vern2

Hello. I had been using the Health eVet web site to access my VA notes from my C & P exams, but for last two weeks have been unable to download VA notes.Finally called the help desk and was told they are aware of issue but will take at least 3-4 weeks to resolve problem. Funny, this happened after I complained about the C & P exam. Has anyone else had this probblem? Vern

I sent certified mail to VA calling CUE on an old claim settled in April 2007 on August 29, 2013. How long does the VA have to respond? Or is there a time limit on their response? this is my first CUE, so not sure how the process works. Vern

Asknod, what is the title of your book? I have several books, but would like yours.

I have had my 2 cardio doctors fill out the DBQ and do separate letter, one was military and other was private doctor.

Health e Vet or the FOIA office.

I also have CHF and CAD, filed claims on those as well

I have two IMO, plus they also did the DBQ and reached different conclusions than that idiot MacDonald! What makes my C & P more interesting is that I filed a complaint againt the last person that did my C & P last year as same medical facility. We all know that the Examiners are completely unbiased and professional- just joking!

My c & p examiner noted that reason for my chf was not the sc htn but my age (64) and that the chf was a natural age progression. He states this on 2 of my contentions. I am seeking increase for current 30% htn rating, due to atrial fibrillation and chf. He claims the Afib is more in keeping with non-service cardiac conducting system dysfunction. Not sure how to rebutt this assertion, but htn does get progressively worse with time, claimdate is retro to May 2003- DRO granted 30% in April 2007, so only 6 years have elapsed frm date of award. Looked at 4.19 and it appears age can be used, exceptfor TDIU. ANY IDEAS?

Berta, I wish I had the actual Echo, all I have is the report and the doctor's office stated that they destroyed all old files. Cool Breeze, thanks for the advice. I received 30% for pulmonary HTN and a simple reading of the facts/evidence shows that should have been rated at 60% back then. I will file my CUE this week. Agreed, every word is vital when dealing with VA. This agency tends to lose files, transpose words to suit their denial, etc. Wish I could afford a lawyer to do this task, but it will be me!

Berta, I really appreciate your and Jbassers help. Ok, let me post the page from the decision and also a copy of the evidence that the DRO used in arriving at this decision. It appears that the DRO used one part-dilated heart, but ignored the EF of about 50% in arriving at the decision. See Attachments. This is clearly an error. The higher rating should have been used per CFR 38. extract from my CUE letter: This CUE error is not a disagreement on evaluation of evidence or difference of opinion. This is not a disagreement as to how the facts were weighed or evaluated. The error was made in determining the degree of disability based on the available evidence. (38 CFR 3.105(a)). Disability evaluations are determined by application of the VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity as a result of enumerated disabilities. 38 CFR 4.7 states where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Since I had both dilation of the heart AND 50% Ejection Fraction I should have been granted 60% disability rating.

My profile is wrong, should be 30% , not 20%. The VA used an analogous rating for hypertensive heart disease. At this time in 2003, I had out of control htn, for over 15 months. Since then my health has gotten much worse, and the htn has attacked my heart. Cardiac ablation in May for atrial fibrillation/ flutter, for which I have also filed a claim for increase. Not sure what a VA SRD is? The paperwork that I received quoted 38 CFR, and that was all. I had to research to find out how they came up with the 30%.

No, the echo stated "about 50%", never saw this before either.

I was granted 30% service connection for mild pulmonary hypertension in 2007. The VA granted me 30% compensation due to fact I had evidence of cardiac hypertrophy or dilation on electrocardiogram, or echocardiogram, or X-ray as revealed on the echocardiogram dated XXX. by Dr. XYZ. A further reading of the reasons stated: “left ventricular dysfunction with an ejection fraction of 30 to 50 percent” would be reason to grant the claimant 60%. The Echocardiogram clearly stated that I had an EF of about 50%, thus the error was made. My question is was a CUE committed by the DRO in arriving at this decision? He used part of the evidence to grant me 30%, but the entire evidence showed that I should have been granted 60% based on the VA schedule of ratings. Is this a mere difference of opinion or evaluation or is this a real CUE? §4.104 Schedule of ratings—cardiovascular system. 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.................. 60 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.................................................................................... 30 This schedule was updated in 2006, and decision was not made until 2007, so has not changed. I am unsure as to what to do, seems like a CUE, but want the mor experienced members input before I proceed with a CUE letter. Vern2

