Philpott Article On New Ao

[Berta]

John Miterko of the VVA reflects here the possibility that -as I feared-that VA could provide a limiting criteria for IHD claims.

http://www.military.com/features/0,15240,208380,00.html

Would that be possible? Can IHD be solely attributed to cigarette smoking or to obesity and then denied even if the vet was exposed to AO?

Does this mean vets will surely need to incur the expense of IMOs if the VA tries to deny AO IHD solely on these bases?

I heard you guys all had smokes in your C rats – as Gov issue in Vietnam.SO much for that etiology.

The FR still doesnt have the regs yet.

BTW-I was just sent email pdf from Gen Counsel of a letter I didn't get in mail yet from the OGC. It discusses how they contacted the RO regarding my AO claim and FTCA matter.On Dec 24^th.

Quite of bit of action has been taken since but I dont know exactly what as someone told me the wrong info from their PC screen.

When I asked the VARO to CUE their 2 inaccurate award letters- I was right-

I was also right in asking them to refund my FTCA offset money.

They ignored my letters on that but sure didnt ignore what they got from the OGC in DC.OGC agreed with my complaint.The RO is re-doing the award letters and figuring out the cash.

Not only might these proposed IHD regs be difficult for some AO vets to obtain award on but my situation goes to show how the ROs will still attempt to defy the Nehmer Court order.And string out these AO retro payments-when they have an established criteria in place for the proper handling of these retro payments.

Between the fact that some RO raters dont even comprehend Nehmer-even when the claimant does what I did -- I sent the court order to them myself-

and with this potential limit to some AO IHD claims- IHD will cost VA plenty but they might try to hold back plenty. The VVA guy mentioned in this article is just only personally opining on how the VA could potentially deny some AO IHD claims. This is not a fact in granite. But he raised a good issue-

because it all boils down to money-and VA will save every penny of AO comp they possibly can.

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Edited December 31, 2009 by Berta

[JRW]

I would like to venture an opinion. Keep in mind I am very new here, a newbie to be exact. Many of you are much more versed in the nuances of the VA. However, over the last several months I have been scrutinizing, on the internet, as much information about Ischemic Heart Disease as possible, and also on vets who have had a rating from IHD that was apparently secondary to a primary AO disease. I have also been studying the VA regulations concerning the rating schedule, once a veteran has a confirmed diagnosis of IHD.

I would venture to say that some of these veterans that have received a rating on IHD that was secondary to a primary illness on the AO list probably, in their lifetime have partaken to some degree, of the tobacco, alcohol, and the good food that for those not exposed to AO might suggest a linkage to IHD. But for these veterans, it has made no difference. I say, good for them!

This is very important to me because, I too, am filing for the very first time for the above, since IHD is being in the process of being added to the AO list. I have not used tobacco, alcohol, and not a lot of the good food over the years.

To me, I think a significant hurdle will be for vets applying for IHD from AO, will be that of getting a confirmed diagnosis. For those who have been diagnosed with IHD from their private physician and it is clearly documented in their medical files, it should only come down to the percentage based upon the current regulations. For those who have a confirmed diagnosis from their VA physician and it is clearly documented in their VA medical file, the same should hold true. Also, I don't see the current VA medical regulations relating to IHD being changed as this could impact other veterans who are already receiving compensation. The public outcry would be too much, even for the VA to withstand.

What really, really worries me the most here, is those veterans who do not have access to a private physician and who may try to get the VA medical staff to test them for a diagnosis of IHD. I have to wonder if the VA medical staff may be slow to conduct the necessary tests to possibly validate a veteran's concern for IHD from AO. I hope not, but I have to wonder.

Now I will end this by again saying I am new here. So be kind to me and don't blow me out of the water too much. I do a lot of reading here and elsewhere and I am getting a lot of good information from all of you.

[N4XV]

I think this John Miterko guy's only accomplishment with his statement in that last paragragh is striking fear and anxiety into AO exposed vets that are Dx'd with IHD. 

Now that IHD is/will be a presupmtive condition added to the AO list I think it has to be considered the cause of the disease. Smoking is just a risk factor that increases the chances of someone developing the condition but is not in and of itself the cause.

Causes of IHD

The cause of IHD is multifactorial; not single; and a number of risk factors are factors that make the occurrence of the disease more probable. Some of the risk factors are modifiable i.e potentially changeable by life style modifications or medical treatment; but others are not. Presence of any one of these risk factors places an individual in a high risk category for developing IHD.

The greater the number of risk factors present, the more likely one is to develop IHD.

The important risk factors are:-

Fixed (not modifiable)

Age : Risk increases as the age advances

Sex : Man has more chances than pre menopausal women

Positive family history : In whom first degree relative has developed IHD before age of 50.

Genetic factors:

Modifiable (potentially changeable with treatment or life style modification)

Hyperlipidemia

Cigarette smoking

Hypertension

Diabetes Mellitus

Lack of exercise

Obesity 

Gout (increase uric acid)

Contraceptive pills

Heavy alcohol consumption

Personality

Homocystinemia

Blood coagulation factors; High fibrinogen, factor eight

High C reactive protein

So how could the VA conceivably pinpoint the cause as anything other than AO?