Is Low Balling The Future Of Ihd Claims?

[N4XV]

After 20 years of no significant improvement. Since the announcement of IHD to become a presumptive my heart condition has gotten better.

All these tests were performed at the same VAMC

From Chemical Stress Test study performed on 01/27/05.

Impression:

1. Abnormal adenosine myocardial perfusion scan.

Nontransmural infarction of the inferior wall from apex to base

with potential ischemia of the residual viable myocardium

primarily in the apical half of the infarct zone. Potential

ischemia in the adjacent inferolateral wall from apex to base.

2. Mildly depressed resting left ventricular systolic function

with an ejection fraction of 46%. ( I figure this impression to be worth at least a 60% rating)

From Chemical Stress Test study performed on 11/14/2008.  

Impression:

1. Abnormal adenosine myocardial perfusion scan. Potential

ischemia in the inferior, inferolateral, and lateral walls from

apex to base superimposed on inferior wall scar with an element

of post stress "stunning" in the potentially ischemic zone.

However, findings are similar to hard copy images of previous

study performed on 01/27/05.

2. Globally reduced left ventricular systolic function with an

ejection fraction of 42-45%. ( I figure this impression to be worth at least a 60% rating)

From ECHO-DOPPLER REPORT (Echocardiogram) performed on 01/07/2010 for a C&P exam in connection with my recent IHD claim under the new AO presumptive.

Impression:

LV systolic function is preserved. Estimated ejection fraction is 50-55%.

LV wall thickness shows mild concentric left ventricular hypertrophy.

LV wall motion abnormality was noted, suggestive of CAD.

Grade II diastolic dysfunction is present

  ( I figure this impression to be worth no more than a 30% rating)

I also had an Electrocardiogram (EKG) performed on 03/05/2010 that said - Abnormal EKG and possible Inferior Infarction. But the VA cardiologist said my heart condition had improved since 11/14/2008 yet warranted an increase in dosage of two of my heart meds. 

Before 1991 I had 4 heart attacks and a triple bypass. Now since there has been no real changes in my life style or improvement shown in my heart condition for the past 19 except for a Transient Ischemic Attack (TIA or silent stroke) in Feb. of 2008 it makes me wonder if the powers that be in the claims part of the VA are somehow influencing the interpretations of tests and exams for new IHD claims under the new presumptive due to AO exposure.

[N4XV]

I am rated 60% for CAD by the VA. I have never seen a VA cardiologist. My C&P was done by a PA. I have seen a private cardiologist on my own dime. I believe the VA thinks that the PCP can DX and treat all illnesses from PTSD to heart disease. I don't know if the VA will low ball IHD due to AO. I do know they low ball all most every other injury or disease. The heart cath is really the only way to know for sure about the extent of heart disease. The cath has risks of its own. I don't want the VA running a wire into my heart. I will pay to have the best heart surgeon in my city to do it. I don't want a first year resident putting a hole in my aorta by mistake.

john999,

I agree with you 110% but am financially stuck between a rock and a hard place as my wife and I are raising our two grandchildren on just my SSDI and 30% VA comp. Mortgage and living expenses eats up just about all of that. We get no support from the state or the parents of our grandchildren. So my only option for private medical is through a medicare HMO. Hopefully it is not near as screwed up as the VA system.

[Berta]

Along with Secretary Shenseki's bright idea last week of an "automated claims system" that would take a year to set up- in order to process the new IHD claims-more efficiently (yeah right)

I can guarantee that:

"it makes me wonder if the powers that be in the claims part of the VA are somehow influencing the interpretations of tests and exams for new IHD claims under the new presumptive due to AO exposure."

your wondering here will probably come to pass as eventual Fact.

They wont even publish the IHD regs for pubic comment yet so that has been a red flag for me to consider.

And scuttlebutt in the vets advocate network suggested that if a vet wth IHD also has smoking history-that right there might help the VA deny many IHD claims.Even though the gov put them into your rations decades ago-guaranteeing nicotine addiction could occur.

