Secondary Conditions

Question:

Jim, I asked a question a couple day ago about filing a claim for rating increase for my service connected Agent Orange Ischemic Heart Disease due to a pacemaker implant for Symptomatic Sick Sinus Syndrome. My cardiologist does not want to include a note in my health record saying that the SSSS is secondary to IHD. If I file a claim for an increase is there any chance at all of it being approved without his note. Thanks much for your help.

Jim's Reply:

 

I understand. The doctor who isn't expert in disability medicine isn't always comfortable with suggesting a certain absolute cause for a given condition if and when there are other options. In other words, it isn't a sure thing that your SSS was caused by IHD but that's a pretty good option and seems likely barring other conditions

If I were you I'd now skip seeking notes from your treating doctors and I'd proceed to filing the claim for the pacer as secondary to IHD. You'll get a C & P and the examiner may well agree with you as you present your case. If not and you're denied, then you'll turn to an appeal with an Independent Medical Opinion (IMO) from an expert disability doctor to support the likelihood of your claim. Another option is to go ahead and get an IMO now as you file the claim. You'll likely save yourself the frustration of an appeal if you do that.

Yes, this seems convoluted and it'll take some time. Welcome to VA disability benefits.