N4XV

Just wanted to up date everybody, big white envelope arrived this afternoon. Long story short I'm rated 100% P&T effective date July 30,1991. The letter and decision notice was only 17 pages not counting all the forms attached for extra bennies. So I guess I'll be covered under the 20 year rule as of tomorrow. I had some good cardiologists over the years that documented my heart condition very thoroughly so there was no question how sick my heart has been. They even threw in my bypass scar at 0%. They didn't forget to add my wife as a dependent on my claim either. Now just waiting on my ED claim to get finished. Again, I want to thank you all for your kind words and help over the last 2 years.

No big envelope yet but super large DD in bank today. $485K. The VA must have gone 100% all the way back to 1991 for that much retro.

Actually I wasn't denied SC in 1991. I applied for and was granted non-SC pension for CAD/IHD in 1991 then the VA took it back when I was granted SSDI. In 2001 I was granted SC for DMII 20% and denied for CAD/IHD secondary to DMII because the CAD/IHD was diagnosed before the DMII.

Just a minor update. I did not receive the big envelope from the VA yet, but I did get a VA med copay bill this afternoon. So just for grins and giggles I called the 1-866# they provided if you have questions. I explained about the letter I got on Saturday stating I am rated 100% and wanted information on getting a refund on my copays. They looked me up on their computer and the rep said it says I am rated 100% back to Sept., 2003 and I am entitled to a refund. She said she would update my copay account and the refund would be automatic. She said there was no other information on what ratings are prior to that date. So I am figuring that prior to 2003 my IHD percentage rating will decrease back to 1991. Even if my claim doesn't go back to 1991 I am elated with the 100% back to 2003. Will update again when the big envelope gets here.

SP4RVN1971, Thank you. Although the letter I received didn't state P&T I'm assuming the decision letter will. After I get it I plan on visiting my county VSO to find out all the state and federal benefits I might be entitled to.

I think it is a certification letter from VA for obtaining free FL DV tags. Basically states: This is to certify that the records of the above-named honorably discharged veteran of the Armed Forces of the United States show that he has a service connected disability evaluated at 100 percent for purposes of compensation. Letter dated July 16, 2011but post mark was July 22, 2011 The letter goes on with instructions on how to apply for the DV tags. Have not yet received decision letter or retro info but hopefully within the next week or so.

Any copays you made to the VA for Meds for IHD will be reimbursed to you but you have to ask for it. You should contact your VA Pharmacy or call the phone number on the top right portion of your billing statement. It will take about thirty days to get reimbursement back to your EED. The VA will not reimburse you for any Meds you obtained outside the VA.

681 and 687 and 405 are VA end products. VA currently lists NONE of these end products as being over 125 days old. This is based on the fact the VA established these end products as of November and December. Obviously the claims are in excess of 124 days but the end products are not, at this time. Vietnam Veterans and survivors who were previously denied service-connection (between September 1985 and end of month September 2010) are listed as end product 687. An additional number of new claims have been received since the Secretary announced his intention to add three new conditions to the presumptive list on 13 October 2009. These claims submitted from October 2009 until the final regulation was passed on 31 October 2010 are listed in end product 681. All of these claims (681 and 687) must be adjudicated/re-adjudicated in order to comply with the Final Nehmer Stipulation. This is why you will hear about or see a claim as being "RATE REVIEW". If during the rate review the VA finds nothing in the claim file that "could" be a claim that was previously denied or some how not processed under Nehmer will remain in the 681 end product and go on to regular claims processing. Generally the retro pay will go back to the date the claim was filed but not before October 2009. IF during the Rate Review the VA finds "something" in the 681 end product that "could" be a possible "old" claim or an item that could be processed as a Nehmer then the 681 is changed to the end product 687. ALL 687 claims require additional follow up by the VA as generally it means there is an "old" issue that needs to be resolved/addressed. The retro pay on a 687 claim "could" go back to September 1985, depending when a claim is found to have been made but denied. A 405 end product is a claim made AFTER 1 November 2010, unless during a rate review the VA finds out something and it could change the end product to 681 or 687. Note: This info was copied and pasted from another Veteran Help WEB site.

sgtmaj, It makes no difference if you filed you claim secondary to some other condition or directly due to your service. In the Nehmer Training Guide it states: In its February 11, 1999, Nehmer order, the Court held that a Nehmer class member’s compensation claim need only have requested service connection for the presumptive condition in order to qualify as a Nehmer claim. It is not necessary that the class member assert the condition was caused by herbicide exposure.

