Lorraine

I'm wondering the same thing about Vet's who have already filed claims for IHD/AO. My husband did not receive this form from Seattle RO, but he filed last NOV09' and it looks like the form didn't come out until May2010. He had a C & P and was sent for an Echo in lieu of a stress test so they already have this information. I absolutely do NOT agree with the statement refuting hypertension, strokes, peripheral vascular disease not being related to IHD! VA has been adamant about hypertension not being a AO presumptive so feel they are protecting that decision with this statement. I like the form for its brevity and concisemness. If the treating cardiologist is willing to state that the Vet has IHD and they've served time in VietNam it SHOULD be a done deal, then the rating will all depend on the severity of the disease determined by the Mets level, ejection fraction,presence of history of CHF, etc. Will save reviewers/raters lots of time if the cardiologists are willing to fill this out. They won't be having to search through years of clinical visit notes for documentation. I'm curious as to whether the section that states "Provide only diagnoses that pertain to IHD" doesn't provide the format to include such things as Hypertension, CVA(stroke), etc.? if the doctor states these other diagnoses are caused from IHD? This could get very interesting. Lorraine

N4XV, Appears that your medications just need some fine tuning. I'm having the opposite effect from Carvedilol,just got started on it in August for heart failure and my blood pressure has gone up considerably. The cardiologist is attempting to tweak the dose, but bp is still climbing. We all react differently to medications, so it's important to keep the prescribing doc informed. I'm glad you went back and some adjustments are being made. Hope you get feeling better soon. Don't wait 30 days if your symptoms don't improve. Lorraine P.S. - I guess after NOv 1st rolls around ,or, IF and WHEN my husband hears from VA on his AO/IHD we'll know if my increasing bp is due to the new Rx or waiting for the VA to make a decision!! :-)

Airdale-just read your post and am so sorry about your SA, subsequent trials with VA. and your health issues. It takes a lot of courage for any rape victim to come forward, but especially for a guy. I'm just appalled that anyone thought that your assault was a "gay" issue, including you. You have no way of knowing your abusers sexual orientation, those two guys could have had wives and children. Rape is not about SEX, it's about power and intimidation. My heart aches for you. I don't have any helpful information to help you with your claim; but, just had to let you know that someone out here in cyberspace cares about you and wishes you well with your health and your claim. Take care of yourself. Lorraine

Berta, I couldn't be more sincere in complimenting you folks that are so good to be responding to us "newbies" to this journey. I have spent hours and hours reading through info since I found this site, so have some idea of the time and effort those of you have put in to help others. You are like an encyclopedia of very detailed information-remarkable! I'll dig through the private medical records to determine if I can find the necessary wording about hypertension being caused by the IHD. The cardiologist has SAID those words, but whether or not they are in the records remains to be seen. He's a real pistol all right. He's absolutely brilliant and well thought of in the community for his expertise, but even other docs agree he has the bedside manner of a porcupine and is as arrogant as they come. In fact, he had to move out of our local community because the old-fashioned family docs quit referring patients to him!! But, he's kept my guy going when the prognosis sure wasn't very good, so I've had to let it be. I DO fight back tho- when he made his holier than thou statement about not believing for one minute that AO had anything to do with causing IHD, I just sarcastically said "well, aren't we lucky that it's not you making that decision since you obviously haven't even looked at the research yet, but are willing to make that judgment!" We've had several go arounds over the years. My husband has quite severe scarring cuz he had the initial quadruple by-passes in 1980, then six yrs ago had quintuple by-passes. His chest of course is sliced up, but his legs have really been hacked on to get the veins - had to take mammary artery the last time since they are out of options. I had no idea about a rating for scars - the C & P doc did measure and document those, but we didn't do any kind of a claim for them. After all I've learned here on this site, I realize now all the things we should have filed for - never went back to the VA after the denial in 1979, not even after his heart attack and surgery and his inability to work for three months! We were young and naive - when VA told us he was fine, no problem with blood pressure, etc. and then denied the claim for hypertension, we thought it was a done deal. Never looked back until the AO/IHD stuff hit the press and we filed the claim. So, even tho he had to quit working and take an early retirement at age 60 due to health issues, we also didn't do anything about Soc Sec disability - dumb, dumb. We nearly had to file for bankruptcy for the medical expenses that weren't covered by the old Champus plan and then he couldn't work! He's 69 now and it's a moot point. Just glad to be here to be doing battle with the VA. It looks like I've got more homework to do Berta, but you sure have provided me with lots of valuable information. If I get stuck, looks like "Hadit" is the place to get some guidance. I'll keep you all posted as to the decisions in hopes that it might help someone else starting out on this journey. Again, I thank you. Lorraine

