vern2

Hope this is good, but in my dealings with VA since 2003, do not trust a word of their talk.

Had my MH exam today. Exam lasted 35 minutes. Dr. Haggans, psychologist asked questions conducted some memory tests, did ok on some but asking me to recall a series of words he had given to me at end was very hard. Also had problems with math. He stated had not read my c-file that he would read AFTER the exam. I found out the reason for the MH exam is because in Sept. Of last year I had told VA person on phone that I was having memory issues and was very depressed due to sleep apnea. I had for goton about this conversation.VA must record our phone calls?

This is where the VA often makes mistakes. See attachment. NO LEGAL ADVICE INTENDED, this is just FYI! Analogus ratings by W & M law school.pdf

The Anti-Pyramiding Rule The VA’s rating system will rate all diseases separately according to the ratings schedules of 38 C.F.R. § 4. However, 38 C.F.R. § 4.14 requires that the VA not award multiple disability ratings for the same disability shown under different diagnosis. This can be very confusing when an injury can cause multiple disabling conditions. In attempting to avoid these anti-pyramiding regulations, the Veteran needs to argue that there are separate disabilities with separate symptoms, regardless of the overlapping symptomatology. The bold is by me. If you file a claim, make sure that it lists separate disabilities, i.e. aggratated pulmonary hypertension, then heart disease secondary to it, even though there may be overlapping symptomalogy.

Thanks Berta and JBasser for your help. I will work on the CUE, as cleary they can not have it both ways. I am a lot more knowledgable about VA claims than I was back in 2003. Still got a lot to learn, especially about C & P exams. I have been through two and it appears that the claim examiners sole purpose is to find ways to help the VA in denying your claim.

I have filed a claim for sleep apnea due to fact my breathing problems were "Noted" in service, yet no sleep test was done until after I separated. I do have OSA, use CPAP every night. Please see attachment for my explanation form VA. forgot to mention that the same echocardiogram they used for granting me 30% had an EF of "about 50%" as noted on the printout. This may be the basis for my CUE, Clearly should be grantged 60% since I had my last Echocardiogram with 60% rating less than 5 months after separation.

I have filed a claim for sleep apnea due to fact my breathing problems were "Noted" in service, yet no sleep test was done until after I separated. I do have OSA, use CPAP every night. Please see attachment for my explanation from VA when the finally made the award, based on claim I filed in 2003, took 4 years to get this award. The VA did not provide any supporting documentation for how they arrived at the 30%, toher than what was stated. This appears to be from 7007.

I have submitted a lot of medical records and STR as well as doctors statements. I have not submitted the DBQ's that my doctors have completed. I want to hold these until I get a decision and then can use to rebut the C & P exam or the VSRS. This is based on advice from this forum, I think?

The list of items added to my contentions contains several that were added by the VA; 1. Memory loss secondary to HTN (secondary) 2. Depression 2ndary to sleep apnea (Secondary) These are new to me, I did not file for them, yet scheduled for MH exam next Tuesday. I am suffering from adjustment disorder per my Behavior Medicine licensed clinical social worker, and receiving counseling and taking Prozac (10mg) ffor that, but htis was just diagnosed on Tuesday and VA did not know about it. The adjustment is due to stress and anxiety about my current health AND the VA claim. I am in poor health due to heart problems and aggravated HTN. I have asked this before, is it normal for VA to add contentions to my list? Seems kind of odd? I had C & P last year, same time and examiner only went over 2 areas, and not sleep apnea. the exam yesterday still did not go over sleep apnea, yet scheduled for mental health exam for depression 2ndary to sleep apnea. BTW: I did file an objection to the exam last year, PA Chadwell was not qualified to do the exam IMHO, did not even look at my ankles or legs and stated I did not have pedal edema- what a crock. The examiner yesterday did examine my legs and ankles and remarked that this was periphal (sp) pedal edema. My leg/ankle swelling does not go down anymore, and get worse in afternoon.

Complained of sleep problems back in 2002, and military doc told me to follow the laws of sleep. What BS. Never tested for sleep apnea, in fact never heard of it until 2008. Tested in 2009, Sleep Apnea confirmed Wonder if I have a chance since my sleep problems were NOTED while in service, just never tested?

Does anyone know who is this VA contract doctor? Name is Dr. Jack McDonald and stated he was retired after 35 years in South Fla, used to live on island near Sanibel, maybe Capitva? Had to be wealthy to live on this island, so why is he now a VA contract doctor. He actually listed to my heart, did pressure sensitive test on my hands and feet, as well as look into my mouth and ears, and had me stand on tiptoes and do balance tests. My C & P last year, the PA just listetened to my heart, never looked at my feet.

