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?

[allanE]

Thanks for your reply. This is a claim for IHD due to AO and is my first and only claim. I have been getting all my medical care from the VA since 2003, so my primary Dr is a VA doctor and she is the one who completed the Ischemic Heart Disability Quentionnaire. Wouldn't that eliminate the need for a C&P exam since it was done by the VA? or is still possible that they will want a C&P exam?

Got a question for you.......I initiated this claim with the help of the American Legion (DSO located in the VA hospital). I thought I was going to the DAV and just went to the first open door in this department and soon discovered that I was at the American Legion. On the first day I didn't have my DD214, so I had to bring it back. The next day I called to let him know I would be bringing it in today and they said he was out sick and I should take it to the Regional Office (which I did). The VSO I spoke to that day was very nice, BUT.....ever since that day, I cannot contact them at all. I have sent a couple e-mails and called three times and left messages (no one ever answers to phone). I just have a few questions and would never bug them (cause I know how long these claims take), but they will not call me back. I just want to make sure that they have everything they need from me (if so, then I'll just wait like everybody else). Since my claim has been filed and is pretty basic (only one disease) do you think I need the American Legion? I signed up for ebenefits so I could get the status of my claim, but that part of ebenefits always says the same thing - not available at this time. I signed an agreement with the American Legion, but I'm pretty sure I can "fire" them, right? Do you have any idea how I would go about that? Thanks for your help. Allan

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,

[71M10]

Thanks for your reply. This is a claim for IHD due to AO and is my first and only claim. I have been getting all my medical care from the VA since 2003, so my primary Dr is a VA doctor and she is the one who completed the Ischemic Heart Disability Quentionnaire. Wouldn't that eliminate the need for a C&P exam since it was done by the VA? or is still possible that they will want a C&P exam?

Got a question for you.......I initiated this claim with the help of the American Legion (DSO located in the VA hospital). I thought I was going to the DAV and just went to the first open door in this department and soon discovered that I was at the American Legion. On the first day I didn't have my DD214, so I had to bring it back. The next day I called to let him know I would be bringing it in today and they said he was out sick and I should take it to the Regional Office (which I did). The VSO I spoke to that day was very nice, BUT.....ever since that day, I cannot contact them at all. I have sent a couple e-mails and called three times and left messages (no one ever answers to phone). I just have a few questions and would never bug them (cause I know how long these claims take), but they will not call me back. I just want to make sure that they have everything they need from me (if so, then I'll just wait like everybody else). Since my claim has been filed and is pretty basic (only one disease) do you think I need the American Legion? I signed up for ebenefits so I could get the status of my claim, but that part of ebenefits always says the same thing - not available at this time. I signed an agreement with the American Legion, but I'm pretty sure I can "fire" them, right? Do you have any idea how I would go about that? Thanks for your help. Allan

Allen,

Yes you can revoke a power of attorney, I haven't needed to since I have always done things myself. If my current DRO processes don't get the proper results I think I will move my representation to a lawyer for the BVA business. I can look the information up for you but I know there are members on HADIT that have done this and they could answer much more quickly. I will give other experienced members a couple of days to respond, before I muddle about with it.

It is still possible they will want a C&P. Why, who knows, my guess is that if they go down the checklist it is easier for them to justify ratings if questioned, than by using the existing medical records.

Many people think the best situation for most veterans is to represent themselves at least up to the point of your decision. After you have been denied(if you are) you can have a lawyer pick up your claim and do the work for the Low Low price of 20% of your retroactive pay.

Since you are dealing with a presumptive service condition, If your DD214 clearly shows boots on the ground in Vietnam and you have a VA doctor treating your IHD, you are pretty safe at doing it yourself. With that said, you do need to make one serious change on how you communicate with VA. Send everything to them Certified Mail return receipt requested. make a complete copy of everything you send to them. When the little green card comes back in the mail with the signature and name of the person who signed for it at your local VARO, place that on top of the copy and staple or clamp it in place(i hate paper clips to flimsy). Buy a plastic file box from staples and a sharpie and write VA RECORDS keep it all together in chronological order.

Best regards,

[allanE]

Again, thanks for your reply. It's funny that you mentioned the "little green card".....just the other day, after failing to get my claim status from ebenefits many times, I called the 800 number and they called me back (pretty amazing). The young man I talked to was very nice and pulled up my file. He said from what he could tell, they are still waiting for my military records. I called the records center and asked for my military records way back when I first initiated the claim and got them pretty quick - I couldn't believe the VA was still waiting. SO.....I immediately took copies, put the file number on each page, typed a short cover letter and faxed the whole file to a fax number that he gave me, and then the next day I took the whole package to the Post Office and sent them" return receipt requested". I got the green card back two days later and did exactly what you mentioned.....I stapled it to the cover letter and the copies. At this point, I think I'm just going to ignore the AL, just as they have done to me. In a week or two I will call the 800 number again to make sure they got the package I sent. The only thing the American Legion has done for me so far is assist in filling out the original claim and sending in my DD214. I will see this through myself now and If they deny my claim, and I need to file an appeal, I will find an attorney.

Do you have any idea what the problem is with ebenefits? I know they scheduled down time over this past weekend so I assumed it was to fix the problems, but checking again today, it still says "open claims unavailable at this time". Is this common or what?

