Ihd Exam

[jalexand]

Wow, I have already received notification of scheduled exam on my recently filed IHD AO Claim. I had filed my claim via VONAPP on June 2, 2010 and this morning while I was still in bed asleep the VA telephoned, talked with my wife and informed her that I am to appear at the Roudebush Medical Center this Saturday at 1:30 pm for an exam. This is way unusual in my view of things. I have never, ever received an appointment via telephone for anything connected with the VA, I always in the past have received notification by letter of any appointments, etc..

I have two basic questions about this exam. First, what should I expect? Will they put me through a battery of tests to determine the existence of my Heart Disease, ekg, echos, etc.?

What should I take with me to this exam? My heart disease dates back to 1985 with having received 10 angio-plasties over the years and having suffered a major Myocardio Infarction (MI) in 1993. However, so far I have only managed to obtain my most recent medical records from my current Cardiologist who I have only been seeing since 2006. I have looked through these records and while there are a bunch of references to "Myocardial Infarction" and contain test report documents referring to my "Ejection Fraction" being 35-40%, etc., I have not read the term "Ischemic Heart Disease" anywhere. Also, what I hvae are just test reports, there are no narratives what-so-ever. As I indicated, my disease goes back to 1985 and as a result my records are scattered all over the place where I have received treatment over the years. I contacted the Hospital where I was first treated for my MI back in '93 and they have informed me that they have NO RECORDS of my treatment as they are only required to keep records 7 years and all previous records have been destroyed.

Actually my Heart Disease should be pretty obvious to anyone who looks at an EKG or does an Echo Cardiogram on me, but will the VA do this or is it up to me to proove the disease exists?

Thanks in advance for any help or advice.

Jim

[Donna]

My husband has a AICD implant since 2004. I wonder what testing they will be able to do on him. His Ischemic Heart disease reached a level of needing a defibrillator implant. His diagnosis in Ischemic cardiomiopathy and CAD. Scheduled for an device check tomorrow with private cardiologist.

[jalexand]

I had this exam back in Feb. Most of the report that the examiner stated came from my private cardiologist.

Answer only the questions that are asked of you. Do not volunteer information. I tend to ramble on and it has jumped up bit me in the butt !!

They are looking for METS and LFV's. It would be good if your records stated IHD, but I think MI,s and stents, along with CAD will meet the threshold for IHD. But that is my personal opinion. No test were performed or ordered due to the fact that I have been using VAMC for heart doctor and most of records were in treatment notes. In and out in less than a hour.

I was also asked "how has this affected you and your daily living"? I ended up with a METS level of 3 or less and a LV of 46. This should put me in the 100% rating if they use the METS, which I think they do.

Also, have you been denied for this in the past, because Nehmer will effect a lot of veterans.

And your test results have to be less than a year old. Dave

Understand what you are saying here about "volunteering" too much info., I like you tend to ramble on way too much. ALso the matter of giving too much information bothers me also. Even though the "presumptive" in this proposed compensation award is there, I too worry about being denied for other reasons. Such as, I just read throught the Narratives I received from my Cardiologists records I received and under diagnosis it mentions such things as "Family History" - Ischemic Heart Disease, "Family History" - stroke, and actually uses the terminology "Abuses Tobacco" - yes I have smoked on and off over the last 40 years. But it is this same narrative that describes in some detail my past history of IHD, including history of Myocardial Infarctions in 1985, '91, '93 and '95., etc. So, should I turn these records over to the VAMC tomorrow or not? Obviously it will be easy for them to obtain them anyway and it probably may be necessary to proove my disease? I also have records of test results over the last couple of years that report my MET's at 2.0 and my ejection fraction at 35-40%.

Heck I don't know, can they determine that I have IHD just by doing simple tests like an EKG? (me ekg is quite abnormal due to infarct damage) Maybe I don't have to provide any of my private doctors records?