I just finished a one plus hour C & P exam. It was conducted by a contract doctor, Dr. Jack McDonald. He stated that he was ctr, retired MD, not specilaiszed in cardio or Board Certified. He had a lis tof things to ask me. Funny thing is he kep asking about constipation and headaches. WTF? I did mention that VA doctor gave me SpiroLactone in 2008 for pedal edema and then he asked me about headaches. I told him I was having 1-2 episodes per week since recent heart problems. It seems that want to refute my non-allergic rhinitis claim by saying i have sinus headaches (had me do sinus series x-rays). I told him that I had sinus surgery in 20011 and have no sinus issues at all, but he persisted. I do have some headaches but I tgold him I think related to episodes of very high blood pressure readings and stress due to heart problems and the problem of dealing with this VA claim. I do not feel good about outcome of the exam. I filed claim for one thing and VA is told to examine me on constipation and headaches. Strange? I still had no questions on Sleep Apnea, even though this is my second C & P exam. I have mental health exam next week as welll as echocardiogram for Ejection Fraction measurement. One good thing, he did ask questions and look at my pedal edema. Asked if swelling of ankels goes down. NO, is what I told him, and now shoe size is from 9.5d to 104E. and I wear compression socks. ( I have CAD) Has anyone else ahd experience with this contract doctor?

I forgot to mention that the codes and ratings in 38 CFR that the DRO used have not changed since 2007, when my DRO made the decision on my NOD dating from claim in 2004. The key is the semicolon, which in this instance is used to join a list of conditions that would grant you 60%.

I have reviewed my VA claim from 03-07 and noted a possible CUE. I was awarded 30 SC based on aggravated hypertension "with confirmed dilation of the heart" The exact wording is: we have evaluated the condition analogous to hypertensive heart disease based on the fact that you have associated pulmonary hypertension with confirmed evidence of dilation of the heart. this is more advantageous to your as your hypertension would be evaluated as 10 per cent disabling. An evaluation of 30 per cent is assigned is there is workload greated than 5 METS but not greater than 7 METS resulting in dyspnea, fatigue, anginia, diziness, or syncope; or evidence of cardiac hypertrophy or dillatation on electrocardiogram, echocardiogram, or X-ray. A higher evaluation of 40 percent is not warranted unless diastolic pressure is predominantly 120 or more. A higher evaluation of 60 per cent is not warraanted unless there is more than one episode of acute congestive heart failure in the past year; or workload greater than 3 METS, but not greater than 5 METS resulting in dyspnea, fatigue, anginia, diziness, or syncope; or left ventricular dysfunction with an ejection fraction of 30 to 50 per cent. One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. I was granted 30% according to rating guidelines during my active service with approximatley one year of uncontgrolled pressures with the subsequent development of pulmonary hypertension with cardiac hypertrophy. A review of the evidence submitted shows that an echocardiogram (which is listed by VA as part of the evidence) shows that in addition to mildly dilated left atrium the left ventricular systolic function revealed distal septal hypokinesia with an ejection fraction of about 50%. Regional wall abnormalities as desccribed above with mild ventricular systolic dysfunction. My echocardiogram clearly showed that I had an EF of about 50%, which should have granted me the 60% rating. Note the semicolons, which denotes I had to have one of several conditions to meet the 60% requirement. Does this sould like a valid CUE? I am reluctant to go forward unless I can get some advice.

Yes I am Vietnam era- never went there, was still in school most of this time, I am overweight, gained 20 lbs since heart problems began.my surgery was 3 months ago, but still having chest wall pain- been to ER 2 times with this problem.

Correction, my last EF was 44%.

I am already 30% for s/c htn, filed a claim for increase due to worsening of htn, now I have CHF, AFib, 2 heart surgeries, including cardiac ablation, mets last year was 7, b4 heart problems and ef was 60%, but since then it has been 55 and latest is 50%, enlarged heart, PEDAL edema, not sure what my mets is now. QUESTION? It is my contention that this is not pyramiding, but secondary to the HTN. Am I correct?

Just right click and copy the pages after documents and save in a MS Word document, give it name for what you uploaded and then save it in file for your va claim. Works for me.

Yes I have have an eBenefits account as well as health evet, and theyjust showed up there a few weeks ago.

Thanks, but why the mental health exam?

Ok, so where is it now?

FNG here. 30% SC for HTN, has gotten worse, heart problems, and chronic micro vascular disease, diastolic dysfunction stage 2, so why am I scheduled for a mental health exam as well as another c & p exam, and ekg-to measure ejection fraction? My claim was filed over one year ago, now a sudden flurry of tests from the VA. Called them and was told all claims over one year old are on fast track.