Terrible News Posted On E-Benifits

[COOL BREEZE]

I just checked my e-benefits and noticed some disturbing information. I submitted through the DAV at my local VA hospital for a temporary 100% for convalescent. (JULY 17,2013) I provided all information, date of surgery, discharge summary and paper work showing how long I would be out for convalescent.

I also faxed in 1 month ago paper work that showed this was going to be extended for 2 months. E-benefits shows this claim was closed due to lack of paperwork submitted by date indicated. What the heck!

It now says it is in the rating phrase so they can do a quick denial so they can chalk this up as another claim processed. So-I am going to have wait another 5 years. I submitted this as a fast track claim also. The DAV rep was clueless how to do this. He told me to wait and submit this in another 6 months. Also, he is very seldom there either.

I submitted an IRIS, however I never received a response from the last one submitted 1 month ago. And they reopened a claim which has been noted as P &T for my heart which is currently 60% for an increase. I never asked to do this. They could do another one and down grade me if they show it has changed for the better. No one in there right mind would open this up again unless you had a triple heart attack, and the test was clearly show this which it wouldn't happen. I asked in the iris to close this asap. Any ideas.

[71M10]

You mentioned last year when you were at the hosptial your ejection fraction was 60%. You are freaked out because they are proposing to look at your heart again increase for P&T. From different snippets of dates and information you have provided, it sure looks like this is a standard 5 year review on your condition, if it is the same or worse they will then possibly consider it P&T. I am in the same situation had a 50 LVEF which popped my rating to 60 instead of 30. Waiting on a copy of a Echo from June (done as part of treatment) to see what the numbers are.

If your LVEF is above fifty and your METS evaluation doesn't warrant the 60% rating, and you don't have CHF then you SHOULD be reduced, maligning and bitching about the VA doesn't change the fact that you may not qualify for that 60% anymore.

Read the VASRD, make sure they follow the rules!

You might want google CHF with preserved ejection fraction. That is what they are going to be dealing with if they propose a reduction on me (my METS numbers, periph Edema and mild asceties are issues they have to deal with).

[COOL BREEZE]

What actually happened, someone at the claims dept was reviwing my file and accidentally put in for an increased claim for enlarged heart that had been approved via cue as report showed 50% ejection fracture. It had been noted as P & T. All these issues were put in under one category, not separate.

I sent an iris and called the VA to have this removed. I have done this severa times on other claims I had in and changed my mind(sleep apnea) as I would have wasted everyones time as I didn't qualify for this.

Also they informed me when I just called the 800# to check on a claim. that they have a wrong address that was updated recently. I have been living in my home for 10 years and have even recently received correspondence from phoenix. Good news my claim for temp 100% for cervical is at decision stage, not preparing for decision as indicated on e-benefits. What is the VA doing lately?? LOTS of mistakes.

[jbasser]

What did your last echo say. Do you have it. Did it say Cardiomegaly. Also look at the Left Ventricle. If it is enlarged, then dont worry about the enlarged heart.

J

[COOL BREEZE]

It States "the computer -generated left ventricular ejection fraction was calculated to be 50%. Also, the examiner estimated my excercise capacity at 5-7 ets based on exertion limited to types of activities such as climbing stairs, carrying objects 30-60 lbs, shoveling dirt, walking 4-5 mpg. The heart revealed a regular rythm with grade 1/6 systolic murmur. THis was done in 2010. THere were other exrays that said enlarged heart as well. It is classified as "Functional heart murmur and cardiomegaly-60%.

I had the VA 800# put in a statement to close that case requesting an increase for enlarged heart.

[jbasser]

I dont see it being a decrease. It should remain 60 percent with the Neck Surgury issue 100 percent convalesence.

J

[COOL BREEZE]

The neck and heart were 2 separate issues. I never requested an increase on the cardio rated at 60%. I have 2 request to have that removed asap. My main goal is to have the cervical rated at something higher than 0%. If they give me the temp 100%,they are supposed to make a decision of what rating I will have when this ends, not 2 years from now. Very complicated as there is a NOD in over 3 years for the 0% for the cervical as well.