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  1. Hey all, Bit of an update. I have been SC for PTSD at 30% and tinnitus at 10%, denied for two other conditions and my TBI claim was "deferred". I had my TBI C&P about a month ago and in the process I've recieved two notifications on va.gov that two more exams have been scheduled. Well I called VES today after not hearing from them about any new appointments for two weeks and the rep on the phone told me that there was no new exam requested...that the VA actually just "kicked back" the C&P two times. They said they are "reworking" the exam. Anyone experience this before but not get scheduled for a new appointment?
  2. I have roughly one million questions but I'll try to keep it simple. This is the first time I am appealing a denied claim (though not my first denied claim - I currently have 50% combined). Almost exactly one year after my C&P exam I finally got a denial for both of my knees). I did a HLR informal conference and now my va.gov status says "The VBA is correcting an error". Here is the decision I received on Dec. 7th after the Higher Level Review (sorry I couldn't figure out how to add image) and below that are my questions. Decision: 1. A duty to assist error has been identified during the Higher Level Review of left knee pain. 2. A duty to assist error has been identified during the Higher Level Review of right knee pain. Evidence: Timeline from intent to file on 10/2/19 to HLR informal conference on 12/2/20 Reasons for Decision: 1. Higher Level Review for left knee pain The issue of left knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of patellofemoral pain syndrome. 2. Higher Level Review for right knee pain The issue of right knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: A nexus or link has been established between your claimed issue and an in-service event or injury. During VA exam dated 11/7/19 the VA examiner provided a positive medical opinion linking your right knee to service. You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of right meniscal tear, right knee instability, and patellofemoral pain syndrome. MY QUESTIONS 1. Am I just out of luck because I didn't seek treatment during Active Duty? 2. Under "favorable findings" it states that "a nexus, or link, has been established between your claimed issue and an in-service event". Isn't that the literal definition of a service connected disability?! 3. What is the error? What have you all seen as timelines and outcomes for this? Thank you to everyone who takes the time to respond and post. Reading these questions/answers over the last year has been both educational and comforting.
  3. Hi Everyone I recently had a C&P exam on the 9th of July, the examiner told me that it would take 30 days for her to do her research and come to a decision about my claim. So the 9th of September was the 30 day mark and the case is still open as of today. I checked my blue button records and she actually made a decision on my claim the same day she said it's less likely than not. So my question is has any one seen results take this long and why would she lie to me and say it's going to take 30 days for her to find results and she made a decision the same day.
  4. Hi Everyone I had a C&P back in Dec for my migraine condition and I was denied and the examiner said the condition was less likely than not related to my car accident. So I filed a HLR and the VA gave me another C&P and I just looked in my blue button records and the C&P examiner this time said that my condition was not at least as likely as not related to my car accident. Can someone explain the difference to me because they sound like they are saying the same thing and thanks in advance.
  5. Shouldn't it be in medical records that I can access on va.gov? My request for a copy of my C&P exam has been in evidence gathering for 6 weeks. What the hell is there to gather?
  6. I have a C&P for Sleep Apnea secondary to Pes Planus and weight gain. What type of questions should i expect?
  7. Hello Everyone I recently had a HLR and the VA came back and said that they found errors with the previous C&P by LHI. So they scheduled me for another C&P exam which I had on last Friday with a VA NP. She asked me the standard question on the migraine questionnaire and then at the end she said she would have to do some research into the connection between PTSD and migraines and that I would have my decision in 30 days. I wanted to know is it normal to take 30 days because all the other C&P exams that I've had I received the results the day after the C&P exam.
  8. So i just finished my C&P for tdiu/increase last week. Everything went well, "can't hold job due to service connected symptoms etc".. Now they're saying "We have requested copies of your disability medical records from Social Security." I just contacted social security and they have no records for me, because I never filed for social security. I'm worried about them denying me because I never filed for social security. Should I be worried? Is this normal?
  9. Just what the title says. Made me uneasy, but I felt like I couldn't say no. I changed the password once I got home, but given my history of examiners sometimes feeling like they can make stuff up or say whatever, I really don't feel comfortable that this guy now has access to everything in the VA online as if he was me, including communications, appeals, etc. I'm pretty sure all of it is linked and he can pretty much screw with anything he'd like. What can or should I do?
