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My husband got letter from VSO VFW ref claim from 10/2010 for IHD, Meneires, Tintinus (sorry for spelling) He went to hearing with RO. Letter said husband will granted EED for DMII and hypertension to 5/01, granted in 7/01. i asked what happened with IHD Nehmer? He said info VA had from ER visit which was requested from 7/01 claim, showed his heart enzymes were elevated and he may have had heart attack, and may does not mean had. Should he have gotten a NSC rating for heart disease? How do I know if he did? The C & P exam showed "fourth heart sound" (which is heart disease), and noted he had no heart disease??? VSO informed me that Nehmer is only if previous claim was made and denied. Would this possibly fall under Footnote 1?

Well just when we thought this was all over, husband's status went from descion phase, to requesting info phase. The info requested is the C & P exam from the 10/2010. The same problem exists: Examiner wrote on exam, "canceling claim". examiner did not want husband to loose any benefits, which can happen if claim gets reopened for anything.. Husband was 100% = 60% since 8/2003., he has defrilblator also records show he had silent heart attack, which I think happened in 2001. We went to C & P office and was told exam results could not be given as cancel was on it (this must be true as VA hasn't been able to get it since 2010) I have seen other people go from back to square 1 on this site so I knew what to expect. Well when I called 800 number, i was told someone is reviewing the ROs decision to prevent any overlooks and they are checking to see if and EED can be given for IHD maybe an earlier 100% date. I hope so and i have my fingers crossed. Also husband has foot drop, he can hardly walk without his brace. VSO said to put in for that if approved he can get another SMC. i thought i should wait until they are totally finished with this claim, but VSO said to put in for it as soon as possible. Thank you, and keep faith

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IHD can only be diagnosed wit the following tests.


Cardiac Catherization or heart cath.

Did he have any of these tests done in 01?


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I am a Nehmer Footnote One widow and I think some Nehmer vets here are Footnote one vets.too.

There is a wealth of info on Footnote one in our AO forum but the Nehmer Training Letter (also here in that forum) and this footnote regards claims solely under the New AO 2010 regulations.)

The email quotes to explain Footnote One are directly from the Nehmer Division Director,attorney Rick Spataro.

" Should he have gotten a NSC rating for heart disease?"

"How do I know if he did? " Check every past rating sheet he got.

“If there was a NSC Heart CAD or IHD rating, it is possible he could now fall under Nehmer ?" Yes but

The VSO is correct as to the Nehmer criteria. Past denial with IHD NSC rating.

However Footnote one clearly states, if rated or “should have been” rated in a past decision.

In 1998 the VA “should have rated "my husband's heart disease on my first DIC award but they didnt.

In 2004 I filed a CUE claim on that. The IHD claim and the CUE was awarded by Nehmer in January.

So the “should have been rated “

part of Footnote one kicked in as soon as they awarded the CUE for the IHD claim.

There is not enough info here to be able to determine if your husband falls under Footnote one, either due to past NSC IHD rating in a denial or by medical evidence in his med recs that he”should”have been rated in a past VA decision.

The "should have been rated"scenario is the basis for a CUE claim, if the VA never rated his IHD at all but "should have" by medical evidence they had in their possession for any past rating decision that was not appealed.

However that is a long road to climb and I believe your VSO already has eliminated that potential as the VA almost always rates all NSC conditions they are aware of and that the veteran has claimed.

Edited by Berta
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John, I can't say for sure, but I believe the test were done in 2001 in ER, he was kept in hospital over night. Doctor had told me he had heart attack, he was in awful shape. i have to check to see if i still have records.

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I bumped up one of the Footnote One links for you in our AO forum in my response here and I think we posted at the same time-

Did your husband receive a formal Nehmer Letter from the VA since 2010?

Does he have copies of all of his VA med rrecs, private med recs, and also a copy of his C file?

Edited by Berta
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Thanks again Berta, John for responses - I hope the review of RO decision will bring things to light. Person at 800 # seemed to think that 2nd review my prevent a CUE from happening. He said they are looking to see if an earlier 100% can be awarded. i was thinking maybe if the heart attack was acknowledged, is there a time period for after the attack at 100% for a few months? Also the other ear conditions ( secondary service connected have not yet been resolved, again C & P office had husband cancel hearing exam, didn't know he needed it for tinnitius) VSO said they were going to send husband for another hearing loss exam during the RO meeting. 800 number said that there were no hearing exams scheduled and matter was resolved. I did send in doctors IMO on issues, maybe the will just use that.

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Berta, He never received a Nehmer letter, he does see a doc at the VA, but uses a private doc also. I have alot of private doc copies of records, but the only thing from his C-file is the C&P exam from DMII claim in 7/01, stating "fourth heart sound", the only way this can be heard is with stethoscope I dont believe he was even given a EKG then. I know the reports from ER visit back in 2001 are in his C-file from previous claim for initial DMII, because the VSO mentioned what letter from hospital said. Husband said he was so disoriented that day, he did not know how to get home and how he went to hospital that was not by our house. Thanks for the Footnote1 bump up. I was holding off on requesting C-file until claim finished, is that right thing to do? I thought I read that here.

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