. ( Offset of veterans' awards of compensation. If a veteran's disability is the basis of a judgment under 28 U.S.C. 1346( awarded, or a settlement or compromise under 28 U.S.C. 2672 or 2677 entered, on or after December 1, 1962, [[Page 274]] the amount to be offset under 38 U.S.C. 1151( from any compensation awarded under 38 U.S.C. 1151(a) is the entire amount of the veteran's share of the judgment, settlement, or compromise, including the veteran's proportional share of attorney fees. © Offset of survivors' awards of dependency and indemnity compensation. If a veteran's death is the basis of a judgment under 28 U.S.C. 1346( awarded, or a settlement or compromise under 28 U.S.C. 2672 or 2677 entered, on or after December 1, 1962, the amount to be offset under 38 U.S.C. 1151( from any dependency and indemnity compensation awarded under 38 U.S.C. 1151(a) to a survivor is only the amount of the judgment, settlement, or compromise representing damages for the veteran's death the survivor receives in an individual capacity or as distribution from the decedent veteran's estate of sums included in the judgment, settlement, or compromise to compensate for harm suffered by the survivor, plus the survivor's proportional share of attorney fees. (d) Offset of structured settlements. This paragraph applies if a veteran's disability or death is the basis of a structured settlement or structured compromise under 28 U.S.C. 2672 or 2677 entered on or after December 1, 1962. (1) The amount to be offset. The amount to be offset under 38 U.S.C. 1151( from benefits awarded under 38 U.S.C. 1151(a) is the veteran's or survivor's proportional share of the cost to the United States of the settlement or compromise, including the veteran's or survivor's proportional share of attorney fees. (2) When the offset begins. The offset of benefits awarded under 38 U.S.C. 1151(a) begins the first month after the structured settlement or structured compromise has become final that such benefits would otherwise be paid. > > > > > > > > > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > > > > > doctors have to think + have attended class that day. > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > > > > > soars in the process if the boxes had been checked years ago. But > > > > > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Hmm. Proving DM is service connected will be difficult as almost all DM 2 is caused by eating too much. So you will need to document that you gained wt in the service and that when you were discharged you glucose was high. And I would want to be certain that there was no DM in the family.Again the Devil's advocate.Must have been checked. CE Grim MD I understand that re. DM although I have yet to receive that ruling from them. Not sure what you base your suit recommendation on but I am not far enough along to even seriously consider, say nothing about make a decision. But then, many good lawyers look like they are well fed so I'm sure I can find one or two that would make their opinions known! > > > > > > > > > > > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > > > > > > doctors have to think + have attended class that day. > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > > > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > > > > > > soars in the process if the boxes had been checked years ago. But > > > > > > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > > > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Diabetes is also one of the assumed diseases caused by exposure to Agent Orange,

all you have to do is prove you were in country or the gray waters for atleast a

day. I was in the Air Force at Danang Air Base and as the major northernmost

base much of it was dispatched from there. In fact a group of Canadian

Scientists did some research a couple of years ago and foung the level of toxins

was still 30 times higher than would be allowed by Canadian standards!

There is a whole list of exciting things that can show up and we are reaching

the age where they get noticed, alot tumor related. (Wonder about adrenal

tumors!) In fact they offer an Agent Orange registery exam which I've signed up

for - only been on the list for a year now!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > > > > > > > > >

> > > > > > > > > > > Ahh, but the PA boxes are still not there to

> > check. To dx PA,

> > > > > > > > > > doctors have to think + have attended class that day.

> > > > > > > > > > >

> > > > > > > > > > > Val

> > > > > > > > > > >

> > > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > > > >

> > > > > > > > > > > On the check the box robot dr my guess most would

> > not be here

> > > > > > > > > > soars in the process if the boxes had been checked

> > years ago. But

> > > > > > > > > > hey we do not want to interfere with a Drs right to

> > do what s/he

> > > > > > > > > > wants without being a boxer.

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

See previous response, DD214 says I have 10 months and 28 days of credit in

country! (BTW there is NO DM in the family!)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > > > > > > > > > >

> > > > > > > > > > > > Ahh, but the PA boxes are still not there to

> > check. To dx PA,

> > > > > > > > > > > doctors have to think + have attended class that

> > day.

> > > > > > > > > > > >

> > > > > > > > > > > > Val

> > > > > > > > > > > >

> > > > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > > > > >

> > > > > > > > > > > > On the check the box robot dr my guess most

> > would not be here

> > > > > > > > > > > soars in the process if the boxes had been checked

> > years ago. But

> > > > > > > > > > > hey we do not want to interfere with a Drs right

> > to do what s/he

> > > > > > > > > > > wants without being a boxer.

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Here is the list for Agent Orange. As it says they are presumptive diseases. By

doing research they have found Vets that were Exposure to Agent Orange have a

higher rate of certain diseases than normal.

They can not really prove if you get one of the listed diseases the cause is

Agent Orange. Some are and some are not. Since they don't know if you get DM

what the cause is they can only guess so they presume the cause is Agent Orange.

Agent Orange: Diseases Related to Agent Orange Exposure

VA assumes that certain diseases are related to qualifying military service.

These are called " presumptive diseases. " VA has recognized certain cancers and

other health problems as presumptive diseases related to exposure to Agent

Orange or other herbicides during military service.

¡Veterans' Diseases Related to Agent Orange Exposure

¡Birth Defects in Children of Vietnam and Korea Veterans

Also, VA presumes amyotrophic lateral sclerosis (ALS) diagnosed in all Veterans

with 90 days or more continuous active military service is related to their

service.

