Nehmer Fast Letter Of

[Berta]

This Fast letter re-defines how these claims should be handled- it is a stronger statement than the more recent Fast letters on the new AO presumptives and shoul;d be considered in the context of the proposed regs on the 3 new AO disabilities.

Please note one page one of this letter to all VAROS

"ACCOUNTABILITY

Regional Offices must stricly comply with the instructions set forth in this letter and attachments.It is critical that NEHMER claims be handled expeditiously and correctly. The processing of Nehmer claims requires VA to operate under court-imposed deadlines. Failure to comply with instructions could result in court-ordered sanctions against VA and/or VA officials."

I gave the VA plenty of time since my April 2009 AO death award to comply with Nehmer but they failed to.

After contacting the OGC in DC a few weeks ago-from that point on my claim was handled expeditiously. I wanted a decision by Christmas as to the Nehmer court order.A decision was made on Dec 24th 2009 and the monetary award is due to be sent on Jan 4th 2010.The lawyer mentioned in this Fast Letter on page 5 of 14 is the OGC lawyer who took immediate action on my case.

I anticipate my award will be the wrong amount-only because the VA has never in over 10 years sent me a proper monetary award right off the bat. In spite of their sophisticated computers they still manage to add wrong.

But maybe I will be surprised on that.

Nehmer costs the VA lots of $$$$$. In many cases even if a Nehmer vet dies and then his widow or her widower dies- the Nehmer money that was due still has to be paid to the next of kin or estate of the veteran.

There is absolutely no incentive for the VA to attempt to withhold Nehmer Retroactive payments but they have done this and will continue to until- all vet reps and all Nehmer class action members take a stand on getting their proper retro awards.

Nehmer claims are handled in a special way -that is explained in this fast letter attached.

If they arent handled this way- the AO vet or survivor has to take other action as the VARO has committed CUE and also defiance of the mandate of the Nehmer COurt Order.I will certainly explain how that goes if and when we get vets or widows who are owed Nehmer money that the RO failed to pay.We had a few here already at hadit.

If the VA had properly handled my claim and sent it to the PRC in May of 2009 my case would be resolved by now. But I am grateful they again buggered up my claim as I learned of the internal VA AO claims procedure- and would not have known how it worked if they had given me the proper AO award at that time.

The attachment is 14 pages long.(sorry I posted it twice and dont know how to remove one of them)

VA_Nehmer_Feb_2009_Fast_Letter.doc

Edited December 29, 2009 by jbasser

[Philip Rogers]

As I see it, and I don't know you're effective date but if IHD is noted in your VA medical records, previously, the VA could(but not likely, my opinion) go back to that date(ie: 1994), based on Nehmer. They'll probably go back to 9/09 but I believe IHD claims are being held up while the VA drags it feet trying to (delay/deny) I mean figure out how to process these claims. I believe they are currently being bombarded w/IHD claims.

I personally think you'll have a long appeal process trying to get 1994.

pr

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effective date for retro is: ?

I filed for AO IHD 26sept09 on 2Feb09 had C&P

today got ROI and looked at the C&P exam notes....

looks very good, just a question what the rating will be, as I read the notes

looks like more than 80%.... with the ICD I have I was told by some that

the rating will be 100% for sure..... time will tell

Now I wait for the decision.

question what is my effective Retro date ?

[murph]

vperl

Your date of claim (26sept09) should be your effective date for retro.

as I read the notes

looks like more than 80%....

I do not understand what the 80% you refer to in the above statement actually means. 80% of what?

METs

The criteria for evaluating heart conditions incorporates objective measurements of the level of physical activity, expressed in METs (metabolic equivalents), at which cardiac symptoms develop.

METs are measured by means of a treadmill exercise test, which is the most widely used test for diagnosing coronary artery disease and for assessing the ability of the coronary circulation to deliver oxygen according to the metabolic needs of the myocardium 

Evaluation criteria

• A 100-percent evaluation is warranted if a workload of three METs or less produces dyspnea, fatigue, angina, dizziness, or syncope. A workload of three METs represents such activities as level walking, driving, and very light calisthenics.  

