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JessM

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About JessM

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  1. I really appreciated all the advice that I received here so wanted to update this post on the result of what I decided to do. For a recap, I originally applied for compensation due to heart failure on 03/18/2015 and was denied. In the end, I decided to file a new claim instead of appeal. I filed the claim on 05/18/2015 but put it specifically under “arteriosclerotic heart disease secondary to hypertension (Secondary)” To reiterate all my medical treatment has been through the VA. On June 30, 2015, I had a P&C consultative exam with a different VA doc in a clinic I didn’t go to. I thought it was odd since all my records were VA, but in the end, I realized it was part of the process and that she had to do a write up about my case specifically for pension and compensation. About 3 weeks later, sometime in late July, the status of my claim on eBenefits changed to something like “pending decision.” I have checked every day since on the status. Today the case cleared and on the disabilities page it has me rated at 100%. Even better when I went and checked the benefit verification letter it stated that my start date for 100% was April 1st, so they went with the original date I filed in March as my onset instead of the one in May. I hope this helps someone out there and gives a bit of hope, because I know how crushed I felt when I was originally denied. Good luck to everyone.
  2. Upon discharge from AD 12 years ago I was awarded: Asthma 30% Hypertension 10% Tinnitus 10% Acid Reflux 10% I don’t know if I have to have a nexus/connection from a cardio doctor, by VA regulations and court precedent it seems that since my hypertension is SC the CAD is as well. In a VBA decision citation NR: 0304743 the board wrote: “…the Board determined that service connection was warranted for the veteran's hypertension on the basis that the disease had its onset during service. In addition, the evidence shows that the veteran has been diagnosed as having coronary artery disease… In this regard, the Board notes that VA recognizes that coronary artery disease and its resulting manifestations are part of the same disease process as hypertension. See 38 C.F.R. § 3.309(a). Service connection for coronary artery disease with history of myocardial infarction and tachycardia is thus warranted on a secondary basis. See Allen; 38 C.F.R. § 3.310.”
  3. So, for full disclosure on my request for compensation: JESS This page is a continuation of VA form 526EZ. **************Continued from block 9 21-526 EZ New Claimed Disabilities: 1. heart failure Reopened Disabilities: 1. gout 2. type 2 diabetes **************End continued block 9 21-526 EZ Under Item 10, "list VA Facilities" I put: Carl T. Hayden VA Medical Center, Phoenix, AZ: 01/01/2015-Present VA Puget Sound Health Care System, Seattle, WA: 01/01/2006-12/31/2013 I also submitted private medical records to support my gout and diabetes claims. Here is what they listed for Evidence. Evidence Considered In making our decision, we considered: · Rating Decision, and all evidence contained therein, dated September 18, 2014 · DD Form 214, Certificate of Release or Discharge from Active Duty, from July 20, 1993 through April 4, 2003 · Private Treatment Records, Shoreline Family Medicine, received March 18, 2015 · Outpatient Treatment Records, Puget Sound VA Medical Center, from July 31, 2004 through June 26, 2008 · Service Treatment Records, received April 10, 2015 · Outpatient Treatment Records, Sun City VA Medical Center, from April 17, 2015 through April 22, 2015 · Outpatient Treatment Records, Phoenix VA Medical Center, from June 10, 2014 through April 15, 2015 · VA Form 21-526 EZ: Application for Disability Compensation and Related Compensation Benefits, dated March 18, 2015 · VA Form 21-0820 Report of General Information, VAMC Puget Sound, No records beyond 6/26/2008, dated April 15, 2015 I did not submit my claim until after the ECHO and Catherization was done. In fact, I submitted the claim when I was home recovering from my 1st stent procedure. I was also denied for Gout and Diabetes but I understand those rulings as I was not officially diagnosed with either condition until after the 1 year presumptive period (23 months after separation for diabetes and 36 months for gout). So I am gathering my evidence for those cases. One of the best things I did is when I separated (besides making the VA claim) was that I made a copy of my service medical record. So I am going through it now looking for medical reviews and lab test results to support my claims that both started in service (uphill battle, I know).