DX = diagnoses

Ok I read your other post in Test Posting Messages Here and it explains your situation a little better. Seems like the VA is saying there is no record of your filing a claim for compensation in 2000. In 2000 shortly after filing your claim you should have gotten a letter from the VA stating they received your claim and requesting what additional information they needed from you. You stated "My wife file for disability and treatment for my heart to the VA and I was being treated for the heart from 2000 to current. We got a copy of my medical records and it showed she filed the consent to release information form for the CAD & heart. It was not filed as Agent Orange,but tied to service in Vietnam." Was this actually a claim filed to a VARO? The VARO is the side of the VA that handles Compensation and Pension claims whereas a VAMC or VA Outpatient Clinic handles the health care side of the VA. Usually they do not communicate with each other unless the VARO requests medical info from the heath care side. Is it possible your wife only applied for heath care thinking it was also a claim for compensation? The only thing I can suggest is you seek out a VSO and see if they can help you.

When were you granted SC for CAD secondary to PTSD? Did you get a denial letter for your 2000 claim for CAD? The info you provided so far is a bit sketchy. I don't want to assume anything but if your claim for CAD due to AO in 2000 is the same granting SC secondary to PTSD it would make Nehmer somewhat moot.

Not meaning to bust any bubbles but I called the 800# on Monday. My claim is also at Bay Pines and they told me mine has been with the rater since Oct. 12th. Mine is one of the more complicated claims so I don't expect to hear anything from the VA until mid to late Feb.

stillhere, I see where you are coming from. In your case it was dx'd or noted in your C&P report and gave the VA sufficient evidence or information to infer additional disabilities. The OP stated: "Veteran lost private medical coverage and requested care under VA since 1997, first as a 0% SC and later on at 20% SC" and "The veteran first filed for IHD disability in 2008, which was denied. So the veteran comes under Nehmer." To me this means at some point prior to his original claim for CAD/IHD in 2008 he had another claim that granted him a 20% SC rating. Now if at some point during the processing of his prior claim granting the 20% rating the issue of CAD/IHD was brought up he might be entitled to an earlier effective date back to his first claim. The OP states nothing to this effect. The effective date of claims for service connection is the later of the date VA received the claim on which the prior denial was based or the date the disability arose "For purposes of Nehmer IHD, PD, or HCL claims, the date a disability arose is the date VA had sufficient evidence or information to identify the existence of such a disease" In the OP's case it is reasonable to assume at this point in time that the earliest the VA had sufficient evidence or information to identify the existence of his CAD/IHD was his 2008 claim. If it wasn't put at issue in his 20% claim a rating specialist is not required to put it at issue if at that time no nexus exists. The nexus being an assertion that the CAD.IHD is thought to be SC'd by either the vet or an examiner and it being recorded in the vet's records. Bare in mind that even though the vet was getting VA medical treatment since 1997 for his CAD/IHD and his VA medical records show this, without that assertion prior to his 2008 claim all that earlier VA medical treatment information it moot as far as getting retro prior to the 2008 claim. There are the facts, anything else is smoke and mirrors.

The effective date of claims for service connection is the later of the date VA received the claim on which the prior denial was based or the date the disability arose The later is the prior denial not the date the disability arose. There are a lot of people upset that their claims will not retro back to when their disability arose and they didn't file a claim for it at that time. You are beating a dead horse right now. Like Berta said if you do not agree with the EED then appeal it.

NSA-Saigon-ET, I don't see this happening because the VAMCs and VAROs do not communicate like that. Although you were in the VA health system in 1997 your VAMC or Out Patient Clinic does not covey this information to the VARO until it is requested by the VARO and that does not happen until a claim is initiated. "The date a disability arose is the date VA had sufficient evidence or information to identify the existence of such a disease " I believe VA means the VARO not VAMC. If you did not bring up the issue of your CAD/IHD in a previous claim somehow as being SC also. The VARO would not consider it. It also says or the date of claim, whichever is later. You mentioned in your original post : Archived VAMC records should have the IHD condition listed. I have not requested the older archived records, but did retrieve the newer records for another issue some time ago. They also list the IHD condition. These go back to 2001-2002. The other issue some time ago I assume was another claim. Was the issue of CAD/IHD brought up in the decision letter? The VA's duty to assist basically has to do with them assisting in getting your medical records/service records in support of your claim. The Department of Veterans Affairs (VA) is obligated bylaw to: · notify a claimant of what information orevidence is necessary to substantiate his/her claim · assist a claimant who files a substantiallycomplete claim in obtaining evidence to substantiate his/her claim beforemaking a decision on that claim, and grant every benefit supported by the law whichis consistent with the facts of the case, while protecting the interests of thegovernment per 38 CFR 3.103(a). As I said in a previous post: Simply mentioning or being diagnosed with a condition isn't enough; there must be a positive assertion that it is due to service before it is an inferred claim. Unless you made that positive assertion and it is in your records, I concur with Berta that your retro date will be from the 2008 claim.

Simply mentioning or being diagnosed with a condition isn't enough; there must be a positive assertion that it is due to service before it is an inferred claim. I noticed NSA-Saigon-ET is 20% SC. Now if when he filed a formal claim for SC for the condition that he got 20% for and while undergoing a C&P exam happens to mention to the doc that he thinks that his heart condition is also due to service, if the doc notes this assertion by NSA-Saigon-ET in his report, the decision maker at the RO is required to put the heart condition at issue just like he does the claimed condition.

