Parameters for IHD Rating in Agent Orange, Heart Disease, Prostate and Parkinson's Forum

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Parameters for IHD Rating

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BW326	Parameters for IHD Rating		Lead	[-]
Posts: 25 Feb 26 12 9:55 PM	I had read in a previous post about IHD ratings "are measured solely on the amount of heart damage there is based on the worst reading of METS or LVEF. Stents or bypass are in a sense fixes" I filed for IHD in Jan of 2010 and the VA gave me a 10% rating in Jan on 2011 because I had a realtively acceptable METS rating (minimal or no heart damage yet), however, in Feb of 2010 the VA scheduled me for a stent replacement surgery for blocked artery but found when then got in there that it had closed and died. 7 months later they scheduled me for another severly blocked artery but after 3 attempts to install a stent they made the decision to stop. Due to it's location it was inoperable and the surgeon and my VA cardiologist said that all they can do is try to manage my chronic angina with medication. - My VA cardiologist signed a form for a state handicapped sticker stating I was Class 3 heart disease (the most severe classification) - My VA doctor suggested I try SS disability and I was granted 100% disability after just 6 weeks based soley on the IHD. This was in Dec 2010. - I applied for Voc Rehab in Jan 2011 and they gave me a decision that I should not try to go back into the workforce. - VocRehab just accepted me on their 'Independent Living Program" based on my SC IHD (requiremenst are, "severely disabled, unable to work") I did file a NOD in Jan of 2011 on the 10% IHD rating. I have sent all this documentation to the compensation board. I understand that I have to be patient and there are 10's of thousands like me but my question is, since IHD is a disease of the arteries, and I have lost 2 already and have been classified by the VA as severely disabled (every department except the compensation board) do I have a chance at getting an improved rating or do I have to have a heart attack (and heart damage first) which seems to be the only parameter right now? I don't think they had considered originally what happens when the operations are not successful and stents and bypasses fail.
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brewha44		#1	[url]	[-]
Posts: 996 Feb 26 12 10:06 PM	BW, Of course there is no guarantee! But you should receive a substantial increase with this new evidence. SSDI records should help! Edited 2 times by brewha44 Feb 26 12 10:10 PM.
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BW326		#2	[url]	[-]
Posts: 25 Feb 26 12 11:41 PM	Thanks! That's all I was looking for was that there might be some hope of flexibility with the requirements. My biggest problem is managing anxiety right now because it drives the heart rate up right into angina. I remember when the final parameters for AO IHD were released and I had always worried that they had just taken the verbiage from the old 'heart disease' criterion and used it for IHD which is a disease of the arteries. Over the years I've had a double bypass operation, an arterial stent, and a carotid artery procedure and they'd all been successful but in the last 2 years, the last 2 arterial procedures failed, but, since I haven't had the big heart attack yet I was falling outside of the criteria they established.
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LouF		#3	[url]	[-]
Posts: 12936 Feb 27 12 8:44 AM 10,000 plus post...	Actually when those arteries failed you probably had some minor heart damage. Remember though what I said inthat prior post that your disability is rated on the worse of METS or LVEF. You cannot possibly have acceptable METS with the angina you describe, METS are based on the level of exercise before angina or heart changes occurs. Frankly if you suffered severe angina during the stress test they should have seen that on the EKG. I hope you didn't try to be King Kong and suffer a lot of angina during the test. Did they give you a current LVEF during that last procedure Lou SSG Santa Fe NM 4/21 11LIB Americal 1/69-8/70 50% PTSD 60% IHD 100% IU P&T
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BW326		#4	[url]	[-]
Posts: 25 Feb 27 12 10:04 AM	Unfortunately, that's exactly what I did. I had a nurse and a doctor there and they told me to keep pushing and against my better judgement I went until I couldn't take it anymore. When I stepped off the treadmill I almost immediately blacked out and they both went into a panick. After 5-10 minutes I was stable again. Several weeks later I requested a copy of the test from the records section and, though I have no medical knowledge, I wasn't able to see any notation about the problem I experienced. When I talked to my cardiologist at my next appointment she said that I wouldn't be given that type of test again. After my last failed stent operation in Sept 2010, both the surgeon and my cardiologist at the VA said that I would need to train my heart to operate in the 55-65 beats per minute range and that during exercise I shouldn't try to exceed 90 beats per minutes (which is about where the angine starts to take off now). Unfortunately, the only METS rating I have is from about a year and a halg ago when I had that bad experience. Would it help if I talk to my VA cardiologist about writing something in my file to clarify the situation? I have my next appt in about 2 weeks. Thanks for your help
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LouF		#5	[url]	[-]
Posts: 12936 Feb 27 12 10:15 AM 10,000 plus post...	Any new evidence helps, I would ask for an echocardiogram to see your LVEF. Think of the science here, angina is caused by insufficient blood flow to the heart muscle. My first cardiologist put a rubber band tight around my wrist and told me to pump,my hand. It immediately started hurting, he said that was angina. Insufficient blood flow causes the heart to work harder to supply the body with the blood it needs when under physical stress. That again is angina, but by working harder it also causes and enlarged heart and thickening of the cardiac wall also,know as cardiomyopathy. The amount of the myopathy also affects the LVEF. That is why they look at both. A person who has gone through cardiac rehabilitation can have a very high mets but a low LVEF. The legs have built up so much strength that it takes a lot of stress off the heart and they don't require as much blood. Imam going to move this to the AO forum because all the heart guys are there and you will get a lot of experience Lou SSG Santa Fe NM 4/21 11LIB Americal 1/69-8/70 50% PTSD 60% IHD 100% IU P&T
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Jimmy Buffit		#6	[url]	[-]
Posts: 79 Feb 27 12 11:01 AM	Any new evidence helps, I would ask for an echocardiogram to see your LVEF. I agree with Lou. Also, can you see a non-VA cardiologist?
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m109howitzer	dreadmill	#7	[url]	[-]
Posts: 3425 Feb 29 12 9:36 PM	I hear it time and time again. They put you on that damn thing and try to kill you.All my life I was active as an electrician. Then heart attack mild one I guess. And back on that damn thing to see if you got better I guess I did as my mets were estimated at 6, but if the rater ever got past that they wouldhave seen I had a v-tach, finally it was documented. I almost passed out and they decided to stop when it hasppened. The tech almost crapped in her pants when they saw what was going on. No more on that rat race machine. I guess that and the aorta anurism will keep me off it for good, maybe the VAMC will re=-evaluate me on it or kill me on it, Anyway my wife would get dic sometime after my demise.I had told them that I passed out two times , and they could not find out why till they saw the tachardia on the dread mill. AICD three months ago, NOD in progress. Good luck.
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