  10. Good Afternoon All, I have a PTSD claim for increase tomorrow via video conference. I know that if you went in person, they wouldn't let your spouse or SO in with you. I'm wondering if anyone has had any experience with the video conference exam. My wife is going to be sitting next to me when the conference begins and it will be curious to see if they ask her to leave the room. I saw a video from Attorney Chris Attig that suggested it may be beneficial to an impending appeal (if the claim is denied), if the evidence of the record suggests or shows that the spouse was asked to wait outside and that the lay evidence is extremely important to the claim. At my C&P exam in 2015, they said I had to come alone, but I was granted at 50%. Sgt. Wilky
  11. Wilson


    My claim status has been in evidence gathering and review for several weeks.Had my c&p exam about a week ago and now my evidence gathering and review has or is showing updated. What does that mean?
  12. Right then, last year I had two C&P exams. Due to living in Germany, the VA hands it off to the VES who schedules everything. The VES contacted me last year in August with a wee questionnaire and also asked if I was available during the next 60 days. Both appointments were done within that time. This year seems a different animal. The VES contacted me at the beginning of March with the same questionnaire and the 60 day question. I had a mental health appointment within 3 weeks! There are still two matters pending. I sent the VES an email at the end of May (near on 3 months) and the response was merely waiting for an appointment. This is for hearing loss and tinnitus. A 90 day wait for an appointment with a hearing physician? Again, I can well imagine a difference between countries, but this seems a wee off. Anyone have insight?
  13. Wondering if anyone has some insight on my current situation. Long story short, I became 70% service connected in 2018 due to a combination of issues, to include 30% for PTSD. During my initial physicals with my VA primary care Dr I screened positive for TBI from a vehicle rollover in Afghanistan and began testing/treatment. I eventually had a neuropsychological exam that Identified several severe cognitive impairments (auditory memory, processing speed) and several more moderate-mild impairments. Based on this I filed a disability claim for TBI in November of 2019. I just finally had a C&P exam for TBI that did not last long. Based on browsing these forums, I am thinking that the neuropsych testing will be used and hopefully the severe cognitive impairment is listed. Two weeks ago I did an ACE exam for migraines related to TBI. I have been sitting around wondering when I will get my decision letter but instead just got informed that I need to do another C&P exam for PTSD. Does anyone know why the PTSD C&P exam is needed now? Are they trying to identify what symptoms are caused by TBI vs PTSD? Can this even be determined? Will they lower my PTSD or combine them? It has been 18 months since I filed this claim and I am getting pretty stressed out at all the additional testing they are making me go through. Maybe am stressing over nothing but waiting around for a decision for 18 months can really put a strain on the process.
  14. Hello everyone, I have not been able to find much information on routine future examinations (RFE). I did not apply for an increase or any new claims. I have a RFE scheduled for bilateral knee instability a little after 5 years of service connection. My understanding is that this is supposed to be an evaluation of the current severity of symptoms and if the disability continues to be a problem and to what extent. I asked the person on the phone making the appointment and she said to be prepared to discuss my event in service and why I think it is service connected. I don't understand why veterans would have to discuss the event in service again and why they think it is related to their current disability if the nexus has been established. My experience has always been that the C&P examiner will not look at any of my records during the examination and if I insist, the rest of the exam does not go very well. I had to appeal a denial due to a bad C&P the first time around and it took a while for them to service connected. My plan was to let him know from the start that this is a re-evaluation, but the moment you try to manage the situation, it can go very wrong for you. All I'm looking for is a fair chance to explain what is going on with me currently and fully comply with VA requirements. The problem is we barely have any time with the examiners and you must make every minute count. Does anyone know what happens during these re-evaluations? Is it appropriate to go back to event in service and how it is related to your disability? Should the C&P examiners at the VA know that this is a RFE and not a new claim? Should I bring anything with me since they almost never look at documents? I appreciate any feedback anyone may be able to provide on this.
