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If you know about medical or VA issues, please help me figure out what to do

post #1 of 14
Thread Starter 
It has taken me two hours to stop shaking enough to type. My mom's future is about to be destroyed if I can't figure out how to make the right thing happen. If you have any ideas that might help, I desperately need your advice.

My father served 32 years in the US Army, was a highly decorated hero of three wars, won the Silver Star. Because of injuries he suffered in the service, including exposure to Agent Orange and the diabetes and heart disease that resulted from it, the VA judged him 100% disabled.

He had congestive heart failure, a six-way heart bypass, and severe emphysema, and he had been on 24-hour oxygen for years. During the final few months of his life, his heart grew increasingly weak and erratic, despite his pacemaker. As a result, he became increasingly dependent on the oxygen, and in the final weeks, no amount of it was enough for him. When the hospice people started giving him nebulizer treatments, they were shocked that it had not been done long ago.

He also had cancer in his liver (metastatic from the colon cancer he had years ago), but his liver function was found to be normal just a week or so before he died. We all knew that the cancer meant he was terminal, but nobody in either the home health agency or the hospice agency expected him to pass as quickly as he did -- the cancer just was not that far along yet. They thought we had at least a couple of weeks, and Papa's oncologist had said we might have two months to two years. (Papa died just ten days after he said that.)

Therefore, we feel that Papa died from heart-related issues, which may have been exacerbated by the general weakening the cancer caused -- but not from the cancer. We were told a week before he died that his liver was still working at normal capacity!

The reason it matters is that, according to the VA, if Papa died of heart disease or diabetes, then his death was service-connected and Mom is entitled to full benefits, which would be enough to live on frugally, and with my help.

If he died of the cancer, it is NOT considered service-connected, and Mom gets only about $600 a month. I will work, of course (either way) -- but I'm not sure how good a job I can get at my age.

There is a life insurance policy, but in a very small amount. That, plus withdrawing my entire 401k, would keep us afloat for less than a year.

So we need desperately for my father's death certificate to say he died of heart disease. But I learned today that his primary care doctor refuses to give that as the cause of death. And he won't even let me come talk to him and tell him what I've just told you (much of which he does not know).

I persuaded his nurse to hold off on the certificate and let me try to get the hospice agency doctor to issue it instead, with a heart-related diagnosis. Tomorrow, I have to go talk to that doctor and hope to heaven he agrees.

If I fail, all I can think to do is just try to sell the house as fast as we can, no doubt at a huge loss... because as long as we own it, we can't even qualify for welfare to keep us going until and unless I can generate enough income to carry us both -- which is not by any means a certainty.

And underlying all this is the sick feeling that we're somehow fighting to profit from my father's death, which I know is not how it is, but... you can imagine how awful it feels.

Please... if you can shed any light, point out any angle I've missed, anything... I'm just frantic. I don't know how we can survive if they do this to us.
post #2 of 14
Carol, I'm so sorry that you and your family are going through this right now. I don't have answers, but I can offer to you. Please take care of yourself and your family.
post #3 of 14
Carol, have you tried contacting your states vital records office? I'm sure they could advise you on what to do. I know you can get a court order to have info changed once it's certified. Or maybe the state medical board?
post #4 of 14
The only thing I can think of is to consult a lawyer. I'll be thinking of you and sending lots of vibes!
post #5 of 14
i wish you the best of luck.
I dont understand why, the doctor wont talk to you about the cause.
post #6 of 14
My father was a WWII vet. He was diagnosed with cancer of the larynx and died 3 years after surgery. At the time that he was dying, no hospital would take him in but the Veterans Hospital. They made his last days as comfortable as possible.

I got veterans benefits as the surviving child under 18. My Mom used that money to supplement her salary. When I turned 18 and went to college, the money came to me and helped pay my tuition. (Don't worry, Mom had enough without me at home.)

So, is the amount the veterans are giving you Mom not enough? Can you appeal to the VA? Does the cause of death matter that much these days? If I were you, I would go back to the VA and see if the cause of death doesn't need to be changed because they may still approve a higher monetary. If that fails, I might first try to write to your Congressman about your case. They are the ones who recommend you to the Armed Forces Academies. They gave my older brother a hardship early discharge because our father was dying. I would definitely start there before the lawyers.

