bm6546

Wings and Hoppy, You both are providing some excellant information that I am trying to absorb and understand. I am keeping all the information that you two are posting and will take this information to my VSO when the VA responds to my NOD. I sent an IRIS e-mail a few days ago and got this response: "Our records indicate that your appeal for increase and service connection due to supraventicular arrhythmia is open and in process at the Oakland Regional Office. We are unable to determine whether your documentation has been added to your claim folder. We are only able to access your electronic files through our inquiry system." It appears they have now changed my diagnosis from PAT (Paroxysmal Atrial Tachycardia) that I have been SC for over 40 years and changed it to Supraventicular Arrhythmia. Not sure what this means or if it will help or hurt my claim. This whole VA process is very confusing and frustrating. It's enough to give anyone an anxiety disorder or depression or at the very least, Supraventicular Arrythmias. Thanks for your help. Brian

cowgirl, thanks for the info. Can you tell me what kind of help I might expect from a colleg or university type medical center? Not quite sure I follow your angle. Thanks in advance, Brian

Hoppy, I agree that I need a Cardiologist to give me a medical opinion on my medical records. I went to my private cardiologist and he was no help to me at all. I live in a small town and he is the only cardiologist here. I have to go closer to a city and try and get a cardiologist to write a good medical opinion for me. Unfortunately, I am living on my SSDI and can't afford to pay for a medical opinion. Any suggestions on this would help. Thanks, Brian

Hoppy, Back in 1964 my PAT was positively evaluated under Sec 4.104 Diagnostic Code 7013 and I was awarded 10% compensation and SC for my PAT. 1 year later they took my 10% away and left me 0% SC. In 1998 they changed the Rating Code and the PAT to Supraventicular Arrythmias under Code 7010. I didn't know back in the 60's and 70's that I was having a "panic attack" or "anxiety attack". All I know is that everytime I had a PAT attack, especially while I was driving, it scared the crap out of me and my heart would palpitate and skip all over the place. I would get very swetty and dizzy I thought for sure I was going to die right there on the spot. Its enough to give anyone a "panic attack" or "panic disorder". Unfortunately, nobody back then knew what they were called. For this reason I don't have any medical records to substantiate this. Over the past 3 years I have been seeing VA Psychiatrists, Psychologists and Social workers and everyone of them have diagnosed me with panic attacks, anxiety and depression.

Wings, thank you for posting this CUE. If I read this correctly the BVA reversed the 40% rating and awarded a 60% rating back to Feb 24, 1960 on a CUE. That is over 30 years of retro. Good for him. As far as the CAD it sounds like the BVA wants to award the CAD as SC, but they won't accept it because it wasn't addressed properly. Is this correct? With my case, I have CAD from my heart attack or PAT, not sure. It has never been established what caused my CAD. We also don't know if I had my CAD while I was in the service or got it recently. How can I establish how and when I aquired my CAD? In my SOC that I posted, it is mentioned that I am being treated for CAD. Thanks, Brian PS I sent an inquiry to IRIS asking what was happening with my claim appeal for PAT and when would it be decided. Haven't heard back from the VA yet.

bronco and carlie, I too was a little confused with carlie addressing bronco instead of me. Honest mistake on carlie's part. Thanks for pointing that out. bm6546

carlie, I found my RATING DECISION back in 3-3-67 when they took my 10% away. ############################################ Evaluation of SC tachycardia. Cited exam discloses the veteran is steadily employed but complains of occasional dizziness, a heavy feeling in the chest and that his heart flutters. Current examination does not disclose a compensable condition. Rating of 3-3-67 amended as follows: 1. SC 38USC 331 & 310 (Agg. PTE; VE from 10-1-67) 10% from 11-26-66 0% from 5-1-68 PAROXYSMAL ATRIAL TACHYCARDIA Not entitled --38 USC 336 ############################################# I am still confused in the fact that I was still experiencing my PAT at the time of my C&P, the same symtoms as I had while I was in the service, and they still took my 10% away from me.

As in #2, they said because I was working full time I did not need the 10% anymore. But like it said in the enclosed SOC, when I went to my C&P exam in 1967 the VA examiner even admits the veterans symtomology clearly met then existing DC 7103 rating criteria for frequent attacks of PAT with impaired occupational functioning, whereby his "attacks" were "at times" manageable; and by default, other times not. Proving that 1967 C&P Re-examination of PAT was incomplete, is the Federal Regulation which provides that, "Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction."

