tdiu Bva Decision

[bm6546]

After 3 years at the BVA, I finally received an answer back. The BVA has remanded it back to my RO. The BVA wants the RO to determine if I am eligible for TDIU. I have been disabled since Jan 06 due to my heart attack. I am SC at 0%. I don’t understand this.

The BVA also wants me to have another stress test for my heart. Of course, they also say “under no circumstances should the health of the veteran be placed at peril to perform a test.” Six years ago the VA cardiologist prescribed medication to help control my heart problems. Do they want me to stop taking my medication so my heart problems will re-occur so I can fail the stress test. I don’t understand this at all.

The BVA is asking the RO to make a decision as to whether my Supraventicular Arrhythmia best characterizes the veteran’s service connected disability, and to address all manifestations of the veteran’s service connected heart disorder. (I had a heart attack in Jan 06). They are trying to determine whether the 2 heart conditions are related.

They also want to schedule me for a VA examination to evaluate my ability to secure gainful employment. (I am 65 years old). I haven’t been able to work for almost 6 years.

Not sure where to go with my claim.

[halos2]

You get SS or SSDI? How long you been receiving SS benefits? When did you put in your original VA claim? Military records validate any of your diagnoses? Are you AO related?

[bm6546]

You get SS or SSDI? How long you been receiving SS benefits? When did you put in your original VA claim? Military records validate any of your diagnoses? Are you AO related?

I have been on SSDI since Jan 06.

I filed my claim in June 06

I was dicharged in 1966 with SC 10% for my heart condition after the VA diagnosed me.

No I am not AO related.

[bm6546]

John is right.

"As far as the TDIU is concerned. I am not sure how that will work for me. I am SC 0%. Don't you have to be somewhere around 60% or 70% SC in order to qualify for TDIU? Not sure how that would benefit me. In my remand from the the BVA, they mention TDIU several times. Its almost like they want me to file a claim for TDIU. "

The BVA is ,in my opinion without seeing the remand,insuring that if,in fact your heart condition is service connected by the RO, that they will then consider you for TDIU.

This is what I stated in the prior post I made:

"If you get SSDI solely for the main heart problem and VA finds it is due to your service (the main heart condition) than they will consider you for TDIU."

However you get it for both anxiety and heart problems so that will not help a TDIU claim.

"The Social Security has diagnosed me with:

1. Primary Diagnosis - Anxiety Disorders

2. Secondary Diagnosis - Chronic Ischemic Heart Disease with or w/o Angina

My VSO did not submit the letter to the VA from my private Cardiologist which states that my 2 heart conditions are not related. I do not know what my Cardiologist attributed the reason for my MI.

I am not sure what you mean by "do you have a valid nexus to your service for your present disabling heart condition".

What I meant was could your present heart condition possibly have a nexus to your service aside from the PAT.

But by now I am sure you would have fOund anything like that in your SMRs.

I am assuming you are not an incountry Vietnam veteran not exposed to Agent Orange elsewhere for a presumptive SC award.

Is the anxiety at all related to your service?

If so have you ever pursued that type of claim?

"Supraventicular Arrhythmias" This is different from the PAT diagnosis.

Do you still have this condition?

It is very possible that this condition (apparently diagnosed as PAT incorrectly before by VA?) would have the nexus you need to your current ischemic heart disease.

Have you ever used a Holter Monitor?

When was your last EKG and did that EKG or any other medical test reveal evidence of

Supraventicular Arrhythmias?

Are you able to get an Independent Medical Opinion from a different cardiologist?

Have you fully read over your med recs (VA and private records) to see if the PAT (which BVA has recharacterized) has any documented nexus or link to your ischemic heart disease?

You would need to explain to the IMO doctor exactly what you are seeking-

a clear diagnosis based on your SMRs and med recs of all of your heart related conditions and you seek to establish a nexus between the prior SC and the present IHD.

The full IMO criteria is here in our IMO forum.

One question- what was the Reasons and Bases for the VA to reduce the original PAT SC rating?

Can you scan and post that info here from the decision?

Also can you tell us what diagnostic code they used then for the PAT?

I really dont like to recommend IMOs because I know how expensive they can be.

IMOs bring no miracles and sometimes will not help a claim at all.

