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RDT

Cue Agent Orange

Question

If you have an enjection fraction of 48% in the year 2002. Would not your rating be 60%.

The VA rated me 10% retro for 2002 based on a C&P in 2008 that guest MET at 10,C&P in 2009 that quest MET at 11 and last C&P in 2010 that show MET at 5 and injection fraction at 50%

I would think it would be 60% based on the injection fraction in the year 2002, not some C&P in 2008-2009 that I disputed.

Would a rating in 2000 that show 40% and a new award at 60% no bet = 78%

Thanks

RDT

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Gee, the silence is deafening ...

First, is this a recent Rating Decision? What was the date on the notification letter? If the Decision is dated within the last year, a Notice of Disagreement (NOD) would likely be better - and perhaps quicker - than filing a Clear and Unmistakable Error (CUE). Unless of course, ya just gots ta' have a CUE to fulfill some inner need.

If everything actually is as you wrote, and all the alleged medical evidence is of record in your claims file, this is how the evaluation for coronary artery disease (I presume) should run:

2002-2008 : 60% because of EF between 30 and 50%.

2008-2009: Reduced to 10% because of METS greater than 7 but not less than 10.

2009: Reduction to 0% because of METS greater than 10.

2010: Increase to 60% because of METS greater than 3 but less than or (or, EF between 30 and 50%)

While I admit your medical findings are all over the chart, you'd need some other evidence to countervail or overcome the C&P examinations from 2008 and 2009 that you dispute. You might need your own Independent Medical Opinion (IMO), based on a review of all your treatment records, that those C&Ps were invalid.

As for Would a rating in 2000 that show 40% and a new award at 60% no bet = 78% , the actual number depends upon whether that 40% is a single 40%: several disabilities that combine to 40%; whether the bilateral factor comes into play, and so forth. However, almost any way you compute it, the number is 75% or greater, which rounds up to 80%.

If you have an enjection fraction of 48% in the year 2002. Would not your rating be 60%.

The VA rated me 10% retro for 2002 based on a C&P in 2008 that guest MET at 10,C&P in 2009 that quest MET at 11 and last C&P in 2010 that show MET at 5 and injection fraction at 50%

I would think it would be 60% based on the injection fraction in the year 2002, not some C&P in 2008-2009 that I disputed.

Would a rating in 2000 that show 40% and a new award at 60% no bet = 78%

Thanks

RDT

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Than You for the responds.

The 2 C&P were by nnew Nurse and lasted about 20 minutes. That is why I disputed them and when they scheduled the new C&P in Janurary 2011 it shower the correct LVL and METS, which matched in 2000. As you can see in the decision the VA stated the LVL was 48% in 2000.

I will file a NOD. I will keep searching here on the site to see if I can find how they apply medical evidents on a claim that is 11 years old.

Thanks for your advise and any other input would be great.

Ray

Gee, the silence is deafening ...

First, is this a recent Rating Decision? What was the date on the notification letter? If the Decision is dated within the last year, a Notice of Disagreement (NOD) would likely be better - and perhaps quicker - than filing a Clear and Unmistakable Error (CUE). Unless of course, ya just gots ta' have a CUE to fulfill some inner need.

If everything actually is as you wrote, and all the alleged medical evidence is of record in your claims file, this is how the evaluation for coronary artery disease (I presume) should run:

2002-2008 : 60% because of EF between 30 and 50%.

2008-2009: Reduced to 10% because of METS greater than 7 but not less than 10.

2009: Reduction to 0% because of METS greater than 10.

2010: Increase to 60% because of METS greater than 3 but less than or (or, EF between 30 and 50%)

While I admit your medical findings are all over the chart, you'd need some other evidence to countervail or overcome the C&P examinations from 2008 and 2009 that you dispute. You might need your own Independent Medical Opinion (IMO), based on a review of all your treatment records, that those C&Ps were invalid.

As for Would a rating in 2000 that show 40% and a new award at 60% no bet = 78% , the actual number depends upon whether that 40% is a single 40%: several disabilities that combine to 40%; whether the bilateral factor comes into play, and so forth. However, almost any way you compute it, the number is 75% or greater, which rounds up to 80%.

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My 40% in 2000 was for chronic low back syndrome. It was increased to 50% in 2003. Not sure how the bylateral factor work on this.

Thanks

Ray

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Each bit of information makes this clearer ... almost like having full access to your claims file and being able to read it. In any event, based on what you've written, I presume you are a boots-on-the-ground Vietnam vet; you have been diagnosed with CAD/IHD; and, you initially filed a claim for service connection for CAD/IHD in 2002 (or have an implied claim from that date); your claim was resurrected (or transferred for processing under Nehmer); and, you are potentially eligible for retroactive disability compensation under Nehmer from sometime in 2002 .... am I correct, more or less?

Anyway, it is still not clear to me whether you have received a Rating Decision based on the disputed examinations/information from 2008 and 2009. Have you already received that Rating Decision? If so, a NOD is the way to go. If not, you have nothing to disagree with - yet.

However, your situation would not be a Clear and Unmistakable Error (CUE) because a CUE is a mis-application of the laws. From what you wrote, it appears to me that the laws, based on the evidence at hand, were applied properly. So, the NOD is the better way to go.

FYI, a C&PE is in most cases but a snapshot of a veteran's condition at that moment. Again in most cases, unless a Rating Veterans Service Representative (RVSR) has something else that states that those examinations were invalid, the RVSR still has to go with the examinations; otherwise, the RVSR would be supplying his/her own medical diagnosis. So, unless that C&PE from 2011 mentioned that those examinations were invalid, I'm afraid that the examinations likely will stand. With those erratic exams, an RVSR likely would: (a) have to rate the claim with the evidence at hand; or, (b) delay the claim even longer by sending the claims file back to the last examiner to state whether the previous two exams were valid/invalid; or, © do some fancy footwork to state why the disputed exams were invalid; again, this verges on supplying a medical opinion.

FWIW, when a nurse practitioner (CNP) says something that is in the veteran's favor, that CNP is caring, compassionate, and really knowledgeable. If the CNP states something negative, or with which the veteran disagrees, the CNP is superficial and incompetent.

Than You for the responds.

The 2 C&P were by nnew Nurse and lasted about 20 minutes. That is why I disputed them and when they scheduled the new C&P in Janurary 2011 it shower the correct LVL and METS, which matched in 2000. As you can see in the decision the VA stated the LVL was 48% in 2000.

I will file a NOD. I will keep searching here on the site to see if I can find how they apply medical evidents on a claim that is 11 years old.

Thanks for your advise and any other input would be great.

Ray

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Based on what you wrote in this and your earlier messages, and a little knowledge of the Rating Schedule, it's not likely that the bilateral factor has any bearing in this situation. Unless, of course, there's something else ....

My 40% in 2000 was for chronic low back syndrome. It was increased to 50% in 2003. Not sure how the bylateral factor work on this.

Thanks

Ray

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