hypertension Old C & P Exam

[FrankieG23]

My husband filed for DMII in 7/01. Got approved for DMII, hypertension and PN, both secondary to DMII. In 6/03stenting and ablation approved for heart disease at 60% and 8/03 approved finally at 100% as he had a pace maker/defibrillator (the defib part made him 100%PT, I dont think just a pace maker alone would have done it) The heart disease was approved as secondary to DMII. His IMOs all had heart disease due to DMII. That is just a little background. This is my question. He put in for IHD 10/31/10. The 800 number said to do so, since a rater can decide if he ever got rated for IHD or it would make difference if he passes away. I did it as maybe he could get an EED. Well I have been going thru papers as I had never put in for CHAMPVA, and I find on his C & P exam copy of doc's report that the doc found a soft 4th heart sound. This was exam for DMII back in 12/01, but it also had he listed as no heart disease. Things I have looked up under 4th heart sound show this is never audible in normal subjects, and cardiomyopathy can be a result of this (which is part of IHD). He is still in the decision phase. Do I fax over this report, does the writing of "no heart disease" on it hurt him for chances of EED? Would this be part of something that was found during an exam that should have been address by the VA, and can quailify for having a disease without a formal claim. Is he better off waiting until the R/O makes decision? It was less than 2yrs and all his heart problems came to head. The C & P doc's report seemed to be contraditory 4th heart sound can be IHD, how can he write on page 2 of same report no heart disease. Also no further testing was done at that time, except maybe a EKG, which doesn't always show heart disease the first time. He never received a stress test or echo during this C & P exam. He was never denied heart disease. Would this be something I should show to the overseers of Nehmer? Thank you for your time, this is a very knowledgeable board and I have learned many things. That is why I am putting in for CHAMPVA. I have always had insurance, but have had co-pays on my meds. I didnt know I could get re-imbursed until I saw it here.

[FrankieG23]

"I saw Heart Disease 100% he does get SMC home bound also"

The only benefit I foresee from the claim is if the EED was wrong as explained within my other posts and if that could produce some additional SMC benefit.

If I were you I would contact NVLSP at their Agent Orange addy and ask them if this is a claim under Nehmer.

"No previous claim made for IHD prior to 6/03 when he had testing and was told he needed stent. Had 30 day halter which found a lot of heart disease including a silent heart attack. I beleive he was granted heart disease all secondary to DMII 800 number told me that since I am not a doctor and there is alot of conditions with the heart, they might not have called it IHD, and 800 # told me that the VA needs to put it on his rating"

Was the 100% for heart disease EED determnined back to June 2003?

[hawkfire27]

I think that before you submit the info as evidence for your IHD claim, you should talk to an Independent Cardiologist.

The information itself would probably be harmful because of the "No heart disease" statement. However, you could use it as a basis for an Independent Medical Opinion and then submit the IMO, instead is the piece of paper you found. If a cardiologist interprets that information favorably that is better than a rater at the VA assuming he had no heart disease.

Good Luck.

[FrankieG23]

Thank you everyone for all the advice. I reviewed all his ratings DMII 20% Lower PN L/R both at 20% Upper PN L/R both at 10% Hypertenson 10% this was all in 7/2001 In 2002 he got diabetic retinophy 0% and hearing loss 0%. John you were right about heart, only 1 rating 6/2003 CAD and stenting 10% which was increased to 100% on 9/2003 for the defib, so he had 100% plus the other 70%. It didn't look like they addressed a silent heart attack. Berta, he just got an increase no EED to 6/2003 The 800 # still states it is at Nehmer. I will show the old C & P letter to his heart doc. I just wonder if someone at VA had mention the soft 4th heart sound, could we have done something sooner concerning his heart. How do they say "no heart disease" without giving test to determine it? I will look up previous post ref NVLSP. How can you claim a condition you don't know you have, like in my husband's and John's case??? I hate taking chance again but I can put in for an increase to DMII as he is on insulin and has difficulty walking. I think I will wait till all this other stuff is sett;ed or maybe we will just leave it alone. We are just hoping he can get approved for the tininitus or meneire's disease so he can get the VA insurance. It's good to have a place to go to were people share knowledge and experience. I can do a little but some of this is way out of my range. The 800# said what Berta had said, that there may be possiblity of another SMC he can qualify for.

[Berta]

"How can you claim a condition you don't know you have, like in my husband's and John's case???"

You can claim it under Section 1151 and/or as secondary to a SC established condition.

I see the point you have made-

" How do they say "no heart disease" without giving test to determine it?"

This was the basis of my FTCA and Sec 1151 claim.( and the basis of my husband's pending 1151 claim when he died- ) The VA said 'no heart disease' the same day they read my husband's ECHO which showed him at 60 % IHD rating criteria and he should have been diagnosed for heart disease years before that when he had a heart attack while at work (at the VA) and they called it a sinus infection and sent him home for 3 days with sudafed.

I am still angry as I await my IHD claim results under Nehmer.The heart disease he had has never been rated yet after 17 years.They didnt even rate it in my award from last year nor as part of my 2--4 CUE claim still pending.

"How can you claim a condition you don't know you have, like in my husband's and John's case???"

I repeated this because I used a different tactic for my last claim that BVA awarded.

I could not claim malpractice over the same death again so I had to word this claim very carefully- my daughter insisted I file a claim for my husband's undiagnosed diabetes due to AO as a factor that caused his death directly due to service.

I claimed a condition neither he or I knew he had in his lifetime.

I used my prior awards under FTCA and 1151 and this time I got 3 IMOs.BVA awarded that claim last year.

I had to do a complete review of all of the medical records and look at them a different way then before.

I prepared a cover sheet for my IMOs and took the doctor step by step.By this point I had developed a medical background based on my husband's clinical records.One doc prepared 2 different IMOs for me and the other doc gave me a brief 2 sentence freebee but BVA gave his 2 sentences IMO much weight.(long story as to why)

I believe 100% is usually warranted for three months after having a heart attack- then a staged rating as to residuals but I am hoping the Nehmer decision I get will account for that and this decision would also help your question if they didnt rate for 'silent' heart attack.

Any heart attack that shows up on EKG is not 'silent' but diabetics ,due to neuropathy, might not react to the pain and other symptoms would present themselves as heart attack.

When I proved a sinus infection that caused my husband to collapse on the job at VA many years ago- was a heart attack-

I used considerable information that appeared on the 2 page ER med certificate (I had to learn how to decifer it all first) as well as the EKG.

A silent heart attack ,if it is serious enough to cause residual problems,will have a paper trail as to ECHO or EKG results in the med recs.