Thanks for all your information and help. Allan

Allen,

Yes you can revoke a power of attorney, I haven't needed to since I have always done things myself. If my current DRO processes don't get the proper results I think I will move my representation to a lawyer for the BVA business. I can look the information up for you but I know there are members on HADIT that have done this and they could answer much more quickly. I will give other experienced members a couple of days to respond, before I muddle about with it.

It is still possible they will want a C&P. Why, who knows, my guess is that if they go down the checklist it is easier for them to justify ratings if questioned, than by using the existing medical records.

Many people think the best situation for most veterans is to represent themselves at least up to the point of your decision. After you have been denied(if you are) you can have a lawyer pick up your claim and do the work for the Low Low price of 20% of your retroactive pay.

Since you are dealing with a presumptive service condition, If your DD214 clearly shows boots on the ground in Vietnam and you have a VA doctor treating your IHD, you are pretty safe at doing it yourself. With that said, you do need to make one serious change on how you communicate with VA. Send everything to them Certified Mail return receipt requested. make a complete copy of everything you send to them. When the little green card comes back in the mail with the signature and name of the person who signed for it at your local VARO, place that on top of the copy and staple or clamp it in place(i hate paper clips to flimsy). Buy a plastic file box from staples and a sharpie and write VA RECORDS keep it all together in chronological order.

Best regards,

[71M10]

Again, thanks for your reply. It's funny that you mentioned the "little green card".....just the other day, after failing to get my claim status from ebenefits many times, I called the 800 number and they called me back (pretty amazing). The young man I talked to was very nice and pulled up my file. He said from what he could tell, they are still waiting for my military records. I called the records center and asked for my military records way back when I first initiated the claim and got them pretty quick - I couldn't believe the VA was still waiting. SO.....I immediately took copies, put the file number on each page, typed a short cover letter and faxed the whole file to a fax number that he gave me, and then the next day I took the whole package to the Post Office and sent them" return receipt requested". I got the green card back two days later and did exactly what you mentioned.....I stapled it to the cover letter and the copies. At this point, I think I'm just going to ignore the AL, just as they have done to me. In a week or two I will call the 800 number again to make sure they got the package I sent. The only thing the American Legion has done for me so far is assist in filling out the original claim and sending in my DD214. I will see this through myself now and If they deny my claim, and I need to file an appeal, I will find an attorney.

Do you have any idea what the problem is with ebenefits? I know they scheduled down time over this past weekend so I assumed it was to fix the problems, but checking again today, it still says "open claims unavailable at this time". Is this common or what?

Thanks for all your information and help. Allan

To be blunt, the problem with E-benefits is that the Veterans Administration and Department of Defense have designed and operate it!

Detroit VARO seems to not bother with updating information to it, and As of 9/30/2011 according to e-benefits, my appeal was completed by the BVA and mailed to me on October 3, 2011. The only problem is I have never had anything go to the BVA yet. I called the BVA number and they indicate that entry was made by my VARO. Called the 800 dial-Idiot number and they indicated it represents a claim that cannot be appealed since it is over a year old, then updates me on the status of the DRO Review that was started from the NOD that was issued against the decision they just told me couldn't be appealed because it is over a year. All other items in the list read "Information not available".

I actually want to apologize to any one who works the 800 827-1000 number, i know you are not idiots, you are paid to do a thankless job, you are forbiden to problem solve, you can only give out certain information, and you have to work with a data system designed by the finest contractors VA could hire.

Sorry bit of a rant!

[jachay]

Allan,

My husband's claim was worked from the St. Pete office. It took a little over 7 months. He received a 100% P&T rating. His case was much like yours except he filed a claim in 2004 and was denied.

His private cardiologist filled out the form provided by the VA and he checked that he has chronic Congestive Heart Disease. The C&P doctor confirmed it. He had had one episode in about 3 years but has taken medication for it for years. Are you taking medication for Congestive Heart Disease?

In CFR 38.4., the "OR" is the key. If you have Congestive Heart Disease, no mets or LVEF is needed....at least, it wasn't in his case. You either have Congestive Heart Disease or you don't. The VA should have all that information since they have been treating you.

The key, IMO, is the mark in the YES box asking if you have Congestive Heart Disease. Ask for clarification from your VA doctor if that is the only doctor you see.

We compared his C&P to the CFR 38, 4-104, (7005) CHD, Coronary Heart Disease. The "OR" confirmed to us that a 100% rating was coming although many here said 60% because of mets/LVEF.

Hope this helps. Good luck.

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?

[Harv]

Allen,

My situation is somewhat similar to yours. Had C & P exam earlier this month for IHD. C & P Dr. stated 60%LEVF(from 2007 catherization), and 3 to 5 Mets. Have no energy and have a pacemaker. My one Dr. diagnosed CAD and Hyperthroidism, not sure about my cardiologist, although I know he sent in recent echocardiogram and Nuclear Stress Test. Now is just a waiting game like many.

Feel it could go either way. Depends on the rating officer and what the Cardiologist reported. Hopefully, will have good news in a few months or more, maybe. I've filed my own claims, with all the info I gained from great Hadit members. And, just to confirm, always send return receipt requested, all information. Was boots on the ground in Vietnam 69-70.