I had an IMO doc briefly assess my past claim via email.(Dr Bash)

I briefly told him what benefit I sought and a short list of what evidence I had.

His email reply was 'if you have that evidence, this is a good case.'

Then I sent him the money for the IMO and the records and evidence etc.

Perhaps an IMO doctor could assess your chances for a nexus via email before you would have to pay a fee.

Berta,

I am a Viet Nam era veteran but did not serve in a war zone.

I did file a claim for anxiety and depression second to my PAT. The RO denied my claim on both.

The VA changed my diagnosis from PAT to Supraventicular Arrhythmia.

Yes, I still have the PAT. The VA Cardiologist prescribed medication and it is helping.

Someone wrote a "Statement In Support of Claim" for me. The partial wording is as follows.

"An active-duty diagnosis of Tachycardia necessitated Holter Monitoring for approx three weeks duration, which objectively confirmed the diagnosis PAT and was positively evaluated under Sec 4.104, Diagnostic Code (DC) 7013.

On 11-26-66 active duty member was granted service connection for PAT under DC 7013, and awarded 10% compensation rating.

Following an incomplete VA Compensation and Pension Examination 12-12-67, the veteran's 10% compensation was reduced to a non-compensatable 0% rating.

The veteran herein challenges that VA Rating Decision of 2-5-68, by claiming Clear and Unmistakable Error (CUE), 38 USC 5109A."

Berta, I have read several references that you have made regarding Dr Bash. Do you think I should contact Dr Bash to see if I could get him to submit an IMO for me? What do you think about Dr Bash?

Thanks in advance for your help.

Brian

[Berta]

Dr. Craig C Bash can be contacted through his web site:

http://www.veteransmedadvisor.com/

He recently did a SVR radio here at hadit that is in the SVR archives.

He is a NeuroRadiologist and although my claims involved heart disease, they also involved neurological conditions and he was able to prepare 2 separate IMOs for me.

IMOs are expensive. You might want to contact a cardiologist instead of a NeuroRadiologist but then again his IMOs ,in my case, regarded diabetes and heart disease as well as cerebral vascular disability.

He used Braunwald -(the top cardio text in the USA) as one of the references he gave.VA uses Harrison's for heart disease as to defining IHD but Braunwald contributed to Harrison'a texts.

I have Braunwald on Cardiology -it is so large and heavy I cannot scan anything from it.

But every cardio doc would have it or be able to access it via the net.I think non professionals cannot access the text on the net and this is why my daughter gave this to me for Christmas last year.I thought it would help with AO IHD claims but so far I only needed to refer to it once or twice.

By all means you can send an email to Dr. Bash.Briefly describe the type of IMO you need.

And also try a cardio doctor as well.

The IMO must outweigh anything any VA doctor comes up with.I hope others will chime in here because

Dr. Bash is a NeuroRAdiologist and not a Cardiologist.

Then again he opined successfully over a VA Endodrinologist for my diabetes claim.

I need to add-

I presented him a very compelling claim.

I have done my medical homework and knew my IMO fees would be absorbed by an eventual award.

I sent along with the Med recs, and numerous other documents,

my assessment of what really caused my husband's death.

In that assessment I referred to specific enclosures that I had highlighted.

I did this for a cardio IMO I didnt need.

If I can find who that doctor was I will let you know-it is in a file somewhere here.

I contacted him via a Forensic firm on the net.

His charge was cheaper than Dr. Bash's but specific only to the cardio disability.

You have to determine who would be the best person to opine on your claim based on their expertise.

They must meet the IMO criteria here in our IMO forum.

Dr. Bash, as a former VA doctor,knows that criteria in and out and is familiar with SOCs etc.

If I find time I will see what I can find in the Braunwald text-

but I have a question-

did you experience anything that profoundly stressed you out in the military that could have been the cause of the PAT?

With SSDI for both the heart condition and the anxiety- what did SSDI attribute as the nexus for the Anxiety?

also:

"did file a claim for anxiety and depression second to my PAT. The RO denied my claim on both."

Could an in service situation have caused the anxiety as well as the PAT?

Edited November 15, 2011 by Berta

[Berta]

Gee-I am more organized than I thought! I just found my cover letter to the cardio doctor I mentioned:

“Health Information Search, Inc, April 13, 2009

1514 Potomac Drive

Houston, Tx. 77057-1928 Re: IMO for VA claim

Dear Dr Campos,”

I found this Company and Dr Campos under a search for Forensic Medical Opinions.

