Heart Disease Rate Increase

[stillhere]

I am rated 60%heart disease / 20% DBII / 10% NP left / 10% NP right I am being compensated at 70% VA Math.

Recently had another blockage issue in the heart and another stent implanted doc said limit duty next month and come back and see him for evaluation. Called the VA for advise as to rate increase they said would send paper work in 60 days and then file.

My questions are should I file for this rate increae or go with a NOD from my last award in Feb. 07

If I go with NOD (Sept.06 one year from that date)I was thinking of asking for a different award date. They only added the heart disease after I had a heart attack in Oct. 05 although I had complained of heart pain on my first claim in 03 and it was denied. I then reapplied in August of 06 and they again denied heart only after I had my heart attack in 05 did they finally allow the heart issue as secondary to DB2.

I feel it is obvious that something caused my heart issue and it was there long before Oct. 05 but all the test they where running stress, cardio and such showed nothing. Is this a CUE?

Anyhow all help would be appreciated on this matter. I have the feeling things are going down hill very quick and don't know how much more I can battle with them before I have another heart attack.

[Berta]

That would be good if the cardio doctor could write that up-

then you could even ask the VA to reconsider their last decision-

It doesnt stop the clock in the year the NOD is due- and you would have to watch out for that year date- but a Request For Reconsideration

at top of the page could show to VA in your own words and with the doc's statement to refer to- that the heart disease is directly due to the DMII that you were diagnosed with and that the heart disease was prevalent before the EED they gave you-

Again it is not the formal NOD- but a reconsideration request might get you a faster and better decision-

John is also making the point I am making- they WILL pull this-if they can -and they tried to pull it on him-regarding the PN.

Ridiculous.

I see vets with DMII already established and the VA gives them the date of the C & P exam as the EED for the DMII-

Absurd!

How can a vet catch diabetes from a doc at a C & P?

That sounds nuts but it is basically the same logic Va USES SOMETIMES.

We are trying to help you overcome these pitfalls by making sure the VA doesnt try to say your heart disease happened before the DMII occurred.

Then they might not want it to remain SC at all! if you catch my drift----

The doc would have to clearly state that the heart disease you have is result of your diabetes which he diagnosed in 2001.

[Berta]

One other thing I just thought of-

You applied for the heart disease in 2003. You continuously appealed any denials.

then they gave you the 2005 date after you had a heart attack---

60 %- SC -

Therefore what happened to the staggered ratings that got you to the 60% point?

In other words- one does not go from nada to 60% overnight.There must have been medical evidence to warrant staggered ratings back to 2003-

Anyone see what I mean?

If the VA ever removes their digits from their rectums on my Cue claim for SMC - this is the same problem they will face-and I want them to consider it all-

at death Rods heart disease was obviously 100% (fatal heart attack)

first misdiagnosed heart attack-1988 -right at the VAMC.

1992- major CVA due to the same problems that caused heart disease (misdiagnosed diabetes)

the VA will have to make a staggered rating for 2 years prior to his death for DMII as well as CAD.

They gave him 100% for the CVA and residuals under Sec 1151 but never paid for it or the other stuff-

Any I seeing this right?

surely at some point your heart condition was at ratable percentages-

because one does not have CAD that is 0 then is 60%-overhight-

By the way-do you have HBP too and is this in your claim?

was it in the original claim?

[Chuck75]

This is the exact issue I'm struggling with! It seems that the classic diabetes diagnosis levels used to determine that a patient has diabetes are high enough that there is a strong likely hood that various other problems such as cardiovascular can and do occur well before the formal diagnosis of diabetes.

The key seems to be "prediabetes", something that is only obvious after the fact, and (at least from current medical references) may exist for years. (Ten or more) It is during the "prediabetes" period that cardiovascular problems may occur. Further, a cardiovascular "friendly" diet will likely delay reaching the levels used to formally diagnose diabetes. A nexus for both (if you look at recently released "Ranch Hand" results) is guess what! Agent Orange exposure.

Even if The VA refuses to service connect Diabetes as causative to a secondary condition, you should be able to get them to SC on a "develop further", if you can show that the problems were stable until diabetes was diagnosed, and then became worse.

If the secondary condition reaches a schedular 100%, and diabetes contributed to the severity, then the secondary condition (By the VA's rules) be considered SC. This supposedly eliminates the % offset used when the condition is less than 100%.

"So a vet could actually have diabetes for years and not even know it or have VA not diagnose it and then the vet suffers from CAD BEFORE they diagnose the DMII-and then the VA can say this was NSC and predated the SC DMII and therefore isn't secondary.

A good IMO from a real doc who uses the ADA guidelines and knows all the literature that can define a specific type of heart disease as Exactly due to DMII-such as left ventricular hypertrophy-etc can help a vet get proper secondary as well as the proper EED on these claims."