Thanks so much, Berta and Chuck. I have copied off the information you provided for our growing VA file. Berta, you asked some specific questions so will attempt to answer them No, my spouse was never "treated" for hypertension while in the service. He was diagnosed with borderline hypertension and monitored for that, but rec'd no treatment. It evidenced on his retirement physical also and it was recommended he file a VA claim at that time to get it "on record" The claim was denied as his "numbers" did not meet their criteria for hypertension. (Too bad somebody didn't do something at that time, but told he was fine and sent him out the door. 14 months later he had three cardiac arrests and four by-passes at age 39!) Yes - we do have all of his service medical records, but his "numbers" weren't real high then, just a warning of things to come. ALL of his medical treatment has been through private civilian sources and his cardiologist has stated that his hypertension is related to his IHD. But, whether or not he'd be willing to put that into writing is another case. He was pissy when he found out my husband was filing for IHD/AO - doesn't believe "for one minute" that it's a presumptive disease for agent orange. We'd gone to him to ask if it was safe for my hubby to have the stress test req'd for the C and P. He blew us off and said - "it's your choice, I suppose it depends on how much money VA would pay you for a disability - you could always give that up!" Fortunately, the C & P doc rescinded the request for the stress test after reviewing his records(he's had another five by-passes) and ordered an echo instead and his ejection fraction was rated at 50%. I totally agree with you, Berta, about there being no "nexus" for the hypertension. We'd filed the claim BEFORE I found this site and learned all of those things. Here's my thinking now. I'm thinking we should wait until the deferred decision on IHD comes in and if that's a "go", then attempt to obtain an IMO from his cardiologist regarding the hypertension being caused by his IHD and then proceed per your advice from there. IF you don't concur, let me know which direction we should be heading in. I really appreciate all that you elders provide in the way of information. I know the kind of time it takes and want you to know how much you are appreciated. You spend hours of your time helping others so I'm hoping that only good things come your way for all of your efforts. Lorraine

Denial info for hypertension claim posted in Claims section. The claim was for hypeertension secondary to ischemic heart disease/ischemic heart disease based on heribicde exposure. But, along with the denial for hypertension, this is the communication from Seattle RO about IHD/AO claim filed last October! "We have deferred a decision on your claim for ischemic heart disease based on herbicide exposure. However, this disease has not yet been added to the Dept of VA regulations governing diseases presumptively associated with herbicide exposure. In order to add this disease, we must follow a series of legal requirements, including publishing a notice in the Federal Register. We have begun this process, but are holding your claim until these legal requirements have been met. When the process is complete, we will make a determination on your claim and provide you with a notice of our decision. Letter Dated October 4, 2010 Lorraine

