hypertension Ihd -Va Definition And

[Berta]

With the hopeful resolve of most AO IHD claims in the next few months-I wanted to get this info posted here again.

And to remind all- if their claim comes under Nehmer and they have contacted NVLSP, I have posted the link here many times, please contact NVLSP again to let them know of the decision.

"According to Harrison's Principles of Internal Medicine (Harrison's

Online, Chapter 237, Ischemic Heart Disease, 2008), IHD is a condition

in which there is an inadequate supply of blood and oxygen to a portion

of the myocardium; it typically occurs when there is an imbalance

between myocardial oxygen supply and demand. Therefore, for purposes of

this regulation, the term ``IHD'' includes, but is not limited to,

acute, subacute, and old myocardial infarction; atherosclerotic

cardiovascular disease including coronary artery disease (including

coronary spasm) and coronary bypass surgery; and stable, unstable and

Prinzmetal's angina. Since the term refers only to heart disease, it

does not include hypertension or peripheral manifestations of

arteriosclerosis such as peripheral vascular disease or stroke.

http://www.regulatio...A-2010-VBA-0005"

(Of course if IHD has caused stroke or any other secondary condition, those conditions should be claimed as secondary to the IHD and will need medical evidence of the nexus of the claimed secondary to the IHD. )

VA will be using 38 CFR$ 4.104 to rate the AO IHD claims.

They will be using either diagnostic code 7005 0r 7006

"7005               Arteriosclerotic heart disease (Coronary artery disease):

 

                            With documented coronary artery disease resulting in:

 

                            Chronic congestive heart failure, or; workload of 3 METs or less results

                                          in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

                                          dysfunction with an ejection fraction of less than 30 percent              100 

 

                            More than one episode of acute congestive heart failure in the past year,

                                          or; workload of greater than 3 METs but not greater than 5 METs

                                          results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

                                          ventricular dysfunction with an ejection fraction of 30 to 50 percent              60 

 

                            Workload of greater than 5 METs but not greater than 7 METs results

                                          in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

                                          cardiac hypertrophy or dilatation on electrocardiogram,

                                          echocardiogram, or X-ray              30 

 

                            Workload of greater than 7 METs but not greater than 10 METs results

                                          in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

                                          medication required              10 

 

7006               Myocardial infarction:

 

                            During and for three months following myocardial infarction,

                                          documented by laboratory tests              100

 

                            Thereafter:

 

                            With history of documented myocardial infarction, resulting in:

 

                            Chronic congestive heart failure, or; workload of 3 METs or less

                                          results in dyspnea, fatigue, angina, dizziness, or syncope, or;

                                          left ventricular dysfunction with an ejection fraction of less

                                          than 30 percent              100 

 

                            More than one episode of acute congestive heart failure in the past year,

                                          or; workload of greater than 3 METs but not greater than 5 METs

                                          results in dyspnea, fatigue, angina, dizziness, or syncope, or;

                                          left ventricular dysfunction with an ejection fraction of 30 to

                                          50 percent              60 

 

                            Workload of greater than 5 METs but not greater than 7 METs results

                                          in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

                                          cardiac hypertrophy or dilatation on electrocardiogram,

                                          echocardiogram, or X-ray              30 

 

 

                            Workload of greater than 7 METs but not greater than 10 METs

                                          results in dyspnea, fatigue, angina, dizziness, or syncope, or;

                                          continuous medication required              10 

 

VA Schedule of Ratings.

[Gastone]

Trey, US Coast Guard Service AO Nehmer involved? In-country Nam Service? Could you clarify?

What's his current CSC?

[treysnonna]

Gastone,  my husband was in the navy from 64-68.  He got out and became police officer for 4 yrs in st.louis then Waco to for 4 yrs.   then was able to reinlist into the USCG and go back at the rank he got out at in 68.  He did 16 yrs to complete his 20.  Then got out of it and went back into law enforcement for another 9 yrs.  then 5 yrs with homeland security.  He was boots on ground in veitnam with coastal survalence.      I’m going to copy the decisions on these claims. When I have time.  My daughter just had surgery a few days ago.  And to tired right now.  Besides that this old body took a fall on the hospital floor of th hospital.  I’m so sore now I have problems getting up and down.  What is funny I’m sore in upper left chest area. Hope I feel better in a few days.

[Chuck75]

"Since the term refers only to heart disease, it does not include hypertension or peripheral manifestations of

arteriosclerosis such as peripheral vascular disease or stroke."

Very true - - However, A decent letter or IMO from a treating cardiologist can do wonders!

After having PAD and HBP denied, a sort of favorable C&P, combined with a cardiologist's letter pointing out the relationships,

the combination of DMII and IHD was accepted by a VA Nehmer team as the basis of SC and award in April this year.

It was interesting that the determination listed specific records and dates, instead of the VARO's usual hospital and treatment records, service records, etc. general statements.

Such generalized statements leave a large uncertainty as to the actual records used to justify a decision.

In the case of a denial, it may leave an opening, since general statements can generate doubt as to what specific records were actually used in the decision.

The real problem is to then get the percentages to where they should be. Even the Nehmer team seems to try to hold awards to less than 160% total.

(I wonder why?) <G>