Va Is Changing My Diagnosis !

[bm6546]

I have been diagnosed by the VA for over 40 years with a heart condition called PAT-Paroxysmal Atrial Tachycardia. I was discharged with this PAT and am SC for this heart condition. When I saw my VA Psychologist last week he informed me that he was told that he could no longer check the box that "this visit is related to Service Connected Condition" as SC for my Supraventricular Arrhythmias. That means that I have to start paying for the office visits to see him.

I told him that I have never heard of this Supraventicular Arrhythmias and that I was diagnosed with Paroxysmal Atrial Tachycardia. He said that he can only go with what was in my records. He also gave me a GAF of 60.

After my heart attack 2 1/2 years ago I have claimed my heart condition, depression, anxiety disorder and ED. Has anybody been diagnosed with this Supraventricular Arrhythmias and can help me understand what is going on with the change of condition. And what can I do about this? How does this help or hurt my claims?

Thanks in advance for any help....Brian

[john999]

Have you talked to your VA doctor to ask why your diangosis was changed. It must be to benefit the VA somehow so I would follow up on this. Was this the result of a C&P exam? They may have just made a mistake in your records.

[jbasser]

Why are you zero percent after a heart attack.

Did you have stents or a Bypass?

The way I read it is that your procedure you had after the heart attack improved your condition.

After 40 years, they cannot take the rating away from you even at zero percent. 20 year rule may come into play.

J

[Berta]

I am not a doctor but have studied cardiology-

Paroxysmal Atrial Tachycardia usually involves rapid heart beat in upper left heart chamber-

Supraventricular Arrhythmias are arrythmias that begin above the heart ventricles-

Paroxysmal supraventricular tachycardia (PSVT)

can also be a result of these conditions-

What I see here is that this doctor is assuming that you would have to be SCed for the diagnosis he gave you- without regard to the diagnosis you already have-

it is more than likely medically that these conditions are related.

I am not a doctor- so whatever I say wont help you-

Why is a psychologist involved in a heart disease diagnosis anyhow?

Why does your profile say 0% SC?

What is your SC specifically for and at what rating?

"After my heart attack 2 1/2 years ago I have claimed my heart condition, depression, anxiety disorder and ED" was that your first SC claim?

"I was discharged with this PAT and am SC for this heart condition."

Are you SC but at 0 % for it?

[rentalguy1]

I am with everyone else in regards to your SC'd percentage after a heart attack, but in regards to a change in diagnosis where a rating is concerned, here is the reg you need:

38 CFR 4.13:

The repercussion upon a current rating of service connection when change is made of a previously assigned diagnosis or etiology must be kept in mind. The aim should be the reconciliation and continuance of the diagnosis or etiology upon which service connection for the disability had been granted. The relevant principle enunciated in §4.125, entitled “Diagnosis of mental disorders,” should have careful attention in this connection. When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in thoroughness of the examination or in use of descriptive terms. This will not, of course, preclude the correction of erroneous ratings, nor will it preclude assignment of a rating in conformity with §4.7.

[29 FR 6718, May 22, 1964, as amended at 61 FR 52700, Oct. 8, 1996]

[bm6546]

Have you talked to your VA doctor to ask why your diangosis was changed. It must be to benefit the VA somehow so I would follow up on this. Was this the result of a C&P exam? They may have just made a mistake in your records.

I have an appt next week with my VA doc and will certainly discuss this with him. All the VA medical records say my diagnosis is PAT. Apparently the Mental Health records have the diagnosis of Supraventiricular Arrhythmias. I have no idea how the different diagnosis shows on my records. This will probably give the VA reason to continually deny my claims because they will say my records are all screwed up.

[bm6546]

Why are you zero percent after a heart attack.

Did you have stents or a Bypass?

The way I read it is that your procedure you had after the heart attack improved your condition.

After 40 years, they cannot take the rating away from you even at zero percent. 20 year rule may come into play.

J

I have been at 0% for over 40 years. I had my heart attack 2 1/2 years ago and have filed several claims with the VA in the past 2 years. The VA has denied one of my heart condition claims over a year ago and I filed a NOD. That claim is before the DRO.