Yes Berta, it is very well written. The person that wrote this for me is well informed on VA rules and regulations and I appreciate the work this person spent on this. You are also right on the anxiety disorder. My VSO said we should file this as a seperate claim after the VA gives me back my 10% , and hopefully raises it to 30% for my PAT. My current diagnosis is CAD and PAT. The VA doctors have prescribed medication for both of these heart conditions. Hopefully this helps, I'm not too savvy on all the medical terms. Thanks, Brian

broncovet, we have filed 2 NOD's over the last 3 years. I am currently waiting for the VA to make a decision on the current NOD which we filed Dec 07. My VSO sent in the previous SOC and we are hoping it will be read as part of our present NOD. At first when I approached my private cardiologist with my military records and my private records he seemed like he wanted to help me. But then he sent a letter to my VSO and said "that my 2 heart conditions were not connected and that is probably why the VA has turned down his claims". I live in a small town and he is the only cardiologist that I am aware of. I am looking for another cardiologist but I also can't afford to pay for an IMO because I am barely living on my SSDI. I am also trying to get the VA to waive my prescription and medical bills. Brian

Pete53, The only problems I can link to the service are my heart problems which the VA admits was caused from the service. Social Security diagnosed me with Anxiety Disorders as the Primary Diagnosis. The Social Security Psychiatrist diagnosed me with extreme level of anxiety and depression. Even all the VA Psychiatrists and Psychologists diagnosed me with anxiety and depression stemming from my heart attack and PAT. Unfortunately, I had to stop seeing the Psychologist because I can't afford to pay for any doctors as I am trying to live on my SSDI. I have all the copies of Social Security and all the VA mental health exams.

TS Snave ,Thanks for your reply , Unfortunately, my private cardiologist did review my military and private medical records and basically said the 2 heart conditions are not related. That's it, no explanation, he pretty much could care less. I am looking for a new cardiologist, one that has some bedside manners. My VSO told me she wants the VA to give me back my 10% and then we will go after the anxiety claim. I don't have any records that show my anxiety is connected to my service.

I just submitted a CUE that will go back to 1968. Not sure what will happen but will let you know. Brian

