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wbonebrake

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Posts posted by wbonebrake

  1. They may be working on changing it. As you mentioned, when I was still awaiting my appeal, I researched my diagnoses in the cfr38, and pulmonary hypertension was listed as 100%,with no mention to the severity ,simply the diagnosis. The Rating Decision I originally posted about has been sent back to the rater by the authorizer, was administratively changed, and is now awaiting the rater again. Hopefully it's at 100%this time !

  2. My PH was diagnosed via echo. Not currently on O2. I'd have to look at my records to get the ejection fraction but I do know that the pulmonary artery pressures were around 35, clearly a sign of PH. The strange thing is though, that the VA C&P examiner who was working my claim fully agreed with the diagnosis of PH, but it was rated as something different altogether. 

  3. OK, so here's my story. I was in Iraq in 2008-09, and started having chest pain. It was dismissed by the army doctors as probably just a strained muscle. Fast forward a few years, and I was diagnosed with pulmonary hypertension and stage one heart failure, both of which are ultimately fatal. I submitted a claim for these conditions, which was denied. I appealed this denial to the DRO in St. Louis, MO. The C&P doctor doesn't feel like I am still afflicted with heart failure, even though I have been seeing a cardiologist for it for years. I received a SOC for the heart failure and another contention for sleep apnea, which I filed the form 9, and continued the appeal on these issues. The contention for pulmonary hypertension has a pending rating decision in the system according to my VSO, of which they gave me a copy. Here's my issue. I am diagnosed with Pulmonary Hypertension, as well as other diseases. The doctor who did my C&P exam clearly stated that he believed that my PH was service connected. The pending rating states that I am granted service connection for PH. However, in the section that details the rating, it is rated at 30% as "Symptomatic, following resolution of acute pulmonary embolism." I have never been diagnosed with pulmonary embolism, only pulmonary hypertension. In the CFR 38 section 4.97, diagnosis code 6817, Non-tuberculosis diseases of the respiratory system, Pulmonary Hypertension is clearly listed as a 100% condition. I called the 1800 number to check on the rating decision, and I was informed that it was sent to the authorizer, who then sent it back to the rater, and it is now just waiting to be authorized again. Is it possible that the authorizer saw this, and felt that the " Symptomatic, following resolution of acute pulmonary embolism" was not an accurate representation of my diagnosis, and asked for it to be updated? Also, this decision was issued on the 12th of April, 2017, and it is now May 21, 2017. What could be taking so long in getting that decision finalized? Thanks in advance!

  4. OK, so here's my story. I was in Iraq in 2008-09, and started having chest pain. It was dismissed by the army doctors as probably just a strained muscle. Fast forward a few years, and I was diagnosed with pulmonary hypertension and stage one heart failure, both of which are ultimately fatal. I submitted a claim for these conditions, which was denied. I appealed this denied to the DRO in St. Louis, MO. The contention for pulmonary hypertension has a pending rating decision in the system according to my VSO. Here's my issue. I am diagnosed with Pulmonary Hypertension, as well as other diseases. The doctor who did my C&P exam clearly stated that he believed that my PH was service connected. The pending rating states that I am granted service connection for PH. However, in the section that details the rating, it is rated at 30% as "Symptomatic, following resolution of acute pulmonary embolism." In the CFR 38 section 4.97, diagnosis code 6817, Non-tuberculosis diseases of the respiratory system, Pulmonary Hypertension is clearly listed as a 100% condition. I called the 1800 number to check on the rating decision, and I was informed that it was sent to the authorizer, who then sent it back to the rater, and it is now just waiting to be authorized again. Is it possible that the authorizer saw this, and felt that the " Symptomatic, following resolution of acute pulmonary embolism" was not an accurate representation of my diagnosis, and asked for it to be updated?

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