[Agent Orange - Secondary]

Berta, I did include all the information you suggested in my original claim. My current plan is to wait until the decision on IHD is made in November. My METS is 3-4. After I receive that determination and I find out if they really are going to revisit my claims for hypertension, stroke, and vestibular hypofunction, then I will appeal if necessary. The current decision denies all but IHD because of the lack of service connection. I feel, as you do, that all of these ailments are related to the same process in the body. That process is the destruction of endothelial cells which leads to artery damage. This damage is not just in the heart but throughout the body. I know my layman opinion means nothing to the VA but I will submit a NOD as soon as I get the IHD rating in Novemeber. Thank you and everyone else for the feed back. Any other thoughts on this problem are welcome.

I see this differently than CHuck does-

Maybe I need more coffee-

I dont see any denial here-nor any cause to file a NOD

If you were denied in the past for the IHD -make sure VA is aware of the date of the past denial.and email NVLSP (I posted their AO addy in another topic)

Your claim is similar to mine.My husband died of ischemic heart disease with multiple cerebral ischemia contributing.

I spelled that out carefully in the claim so they do not miss his secondary and 100% disabling CVA and HBP.

I was thinklng the other day-when the regs were posted for public comment ( and my comment was referred to in the final reg analysis if anyone read the extensive info from VA on that as I questioned some figures they used regarding Nehmer)

that the amount of retro VA will pay might well be much higher than they thought for reasons like your claim and mine-

These regs for IHD open the door for more secondarys like CVAs and HBP that might generate a lot of retro that VA never considered.

IHD from AO could even "aggravate" NSC disabilties in some vets, so more comp potential there too.

VA loves to say a vet's HBP is "essential" meaning no known cause but Chuck is right-one cause is IHD and if not properly controlled the HBP from IHD can lend to stroke.

And vets have to make sure their IHD claims include these secondary conditions as due to AP induced IHD -otherwise VA will ignore them.

[Agent Orange - Secondary]

In November of 2009, I applied for compensation based upon agent orange exposure while I was in Vietnam with the Army in 1967 - 68. I have had heart disease since 1989. I also claimed vestibular hypofunction, stroke and hypertension as secondary. All of these ailments are caused by endothelial damage to the arteries as is IHD. I finally had a C&P in August 2010 for all the condtions claimed. Each VA physician or health care professional I saw confirmed and stated in the C&P report that all health problems I claimed were at least as likely as not caused or aggravated by exposure to agent orange. My Board Certified private cardiologist of 20 years also stated the same in a letter he personally wrote to the VA.

Today, Oct 10, 2010, I received a rating decision from the Cleveland Ohio VA. I quote as follows - "Decision - A decision on entitlement to compensation for ischemic heart disease is deferred. Service connection for vestibular hypofunction, stroke and hypertension is denied". The decision also states the following: "PLEASE NOTE: As you claimed secondary service connection for hypertension, vestbular hypofunction, and stroke, the disabilities will be reconsidered on a secondary basis following finalization of the new additions to 38 CFR 3.309(e), which establish ischemic heart disease as a presumptive disability of herbicide exposure".

In regards to the PLEASE NOTE above - I thought this had already been completed so I went to 38 CFR 3.309(e) and confirmed that the three new presumptives are already there. How could the rating officer not know the CFR has already been updated? When does the mental torture stop? Does anyone know what's going on? Has anyone else received anything like this recently? Do I now have to go back in and ask the VA to reconsider the secondary basis conditions or will they automatically do this? By the way, they told me how to appeal in the same letter although the letter states the IHD is deferred and the secondary conditions will be reconsidered. Wonderful - after a year, I still don't know whats going on. Any suggestions on what to do now???

[Scars]

Based upon past medical history and records I provided plus a letter from my cardiologist, the VA doctor perfroming the C&P ordered a MUGGA scan (nuclear medicine scan) and a echocardiogram. I did not do a treadmill because past echo's (multiple echo's) revealed ejection fraction below 50% plus I have left ventricular hypertrophy and diastolic dysfunction Grade II. I assume my comp level will be based upon the METS level assigned by the VA physician conducting the C&P since the ejection fraction is considered normal above 50%. My original question was about the scars from the open heart being secondary to IHD. I would assume they are compensable but will have to wait.

If you just had a C&P did they do a stress test for your heart? If they did there should be a reading there for your mets and for your LVE they will use the one that gives you the best rating.

I question how you could do a walking stress test if you have trouble with balance?

All I can offer you as far as the suffering and losed career is I am deeply sorry for you and I know that will not get you anywhere, but thought I would mention it. The other thing your mistake for not filing for IHD was just that a mistake, how were you or any of the many vets that did not file and all those that died!

As you can see this particular issue really gets my dander up!

I hope I can control myself on the 25th!

