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Review Of Echo And C&p

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john999

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  • HadIt.com Elder

My regular private internist reviewed my Echocardiogram and my C&P exam for heart disease from the VA. The VA examiner said No Heart Disease. However, she missed the physical evidence of HBP that the echo showed. She missed it because she refused to see it, or was so incompetent that she could not see it. My doctor looked at the Echo and checked my blood pressure and said that I needed to be on HBP meds. The heart muscle had gotten thicker than normal. This means it is pumping harder which often indicates HBP. The C&P doctor was so focused on ruling out heart disease that she never even considered this. My VA Primary never reviewed the Echocardiogram I am sure. So a potential problem was missed twice by these people that call themselves doctors. Anybody out there who is just depending on the VA to save money I say you are risking your life. You may think you are getting world class care but you are not. They don't have time or the competence to give it to you. Since I have DMII I believe I will claim the HBP as secondary. If I had not claimed DMII they would never have SC'ed it. If I had not claimed each and every secondary condition of DMII they never would have SC'ed it. This makes four secondary conditions and working on cataracts as number five that the VA has just ignored. I have to be a medical Sherlock Homes. Every time I complain about them doing something like this they retaliate by like cutting of my pain meds. I will live long enough to ^%$% on their graves.

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  • HadIt.com Elder

No chest X-Ray, and unless I complain I don't belive my VARO will return the C&P because no stress test was done. I read the regs and I should have had a stress test. There are no counterindications for a stress test. They are just in a hurry to deny the claim. Should I write the VAMC medical director and tell them the C&P was inadequate, or am I just going to have to NOD this decision when it comes down. I believe I will add a claim for HBP secondary to DMII. I am pissed at their sloppy work of my primary doctor and the C&P. Neither one really looked at the echo. The C&P PA just looked at the parts she wanted to quote and ignored the rest. The HBP drug my private doctor put me on is Benazephril 20 mg. once a day. The only objective test I got was the echo. What I really resent is the lack of follow-up from the VA primary care doctor. All she does is look at her computer and ask me if my back hurts. I got the echo because I asked for an increase in the heart disese and vascular artery disease which I was rated at 0%. They found that by accident.

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  • HadIt.com Elder

First, call the patient advocate. The one in Dublin is VERY helpful. She busted her patootie trying to get us answers. If you don't get satisfaction there, go to the Chief of Medicine. That's what we just did about my husband's C & P. We ended up talking to the Chief of Medicine anyways because the Patient Advocate wanted us to be fully satisfied.

No chest X-Ray, and unless I complain I don't belive my VARO will return the C&P because no stress test was done. I read the regs and I should have had a stress test. There are no counterindications for a stress test. They are just in a hurry to deny the claim. Should I write the VAMC medical director and tell them the C&P was inadequate, or am I just going to have to NOD this decision when it comes down. I believe I will add a claim for HBP secondary to DMII. I am pissed at their sloppy work of my primary doctor and the C&P. Neither one really looked at the echo. The C&P PA just looked at the parts she wanted to quote and ignored the rest. The HBP drug my private doctor put me on is Benazephril 20 mg. once a day. The only objective test I got was the echo. What I really resent is the lack of follow-up from the VA primary care doctor. All she does is look at her computer and ask me if my back hurts. I got the echo because I asked for an increase in the heart disese and vascular artery disease which I was rated at 0%. They found that by accident.
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  • HadIt.com Elder

John,

If you are SC for any Repiratory problems look over the rating schedule. Right ventricular hypertrophy is quite often a 100% rating.

Best regards,

Tyler

Tyler, RVH is a different issue as it is otherwise known as cor pumonole. It is often a result of Pulmonary Hypertension associated with the following: Primary Pulmonary Htn, Long term sleep apnea.

It is a result of the heart overworking itself trying to pump blood through the lungs. That is why it is rated as a lung condition.

J

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  • HadIt.com Elder

John, you're doin good asking questions. I'm not medical, but maybe check your private doctor with a copy of that echo, any notes and clincians guide, rating criteria too. Just a thought.

Note that if left ventricular dysfunction is present and the ejection fraction is 50 percent or less, or if there is chronic congestive heart failure or there has been more than one episode of acute congestive heart failure in the past year, stress testing is not needed

Found this on web search dunno if it applies...Echo: test that measures the fraction of blood pumped or ejected from the heart with each beat. this measurement is ejection fraction, which can be measured with a heart ultrasound called an echocardiogram or "echo." A healthy heart pumps about one-half of the blood it holds with each beat. A normal ejection fraction is 50-55%. A reduced ejection fraction indicates that a cardiomyopathy is present

Best to ya,

Cg!

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John, Just read your first post on this subject but I would like to add you are dead on about the VA docs and the care. I have been fighting with them for 2 months now over a knee situtation and the ortho doc after an xray and a MRI looked at me and said "I have never seen anything like this in the 55 years I have been practices"! What a quack I am going to the VAMC tomorrow and get all my pictures and going to an outside guy. My wife is really pissed I even deal with the VA except to get my meds!

The other thing you are right about don't trust the VA pcp to help you with your claims and tell you this is caused by DB2 or secondary to it, mine blows everything off as you are getting older. Yeah right and I am going to die soon too. I thought they were there to help vets it sure seems like the other way around to me.

OH, well thanks for letting me vent on your post but wanted you to know that you are not alone in this battle for better care and proper compensation from the VA.

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John,

Get a copy of your echo and see what it says, if you want post it. They should have measured the EF. An echo is used primarily to see if there is any valvular problems and to estimate the EF. Since they are required to do a stress test and they didn't use that criteria against them for your rating.

Requirements for stress testing: Types of heart disease which require stress testing, and the exceptions for requirements, are listed on the examination worksheets (See B4 on HEART worksheet). Note that if left ventricular dysfunction is present and the ejection fraction is 50 percent or less, or if there is chronic congestive heart failure or there has been more than one episode of acute congestive heart failure in the past year, stress testing is not needed. Many other conditions, especially during active infection or acute stages, such as valvular heart disease during active infection also do not require stress testing.

If your EF is below 50% on the Echo point that out also.

Ruby

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