  15. Hi Everyone, On January 7, VA contractor, VES, did my C&P exam . After nearly pulling teeth trying to get a copy of the exam from the VA, I finally got it a few days ago. Although the doctor found that I have the condition and found that it was caused by military service, she was way off with her box checks for my symptoms--missing or ignoring several of my symptoms. Also, her assessment of my symptoms conflicted with my privately provided DBQ. It's frustrating because I answered the questions the same way with both doctors. Can I challenge/dispute the VES contractor's C&P findings? If so, where can I find the rules for how to do this? And how much time do I have? Thank you in advance for your advice on this.
  16. LHI contracted with a doctor who is licensed only in South Dakota and Nebraska to perform my husband's C&P exam in Iowa. Can the doctor do an exam in a state where he is not licensed? He did the exam on 12/31/20, but as of today (March 12, 2021) has not returned the exam report to LHI. LHI has reached out to him repeatedly. I have even found out where he practices, called his assistant and asked that he return the report. He will not respond to anyone. The VA has close (denied) my husband's claim without these results, so it has to be appealed. Just trying to figure out WHY this doctor would drive 8 hours, perform a 2.5 hour exam, drive 8 hours back home, and not do what is needed to get paid for his time?
  17. Are C&P exams always ordered? At what point are they ordered? I filed an appeal to the board Dec 2019, AMA, evidence. Still waiting for it to be assigned to a judge. I submitted a nexus letter from my VA psy doc at the time of filing appeal. Are C&P exams always ordered? Or will they bypass since both my VA psy docs have nexus stated in file, plus the letter from one? Thank you. Gene
  18. HI, Okay quick question and I hope I get some quick advice before its too late. Okay so I put in for an increase in my husband's ihd, and his lungs because he's had terrible residuals since he had radiation for lung cancer. We applied for the caregiver program and was approved but the lady told me that his 100% for his lungs was temporary (which I knew) and that I should be trying to get him increased or made P&T so that his overall average would never go below 70%. So I put it in. Well the rep at the VA went in and said that he was Permanent and Total...yay. So I thought they were done because I saw the notice saying a decision letter was being mailed. However, today a lady calls and says she will be scheduling him for a c&p for his lungs. Well as it stands he has 100% for his lungs. They have not set the appointment yet...should I go in and request this cancelled? THere is nothing to gain and I'm thinking the wrong doc could certainly give something to lose especially since she said they will be using a community doctor. It's a moot issue right now right? If they haven't made a decision which obviously they haven't can I cancel or is it too late?
  19. I looked around on here and didn't see an answer (or I missed it) but hopefully someone can answer. I had a C&P at my local VA last Wednesday and was curious to if I can pull a copy of the Dr's notes from that exam from the VA site (Blue Button Report or somewhere else). I'd like to know what he wrote about the exam and try to get an idea of what he said. Thank you!
  20. Hello again. I'm posting this to a new thread although its related to a post of two days ago. I just had my C&P exam on 16 Feb for a PTSD increase. Based on my claim status online which I just checked this morning, 18 Feb, the VA sent a decision letter and closed the claim. Is it possible for the VA to reach a decision this quickly after an evaluation? This claim was submitted as a fully developed claim and the only other evidence I had in my file was a DBQ and narrative or nexus letter prepared by my treating doctor of 11 years. I'm enclosing a screenshot of a status that I asked the VA about twice and received two different answers. I asked them if an exam was required. The status on the screenshot says no longer needed. In one call the VA said it was not required. In another call they said it was required and provided me LHI's contact information. The exam was scheduled and conducted through LHI. Has anyone dealt with this type of inconsistency? Is it possible the VA made a decision without this evaluation considering how fast a decision letter was sent after the evaluation. Or do you think the evaluation was considered in their decision? I contacted the VA this morning and the rep said he cannot discuss the contents of the decision but confirmed that an exam notification was sent out back in January. I also asked him how long it takes ebenefits to show the new rating if the decision is for an increase. He confirmed for me my rating he sees now but this rating is my current rating. How long does ebenefits take to update a rating that may have increased after a decision letter was sent? Thanks
