Clarke221

Hi All, We are headed to MD to see the leading doctor for ARVD (Arrhythmogenic Right Ventricular Dysplasia) at the end of the month, and he is going to write an IMO in support of our claim to the VA. My husband had palpitations while in the Army but they were never documented in his SMRs. He was honorably discharged October 15, 2009 with 30% disability but none of it was heart related. In December 2009, he had an EKG done that said he had an abnormal heart rhythm that left room for concern. We went to a cardiologist in May of 2010 and they wrote it off as something insignificant after doing another EKG, a holster monitor for 24 hours, and an echo. Then September 2, 2010 he landed in the hospital for 18 days and was diagnosed with ARVD and had 2 heart caths, a cardiac MRI, numerous echos and other procedures, and an AICD implanted. The doctor we are going to see is not the doctor that originally saw him and treated him for the condition. He is however the leading expert on ARVD in the country, so I feel that his opinion will work. He has asked us to bring some examples and/or directions for the letter so he can write it while we are there. Can anyone give me some suggestions of what it should say. I know it should say something to the term of the ARVD as likely as not developed during my husband's time in service. Also that the physical stresses of active duty as likely as not aggravated the condition. This can be a genetic condition, but it is only found to be genetic 50% of the time. The doctor that treated my husband in the hospital is under the impression that it is genetic, period. So I'm guessing the IMO needs to read that it is as likely as not a genetic condition? Is "as likely as not" good enough to help us out or does he need to use different terminology? What else do we need to make sure is in there? Some of you may have seen my post about the C&P exam. They are not sending my husband to a C&P exam for his heart. He's already had all his other exams for the rest of the claims we submitted earlier this month. Hoping that if we get the IMO in the first week of February that it's not too late. Thank you in advance for your help!

Also thought I would add, there is nothing in his SMR's that shows heart issues. He had palpitations while in the army but was told since he never had them during duty hours not to worry about them. His troop was big on the "quit being a baby" thing and told all their soldiers to suck it up and deal with it unless something was broken or life threatening. This is the only thing I feel could hurt us. Just need to get that IMO.

Jbasser, no he has not taken either. He is on amiodarone for his heart, as well as about 6 other medications. As for the heart caths, those, along with a cardiac MRI were sent with his records. He had an 18 day stay in the hospital, most of it in ICU, with two heart caths, an MRI, and the defibrillator implantation. Thank you for the BVA website, I will take a look at it. Pete, he is not working. He is on short term disability with his company now, and we are in the process of filing for long term. We are also about to submit a claim for social security. Hoping that will help us with the VA.

Suppose I should have added: The ARVD surfaced within a year after he got out of the Army, and he had an EKG two months after he got out that said his heart beat was off, and something was wrong. So our rep told us since it's within a year of his release, that there's a good chance it would be honored without too much of a fight. As for it being a genetic condition, we haven't had the genetic testing done yet, but only about 50% of the cases have turned out to be genetic. So there is no proof to say that his condition is definitely genetic. We are working on an IMO to say that the Army as likely as not worsened and aggravated his condition. Should have it within a month. I'm hoping that's not too late. Sounds like my fears are right though, that they're just going to deny it.

Trying not to read too much into it, but I'm really curious about this, and since it's the holiday, can't call our VARO to ask. We submitted a claim for multiple things for my husband in late November. He's been to 3 C&P exams, and in the letter they sent that was all they said he would go to. Those were for PTSD, knees and back, and hearing/tinnitus. We also submitted a claim for his heart (he has a defibrillator and has been diagnosed with ARVD) along with no less than 100 pages of medical records as proof. Because we've never been through this, I just thought they would do a C&P for his heart too. Since they aren't going to do one, is this a bad sign, or are they just skipping that appointment because we submitted enough evidence that he has a condition and a defibrillator? Thanks in advance!

