C & P Results

[SpaceAce54]

I just viewed my C&P results for CAD/IHD secondary to DMII on blue button after waiting the now required 30 days, I think they were positive for the most part.

The examiner stated it was more likely than not 50% or more related to DMII.

Items of issue are in ref. to MET rating of 5-7 and in ref. to scar from surgery I told the examiner it was still painful but he marked on the DBQ no pain.

Do I just wait for the rating and file an NOD or is there something I should do ahead of receiving a decision, I have an appointment with my cardiologist this month an plan on asking him what my MET is.

Any and all info is appreciated.

 

[SpaceAce54]

Hello VYNC

Thanks for your input, now it is all wait and see want the out come will be.

[Dustoff1970]

Okay like you others I have been diagnosed and rated for AO IHD Ischemic Heart Disease in very recent years and here is very IMPORTANT UPDATE INFO for all of us for liberalizing rule change by VA to 38 CFR 4.104 Diagnostic Code 7005 that does the following:  See also my attachment that shows the rule is now final in bottom right hand corner of the attachment.  VA liberalizing rule change is retro active if you have a claim or appeal in progress on this very issue of IHD DC code 7005.

On August 1, 2019 the VA published proposed regulations liberalizing Title 38 CFR 4.104 DC 7005 to change/eliminate any references to congestive heart failure or ejection factors but to rely only on METS scores to determine rating level of CAD under 7005 Diagnostic Code.
This new liberalizing rule change may become law anytime after the 30 day notice in the Federal Register published on August 1, 2019.

Furthermore the VA raters are always suppose to take the lower METS score over any higher LVEF ejection factors but they routinely ignore this in initial decisions.  They also ignore your more accurate lower Treadmill Stress Test METS in favor of a GD C&P examiner's ESTIMATED higher METS score which is a big NO NO.

See my TWO Federal register file attachments.  38 CFR 3.114(a) covers liberalizing rule changes

Above info is not legal advice as I am not an attorney, paralegal or VSO.
 

AQ67_ScheduleforRatingDisabilities_TheCardiovascularSystem Federal Register.pdf

Edited January 9, 2020 by Dustoff 11

[Vync]

@Dustoff 11 That doesn't sound promising for SpaceAce54. With METS alone, he would get a 30% rating via METS, but with LVEF he would get a 60% rating. He is literally right on the border of the 30%/60%.

I went back and checked my records. My LVEF was 48%, which falls under 60%. The average METS from my last couple of weeks of cardio rehab sessions were between 2.8 and 3.1, both with dyspnea. With METS applied, that puts me at 100% or 60% depending on the day of the week.

Of course, I assume the VA would bring each of us back in for follow up evaluation because they expect our conditions to improve. At least the evidence of record at the time the claims were filed would be adequate enough to justify decent initial ratings...

[Dustoff1970]

I have not yet seen this new rule change take effect in the current 38 CFR regulations however it has become final according to the Federal Register and  regulations government website. 

If a claim has become final under old rules of 38 CFR 4.104 DC 7005 then my long time understanding is no one will be reduced under the new rules as this is against the law of 38 U.S.C. and according to other knowledgeable sources the VA could immediately or months from now change the 38 CFRs to reflect this latest rule change in the Federal Register. 

As with all things VA they will leave us in confusion and everything up in the air for some time.

My info is not legal advice as I am not an attorney, paralegal or VSO

[Vync]

@Dustoff 11 I appreciate you posting what you found. I located the VA info describing how they may change effective dates when a liberalizing law changes. It's their way of saying you might have a certain percentage effective under the old laws and effective later it may change.

https://www.va.gov/disability/effective-date/

Quote

Liberalizing law change

If there’s a change in law or VA regulation that allows us to pay disability compensation (monthly payments), the effective date may be assigned in any of these ways:

• If we get your claim within one year of a law or regulation changing, the effective date may be the date the law or regulation changed.
• If we review your claim—or you request a review—more than one year after the law or regulation changed, the effective date may be up to one year before the date we got your request or the date we decided to pay benefits on your claim.

 

 

[ruby]

Look up painful scars and see what the rating might be.  Scars are difficult because they require to be a large surface.  If you think it’s worth the percentage I would write a request for a new c &p due to the the fact the examiner wrote no pain when you specifically stated it was painful.  I would also do what Shrek said see the Chief in charge of C&Ps first.

But it may not be worth doing anything.