Does Presumpitve Ihd With Aicd Require Nexus ?

[jcolwell]

I was approved presumptive IHD with AICD for 30 %
Went to VA today to ask why rating was low with AICD. They stated I needed a nexus between IHD and AICD even though I am approved for Presumptive for Herbicide Thailand and DM.,.
My DBQ was done in 2011 so they have requested a new DBQ before they approve 100 %.They want a NEXUS between IHD and AICD ......
I thought with the presumptive claims no nexus was required...............
Care is with outside physicians...........
What did I miss on this one.
Thanks JC

[free_spirit_etc]

So it sounds like they are basically saying they want you to show that the AICD is needed because of the IHD, and not from another condition? I guess they are considering the IHD presumptive, but needing someone to connect the dots between the IHD and the AICD?

Edited October 24, 2013 by free_spirit_etc

[free_spirit_etc]

This is the question they apparently need answered on the DBQ

MPLANTED AUTOMATIC IMPLANTABLE

CARDIOVERTER DEFIBRILLATOR (AICD) (If

"Yes," is it as likely as not that the veteran's

AICD is due to IHD?)

But you already turned in the DBQ...

"My DBQ was done in 2011 so they have requested a new DBQ before they approve 100 %"

If you 2011 DBQ says yes to the question above -- it does not seem like they would need a new DBQ. That doesn't seem to be something that would have changed between 2011 and now.

Edited October 24, 2013 by free_spirit_etc

[john999]

Give them what they want. If they want a new DBQ give it to them. Have your doctor write the nexus statement so clearly that a 6th grader could understand it. The VA held up my DMII presumptive claim because they asked for a certified copy of my DD214. I knew they already had one, but I got a copy and walked it over there. This knocked off a year's worth of back and forth.

John

[meghp0405]

the implantable cardioverter-defibrillators (AICD's) are rated under diagnostic code 7011, 38 CFR 4.104. Somewhere in your cardiologist's records, should of stated that the AICD was necessary due to your IHD.

VA was correct (I believe) in that if it wasn't annotated, then they are not going to rate it. raters are different, one will say after reading your records, yep it was necessary and another rater will read the same thing and say, it doesn't state it so it's not going to be rated. no consistency within the raters. They themselves will even tell you that.

Check your medical records and see what is written. If it is absent, go back to your cardiologist's and have him/her write you an IMO stating why you needed the AICD and how he came to that decision.

The ACID will be rated using the results from your heart testing. If you have a workload greater than 7 mets but not greater than 10, the disability is 10%

The rating will increase if the mets are lower. A workload of 3 mets or less is rated at 100%.

hope this helps...

[jcolwell]

All, DBQ was old to 2011 and thus he wants a new one and wants it to clearly link IHD to ICD . I never saw the DBQ as it went straight to VA from Physician. My Primary care doc did it. My mistake should have used heart doc... and apparently he wants a new one. Cardiology will do a new one on Monday and as a RN I checked all the key boxes myself as I know they just don't spend enough time on these............Thanks for helping.

[meghp0405]

VA will not use a DBQ if it is 6 months or older. Seems like your on the right track with the info stated above.