hypertension Post C&p Information Request

[jalexand]

As I reported in another post a few days ago, I had my C&P exam on my AO IHD claim at the VARMC last week. At that time after answering the questions I was asked and providing the examiner with

copies of my latest test reports from my private cardiologist which showed diagnosis, mets, ejection fraction, etc. etc, and being asked to have the results of additional stress testing that I am scheduled for

next week be FAXED to the examining oficer I thought I had covered my bases. But..................apparently not!

Today I received what might be a normal letter on a claim (but new to me) asking me to provide additional information. I am a little stunned, to say the least. First thing they are asking for is:

"medical evidence that shows the diagnosis and earliest symtoms for each disabiity below that resulted from your exposure to herbicides (Agent Orange)

Ischemic Heart Disease"

"We need evidence showing that the following conditions(s) existed from militaty service to the present time:

Ischemic Heart Disease"

Well, to be truthful I have no evidence of the existence back to my military service because I did not have the onset of the disease until I was 37 and I retired at age 21. To make matters worse, all the records associated

with the onset of my disease at age 37 have been destroyed as my doctors office indicated to me that they only keep records 7 years. (I may have some records that go back almost that far, but have not been able to

locate them yet)

And as to the first request, I have no evidence other than what will become effective down the road with the initiation of the Presumptions that are forthcoming regarding the IHD and AO.

What really stuns me though is one of the things that comes next in this letter is:

"What have we received?"

Here they list the claim for benefits, VA FOrm 21-4142 (2), VA FOrm 21-256 (VONAPP). They make no mention of the medical evidence that I provided at my visit!

They follow this with "what have we done?" Here they list: VA Exam Cardiovascular Heart and Hypertension (if the C&P I had is supposed to be that, I'll eat my hat) and they go on to say: "We have requested

copies of treatment records or other evidence from: Dr. George B Bittar (my cardiologist) (again I state that I personally handed them these records, which now they don't even mention in this letter)

They also state that while they have asked for these records, it is up to ME to make sure they get them. I don't know what would be more effective than my having personally carried them to them, which as I say again

is not mentioned in this letter.

Then they state that they have asked the VA Medical facility nearest me to schedule me for an examination with the claim. They will notify me of the place and time. What would this be all about?

They have also included in this packet explanations on what I need to provide to prove the claim, etc., as well as a VCAA Notice Response that I am supposed to sign and return which gives me the option of

including the info now and asking to have my case decided immediately or ask for a 30 day extention of the time to respond.

So, I am totally confused about what is happening here. They give me a phone number to call if I want to contact them, should I try a phone call to see if I can get this cleared up?

I hope I can get some good advice on this, cause I don't know what to do at this point, especially regarding the evidence they are requesting.

Jim

[jalexand]

I too am preparing an IHD claim.I already receive DC for AO death but the IHD rating would support a CUE claim I have pending (actual it would render that CUE moot and they would need to make a new SMC decision as accrued under Nehmer)

As many know my husband was malpracticed on by VA to include malpractice of his IHD.That issue was resolved.

He had no heart disease treatment records at all but the VA evidence clearly proved he had IHD that VA failed to treat.

I have the VA's decision on that, 2 IMOs that also cover it and 2 EKGs and one ECHO (the only medical documents from VA that

ever transpired on his heart disease.A VACO doctor agreed with me that his EKGs ,ECHO and autopsy all revealed prior Myocardial infarction which was diagnosed as sinus infection and treated with sudafed.

Actully I think I only need to send them the ECHO report and their past decision admitted his ischemic heart disease was mever properly diagnosed and treated.

As I went over the C & P worksheet (here at hadit)it appears to me that when IHD is suspected an ECHO is certainly in order to determine extent of occlusion and the Ejection Fraction.The regs seemed shaped to ECHO results as well as METS etc if those tests were done.

My point here is that the ECHO , any EKGs and any record of ischemic cardiovascular disease appearing in the medical records with proven AO exposre ahould make these IHD claim relatively easy to resolve.

I would not depend on VA to search the whole med rec file and if you have copy of an ECHO and any EKG results or copies of any IHD entries from your doctor-this would be enough to save time for VA to assess the clincal record and then resolve the IHD claim sooner than later.

"One thing for sure, I don't think he will be inclined to offer me any help with my claim and I am actually considering changing doctors because of the attitude that he displayed during this encounter. He is a good cardiologist, but maybe not the guy I want on my team at this point?"

If your medical records clearly reveal you have IHD and that you were exposed to AO, then it doesnt matter what he thinks about the new regs.

Berta,

I am sorry to hear of your situation regarding your and your husbands experience with the VA over the years. I for one have avoided contact with the VA for over 40 years due to just the sort of thing you sescribe. I had always heard horror stories of mis-diagnosis and just plain poor treatment from the VA and because I have always had private medical insurance I steered completly away from the VA. This claim for IHD is really my only contact with the VA I have really ever had and I am finding it to be just the sort of "circus" that I had alwasy heard about. It is a sad commendary that the VA treats Vet's claims as an adversarial relationship rather than one of assistance? I can only assume that this adversarial attitude of the VA is a direct result of the thousands of illegitimate, trumped up claims that they receive all the time. Looks like the latest quick way to a free paycheck is via the PTSD route. I personally know of a Vet who continued to file under that one until he finally got something, even though I know that there is absolutely nothing wrong with him. Unfortunately the VA compensation program has been turned into one of the latest "entitlement" programs. I believe that most any Vet coming back from Afganistan or Iraq that applies will receive some form of PTSD comp. Many will proably deserve some compensation, most will not but will get it anyway. Meanwhile many RVN Vets, like myself who had real dibilitating disfiguring wounds that have caused us to loose the best periods of our lives and leave us deteriorating and suffering in pain as we age don't receive half what we deserve. In my day, sure most of us had PTSD, it wasn't called that in those days, but was the same thing. I can't tell you the number of nightmares I had for the first couple of years after I came home from that was, but I handled it in my own way as did most of us, we didn't go off running around crying about it ans looking for a free hand out from Uncle Sam. In this days it was also considered a bit of a stigma and I can guarantee you that I would NEVER have held the job I had were it known I even had any negative thoughts about the war, let alone admit to nightmares and night-sweats. Not today. Some of these later guys wear it like a badge of honor. I basically think we live in a "sissy" culture and as a result we lack the kind of American Fighting Men we had just a few short years ago.