Hope this helps and good luck!

We should all appreciate our soldiers for serving our country.
post #7 of 14
I'm so sorry that you are going through this

Ask them to perform and Autopsy to determine the cause of death.

I work a great deal with cancer patients and TBH cancer is like a time bomb. There are no guaranties as to the life expectancy of someone with cancer. Doctors can sort of estimate based on previous cases of people who had the same type of cancer, but everyone is different. Some people told "6 months' might very well live 2 years. Some told 1 year could very well die in a couple of weeks. It could very well be that he did in fact die from the cancer.

He had terminal cancer and was expected to die, so that is why they are putting that on the death certificate.

If you want a more definitive cause, push them to do an autopsy. It may however, turn out to be inconclusive for heart related problems, because Cancer ravishes the body.
post #8 of 14
With so many things wrong I don't know how they can determine a cause of death without an autopsy. However I seriously doubt it was the liver cancer which caused your Papa's death if his LFT's were normal the week before.

What is up with the PC Dr? Does he work for the VA? Was he told to alter he cause of death? I am going to assume you were authorized by your Dad to have all his medical information through HIPPA, so the Dr. can't say he isn't allowed to talk to you. Something doesn't seem on the up and up on the doctor's part.

Please do not feel like you are trying to profit off your Papa's death. That is not even in the realm of reality. This is money he earned for his family's wellbeing by faithfully serving his country.
post #9 of 14
Who is signing/signed the death certificate?
Call the oncologist's nurse and explain the situation and see if she can talk to the doctor.
Get the oncologist to talk to whoever signs the death certificate.

I believe they can list the primary cause of death and contributory factors.
post #10 of 14
Carol, I have no practical suggestions for you, but heaps of and prayers.
post #11 of 14
Saying a prayer for you both, and sending mega vibes...I agree with what others have said, I don't see how the doctor can refuse to speak with you, or to share those records, a good lawyer might be your best bet.
post #12 of 14
I think it is DISGRACEFUL the way our own US millitary treats their own when they are injured serving OUR OWN country!!!!

Then they pay worthless people in gov't, 6 figure incomes for little or NO contribution.

Cutting off health needs after a problem is a disgrace while they were on active duty or even other circumstances resulting from Service.

I was an Army wife from 1980-1984 in Ft. Knox and there was no war at that time.
Althought the Iran hostages were taken around then.
No wonder there is no MORAL in these ranks.
WE NEED to care of your own!!

One of my close friends husband was one of the first to die in Iraq when this war started a few yrs back.

How can they continue to expect quality (^her husband was Ntl. Guard and dedicated) MEN, when they are one of the LOWEST paid of the country, expected to live and DIE under these circumstances.!!!!!!!!!!!!!!!!!

Been there, seen this!

This country is not going to survive with this kind of 'Leadership'!

I don't have any answers for you Carol, but do NOT GIVE IN and do NOT GIVE UP!
Someday they WILL have to listen.

stepping off my soapbox now.....
post #13 of 14
If your father's family practice physician refuses to talk to you, you should probably have his oncologist send a certified letter (to prove that it was received) explaining about the normal liver function tests that are proof that he did not die of liver related issues. It probably wouldn't hurt to also have the hospice people do the same thing, write a certified letter describing his need for increased oxygen and need for breathing treatments before he passed away. I would try to hire a competent lawyer and fight this aggressively. Your fathers physician is being extremely unreasonable. Good luck!

Edit: Is there a specific reason why the family practice physician must fill out the death certificate? Why wouldn't the oncologist be the one, since your father was under his direct care? I'm not sure, but isn't Hospice able to do it also? Also, if he spent any time in the hospital, the hospital social workers may have some valuable advice about this particular situation. I doubt it is totally unique, they might have some insight or be able to guide you. I would talk to them and explain the situation. Good luck Carol, you and your mom are in my prayers.
post #14 of 14
Thread Starter 
I'm so glad I imposed on you good people again -- you've raised a number of points that really may help us work this out. Thank you so much!