I had 2 stents put in and have developed depression, anxiety, PTSD and ED since my heart attack. I have been under the care of the VA Psychiatrist and psychologist for almost 2 years with some progress.

I don't know anything about the VA taking away my 0% rating. I also don't know anything about the 20 year rule. Not sure what to do at this point. My VSO is on vacation and won't be back until the middle of July. I guess I will have to wait until she returns or if someone on this forum can tell me what to do.

Thanks for your help...Brian

[bm6546]

I am not a doctor but have studied cardiology-

Paroxysmal Atrial Tachycardia usually involves rapid heart beat in upper left heart chamber-

Supraventricular Arrhythmias are arrythmias that begin above the heart ventricles-

Paroxysmal supraventricular tachycardia (PSVT)

can also be a result of these conditions-

What I see here is that this doctor is assuming that you would have to be SCed for the diagnosis he gave you- without regard to the diagnosis you already have-

it is more than likely medically that these conditions are related.

I am not a doctor- so whatever I say wont help you-

Why is a psychologist involved in a heart disease diagnosis anyhow?

Why does your profile say 0% SC?

What is your SC specifically for and at what rating?

"After my heart attack 2 1/2 years ago I have claimed my heart condition, depression, anxiety disorder and ED" was that your first SC claim?

"I was discharged with this PAT and am SC for this heart condition."

Are you SC but at 0 % for it?

Berta,

I am SC for the PAT. Do you think I should try to get SC for my CAD which my private doctor has diagnosed me with?

I am being treated by the VA psychologist for depression, anxiety and PTSD, and also ED. These all came about after my heart attack. Mainly I am very afraid of having another heart attack. The doctors are helping me to overcome these fears. I also am on SSDI for 2 years now because of all these problems. I go on Medicare on July 1 and am very happy because it will be a LOT cheaper.

I have been at 0% SC for over 40 years. My 0% sc is for my PAT that the Navy discovered that I had and they gave me a medical discharge in 1966. They also gave me 10% SC for 1 year and then took it away because they said that I was cured and didn't need it any more. I didn't fight it back then.

I am waiting for a decision from my NOD that I filed over 1 year ago. Nothing yet. They sent me to a C&P for my ED. The same NP that screwed me on my heart claim diagnosed me with ED but said it was not related to my PAT. So I guess the VA wont give me the SMC for ED.

I'm still waiting to hear from the VA. Thank you in advance for any help...Brian

[bm6546]

I am not a doctor but have studied cardiology-

Paroxysmal Atrial Tachycardia usually involves rapid heart beat in upper left heart chamber-

Supraventricular Arrhythmias are arrythmias that begin above the heart ventricles-

Paroxysmal supraventricular tachycardia (PSVT)

can also be a result of these conditions-

What I see here is that this doctor is assuming that you would have to be SCed for the diagnosis he gave you- without regard to the diagnosis you already have-

it is more than likely medically that these conditions are related.

I am not a doctor- so whatever I say wont help you-

Why is a psychologist involved in a heart disease diagnosis anyhow?

Why does your profile say 0% SC?

What is your SC specifically for and at what rating?

"After my heart attack 2 1/2 years ago I have claimed my heart condition, depression, anxiety disorder and ED" was that your first SC claim?

"I was discharged with this PAT and am SC for this heart condition."

Are you SC but at 0 % for it?

Berta,

I am SC for the PAT. Do you think I should try to get SC for my CAD which my private doctor has diagnosed me with?

I am being treated by the VA psychologist for depression, anxiety and PTSD, and also ED. These all came about after my heart attack. Mainly I am very afraid of having another heart attack. The doctors are helping me to overcome these fears. I also am on SSDI for 2 years now because of all these problems. I go on Medicare on July 1 and am very happy because it will be a LOT cheaper.

I have been at 0% SC for over 40 years. My 0% sc is for my PAT that the Navy discovered that I had and they gave me a medical discharge in 1966. They also gave me 10% SC for 1 year and then took it away because they said that I was cured and didn't need it any more. I didn't fight it back then.