In my case, the fact that I suffer IHD, in the form of CAD is a given and the fact that I already receive compensation for Service Connected Combat wounds received in RVN in 1968 while situated at KHE SANH, where I endured the Siege of the Tet of '68 and that it is a documented fact that in addition to the "presumption" of exposure just by serving in RVN it is known that over 46,000 gal of AO were sprayed in the Khe Sanh area during that period leave no doubt of my exposure. Since the VA is not now and will never pay any back claims regarding this disease, I see no point in my even trying to locate and transmit 25 years of medical records to them to establish the onset of the disease in 1985. Therefore, I have decided to file my current documents in the form of stress tests, echo's and ekg's that are current and just let that evidence speak for itself. I see no point in adding the additional stress to my life that any further "fight" would either be justified or necessary in this case. The only question in my case will be as to what degree I will be awarded. I have tests that show EF of 28% with 2.00 MET's, but other tests have shown EF of 30-35%, depends upon when and where the tests were taken. What is really unfair about this situation is if I receive the 60% rating on award (if and when it comes) due to the combined rating table I will still be 90% disabled receiving not on CENT of increase in pension.

[mozartplayer]

Most doctors at the VA don't have any idea about the presumptive AO diseases. I have never met a private doctor who knows that AO is a risk factor for DMII. No cardiologist I know is aware of AO and IHD connection. I don't know any that know that AO and prostate cancer have strong connection. I don't believe doctors inside and outside the VA know about AO presumptives. Not one has ever asked me if I was exposed to AO even those who know I was in Vietnam during the war. Only C&P doctors have asked and verified that I was in Vietnam when I filed a claim.

None of my doctors seemed to know of the connection between Agent Orange and the prostate cancer I had in 2005 and the hairy cell leukemia I was diagnosed with in 2007 and that includes my internist, oncologist, urologist, and radiation oncologist, not to mention my ophthalmologist. My compensation claim has been pending since last August, but it's on stay until new reg is final. I did not file a claim for the prostate cancer in 2005, but did file last August when I read that the VA was going to add the three new diseases, one of which is hairy cell leukemia for which I see my oncologist every 4 months. I do know the VA continues to approve some claims because I learned yesterday that a relative of mine just got a 100% rating for the rare form of incurable soft tissue sarcoma he has. He was initially denied, but I encouraged him to appeal which he did and gave him some suggestions to help his appeal. He's being paid back to first day of the month in which he filed his claim.

[Berta]

Jalexand said :

"I am sorry to hear of your situation regarding your and your husbands experience with the VA over the years"

I am sorry I read your reply.

you said:

"I can only assume that this adversarial attitude of the VA is a direct result of the thousands of illegitimate, trumped up claims that they receive all the time. Looks like the latest quick way to a free paycheck is via the PTSD route"

My husband also was 100% SC P & T for PTSD.

How dare you suggest that PTSD veterans are filing illegitimate PTSD claims?

You owe many many men and women here an apology.

If you dont have PTSD then you have no idea whatsoever of what they deal with.

[rotorhead]

Well said Berta.

[jalexand]

Jalexand said :

"I am sorry to hear of your situation regarding your and your husbands experience with the VA over the years"

I am sorry I read your reply.

you said:

"I can only assume that this adversarial attitude of the VA is a direct result of the thousands of illegitimate, trumped up claims that they receive all the time. Looks like the latest quick way to a free paycheck is via the PTSD route"

My husband also was 100% SC P & T for PTSD.

How dare you suggest that PTSD veterans are filing illegitimate PTSD claims?

You owe many many men and women here an apology.

If you dont have PTSD then you have no idea whatsoever of what they deal with.

I didn't mean to suggest that there are not legitimate PTSD veterans out there. What I meant to indicate is that there are many that are not and those are the ones that clog the system and make it more difficult for those with legitimate claims to receive just and fair compensation without a fight with the VA. If you don't believe that there are many "trumped up" claims, then you are not living in the real world. I have a lot of Vietnam Vet friends and we talk among ourselves a lot. We know who those of us are that experienced a lot of trauma in Nam and we know who the guys are that came home after the war and put the war behind them and moved on with their lives, who the ones are that have legitimate problems and who the few are that have the attitude that they are owed a living because they served one tour in Nam. PTSD is obvioulsy the most abused because while you can't fake a bullet or schrapnel wound, you can fake PTSD and there are some that try in hopes that they will receive a pension check from the VA. This is not pretty, but it is reality!

[stillhere]

Sounds like some folks here live in glass houses!

PTSD can be an is a itch. I would suggest you quit worrying about you Vietnam vet friends and what you consider fraud until you walk in their shoes for a while.

The word busy body comes to mind.

Berta is a very good poster and senior helper for vets you owe hear an apology.