Jim

[jalexand]

I had this C&P exam regarding my AO-IHD claim at the Indianapolis VAMC last Saturday and I thought I would pass along my experiences regarding same. I arrived on time for the exam and ended up having to wait about half an hour to be seen. I finally was called to an examination room and introduced to a VA Doctor who said she was going to conduct the exam and it would entail only a few questions that I need to answer followed by a physical examination.

As she sat at a computer console where she was typing in my answers she began by inquiring as to when I first began having heart problems. I explained to her that my first onset had been back in 1985 and that over the course of the following years I had many events that involved hospitalization, mainly in St. Vincents Hospital in Indianapolis and that I had undergone some 10 angio-plasties over the years and had suffered a major Myocardial Infarction in 1993 which left me with 40% heart damage. The doctor inquired as to what hospital I had gone for my very first episode and I told her it was to a local hospital in my home town but that I was subsequently transferred to Indianapolis for treatment. I also explained to her that I had contacted this hospital several weeks ago in attempt to gather any medical records of the incidents, including records of my ER visit in '93 when I suffered the MI as I was first treated in that facility, but again subsequently transferred to St. Vincents in Indy and that I had been informed that as the hospital only keeps records for 7 years none of those records were available. About her only comment during this portion of the interview was something like "Wow, so you were only 37 when you had your first attack?"

The interview continued and she asked about my current treatment and what medication I was taking. As I had obtained records of my past couple of years treatment from my cardiologist, I offered her copies of my latest stress tests, which show my EJ at 28% and my METs at 2.00. a copy of my latest EKG and also a current copy of all of my medications. I also indicated to her that I was scheduled for additional testing this month as my last visit to my cardiologist revealed a change in my EKG about which my cardiologist was concerned. The doctor seemed very pleased that I had brought copies of these records and indicated to me that these would serve to greatly enhance my claim. She also indicated a desire that I have the record of my upcoming stress testing FAXed to her and said that this would suffice to avoid my having to come back to the VAMC to have this testing performed.

At that point the interview portion of the exam concluded and the doctor then performed the physical part of the exam. This is where I thought it rather strange as all she did was take my blood pressure, weight and listened to my heart for a few seconds. No EKG, nothing. In fact the "exam" probably did not last more than 4 minutes.

The entire interview/exam probably did not last longer than about 15 minutes. No questions about risk factors, I thought for certain I would be questioned on things like smoking, family history, work history, etc. etc., but nothing was asked along those lines at all!

I must say that the whole thing was surprising in it's simplicity and to call it an "exam" would be stretching it quite a bit in my mind. But, who am I to question things?

Jim

[Berta]

"I offered her copies of my latest stress tests, which show my EJ at 28% and my METs at 2.00. a copy of my latest EKG and also a current copy of all of my medications. " I am sure she appreciated this info and maybe this is why the exam didnt take too long.

You should request a copy of the actual results as soon as the exam is typed up and this would give you a leg up as to the outcome of the claim.

[jalexand]

"I offered her copies of my latest stress tests, which show my EJ at 28% and my METs at 2.00. a copy of my latest EKG and also a current copy of all of my medications. " I am sure she appreciated this info and maybe this is why the exam didnt take too long.

You should request a copy of the actual results as soon as the exam is typed up and this would give you a leg up as to the outcome of the claim.

Berta,

I am not sure what you are referring when you say I should ask for a copy of the "actual results" Are you talking about the results of the VAMC exam? If so, how do I go about requesting a copy of the exam results?

By the way, I was going to ask this in a separate post, but I will address it here also. I had requested a copy of my "C" file about a month ago and while I received an acknowledgement of that request I have still not received anything else from the VA. How long should it take for me to receive this information from the VA?

Jim

[Berta]

I don't know how long the C file copy will take. If you ask them via Iris (the VA web site Contact us area at www.va.gov) maybe they will have some idea.

You can write and ask for a copy of the C & P results -send the letter to the VAMC where the exam occurred- or ask the Privacy Act Records Access Person there if they have a form you can fill out to get a copy when it is typed up.