Hyperlipidemia

[stillhere]

Berta picked up on this a couple of years ago.

In my case for EED for heart disease I was diagnosed with hyperlipidemia that was noted in my SOC and my chest pains were denied as heart disease in 2003. I went on to have a heart attack in Oct.05 I then sent the VA the info of my hospital stay and surgery and was granted heart disease but only back to the date of my heart attack.

The case below states a law where if condition such as hyperlipidemia causes a disease it should be considered back to that date.

Will this help me if I refer to this law? Am i reading this right?

In this case, the Board notes the facts are not in dispute

and that the medical evidence of record includes findings of

hyperlipidemia. The Board notes, however, that

hyperlipidemia is not a disability for VA compensation

purposes. Nor is there any evidence of a chronic disability

having been incurred as a result of hyperlipidemia. The

Court has held that, in cases such as this, where the law is

dispositive, the claim should be denied because of the

absence of legal merit. See Sabonis v. Brown, 6 Vet. App.

426 (1994). Therefore, the Board finds entitlement to

service connection for hyperlipidemia must be denied as a

matter of law.

[broncovet]

Again, I agree with Berta, and would like to add an example of this, tho not necessarily MY example:

Sample: Veteran applies for depression, and is awarded SC for depression at 30%. Medical record shows a history of suicidal ideations. For this example, refer to the rating criteria for medical disorders and their percentages. If you look at this criteria, you will see "suicidal ideations" is ONLY in the 70% or 100% categories, and NOT in 0%, 10%, or 30% categories. The presence/absence of suicidal ideations is a matter established by the medical records, and not a "judgement call". The doctor either documented you had suicidal ideations, or stated that you were not suicidal. I think an award for depression of 30% when a Veteran had a medically documented history of suicidal ideations would be grounds for CUE. This is my opinion only, and I can not cite a case/example. This is not a judgement call..it is in the rating criteria, and either the Rating specialist used the rating criteria or he did not. If he did not use the required rating criteria, then he did not follow regulations. Other rating criteria are not applicable. It is not applicable if the rating specialist likes your or not, and it is not applicable if the Veteran's religious beliefs conflict with the rating specialist.

[stillhere]

Great dicussion! Well at least I think so below are the two denials the first one is from 03 and the second is 04. Thank you for any comments!

03 denial

Service connection for Heart Pain as secondary to the service-connected

disability of Diabetes Mellitus.

Service connection for Heart Pain as secondary to the service-connected disability of

Diabetes Mellitus is denied. The private treatment reports did not provide medical

documentation to support your claim of a heart condition related to diabetes mellitus or

military service. Your cardiac workup was normal. The VA exam documented your

current condition as no diagnosis of a coronary condition. While you did complain of

chest pain, it was not increased by activity or radiate to the neck or arms. Your stress test

was normal.

The service medical records were negative for this condition. There has been no medical

evidence received which shows that this condition existed or that it could be linked to

your military service. You have not provided medical documentation of a current.condition or a medical opinion that links this condition to your military service. The evidence does not show that Heart Pain is related to the service-connected condition of

04 denial from SOC

4. Service connection for heart pain.

Service connection for heart pain remains denied because there is no evidence that a heart

condition currently exists. In your Notice of Disagreement you reported that you take Lipitor for

medication for heart disease that is caused by diabetes type II. During your VA examination you

reported dull mid-sternal pain that is not related to physical activity. You noted that sometimes

you get dizzy and that you fainted one time after having a phlebotomy. You complained of chest

pain that can last for a number of hours, but that it is not increased by activity or radiate to the

neck or arms. You denied taking any medication for a heart condition. You also denied

congestive heart failure, rheumatic heart disease, or heart surgery. You reported that you are

treated with Lipitor for heart disease. However, the evidence shows a diagnosis of

hyperlipidemia only. Objective examination revealed normal heart with no murmurs, congestive

heart failure, cardiomegaly, or cor pulmonale. Stress test is normal with no chest pain, premature

ventricular contraction, pulmonary artery catheter, or arrhythmia. METs level is 10.1. Examiner

noted there is no diagnosis of a heart condition. As there is no evidence of a current heart

condition secondary to your service connected diabetes mellitus, service connection is denied.

[broncovet]

Remember this:

Just because your RO decision says your medical records are negative for......condition, does not necessarily mean they are not in your medical records. It is highly possible, or even likely, that these records were shredded, in a different place, or just plain overlooked. Check your medical records, thoroughly, to see if they fail to mention what your decision says. If your medical records DO show that you had one of these conditions, but RO decision says nay, then you have a possible basis for CUE. The RO has to consider ALL the evidence, and there is a case referred to as "constructive receipt".

