VA disability for heart valva replacement

Discussion in 'Disability' started by kennybob, Apr 17, 2008.

  1. kennybob

    kennybob New Member

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    Hi. I am new to this website.

    I recently (10 weeks ago) had heart surgery to replace a defective aortic heart valve, repair my enlarger aorta and install a pacemaker. I am recovering nicely.

    I retired in 1984 with a 30% disability for the heart problem and have now requested an increase in my VA disability.

    Has anyone had a similar surgery and gotten an increase in their disability %? If so, what was the increase?

    Also, Was there any temporary 100% disability given for the surgery and recovery?

    Thanks for any info you may have for me on this issue.
  2. TinCanMan

    TinCanMan Active Member

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    kennybob

    There are plenty of BVA citations indicating increased evaluation in situations like this. At the moment, I'm not exactly sure how your situation would be evaluated. I've asked a more experienced person for help understanding this and will get back when I get some answers. As far as your question regarding a temporary rating goes, you could be entitled to a temp 100% for up to a year under 38 CFR § 4.29 for the inpatient stay and/or 38 CFR § 4.30 for the convalescence. Just write the VARO and tell them of the surgery and your doctors contact info and they'll figure out the details.

    § 4.29 Ratings for service-connected disabilities requiring hospital treatment or observation.
    A total disability rating (100 percent) will be assigned without regard to other provisions of the rating schedule when it is established that a service-connected disability has required hospital treatment in a Department of Veterans Affairs or an approved hospital for a period in excess of 21 days or hospital observation at Department of Veterans Affairs expense for a service-connected disability for a period in excess of 21 days.

    § 4.30 Convalescent ratings.
    A total disability rating (100 percent) will be assigned without regard to other provisions of the rating schedule when it is established by report at hospital discharge (regular discharge or release to non-bed care) or outpatient release that entitlement is warranted under paragraph (a) (1), (2) or (3) of this section effective the date of hospital admission or outpatient treatment and continuing for a period of 1, 2, or 3 months from the first day of the month following such hospital discharge or outpatient release. The termination of these total ratings will not be subject to §3.105(e) of this chapter. Such total rating will be followed by appropriate schedular evaluations. When the evidence is inadequate to assign a schedular evaluation, a physical examination will be scheduled and considered prior to the termination of a total rating under this section.
  3. TinCanMan

    TinCanMan Active Member

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    OK, Spoke with a friend that is authoratative on the subject and he tells me Valve Replacement is evaluated as residuals after convelescence. You would be rated under 38 CFR §4.104, Diagnostic Code 7016 for the Valve replacement and in the event that lead to a 0% rating, you would receive a minimum of 10% for the pacemaker under DC 7015.

    38 CFR $4.104

    7016 Heart valve replacement (prosthesis):
    For indefinite period following date of hospital admission for valve replacement ....... 100
    Thereafter:

    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

    NOTE: A rating of 100 percent shall be assigned as of the date of hospital admission for valve replacement. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter
  4. dorstewitz

    dorstewitz New Member

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    Similar Problem

    My husband served in vietnam, was exposed to agent orange, developed hodgkins disease, received mantle radiation treatment, developed aortic stenosis from the treatment, required valve replacement on October 6, 2007, he developed sepsis following the surgery, went into septic shock and passed away on November 7, 2007. Ed filed repeatedly and was denied benefits every time, he received absolutely nothing ever. We have 4 children, Ed struggled to work and we made it.
    I helped him refile in October and last week I received another denial. Because Ed has passed away he receives nothing. I receive nothing as his widow, his children receive nothing. How can this be? If anyone else owed Ed I am able to collect. Why does the VA not have to pay benefits to Ed's spouse and children. Is this a horrible scam, just stall until the vet dies, no matter how long it takes, then deny because he passed away? Please somebody advise me.
  5. TinCanMan

    TinCanMan Active Member

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    Something is very wrong here, on several levels. In another thread you said he filed beging 1971. Which begs the question; What did he file for and when? What did the VA say was the reasons for denial? You also say he filed last October for Hodgkin's Disease but passed away before the decision was made. Hodgkin's Disease is on the list of presumptive conditions and if your husband served within the land boarders of the Republic of Vietnam and he had a diagnosis for Hodgkin's Disease, an award would have been a slam dunk. Unfortunately, he passed away before the award was made. As his widow you are not entitled to his award. That's the law. See Congress about that. You can, however, open another claim for your self for Dependents Indemnity Compensation.

    Look at all his old decisions, tell us when they were made, what was claimed and "exactly" what the VA said was the reason for denial. Look in the section labeled "Reasons" or "Reasons and Bases".

    If you are going to file for DIC, you need to make sure your husbands DC lists Hodgkin's Disease as the cause of death, otherwise the VA will deny the claim.

