Hypertension And CKD

[Hardtyme]

I was diagnosed with hypertension before I separated form the military and over the years I've developed chronic kidney disease (CKD) with eGFR of 54 sometimes int he 40's.  And, I am wanting to get this CKD or renal insufficiency service-connected.  I'm 10% on the hypertension already but don't know what the final outcome will be whether they'll combine the disabilities or rate each separate.

So, I am wondering if I need a nexus letter  from a physician or will the VA accept the doctor's notes from a nephrologist that says Diagnosis "Hypertensive chronic kidney disease with stage 2 through stage 4 chronic kidney disease, or unspecified chronic kidney disease.  All the VA doctor's notes have the lab  eGFR's at or near what the Nephrologist's office obtained.  So do I need a Nexus letter?  i guess it would help but sometimes doctors just don't want to prepare a letter.

[Berta]

A doctor would have to state that the chronic renal ( kidney disease) is due to your hypertension.

The 10% rating is probably way too low so ,inmy opinion, a higher rating should be claimed for the HBP if your med recs reveal you are in a higher rating criteria, and also claim the Kidney disease as secondary to it.

If your nephrologist  is a private doctor and they make a strong medical  statement as to that the HBP "as likely as not" caused the renal disease, and states that you have no other known etiology for the CKD , that should help get the CKD service connected.

There is no doubt in the medical community of the potential nexus of HBP ro CKD:

https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-related-kidney-disease

I am sure a real nephrologist ( whose opinion can outweigh any bogus C & P opinion, because the C & P might be done with a doctor with no expertise in Renal disease) will be able to bolster his opinion with at least one or two good medical treatices or abstracts, that would be stronger than the Web MD article,as to th nexus between HBP and CKD.

VA is often quick to call HBP " essential" meaning they do not know what causes it, nor do they want to find out.

If the C & P doc googles for any info as I did as to HBP causing Renal disease, he/she might well see the link I used and realize the claim is valid. Still I think you will need a brief but strong IMO from a expert in CKD.

Try to get a copy of the C & P exam when you claim the CKD (and higher HBP rating, if possible,) as the C & P exam results will determine if the VA awards or denies, and if you will need an independent opinion.

 

 

Edited May 15, 2018 by Berta

[Hardtyme]

I filed and sent all the notes from the Nephrologist that said it was HTN related or CHD related (I am 10% heart, 10% HTN).  They do not want any more info from me but they did ask for the VA notes which again states Stage 3 Renal Insufficiency.  The Ebenefits site says they'll make a decision between 8 Aug-18 Oct.  It will be interesting to find out what they say.  I'll post the results here.

Edited July 21, 2018 by Hardtyme

[Hardtyme]

I sent in all the treatment notes for my PMD and Nephrologist who state CKD secondary to hypertension with a cover letter stating that I am claiming CKD as secondary to HTN.  Ebenefits however has changed the date of decision from Aug-Dec 2018 to Jan-Apr 2019. It really doesn't matter if there is  a delay because I'm 100% IU.  They aren't asking for any more information from me or other agencies/individuals but if they should I feel that I can obtain a letter from my Nephrologist.  I'll keep you posted as time wears on...

[broncovet]

Yes, you need a nexus, but you need to make sure you understand what one is:  They are a yellow car similar to a Honda...(This is what a lot of VSO's think they are).  

A Nexus is a statment, by a qualified medical person (doctor, NP, or some other witness who is an expert in the applicable field, but best is to use a doctor.) The format VA wants is that your CKD is at least as likely as not related to your high blood pressure or other sc condition.  Since this is a secondary condtion, you dont need another "in service event", you just need a diagnosis and a nexus.  

[broncovet]

If you read your file, and see if a doc made an opinion very close to what I posted, then you are good to go.  

However, if you have no nexus documented, you will need same before getting sc.  The general link between hbp and CKD wont help you, you need a doctors opinion that YOUR CKD is related to YOUR hbp.  It does not matter if 100 people in the research study with CKD ALL had HBP..it matters whether it affected YOU or not.  The doctor can make an opinion based on the research, but you and I can not.  A nexus is an opinion.  

[Hardtyme]

Thanks for your reply broncovet, you are correct, I will need a Nexus and that is what I am going to ask my Nephrologist for when I see him in October of this year.  I appreciate your answer!  Good advise.