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shotkawla

C&P Opinion

Question

Please let me know your thoughts on possible rating:

OPINIONS:

The veteran still suffers from right ventricular dysfunction as the result of tricuspid regurgitation discovered by transesopageal   echocardiogram performed 5 Sept 1995 in-service. To ascribe now a present right or left ventricular ejection fraction would require cardiologic studies not orderable by C&P examiners.

RATIONALE:

Service treatment records as well physical examination board proceedings via VBMS, CPRS, physical examination, radiologic findings of 12 OCT 2016 as well as examiner's clinical experience.

Other notes from exam:

[X]     (1-3 METs)  This METs level has been found to be consistent with activities such as eating, dressing, taking shower, slow walking (2mph) for 1-2 blocks

Does the Veteran's heart condition(s) impact his or her ability to work? [X] Yes

 

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This appears to be for a TDIU claim...but it does not appear to be a complete VA C & P exam.

The opinion does state that this impacts on your ability to work but gives no further rationale.

Do you receive SSDI and if so, is the SSDI solely for these vascular -heart conditions?

If so is VA aware of the SSDI determination?

Was the 2013 CUE resolved by the 40% SC Edema rating in both legs?

 

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Hi Berta,

I am working with a company that went through my service record and discovered that VA should have rated me for severe tricuspid regurgitation upon my initial evaluation when I exited the service so we put in for it and my claim is now in prep for decision.  According to the company, this rating would fall under VASRD 7020.  I was hoping someone here could validate is there best guess based on experience.  Also, the CUE was denied, but the denial was not what I was requesting so I am still fighting that battle.   I am not receiving nor have thought about applying for SSDI.  Thank you very kindly and I look forward to your reply.

Edited by shotkawla

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"I am working with a company that went through my service record and discovered that VA should have rated me for severe tricuspid regurgitation upon my initial evaluation when I exited the service so we put in for it and my claim is now in prep for decision.  According to the company, this rating would fall under VASRD 7020. "

What company was this and what did they base their opinion on?

Is it a CUE claim they prepared, that is in prep for decision?

I have had 3 'should have rated' CUE claims, involving stroke, Ischemic heart disease and also HBP that were awarded under CUE but this was a different scenario that what you have.

Did the "company" find evidence that VA "should have"  treated you for this condition? as well as list it in a rating decision?

Was it ,under DC 7020, at a ratable level at the time they "should" have rated it.

Was it formally claimed prior to their lack of rating?

 

 

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Better yet---can you scan and attach here  a copy of the CUE claim that the 'company' put in?

Cover names address etc and your C file # prior to scanning it.

Did you mean the 2013 CUE was denied and this regards a different claim?

CUE claims have to be worded VERY carefully.

I used a regulation regarding the 'lack of' ratings for some of the above CUEs.I forget what it was, those CUE claims are here somewhere,... but the 'company' probably used the same regulation....I dont know.....

I

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Berta, this was submitted as a fully developed claim.  With the C&P examiners agreeing with my condition has during service I think once I'm officially rated for 7020, I would look at doing a CUE.  What are your thoughts?

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