Got The Decision Today. Good News, But.

[OldDave]

I applied in July for SC for DMII as a result of AO exposure with CAD and HBP as secondary. The award letter gives me 20% for DMII, 60% for CAD and 10% for each limb for PN. VA math = 80% total. The HBP was denied. The 60% for CAD is because the VA Echocardiogram Tech at the C&P gave me an Ejection Fraction of 40%. No stress test necessary. I got a copy of my C&P exam report. Blood work also showed a Creatinine level of 1.6. This indicates possible kidney problems. The award letter states the VA will be sending me for more tests to determine if the kidney disease is SC by way of being secondary to DMII.

Back in April of 2007 my cardiologist did an Echo and Nuke Stress test and called it EF = 72% and METS = 6. Needless to say the EF drop from 72 to 40 and Creatinine level worried me. I had an appointment with my pvt doctor last Monday and told him of my concerns. He ordered an Echo for Tuesday and a 24 hr protein test for next Monday. I don't have the offical results for the echo yet, but the tech told me it would run about 60%. I'm hopeing the protein test shows no problems and no reason for the VA to have to make another decision.

What would be the best way to notify the VA of the error? I plan on filing a NOD to argue that the HBP IS secondary to DMII. Would including it in the NOD be the best way? Once they accept the posibility that the EF is greater than 50% the will want to do a stress test. Maybe I should notify them immediately so that they can schedule a stress along with the kidney tests. I think the stress would reveal METS between 5 and 7, in line with what my cardiologist got. This would yield a rating of 30%. This is what I think it should be. But, what if the VA blows the stress test as well and gives me highter METS and I end up with a rating of 10%. I want to do the right thing, but I don't want to shot myself in the foot.

Any advice would be greatly appriciated.

[Ron II]

I'm surprised at the replies preceding mine. This is an ethical and moral question.

Are you going to knowingly keep something that is not rightfully yours?

The fact that the VA is a less than a respectable organization is immaterial. Additionally, it's quite likely that the error will be discovered at a later date and you might be liable for overpayments.

What would you advise your children or grandchildren with regard to a similar situation?

Ron

Edited December 27, 2008 by Ron II

[rentalguy1]

I'm no MD, but it seems reasonable that a EF, as any medical condition, can change from day to day. Just like a vet with PTSD can have a GAF of 38 today, and a GAF of 65 tomorrow. That being said, there is no need to let the RO know anything because if they retested you it may be higher, or it may be lower, or it may be the same.

[rentalguy1]

Just did some quick reading, and the EF will, in fact, fluctuate. It is most likely a valid number from the C&P, and there is no need to notify anyone of anything. They just saw you at your worst on that day.

[Commander Bob]

WOW!!! ...we all jumped on that one at the same time. Thanks rentalguy1. I feel better for Old Dave. now,...

[JR Reihs]

I'm surprised at the replies preceding mine. This is an ethical and moral question.

Are you going to knowingly keep something that is not rightfully yours?

The fact that the VA is a less than a respectable organization is immaterial. Additionally, it's quite likely that the error will be discovered at a later date and you might be liable for overpayments.

What would you advise your children or grandchildren with regard to a similar situation?

Ron

I disagree , this not a ethical or moral question, it is medical question that the VA has decided under their guides ,using their criteria, and even if it is a close call, the benefit of doubt rule go in Daves favor.

Dave need not also worry about liability should the VA question this claim at a later date, the most the VA could due was to call CUE on itself and ammend the award, but that is another story in-itself.

Edited December 27, 2008 by JR Reihs

[Commander Bob]

Your kids and/or grand kids are most fortunate to have you around Ron II . I understand where your coming from. I'm reminded of an old Crosby, Stills, Nash & Young song from the 60's..." Teach your children well". Great song.

http://www.youtube.com/watch?v=p6pphVs8bF0

Edited December 27, 2008 by Commander Bob 92-93