  21. Hello everyone, I hope this finds you all well. So, quick background.. I was ADMIN Separated from the military, all while going through a MEDBOARD. I was send to a Medboard for PTSD, Depression, Anxiety, Inguinal nerve damage.. years of medical history showing these injuries. My lawyer during this process stated that the Military found me fit because I was going through a ADMIN separation. All my doctors wrote letters to the board stating that all diagnosis were current. The Board came back to state that they did not believe my doctors and stated that my actions were for secondary gains. It was obvious, as per my lawyers, that the board was not fond of the fact that I was being Administratively (after 17 years. Because of my traumas, I acted out and go into trouble. My discharge was a General (Under Honorable)) and I was found fit. Fast forward a few months, here I am at the C&P... I went to the C&P and the provider was kind and respectful. She asked me questions about my past, she even started some small talk about how we had the same ethnic background.. She then began to ask me how the PTSD hinders my life. She went on to say " So, from what I see.. I don't think you can work?"... I replied, I am currently sleeping in my car.. I have nowhere to live. ( this is all true).. She then stated that she was having a hard time finding the exact moment when I suffered the personal assault..., but went on to say that she understands that most men don't report that... I told her that she was absolutely right.. She then stated "I see that you have been going to medical for depression for years, around that time of your assault.. I can almost hear "assault" through all the depression encounters, even though you didn't say it.. is that correct?"... I began to cry because that was exactly the case. She then said, I understand and I am sorry.. I went on to say, I never had a provide pick up on it.. I was always so embarrassed to tell anyone about the assault, but I kept going in hopes someone would see it and help me.. We spoke about my father.. 2) How my life was prior to the military 3) how I felt during the service 4) what I did on my off time ( I sleep in my car and at times, at a friend's couch, when I am really frightened.. in a closet. She ended the meeting with " Do you have any questions".. I replied yes... I wanted to know how bad my depression is from a professional stand point since I don't have a provider anymore.. She stated, " I don't diagnose and I can't tell you how bad your symptoms are... but what I will tell you, and probably shouldn't... I think you case is severe.. She walked me to the lobby, said something to me in our native tongue.. and then said, " we will see you in 5 years... - I remembered that I had forgotten to tell her about my memory problems (Ironic)... so I called and left her that exact message with my number... 15 minutes later, she called me laughing at my message, thanking me for calling since she had forgotten to ask me that. I left very paranoid because I never seen a doctor like that.. I walked out feeling cared for, but then my paranoia set in.. I began question the whole encounter.. I began to ruminate on the fact that during my Medboard a doctor stated "Secondary gains," basically stating that I was trying to medically retire before getting separated ( I was already in the Medboard process before getting in trouble).. Will they hold that against me? All these things came to mind and then I found this group.. I am paranoid, anxious, struggling because I feel like I was being played with.. I have 3 doctors that have evaluated me and stated that I have these conditions.. I just don't know what to think.. Has anyone else had an experience like this?
  22. If you have a vendor exam and they cancel because of Covid they are supposed to reschedule when they are able, and alert us as well through our portal of the exam status (we log onto them and check anyway just in case). However if YOU call and cancel an exam and don't reschedule (due to covid, difficulty, whatever) they are NOT reaching back out to reschedule. They are NOT closing the exams request, it just sits in stasis....and sits.....and sits....... you have to call them, or call/write/email/21-4138 US so we can contact them to let them know you are open for scheduling contact again. This just started in the last 2 weeks or so. There is no mass letter yet from us, and I don't know if the vendors sent anything out or not. Here is what I have been sending to veterans that cross my desk that are in this situation. I got called out on it this morning by a Quality evaluator through my boss, but once I explained WHY I sent a letter (how are vets supposed know if the vendors don't tell them, and VA hasn't ginned up a letter of their own yet?) he decided to take it back up the chain so I wouldn't get dinged for an unnecessary action that might delay a claim, and possibly add my text block to our list of 'canned' responses so we don't have to type so much. "Veteran Name...." Vendors for Exams are no longer contacting veterans that have been unavailable for appointments due to concerns about Covid-19. The exam request is still valid, but they are waiting for contact back from the veteran before rescheduling examinations. Please contact [VENDOR] to reschedule to indicate willingness for physical or telehealth examination, or contact VA at 1-800-827-1000 to let us know so we can contact the Vendor, or in writing via Ebenefits (VA Form 21-4138) if you wish to reschedule or no longer wish to have these examinations performed.