It is strange that the primary care doctor won't even talk to us, but somebody said "Does he work for the VA," and the answer is no -- but he used to. He was a geriatric specialist for a VA hospital for years before going into practice up here. And it occurs to me now... maybe he's just determined not to invite any questions from the VA.

In fact, maybe he left the VA because of some sort of accusation. Because you're right, it makes no sense for him not even to talk with us. Maybe there's some history there, and he's just afraid of doing anything but the most obvious diagnosis. (He never saw Papa after the diagnosis -- I went to him with the X-ray report and he took one look and said, "Well, that's terminal," and told me to take Papa to the oncologist. So he had no first-hand knowledge of how Papa was doing at that point.)

Late last night, we thought of calling my uncle Larry, who is retired Air Force, and who dealt at length with the VA about his disability rating (he destroyed both knees in a parachute jump, but the VA didn't consider him disabled). He finally had to get an attorney to secure his disability compensation. I hope it won't come to that point for us, but at least we know that it can work.

And yes, there are ways to appeal decisions, even without a lawyer, but... if the death certificate shows a non-service-connected cause of death, our case is severely compromised. My uncle pointed out that, without an autopsy, they can't prove Papa died of the cancer and not the heart disease... but neither can we prove our contention. It would seem in such a case that the benefit of the doubt should fall to the widow, but... the government is not much known for its mercy, especially these days.

I'm afraid our congressperson probably wouldn't help us -- she's a Bush Republican, and all our names have appeared on a number of petitions asking her to support his impeachment. We would be persona non grata in her office.

The cause of death does matter a great deal -- it's the sole determinant, apparently, in how much of the veteran's pension while living the VA considers his widow to be entitled to after his death.

But the idea of exhuming my father's body to do an autopsy is unthinkable... he's at rest, and he will stay there, no matter what happens to us.

I think you are right that I have to talk to Papa's other doctors, and maybe to some of the home health people, too. It was his home health nurse (who had been a cardiologist in Russia) who told us his heart was becoming weaker and more unstable, and that we should see his cardiologist. The cardiologist ordered the chest X-ray that revealed the extreme emphysema and the mass in the liver, and also did the first of the blood tests that showed Papa's liver function to be normal. He and the oncologist were the last doctors to see Papa. The hospice agency doctor never actually saw him -- just provided prescriptions for the "comfort care" the hospice people do (painkillers, mostly).

I think we're going to talk to our VA rep first -- we know him, and he's been wonderful to us -- just to see if he has any ideas. Then if he agrees it's what we should do, we'll meet with the cardiologist and see if he will issue the certificate with the heart as the primary cause. And if that isn't immediately successful, maybe the oncologist would do it, or at least provide information to help support the heart diagnosis.

The trouble is, as Uncle Larry pointed out, doctors don't like to disagree with each other. If I had to guess which of Papa's doctors would be openminded enough to recognize the ambiguity of the situation and choose to lean toward the diagnosis that allows my mom something to live on, I would have guessed it would be Dr. A, the one who won't even meet with us. So my instincts are obviously no good. But between the cardiologist and the oncologist... I think the oncologist is more likely to stand up. Maybe that means we should go to him first.

I don't know I don't know I don't know what to do, but I've got to do it right now.

It just amazes me that a man can go through so much, have two pacemakers, four heart attacks, two incidents of near-fatal congestive heart failure, a six-way heart bypass, progressively weaker and more erratic heart rhythms, and intensifying dependence on oxygen... and yet when he dies, the verdict is that he died from cancer. As if he would have been just fine if only he hadn't gotten cancer.

I truly believe that if not for his heart problems, he would still be here now -- he would not have died so soon.

Thank you all for your very wise advice and your moral support. And PJK, your rant warms my heart.

I don't understand how this government can funnel billions of dollars every day into the corporate coffers of war contractors who, in many cases, aren't even doing the jobs they were supposedly hired for... but a man who spent his entire life in service to his country can't rest in peace with the knowledge that his widow will be able to survive, unless he has died of the right disease.
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