hypertension First C&p For Diabetes And Coronary Artery Disease

[JohnO]

First time post here. Greetings to all and thanks in advance for the help.

I am a Vietnam vet, served in III Corps in an assault helicopter company. I'm rated 0% right now, but am going for my first C&P on the 30th of this month.

My claim filed under Agent Orange is for Type II Diabetes with secondaries hypertension, neuropathy and coronary artery disease. This is how my VSR said to file. I'm not exactly sure why coronary artery disease cannot be considered separately given the recent IHD addition to the list of diseases covered under Agent Orange. Perhaps one of you will enlighten me about this.

I had a heart attack in '96. I have a stent and see a cardiologist 3-4 times a year, including an annual stress test. I have a neurologist that sees me twice a year for my neuropathy and my motor neuron disease. My family doctor treats my diabetes and hypertension.

My question is that I have two types of neuropathy or chronic pain. I've had chronic pain all over my body 24 hours a day since '89. Just the last three or so years, I noticed a new layer of pain in my feet, ankles and hands. My neurologist said that the "new" pain is diabetic neuropathy. Is diabetic neuopathy considered a secondary compliant to diabetes by the VA?

I have a complicated list of diseases and complaints. I'm unsure how to approach this hearing. What can I expect? Will I be throwing the examiner a curve if I talk about my chronic pain (been with me since '89) and my diabetic neuropathy that has been with me for three or for years?

[carlie]

JohnO,

Welcome to Hadit.

Other's will chime in.

[Pete53]

Welcome to Hadit.

Since you served in Viet Nam the C&P should be fairly routine.All of your concerns are valid and should be discussed. Symptoms of neuropathy as you have listed go part and parcel with Agent Orange and diabetes.

Good Luck

Edited June 19, 2010 by Pete53
Additional comment

[john999]

When were you dx'ed with DMII? Your secondary conditions should all be dx'ed after the DMII dx in order to have smooth sailing for those secondary conditions. You can claim chronic pain due to PN. Just make sure you tell them the pain started after the official DX of DMII. DMII is the condition that underpins all your other claims and it should proceed them. After you get SC'ed for DMII and PN you should probably file a claim for chronic pain disorder and depression. I have been down this road you are on now.

[JohnO]

When were you dx'ed with DMII? Your secondary conditions should all be dx'ed after the DMII dx in order to have smooth sailing for those secondary conditions. You can claim chronic pain due to PN. Just make sure you tell them the pain started after the official DX of DMII. DMII is the condition that underpins all your other claims and it should proceed them. After you get SC'ed for DMII and PN you should probably file a claim for chronic pain disorder and depression. I have been down this road you are on now.

I had the heart attack before I was diagnosed with diabetes. Thanks for pointing it out.

It is hard to pinpoint specific dates. I remember my doctor watching for diabetes for years before I actually began taking metformin. Also, I was diagnosed with my motor neuron disease in 86, yet I began experiencing loss of muscle mass and strength years before that date. Again another date problem will be my coronary artery disease. I had my heart attack in '96 (or 95?) yet I remember signs of heart problems about the time I was diagnosed with the neuromuscular disease. I asked my neurologist at the time if I needed to worry about my heart and he told me to eat, drink and be merry because the neuromuscular disease was going to kill me. I'm still here, so I guess doctors can be wrong sometimes.

[Berta]

"I'm not exactly sure why coronary artery disease cannot be considered separately given the recent IHD addition to the list of diseases covered under Agent Orange. Perhaps one of you will enlighten me about this."

As long as the CAD is directly due to the AO DMII-you might have better chance at a faster decision than using the IHD regs. Some Senator is going to hold the IHD regs up for months.

"My neurologist said that the "new" pain is diabetic neuropathy. Is diabetic neuopathy considered a secondary compliant to diabetes by the VA?"

Yes.

"I'm unsure how to approach this hearing."

A hearing???? You were denied at a SC rating higher then "0" for DMII????

I sure don't understand that.What ws the date of that decision?

Did the VA obtain every private medical record you had?

If you had DMII at a ratable level and were incountry Viewtnam, then the date of the past claim they denied on the DMII might be your retro date when Nehmer Court Order comes into play.

It is hard for me to be sure based on the limited info here.

I am just surprised they denied yo or do you mean they awarded you for DMII but only at "0" %?

Do you have someone on your POA who will be at the hearing with you?

[Berta]

Sorry I missed this before:

I had the heart attack before I was diagnosed with diabetes.

Do you have a vep rep? reason I ask is that if the etiology for the CAD was not the DMII then VA will not SC the heart disease.

However would your doctor be able to make a statement to support a claim of aggravation? That the DMII from AO aggravated the heart condition?

They would rate the percentage of what they would consider aggravation of a NSC condition (the CAD) due to an SC condition.

MANY Americans ,when having an initial heart attack, are then diagnosed with diabetes. It is one of the most undiagnosed conditions in the US.

My husband had a heart attack while employed at the VA. They misdiagnosed it as a sinus infection.

I proved years later it was a malpracticed heart attack.

I then proved fairly recently to VA that this initial heart disease was due to undiagnosed and untreated diabetes mellitus.

The word diabetes never once appears in his medical records.

Unfortunately OI believe (due to the extensive research I did to win those claims after he died, that any heart attack should be considered as potentially from undiagnosed DMII. A HBIAC test immediatelky after a heart attack cold be one good way of determining if in fact the CAD is drectly due to the DMII.

In your case)I read this so fast I missed something at first)in my opinion your claim should not only raise the NSC aggravation issueabove but also raise direct SC for the IHD due to the new AO presumptive regulations which are pending.