re-evalutation of temp 100% ischemic heart disease

[joe appel]

Have a question:

Am 70 years old, served in Navy 66-70, was in SAR (search and rescue) helicopter squadron from 68-69, did 3 3-4 month tours in Nam . Got triple-bypass in October of last year, and VA awarded me temporary 100 disability in Feburary of this year.  The awards letter states that I will be re-evaluated Jan of 2019. 

Anyone have any experience with this, meaning at my age could they lower it. I was told by a few doctors that there is no cure for coronary artery disease, and chances of lowering the 100% is slim.

 

Edited February 25, 2018 by joe appel
missed informaqtion

[Gastone]

After BPass surgery, A CAD SC Vet receives 100% Comp post surgery for X (3 or 6) number of months, then the Rating goes to 30%, which is the 38 CFR 4 Scheduler rating for CAD with B-Pass surgery.

You're 70 and you don't indicate any other SC Conditions. Don't rely on what your Drs say about Ratings, that's not their area of expertise. Were you retired an how long, pre CAD Surgery?

B-Pass Surgery 10/2017, you should be coming up on your 93) month post surgery eligibility for Cardiac Rehab, what does your Cardiologist have to say about the Rehab?

That 100% for CAD is dependant on the results of a Diary Dated Re-Exam consisting of an Echo Cardiogram and/or a Nuclear Stress Test.

You get a chance, give us a rundown on any other SCs you've been Awarded.

[Berta]

These BVA decisions hold some rating info:

2.  The criteria for a 100 percent rating for CAD, status 
post bypass surgery associated with hypertension, have been 
met effective April 28, 2005, but the criteria for a rating 
greater than 60 percent prior to this time have not been met.  
38 U.S.C.A. §§ 1155, 5107(b) (West 2002); 38 C.F.R. §§ 4.1-
4.14, 4.104, Diagnostic Codes (DC's) 7005, 7017 (2008).

https://www.va.gov/vetapp09/files1/0909390.txt

Also this case states:

"The Veteran was granted his 30 and 60 percent disability 
ratings under 38 C.F.R. § 4.104, Diagnostic Codes 7005 and 
7019.  Diagnostic Code 7005 is for arteriosclerotic heart 
disease (coronary artery disease) and Diagnostic Code 7017 is 
for coronary bypass surgery.  

Under 38 C.F.R. § 4.104, Diagnostic Code 7005  and Diagnostic 
Code 7017 have the same rating criteria with the exception 
that Diagnostic Code 7017 allows for a 100 percent disability 
rating for three months following hospital admission for 
surgery.  Under 38 C.F.R. § 4.104, Diagnostic Code 7005 and 
Diagnostic Code 7017 a 10 percent disability rating is 
warranted when workload of greater than 7 METs but not 
greater than 10 METs results in dyspnea, fatigue, angina, 
dizziness, or syncope, or; when continuous medication is 
required.  A 30 percent disability rating is warranted when 
there is workload of greater than 5 METs but not greater than 
7 METs results in dyspnea, fatigue, angina, dizziness, or 
syncope, or; evidence of cardiac hypertrophy or dilatation on 
electrocardiogram, echocardiogram, or X-ray.  A 60 percent 
disability rating is warranted when there is more than one 
episode of acute congestive heart failure  in the past year, 
or; workload of greater than 3 METs  but not greater than 5 
METs results in dyspnea, fatigue, angina, dizziness, or 
syncope, or; left  ventricular dysfunction with an ejection 
fraction  of 30 to 50 percent.  A 100 percent disability 
rating is warranted when there is chronic congestive heart 
failure or; workload of 3 METs or less results in dyspnea, 
fatigue, angina, dizziness, or syncope, or; left ventricular 
dysfunction with an ejection fraction of less than 30 
percent.  

Note (2) states that if a laboratory determination of METs by 
exercise testing cannot be done for medical reasons, and 
estimation by a medical examiner of the level of activity 
(expressed in METs and supported by specific examples, such 
as slow stair climbing or shovelling snow) that results in 
dyspnea, fatigue, angina, dizziness or syncope may be used."

https://www.va.gov/vetapp09/files2/0913774.txt

Both above cases considered the veteran's hypertension and show how the ratings are dependent upon ECHO results.

You mentioned Vietnam.

Did you ever file  a past claim for CAD that VA denied?

Reason I ask- CAD ( ischemic IHD ) is an Agent Orange presumptive.

 

 

 

[broncovet]

Berta and Gastone have given great, detailed advice.  

While this is apparently a temporary rating (convalescent), the VA normally does not do a reduction exam for people over 55..it even says so in the regulations.  

