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hypertension Possible Cue
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VA different higher normal HBP/HTN for vets 1 2
By Dustoff1970,
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vern2
I have reviewed my VA claim from 03-07 and noted a possible CUE.
I was awarded 30 SC based on aggravated hypertension "with confirmed dilation of the heart"
The exact wording is: we have evaluated the condition analogous to hypertensive heart disease based on the fact that you have associated pulmonary hypertension with confirmed evidence of dilation of the heart. this is more advantageous to your as your hypertension would be evaluated as 10 per cent disabling. An evaluation of 30 per cent is assigned is there is workload greated than 5 METS but not greater than 7 METS resulting in dyspnea, fatigue, anginia, diziness, or syncope; or evidence of cardiac hypertrophy or dillatation on electrocardiogram, echocardiogram, or X-ray. A higher evaluation of 40 percent is not warranted unless diastolic pressure is predominantly 120 or more. A higher evaluation of 60 per cent is not warraanted unless there is more than one episode of acute congestive heart failure in the past year; or workload greater than 3 METS, but not greater than 5 METS resulting in dyspnea, fatigue, anginia, diziness, or syncope; or left ventricular dysfunction with an ejection fraction of 30 to 50 per cent. One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute.
I was granted 30% according to rating guidelines during my active service with approximatley one year of uncontgrolled pressures with the subsequent development of pulmonary hypertension with cardiac hypertrophy.
A review of the evidence submitted shows that an echocardiogram (which is listed by VA as part of the evidence) shows that in addition to mildly dilated left atrium the left ventricular systolic function revealed distal septal hypokinesia with an ejection fraction of about 50%. Regional wall abnormalities as desccribed above with mild ventricular systolic dysfunction.
My echocardiogram clearly showed that I had an EF of about 50%, which should have granted me the 60% rating. Note the semicolons, which denotes I had to have one of several conditions to meet the 60% requirement. Does this sould like a valid CUE? I am reluctant to go forward unless I can get some advice.
Vern 2
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