  23. Hello, I have C&P exams all in one day in January. Any advice on what to expect? Here's a synopsis on what I'm up against/working with. - PTSD increase is based off several years of VA mental health treatment and a Nexus letter written by my mental health doctor, which named PTSD, Depression, Chronic Pain Syndrome with depression, Panic D/O with Agoraphobia and survivor's guilt as a diagnosis (last 3 are recently added to records). - Knee pain- VA issued me a big knee brace and my primary care (tricare) orthopedics specialist just put me an Ankle-Foot Orthosis (AFO) brace because she says I have drop foot and weakened ankle support which tried to compensate for my weak knee/muscle strength - Foot pain- I reviewed all of my previous C&P exams and realized my foot pain rating had dropped from 30% to 10% because the rater misquoted me (lied) on the C&P exam. I told him these insoles and stuff didn't work. that my feet hurt all the time. He wrote, I said they were not effective insoles and I have to use all kinds of feet massages equipment to get through my work days. The primary care sent me to this foot pain doctor. All she did was cortisone shots (3 times) in my feet and tried to up-sell me on her brand of insoles. - Migraines- Been at zero percent since retirement. Last year I was hospitalized twice and misdiagnosed with having TIA and strokes/CVA. My VA advocate put in a secondary claim to my service connected cervical damage. End result not service connected for CVA/TIA. However, ALL TESTS revealed that I've never had a stroke. The neurologist diagnosed me with Hemiplegic Migraines. These rare migraines an mimic strokes, causing weakness on one side of the body. They can last from a few hours or in my case,first one lasted 3 months. The neurologist provided a letter stating that all of the hospital doctors had misdiagnosed me with having CVAa. He also diagnosed me with exertional headaches. I know I'm no more special than the millions of other veterans out here, but this "deny 'til they die" tactic is wearing me down. Thanks for any advice.
  24. Hello! I filed for an increase, with a fully-developed claim, on an issue that I'm currently rated at service-connected 0%. I established my "Intent to File" on the 24th of September. The file was submitted/received on the 30th of December 2020 and moved to "Evidence gathering, review, and decision" on the 4th of January 2021. This morning (6th of January), a call came in and I was told that I would be scheduled for a C&P Exam. They needed to know if I was available due to Covid, to which I told them that I was. The woman informed me that within 2-3 weeks I would be notified of the date/time of my appointment. I thought I would be able to avoid a C&P Exam, because since October 2020, I've had 20+ VA appointments, 1 VA hospitalization, 1 VA MRI, 2 VA ultrasounds, 2 VA blood transfusions, and numerous VA blood draws, in regards to the issue that I'm asking an increase for. I'm even tentatively scheduled for surgery on the 26th of January (depending on how Covid issues play out here in California). I purposely waited, until I had gone through all those appointments/procedures/tests, so that I could include them in my fully-developed claim. I've had my fair share of C&P Exams, which have always been brief and perfunctory. I'm concerned about how much that exam will play into the rater's decision, when they already have a wealth of information from doctors/surgeons at the VA, all of which has been recently documented over the last 3 months. Has anyone experienced a situation similar to this? Did they end up changing their mind about making you submit to a C&P Exam? If not, did the C&P Exam weigh heavily on the type of decision the rater made? Thanks.