I think what they are referring to as "constructive receipt" is that if your VA medical records were in the VA's hands, and you noticed that they Did NOT address an issue contained in your record, the VA is assumed to have those records whether they had them in their possession or not. I think the way it works when this happens, you can send in the medical records, and the VA has to regard them as if they had them at the time of the decision, that is, in reference to an effective date. I think this is New and Material Evidence, but the Veteran is not "docked" on the effective date because the VA lost your records. Someone else can chime in if you think I have this wrong. Carlie?

[carlie]

Again, I agree with Berta, and would like to add an example of this, tho not necessarily MY example:

Sample: Veteran applies for depression, and is awarded SC for depression at 30%. Medical record shows a history of suicidal ideations. For this example, refer to the rating criteria for medical disorders and their percentages. If you look at this criteria, you will see "suicidal ideations" is ONLY in the 70% or 100% categories, and NOT in 0%, 10%, or 30% categories. The presence/absence of suicidal ideations is a matter established by the medical records, and not a "judgement call". The doctor either documented you had suicidal ideations, or stated that you were not suicidal. I think an award for depression of 30% when a Veteran had a medically documented history of suicidal ideations would be grounds for CUE. This is my opinion only, and I can not cite a case/example. This is not a judgement call..it is in the rating criteria, and either the Rating specialist used the rating criteria or he did not. If he did not use the required rating criteria, then he did not follow regulations. Other rating criteria are not applicable. It is not applicable if the rating specialist likes your or not, and it is not applicable if the Veteran's religious beliefs conflict with the rating specialist.

bronco,

With suicidal ideation it helps to be medically documented as

an active process of a MH diagnosis.

Many times when the record contains "history of suicidal ideation",

is viewed as past tense and gets rated at 50 %.

jmho,

carlie

Example:

http://www4.va.gov/vetapp09/files3/0921941.txt

The Board notes that the objective medical evidence of record

reveals that the Veteran still sufferers from intrusive

thoughts, mild hypervigilance, nightmares, disturbances of

motivation and mood, and difficulty in establishing and

maintaining effective work and social relationships.

However, such manifestations are already contemplated by the

50 percent rating currently assigned.

He has never presented several of the criteria required for a

disability rating of 70 percent, including obsessional rituals

that interfere with routine activities; speech intermittently illogical,

obscure, or irrelevant; near-continuous panic or depression affecting

the ability to function independently, appropriately and

effectively; spatial disorientation; or neglect of personal

appearance and hygiene.

With regard to difficulty in adapting to work settings, and

difficulty getting along with coworkers and supervisors the

Board notes that although the Veteran claimed that he had no

friends at work during his career, he nonetheless maintained

continuous employment at the Ford Motor Company for nearly 30

years until retiring.

In addition, while the Veteran reported a past history of

suicidal ideation prior to his current appeal, including history of

one suicide attempt in 1978, the Board notes that the only evidence

of suicidal ideation during the period under consideration in this appeal

appears in medical records dated during the period of April

2006 to July 2006, amid a period in which the Veteran was

also found to be experiencing a greater degree of anger and

suspicion.

However, medical records dated both before and

after that period show that the Veteran repeatedly denied

current suicidal ideation. Thus, the suicidal ideation

appears to be isolated and the result of a temporary

worsening of his disorder that subsequently improved.

Given the absence of such findings throughout the remainder of the

period under consideration, the Board finds that the greater

weight of the evidence remains against granting a 70 percent

rating or higher for his PTSD.

[john999]

The hyperlipodemia sort of reminds me of alcoholism in the sense that a vet may suffer from alcoholism and that is not a disability. However, illness due to alcoholism could be service connected. So having high cholesterol readings in service (I mean really high readings) could possibly be the cause of genuine disabilites that could be SC'ed. You know 20 years ago the optimum level for total cholesterol was 240. A person was not considered to have hyperliopdemia unless they had total readings above 300. That has all changed. Now if you have a level of 240 that is considered high. Optimum levels are below 200. I can see a claim for heart disease due to high cholesterol going off the rim if you smoke as well. That is a deadly combination and smoking diseases are not SC'ed. I can see the VA really fighting back hard against vets who have high cholesterol readings in service and then have a heart attack 20 years later. How can you say that is service connected? But I see where a vet could be discharged for alcoholism and then 20 years later have his liver fail and that could be SC'ed, so I guess anything is possible.

[broncovet]

Carlie..

You ARE good. That BVA decision even makes sense. I have heard of people counting the number of symptoms in each criteria..30% 70%, etc, and then see which one "more closely approximates" the Veterans current disability. However, medically documented suicidal ideation is hardly on the same level as, say, "speech intermittently illogical"/