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?

[Chuck75]

When all is said and done, the pacemaker will be a strong factor in granting 100%.

CAD is another, and the two together show cause and effect. The results of the chemical stress test are also important, and are more accurate than the usual

treadmill test the VA likes to call for. You indicate that you are a Vietnam veteran with feet on ground. It's possible that the VA has not placed you on the Nehmer

list. I'd contact the NVLSP to find out. http://www.nvlsp.org/contact_info.htm The Nehmer court case rulings can take your case and retro pay back to the first VA claim

date, even when IHD was not specifically claimed. This can occur as a result of "implied claim" and other clauses in the law.

"Have no energy and have a pacemaker" is of concern. I'd look into it, as the pacemaker settings may need to be adjusted.

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.

[Harv]

Thank you Chuck,

Thank you for the advice and concern, will contact NVLSP. I did have the pacemaker upped to 61 from 60 but didn't seem to make a difference. May have them jump it up to 65 if they will. Just takes a press of the computer keyboard, I'm sure. Will let everyone know how I make out in the decision, hopefully in success stories. Thanks for your encouraging assessment also.

[Lorraine]

Allan

I'd just like to give you some encouragement with your AO/IHD claim. My advice to you would be to read something on the Hadit site every day, copy things that pertain to your situation, take notes. LIke you, my Vet filed a claim for AO/IHD and we were very ignorant as to the workings of VA when we started out on this journey. We got to Hadit after his claim was filed (darn! - it would have helped so much to have gotten to this site first!).

Even tho his medical records from private cardiologists and cardiovascular surgeons had information about EF, the VA still required that he have a C & P (if this is required of you, take the time to read the Hadit article on how to prepare for your exam - courtesy and sincerity go a long way!). The contracted doctor (QTC) was an internist, not a cardiologist. From the information he obtained from questioning about activity level, he rated the METS at 3-5. VA had also set up an appt. for a stress(treadmill) test, but the QTC doc felt there was too much risk, so cancelled that and they scheduled him for an echocardiogram to get a current EF. That was done at a cardiovascular specialty clinic. My Vet has no history of CHF and he doesn't have a pacemaker, so the similarities end there for what your rating could eventually be. His EF was less than 50%, so he got rated at 60%.

It took about a year from first filing the claim for the 60% award to be granted. We had a really good experience with working with a Viet Nam Veterans of America VSO at the Regional Office, so I suggest if you aren't getting a good response from the AL that you go elsewhere. Some folks are great at filing and obtaining all of the informaiton they need on their own, but if you are

feeling like you could use some guidance, you might try another VSO.

You eventually WILL get your past due award and you will get retroactive pay back to the day that you filed. All you can do now is practice PATIENCE and know that your day will come. eBenefits were terrible for us getting info and the IRIS calls all were so "canned" that we never got anywhere. Our VSO was able to tell us easily where our claim was, any updates, etc.

I wish you a speedy settlement, but mostly, I wish you good health so that you may enjoy your award!

Lorraine

[Berta]

Chuck is always right on the AO Nehmer button !!!

Go over any past old decisions you have since Sept 25, 1985 from the VA and see what the rating sheets say.

Also as Footnote One Nehmer says- anything that was coded or SHOULD have been coded in a past VA rating could put you under the Nehmer court order if for any new presumptive or could be easily be construed as one of the new presumptives. Such as if you claimed "heart problems" and they denied and probably coded it with a Diagnostic code and then NSC and then a rating.

There is more info on Footnote one in our AO forum.

I am a Footnote One AO widow.

My husband presented IHD in Aug 1988 via a heart attack while employed at the VA.They rushed him from his VA job to the VA ER.

Although his IHD was misdiagnosed and never treated by VA, still it SHOULD have been coded in 2 past rating decisions.

In my Section 1151 award letter the VA clearly stated the exact findings from Office of General Counsel as to my wrongful death case and settlement.

"Multiple deviations" had occurred - all of which resulted in the veteran's death. Then they listed the exact deviations, beginning with his fatal and malpracticed IHD back to August 1988.

Still the VA failed to even code or rate his IHD and gave wrong codes to other stuff in my Sect6ion 1151 award letter.

I fall under the "SHOULD have been coded" part of Nehmer Footnote One.

When you contact NVSLP at their AO email addy-

it is good idea to let them know dates of any past decisions that could now be construed as falling under Nehmer.

I had the impression this was your first VA claim but I guess I was wrong.

I prepared my email to them off the NVLSP site in OfficeOrg so that I could give them all of the data as well as hyperlinks to my old BVA cases and then I responded to their questions via the NVLSP email link by copy and paste so I didnt leave anything out.

I will bump up their contact info in our AO forum.

In a few days they will respond to you. In my case they asked a few more questions and I responded to that.

[Harv]

Berta,

I have learned a lot from your posts, thank you. I have contacted NVLSP, but don't remember mentioning any heart problems in my earlier claims. I had notified my VA PA of the pacemaker being placed and had complained to the VA Drs. previous to that of being fatigued most of the time, but they just attributed it to the meds I was taking for PTSD., apparently was not the case.

I had my private Cardiologist send confirmation to the VA in early 2011 of the pacemaker. I had done my PTSD myself, under older rules, and the Tinnitus and recently the IHD Claim. First 2 awarded first time through, by different VAROs, thanks to all the information I learned from this site.

In reading the Nehmer decision, I don't think I qualify, but sent the email to NVLSP to confirm either way.

[Berta]

Even if your claim doesn't fall under Nehmer, it should still fall under the regular AO IHD regs.

The basic difference is the EED.The EED for non Nehmer AO claims is usually the date the claim was filed.

If there is also a SSDI award for IHD and that award preceded the IHD claim, then the vet can very possibly attain up to another additional year of retro.That goes for any claim.

I always use my husband's claims as example.

He got SSDI for PTSD with EED of Nov 1991.His VA SC for PTSD was 30% at that time with claim pending for higher SC rating and claim pending under 1151.He also had applied for TDIU but VA never mentioned that in the posthumous decision.

Although the VA never seemed to consider the SSA award as evidence, they did award posthumously PTSD at 100% P & T based on his psychiatric records which his doctor gave me and who also sent them a letter referring to his SSA and his treatments at VA with him.

They VA gave him the same EED as SSA did, Nov 1991-for his posthumous rating.

Of course he had been dead by then for almost 3 years so

the EED was used for my accrued benefit award.

Accrued benefits derive from any claim pending in a veteran's lifetime that the survivor continues until awarded.They must be applied for within one year after death.Usually they are applied for as part of the 21-534 DIC application.

Under Nehmer there are more favorable accrued benefit provisions, however.

Will explain that further in article I am doing for our AO forum.