  25. Okay my husband is rated as follows: 10% tinnitus, 30% Ischemic heart, 40% hearing loss and 100% temp lung malignancy. He's had that temp 100% for over two years. He's had all kinds of heart issues since the original heart rating to include two stents, a new aortic valve and chronic congestive heart failure, all of which are documented in his VA file. He is a mess and I take care of everything for him. I applied for the caregiver program and have just been approved. The people with that program told me I need to see about getting his heart rating up and to request he be rated permanent and total. I put in the completed claim and they did a C&P in December. I just saw the c&p report. Here is what it says: PERTINENT HISTORY:1966-1968 USA Viet Nam 1968. OCCUPATIONAL HX: Retired 1993. PMH: SC CAD, SC Lung Cancer S/P Radiation, COPD. PSH (with results): TAVR. 2019. SH: 50 pk/yr of tobacco use, stopped 2014. Denies ETOH. 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with a heart condition? [X] Yes [ ] No [X] Coronary artery disease Date of diagnosis: SC [X] Heart valve replacement Date of diagnosis: 2019 2. Medical History ------------------ a. Describe the history (including onset and course) of the Veteran's heart condition(s) (brief summary): Veteran is SC for CAD. Reports having several stents in past several years, no stents in past year. Veteran reports a significant noncardiac hx, has a hx of COPD and non small cell lung cancer s/p radiation. Currently using 5 l O2 for COPD. b. Do any of the Veteran's heart conditions qualify within the generally accepted medical definition of ischemic heart disease (IHD)? [X] Yes [ ] No If yes, list the conditions that qualify: CAD/IHD. c. Provide the etiology, if known, of each of the Veteran's heart conditions, including the relationship/causality to other heart conditions, particularly the relationship/causality to the Veteran's IHD conditions, if any: Heart condition #1: Provide etiology Presumptive AO exposure. Heart condition #2: Provide etiology Hyperlipidemia d. Is continuous medication required for control of the Veteran's heart condition? [X] Yes [ ] No If yes, list medications required for the Veteran's heart condition (include name of medication and heart condition it is used for, such as atenolol for myocardial infarction or atrial fibrillation): ASA, Meotoprolol 3. Myocardial infarction (MI) ----------------------------- Has the Veteran had a myocardial infarction (MI)? [X] Yes [ ] No MI #1: Date and treatment facility: 1/16/2002 Fort Myers, Florida. 4. Congestive Heart Failure (CHF) --------------------------------- Has the Veteran had congestive heart failure (CHF)? [ ] Yes [X] No 5. Arrhythmia ------------- Has the Veteran had a cardiac arrhythmia? [ ] Yes [X] No 6. Heart valve conditions ------------------------- Has the Veteran had a heart valve condition? [X] Yes [ ] No a. Valves affected (check all that apply): [X] Aortic b. Describe type of valve condition for each checked valve: AS. S/P TAVR. 7. Infectious heart conditions ------------------------------ Has the Veteran had any infectious cardiac conditions, including active valvular infection (including rheumatic heart disease), endocarditis, pericarditis or syphilitic heart disease? [ ] Yes [X] No 8. Pericardial adhesions ------------------------ Has the Veteran had pericardial adhesions? [ ] Yes [X] No 9. Procedures ------------- Has the Veteran had any non-surgical or surgical procedures for the treatment of a heart condition? [X] Yes [ ] No If yes, indicate the non-surgical or surgical procedures the Veteran has had for the treatment of heart conditions (check all that apply): [X] Percutaneous coronary intervention (PCI) (angioplasty) Indicate date of treatment or date of admission if admitted for treatment and treatment facility: 1. 2002 Coronary Stent, Charlotte Florida. 2. 5/2015 Stents Mid RCA/Proximal Circumflex, Keesler AFB. Indicate the condition that resulted in the need for this procedure/treatment: 1. CAD 2. CAD. [X] Valve replacement If checked, indicate valve(s) that have been replaced (check all that apply): [X] Aortic Indicate date of admission for treatment and treatment facility for each checked valve: 12/2019 TAVR Ocean Springs Indicate the condition that resulted in the need for this procedure/treatment: Hyperlipidemia. 