Is Low Balling The Future Of Ihd Claims?

[N4XV]

After 20 years of no significant improvement. Since the announcement of IHD to become a presumptive my heart condition has gotten better.

All these tests were performed at the same VAMC

From Chemical Stress Test study performed on 01/27/05.

Impression:

1. Abnormal adenosine myocardial perfusion scan.

Nontransmural infarction of the inferior wall from apex to base

with potential ischemia of the residual viable myocardium

primarily in the apical half of the infarct zone. Potential

ischemia in the adjacent inferolateral wall from apex to base.

2. Mildly depressed resting left ventricular systolic function

with an ejection fraction of 46%. ( I figure this impression to be worth at least a 60% rating)

From Chemical Stress Test study performed on 11/14/2008.  

Impression:

1. Abnormal adenosine myocardial perfusion scan. Potential

ischemia in the inferior, inferolateral, and lateral walls from

apex to base superimposed on inferior wall scar with an element

of post stress "stunning" in the potentially ischemic zone.

However, findings are similar to hard copy images of previous

study performed on 01/27/05.

2. Globally reduced left ventricular systolic function with an

ejection fraction of 42-45%. ( I figure this impression to be worth at least a 60% rating)

From ECHO-DOPPLER REPORT (Echocardiogram) performed on 01/07/2010 for a C&P exam in connection with my recent IHD claim under the new AO presumptive.

Impression:

LV systolic function is preserved. Estimated ejection fraction is 50-55%.

LV wall thickness shows mild concentric left ventricular hypertrophy.

LV wall motion abnormality was noted, suggestive of CAD.

Grade II diastolic dysfunction is present

  ( I figure this impression to be worth no more than a 30% rating)

I also had an Electrocardiogram (EKG) performed on 03/05/2010 that said - Abnormal EKG and possible Inferior Infarction. But the VA cardiologist said my heart condition had improved since 11/14/2008 yet warranted an increase in dosage of two of my heart meds. 

Before 1991 I had 4 heart attacks and a triple bypass. Now since there has been no real changes in my life style or improvement shown in my heart condition for the past 19 except for a Transient Ischemic Attack (TIA or silent stroke) in Feb. of 2008 it makes me wonder if the powers that be in the claims part of the VA are somehow influencing the interpretations of tests and exams for new IHD claims under the new presumptive due to AO exposure.

[rotorhead]

I just got the results of my IHD C&P yesterday from the FOIO. I will post some of their determinations.

SUMMARY OF PROBLEM SPECIFIC HISTORY;

PROBLEM; Ischemic Heart Disease/CAD

DATE OF ONSET; 01/2004

CIRCUMSTANCES AND INITINAL MANIFESTATION OF THE DISEASE OR INJURY: Veteran is agent orange conceded with DM II back to 2005. Currantly elvaluated for CAD.

COURSE SINCE ONSET; Progressively Worse.

DIAGNOSIS; Ischemic Heart Disease

PROBLEM ASSOCIATED WITH DIAGNOSIS; Ischemic Heart Disease/CAD.

EFFECTS ON USUAL OCCUPATION AND RESULTING WORK PROBLEMS; Veteran is retired.

EFFECTS ON OCCUPATIONAL ACTIVITIES; Lack of Stamina, weakness or fatigue.

ARE THERE EFFECTS OF THE PROBLEMS ON USUAL DAILY ACTIVITIES? YES

DESCRIPTION OF THE EFFECTS OF THE PROBLEM ON USUAL DAILY ACTIVITIES; Fatigue and malaise associated with miminal exercise.

STRESS TEST RESULTS (METs) Veteran had a partial mechanical stress test 04?08 and was unable to complete stress test due to fatigue, and dyspenia. Currantly on Atenlol. Esimated METS Category III, can wash dishes, drive a car. and fish and play billiards.

IS EXERCISE TESTING MEDICALLY CONTRAINDICATED; YES

MEDICAL CONTRAINDICATION; Veteran tried to complete a Stress Test 04/09 and was unable to complete due to fatigue and dyspenia.

ESTIMATE OF ACTIVITY LEVEL IN METS (3 or less).

There is more to the report but think that was the important part.

Now the C&P for the agent orange exam was a totallly different deal, I will post on that later. df

[vperl]

If the veteran with AO IHD claim, it might be interesting to know a couple of things.

Remember, the VA may decide to change the rules at anytime, and use different scales and even change the Federal

registary if they indeed post the new AO proposed rules.

1. a vet with a ICD cannot be made to have certain EF tests. The regulation forbids the use of many of the invasive

and dangerous tests.

2. If the veteran has a ICD, the federal regulations for IHD for service connection grant the veteran 100%

(AO IHD maybe different, who knows for sure..)

will the VA get off it's butt and publish the proposed rules today is the dealind may groups have set.

**

We all need to remember that the types of test or t he determining factors for Heart Disease. The Criteria states on EF rateings that the measurememnt of EF is based on either of 2 tests.

A Heart Echo or a Cardiac Cath.

A Heart Echo is a fine test if the Veteran is of normal size. If the Veteran is a bigger person with a big chest then it becomes a guess as the Ultrasound waves have to pulsate through a thick walled chest and the image becomes somewhat distorted.

Cardiac Cath is the Mac Daddy when it comes to measuring EF as it is an actual measurement taken with the Naked Eye. It is a little more risky but it cant be questioned.

If you have had several MI's then you obviously havce had a few Caths in your day. These out weigh the old echo my a mile.

J

[john999]

I was really shocked when the VA proposed making IHD presumptive for AO exposure. If they are going to look at life style then how can they not look at life style for DMII or cancers of the lungs? It is not consistent. I think the VA bean counters must have had IHD themselves when they found out that the Secretary was going to make IHD presumptive. Us RVN vets who live long enough will likely get prostate cancer or heart disease. Also, it seems that if the VA connects a vet for IHD then high blood pressure may be an obvious secondary. It is the right thing to do since the "boots on the ground" RVN vets are dying every day. Out of 2.7 million how many are left anyway? AO is a contains cancer causing dioxin so why not make all cancers presumptive? The reason, of course, is that if they stall long enough we will all die for IHD, heh,heh.

[N4XV]

Rotorhead

From what I read it looks like a very favorable C&P exam report and an estimated METS of 3 or less should warrant a 100% rating. 

[billy2]

N4XV

I don't feel the outcome for IHD will be that generous

Bill

[rotorhead]

I am thinking in the same vein, way too easy, but I had a lot of outside medical records to support the findings. I was deined heart condition in 01/06, I should come under the Nehmer ruling. I am also AO condeded for Diaibbtes II, I now have claims in for HBP, Perferial Neurophy, Hepititus C(was hospitalized 22 days after separation 1973, ED, Albuminuria which is first stage kidney failure, PTSD. just wish I had started this 30 years ago.

Serviced Connected 0% for Hammer Toes.

US Army 1967-1973

MOS 67A1F Doorgunner RVN 1969-1971 240th AHC

III Corp, Bear Cat

PS, sorry for all the spelling and grammer, but couldn't get spell check to work.