I would like to ask the members on Hadit.com for some help. I am not sure which direction to go with my VA claim. I have been fighting with the VA for almost 3 years with my claims that go back over 40 years. In the last 3 years they have denied my claim twice and I am very frustrated and not sure what to do next. Someone on Hadit.com has a few ideas that they think might help me with my claim. They were nice enough to do some research and write up a "Statement In Support of Claim". I would like to briefly set this up and attach the comments that this person has sent me and I would like the Hadit members to let me know what they think. I apologize in advance for the length of this post but I don't know what else to do. I was discharged from the US Navy back in 1966 with a heart condition called PAT (Paroxysmal Atrial Tachycardia) and was given 10% SC for approx. 1 year and then it was discontinued. (You can review my past posts for more detail info on this claim). I have been in and out of different hospitals over the last several years with this heart condition and 3 years ago I had a heart attack and I am now on SSDI because I am not able to work any more. I suffer from anxiety, depression and heart problems. And to top everything else I am going thru a divorce after 25 years of marriage. I have tried to connect my PAT and heart attack and the VA says they are not connected and denied my claim twice. I am currently on several medications thru the VA for depression, anxiety and my heart condition. I am trying to at least get my 10% back and am trying to get it raised to 30%. Here is the attachment: ******************************************************************************** *************** Statement In Support of Claim THE ISSUES 1. Claim for Increase for Paroxysmal Atrial Tachycardia (PAT) currently rated 0 percent, under 38 C.F.R. Sec. 3.160(f) resumption of payments previously discontinued. 2. Entitlement to Service Connection for Anxiety Disorder, under 38 C.F.R. Sec. 3.310(a) Disabilities that are proximately due to, or aggravated by, service-connected disease or injury. INTRODUCTION The veteran served the Vietnam Era, active duty in the US Navy from November 10, 1964 through November 25, 1966. While active-duty, veteran reported heart palpitations, shortness of breath, aching chest pain, dizziness, fainting and syncope. An active-duty diagnosis of Tachycardia necessitated Holter Monitoring for approximately three weeks duration, which objectively confirmed the diagnosis Paroxysmal Atrial Tachycardia (PAT), and was positively evaluated under Sec. 4.104, Diagnostic Code (DC) 7013. On 11-26-66, active-duty member was granted service-connection for PAT under (DC) 7013, and awarded 10% compensation rating. Following an incomplete VA Compensation and Pension Examination, 12-12-67, the veteran’s 10% compensation was reduced to a non-compensatible 0% rating. The veteran herein challenges that VA Rating Decision of 2-5-68, by claiming Clear and Unmistakable Error (CUE), 38 USC 5109A. In that 12-12-67 C&P Examination, the VA Examiner noted: "... while in service he had episodes of palpitation following inspection, with fainting and ended up in sick bay. He then began to have palpitation with some pains in mid sternal area following exertion, drills, and at times even when resting. The spells of palpitation may last from 5 to 20 minutes now, and in recent months has had 6 episodes, the last one 3 - 4 days ago. He has learned to lean forward with head between knees, and take deep breaths and this at times shortens the interval and length of attack. He is working now, gets the episodes at work, but continues working, [only] after they subside." Emphasis in italics. By the examiner’s own admission then, the veteran’s symptomology clearly met then existing DC 7103 rating criteria for frequent attacks of PAT with impaired occupational functioning, whereby his “attacks” were “at times” manageable; and by default, other times not. Proving that 1967 C&P Re-examination of PAT was incomplete, is the Federal Regulation which provides that, “Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction“, Sec. 3.344 Stabilization of disability evaluations. A Holter monitor provided positive objective evidence of an active-duty diagnosis of PAT; therefore, that 1967 C&P Re-examination of PAT was less full and complete without reference to the Holtor Monitor criteria. Under then existing diagnostic criteria, the active-duty member’s medical condition was evaluated under (DC) 7013, “Tachycardia, paroxysmal”, which provided for 10 percent evaluation when there were infrequent attacks, and 30 percent evaluation when there were severe, frequent attacks. The words "slight," "moderate" and "severe" as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the VA must evaluate all of the evidence, to the end that its decisions are "equitable and just." 38 CFR 4.6 (2004). See also 38 CFR Sec. 4.7 providing that, “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.” New regulations for rating service-connected cardiovascular disorders became effective January 12, 1998, 62 Fed. Reg. 65207- 65224 (December 11, 1997). These revised regulations no longer contain criteria applicable specifically to PAT; but rather rate PAT by analogy to Supraventricular Arrhythmias under Diagnostic Code 7010. Under DC 7010, a 10 percent evaluation is warranted for supraventricular arrhythmias with permanent atrial fibrillation (lone atrial fibrillation), or; one to four episodes per year of paroxysmal atrial fibrillation or other supraventricular tachycardia documented by electrocardiogram or Halter monitor. A 30 percent evaluation is warranted for supraventricular arrhythmias with paroxysmal atrial fibrillation or other supraventricular tachycardia, with more than four episodes per year documented by electrogram or Holter monitor. 38 C.F.R. § 4.104, DC 7010 (2004). Significant is the application of Section 4.100 Application of the evaluation criteria for diagnostic codes 7000–7007, 7011, and 7015–7020. (a) Whether or not cardiac hypertrophy or dilatation (documented by electrocardiogram, echocardiogram, or X-ray) is present and whether or not there is a need for continuous medication must be ascertained in all cases. (B) Even if the requirement for a 10% (based on the need for continuous medication), or 30% (based on the presence of cardiac hypertrophy or dilatation) evaluation is met, METs testing is required in all cases except: (1) When there is a medical contraindication. (2) When the left ventricular ejection fraction has been measured and is 50% or less. (3) When chronic congestive heart failure is present or there has been more than one episode of congestive heart failure within the past year. (4) When a 100% evaluation can be assigned on another basis. © If left ventricular ejection fraction (LVEF) testing is not of record, evaluate based on the alternative criteria unless the examiner states that the LVEF test is needed in a particular case because the available medical information does not sufficiently reflect the severity of the veteran’s cardiovascular disability. [71 FR 52460, Sept. 6, 2006] VAMC Reno Cardiologist prescribed the Metoprolol Tartrate (date). Veteran has Heart Disease. CLAIM FOR GENERALIZED ANXIETY DISORDER Where separate and distinct manifestations have arisen from the same injury, separate disability ratings may be assigned where none of the symptomatology of the conditions overlaps. See Esteban v. Brown, 6 Vet. App. 259 (1994). Under the circumstances in this case, the veteran should be provided with VA heart and psychiatric examinations in order to obtain current information to evaluate his generalized anxiety disorder and PAT under the appropriate regulatory criteria. Massey v. Brown, 7 Vet. App. 204 (1994). Sec. 3.102 Reasonable doubt. It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. ******************************************************************************** ************************* I took the attached "Statement In Support of Claim" to my VSO and she liked it very much and she submitted it to the VA in it's entirety. My PAT claim is still pending and it has been almost 1 year to the date. I am reaching out to the members on Hadit.com and asking anyone for any help you can give me. I would appreciate ANY suggestions and would be happy to answer your questions. Thanks in advance. Brian

