hypertension Anti-Pyramiding Rule

[vern2]

The Anti-Pyramiding Rule

The VA’s rating system will rate all diseases separately according to the ratings schedules

of 38 C.F.R. § 4. However, 38 C.F.R. § 4.14 requires that the VA not award multiple disability

ratings for the same disability shown under different diagnosis. This can be very confusing when an injury can cause multiple disabling conditions. In attempting to avoid these anti-pyramiding regulations, the Veteran needs to argue that there are separate disabilities with separate symptoms, regardless of the overlapping symptomatology.

The bold is by me. If you file a claim, make sure that it lists separate disabilities, i.e. aggratated pulmonary hypertension, then heart disease secondary to it, even though there may be overlapping symptomalogy.

[meghp0405]

that's fine, but what does the medical documents say? I'm not an advocate for VA, but they can and do review medical records. What if you had the heart disease then the htn?

I believe that you or any other veteran would need a strong IMO to defend their case, if the diagnosis were as I stated above.

[vern2]

that's fine, but what does the medical documents say? I'm not an advocate for VA, but they can and do review medical records. What if you had the heart disease then the htn?

I believe that you or any other veteran would need a strong IMO to defend their case, if the diagnosis were as I stated above.

In my case, had the htn first, and 11 years later, htn impacted my heart. I have two separate IMO, from 2 cardiologists, as well as my PCM. I have a natural progression of htn.

[jbasser]

If you are connected for Heart disease then the HTN is to be rated separate.

Now if you have right side heart disease or a prelude to CorPumonole, Then it can be rated as a lung issue. PPH is also a lung issue and one can be rated for both. PPH and essential HTN are different issues. Essential HTN is heart and vascular. PH is pulmonary.

J

[vern2]

J and Meg: the original claim granted me SC for hypertension with mild pulmonary hypertension. The VA stated that evaluated the condition analogous to hypertensive heart disease based on fact I have assocciated pulmonary hypertension with confirmed evidence of dilation of the heart. The connection has already been made by the VA between the HTN and my hypertensive heart disease in the original decision. The condition of my heart has worsened in the last 6+ years and am filing for an increase from 30% to 100% on this contention alone. 3 episodes of CHF in last year, hospitalized 2 times since April and EF has gone from 60% down to current 44%. Cardio version and cardio ablation performed in May. Heart rate is normal, yet BP is still 170+-180+ over 86-100.

[jbasser]

OK here is what you need to do.

Get a copy of the exact rating codes you are service connected for.

If the VA service connected PH and your only at 20 percent, I see a major leaguer CUE.

On the other hand, Pulmonary HTN is a Pulmonary issue. If the heart disease is aggravating the PH which it does then , I can see a low ball sort of rating as they pay only to the extent of the aggravation.

If you have lung disease, Restrictive, Obstructive, Interstatinal, and you are service connected for it, The PH is to be rated at 100 percent and no less.

You may have been cheated out of an SMC.

J