Followup after cardiac rehab

Jim,

An update to my case that you have been following. I have completed (successfully) cardiac rehab and have at least one more disability payment left at the 100% level. More would be nice of course. I will keep you infomed of changes as they take place. I hope to hear from the VA before the end of March or very early in April. I would like to learn what the next step will be and what kind of rating they will give me.

Reply:

I'm happy to hear you're doing well with the cardiac rehab. Your health is more important than the rating.

The rating for coronary artery disease or "Ischemic Heart Disease" is usually specific to one of two factors. How well your heart works to pump blood is the ultimate measure of how damaged it may be and how disabling that is to you.

The efficiency of your heart may be measured in 2 standard ways. First is by echocardiography where the "Ejection Fraction" (EF) http://en.wikipedia.org/wiki/Ejection_fraction is measured and recorded. Then there is the METS measurement http://en.wikipedia.org/wiki/Metabolic_equivalent that will give the doctor roughly the same sort of gauge of how well that muscle is pumping.

Once you have either of those numbers the Ratings Veterans Service Representative (RVSR) at the Regional Office will consult the Schedule for Rating Disabilities http://www.benefits.va.gov/warms/bookc.asp and drill down to 4.100 - 4.104 - The cardiovascular System and then to Diseases of the Heart, 7005 Arteriosclerotic heart disease (Coronary artery disease). In that section the numbers from those tests are aligned to the appropriate % of the rating.

Other health issues such as the surgical scars and any other residuals of surgery or invasive procedures (stents and so on) will be considered but the most weight is given to the health of the muscle of your heart.

It’s worth remembering that the rating assigned should be a reflection of the moment. All the suffering of previous heart attacks or hospitalizations aren’t considered for the current rating.