Worsening condition denied.

[Jayco]

Filed a claim for worsening condition of my service connected heart disease.  Since I was first service connected for heart disease, I have had a heart attack and diagnosed with hypersensitive carotid artery which required a pacemaker.  VA paid for both the heart attack and the pacemaker.   VA wears me out, so I have to take time to build up the fortitude to file a claim.  After a couple of years filed a claim for both of the above as worsening condition.  Heart attack was approved, but rated 0.  HCA was denied claiming it was not related to the heart, so it was also denied.   Found an article on Pubmed where it said HCA was a marker of heart disease.  Later received an error letter reversing their decision on HCA.  They made it part of heart disease, but the heart disease rating did not change.  

On the same claim I filed for Parkinsons' which was approved.  It put me to 100%.  Not 100% P&T.  If HCA and a heart attack doesn't qualify for worsening condition rating, then what does.  The HCA alone required a pacemaker, quarterly visits to check the pacemaker, months of heart rhythm irregularities before getting the pacemaker set right, and an operation roughly ever 7 years to change the battery.  

Is the fact I hit 100% have anything to do with not being approved for a rating for worsening condition of heart disease?

Thanks in advance.

[Dustoff1970]

Okay the VARO is basically saying they don't consider your medical evidence as sufficient for any increase at this time.  To overcome this you will need to

1. have heart medical specialist to say your condition has worsened or is indicative of more severe symptoms and this should include more testing and review of ALL your VA and private medical treatment notes and diagnosis.

2. Make sure the VARO has all your medical treatment records both VA and private for your heart disease and send them copies only of what you have or will have in the future.

3.  I and many others have won our claims on appeal to the BVA based upon same evidence that the VARO rater pukes denied on initial and HLR claims.

4.  Last year my Nam Agent Orange Ischemic heart disease (presumptive) was increased from 30 to 60% by the BVA appeals judge based on same evidenc denied by VARO raters.  They claimed I provided no evidence to support my increase claim.

5.  Among my strong positive medical evidence was an independent private heart surgeon IMO opinion that my IHD/CAD heart disease was more severe than the 30% rating given by the VARO.  He was a fee doctor that I paid a modest fee for his IMO and he reviewed all my VA and private treatment records plus conducted an intensive telephone interview with me.

6. For the one same fee he also earlier helped me win an OSA Sleep Apnea due to PTSD appeal for a 50% rating based on again same evidence denied by the chicken chit VARO.

7. I consider $1500.00 total for a $25,000 back pay as a good bargain.

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

[broncovet]

Maybe.  The VA often declines ratings "they consider" to be "moot".  Being moot suggests there is no good reason for the rating, you already have 100 percent.  

But, its not always true.  I got denied tdiu because "it was moot".  I appealed, arguing it was NOT moot because:

1.  It could result in an earlier effective date AND

2.  It could result in SMC S (Statuatory).  SMC S statuatory, is if you have a single 100 percent rating and additional ratings combining to 60 percent, seperate and distinct, you get SMCS, which is about $450 extra per month.  $450 a month may be "moot" to va rating specialists, but that sounds like a new car payment to me.  

[jfrei]

I have filed for a couple increases since 2016 when I was awarded my P and T for my TBI. But the other stuff was lowballed couple 0s and 10s. I filed an increase on my headaches which were rated at 0 and then in 2019 magically 50%, no backpay just wanted an accurate rating and my tinnitus from 0 to 10 around the same time. If I were you I would get a medical opinion from a heart doctor not at the VA, reopen the claim, submit opinion in as evidence. Watch the Va have a deer in headlights look…. 

Edited August 22, 2023 by jfrei