Unfortunately, the highest rated doctor(s)(by my insurance company)are not interested in writing an IMO that meets the VA's requirements. Naturally, when I first started going to them, it was "no problem" to write the IMO. (Until I showed them what a real IMO was - today!) This wasted quite a bit of my time and money.

Edited April 11, 2007 by Chuck75

[stillhere]

Berta,

Glad you picked up on that and is my point exactly. They denied 3 times heart disease and any rating for heart disease until I had my heart attack! Then they gave me 100% for 3 months and 60% since after my first operation. Now that I have had another operation I assume they will make it another 100% and then back to 60% after recovery so to speak. I just don't see how they could deny, deny, deny and then bam!

Oh and by the way I am rated 0 but sc for Hpertension GO figure!

One other thing I just thought of-

You applied for the heart disease in 2003. You continuously appealed any denials.

then they gave you the 2005 date after you had a heart attack---

60 %- SC -

Therefore what happened to the staggered ratings that got you to the 60% point?

In other words- one does not go from nada to 60% overnight.There must have been medical evidence to warrant staggered ratings back to 2003-

Anyone see what I mean?

If the VA ever removes their digits from their rectums on my Cue claim for SMC - this is the same problem they will face-and I want them to consider it all-

at death Rods heart disease was obviously 100% (fatal heart attack)

first misdiagnosed heart attack-1988 -right at the VAMC.

1992- major CVA due to the same problems that caused heart disease (misdiagnosed diabetes)

the VA will have to make a staggered rating for 2 years prior to his death for DMII as well as CAD.

They gave him 100% for the CVA and residuals under Sec 1151 but never paid for it or the other stuff-

Any I seeing this right?

surely at some point your heart condition was at ratable percentages-

because one does not have CAD that is 0 then is 60%-overhight-

By the way-do you have HBP too and is this in your claim?

was it in the original claim?

Edited April 11, 2007 by stillhere

[Berta]

Chuck in 1997 the ADA lowered the diabetes glucose criteria-

the VA "expert" opined on my claim and said that my husband didnt fit into the ADA criteria prior to that time-and could not even tell what military time was on the med recs for glucose readings.

Dr. Bash said she was "medically inaccurate"

She did not even consider after Rod had a CAD and many strokes- that he had abnormal high glucose while on a feeding tube-for 3 weeks-

and also had exhibited many signs of diabetes as far back to 1988- all documented in VA med recs.The VA abnormal high glucose criteria at that time was anything over 105-that would trigger VA to test further.

By the time a VA doctor (former VA doc who gave me a freeby brief supporting IMO)

wanted to diagnose him properly- so much damage had been done in the years of misdiagnosis that I guess they figured he would die anyway-

and proper care would have been quite an expense for VA at that point.

That doctor was overruled by the other VA docs-when he ordered the fingerstick test.

Best to cover it up- the vet and the wife will never know.

But it ended up costing them plenty under FTCA.I found out what they did.

The coroner was astonished when he asked me twice- if Rod was a diabetic -because I said no-

now I know why- Rod had considerable atherosclerotic heart disease and numerous strokes-proven via autopsy -with no possible etiology at all but for diabetes mellitus- never diagnosed or treated by the VA.

What might look like a normal glucose level on blood work you got done after sitting around at a VAMC for hours waiting to see the doc and having no food since breakfast might not indicate anywhere near how high that glucose could raise hours later after you have eaten a meal and then be fully within a diabetic criteria.

[stillhere]

Wow that is scarey!!

Chuck in 1997 the ADA lowered the diabetes glucose criteria-

the VA "expert" opined on my claim and said that my husband didnt fit into the ADA criteria prior to that time-and could not even tell what military time was on the med recs for glucose readings.

Dr. Bash said she was "medically inaccurate"

She did not even consider after Rod had a CAD and many strokes- that he had abnormal high glucose while on a feeding tube-for 3 weeks-

and also had exhibited many signs of diabetes as far back to 1988- all documented in VA med recs.The VA abnormal high glucose criteria at that time was anything over 105-that would trigger VA to test further.

By the time a VA doctor (former VA doc who gave me a freeby brief supporting IMO)

wanted to diagnose him properly- so much damage had been done in the years of misdiagnosis that I guess they figured he would die anyway-

and proper care would have been quite an expense for VA at that point.

That doctor was overruled by the other VA docs-when he ordered the fingerstick test.

Best to cover it up- the vet and the wife will never know.

But it ended up costing them plenty under FTCA.I found out what they did.

The coroner was astonished when he asked me twice- if Rod was a diabetic -because I said no-

now I know why- Rod had considerable atherosclerotic heart disease and numerous strokes-proven via autopsy -with no possible etiology at all but for diabetes mellitus- never diagnosed or treated by the VA.

What might look like a normal glucose level on blood work you got done after sitting around at a VAMC for hours waiting to see the doc and having no food since breakfast might not indicate anywhere near how high that glucose could raise hours later after you have eaten a meal and then be fully within a diabetic criteria.