10. Hospitalizations -------------------- Has the Veteran had any other hospitalizations for the treatment of heart conditions (other than for non-surgical and surgical procedures described above)? [ ] Yes [X] No 11. Physical exam ----------------- a. Heart rate: 90 b. Rhythm: [X] Regular [ ] Irregular c. Point of maximal impact: [X] Not palpable [ ] 4th intercostal space [ ] 5th intercostal space [ ] Other, specify: d. Heart sounds: [X] Normal [ ] Abnormal, specify: e. Jugular-venous distension: [ ] Yes [X] No f. Auscultation of the lungs: [X] Clear [ ] Bibasilar rales [ ] Other, describe: g. Peripheral pulses: Dorsalis pedis: [X] Normal [ ] Diminished [ ] Absent Posterior tibial: [X] Normal [ ] Diminished [ ] Absent h. Peripheral edema: Right lower extremity: [ ] None [X] Trace [ ] 1+ [ ] 2+ [ ] 3+ [ ] 4+ Left lower extremity: [ ] None [X] Trace [ ] 1+ [ ] 2+ [ ] 3+ [ ] 4+ i. Blood pressure: 126/70 12. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ------------------------------------------------------------------------ a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [ ] Yes [X] No b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: No response provided 13. Diagnostic Testing ---------------------- a. Is there evidence of cardiac hypertrophy? [ ] Yes [X] No b. Is there evidence of cardiac dilatation? [ ] Yes [X] No c. Diagnostic tests Indicate all testing completed; provide only most recent results which reflect the Veteran's current functional status (check all that apply): [X] Echocardiogram Date of echocardiogram: 7/10/2019 Left ventricular ejection fraction (LVEF): 55 % Wall motion: [X] Normal [ ] Abnormal, describe: Wall thickness: [X] Normal [ ] Abnormal, describe: [X] Coronary artery angiogram Date of angiogram: 8/6/2019 Result: [ ] Normal [X] Abnormal, describe: Prior stents patent. No new significant lesions. 14. METs Testing ---------------- Indicate all testing completed; provide only most recent results which reflect the Veteran's current functional status (check all that apply): a. Exercise stress test No response provided. b. If an exercise stress test was not performed, provide reason: [X] Exercise stress testing is not required as part of Veteran's current treatment plan and this test is not without significant risk c. [X] Interview-based METs test Date of interview-based METs test: 12/7/2020 Symptoms during activity: The METs level checked below reflects the lowest activity level at which the Veteran reports any of the following symptoms attributable to a cardiac condition (check all symptoms that the Veteran reports at the indicated METs level of activity): [X] Dyspnea [X] Angina [X] Syncope Results of interview-based METs test METs level on most recent interview-based METs test: [X] (1-3 METs) This METs level has been found to be consistent a shower, slow walking (2 mph) for 1-2 blocks d. Has the Veteran had both an exercise stress test and an interview-based METs test? [ ] Yes [X] No e. Is the METs level limitation provided above due solely to the heart condition(s) that the Veteran is claiming in the Diagnosis Section? [ ] Yes [X] No If no, complete Section 14f. f. What is the estimated METs level due solely to the cardiac condition(s) listed above? (If this is different than METs reported above because of co-morbid conditions, provide METs level and Rationale below.) METs level METs level on most recent interview-based METs test: [X] The limitation in METs level is due to multiple medical conditions including the heart condition(s); it is not possible to accurately estimate the percent of METs limitation attributable to each medical condition g. Comments, if any: METS is based on general conditioning, natural age and combined medical conditions. Most middle aged individuals have a METS 5-7; and most elderly individuals have a METS of 3-5 - irrespective of heart function. Therefore, the veterans LVEF is more accurate representation of his/her cardiac function at this time. 15. Functional impact --------------------- Does the Veteran's heart condition(s) impact his or her ability to work? [ ] Yes [X] No 16. Remarks, if any ------------------- No remarks provided. Okay so I don't have a clue how this will come out. Ebenefits says that a Regulatory and Procedural Review opened on Dec 15 and closed on December 23. Decision letter mailed, allow 7-10 days. Any thoughts on this report? One issue I have with this and its a big one if he is denied or lowered and that is that my husband has Chronic Congestive heart failure and has been in the hospital twice this year for treatment of this and pneumonia. It is on his active list of things wrong with him and is documented as being treated when in the hospital. So I don't get how this guy could so blatantly say he doesn't have it. Any insight would be appreciated and who should I call if I don't get this letter soon? I'm trying to be patient because I know the mail is really messed up out there. Thanks in advance.
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