hypertension Ihd Claims

[pkelly4576]

This may sound like a dumb question but on my Ischemic Heart Disease Questionnaire my doctor filled in under diagnoses

1 CHRONIC ISCHEMIC HEART DISEASE

2 CHRONIC SYSTOLIC HEART FAILURE

3 HYPERTENSION W/CHF

My question is: to be rated at 100% there must be chronic congestive heart failure ot workload of 3 METS or less

My METS now are 5-7 according to his paperwork but it under conditions it does not say CHRONIC CONGESTIVE HEART FAILURE.

Pkelly4576

[jbasser]

Pkelly, the way the part 4 reads this is as follows. Chronic congestive heart failure or mets.

Or is a big word here so your rating should be 100 percent according to the schedule.

Don't let them low ball you.

Basser

[evandc]

How did you get METS 5-7? Did you tell them you could walk mile or more, cut grass, do yard work, etc.? That's what that METS score tells me they put down. They gave me 3 because doctor said you can't do much in the yard & I agreed with her & by the way it's the truth. Also agreed that could walk very ittle & shortness of breath etc. Don't know if any of this applies to you but for anyone reading this that METS score (JMHO) is what comes out of your mouth more than anything.

[NJBB62]

That Met score is very high, I can only walk 100 feet before having chest pain, my Mets are at 2 which awarded

me 100% P&T with no Further exams, Did you do a stress test or did they just guess at it, on mine they could not

do a stress test as my condition is known, something does not sound right with the Mets that High!

NJ

[jbasser]

Another thing to look at is this. Take the reports from your last heart cath or echo, (Preference will be cath) Look at the LVEF.

Ejection fraction over rules any met predications or met guesses

That is your bread and butter in this issue.

Basser

[Testvet]

you can have CHF without it being chronic, there are varous stages of it, I was diagnosed last April after a major heart attack with end stage heart failure I have been hospitalized 3 times in the past year for congestive heart failure two of them for 28 days and once for a week all ICU time they implanted a biventricular pacemaker/defib and I use a wheel chari all the time now and my EF is 10, I have been on O2 since June due to CHF

I am trying to get the housing grant and mortgage insurance now I had the C&P in Jan and the doctor noted I am wheel chair bound I will see how hard they fight on this one they fought my heart disease for 9 years lol