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ASU_0331

METS Estimated range

Question

So what happens when the C&P examiners estimated METS range covers two ratings criteria?  Had a C&P recently for CAD and hypertension.  Estimated METS range by examiner was 5-7.  A 60% rating METS is 4-5 while a 30% rating is 6-7.  Not sure what my ejection fraction rate was, but tech said that from one angle it was 47% and 49%.  If those numbers hold true, then I will be at 60%, but wondering what the estimated METS range would rate. 

Also, does the examiner and DRO for that matter take into account severity of the CAD or does it just fall on the strict guidelines in the CFR?  I had a heart attack in 2005 due to two blockages in my lower anterior descending and right circumflex that required stents.  Now that the VA has finally given me a cardiac work-up after 6 years of just prescribing me heart medications, it turns out that my right coronary artery is COMPLETELY blocked and only getting some collateral flow from right conus and lower anterior descending.  Cardiologist and surgeons that performed my last catheterization just this last August says there is no remedy to my condition as there is nowhere to bypass on the right coronary since it is blocked from top to bottom and the build-up is "rock hard".

Examiner already told me she was service-connected it to my DM II, so that is not a worry.  Just waiting on the actual rating now is making me question everything.      

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Hello Asu,

They should rate based on L-VEF. It's either one of them. Either METS of 3-5 or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent. Generally, they rate on what is higher for the Veteran.

 

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You posted, 

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So what happens when the C&P examiners estimated METS range covers two ratings criteria?

The decision maker has to make a judgement call, that you can appeal.  As RTKOOC pointed out the VA is supposed to give the Veteran the benefit of the doubt.  

However, if VA actually did give the VETeran the benefit of the doubt, we would probably not need the Board of Veterans Appeals OR the Court of VEterans claims, because the Veteran would have already gotten that higher rating and he would not have to appeal it, ever.  

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I ended up with a 60% rating for my heart.  Even though the estimated METS range covered both rating criteria, the ejection fraction rate was observed at 45% so that got me the 60%.  Waiting on direct deposit and BBE.

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