I assume you are a Blue Water Vet?

Have you proven you were in Vietnam in case HR 2254 doesnt get passed?

[N4XV]

I think that the important thing is to get SC for IHD for your spouse to get something when you kick it. I am diabetic and I think I read somewhere that 2/3's of all diabetics die from heart disease.

Bill

Bill, 

I am almost certain heart disease or a stroke is what will take me out. Infact I am amazed I made it this long. In early to mid 1990, 6 months before my 4 the heart attack ( the one that took me out of the work force and cinching SSDI), one cardiologist (not VA) told me he predicted that with in 4 years I'd suffer a massive heart attack I would not survive. Boy, am I glad he was soooooo wrong

[N4XV]

Along with Secretary Shenseki's bright idea last week of an "automated claims system" that would take a year to set up- in order to process the new IHD claims-more efficiently (yeah right)

I can guarantee that:

"it makes me wonder if the powers that be in the claims part of the VA are somehow influencing the interpretations of tests and exams for new IHD claims under the new presumptive due to AO exposure."

your wondering here will probably come to pass as eventual Fact.

They wont even publish the IHD regs for pubic comment yet so that has been a red flag for me to consider.

And scuttlebutt in the vets advocate network suggested that if a vet wth IHD also has smoking history-that right there might help the VA deny many IHD claims.Even though the gov put them into your rations decades ago-guaranteeing nicotine addiction could occur.

I assume you are a Blue Water Vet?

Have you proven you were in Vietnam in case HR 2254 doesnt get passed?

Berta, 

I am a verified Brown Water in country Vietnam Vet. I am already SC for DMII due to AO exposure since 2001 but was denied SC for CAD because I was DX'd with CAD before being DX'd with DMII.

I agree the longer the VA draws out the publishing of the new regs makes us think they are coming up with ways to limit as many new IHD claims as possible. But then to bring life style choices into the mix for IHD and not everyother persumptive disease or condition in the past that life style choices could have been considered risk factors would really open up a can of worms. The VA could then deny or recind granted claims for an AO presumptive such as lung cancer because the veteran had a history of smoking or the same for DMII because the veteran is obese. All hell would break loose. I might way wrong about this but life style choice risk factors just increase the chance, where as the presumptive is considered the cause. IMHO

[john999]

Berta

I get the feeling that the VA is stalling on IHD with knowledge that many vets will die while they construct this knew system. Less living vets, less compensation. This is all they think about is saving money at our expense.

[JRW]

I agree with you on the lifestyle part. I really don't expect the VA to attach lifestyle restrictions to the new presumtions being added to the Agent-Orange list. There is already enough precedent on prior Agent Orange claims from veterans where life style, or even family history for that matter, does not play a part in the awarding and or determination of the percentage of disability.

I do wonder, however, if they (VA) are taking a closer look at the many various secondary conditions that may be resulting from the new presumptions, especially IHD, and determining what the legal response will be, and or the granting of additional disability from such. If you think about it, announcing that IHD is presumtive for Vietnam veterans is a major inclusion to the Agent-Orange list. Of all the previous illnesses that have been added to this list, this one is, in my opinion, the "the grandaddy of them all." This could be a reason for the time it is taking to post the comments for review and ultimate insertion into the Federal Register.

I do think that if you have clear-cut and unequivocal evidence of IHD, your case will be a matter of determining the rating percentage. Now, on the other hand, if you are trying to prove that you have IHD as a Vietnam veteran, and are relying strictly upon the VA health system to validate such claim, there is where the "rubber hits the mat." Now, I am not saying that the VA health system would intentionally lowball the severity or deny an illness. But, as I stated in a previous post, if you can afford the services of a private heart PCP, who can run the necessary tests and conclude one way or the other, you will be ahead of the game. Having private medical records to validate this illness to me, kind of levels the playing field.

This is just my two cents worth. I'm not an expert, but I do a lot of reading and digesting of what I read up on.