hypertension Hypertension And Heart Disease

[vern2]

Saw on another Vet forum that a member wrote that heart disease is automatically assumed as a secondary condition if you are service connected for high blood pressure. Tthen another member wrrote that not just any heart diseasee, it was limited to myocardial damage and coronary occlusion. "Essentially we are talking about coronary artery disease. If you have this heart disease the connection to service connected hypertension has already been made for you by the Secretary. This is spelled out in their operating manual, M21-1MR. Any other type of heart disease, except for hypertensive heart disease of course, will require a medical opinion from your doctor"

I was service connected for hypertension, and filed a claim for atrial fibriallation, carotid artery disease (coronary artery diesease- CAD), and hypertensive heart disease. They were denied as not service connected, even though I had extensive heart tests 5 months after came off AD to confirm had enlarged heart, and CAD. I am on appeal and have filed new claim for cardiomapathy, cardiomegaly and re-filed the CAD again.

Has anyone ever hear of automatic connection for heart disease if you have SC hypertension? The actual M21-1MR was part III, Subpart iv, Chapter 4, Section E. Sounds like a CUE has been made in my claim, but not sure?? Or could have been judgement call on the part of the C & P examiner??

Vern2

[Berta]

It does sounds like a possible CUE.

Can you scan and attach their Reasons and Bases here ( cover C file number, name and address first)

And the Evidence list?

M21-1MR was part III, Subpart iv, Chapter 4, Section E. Sounds like a CUE has been made in my claim, but not sure?? Or could have been judgement call on the part of the C & P examiner??

Under that M21-1MR link at 20, ( G) it states:

"If any of the following arteriosclerotic manifestations are diagnosed in a veteran with service-connected (SC) hypertension, grant service connection through the relationship to hypertension:

· symptoms and signs in the brain that warrant a diagnosis of cerebral arteriosclerosis or thrombosis with hemiplegia
· nephrosclerosis of the kidneys with impairment of renal function, or
· myocardial damage or coronary occlusion of the heart.

Notes:
· Arteriosclerosis occurs with advancing age without preexisting hypertension, and may occur in some younger individuals who are predisposed to arterial changes.
· The existence of arteriosclerosis does not imply or indicate previous hypertension."


I am not a doctor but unfortunately familar with some of these terms due to my husband's VA issues.

"symptoms and signs in the brain that warrant a diagnosis of cerebral arteriosclerosis"

This means evidence by MRI of ischemic events in the brain ,usually due to clotting, which is often due to atherosclerosis (plaque build up in brain. There can be many others reasons for ischemia of the brain but it means ( as in IHD as well, something stopped the flow of oxygen to the brain, cauing the ischemic event.

In my husband;'s case, the ischemia led to multiple transcients attacks and ultimately to a major stroke, which the VA ( under FTCA) determined was due to his improperly treated HBP and also prescribed medication, contraindicated by his HBP.

This was not an award for SC HBP causing heart disease. It was a 1151 award. His IHD was Sced under Nehmer.Still I had to prove the nexus between his HBP , TIAs, and his major catastrophic stroke

Thrombosis and hemiplegia can mean evidence of brain hemmorage on an MRI.

The VA does SC HBP to service connected renal disease mentioned in M21-1MR

Myocardial damage or coronary occlusion of the heart is determined often by noting hypertrophy in initial heart X rays but more adequately by a Doppler ECHO, which gives measurements of arteries that can reveal occlusion.

Although M21-1MR is quite clear on this way to get heart disease service connected as secondary,to SC HBP , I bet plenty of C & P examiners probably don't have the medical background need to properly consider every cause.

What is the SC HBP rating you have now?

Edited August 10, 2014 by Berta

[lotzaspotz]

We have a Board remanded appeal in for hypertension that the RO recently denied via SSOC, it's on it's way back to the Board. Our argument was that it was a secondary effect of steroids taken for service connected hypoadrenalism. This question interested me because my husband, a 'Nam vet, is already 10% rated for ischemic heart disease for two cardiac stents. The hypertension claim pre-dated the IHD claim. I wonder if there's also a plausible cause and effect there, as well.

[vern2]

Berta, the reasons and bases simply stated " not service connected", in both 2005, again in 2007 and again in 2012. They did use one page of my heart test in October 2003- ( I came off AD in May 2003), dilated left atrium in the analogous award of 30% for mild pulmonary hypertension. I am thinking CUE, but in either respect, the evidence was ignored 3 times!! I am still waiting on DRO review. I am coming up on 1 year in September 22, 2014. I have sent three separate NOD letters, I refuse to use the form 9. I have recieved one form letter and thre IRIS emails on the delay. The IRIS emails do not even acknowledge my NOD, but mention the one year time limit?? I think the VA has too many "teams" handling the claims and they are not on same page, as usual.

lotzaspots, please check out the M-21, part iii, subpart iv, chapter 4, section E-H. Sounds like a valid claim.

Vern2

[jbasser]

That is not a possible cue, It is definite cue as the regs state that cardiomegaly and enlarged left ventricle are rating criteria for heart disease.

Do you have a copy of an echo? Have you had a cath?

I have been connected for this for years.

Basser

[vern2]

Many echos, heart cath on Nov 3, 2003, less than 6 months after I came off Active Duty, and denied my claim for CAD as not service connected. Unbelieveable, but that is typical VA response to claims. My heart was also noted as enlarged by VA in granting me SC for hypertension. Been fighting the VA system since 2005. I will prevail, but just a long stressful experience.

[jbasser]

what is your lfev from the echo?