hypertension Possible Cue

[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.

[jbasser]

CUE is the word here. The VA did not properly apply the regs to this case.

Your EF is 40 so that warrants a 60 percent rating.

Now I take it you may have Sleep Apnea unless you have another lung disease. You have had it for an extended period of time. It takes time for PPH to develop.

Pulmonary Hypertension is the key here. Are you service connected for any lung issues?

If you are or get service connection for any pulmonary issues, then You will be at 100 percent P and T with SMC S with the 60 hart rating. If you need help with the Cue Shoot me a PM.

The change in the heart regs in 08 also separated HTN as a separate rating.

J

[jbasser]

You may also use the heart disease as an agravation to the pulmonary HTN

J

[vern2]

CUE is the word here. The VA did not properly apply the regs to this case.

Your EF is 40 so that warrants a 60 percent rating.

Now I take it you may have Sleep Apnea unless you have another lung disease. You have had it for an extended period of time. It takes time for PPH to develop.

Pulmonary Hypertension is the key here. Are you service connected for any lung issues?

If you are or get service connection for any pulmonary issues, then You will be at 100 percent P and T with SMC S with the 60 hart rating. If you need help with the Cue Shoot me a PM.

The change in the heart regs in 08 also separated HTN as a separate rating.

J

I have filed a claim for sleep apnea due to fact my breathing problems were "Noted" in service, yet no sleep test was done until after I separated. I do have OSA, use CPAP every night.

Please see attachment for my explanation from VA when the finally made the award, based on claim I filed in 2003, took 4 years to get this award. The VA did not provide any supporting documentation for how they arrived at the 30%, toher than what was stated. This appears to be from 7007.

[vern2]

CUE is the word here. The VA did not properly apply the regs to this case.

Your EF is 40 so that warrants a 60 percent rating.

Now I take it you may have Sleep Apnea unless you have another lung disease. You have had it for an extended period of time. It takes time for PPH to develop.

Pulmonary Hypertension is the key here. Are you service connected for any lung issues?

If you are or get service connection for any pulmonary issues, then You will be at 100 percent P and T with SMC S with the 60 hart rating. If you need help with the Cue Shoot me a PM.

The change in the heart regs in 08 also separated HTN as a separate rating.

J

I have filed a claim for sleep apnea due to fact my breathing problems were "Noted" in service, yet no sleep test was done until after I separated. I do have OSA, use CPAP every night.

Please see attachment for my explanation form VA.

forgot to mention that the same echocardiogram they used for granting me 30% had an EF of "about 50%" as noted on the printout. This may be the basis for my CUE, Clearly should be grantged 60% since I had my last Echocardiogram with 60% rating less than 5 months after separation.

[jbasser]

They do this because they can get away with it. If a veteran doesnt catch it in the first year then he or she has to file a cue claim. Any claim decision made and is not disagreed with in the initial one year period is the same as the Vet saying I agree with you.

Now they interpet the regs to their advantage which is against the law as they are not attorneys and have no legal reason for interpetation which is to be argued in a court of law. They also play doctor and make medical determinations based on record. This is also a No - No.

Go ahead and file a cue claim. You will win, eventually.

Basser

[Berta]

Jbasser is RIGHT! in my opinion.

Did VA use 7007 as the diagnostic code for their original rating?

The worst CUE claim of all is the one that is never filed.