Jump to content
  • Latest Donations

  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

Sponsored Ads

  • Searches Community Forums, Blog and more

  • Donation Box

    Please donate to support the community.
    We appreciate all donations!
  • Available Subscriptions

  • 0
wbonebrake

Pulmonary Hypertension rated at 30% as symptomatic resolved pulmonary embolism

Question

OK, so here's my story. I was in Iraq in 2008-09, and started having chest pain. It was dismissed by the army doctors as probably just a strained muscle. Fast forward a few years, and I was diagnosed with pulmonary hypertension and stage one heart failure, both of which are ultimately fatal. I submitted a claim for these conditions, which was denied. I appealed this denied to the DRO in St. Louis, MO. The contention for pulmonary hypertension has a pending rating decision in the system according to my VSO. Here's my issue. I am diagnosed with Pulmonary Hypertension, as well as other diseases. The doctor who did my C&P exam clearly stated that he believed that my PH was service connected. The pending rating states that I am granted service connection for PH. However, in the section that details the rating, it is rated at 30% as "Symptomatic, following resolution of acute pulmonary embolism." In the CFR 38 section 4.97, diagnosis code 6817, Non-tuberculosis diseases of the respiratory system, Pulmonary Hypertension is clearly listed as a 100% condition. I called the 1800 number to check on the rating decision, and I was informed that it was sent to the authorizer, who then sent it back to the rater, and it is now just waiting to be authorized again. Is it possible that the authorizer saw this, and felt that the " Symptomatic, following resolution of acute pulmonary embolism" was not an accurate representation of my diagnosis, and asked for it to be updated?

Share this post


Link to post
Share on other sites

Recommended Posts

  • 0

Was the PH DX based on an Echocardiogram or Heart Cath?   What was your RV Ejection Fraction numbers? The Heart Cath is the "Gold Standard" for DXing and Determining the exact Ejection Fractions for Staging your PH. Are you currently DX'd requiring Supplemental 02?

I had an Echo DX 11/14 Stage (1) PH SC 0% (FDC filed 01/15) 03/15 Awarded Secondary to an SA (10/10) 50%. I immediately (03/15) filed an FDC for SA Increase, denied 07/15.

Rating Dept 12/15 Quality Review of 07/15 Denial, Awarded SA Increase to 100%. Without the PH DX, the 100% Bump wouldn't have happened. My PH Stage (1) rating is still at 0%.

Semper Fi

 

Share this post


Link to post
Share on other sites

Ad

  • 0

My PH was diagnosed via echo. Not currently on O2. I'd have to look at my records to get the ejection fraction but I do know that the pulmonary artery pressures were around 35, clearly a sign of PH. The strange thing is though, that the VA C&P examiner who was working my claim fully agreed with the diagnosis of PH, but it was rated as something different altogether. 

Share this post


Link to post
Share on other sites
  • 0

I had to look at the PH Ratings again, been awhile. What condition preceded the PH DX, Acute Pulmonary Embolism or Thromboembolism?

Any mention regarding the need for a Right Heart Cath, by any of your VA Drs? Do you have an SC'd Heart issue?

I'd have to look back but I think my PAP was 26+, very low end of Stage 1 PH DX. Regardless of low Stage 1 or About to check out high Stage 4, PH is considered Heart Failure (aka Cor Pulmonale). The PH DX itself, not the SC 0%, got my SA bump to 100% because of the Cor Pulmonale/Heart Failure association.

Semper Fi

Share this post


Link to post
Share on other sites
  • 0

Thats the thing, i never was diagnosed with thromboembolism or anything else revarding my lungs other than PH. I was also diagnosed with stage 1 heart failure though. My heart failure diagnosis was denied by the VA, but they did rate me at 10%for vasospastic angina. 

Share this post


Link to post
Share on other sites
  • 0

This below might help: (these types of cases on remand are why the backlog occurred. A Remand is 99% of the time a re-do of what the RO should have done in the first place.

 

"1.  Since September 17, 2012, the Veteran's pleural plaques with mild reactive airway disease has been manifested by pulmonary hypertension.

 

2.  Prior to September 17, 2012, the Veteran's pleural plaques with mild reactive airway disease was not manifested by Forced Vital Capacity (FVC) of 50- to 64-percent predicted, Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) of 40- to 55-percent predicted, maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation, cor pulmonale, pulmonary hypertension, or requiring outpatient oxygen therapy."

https://www.va.gov/vetapp16/files6/1647846.txt

I am glad you posted this in the CUE forum because if you can scan and post the decision here when you get it, it might contain a CUE. You can file CUE within the appeal timeframe. My last one took a month from denial to award...because I requested they CUE themselves on the denial and they did. It is all explained here in this form.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Ads

  • Ad

  • Latest News
  • Our picks

    • SHOW YOUR SUPPORT: Ad Free Subscriptions to the Forum available
      Ad free subscriptions are available for the forum. Subscriptions give you the forums ad free and help support the forum and site. Monthly $5 Annually $50 https://community.hadit.com/subscriptions/

      Every bit helps - Thank you.

       
      • 0 replies
    • Choosing a VA Disability Attorney Means Learning What Questions to Ask
      Choosing a VA Disability Attorney Means Learning What Questions to Ask. Chris Attig - Veterans Law Blog 

      <br style="color:#000000; text-align:start">How to Hire an Attorney For Your VA Claim or Appeal Free Guidebook available on the Veterans Law Blog

      I got an email the other day from a Veteran.  It had 2 or 3 sentences about his claim, and then closed at the end: “Please call me. So-and-so told me you were the best and I want your help.”

      While I appreciate the compliments, I shudder a little at emails like this.  For 2 reasons.

      First, I get a lot of emails like this.  And while I diligently represent my clients – I often tell them we will pursue their claim until we have no more appeals or until we win – I am most assuredly not the best.

      There are a LOT of damn good VA Disability attorneys out there.  (Most, if not all, of the best are members of the National Organization of Veterans Advocates…read about one of them, here)

      Second, I don’t want Veterans to choose their attorney based on who their friend thought was the best.  I want Veterans to choose the VA Disability attorney who is BEST for their case.

      In some situations, that may be the Attig Law Firm.

      But it may also be be Hill and Ponton, or Chisholm-Kilpatrick, or Bergman Moore.  Or any one of the dozens of other attorneys who have made the representation of Veterans their professional life’s work.

      There are hundreds of attorneys that are out there representing Veterans, and I’m here to tell you that who is best for your friend’s case may not be the best for your case.

      How do you Find the Best VA Disability Attorney for your Claim?

      First, you have to answer the question: do you NEED an attorney?

      Some of you don’t...
      • 1 reply
    • VA Emergency Medical Care
      VA Emergency Medical Care
      • 3 replies
    • Veterans Appeals Improvement and Modernization Act
      Veterans Appeals Improvement and Modernization Act
      • 0 replies
    • Thanks Berta for your help. I did receive my 100% today for my IU claim on 6/20/2018. It only took 64 days to complete and it is p&t. Thanks for your words of wisdom. 
×

Important Information

{terms] and Guidelines