Wings, WOW, that would be great if you can prove CUE. That would really help me out. Maybe somebody else will jump in and tell us how they think. Thank you very much, Brian

carlie, thank you very much for showing me where to find this stuff. I printed out the section of 3.105 and read it several times. I'll have to read it several more times because it is very confusing to me. Hell.....this whole process of dealing with the VA is very confusing to me. Do they do this on purpose just to confuse me, and everyone else too? LOL Brian

thank you carlie

jbasser, They reduced me from 10% to 0% back in 1967. I have been SC since 1966. I had a heart attack on Jan 25, 2006 and have been diagnosed with CAD. See my other post for reasons for the reduction. I'd love to show you the documents. Not sure how to scan th this Hadit site. Thanks, Brian

carlie, thanks for showing me where to search. Very interesting cases. I've got a lot of reading to do. Brian

Thank you everyone, Commander Bob 92, disabledveteran, Carlie and J Basser, RATING DECISION D. In view of the length of service and worsening of the condition, aggravation is conceaded. 7013 1. SC 38 USC 331 (Aggr. PTE) 10% from 11/26/66 PAROXYSMAL ATRIAL TACHYCARDIA 10. Not entitled 38 USC 336 I went to a C&P exam on 12-12-67 for evaluation. "PT says while in service he had episodes of palpitation following inspection, with fainting and ended up in sick bay. He then began to have palpitation with some pains in mid sternal area following exertion, drills, and at times even when resting. The spells of palpitation may last from 5 to 20 minutes now, and in recent months has had 6 episodes, the last one 3 - 4 days ago. He has learned to lean forward with head between knees, and take deep breaths and this at times shortens the interval and length of attack. He is working now, gets the episodes at work, but continues working, after they subside." Tachycardia not elicited at this examination." RATING DECISION 2-5-68 J. Cited examination. I. Evaluation of SC tachycardia. F. Cited exam discloses the veteran is steadily employed but complains of occasional dizziness, a heavy feeling in the chest and that his heart flutters. Blood pressure was 120/68, 130/64, 103/70 and there is no precordial thrust, no enlargement to percussion. Heart sounds are regular, there is a soft, systolic murmur at the apex with no radiation, no thrill and a rate of 78 to 80. EKG is normal. D. Current examination does not disclose a compensable condition. Rating of 3-3-67 amended as follows: 1. SC 38 USC 331 & 310 (Agg. PTE; VE from 10-1-67) 10% from 11-26-66 0% from 5-1-68 PAROXYSMAL ATRIAL TACHYCARDIA 10 Not entitled --38 USC 336 Basically, they gave me the 10% for a little over 1 year and then took the 10% away and my condition did not change, in fact it got worse. I am not sure why they took it away. Did they have a valid reason or should they have left it alone. I also now have CAD for almost 3 years and have filed a claim trying to link the 2 heart conditions. So what does everybody think? Should I try to pursue this, let it go, file a CUE, hire a lawyer? Any suggestions would be very much appreciated. Thank you in advance, Brian

I am trying to find out some information on past cases where the VA took away someone's 10% compensation or any percentage for that matter. It would be very helpful to find cases such as mine where the VA did the same thing to other veterans. The Navy discharged me with a heart condition and the VA gave me 10% for over 1 year and then took it away because I was working full time. I still have the heart condition and it is worse now than back then.They even wrote that the heart condition is still there and took it away any way. I don't know if this could be a CUE. I want to research this to see if I might have a chance for filing a CUE. I'm just not sure how to search for specific cases. Any help would be VERY helpful. Thanks in advance, Brian

Wings, I sent you an e-mail at the above address. Brian

john999, Thanks for the advice. Not sure if I can afford a lawyer. Do they work on a "get paid when I win the case". How would one go about finding a lawyer that deals with VA? Do I go look in the Yellow Pages or on the internet? The VA paid me 10% back in 1966 for 1 year and stopped payment and said that I didn't need it anymore. Whatever that means. How would I find out if it was severed for reasons that violate VA rules. By the way, I am still SC at 0%. I also am in the medical system and get my drugs through the VA. Thanks for your help, Brian

tagandbag, thanks for your reply. Yes, unfortunately, my cardio doc understood exactly what I needed. Spelled it out with several letters and hospital reports from 2 hospitals. The sad part of this whole thing was that he indicated to me that he wanted to help me and got my hopes up, and then his letter that he basically changed his mind and wasn't going to help me. That really hurt and pissed me off at the same time. Now I guess I have to take the bull by the balls, oops, can I say that? I mean take the bull by the horns, and find a different way to fight this battle. Thanks, Brian

hotcoffee2, Thank you for your interest. I can send you anything you need if it will help my claim. I appreciate the fact that you are willing to do this. Let me know what you need. Thanks, Brian