Its probably best if you consider this will be temp for a few months, but I still think the VA will have difficulty lowering the rating for someone 70 years old, just in principal, reiterating that they are not supposed to call for a reduction exam in someone over 55.  

All this said, if this is a "convalescent" rating, then it automatically goes down after a hospital recovery period.  

[broncovet]

Given they have apparently scheduled a reduction exam in Feb. 2019, this would indicate its not a temporary convalescent rating.   Did you get backpay to Oct. 2017?  This would indicate to me its not a convalescent rating but rather a temporary one.  

Again, unless this is convalescent, I doubt they would lower a 71 year old's rating because he improved.  Remember, VA comp is designed to replace your potential income, so what kind of work can a 71 year old with a coronary bypass do?  

[broncovet]

Its my "opinion" that scheduling an exam in Feb. 2019 is likely a mistake, and this could even be caught later.  You need to understand not all these VA employees are well trained, and this one simply may not have noticed you were 70 and keyed in a scheduled re exam.  

Several years ago, the VA got some trouble because they keyed in re exams then never completed them, sometimes for 10 or more years.  So, they may have to give you a re exam.  

[joe appel]

3 hours ago, Berta said:

These BVA decisions hold some rating info:

2.  The criteria for a 100 percent rating for CAD, status 
post bypass surgery associated with hypertension, have been 
met effective April 28, 2005, but the criteria for a rating 
greater than 60 percent prior to this time have not been met.  
38 U.S.C.A. §§ 1155, 5107(b) (West 2002); 38 C.F.R. §§ 4.1-
4.14, 4.104, Diagnostic Codes (DC's) 7005, 7017 (2008).

https://www.va.gov/vetapp09/files1/0909390.txt

Also this case states:

"The Veteran was granted his 30 and 60 percent disability 
ratings under 38 C.F.R. § 4.104, Diagnostic Codes 7005 and 
7019.  Diagnostic Code 7005 is for arteriosclerotic heart 
disease (coronary artery disease) and Diagnostic Code 7017 is 
for coronary bypass surgery.  

Under 38 C.F.R. § 4.104, Diagnostic Code 7005  and Diagnostic 
Code 7017 have the same rating criteria with the exception 
that Diagnostic Code 7017 allows for a 100 percent disability 
rating for three months following hospital admission for 
surgery.  Under 38 C.F.R. § 4.104, Diagnostic Code 7005 and 
Diagnostic Code 7017 a 10 percent disability rating is 
warranted when workload of greater than 7 METs but not 
greater than 10 METs results in dyspnea, fatigue, angina, 
dizziness, or syncope, or; when continuous medication is 
required.  A 30 percent disability rating is warranted when 
there is workload of greater than 5 METs but not greater than 
7 METs results in dyspnea, fatigue, angina, dizziness, or 
syncope, or; evidence of cardiac hypertrophy or dilatation on 
electrocardiogram, echocardiogram, or X-ray.  A 60 percent 
disability rating is warranted when there is more than one 
episode of acute congestive heart failure  in the past year, 
or; workload of greater than 3 METs  but not greater than 5 
METs results in dyspnea, fatigue, angina, dizziness, or 
syncope, or; left  ventricular dysfunction with an ejection 
fraction  of 30 to 50 percent.  A 100 percent disability 
rating is warranted when there is chronic congestive heart 
failure or; workload of 3 METs or less results in dyspnea, 
fatigue, angina, dizziness, or syncope, or; left ventricular 
dysfunction with an ejection fraction of less than 30 
percent.  

Note (2) states that if a laboratory determination of METs by 
exercise testing cannot be done for medical reasons, and 
estimation by a medical examiner of the level of activity 
(expressed in METs and supported by specific examples, such 
as slow stair climbing or shovelling snow) that results in 
dyspnea, fatigue, angina, dizziness or syncope may be used."

https://www.va.gov/vetapp09/files2/0913774.txt

Both above cases considered the veteran's hypertension and show how the ratings are dependent upon ECHO results.

You mentioned Vietnam.

Did you ever file  a past claim for CAD that VA denied?

Reason I ask- CAD ( ischemic IHD ) is an Agent Orange presumptive.

i had a stent put in in 2005. I applied in April 2017 at the suggestion of friends that the stent is probably related to AO. The VA sent me to a Dr. in Aug, 17 and he said the stent was definitely AO related. They gave me a 0% rating in Sept of 2017. In Oct 2017 I had triple Bypass, and the VA re opened the case and changed the rating to 100% temporary.