    See this link on DIC: http://www.vba.va.gov/VBA/benefits/factsheets/survivors/DICeg_0108.doc
  6. dorstewitz

    dorstewitz New Member

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    thank you for replying about denied claim

    Hi,
    Ed filed originally for hodgkins disease. He was denied because in the early70's the illness was not considered service connected. I found all his files, every piece of correspondence after he died. Ed had refiled on several different occasions. Each time the denial was different. Once the denial stated that the denial was because Ed did not have type 2 diabetes. That is so ridiculous it must have thrown him for a loop. I tried to help him by contacting our local VA but I got nowhere either. I have filed for survivors benefits, I was denied because his death they say was not service related. The death certificate was not filled out in my precense so I did not know what the MD stated at the time, Besides, I had been sleeping in a chair in the ICU for over 3 weeks, Ed had been improving but he died very suddenly in the middle of the night. Everything seems so surreal, the last thing I was thinking about was a properly filled out death certificate.
    I feel sort of guilty trying to obtain funds now, but Ed was entitled. He loved us all so much and we had a good life together. Ed would absolutely want our children and I to receive these benefits. Do uou have any suggestions?
  7. TinCanMan

    TinCanMan Active Member

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    A couple things come to mind here. Firstly, you really need some help with this. If the Service Officer you previously worked with wasn't helpful, find another. In the event you have no choice, you are going to have to get smart about claim processing and learn the ropes of how to prosecute a successful claim. The VA does what it does because they follow the laws Congress legislated. You need to know what they are and how they apply to your situation.

    Before you go any farther, do two things, Contact the VA Regional Office and ask for your husbands complete c-file. This is a record of everything the VA knows about his claims. Read it. Then talk with the attending physician and see if he will amend the death certificate to include Hodgkin's Disease as the cause of death.

    What does the DC currently say is the cause? You also say he filed for Hodgkin's in 1971? Are you sure about that. That would mean he survived Hodgkin's for 35+ years. 1971 was long before any condition was presumptive of exposure to herbicide and such claims were not possible. The Agent Orange Act was passed by Congress in 1991 and was the first time the VA was required to recognize any condition as presumptive of herbicide exposure.

    Diabetes Mellitus or Diabetes Type II was added to the list in 2001 but it is only Type II that was added. Diabetes Type I or Diabetes Insipitus has entirely different causes and Agent Orange isn't one of them. Unless your husband had DM I in the service you won't be successful.

    If your husband passed away from Hodgkin's Disease and he served within the land borders of Vietnam, you can be successful in a DIC claim. You need to prove to the VA that this is the cause of death. A DC listing Hodgkin's can go a long way in showing proof. I suspect a certified statement from his doctor would also work. Get the proof.

    If you paid burial expenses, you can ask the VA for them to pay you a certain amount toward them. The VA will also provide a grave marker at no cost to you. If you're interested, let me know and I'll get the details and contact info. Your husband did not need to be service connected for this benefit.

    There's no need to feel guilty here. As a veteran, he was entitled to certain benefits. You just need to prove your case.
  8. dorstewitz

    dorstewitz New Member

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    thank yu for responding

    Ed was discharged in late 1971. He came home feeling something was medically wrong. He had lost over 50 lbs. in vietnam. His photos from that time reflect that fact. The va lost his medical records from his time of service. As far as he knew, they were never located. He started out behind because there was no medical point of reference. I met Ed mid 1972, he was working, but tired a lot of the time. In early 1974, he began developing clinical symptoms, itching, shortness of breath. He then developed cevical lymph node enlargement. That resulted in a diagnosis of stage II nodular sclerosing hodgkins disease. In 1974 the va did not acknowledge the correlation between agent orange exposure and hodgkins disease. Ed was in the bush nearly 14 full months. They saw the copters spraying defolliant, walked into areas still wet with spray.
    Ed and I were married on August 10,1974. I was blessed with the years we had together, but he died too soon.
    Ed was treated for hodgkins with mantle radiation, his hodgkins disease was no longer a problem, however sometime after his radiation treatments, the va discovered that mantle radiation was causing a quiet killer, aortic stenosis from the radiation. We have lived at this same address since december of 1974. Every time ed filed for disability, he did it from this address. Not only did the va deny him for hodgkins disease, but no one notified him when they found out the mantle radiation was killing people.
    The type II diabetes denial had absolutely nothing to do with anything. Ed never had diabetes and never filed for anything other than hodgkins disease.

    This was a domino effect, the agent orange caused the hodgkins disease, the cure for the hodgkins disease (the mantle radiation) caused the aortic stenosis. the time the stenosis worsened resulted in valve replacement, the valve replacement hospitalization resulted in infection and the sepsis caused his heart to fail. Without the agent orange none of this would be related.

    No one ever dies from hodgkins disease, the cancer causes systems to fail and that is what factually kills someone. I understand what the va needs but I cant get anyone who could change the death certificate to understand. The death certificate says sepsis and organ failure which is technically true but what brought Ed to that point is the hodgkins disease and the aortic stenosis. I miss him so much, if they would just bring him back I would quit bothering them. I have time to do this and I am going to keep trying until they acknowledge that they should have helped him before he died.

    He was a great man, a great catholic, an amazing soldier, the best husband, father, brother and son this world could ever know. He deserves better than this.
    Thanks again for listening and thanks for responding.
  9. MacsWife

    MacsWife New Member

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    My husband had a mitral valve replacement in February 2015. He served in Vietnam from 1967-1969 and was in areas where herbicide was used. They are denying him disability due to herbicides (Agent Orange) because his doctor says he doesn't have IHD. That makes no sense. Medical literature connects mitral valve defects to herbicide use as well. What can I do to help him? He only gets 10% disability for musculoskeletal and he's had a tri-level cervical fusion and is undergoing testing for a lumbar surgery as well. He also has severe hearing loss in both ears. I don't get why it's so hard. We are going to visit with a DAV Service Officer next week. Our VFW SErvice Officer hasn't been too helpful.
    Thanks for any suggestions anyone may have.

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