This is their email addy:

http://www.legalmed1.com/

C.W. Pete de Boisblanc might remember me if you tell him I referred you. He needs to be contacted via their email addy first so he can seek the best doctor he can find for the specific opinion needed.

I need to contact him myself again if the VA does not do my AO IHD claim right as to the level of accrued SMC.

I had an unusual claim and prepared an extensive cover letter regarding my enclosed evidence as well as the type opinion I needed.

Mr. Boisblanc actually called me up when he got my packet- and asked me if I was a lawyer or health care professional.

He said the cover letter was so well prepared, they usually dont see stuff like that much and I think they deal with many lawyers and doctors.

His comments to me caused me to really realize that the efforts that we put into these IMO requests are well worth the time and research.

It pays to tell the IMO doctor exactly what type of opinion you are seeking and then refer them to some specific med recs or documents that support your position.

But an IMO no matter what it costs, cannot produce a miracle.

On the other hand , if the medical evidence warrants a SC award,because of a full medical rationale stated by an IMO doctor, the IMO has been well worth the cost and the efforts to prepare the cover letter.

A Cover letter can be brief but it should highlight some specifics if possible.

An IMO doctor (unlike these VA C & P docs and the raters) will review everything!

Make sure they have copies of any past denials and SOCs, SSOCs, etc as well as copies of past C & P exam results.

Include any corroborating medical opinions as well.If the inservice nexus is questioned , they will need the complete SMRS too.

My cover letter to Dr. Campos was not brief and was almost 11 pages long but directed him to not only the enclsoed exhibits he needed but also to numerous medical abstracts, also to my 3 previous IMOs and also to my FTCA internal VA documents. I believe we claimants cannot leave a single stone unturned.

[bm6546]

Gee-I am more organized than I thought! I just found my cover letter to the cardio doctor I mentioned:

“Health Information Search, Inc, April 13, 2009

1514 Potomac Drive

Houston, Tx. 77057-1928 Re: IMO for VA claim

Dear Dr Campos,”

I found this Company and Dr Campos under a search for Forensic Medical Opinions.

This is their email addy:

http://www.legalmed1.com/

C.W. Pete de Boisblanc might remember me if you tell him I referred you. He needs to be contacted via their email addy first so he can seek the best doctor he can find for the specific opinion needed.

I need to contact him myself again if the VA does not do my AO IHD claim right as to the level of accrued SMC.

I had an unusual claim and prepared an extensive cover letter regarding my enclosed evidence as well as the type opinion I needed.

Mr. Boisblanc actually called me up when he got my packet- and asked me if I was a lawyer or health care professional.

He said the cover letter was so well prepared, they usually dont see stuff like that much and I think they deal with many lawyers and doctors.

His comments to me caused me to really realize that the efforts that we put into these IMO requests are well worth the time and research.

It pays to tell the IMO doctor exactly what type of opinion you are seeking and then refer them to some specific med recs or documents that support your position.

But an IMO no matter what it costs, cannot produce a miracle.

On the other hand , if the medical evidence warrants a SC award,because of a full medical rationale stated by an IMO doctor, the IMO has been well worth the cost and the efforts to prepare the cover letter.

A Cover letter can be brief but it should highlight some specifics if possible.

An IMO doctor (unlike these VA C & P docs and the raters) will review everything!

Make sure they have copies of any past denials and SOCs, SSOCs, etc as well as copies of past C & P exam results.

Include any corroborating medical opinions as well.If the inservice nexus is questioned , they will need the complete SMRS too.

My cover letter to Dr. Campos was not brief and was almost 11 pages long but directed him to not only the enclsoed exhibits he needed but also to numerous medical abstracts, also to my 3 previous IMOs and also to my FTCA internal VA documents. I believe we claimants cannot leave a single stone unturned.

Berta,

Thanks for all the help you are providing.

I am pretty sure I am going to need an IMO, preferably from a Cardiologist. I am going to e-mail CW Pete de Boisblanc at legalmed1.com and see if he can find a Cardiologist that would be interested in writing an IMO for me.

Do you know of any other Cardiologists that I could contact for an IMO.

Thanks in advance,

Brian