hypertension Agent Orange - Secondary

[BILLYBOB]

In November of 2009, I applied for compensation based upon agent orange exposure while I was in Vietnam with the Army in 1967 - 68. I have had heart disease since 1989. I also claimed vestibular hypofunction, stroke and hypertension as secondary. All of these ailments are caused by endothelial damage to the arteries as is IHD. I finally had a C&P in August 2010 for all the condtions claimed. Each VA physician or health care professional I saw confirmed and stated in the C&P report that all health problems I claimed were at least as likely as not caused or aggravated by exposure to agent orange. My Board Certified private cardiologist of 20 years also stated the same in a letter he personally wrote to the VA.

Today, Oct 10, 2010, I received a rating decision from the Cleveland Ohio VA. I quote as follows - "Decision - A decision on entitlement to compensation for ischemic heart disease is deferred. Service connection for vestibular hypofunction, stroke and hypertension is denied". The decision also states the following: "PLEASE NOTE: As you claimed secondary service connection for hypertension, vestbular hypofunction, and stroke, the disabilities will be reconsidered on a secondary basis following finalization of the new additions to 38 CFR 3.309(e), which establish ischemic heart disease as a presumptive disability of herbicide exposure".

In regards to the PLEASE NOTE above - I thought this had already been completed so I went to 38 CFR 3.309(e) and confirmed that the three new presumptives are already there. How could the rating officer not know the CFR has already been updated? When does the mental torture stop? Does anyone know what's going on? Has anyone else received anything like this recently? Do I now have to go back in and ask the VA to reconsider the secondary basis conditions or will they automatically do this? By the way, they told me how to appeal in the same letter although the letter states the IHD is deferred and the secondary conditions will be reconsidered. Wonderful - after a year, I still don't know whats going on. Any suggestions on what to do now???

[N4XV]

In November of 2009, I applied for compensation based upon agent orange exposure while I was in Vietnam with the Army in 1967 - 68.  I have had heart disease since 1989. I also claimed vestibular hypofunction, stroke and hypertension as secondary.  All of these ailments are caused by endothelial damage to the arteries as is IHD.  I finally had a C&P in August 2010 for all the condtions claimed.  Each VA physician or health care professional I saw confirmed and stated in the C&P report that all health problems I claimed were at least as likely as not caused or aggravated by exposure to agent orange.  My Board Certified private cardiologist of 20 years also stated the same in a letter he personally wrote to the VA.  

Today, Oct 10, 2010, I received a rating decision from the Cleveland Ohio VA.  I quote as follows - "Decision - A decision on entitlement to compensation for ischemic heart disease is deferred.  Service connection for vestibular hypofunction, stroke and hypertension is denied".  The decision also states the following: "PLEASE NOTE: As you claimed secondary service connection for hypertension, vestbular hypofunction, and stroke, the disabilities will be reconsidered on a secondary basis following finalization of the new additions to 38 CFR 3.309(e), which establish ischemic heart disease as a presumptive disability of herbicide exposure".  

In regards to the PLEASE NOTE above - I thought this had already been completed so I went to 38 CFR 3.309(e) and confirmed that the three new presumptives are already there.  How could the rating officer not know the CFR has already been updated?   When does the mental torture stop?  Does anyone know what's going on? Has anyone else received anything like this recently? Do I now have to go back in and ask the VA to reconsider the secondary basis conditions or will they automatically do this?  By the way, they told me how to appeal in the same letter although the letter states the IHD is deferred and the secondary conditions will be reconsidered.  Wonderful - after a year, I still don't know whats going on.  Any suggestions on what to do now???

BILLYBOB, the claim is deferred because VA can't do anything on the IHD claim until the 60 day delay is over and that will be Oct 30th. Then they can rate claims and start payments. If granted you will be paid back to your claim date. In the interim they are supposed to be developing claims up to the rating stage. There had been some controversy about the CRA and the general consensus is it will have no effect on the three new presumptives going through. But even in the new Fed. reg it states they have to wait the full 60 days, because it is a major rule, before they can actually begin rating decisions. The fact that you had filed back in 11/09 I would think your claim for IHD and the secondaries are pretty much developed and waiting on the rating process to begin shortly after Oct 31. Just hang in there a little longer. You are not alone with the frustration and waiting. There should be a flood of decision letters coming out in Nov.   

[Chuck75]

It boils down to this--

The VA denied a part of your claim. Even though Nehmer forces them to reconsider the denials, you should file an NOD. The VA is likely trying to say that as secondaries they are included in IHD. This is not necessarily true, and it make take a lawyer to show them the error in their ways.

Next, the 60 day bit or not, the law behind the new presumptives is currently in force, and will remain so unless and until congress votes to change the laws governing the secretaries authority. (Ain't gonna happen, in my opinion)

The 60 day bit may prevent the VA from paying until November, but it does not prevent claims processing. Evidently, some VAROs are processing and awarding claims, and sending out notices that end with something to the effect that payment, etc. cannot commence until November. The money is in place to pay the claims, since it was included in the advance VA funding. Hypertension can have many causes-- among them is coronary artery disease (CAD), one of the causes of IHD.