At least it sounds like good news in respect to your claim moving along. Hopefully they over estimate the 10 - 40 day thing and you hear something in a week or so.

Definitely sounds like he is a Nehmer class member as long as his records show boots on ground. I'm a little confused about his DMII claim. Was he denied then granted comp. for DMII? If that is the case then the VA concedes AO exposure and his IHD/CAD claim should go back to his original claim.

stillhere, not really knowing the inner workings of the VA I personally don't think they rate claims as first in first out. Some claims may take very little time to develop and be ready for a rater than the more complex claims. Knowing all the new presumptive were to be developed as far as they could and then held in limbo until 30 Oct to begin the actual rating process. I filed in mid Oct. of 09. But I have no clue how long it took to develop it before being placed in the holding pattern and I would think many claims filed after mine made it to the holding area before mine. Simply because theirs' were are slam dunk to develop. I filed in Oct 09 and in July or August I get a letter from the VA asking for dependency info back to 1991. This tells me my claim hadn't been developed fully and wouldn't be until they received that info or their waiting time for it ran out. This also tells me there were a lot of claims filed after mine that went ahead of me. I don't think the VA is cherry picking the easy claims but it would stand to reason that if lets say 5 raters each take a claim in turn and 2 of the five are easy claims the the easy ones will get rated first while the other 3 raters will have to spend more time getting their claims rated and ready for review. I don't know how SS does it these days but when I filed for SSDI back in 1991 they told me the earliest I would hear from them would be five months. After 5 months I got a check for one month and a few days later I received a 5 month retro check. They also told me after I was approved that they would have me under review in 5 years but that didn't happen until after 10 yrs. I try to go by the theory or 3's for anything to do with the government. If they say 10 days don't expect anything for 30 days if they 30s day expect 90 days. Hang in there brother, yours is coming and probably long before mine.

Just an update: Since change of meds last Thurs. I am beginning to feel better each day. BP going up a little everyday and those compression sock really help to keep the leg swelling down. Although those socks are somewhat uncomfortable it is nothing compared to how the swollen legs made me feel without them. The zombie feeling is just about gone but still feel real tired around 3 to 4 PM but fighting taking a nap. Hopefully they are on the right track in getting my meds balanced.

The VA can use either MET's score or LVEF (leftventricular ejection fraction) score in ratingIHD. Sometimes if you have both they can conflict in that one would award a lowrating and other would award a higher rating. You are correct in that a MET'sscore of 7.6 would bring a 10% rating. But an ECHO can show other things aBruce stress test won't show such as evidence ofcardiac hypertrophy or dilatation and LVEF that will give a higher rating. I have found, except for some special testing, they want you to take your medications as usual. As I remember for a chemical stress test they didn't want me to have any caffeine products for at least 24 hrs before the test but no problem with taking my meds. I would think withholding meds would/could change the readings of your actual level of disability. ie, make you look more disabled than you actually are.

Yes Lorraine, that is what my PCP put in my records for the Cardio Doc to see and act on. Those compression socks are helping a lot with the swelling but very uncomfortable after a few hours and although its only been one day since the meds change I've noticed my BP has gone up a little. Low 80's over low 60's today. I know I will have ups and downs until they find the right balance in meds for me. My wife thinks it is stress over the new regs but I don't feel stressed over it. I've always been willing to wait until Christmas morning to open the presents. Never felt the need to peek or open them early. Besides I would think stress would cause my BP to up not down. Thanks for your reply and I hope when the decisions start coming out everybody's BP stay normal.

Went to see VA cardiologist today. They lowered my Carvedilol to 25 mg 2 x a day and lowered my Fosinopril from 20 mg to 5 mg once a day for BP. Gave me a BP machine and compression socks to help with the swelling in feet and lower legs. Increased my Furosomide to 3 x a day if I felt the need and told me to lower my fluid intake to 2 ltrs or less a day. Scheduling me for a MUGA scan (MUltiple Gated Acquisition scan). Wants me back in 30 days to see if there is any improvement.

I have IHD and CHF. I had been on Metoprolol Tartrate for almost 25 years. Started with 25 mg once a day and over the years increased to 100 mg twice a day. Last March the VA Cardiologist changed my meds to Carvedilol 37-1/2 mg twice a day and increased my Isosorbide from 60 mg once a day to 90 mg to help with episodes of angina. Also I have been on Furosemide 40 mg twice a day for the CHF for over 10 years. Now it seems the Furosemide no longer helps in reducing the swelling in my lower legs at all since the change in meds. And before the change my meds kept my BP at near text book readings of 120 over 80. Now my BP's are very low, 78 over 47, 80 over 50 and the like. I feel very week and tired all the time. Get light headed when I stand and out of breath with the slightest exertion. Just taking a shower gets me out of breath. The only advantage I've seen to the change in meds is I don't have angina near as often as before. But I feel like a zombie most of the time. Just wondering if other vets on Carvedilol are having adverse side effects also.