Ihd Claims

[cbtvet]

are ihd claims being rated w/o c&p exams. through normal va health care i have had stress test, ekg's heart meds . etc....

[Chuck75]

Yes and no. (How's that for an answer!)

In my claim for IHD and related conditions, the VA scheduled (three times, no less) a C&P. The Nehmer review threw out the last two, since the medical evidence of record was extensive and conclusive, and not rebutted by the "inadequate" C&P exams, to use/summarize the Nehmer review statements. The VA declined to spent the kind of money needed to do less risky (to me) medical exams/procedures that are far more definitive than a simple stress test. My medical records already included the "gold standard" tests anyway.

One of the C&P exams was cancelled when I informed the VA that based upon competent medical advice (in writing, no less) I would not take a stress test. The second was done by a C&P staff RN, not a cardiologist or other qualified specialist. (No stress test)

The third was supposed to be done by a contract cardiologist's group. When I handed them medical records and a statement from my cardiologist, they declined to do the exam (involving another stress test), due to liability and possible malpractice concerns. All they really did was to review & quote the existing medical records.

Not to mention that my cardiologist signs such things as medical continuing education certification for the area cardiologists, member of staff credentials for the area heart trauma and open heart surgery center, and basically "rules the roost" of the area cardiologists

.

I'd also say to anyone having a known and serious heart condition, a physical stress test (VA's favorite, since it's cheap!) can be a large risk to life and health.

A chemical stress test done by a fully qualified interventional cardiologist with either sonic or x-ray monitoring is safer, and since a tap is already in place to feed chemicals or dye, can be reversed very rapidly.

I'd also suggest that a stress test of any kind for a Vietnam veteran be done at or near at least a facility that has the capability to do a heart cath on an emergency basis.

The stress tests that I've had in recent years were at a regional heart center that routinely does emergency and scheduled open heart surgery, not to mention heart cath, stinting, and and balloon angioplasty.

The first, last, and only physical (treadmill) stress test I've had (about 25 years ago) induced a mild heart attack. It was quite scary, since at that time, the nearest major heart center was over a hundred miles away. Fortunately, Nitroglycerin stopped it, and relieved the immediate symptoms. That was followed about a month later by a heart cath, and a resultant trip a month or so later to Emory for multi bi-pass surgery. (THAT REALLY SMARTED!)

Edited September 18, 2011 by Chuck75

[Berta]

You made some very important points Chuck- as always you are right on the mark!

"The first, last, and only physical (treadmill) stress test I've had (about 25 years ago) induced a mild heart attack." That IS scary! and I bet this happens more then we think. My former vet rep said that happened to him too.

My Nehmer claim has no C & P for IHD. It rests on only an ECHO which would warrant a 60% rating.( and records that proved untreated heart attack 4 years prior to the ECHO (and 3 abnormal EKGs)

I re -read my claim the other day ( been ready to rate since April per VA)I had forgotten a point I made at the end of it.

When the ECHO was done revealing the EF and measurements etc----a VA cardio told me after he said he read it, that my husband had NO heart disease at all.He was discharged from the VAMC a few days later and his Discharge cert indicated nothing that lent to IHD. I already proved all this as malpractice after he died but I stated to VA at end of my IHD claim that, since the veteran presented IHD at a 60% ratable level due to the ECHO, the VA chose for the next 2 years up to his death to do nothing about his IHD-which was diagnosed by the coroner and the county ME.(But evident as I proved in his med recs for 6 years prior to death).

With consideration of the malpractice, then how could the 60% rating be considered the proper rating for that 2 year period?

I don't know how that idea will fly.But VA did nothing to prevent escalation of the 60% warranted by the ECHO or alter the ejection fraction by any type of medical care whatsoever.

Since 1995 the VA has admitted to malpractice on his IHD but has NEVER rated it at all thus one of my CUE claims is for that.

"The third was supposed to be done by a contract cardiologist's group. When I handed them medical records and a statement from my cardiologist, they declined to do the exam (involving another stress test), due to liability and possible malpractice concerns" They were smart there. It could have killed you!

[Lorraine]

My Vet was sent for a C&P and scheduled for a stress test with a contracted cardiology group after he filed for IHD/AO. The MD who saw him for the C&P did not think it was wise for my Vet to have a stress test (because of his medical history of three cardiac arrests) I was allowed to attend the C&P exam, and the MD questioned me a lot about his functional status and I expressed my concern about the risk of him having a stress test. So,the VA subsequently re-scheduled him for an echo instead of the stress test. He was awarded 60% In NOV 2010 and advised by VA to file for his Diabetes type 2. He filed a claim for that and was sent back in May-June 2011 for another C&P and another echocardiogram. NO results on that yet. We put in a request for copies of the C&P and echo and his VSO was supposed to give it to us last Thurs, went to the office and he was gone for the day to a meeting. So, now we're waiting for the copies via the mail.

Lorraine

[cbtvet]

Thank you. I e-mailed my varo to check on my claim they told me the ihd was in the decesion phase. since i have had no c&p for ihd i was wondering.If they were going to schedule me one , apparently not.

[Berta]

If they have enough current medical info on the IHD or if your IHD med care was from a private doctor who filled out the special IHD forms they developed, then there is possibly no reason for a C & P.