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stillhere

New Form For Dr's To Fill Out For Ihd Claims

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THANKS stillhere-

I understood months ago that this form woud be sent to most AO IHD claimants who have private medical care for their IHD and filed AO IHD claims.

The form mentions right up top that if the private doctor charges a fee for filling this out, the VA will not reimburse.

for reference:

Dyspnea means shortness of breathe

angina-chest pain defined within http://www.nlm.nih.gov/medlineplus/angina.html

Syncope fainting or loss of consciousness as defined in http://my.clevelandclinic.org/heart/disorders/electric/syncope.aspx

I wonder if I should fill this form out myself. I am the one who diagnosed and proved my husband's heart disease for FTCA case. :wacko:

This is an interesting form because it says that ECHO is only necessary when EKG and chest X ray reveal IHD.

An EKG can often state ischemia right on top of the strip yet the VA will also accept a "limited" ECHO to determine "left ventricular dimension,wall thickness and ejection fraction."

This form seems very concise on VA's part-I just hope the C & P docs also will use a similiar format.

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The actual regs and the form stillhere posted seem to rule out other secondary conditions such as stroke and HBP as potentially due to the IHD:

According to Harrison's Principles of Internal Medicine (Harrison's

Online, Chapter 237, Ischemic Heart Disease, 2008), IHD is a condition

in which there is an inadequate supply of blood and oxygen to a portion

of the myocardium; it typically occurs when there is an imbalance

between myocardial oxygen supply and demand. Therefore, for purposes of

this regulation, the term ``IHD'' includes, but is not limited to,

acute, subacute, and old myocardial infarction; atherosclerotic

cardiovascular disease including coronary artery disease (including

coronary spasm) and coronary bypass surgery; and stable, unstable and

Prinzmetal's angina. Since the term refers only to heart disease, it

does not include hypertension or peripheral manifestations of

arteriosclerosis such as peripheral vascular disease or stroke.

http://www.regulations.gov/search/Regs/home.html#docketDetail?R=VA-2010-VBA-0005

However-wit clear ct medical evidence there are secondarys that should be claimed such as:

Embolic ischaemic stroke is more frequent in patients with atrial fibrillation (80%), myocardial infarction, prosthetic valves, rheumatic heart disease and larger artery atheroma (artery-artery embolus). Most emboli are of atherosclerotic origin, and may partially or temporally obstruct cerebral arteries causing TIAs.5 Embolisms tend to be multifocal and may produce small haemorrhages around the obstruction.

archives.who.int/prioritymeds/report/.../stroke.doc

I was quite surprised this AM to see how many POWs with IHD (who were service connected for it) subsequent developed strokes and the VA denied the stroke as secondary to their SC IHD. These were old claims and there is more info on the net these days as to the relationships of IHD to stroke.

Embolic strokes are strokes from clots that form usuaully in the heart, and if the Pt has IHD, then atherosclerosis has most likely compromised the arteries ,casng a clot to form (emboli) that can go to the brain and then cause CVA.

Not all CVAs are embolic and not all are due to IHD. I see that claimants who do claim IHD with stroke as secondary will need a strong medical opinion to support the nexus.

Maybe this info will help someone.

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Is this form to be filled out by IHD vets who have filed their claims already, and had their c/p's ?

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I'm wondering the same thing about Vet's who have already filed claims for IHD/AO. My husband did not receive this form from Seattle RO, but he filed last NOV09' and it looks like the form didn't come out until May2010. He had a C & P and was sent for an Echo in lieu of a stress test so they already have this information.

I absolutely do NOT agree with the statement refuting hypertension, strokes, peripheral vascular disease not being related to IHD! VA has been adamant about hypertension not being a AO presumptive so feel they are protecting that decision with this statement.

I like the form for its brevity and concisemness. If the treating cardiologist is willing to state that the Vet has IHD and they've served time in VietNam it SHOULD be a done deal, then the rating will all depend on the severity of the disease determined by the Mets level, ejection fraction,presence of history of CHF, etc. Will save reviewers/raters lots of time if the cardiologists are willing to fill this out. They won't be having to search through years of clinical visit notes for documentation.

I'm curious as to whether the section that states "Provide only diagnoses that pertain to IHD" doesn't provide the format to include such things as Hypertension, CVA(stroke), etc.? if the doctor states these other diagnoses are caused from IHD?

This could get very interesting.

Lorraine

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I'm wondering the same thing about Vet's who have already filed claims for IHD/AO. My husband did not receive this form from Seattle RO, but he filed last NOV09' and it looks like the form didn't come out until May2010. He had a C & P and was sent for an Echo in lieu of a stress test so they already have this information.

I absolutely do NOT agree with the statement refuting hypertension, strokes, peripheral vascular disease not being related to IHD! VA has been adamant about hypertension not being a AO presumptive so feel they are protecting that decision with this statement.

I like the form for its brevity and concisemness. If the treating cardiologist is willing to state that the Vet has IHD and they've served time in VietNam it SHOULD be a done deal, then the rating will all depend on the severity of the disease determined by the Mets level, ejection fraction,presence of history of CHF, etc. Will save reviewers/raters lots of time if the cardiologists are willing to fill this out. They won't be having to search through years of clinical visit notes for documentation.

I'm curious as to whether the section that states "Provide only diagnoses that pertain to IHD" doesn't provide the format to include such things as Hypertension, CVA(stroke), etc.? if the doctor states these other diagnoses are caused from IHD?

This could get very interesting.

Lorraine

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