[Scars]

I filed last November for IHD, Stroke, but just completed the C&P last week. It took 8 months to get the C&P. The heart surgery was not done at the VA. Two of the three bypasses failed three months after surgery. No other surgical options were available at that point. I never filed before because I was told - like many others - it wasn't compensable so why file. Big mistake on my part - Nineteen years lost. I did file for CVA as secondary. The stroke caused me to lose my vestibular system (balance) so when I walk I look like a drunk. I used to be a pilot but the heart disease and stoke ended that. I worked as long as I could but had to quit a few years back. It's too bad you can't be compensated for 20 yrs of suffering and a lost career. I have reviewed the VA information and feel I should get something but the damage to my heart is on the right side, not the left (pumping side) so my ejection fraction is above 50%. I don't know what the MET level will be. Anything would help.

Have you filed the IHD claim yet? Is that what the CD & P was for?

I see you listed no SC disability.

Make sure you claim the stroke as secondary to the IHD.

My claim is similiar- I am not a doctor but if you have IHD- it is as likely as not that the CVA is due to it unless the VA could somehow find another reason for the stroke.The reason is that IHD is an atherosclerotic involvement of the heart causing narrowing of arteries- which could include eventually in some cases- -the arteries of the brain.(cerebral ischemia)

If a doctor states that for you and gives a full medical rationale then the VA would SC the CVA as secondary to the IHD.

I assume (but not sure how these new regs will really work)

that if the VA grants 100% for IHD then they should consider SMC entitlement for any additional but independent disabilities due to the IHD.

Did VA ever deny your heart claim in the past?

I mean 'independent' as involving separate organs but yet the etiology would be the same.

[Scars]

I am a VN vet with heart attack at 43, open heart at 43, multiple angioplasties, stent, stroke, etc before age 50. The open heart was performed in 1991 almost twenty years ago. My question is about the scars that were left from that surgery. I have looked at the VA information on that subject listed under "Skin" and I'm still not sure if those scars are considered compensable. The guidance seems to focus on linear vs nonlinear in shape. The scar from my leg where they removed the vein they used for the bypasses and the scar on my chest meet the size requirments for 20%. Are these scars considered secondary to the IHD I have? I ask this question because the VA doctor that examined me for the C&P measured the scars for his report. Has anyone had any experience with this issue?

[Sen-Webb-Questions-New-Benefit-Vietnam-Vets]

Here we go again... Everyone knows we just spent 700 billion plus on stimulating the economy. Does anyone feel stimulated? Senator Webb just spent months passing a new veterans education program worth over 50 billion dollars over the next ten years for those serving since 2001. Compared to the Vietnam era it is extremely generous. The government bailed out wall street, the banks, and even some money went overseas to other countries and now maybe even Greece will get help with some of our tax dollars. All of a sudden our government is concerned about deficits. Now, comes the Vietnam vets and the three new diseases. The cost estimated at 42 billion over 10 years. Suddenly the cost is too much. Do you think Senator Webb or anyone else for that matter would be paying any attention to this if only a few Vietnam Vets had heart disease? Of course not. It's only because many vets have heart disease and the cost for compensation will be a lot.

The war in Vietnam lasted 10 years. When I was there in 1967-68, we had over 500,000 troops on the ground. In Iraq, the most was around 160,000. Many Vietnam vets have the disease because many served and many were exposed. Therefore the cost to treat and compensate will be higher. Agent Orange was everywhere. The run-off from the jungle migrated to the streams and rivers and into our water supply. We cooked with it. We drank it. We bathed in it. What do you think the chances are that a lot of us may have health problems from it? Senator Webb stated that the 1991 rules were established to address those rare cases of agent orange related diseases. Duh... So if a disease was caused by agent orange and it only affects a few veterans then we should take care of the veteran but if a disease, caused by agent orange, affects many veterans, then we should not take care of the veteran. Does this logic make sense to anyone but a politician?

Congress set up the rules in 1991. The VA has followed the rules. The IOM has determined that these 3 diseases meet the same criteria as the diseases already approved in the past. This includes ischemic heart disease. There are four categories that can be assigned by the IOM for the disease studied. They are:1) Sufficient Evidence of an Association, 2) Limited or Suggestive Evidence of an Association, 3) Inadequate or Insufficient Evidence to Determine an Association, and 4) Limited or Suggestive Evidence of No Association. In the past, diseases studied and classified in category one or two were approved. Category three and four were not. The IOM report is 676 pages long. The breakdown of diseases by category is in the report. The IOM went out of their way to be fair and impartial.

In addition, if congress changes the 1991 rules they set up for the VA and also changes the criteria that IOM must use, do we revisit the diseases that have already been approved and apply the new rules to them - thereby changing compensation for already approved diseases? The potential for problems and long delays is limitless and maybe intentional. This whole thing stinks to high heaven. By the way if you want to read the IOM report on line, here is the web site: http://www.iom.edu/Reports/2009/Veterans-and-Agent-Orange-Update-2008.aspx

[Disability Retirement For Fers Employee Who Is Also A Disabled Vet]

Try the Office of Personnel Management (OPM) Web site. There might be something there to help you.