J and Meg: the original claim granted me SC for hypertension with mild pulmonary hypertension. The VA stated that evaluated the condition analogous to hypertensive heart disease based on fact I have assocciated pulmonary hypertension with confirmed evidence of dilation of the heart. The connection has already been made by the VA between the HTN and my hypertensive heart disease in the original decision. The condition of my heart has worsened in the last 6+ years and am filing for an increase from 30% to 100% on this contention alone. 3 episodes of CHF in last year, hospitalized 2 times since April and EF has gone from 60% down to current 44%. Cardio version and cardio ablation performed in May. Heart rate is normal, yet BP is still 170+-180+ over 86-100.

J, I am not sure, will have to ask my cardiologist this question. I am sure it is in the volumes of records I have accumulated in past 2 years. I have never taken a pulmonary function test, just many ekg, echocardiograms, MRI, CT, you name it. Where would I find this lung rating? VA did an echo test on me last Friday and person kept asking me to take deeper breath and was doing best I could, and she was not happy with readings, take a deep breath and hold it. I did best i could, but she was wanting deeper breath. I will see my doc on 29th and ask him these questions. Thanks for the help J.

I am SC for pulmonary HTN, and condition got worse last year, atrial fibrillation. So file a NEW claim with help of my local DAV at VA center. This was a mistake on my part, found out no need to file a new claim, just a simple letter and documentation was all I needed to file for an increase. But, now in year 2 and all the VA has done is kick my claim down the road another year until 2014. Can I do anything about my error? I have learned not to trust my local DAV rep, he is either ignorant or not working to really help the veteran.

Same thing happened to me, then bumped my claim date up another year to get the c-file!

Increase to existing claim for htn, and secondary for heart disease, ED, sleep apnea and reopen rhinitis claim. My review of the exam results reveals 10% for minor impairment for MH issues, and I agree, dealing with VA is enough to cause anyone stress and anxiety.

In my case, had the htn first, and 11 years later, htn impacted my heart. I have two separate IMO, from 2 cardiologists, as well as my PCM. I have a natural progression of htn.

No, I did not eve file for any mental issues, this is something VA added after they started finally working my claim after 14 months.