I am waiting for a decision from my NOD that I filed over 1 year ago. Nothing yet. They sent me to a C&P for my ED. The same NP that screwed me on my heart claim diagnosed me with ED but said it was not related to my PAT. So I guess the VA wont give me the SMC for ED.

I'm still waiting to hear from the VA. Thank you in advance for any help...Brian

[bm6546]

Berta,

I am SC for the PAT. Do you think I should try to get SC for my CAD which my private doctor has diagnosed me with?

I am being treated by the VA psychologist for depression, anxiety and PTSD, and also ED. These all came about after my heart attack. Mainly I am very afraid of having another heart attack. The doctors are helping me to overcome these fears. I also am on SSDI for 2 years now because of all these problems. I go on Medicare on July 1 and am very happy because it will be a LOT cheaper.

I have been at 0% SC for over 40 years. My 0% sc is for my PAT that the Navy discovered that I had and they gave me a medical discharge in 1966. They also gave me 10% SC for 1 year and then took it away because they said that I was cured and didn't need it any more. I didn't fight it back then.

I am waiting for a decision from my NOD that I filed over 1 year ago. Nothing yet. They sent me to a C&P for my ED. The same NP that screwed me on my heart claim diagnosed me with ED but said it was not related to my PAT. So I guess the VA wont give me the SMC for ED.

I'm still waiting to hear from the VA. Thank you in advance for any help...Brian

[Berta]

I strongly suggest that you explain this to your private doctor and ask him to give you an independent medical opinion.

He may or may not charge you for this- I dont know-

It seems obvious that there would be a potential medical connection between the SC "0" PAT and the heart condition you have now.But I am not a doctor-

If your doctor agrees that there is potential 'more than likely' or 'as likely as not'relationship of your present heart disease and the PAT from service-there is possibility that all of the other conditions can be secondarily service connected. They too would need medical evidence that the heart disease is causing these additional disabilities.

Is your private doctor aware of these other disabilties? Perhaps with their IMO they can cover all the basis on them too.

There is a format here under the search feature at top of page called "Getting an Independent Medical Opinion".

The VA will reject IMos that do not conform well to this criteria.

I just read a vet's IMO that might have cost him quite a bundle-

he didnt get a bill yet-(usually IMO docs want the cash up front)

It was a fairly extensive opinion- but even though I had told this vet to read my IMO post-to make sure the IMO conformed to it-still the doctor's opinion still lacked some info I feel the VA will question.

"They also gave me 10% SC for 1 year and then took it away because they said that I was cured and didn't need it any more. I didn't fight it back then."

I dont know if the PAT can be a transcient or non chronic disability-

most problems in the same organ such as the heart can be interrelated to each other-

if the private doctor you have sees any relationship between the PAT and your present condition-you have good basis for your claims with a strong IMO.

[Berta]

PS- have you formally applied yet for TDIU?

If the private doctor agrees with the premise of the claim present CAD from the inservice PAT-I suggest that you send the VA the TDIU form.

Under # 25 Remarks, tell them of the other disabilities that are secondary to th heart disease and tell them of the side effects of the meds you take (the ED might be caused by one of the meds and you could find a medical printout on the web to support that side affect of the meds.)

Under # 18 Check Yes and then in Remarks tell them what you get the SSA for- there isnt much room in # 25 Remarks so it is best to refer them in this block to separate page, put you C file number on it and tell them the above info.

I will attach the TDIU form. TDIU pays the 100% rate of comp.

That would only be contingent in your case if the IMO can connect the PAT to your present heart disease.

TDIU_form.pdf

[rentalguy1]

For a little peace of mind: your 0% SC for PAT is safe. You have had it in excess of 20 years, and it can only be taken away if they prove you fraudulently obtained the rating. If you get an increase in percentage, though, the clock starts all over again.

[Guest Vietnam Tanker]

Leave well enough alone??????????

[bm6546]

PS- have you formally applied yet for TDIU?