Denial of claim states that "the claim for service connection for hypertension remains denied(had filed a claim back in 1979 that was denied because his bp readings, although elevated, did not meet VA criteria for hypertension)) because the evidence submitted is not new and material" (We sent medical records and they obtained medical records for continuous treatment of hypertension since 1980)."Although you submitted evidence to show that your hypertension manifested to a compensable degree....this did not occur within a year from your discharge from military service.""We determined that the following condition(Hypertension) was not related to your military service, so service connection remains denied." Of interest to those of you with IHD claims due to herbicide exposure(AO), it goes on to state that "we have deferred a decision on your claim for ischemic heart disease based on heribicide exposure. However, this disease has not yet been added to the Dept of VA regs governing diseases presumptively associated with herbicide exposure. In order to add this disease, we must follow a series of legal requirements, including publishing a notice in the Federal Register. We have begun this process, but are holding your claim until these legal requirments have been met. When the process if complete, we will make a determination on your claim and provide you with a notice of our decision.(dated Oct 4, 2010) We're in the "dumpers" today and my thought is to wait until we get a ruling on the IHD/AO claim and then go from there - keeping in mind the time restriction for filing a NOD. Anybody have any thoughts? I'm reading through archives related to hypertension claims, but unable to find if the regs apply to bp readings while under treatment or without. My hubby's on numerous meds to keep his bp lowered, can't imagine what it would be untreated - and, is he to go off meds to get higher readings and risk a stroke?? Not wise. Lorraine

Just watched the Senate hearings on AO/IHD and trying to digest all that was said. I was very frustrated with the statistics offered about 80% of the male population having IHD(with or without symptoms!)in the 60-70yr age group. My husband was 39yrs old with his first quadruple by-pass surgery after a massive MI and all one has to do is read the various Viet Nam Vet's sites to learn that age group being affected was not unusual with these Vets. And, what about all of the Vets who are already deceased from IHD and didn't make it to 60 yrs of age???? But, for that age group to have severe IHD is certainly unusual for the general population of males in the U.S. My head is swimming and I'm ticked off, so better quit my rambling. Lorraine

Dear VetsLady- I'm sending you a "virtual" big bear hug and hope it helps. You are just plain tuckered out from carrying the load. Having done homecare and hospice nursing for over 25 yrs, I often worried more about the caregivers than my patients, wondered who was going to give out first at times! You need some respite help and a break to renew your spirit. Please, please, call on whatever limited support you have available to take care of yourself. I'm worried about you! Lorraine

Berta-some confusion as to whether or not I should submit spouse's AO/IHD claim info to NVLSP as I don't want to inundate them with claim info that doesn't qualify. He filed a claim for hypertension back in 1979 when his retirement physical had evidenced hypertension and was advised to file a claim. He was told by the VA doc who did the exam that he was fine, didn't need any follow up for hypertension and the claim was denied. We were relieved, we were young, what did we know? Within a couple of months, at age 39,, he had a massive MI and three cardiac arrests, followed by four by-passes before his 40th Birthday. (Ya gotta wonder if he'd had treatment for his hypertension early on if he would have had a MI at age 39?) His medical file since the MI in 1979 is full of references to his severe IHD. He has since another quintuple by-pass. Had a VA requested C & P in March 2010 with an echo that evidenced an EF of 50%. Have not had decision from them and haven't heard anything about Nehmer, but he has not ever received any compensation, so don't know where he stand on that. My confusion is the hypertension/IHD issue. His re-opened claim states that his claim is for: " Hypertension Secondary to Ischemic Heart Disease(Previously Denied) and Ischemic Heart Disease (Claimed as Heart Disease)(Previously Denied)". Please advise as to whether or not you think this is an appropriate claim for nvlsp. Thanking you in advance for any input. You ARE the AO guru and your wealth of knowledge of working within the VA system is incredible. Thank you so much for your time and effort and studying! Lorraine

Congratulations on your win and kudo's for your tenacity at sticking with it! Lorraine

Rockhound If you are working with a VSO, give him/her a call, our guy always seems to be able to tap into the "system" and get info for us. Also, since my husband's C & P's were done by QTC Med Systems, he called them direct to ask what the exam was specifically for, what kind of tests would he be given, etc. They answered specific questions, but were very tight-lipped. Lorraine

Thanks for the info - UNANIMOUS vote in the Senate? - that's just disgusting. Time to get those letters flying! Lorraine Thanks for the info - UNANIMOUS vote in the Senate? - that's just disgusting. Time to get those letters flying! Lorraine