Attached are results of a Menatal health exam for contentions that I did not even claim, anxiety and depression. I am not sure what all this means, perhaps some of the more experienced can explain what this means. I tried to uplaod as an attachment (Word 10 document but would not allow it.) 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes [ ] No If the Veteran currently has one or more mental disorders that conform to DSM-IV criteria, provide all diagnoses: Diagnosis #1: Adjustment Disorder With Mixed Anxiety and Depressed Mood ICD code: 309.28 Indicate the Axis category: [X] Axis I [ ] Axis II b. Axis III - medical diagnoses (to include TBI): Per VA policy, the undersigned does not have the necessary credentials to speak diagnostically with regard to TBI. c. Axis IV - Psychosocial and Environmental Problems (describe, if any): Problems with primary support group d. Axis V - Current global assessment of functioning (GAF) score: 70 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes [X] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [ ] No [X] Not applicable (N/A) c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? Comments, if any: Per VA policy, the undersigned does not have the necessary credentials to speak diagnostically with regard to TBI. 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [ ] No mental disorder diagnosis [ ] A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication [X] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication [ ] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation [ ] Occupational and social impairment with reduced reliability and productivity [ ] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood [ ] Total occupational and social impairment b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [ ] No [X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? Per VA policy, the undersigned does not have the necessary credentials to speak diagnostically with regard to TBI. SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ If any records (evidence) were reviewed, please list here: C-file. VA medical records. 2. History ---------- NOTE: Initial examinations require pre-military, military, and post-military history. If this is a review examination only indicate any relevant history since prior exam. a. Relevant Social/Marital/Family history (pre-military, military, and postmilitary): "I've been married for going on 34 years - it could be going a lot better - my wife says I'm angry and depressed and having issues, which started in the last year since my health went downhill - I had heart surgery this May, and I suffer from erectile dysfunction, which doesn't make me feel very good and is depressing; I have one adult daughter from a previous marriage - when I got divorced from my previous wife, I didn't see or talk to my daughter for the next 14 years because I moved away, and then I figured they didn't want me in Their lives; I get along great with the people I know outside of family." b. Relevant Occupational and Educational history (pre-military, military, and post-military): "I took an early retirement due to my health in December of 2011 - before that I worked full-time as a community readiness specialist in civil service for 14 years and retired because I was having heart problems and had gotten up to 279 pounds - it was a struggle to get through a day." c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): "I'm seeing a Social Worker who has diagnosed me with Adjustment Disorder With Mixed Anxiety and Depressed Mood, and I'm prescribed Prozac." d. Relevant Legal and Behavioral history (pre-military, military, and postmilitary): Denied and not found in available records. e. Relevant Substance abuse history (pre-military, military, and post-military): Denied and not found in available records. f. Sentinel Event(s) (other than stressors): Denied and not found in available records. g. Other, if any: Mental Status: Alert and fully oriented. Speech normal in rate, tone, and syntax. Thought content and process unremarkable. Mood presented as euthymic with full and reactive affect. No observable responsiveness to internal stimuli. Hallucinations and delusions denied. Suicidal and homicidal ideation, intent, and planning denied. No observable impairment in attention, concentration, or memory. Results of the Montreal Cognitive Assessment were consistent with very mild cognitive impairment (a total score of 25). 3. Symptoms ----------- For VA rating purposes, check all symptoms that apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [ ] Suspiciousness [ ] Panic attacks that occur weekly or less often [ ] Panic attacks more than once a week [ ] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [ ] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [ ] Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks [ ] Memory loss for names of close relatives, own occupation, or own name [ ] Flattened affect [ ] Circumstantial, circumlocutory or stereotyped speech [ ] Speech intermittently illogical, obscure, or irrelevant [ ] Difficulty in understanding complex commands [ ] Impaired judgment [ ] Impaired abstract thinking [ ] Gross impairment in thought processes or communication [ ] Disturbances of motivation and mood [ ] Difficulty in establishing and maintaining effective work and social relationships [ ] Difficulty in adapting to stressful circumstances, including work or a worklike setting [ ] Inability to establish and maintain effective relationships [ ] Suicidal ideation [ ] Obsessional rituals which interfere with routine activities [ ] Impaired impulse control, such as unprovoked irritability with periods of violence [ ] Spatial disorientation [ ] Persistent delusions or hallucinations [ ] Grossly inappropriate behavior [ ] Persistent danger of hurting self or others [ ] Neglect of personal appearance and hygiene [ ] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene [ ] Disorientation to time or place 4. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [ ] Yes [X] No 5. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 6. Remarks, if any: ------------------- The diagnoses above, if any, are based on DSM-IV diagnostic criteria. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. I am not disputing any of this-Yet! I want to see where the VA is trying to go with this exam. Mental Health issues are recent, manily anxiety and depression over declining health.

Correction, his middle initial is W. Found him, he is board certified in family practice, went to foreign medical school, Dalhouise (sp), do not feel he was qualified to do my C & P exam, but I guess the VA would hire a non-qualified person and train them in how to do the exams. I had this funny feeling that this doctor was asking me leading questions, trying to elicit the response he wanted, especially regarding constipation. NEVER TRUST THE VA EXAMINERS, their job is to help the VA deny your claim-IMHO!

Update, just had chance to read blue dot in e benefits. My C&P doctor lied to me about his name. He is really Joseph M MacDonald. He had tol me his name was Jack L. McDonald. Found out he ordered sinus x-rays for me stating I had complained of sinus pain. What a crock. I had filed a claim to reopen my denial of allergy claim to change it to non allergic rhinitis. Never complained of sinus pain, seems to be an angle the VA is trying to deny this claim, and btw, the sinus x-ray showed that my sinus was clear, no problems at all!

Well, I do have moderate OSA just ordered new supplies today, have to wait a little longer as my machine is not quite 5 years old. Not sure about your bs remark, never claim something that you cant prove And is service connected.

Veldrina, the problem is that got off active duty in 2003, and not tested until 2009.