If the private doctor agrees with the premise of the claim present CAD from the inservice PAT-I suggest that you send the VA the TDIU form.

Under # 25 Remarks, tell them of the other disabilities that are secondary to th heart disease and tell them of the side effects of the meds you take (the ED might be caused by one of the meds and you could find a medical printout on the web to support that side affect of the meds.)

Under # 18 Check Yes and then in Remarks tell them what you get the SSA for- there isnt much room in # 25 Remarks so it is best to refer them in this block to separate page, put you C file number on it and tell them the above info.

I will attach the TDIU form. TDIU pays the 100% rate of comp.

That would only be contingent in your case if the IMO can connect the PAT to your present heart disease.

Berta,

Yes my VSO has already sent in the TDIU form approx 1 year ago. I checked out the different referenced posts for the IMO claims. I found these to be very interesting and informative. Of course I will have to wait until I hear something back from the VA before I proceed with any IMO from one of my private doctors. I will also talk to my VSO when she comes back from vacation.

Thanks Berta. I appreciate your help. Brian

[bm6546]

I am with everyone else in regards to your SC'd percentage after a heart attack, but in regards to a change in diagnosis where a rating is concerned, here is the reg you need:

38 CFR 4.13:

The repercussion upon a current rating of service connection when change is made of a previously assigned diagnosis or etiology must be kept in mind. The aim should be the reconciliation and continuance of the diagnosis or etiology upon which service connection for the disability had been granted. The relevant principle enunciated in §4.125, entitled “Diagnosis of mental disorders,” should have careful attention in this connection. When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in thoroughness of the examination or in use of descriptive terms. This will not, of course, preclude the correction of erroneous ratings, nor will it preclude assignment of a rating in conformity with §4.7.

[29 FR 6718, May 22, 1964, as amended at 61 FR 52700, Oct. 8, 1996]

rentalguy1,

Thanks for responding with the VA regulation. I am sorry but I just don't quite understand what any of that means. I have read it several times and it still doesn't make any sense to me. Of course, sometimes I can read a story in the newspaper 10 times and it doesn't make any sense to me. Must be all the drugs, don't know.

Can you or someone help me understand in layman terms what that regulation means.

Thanks in advance for any help...Brian

[rentalguy1]

It essentially means that they will not change a diagnostic code for rating purposes unless there was a gross error in the original diagnosis. In other words, if your previously diagnosed condition caused heart complications, and the newly diagnosed condition also causes heart attacks, then they will not change the rating diagnostic code. If, as in my case, you are diagnosed with a lumbar strain, and then ten years later a MRI shows intervertabral disc syndrome and spinal stenosis, then the diagnostic code can be changed. They do (or at least in my case did) make a big deal out of changing the code.

In short, they most likely would not mess around with your rating or your rating diagnostic code just because a more definitive diagnosis has been provided through a more thorough exam or new technology, because I am guessing the two conditions are fairly similiar. Likewise, it may be difficult to get rated for the new diagnosis in addition to the previous diagnosis due to pyramiding.

Hope this helps to clear it up.

[bm6546]

It essentially means that they will not change a diagnostic code for rating purposes unless there was a gross error in the original diagnosis. In other words, if your previously diagnosed condition caused heart complications, and the newly diagnosed condition also causes heart attacks, then they will not change the rating diagnostic code. If, as in my case, you are diagnosed with a lumbar strain, and then ten years later a MRI shows intervertabral disc syndrome and spinal stenosis, then the diagnostic code can be changed. They do (or at least in my case did) make a big deal out of changing the code.

In short, they most likely would not mess around with your rating or your rating diagnostic code just because a more definitive diagnosis has been provided through a more thorough exam or new technology, because I am guessing the two conditions are fairly similiar. Likewise, it may be difficult to get rated for the new diagnosis in addition to the previous diagnosis due to pyramiding.

Hope this helps to clear it up.

Thanks rentalguy1, that does clear it up. Not sure if the VA has changed my rating, but 2 different ratings are showing up. I will contact my VSO when she returns from vacation. It kind of freaked me out, not understanding what or if the VA was pulling something over on me.