Coronary Artery Disease can easily aggravate Hypertension. Common treatments for CAD include stints, balloon angioplasty, and Bi-pass. All of these tend to reduce hypertension when blood flow to the heart is increased.

In November of 2009, I applied for compensation based upon agent orange exposure while I was in Vietnam with the Army in 1967 - 68. I have had heart disease since 1989. I also claimed vestibular hypofunction, stroke and hypertension as secondary. All of these ailments are caused by endothelial damage to the arteries as is IHD. I finally had a C&P in August 2010 for all the condtions claimed. Each VA physician or health care professional I saw confirmed and stated in the C&P report that all health problems I claimed were at least as likely as not caused or aggravated by exposure to agent orange. My Board Certified private cardiologist of 20 years also stated the same in a letter he personally wrote to the VA.

Today, Oct 10, 2010, I received a rating decision from the Cleveland Ohio VA. I quote as follows - "Decision - A decision on entitlement to compensation for ischemic heart disease is deferred. Service connection for vestibular hypofunction, stroke and hypertension is denied". The decision also states the following: "PLEASE NOTE: As you claimed secondary service connection for hypertension, vestbular hypofunction, and stroke, the disabilities will be reconsidered on a secondary basis following finalization of the new additions to 38 CFR 3.309(e), which establish ischemic heart disease as a presumptive disability of herbicide exposure".

In regards to the PLEASE NOTE above - I thought this had already been completed so I went to 38 CFR 3.309(e) and confirmed that the three new presumptives are already there. How could the rating officer not know the CFR has already been updated? When does the mental torture stop? Does anyone know what's going on? Has anyone else received anything like this recently? Do I now have to go back in and ask the VA to reconsider the secondary basis conditions or will they automatically do this? By the way, they told me how to appeal in the same letter although the letter states the IHD is deferred and the secondary conditions will be reconsidered. Wonderful - after a year, I still don't know whats going on. Any suggestions on what to do now???

[Berta]

I see this differently than CHuck does-

Maybe I need more coffee-

I dont see any denial here-nor any cause to file a NOD

If you were denied in the past for the IHD -make sure VA is aware of the date of the past denial.and email NVLSP (I posted their AO addy in another topic)

Your claim is similar to mine.My husband died of ischemic heart disease with multiple cerebral ischemia contributing.

I spelled that out carefully in the claim so they do not miss his secondary and 100% disabling CVA and HBP.

I was thinklng the other day-when the regs were posted for public comment ( and my comment was referred to in the final reg analysis if anyone read the extensive info from VA on that as I questioned some figures they used regarding Nehmer)

that the amount of retro VA will pay might well be much higher than they thought for reasons like your claim and mine-

These regs for IHD open the door for more secondarys like CVAs and HBP that might generate a lot of retro that VA never considered.

IHD from AO could even "aggravate" NSC disabilties in some vets, so more comp potential there too.

VA loves to say a vet's HBP is "essential" meaning no known cause but Chuck is right-one cause is IHD and if not properly controlled the HBP from IHD can lend to stroke.

And vets have to make sure their IHD claims include these secondary conditions as due to AP induced IHD -otherwise VA will ignore them.

[BILLYBOB]

Berta, I did include all the information you suggested in my original claim. My current plan is to wait until the decision on IHD is made in November. My METS is 3-4. After I receive that determination and I find out if they really are going to revisit my claims for hypertension, stroke, and vestibular hypofunction, then I will appeal if necessary. The current decision denies all but IHD because of the lack of service connection. I feel, as you do, that all of these ailments are related to the same process in the body. That process is the destruction of endothelial cells which leads to artery damage. This damage is not just in the heart but throughout the body. I know my layman opinion means nothing to the VA but I will submit a NOD as soon as I get the IHD rating in Novemeber. Thank you and everyone else for the feed back. Any other thoughts on this problem are welcome.

I see this differently than CHuck does-

Maybe I need more coffee-

I dont see any denial here-nor any cause to file a NOD

If you were denied in the past for the IHD -make sure VA is aware of the date of the past denial.and email NVLSP (I posted their AO addy in another topic)

Your claim is similar to mine.My husband died of ischemic heart disease with multiple cerebral ischemia contributing.

I spelled that out carefully in the claim so they do not miss his secondary and 100% disabling CVA and HBP.

I was thinklng the other day-when the regs were posted for public comment ( and my comment was referred to in the final reg analysis if anyone read the extensive info from VA on that as I questioned some figures they used regarding Nehmer)

that the amount of retro VA will pay might well be much higher than they thought for reasons like your claim and mine-

These regs for IHD open the door for more secondarys like CVAs and HBP that might generate a lot of retro that VA never considered.

IHD from AO could even "aggravate" NSC disabilties in some vets, so more comp potential there too.

VA loves to say a vet's HBP is "essential" meaning no known cause but Chuck is right-one cause is IHD and if not properly controlled the HBP from IHD can lend to stroke.

And vets have to make sure their IHD claims include these secondary conditions as due to AP induced IHD -otherwise VA will ignore them.