Veterans' Diseases Related to Agent Orange Exposure

Veterans may be eligible for disability compensation and health care benefits

for diseases that VA has recognized as related to exposure to Agent Orange or

other herbicides.

Surviving spouses, dependent children and dependent parents of Veterans who were

exposed to Agent Orange and died as the result of diseases related to Agent

Orange exposure may be eligible for survivors' benefits.

¡Acute and Subacute Peripheral Neuropathy

A nervous system condition that causes numbness, tingling, and motor weakness.

Under VA's rating regulations, it must be at least 10% disabling within 1 year

of exposure to herbicides and resolve within 2 years after the date it began.

¡AL Amyloidosis

A rare disease caused when an abnormal protein, amyloid, enters tissues or

organs.

¡Chloracne (or Similar Acneform Disease)

A skin condition that occurs soon after exposure to chemicals and looks like

common forms of acne seen in teenagers. Under VA's rating regulations, chloracne

(or other acneform disease similar to chloracne) must be at least 10% disabling

within 1 year of exposure to herbicides.

¡Chronic B-cell Leukemias

A type of cancer which affects white blood cells.

¡Diabetes Mellitus (Type 2)

A disease characterized by high blood sugar levels resulting from the bodyfs

inability to respond properly to the hormone insulin.

¡Hodgkinfs Disease

A malignant lymphoma (cancer) characterized by progressive enlargement of the

lymph nodes, liver, and spleen, and by progressive anemia.

¡Ischemic Heart Disease

A disease characterized by a reduced supply of blood to the heart, that leads to

chest pain.

¡Multiple Myeloma

A cancer of plasma cells, a type of white blood cell in bone marrow.

¡Non-Hodgkinfs Lymphoma

A group of cancers that affect the lymph glands and other lymphatic tissue.

¡Parkinsonfs Disease

A progressive disorder of the nervous system that affects muscle movement.

¡Porphyria Cutanea Tarda

A disorder characterized by liver dysfunction and by thinning and blistering of

the skin in sun-exposed areas. Under VA's rating regulations, it must be at

least 10% disabling within 1 year of exposure to herbicides.

¡Prostate Cancer

Cancer of the prostate; one of the most common cancers among men.

¡Respiratory Cancers

Cancers of the lung, larynx, trachea, and bronchus.

¡Soft Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposifs

sarcoma, or Mesothelioma)

A group of different types of cancers in body tissues such as muscle, fat, blood

and lymph vessels, and connective tissues

> > > > > > > > > > > >

> > > > > > > > > > > > Ahh, but the PA boxes are still not there to

> > > check. To dx PA,

> > > > > > > > > > > doctors have to think + have attended class that day.

> > > > > > > > > > > >

> > > > > > > > > > > > Val

> > > > > > > > > > > >

> > > > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > > > > >

> > > > > > > > > > > > On the check the box robot dr my guess most would

> > > not be here

> > > > > > > > > > > soars in the process if the boxes had been checked

> > > years ago. But

> > > > > > > > > > > hey we do not want to interfere with a Drs right to

> > > do what s/he

> > > > > > > > > > > wants without being a boxer.

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

Any health problem to get while in service or one that you had prior to going

service and gets worse is service connected.

> > > > > > > > > > >

> > > > > > > > > > > Ahh, but the PA boxes are still not there to

> > check. To dx PA,

> > > > > > > > > > doctors have to think + have attended class that day.

> > > > > > > > > > >

> > > > > > > > > > > Val

> > > > > > > > > > >

> > > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > > > >

> > > > > > > > > > > On the check the box robot dr my guess most would

> > not be here

> > > > > > > > > > soars in the process if the boxes had been checked

> > years ago. But

> > > > > > > > > > hey we do not want to interfere with a Drs right to

> > do what s/he

> > > > > > > > > > wants without being a boxer.

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

The salt tablets were in the box right next to the malaria tablets in the

cafeteria (both boxed loose, just grab what you need.) Sure hope everyone

washed their hands after using the outhouse! Probably caught more than we

prevented!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > > > > > > > > > >

> > > > > > > > > > > > Ahh, but the PA boxes are still not there to

> > > check. To dx PA,

> > > > > > > > > > > doctors have to think + have attended class that day.

> > > > > > > > > > > >

> > > > > > > > > > > > Val

> > > > > > > > > > > >

> > > > > > > > > > > > From: hyperaldosteronism

[mailto:hyperaldosteronism

> > > > > > > > > > > ] On Behalf Of Clarence Grim

> > > > > > > > > > > >

> > > > > > > > > > > > On the check the box robot dr my guess most would

> > > not be here

> > > > > > > > > > > soars in the process if the boxes had been checked

> > > years ago. But

> > > > > > > > > > > hey we do not want to interfere with a Drs right to

> > > do what s/he

> > > > > > > > > > > wants without being a boxer.

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

But you were sweating a bit I suspect.One can lose 30 grams of salt in 4 hrs of execise in a hot and humid environment.CE Grim MD The salt tablets were in the box right next to the malaria tablets in the cafeteria (both boxed loose, just grab what you need.) Sure hope everyone washed their hands after using the outhouse! Probably caught more than we prevented! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > > > > > > > > > > > > > > > Ahh, but the PA boxes are still not there to > > > check. To dx PA, > > > > > > > > > > > doctors have to think + have attended class that day. > > > > > > > > > > > > > > > > > > > > > > > > Val > > > > > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > > > > > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > > > > > > > > > > > > > > > On the check the box robot dr my guess most would > > > not be here > > > > > > > > > > > soars in the process if the boxes had been checked > > > years ago. But > > > > > > > > > > > hey we do not want to interfere with a Drs right to > > > do what s/he > > > > > > > > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >