heart disease update with questions...

[worriedshrimp]

greetings once more, 

Since my last post I've had the bruce stress test, echo-cardiogram and yesterday the non evasive Electrocardiogram-gated CT. Of all these test the last was the most distressing with findings of right coronary artery: heavily calcified (among other things) the test conclusions were: Elevated coronary calcium score at 1337 Agaston units which is at the 80th percentile for age and gender, placing the patient at elevated risk for cardiovascular events over the ensuing 10 years. Also, inadequate evaluation of coronaries due to motion artifact from respiration and presence of heavy calcification. Recommend invasive angiography.

So I expect to receive an appointment for the invasive angiography soon. I remain unsure whether or not any of these coronary problems raise to the level of an agent orange presumptive, however on the outside change that they do I need to prepare for that eventuality.  I'm not sure where to began. I'm assuming the DAV will submit my claim should it be necessary (since they are my VSO). Does this require a C&P exam?  Who fills out the VA DBQ? Is it intended that the DBQ's be completed by the Veteran's health care provider? Or does the private medical clinician fill out the information blocks and sign and date it? Having never gone through this before these are my questions.

Additionally, I wonder if this is also the time and place to file for a hypertension claim and whether that would be separate from the heart disease claim? So many questions so little time...

anyway, thanks for an exceptional forum.

[Dustoff1970]

In 2014 I was diagnosed by private heart surgeon with Agent Orange IHD/CAD Ischemic heart disease after extensive testing including CT, Bruce Treadmill stress test, Echo, EKG, blood test, etc.  and then later the VA service connected me at 30% as the test revealed I also had an enlarged right ventricular due to the IHD disease.

When I filed my claim myself as I have done successfully for past 35 years I also filed for hypertension and VA denied my HTN but gave me the 30% for heart disease that I immediately appealed for a higher 60% rating due to the METS readout on Treadmill stress test placing me in the more severe category than just 30% for enlarged heart.

After the denial I obtained a private medical Opinion (MO) from Dr. David Anaise explaining in great detail and length the medical reasons I should be rated at 60% due to the more accurate treadmill stress test of METS level/scores.

Both the jerk VA C&P Examiner and VARO rater ignored my treadmill accurate METS readouts and instead relied upon the BS subjective "estimated" METS level the examiner used by asking me questions about my physical ability to perform certain functions and he answered those questions himself without allowing me to actually answer his biased questions and attitude.  He also incorrectly relied upon higher LVFE readout instead of again the lower Treadmill METS

The BVA judge agreed that his whole exam routine and negative opinion against me was "defective" and remanded my claim back to VARO for new C&P exams by LHI that I have now finished one of them and next one for ekg is next week.  So far it has been several months since the remand, and I feel confident I will eventually win the appeal and claim due to Dr. Anaise medical opinion.

Under the new 38 CFR regulations for Cardiovascular heart Disease CAD/IHD there is no longer supposed to be any references to LVEF readouts and only METS scores are to be used for evaluation. I hope your VSO is not lazy and is up to date on the 38 CFR 4.104 Diagnostic Code 7005.

When you file your claim ask for the highest rating and stress your many tests but especially your Bruce Treadmill Mets scores and also the adverse impact your heart disease has on your physical ability to do anything and your work and social life ability.  Send extra copies of all your medical records and prescriptions along with DD 214 (copy only) verifying your Nam Service and I also included other extensive evidence of my Nam service in country such as awards of PH, CMB, unit orders, news articles, etc.

The C&P examiner will fill out a DBQ in your presence and if conducted by VA examiner you can get a copy after 30 days.  If conducted by LHI or QTC then you will have to wait till the decisions is sent to you or you can file a FOIA request as I did that takes forever.

If possible, get Dr. Anaise or another qualified doctor to issue you a medical opinion stating the severity of your conditions and explaining why they believe your condition deserves a high rating.  If like me you have an enlarged heart then you will automatically receive 30% for the hydro trophy of heart.

Dr. Anaise is 30 year MD, Surgeon and expert on VA disability claims and has helped me win another appeal for OSA Sleep Apnea due to PTSD and PTSD meds.  He does everything by phone, email, fax and regular mail.  His office is in Tuscon, AZ and his website is easy to find with Google.  Dr. David Anaise.  Good luck

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

Edited June 30, 2022 by Dustoff 11

[worriedshrimp]

WOW.... Thanks Dustoff... 

 

will do