 

• A 60-percent evaluation is warranted if a workload of greater than three METs but not greater than five METs results in cardiac symptoms. Activities that fall into this range include walking two and a half miles per hour, social dancing, light carpentry, etc.  

 

• A 30-percent evaluation is warranted if a workload of greater than five METs but not greater than seven METs produces symptoms. Activities that fall into this range include slow stair climbing, gardening, shoveling light earth, skating, bicycling at a speed of nine to ten miles per hour, carpentry, and swimming.  

 

• A 10-percent evaluation is included for some conditions, which is warranted if symptoms develop at a workload of greater than 7 METs but not greater than 10 METs. Activities that fall into this range include jogging, playing basketball, digging ditches, and sawing hardwood. When symptoms develop only during such activities, there may be some impairment of earning capacity, but it is likely to be slight. The alternative of the need for continuous medication warrants a 10-percent evaluation for some conditions

Alternatives to the METs

 Administering a treadmill exercise test may not be feasible in some instances, however, because of a medical contraindication, such as unstable angina with pain at rest, advanced atrioventricular block, or uncontrolled hypertension. In those instances, objective alternative evaluation criteria were provided, such as cardiac hypertrophy or dilatation, decreased left ventricular ejection fraction, and congestive heart failure, for use in those cases. When a treadmill test cannot be done for medical reasons, the examiner's estimation of the level of activity, expressed in METs and supported by examples of specific activities, such as slow stair climbing or shoveling snow that results in dyspnea, fatigue, angina, dizziness, or syncope, is acceptable. 

 The other objective criteria as alternatives to the METs are:

 

• A 100-percent evaluation is warranted for a left ventricular ejection fraction of less than 30 percent or chronic congestive heart failure.

 

• A 60-percent evaluation is warranted for a left ventricular ejection fraction of 30 to 50 percent, or more than one episode of acute congestive heart failure in the past year.

 

• A 30-percent evaluation is warranted for evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray.  

 

• A 10-percent evaluation is included for some conditions, and a requirement for continuous medication

THE VA should base your evaluation on which of the two "METS OR LEFT VENTRICULAR EJECTION FRACTION RATE" gives you the highest rating.Example if ejection rate less than 30% and mets 4 your rating should be 100%

[vperl]

As I see it, and I don't know you're effective date but if IHD is noted in your VA medical records, previously, the VA could(but not likely, my opinion) go back to that date(ie: 1994), based on Nehmer. They'll probably go back to 9/09 but I believe IHD claims are being held up while the VA drags it feet trying to (delay/deny) I mean figure out how to process these claims. I believe they are currently being bombarded w/IHD claims.

I personally think you'll have a long appeal process trying to get 1994.

pr

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out of 2.8 or so Millions that served in RVN 800,000 of us are still kicking like little girls at the VA DOOR.

the RVN guys are going at 300 per day 7 days a week..... soon the VA can cross us off the budget line....

I filed 2 weeks after the Secretary of VA made the AO announcement....

my VA records in 2007 showed IHD but I never filed, they had turned down everyone...... so did not file.. in 2007.

some think they will start the retro for new claims like mine like mid 2010 april - June

Seems the retro is totally up to the whims of the VA not your filing date...... if it is the filing date 5 months have passed

for me... and probably another 6 - 12 months more....

[vperl]

THE VA should base your evaluation on which of the two "METS OR LEFT VENTRICULAR EJECTION FRACTION RATE" gives you the highest rating.Example if ejection rate less than 30% and mets 4 your rating should be 100%

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I am not sure if any one knows of Jim Strickland here......

I explained my situation, and he mentioned that there is an exception and an addition to what you posted....

I mentioned I have an ICD, 3 different ones over ten years..... (hint...hint )

can you look up the rating with the inclusion of an ICD ?

Would be interesting to see what the answer you have compared to Jim Strickland...

He should have knowledge about such things with the background he has had for over 30 years..