hypertension Hypertension And Heart Failure

[JessM]

I have a few question, but here is a little background first. I served in the Navy from 1993-2003. When I got out, I was awarded service connection and compensation for Asthma 30%, Acid Reflux 10%, Tinnitus 10%, and Hypertension 10%. I have a few others rated at 0% but do not remember them off the top of my head.

In January/February of this year (2015) I went to VA medical with some complaints and was subsequently diagnosed with Cardiomyopathy. To be frank, I am a bit unclear about all my diagnosis; it has been a bit of a trial for my family considering I just turned 40 I feel shellshocked. In the initial diagnosis I was told I had an enlarged heart and from there I had an ECHO and was told that I have an EF<10%. Since then I have had a catherization and 2 stents placed in 1 artery. I go back in for surgery on June 12^th to have another stenting procedure on a different artery.

So perhaps I jumped the gun but in March I applied for compensation for the heart failure. I recently received back the denial notice. It was perhaps my understanding that because I had been diagnosed with service connected hypertension and have received compensation for it since I separated in 2003 that the heart failure would be related to that hypertension, especially since I was told by a VA doctor that part of my heart failure was related to the hypertension.

I am going to file my appeal, but I wanted some advice before I do so, don't want to jump the gun again. What should I actually appeal? Their language in the denial notice speaks to not having any complaints or symptoms while active duty, do I need to spell out in my appeal that I am claiming the heart failure is a direct result of the hypertension? Any other items that I need to consider?

Any advice is greatly appreciated.

[jbasser]

Ok, welcome to my world.

Now you had HTN at 10 percent so that means your BP readings were at or over 160 systolic or 100 diastolic..That being said, the high blood pressure has caused cardiomegaly or enlarged heart, which is a form of cardiomyopathy. Now to put it into perspectie, they denied your claim based on What??

From What I see and I can see only what you post, Your heart problems are secondary to the HTN as mine are. Now with an EF of 10 percent you are barely able to do anything and it is rateable as 100 percent. Any decision they made that denied your claim is an in process clear and unmistakeable error.

I advise you to contact an attorney as soon as possible to get a NOD going. The HTN is still a 10 percent rating but it must be paid separate and distinct from your heart disease. If you need more I will post a link to the regs on this issue.

Call up Bergmann Moore or Bob Walsh. www.vetlawyers.com or robert@robertpwalsh.com

The Dirty dogs strike again. Dont worry too much, you will win.

JBasser

[john999]

Did you ever get a second opinion from private doctors? The VA told me I had had a heart attack and it proved to be false positive on the EKG. I went to real cardiologist on the outside and had a stress test. I would not take the VA's word for anything without an second private opinion. For your claim you need an IME/IMO that explains how, why and when your HTN caused the enlarged heart. Was your high blood under control since your were DX'ed with it? To be DX'ed with enlarged heart at 40 is pretty shocking. My 80 year old neighbor got that DX. This is what I hate about the VA. Unless you explain your disability to them and connect all the dots they deny the claim even if it is obvious. You have to hire a doctor to explain it to them.

John

[JessM]

I am away from home and do not have the denial notice in front of me, but if memory serves, it stated something to the effect that I did not evidence any symptoms of heart failure while on active duty.

The denial seemed quite generic to me. For instance, when I applied for compensation I simply put ‘heart failure’ and trusted that when they reviewed my VA files they would see what I was diagnosed with. When they returned the denial, it still simply stated ‘heart failure.’

I was told after the ECHO that I had both hypertrophy and dilation of my left ventricle as well as an EF<10% so my guess would be that I would fall under 7007 Hypertensive heart disease?

Perhaps my mistake was trusting that the VA would properly review the VA records. When I file, do I need to specifically state that I am applying for Hypertensive heart disease?

[Chuck75]

I am away from home and do not have the denial notice in front of me, but if memory serves, it stated something to the effect that I did not evidence any symptoms of heart failure while on active duty.

The denial seemed quite generic to me. For instance, when I applied for compensation I simply put ‘heart failure’ and trusted that when they reviewed my VA files they would see what I was diagnosed with. When they returned the denial, it still simply stated ‘heart failure.’

I was told after the ECHO that I had both hypertrophy and dilation of my left ventricle as well as an EF<10% so my guess would be that I would fall under 7007 Hypertensive heart disease?

Perhaps my mistake was trusting that the VA would properly review the VA records. When I file, do I need to specifically state that I am applying for Hypertensive heart disease?

When you apply, or appeal, you will certainly need a cardiologist's opinion (IMO) saying that HBP is the major cause, and your LVEF, etc. is secondary.

It sounds like the VA failed in it's "duty to assist'. Calling that out as a sole reason is something that hasn't been too successful.

Failing to consider evidence of record may be much better.

[JessM]

Ok, I am home. I scanned in the VA notice so I can keep all correspondence localized and re-print everything if need be. This is what the VA gave me as an “explanation.”

· Service connection for heart failure is denied since this condition neither occurred in nor was caused by service.

· Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show an event, disease or injury in service. Service connection for this condition is denied on a direct basis, because we have not received evidence that your condition occurred while on active duty; or that manifested itself to a compensable degree within one year from the date of discharge; or evidence of aggravation of the condition in service. In order to grant service connection there must be a chronic condition shown in service, evidence of a current diagnosis, and evidence of continuity of treatment since discharge.

[Berta]

You got great advice from jbasser and John999.And Chuck.

When I saw you applied in March ( I assumed March 2015) and have been denied already I knew something might have been wrong with the way the claim was prepared.....

did you specifically state that the Cardio condition was due to, or secondary to your SC HBP?

I see you did not define the heart condition specifically either.

"The denial seemed quite generic to me. For instance, when I applied for compensation I simply put ‘heart failure’ and trusted that when they reviewed my VA files they would see what I was diagnosed with. When they returned the denial, it still simply stated ‘heart failure.’"

The main problem there is the word "trust". We cannot trust the VA to connect medical dots. It appears that they denied without a C & P exam.
Perhaps a C & P exam would have done that, connect th dots, maybe, but raters certainly cannot do that.

Did the VA send you a 5103 form? Did they ask for all private medical records?

Chuck is right too....I think he is on to something...it looked to me that your DTA rights might have been violated too.

Chuck said:"t sounds like the VA failed in it's "duty to assist'. Calling that out as a sole reason is something that hasn't been too successful."

There is the way I succeed in last month when they violated my DTA rights ....but cant tell if it would work here.

"Failing to consider evidence of record may be much better." Yes it would be.

Can you scan and attach here (cover C file, name, address prior to scanning) the decision to include their Reasons and BAses and the Evidence list in the decision.

Something is wrong here. Many of us had made mistakes in our initial claims.But us hardcore claimants know VA makes plenty of mistakes too.

We can help more if we can read the actual decision.