  4. Hello again, I have been doing some more research and looking through my medical records. These are some pertinent facts that I have found. · 12 Mar 2015 - Cardiac Intervention Note o New onset HF, Ischemic CM · 04 Mar 2015 - Left and Right heart Catherization o Indications: Cardiomyopathy o Left Heart Catheterization § Summary: 2 vessel CAD § Dominance: Right dominant o Right Heart Catherization § ? o Final Diagnosis for Left and Right heart Catherization on 03/04/2015 § Subtotal (99%) occlusion in mid RCA § Subtotal (99%) occlusion in mid LCx § Elevated wedge pressure c/w left sided HF § Pulmonary hypertension · 23 Feb 2015 - Cardiology Outpatient Consult o Assessment/Plan § Heart Failure with diastolic and systolic dysfunction, EF of <10% NYHA Class II-III, Stage C · 20 Feb 2015 - Echocardiogram Summary o Referred for evaluation of dilated cadiomypathy o Overall left ventricle systolic function is severely impaired with an EF<10% o Restrictive LV filling pattern, consistent with elevated LA pressure o The left ventricle is moderately dilated o The right atrium is moderately enlarged o Mild mitral regurgitation present o Moderate tricuspid regurgitation present o There is moderate pulmonary htn Then I did some research and found this reference (M21-1, Part III, Subpart iv, Chapter 4, Section E) in the general claims process. Under section H, Documentation required to support a diagnosis of Arteriosclerotic heart disease (also known as Ischemic heart disease (IHD) and Coronary artery disease (CAD)) there must be documentation of objective testing including ECG or EKG findings, treadmill testing, or cardiac catherization. I have the catherization done on March 4th 2015. Section I, requirement for documentation of Cardiac Hypertrophy, dilation, or need for continuous medication states objective evidence (hypertrophy and/or dilation must be documented by EKG, ECHO, or x-ray) must show that cardiac hypertrophy (or dilation) is present and whether continuous medication is needed. My ECHO states that my left ventricle is moderately dilated and every entry from cardiology has medications as part of my “Assessment/Plan.” The next sections talk about METs, but according to section k I do not have to have the test as an ECHO shows my EF<10%. Under section n, Grating service connection for arteriosclerotic manifestations due to hypertension, it states: If additional arteriosclerotic manifestations are subsequently diagnosed in a Veteran with SC hypertension, grant service connection on a secondary basis through the relationship to hypertension for any of the following · cerebral arteriosclerosis or thrombosis with hemiplegia · nephrosclerosis of the kidneys with impairment of renal function, or · myocardial damage or coronary occlusion of the heart. My Catherization on March 4th shows Occlusions in mid RCA and mid LCx. So after all of this, what am I missing? Berta, you mentioned that the VA was right in their decision and that I would need an IMO/IME. It seems to me by their own rules and regulations that I should be awarded Arteriosclerotic Heart Disease. Was I denied because I wasn’t specific enough? I know this post was really long, I appreciate everyone who worked their way through it.
  5. First, I want to thank everyone for their advice, it has been extremely helpful in trying to get my head straight, as far as this is concerned anyway. Today I found HealthVet web site and downloaded my medical records. I am not a doctor nor have I ever worked in the health care field so it is very slow going. I do not know most of the acronyms that are used. Google is my friend in this. J As I am at work I am unable to donate my full attention to the record, have just scanned the almost 300 pages over the last 5-6 hours. One of the things I was really looking for but could not find was any wording as to the causation of my HF. I found plenty of test results and it was mentioned over and over that I have an EF<10%, but I couldn’t find one sentence that spoke to the ‘WHY’ of it. During my 1st appointment, after my ECHO, when the practitioner was discussing the ECHO results she specifically stated that part of the damage to my heart was due to long term high blood pressure. However, I have read over her notes on that appointment and I find no mention of it. I do not see her again until after my stent procedure on June 12th, so at that appointment I will ask her about it and request that she places the note into my VA record.
  6. Ok, I am home. I scanned in the VA notice so I can keep all correspondence localized and re-print everything if need be. This is what the VA gave me as an “explanation.” · Service connection for heart failure is denied since this condition neither occurred in nor was caused by service. · Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show an event, disease or injury in service. Service connection for this condition is denied on a direct basis, because we have not received evidence that your condition occurred while on active duty; or that manifested itself to a compensable degree within one year from the date of discharge; or evidence of aggravation of the condition in service. In order to grant service connection there must be a chronic condition shown in service, evidence of a current diagnosis, and evidence of continuity of treatment since discharge.
  7. I am away from home and do not have the denial notice in front of me, but if memory serves, it stated something to the effect that I did not evidence any symptoms of heart failure while on active duty. The denial seemed quite generic to me. For instance, when I applied for compensation I simply put ‘heart failure’ and trusted that when they reviewed my VA files they would see what I was diagnosed with. When they returned the denial, it still simply stated ‘heart failure.’ I was told after the ECHO that I had both hypertrophy and dilation of my left ventricle as well as an EF<10% so my guess would be that I would fall under 7007 Hypertensive heart disease? Perhaps my mistake was trusting that the VA would properly review the VA records. When I file, do I need to specifically state that I am applying for Hypertensive heart disease?
  8. I have a few question, but here is a little background first. I served in the Navy from 1993-2003. When I got out, I was awarded service connection and compensation for Asthma 30%, Acid Reflux 10%, Tinnitus 10%, and Hypertension 10%. I have a few others rated at 0% but do not remember them off the top of my head. In January/February of this year (2015) I went to VA medical with some complaints and was subsequently diagnosed with Cardiomyopathy. To be frank, I am a bit unclear about all my diagnosis; it has been a bit of a trial for my family considering I just turned 40 I feel shellshocked. In the initial diagnosis I was told I had an enlarged heart and from there I had an ECHO and was told that I have an EF<10%. Since then I have had a catherization and 2 stents placed in 1 artery. I go back in for surgery on June 12th to have another stenting procedure on a different artery. So perhaps I jumped the gun but in March I applied for compensation for the heart failure. I recently received back the denial notice. It was perhaps my understanding that because I had been diagnosed with service connected hypertension and have received compensation for it since I separated in 2003 that the heart failure would be related to that hypertension, especially since I was told by a VA doctor that part of my heart failure was related to the hypertension. I am going to file my appeal, but I wanted some advice before I do so, don't want to jump the gun again. What should I actually appeal? Their language in the denial notice speaks to not having any complaints or symptoms while active duty, do I need to spell out in my appeal that I am claiming the heart failure is a direct result of the hypertension? Any other items that I need to consider? Any advice is greatly appreciated.
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