Agent Orange

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What will my rating be after this operation?

I had a quadruple bypass in January and was in Vietnam. There is mild aortic valve sclerosis without stenosis. My current EF after surgery is 55-60%. Based on this information would my rating be in the 30% or 10% range ? 

 

 

Reply:

Your bypass surgery tells us that you are diagnosed with Ischemic Heart Disease (IHD). IHD is presumptive to agent orange exposure. IHD is evaluated using either METS or Ejection Fraction (EF) calculations.

https://en.wikipedia.org/wiki/Metabolic_equivalent

https://en.wikipedia.org/wiki/Ejection_fraction

When using these numbers we find that VA rates an EF of 55% to 60% as below:

 

http://www.benefits.va.gov/warms/bookc.asp#j

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 results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction 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%

 

 

Since VA drops the EF numbers over 50%, I'll guess you'll be rated as 10%..."continuous medication required". If you have a record of a METS number, the rater will probably use that.

 

Aortic valve disease isn't presumptive to agent orange. As you don't have any stenosis in the valve, it won't (or shouldn't) be a part of the rating.

 

 

The normal EF is around 60% to 65%. You're fairly lucky that your heart doesn't seem to have lasting damage and that the pump is nearly normal.

No such thing as a "Reconsideration"? Jim explains:

Jim,

I was diagnosed with prostate cancer in August, 2013. Since I am a Vietnam veteran and served on a brown water ship, the USS Krishna, I filed a claim with the VA in September 2013 for exposure to Agent Orange. At first, the VA said that I had not been in VN. After proving through DD214 and a copy of my original orders, they said that they did not have proof that the ship I was on was in an area that was exposed to Agent Orange, even though my ship was listed as one of those on the presumptive list for Agent Orange exposure. Finally, they denied my claim and gave me a 0% rating.

My urologist and I decided to go the "watchful waiting" route and I was prescribed Finasteride for three months to shrink the prostate. I am still on "watchful waiting" and see the doctor every three months for a PSA test and a DRE, as well as a possible biopsy every year. The VA's reasoning for my denial was that I had undergone androgen deprivation treatment for taking Finasteride and had no residuals. My research on Finasteride indicates that it really is not a treatment for prostate cancer, but a treatment to shrink the prostate. The cancer still exists even after taking the Finasteride. I understand that based on the diagnosis, a 100% rating is demanded and that rating continues until a treatment is completed. Am I correct and what should be my next step? Should I just ask for reconsideration and provide information regarding medical expert’s opinions on Finasteride as not being a true treatment for prostate cancer? Thanks for any assistance you can provide.

 

Reply:

 

There is no such thing as reconsideration. Although the term is used a lot on the Internet and by "experts", it doesn't exist.

You should formally appeal. That means to file a NOD and then state your case.

As it happens, I agree with you. I see this all the time...VA tries to interpret watchful waiting as some sort of magic cure if you're given any of the prostate size reducing medicines.

If you got a 0% rating for prostate cancer, the claim was not denied.

It was approved as service connected at a 0% disabled rating. I know this makes no sense at all but it's a constant state at the VA...they pull this all the time. Finasteride is absolutely not a treatment for cancer, it's a treatment for BPH.

So, your nest step is to mail a NOD. Use this form http://www.vba.va.gov/pubs/forms/VBA-21-0958-ARE.pdf

In the NOD tell VA what you told me. If you can get a statement from the urologist that you have had cancer continually since the date of diagnosis, that would help a lot.

Get the NOD into the mail. Mail it using ONLY certified mail, RRR.

Don't deliver it any other way. Then wait patiently.