YIKERS! Catching up on my reading after being gone an extended time over the Memorial Day w/end, so am just now reading this disturbing delay tactic by Senator Webb. I know it's the w/end and all so responses can be slow on this site; but,if anybody reading this has some direction for me in finding out how our individual Senators voted on this, I'd appreciate it. We need to do more than just target Senator Webb, what we have to say won't matter as much to him unless we are from Virginia and can vote there! Hopefully, if we send emails or letters to the entire Senate Veterans Affairs Committee, we'll make them aware that we are watching and that we VOTE! We need to find out how our individual Senators from each state voted. Many of them are coming up for re-election this November and they WILL pay attention to what our views are. I'm personally contacting our niece and her husband who vote in Virginia and any of our military buddies who live there and BEGGING for them to contact Senator Webb on our behalf. Thanks to those of you who stay on top of the issues and keep the rest of us informed. Lorraine

Carlie Catching up on postings and my heart sank with reading of your decision and you being in the "dumpers". I only had a few minutes of reading to be able to be joyous for you, but am so PO'd that you had to go through this torment for days! Congrats, girl. You more than deserve this! If I wasn't so old and arthritic, I'd be turning cartwheels for you down the hallway. ;) Lorraine

Don't be embarrassed....There are MANY of us out there who can't tolerate a MRI or CT scan, I can't even be in a 6 man tent with my hubby without having the flap open (not great for keeping out the mosquitos!!), have a miserable time at the dentist when they TRY to make me lie flat - won't do it! I managed to get thru an "open" MRI with oral anti-anxiety meds, but it was a struggle. Am so glad that you stuck to your guns - no need to have you intubated - IV meds will work great. Good luck. Lorraine

It took about six weeks for my husband's reports to come to the RO. His exam and test were through QTC Medical systems. They informed him they have 30 days to get the reports in, but that's not a hard and fast rule. A VA rep had called him with some questions on a Saturday and my guy asked the Rep if they'd received the reports from QTC and he said they had not, but they'd sent out a request. It was Tues of the next week that the reports came to the RO. I emailed his VSO and asked him to watch for the reports (he's really been good about responding to requests to help us). He was able to get the reports within a day and made copies for us. We are fortunate to live in the same city as the RO so makes it easy to make a trip downtown. We've never had to deal with any VA personnel, the VSO has done all of that for us. From what I've read here, I think we're very lucky! Lorraine

We've corresponded previously so you know that my husband and I are very new to this journey through a VA claim process, so, I can't comment as to the outcome of your rating for disability. But, I'm just thrilled for you to read that after your heart attack that your your EF was 75% during the recent angiogram. I know you've been kind of in the "dumpers" after your CABG surgery, but this is really good news for your cardiac health. The 75% EF might not be so great for your disability rating, but it's wonderful for your prognosis. Hope you are feeling better every day. Just know that if things DO worsen, you can re-open your claim with supporting evidence of your cardiac status worsening. Best of luck to you. Lorraine

Berta, Can't think of anyone more deserving of getting every dime that is coming to you. You worked very hard to get this and your other awards, so, couldn't be happier for you. I've poured over this site gleaning information and so much of it comes from your diligence and hard work. Thank you, thank you - now, go CELEBRATE!!! Lorraine

