diabetes Aortic valve /ihd

[treysnonna]

My husband has had diabetes diagnosised in 2001.   In 2008 he found out he had heart valve problems.  He filed secondary service connected to diabetes.  Boots on ground in Vietnam.  They denied the claim.  Said it was not related to diabetes.  In 2013  he had to have that valve replaced and they found coronary artery disease.  We filed that claim.  Approved it 60%.   But what should the date of benefit start.  And we did not get the 100% for thr three months.  

[Gastone]

Was the DX  07/13 &  13 Heart Surgery done by VA Surgeon and VA Cardio Drs?

If possible, posting redacted Claims, DBQs and Award/Denial letters would be of great assistance to us. We need to see why the VA reached their Decisions and what evidence is listed.

Are you currently using a VSO-Rep? What do they say and recommend as a course of action?

Semper Fi

[broncovet]

It sounds like you are asking an effective date question.  Your effective date will be the later of "facts found" (the date the doc said you were disabled), or the date you applied, with some exceptions.  

One of the exceptions deals with Nehmer, and I dont know if you are a Nehmer class or not, but if he was boots on the ground in VN, then its likely you are.  

One way to figure out if you are entitled to an Earlier Effective date, is to take your most recent decision and take it to a NOVA attorney, along with your cfile, and ask him/her.  

You dont have to commit to hire this attorney, he will want to see your cfile as well as your most recent decision, and you can decide also.  

It sounds like this a RO decsion, so, yes, you can appeal the effective date, by simply filing a NOD disputing the effective date within a year of the decision.   If you feel the effective date is wrong, you can do this.  

In summary, file a NOD.  

However, as mentioned by others we can not tell if you have the correct effective date from what you gave.  One important, or critical issue, is what date did the doc diagnose you with the condition you were awarded.

If you think the condition awarded is related to the heart valve condition (likely) then you may get the benefit of the doubt on this. 

Also, if you feel entitlted to 100% for convalescent, (temporary) benefits while recovering from surgery, then you can appeal that, also, at the same time.  

 

Edited May 23, 2016 by broncovet

[Berta]

The ratings for IHD under 7005 are here:

http://www.ecfr.gov/cgi-bin/text-idx?SID=84f85e37cb7be944e2ef3139ea9e8be6&mc=true&node=sg38.1.4_197.sg5&rgn=div7

He didn't get 60% IHD overnight.

You might have the basis for a Section 1151 claim.

But hard to tell from what info is here.

As many here might remember, they gave my husband sudafed when he collapsed on the job at  a VAMC  and they rushed him to the ER, gave him EKG and Sudafed. The diagnosis was sinus infection. He had 3 days off from VA and returned to work still feeling sick.

That was my first piece of evidence, the ER certificate ,to prove malpractice. It was full of acronyms I had to decifer.

The EKG ,done right away,  the second piece of evidence, stated 'possible inferior wall ischemia' and he was to be worked up by a cardio doc. They never told him he had heart attack, no subsequent treatment at all., so it progressed to the point that it caused his death. My third piece of evidence was the prescribed Sudafed, 4 times a day for 6 years. That contributed to his HBP, his IHD and to his death .I had more evidence as well. but if you feel, when you get his med recs, that they did not properly diagnose and treat the IHD you need am IMO doctor to go over the med recs and if they concur, that is a solid 1151 claim.

They could have masked symptoms of a cardio event your husband might have had, with meds not appropriate at all to his heart condition.

VA even masked symptoms of my husband's obvious but untreated DMII with meds.

No time limits on 1151 claims.

 

On Temp 100% awards I believe there is a time limit for filing.

[Berta]

These are the Temporary Convalescence regs:

http://cfr.vlex.com/vid/4-30-convalescent-ratings-19774382

They only apply to SC disabilities.

"But we were claiming the aortic valve as sec to diabetes.  It was before the presumptive came out.  I'm thinking they found the cad/ihd at the opening of the aortic valve and that was why it would not close all the way."

But they would have had to have an ECHO prior to that......and ECHOs can reveal the potential for atherosclerotic heart disease ( which is IHD)

As I understand this, the VA did not SC the aortic valve ...but they did SC the IHD.....

The IHD claim would only be under Nehmer if they had denied CAD or IHD in the past.

To service connect the aortic value problem and apply for convalescence  (I keep thing there is a time limit on those claims but someone else would know) the aortic value would have be found, by medical evidence and an IMO, to be caused by either the DMII or the IHD.

Have you googled aortic valve medical info to see if these conditions (IHD or DMII) could possibly cause the valve problem?

You could narrow the search down to bicuspid aortic value disease or aortic stenosis.

 

Edited May 23, 2016 by Berta

[treysnonna]

 Berta he was seeing a private cardio.  And I kept asking him if he had ihd and he kept saying no.  And after the surgery I saw on his one piece of paper said cad, so I ask if it was the same, and he said yes.  You are right he did not get to 60 overnight.  But maybe his mets were lower because of the valve problem .  I know the surgeon told me and our daughter his heart was enlarged.    Now I think it was in 2009 he had lung embolism, and they could not say where the clot came from.  I'm suspecting it came from the heart.  He only goes to va for cp exams.  We have tricare and Medicare?

 

[treysnonna]

He also has an appeal in for increase in diabetes ,. He is on Lantus solar star pen and humalog quick pen.  Private dr filled out DBQ and wrote a prescription for restricted diet and activity.  Also filled for renal failure third stage secondary to diabetes.  Private nephrologist filled out DBQ with a diagnosis of diabetic renal failure type2. And diabetic nephrology.  Both were denied.  I don't think they read anything .  They said they did not feel his diabetes had progressed that much.  His aid 8.1.  They said renal failure was denied because he had no proteinuria in his urine sample.   And you had to have proteinuria in your urine to be renal failure.  I was reading online kidney foundation, that you do not always drop proteinuria.  And we were reading over the cp file again and it ask if the veteran had diabetes on it and they did not even check it. And on one spot on it it said his bun was 19 and said it was high.  Then on another spot it said bun was 19 and said it was normal.  It did have gfr at 40 and said low.  But it is like the gfr was just kind of over looked or ignored completely.  And that is the number one way, according to national kidney foundation,  to check if kidneys are dysfunctioning.  They said there was NO dysfunction of the kidneys.  Now on the DBQ from private dr says there is kidney dysfunction.    I picked up all his labs since he has had renal failure, and all the gfr are to low.  Some as low as 34.  Thanks everyone .  And Berta I'm so sorry you had to go thru all that stuff with the va..  And sorry for your loss.