Ihd Ratings

[allanE]

I'm looking for clarification of CFR 38, 4,104 (7005) Coronary (Ischemic) Heart Disease.

It reads "More than one episode of acute congestive heart failure in the past year, or; workload of greater then 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."

I didn't have more than one episode of congestive heart failure this year (but did have one), and my LVEF is not 30 to 50% - it's 60%. On the Ischemic Heart Disease Questionnaire, my Primary Care (VA) Doctor checked 3.5 METS. So the only thing for me that this reg fits is the 3.5 METS. Does that mean I will get the disability rating of 60%

I was "boots on the ground" from 1966 to 1967 in Corp III. I have had ischemic heart disease since 1992. Had two heart attacks - angioplasty once and one stent. I still take medicine to control this disease. And yes there is evidence of cardiac hypertrophy or dilatation.

This is my first claim and I have no idea how it all works. This site is the only help I seem to get. I asked for help from the American Legion, but I think that was a mistake. After several e-mails and phone calls I still haven't heard from them and this all started back in August.

Since this is a pretty cut and dry claim (and my only one), and not complicated, how long do you think it will take to settle?

[NJBB62]

allanE, Put in your claim now do not wait, my LVEF was less than 50% with 3 Mets and I was awarded 60% service connected, Do you have this in your medical records. Make sure you send all paperwork from all doctors. If you can not work apply for TDIU and make sure your Doctor indicates due to your "Chronic" disease you can not do Sedentary or physical work. The word "Chronic" is big here in decisions. This is just my opinion and hopefully others will chime in.

It also took me over 1 year to settle my claim in Florida. Good Luck.

NJ

[jbasser]

The schedule uses the word or. That means either or. Your Mets of 3.5 has rider issues along with dyspnea, fatigue, angina, dizziness, or syncope. If you have these then its 60 percent. If not they will go by the EF and it will be a lower rating.

If this was a c and p exam then it is ok. But as most will see it they will offer a separate exam for the C and P and rate on the doctors opinion. It could go wither way.

J

[71M10]

Allen,

Yes this should rate at 60% due to the METS assesment of 3.5. Now how long is a very common question with no good answer. How long is determined by many factors, I assume from your post that this is IHD due to AO exposure and the rumor is that VA is prioritizing/or making a push to clear many of these. I would plan on at least a year to 14 months, maybe they will suprise you but until you pass a year waiting I wouldn't even look for it. Now your primary care Doc says 3.5 METS, they may send you to a Compensation and Pension Examination where they will ask all the same questions, possibly run tests and that doctor will make some determinations, If that Doc says your METS are above 5, they will try to rate you at 30%. Any decision you disagree with can be appealed, the decision will give you instructions on how to appeal or you can login to HADIT and use the resource pages (a treasure trove of information).

Good luck and best regards,

Edited October 25, 2011 by 71M10

[hueyman]

I am 69 year old VN vet that had aheart attack in 2006. I had stents to keep me alive until I was strong enough to have 5x bypass 1 month later. Applied for IHD,was sent to QTC for exam. Was not able to do treadmill, only echo. QTC"s so called (doctor) said my ejection faction was 50, estimated METS of 9. Said i could (walk) uphill at 5 MPH. Gave me 30% rating. Applied for unemployability for IHD and PTSD 1-6-11 no word yet.I truly hope you get better examiners than I did. Hope their estimates are right . Think maybe I can live another 70 years? Good luck.

[71M10]

I am 69 year old VN vet that had aheart attack in 2006. I had stents to keep me alive until I was strong enough to have 5x bypass 1 month later. Applied for IHD,was sent to QTC for exam. Was not able to do treadmill, only echo. QTC"s so called (doctor) said my ejection faction was 50, estimated METS of 9. Said i could (walk) uphill at 5 MPH. Gave me 30% rating. Applied for unemployability for IHD and PTSD 1-6-11 no word yet.I truly hope you get better examiners than I did. Hope their estimates are right . Think maybe I can live another 70 years? Good luck.

With a LVEF of 50% and left ventricular dysfunction, you should be rated at 60%. Check your exam for the words diastolic dysfunction or Left ventricular dysfunction. I know if you search for it there is a particular case where this issue came up I cannot remember if it was BVA or CAVC.

Best regards,

[71M10]

Hueyman,

It looks like they litigated it again in 2010 and the VA lost again. Since this is a CAVC decision it should be precident setting.

http://www.google.com/url?sa=t&rct=j&q=cavc%20lvef%2050%25&source=web&cd=4&ved=0CEMQFjAD&url=http%3A%2F%2F38uscode.com%2FCourts%2FVetCourt%2FCAVCpreop-02-05%2Fotero_castro_01_1360.doc&ei=Ne6mTqbyIeWzsAKgy-GtDw&usg=AFQjCNHQjBKc5P19cnTaXAlfy_0YTVGw4Q

This should also push your overall rating to a level that TDIU will be easier to achieve.

Best regards,