Saturneneptune I've folllowed your postings and have empathised with your recovery from your CABG. My husbands first quadruple by-pass was in 1980 at age 39, following a massive heart attack. That was a tough recovery and he started a new job way too soon- no rehab at that time. His prognosis was for 7-10 yrs at that time and said they'd never be able to do a "re-do" as he had too much heart damage and the blockages were too diffuse. So, pay close attention to the rest of this cuz it'll give you some positive hope for your own recovery and prognosis. He's lived a really good life, we made adjustments, it changed our lives forever. He really was a "trooper", at 39 yrs, he was highly motivated. He did change his diet, never smoked again, he did his "heart walks" daily and at 7 yrs ended up in the hospital because his grafts blocked off. Then it was another adjustment, now lots of meds., no more "heart walks", always some angina with strenuous exertion, but was able to work a desk job and then took an early retirement. Lots had changed in those years with heart surgery and TWENTY FOUR years after his quadruple by-pass, he had a "re-do" and had a quintuple by-pass done by the same surgeon! (that was 6 years ago, so we are talking a 30 yr recovery from the first surgery and he's doing well!) Not so great about watching his diet these days - at nearly 70, he's really tired of being GOOD! No harping from me either - he fought the good fight for years and years and it paid off. When you have your "blue" days(and you will)just remember this story. It's a tough surgery to recover from, both physically and mentally. It changes your life, but you will come through this, it just takes time. I'd send you a virtual BIG HUG, but I know it would hurt too darn much! Your chest will be tender for months and the numbness may never go away - my husband has an area of numbness, but it's not really problematic. We have made a pact not to let this VA stuff drag us down - we've lived without one iota of help - either medically or financially - from the VA all of these years, so if it all goes south on us, so be it. We'll be okay no matter what. I just happen to be a stubborn Swede and am as tenacious as a pit bull, so I'll do battle, til the battle is over. All of you VETS deserve compensation for any service connected disability, I just wish we'd been more informed when we were younger and challenged his first denial for hypertension. But, knowledge is power and now I'll be on them like "ugly on an ape"! Your C & P sounds very similar to my husbands, so, I was quite pleased with the end results. His report indicated that the M.D. appeared to have read the medical history, English was his 2nd language, but he wrote a very concise, accurate and comprehensive report. You take care of yourself, know that a year from now you'll feel a lot better. You are still in a bit of shock and need time to heal.

My husband had his C & P March 10, 2010 and an Echocardiogram March 22nd. As of last Mon (4/26) VA had not rec'd the results of those exams, but had put out a request to QTC for them. Thurs. (4/27) we rec'd a notice from QTC of the need for him to follow up with his PCP re: his elevated blood pressure and findings on the chest x-ray. I wasn't surprised about the BP concern, but was a bit alarmed about the chest x-ray. Had read here on hadit that it's fairly routine for the "CYA" letter, but still wanted more info. Contacted our VSO via email(he's not good about returning tele calls, but prompt in responding to emails) asking for copies of the C & P and echocardiogram if they were available. He got right back to us Fri morning, said he'd made copies and we could either pick them up in person or he'd mail them. Luckily we can easily get to the RO, so picked them up. Looks like nothing too serious on the chest x-ray (says he has COPD, but this had never been diagnosed before so we'll get it checked out). Could be, he was heavy smoker til 1979 and his heart attack and the first by-pass surgery. Never smoked again ( However, I kept puffing away for another 7 yrs, but that's another story!) In the C & P exam report, the M.D. stated his estimated METS level at 3-5 and the ECHO Ejection Fraction was 50%, so - if everything proceeds as it should, he should initially be rated at 60%. Now we just have to wait on the FINAL ruling as this being presumptive.

Welcome, welcome. Read everything you can manage about the various topics on this site. I'm rather new also and haven't made it all of the way through the numerous topics, but, I'm trying! Lots to gain from and learn. Lorraine

Thanks to everyone for their replies and input. Makes me so glad we followed our own 'gut" feelings and didn't agree to the ECA. Our VVA VSO was certainly FOR it and recommended my husband sign it. It was only by calling other VSO's that we made the decision not to sign any waivers! Now I'm a bit worried about HIM representing us on this journey. I'm sure wishing we'd have found this site BEFORE filing the claim! Lorraine PS to Berta - I wrote down all of the info you provided about how to make comments about the new Regs. I'm so darn computer illiterate, but will give it a try - AGAIN! Thanks for all of the time and effort you put in on this site - you're a jewel!

Tinkerer...thanks for the input. Hadn't read anything about the ECA "offer" on hadit and was curious. I didn't see how it could help us anyway when the final word hasn't come out yet. Lorraine