hypertension New Ao Presumptive

[Berta]

I foresee problems in the new Ischemic AO heart disease presumptive disability-

this case shows what I mean.

Veterans might sure need to rely on ECHO reports and documented Ejection Fractions-and other evidence of atherosclerotic heart disease because heart disease can have many types of names yet only the "ischemic" type is within the new AO presumptive addition.

"The Veteran's death certificate shows that he died from

congestive heart failure. The VA physician who wrote the VA medical opinion in April 2009 concluded that the Veteran's congestive heart failure was not due to ischemic heart disease or hypertensive vascular disease. However, he made no mention of the February 1986 private medical record showing nonspecific ST-T wave changes, the October 1986 chest X-rays showing arteriosclerosis, or the diagnoses of generalized arteriosclerosis and essential hypertension in January 1987. His opinion appears to have been based on an incomplete history, and it is not sufficient to rebut the presumption of service incurrence for atherosclerotic heart disease and hypertensive vascular disease. See 38 C.F.R. § 3.307(d). During the Veteran's lifetime, he was diagnosed as having arteriosclerosis and hypertension. Since atherosclerotic heart disease and hypertensive vascular disease (and their complications including congestive heart failure) are connected to service by presumption in light of the Veteran's POW status, and he died from congestive heart failure, service connection for the cause of the Veteran's death is warranted. Reasonable doubt has been resolved in the appellant's favor. 38 U.S.C.A. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1991). ORDER Service connection for the cause of the Veteran's death is granted. From:http://www.va.gov/vetapp09/files3/0924239.txt

Edited October 17, 2009 by Berta

[Berta]

This recent Q and A in Jim Strickland's column at VA Watchdog points out what problems vets could have with AO ischemic heart disease claims:

http://www.vawatchdog.org/09/nf09/nfoct09/nf102209-3.htm

This is why hopefully the VA will clarify and define this new presumptive and we can help AO vets find the medical terms in their med recs to prove ischemic heart disease if it is not clearly diagnosed as that.

Not all heart disease is ischemic.

I would think that ischemic heart disease might even have a myraid of medical terms in med recs that do not come close to the word "ischemic" but in fact the vet does have ischemia of heart.

The other two new presumptives are pretty clear cut.This one ( probably the most prevalent new presumptive) can create problems for vets if the word 'ischemia' or ischemic isnt in their med recs yet this is the type of heart disease they have.

You don't see ischemic heart disease on death certificates much either -they usually put CHD or CAD or Myocardial infarction (MI)- and that too could cause a DIC claim (without autopsy performed) to be denied under this new AO presumptive disability.

Edited October 22, 2009 by Berta

[stillhere]

Berta, When I had my MI and subsuquent echo test and stress test I would notice that my private cardio doc did not have CAD mentioned but did have Ischemic on my test results.

The VA then took this and in my claims folder it says CAD so I agree this should be interesting how it plays out.

I also remember a retired rater state that if the veteran died of a heart disease and had HTN listed the DIC claim would be honored. It seemed to me like he was saying almost anything having to do with the heart was felt by the VA to be connected. I will see if I can find that statement.

[john999]

I think that if your records don't include ischemic heart disease the VA won't SC you as presumptive for AO heart disease. When money is involved the VA sticks to the letter of the law. The VA said ischemia on my stress test, but I am not SC'ed for ischemic heart disease.

[sweeper68]

PS all- these new AO presumptives will be in the Federal Register for public comment soon.

Hopefully the VA will define ischemic heart disease as any CAD involving evidence that causes ischemia such as abnormal ejection fraction or ECHO results showing atherosclerotic invovlements.

I dont know why they didnt include ischemic brain trauma too- hope I remember that when I make comment at Fed Reg site-

Ischemic brain trauma ( clots causing stroke) more than likely is medically due to heart disease of ischemic nature.

You get a clot in your heart -it can travel to the brain-

these are problems that are highly consistent with undertreated and poorky controlled diabetes mellitus as well as serious cholestrol problems.(hyperlipedimia) which can lead to atherosclerosis of heart and brain.

I am not a doc -but this is public knowledge.

[sweeper68]

Hi Berta, I've been reading all the posts about IHD and AO. Here is something of interest in my 1151 claim . I had a MI in 2000 and coronary bypassx4. After I recovered I filed an 1151 against VA for negligence. They of course denied then closed that claim. But then out the blue they rated me for Post coronary bypass graft at 100%. In other words they said no but awarded SC on their own! I suspect to preclude any admission of responsibilty on their part. I am confused to say the least, I have filed a SF-95 with the VAOIG office where it will sit until I formally file with court. To further add to the confusion they have changed the rating designation from CAD to IHD and finally Post coronary bypass graft (presently) ! I also have a rating for Hypertension at 10%. I also have a medical report from a private physician back in 96 showing abnormal T wave and a note to check for ischemia. The VA has had these med reports since 96 and did no further diagnostics until after my MI in 2000. I have requested Congressional interest from my Congressman to have my 1151 fully adjudicated and I hope to get it to BVA for their review. Any advice on this would be appreciated.. Thanks

[Berta]

The SF 95 must be filed with the OGC within 2 years of your knowledge of the negligence.

FTCA money is-in most cases-completely offset to a Section 1151 award-

Did they say direct Service connection or refer to Section 1151 instead?

"In other words they said no but awarded SC on their own!"

Sounds like they cued their past denial to cover their butts.

Congressmen/women cannot handle 1151 claims.Only medical evidence can make a Sec 1151 claim.

Their intervention will not help-In my opinion- at all-

If you did file a timely SF 95 it should not wait to go to court for resolve.

Mine sat around there and got input from time to time for two years before I won FTCA through the OGC.

Only medical evidence will make a FTCA claim succeed.(just like 1151)

It sounds to me that you are within the Statute of limits and have some very probative evidence.

If the award you got was in fact a 1151 award-BINGO for the FTCA claim.

BUT FTCA awards a lump sum. I invested mine until my offset was paid.

This is the only way a vet can reap monetary gain under FTCA -unless they want to pursue it in federal court-which could mean much more cash but could also mean a losing lawsuit.

If your conditions have been directly service connected (can you cover the personal stuff and scan and post the award letter here?)

In THAT case you could get the SC direct comp and then have NO offset under FTCA at all.

I am in exactly that position.

VA owes me the offset to my FTCA settlement because I did get 1151 DIC but now get direct SC DIC-

M21-1 under 22.07 states No offset to FTCA is applicable to direct service connected awards.

(only to 1151 awards) I got both-maybe this is what they will do for you too-

My 1151 was awarded at regional level-the dopes ooops raters denied even after they got the FTCA settlement info-I called the OGC and raised Hell and then I got my DIC.

!!%! claims and FTCA matters are a major war game with the VA.

I dont advise looking to me as example of how to win these claims- I didnt have a lawyer or an IMO.I forced them to consider my lay medical evidence.

My husbands med recs revealed (when I figured out all the medical terms, abbrevs etc) not only malpractice at one VA but a cover up at another VA.

6 years of heart disease evident in the clinical record and no diagnose or treatment for it-among other stuff they malpracticed on too-

When I reviewed his records in 2003 at my daughter's insistence (she kept on me when she was still in the mil for months because she had begun to think dad had diabetes as cause of his problems (he was Vietnam combat vet)I finally started to read these painful records that caused his demise and found she was right-

DMII malpracticed on- contributing to death- a direct SC death AO award.

It is best to have both these days.

Sweeper I am confused as to the different posters here- are you an incountry Vietnam vet?

I dont know if this was 1151 or an AO award you got.