Disability Ratings for IHD/CAD

Posted on: Thursday, December 31, 2015
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Disability Ratings for IHD/CAD

Jim:  I am a Vietnam Blue Water Veteran. I was just awarded 30% disability for my IHD/CAD.Over the years I've had 6 heart attacks, I have 16 stents and a triple bypass. Should I appeal the award?

Jim's Reply:
 
First up; You're fortunate as a blue water vet to be service connected for your IHD. The IHD rating isn't presumptive for blue water vets. You must have had a strong nexus statement or evidence of going on shore.
 
In any case, the VA doesn't rate IHD by the number of stent procedures, surgeries or how many bypass grafts you may have had. VA looks at the function of your left ventricle (LV).
 
The LV is the main pumping chamber of your heart. The efficiency of the LV is measured by how much blood it can pump during a heartbeat. The norm is right around 50% to 55% or so. The measurement is called the Left Ventirular Ejection Fraction or LVEF.
 
The LVEF is usually measured by echocardiogram, nuclear medicine studies or it may be estimated by METS. See: https://en.wikipedia.org/wiki/Metabolic_equivalent
 
So no matter how many things may have happened to your heart over time, if it is within normal limits at around 50%, you'll get a 0% or 10% rating. The Schedule For Rating Disabilities tells us:
 
7005 Arteriosclerotic heart disease (Coronary artery disease):
 
With documented coronary artery disease resulting in: Chronic congestive heart failure, or; workload of 3 METs or less resultsin dyspnea, fatigue, angina, dizziness, or syncope, or; left ventriculardysfunction with an ejection fraction of less than 30 percent...100%
 
 
More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent...60%
 
 
Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray...30%
 
 
Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required...10%
 
The good news is that your heart isn't sick enough to rate at 60% or 100%. The bad news is that for all you've been through, your rating may be accurate at 30%. If you believe that your rating should be higher, you should appeal.
 
Jim
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