"Who employs this cardiologist? Military? VA, or Private doctor?" This was a private doctor. "I think that would best come from a SSA determination rather then a lawyer." I tend to agree. We will give it a try. "Does your husband have a vet rep helping him with the claim?" He does not. Do we just go to a local VA office to get someone to help us? "Does he have a complete copy of his SMRs?" Yes, we have a complete copy, I will take them with us. I will say, regarding the abnormal EKGs that the dr was not concerned about. After the diagnosis of his condition, the doctors have determined that the EKGs show the condition, but the only way to diagnose it for sure is a cardiac MRI, which was done during the hospital stay. Because the condition is rare, it is normally not diagnosed just through an EKG, as many people do have simply abnormal heart rhythms. Thank you for all your help!

Berta, I'm guessing you are questioning the doctor's lack of concern. He stated that people have abnormal rhythms sometimes. I left out that they did a stress test as well. Because they never saw any palpitations or anything other than an abnormal rhythm, they were not concerned. Our cardiologist now says he would have thought the same thing until my husband went in with a heart rate of 260.

Please forgive my ramblings in advance. So much to say to explain our situation. I posted a little about what is going on in the "introduce yourself" forum yesterday, but thought I would get more in depth here and see what you all have to say. Here is a timeline of what has happened over the past year regarding my husband's service and health: October 15, 2009: honorably discharged from the army with 30% disability for knees and back October 16, 2009: started with National Guard December 2009: medical testing for new job showed abnormal EKG May 2010: cardiologist found abnormal EKG, holster monitor for 24 hours, echo cardiogram, all came out showing abnormal heart rhythm, but cardiologist was not concerned September 2, 2010: landed in hospital with heart rate of 260bpm September 20, 2010: discharged from hospital after 2 cath labs and implantation of defibrillator October 28, 2010: VA received letter from us claiming disability for heart, ptsd, eyesight, hearing, and increase on back and knees. He had heart palpitations throughout his career in the army, but never knew what they were, and the army never examined him for it or took an EKG or any other type of heart tests. He has now been diagnosed with ARVD (Arrhythmogenic Right Ventricular Dysplasia) which is basically a condition that causes cells of the right ventricle to be replaced by a fibrous scar like tissue when they die off. The new tissue does not conduct signals correctly and causes abnormal rhythms and rates. My husband's heart beats at 160bmp now if he does not take his meds. He is on 4 heart meds at the moment to keep his heart strong and at a safe pace. We have sent an initial letter to the VA to claim disability for his heart, and as stated above, also added ptsd, eyesight, hearing, and increase his back and knee rating. We go on Monday to get a letter from our doctor stating that the ARVD had to be present while he was in the army, as it cannot develop over a period of months, and that his activity in the army (deployment, heavy PT, etc) stressed his heart and more than likely made the condition worse. I have done research and assume that we need a nexus letter, although the army medical records show no history of a heart condition. We have yet to get confirmation from the VA that they have received the initial claim. I have also been told to try to get it expedited, but I am not sure about how to get that done. I am going to call my congressman today and see if they can help. Is there a form that I need to submit along with a letter from my congressman? We are in the works of getting together the actual form 21-526, dd214, marriage records, hospital records, etc to send in to back up the original claim sent in October. I know they need to get there within a month of the original claim. Do we need to send in form 21-4138 as well? He has been off work since he went into the hospital, and his doctor will not clear him to go back at all. So he is on disability from his employer. Some have told us to file for social security disability as well, but a lawyer advised that he will not be approved because he is capable of a desk job, and his disability from his employer pays too much to qualify for additional income from social security. He is also still serving in the National Guard and they are in the process of getting him to the med board, but that seems to be the last thing on their minds. I know this can take a while, but they haven't seemed to move an inch over the past two months. He had a doctors note for a temporary profile when he got out of the hospital, but that profile has expired and they don't have him on a profile at all at the moment. They excuse him from PT, as he cannot do anything that is physically draining, but there is still nothing on paper saying he cannot deploy or do physical activity. I'm a little skeptical. Anyone that knows about the VA has told me that we shouldn't have any problems and he automatically qualifies for 100% because he has a defibrillator. I guess I just see them looking down on our claim because he is 25 years old. I'm really hoping we don't get denied and have to go through the appeals process. Any advice would be appreciated. I'm hoping to have everything we need in a folder and overnighted to the VARO this coming Monday, so if you all have suggestions I will try to include everything in that. Thank you in advance.