From VA
http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1796

That's good and there are about 20 other diseases that are caused by dioxin exposure they should add before we are all dead. What is the average age of Vietnam vets now? I bet it is over 60 years of age. Time is running out for us.

The Ischemic heart disease could turn out to be a biggie.

J

Ya know, I once had a job. It was a very interesting job. My job was to make sure that none of the spray nozzles were clogged.
Now, that there was a really interesting job. Why?. Well, because it has haunted me for the last 40 years.
I'm pretty healthy, on the outside, on the inside my mind is all eaten up. They have never been able to take the fear away.
When you wake up every morning thinking, "Well, this is the day that they find out I'm gonna die from............well, geeeez, let's play "Pick a Disease", okay?"
Sometimes I think I'd be better off just beating the grim reaper to the punch and ending it, before it eats the rest of my soul.
I lay awake at night, thinking....................spent from 0200 to 0600 last night, laying there...........sucks, but I can't take enough sleep meds sometimes, sometimes they didn't MAKE enough sleep meds for me to take.
I know, I know, hell, it could be a LOT worse...................I could be really sick, DMII, cancer, PICK A DISEASE!

Ya, I make jokes. Hell, I'm the life of the party. I'm one funny guy!

ho-ho-ho

Larry, I talked to a Vet who in 1968 was stationed in korea and his job was an aircrewman on the Birds that had the sprayers under the wings and his job was to help clean them. So far he has had no issues but he did say almost everyone in his unit has had some type of cancer, Diabetes, All Kinds ofproblems and A lot of his comrads were Already gone.

J

Explain ischemic heart disease as opposed to other types of heart disease? If the VA were to admit that "heart disease" was presumptive for AO that would open the gates for those of us that are left. Does anyone even know how many RVN vets are left? There were 3 million I think. Supposedly I am connected for CAD via DMII via AO. What is the difference between ischemic and CAD? If I die from brain cancer, or something not presumptive I am really going to be disappointed.

John we both must have ESP- I wondered the same thing as soon as I saw this new AO proposed reg -and have been trying to find good medical explanations of ischematic heart disease (usually due to a blockage) as compared to other types of CAD.

There must be a difference because VA didn't put cardiovascular disease or coronary arterial disease in this proposed reg.Then again I believe the majority of all CADs is in fact ischematic heart disease.

Maybe the difference is a minor and moot point -still this baby will cost VA mega bucks due to Nehmer court Order-

I am stunned that Secretary Shinseki is going to approve this. I bet there will be an influx of many re-opened AO claims.

Berta

I bet a lot of RVN vets will be getting stress tests and echocardiograms. Most are reaching the age where these problems begin to happen. I never thought I would live long enough to see the VA make any kind of heart disease presumptive for AO. Perhaps given this decision all kinds of heart disease will be made presumptive because as you say it is sort of a moot point. What causes a heart to stop beating? Usually it is some blockage. They accepted DMII and now a form of heart disease. Every RVN vet should tell their spouses to be sure to file for DIC no matter what they die from given this decision. An autopsy will probably find a blockage in the heart which would be a contributing factor to death.

http://www.nlm.nih.gov/medlineplus/ency/article/000160.htm

A great point John-

Hopefully we can briefly discuss this tonight at SVR and I will try to mention autopsies again-

I know a Vietnam vet with DMII and heart disease but he says he has no blockages or atherosclerosis.Then again as you mentioned -in time any type of heart disease  could possibly progress to atherosclerosis.

The above link seems to indicate that ischemia CAD is almost a term interchangable with CAD.One can assume many Vietnam vets with CAD as secondary to DMII already get properly compensated for it.
Then again many have the CAD without the DMII.

You are always right about the benefit of getting an autopsy.

Right now I have a claim in for CAD as secondary to DM11. My rep at the DAV scheduled me for an appointment at the VA with a cardio specialist to see if the CAD is related to my AO/DM11 or PTSD.

I wonder how these changes will affect my claim.

Bill

Billy2

I think it is a lot easier to show that your CAD is secondary to DMII than to PTSD. The link between CAD and DMII is strong. The only test that really can tell for sure about your CAD is the heart cath which is invasive. Do you have symptoms? I got SC'ed for CAD secondary to DMII and it was a struggle. I had a C&P done by a PA at the VA which basically said I was fine. I appealed and got some more tests and got a rating of 60% for CAD. How could something like that happen you ask yourself? Incredibly poor C&P exam and poor overall care at the VA. I have never seen a cardiologist at the VA even given that I have a 60% rating for CAD. I had tests but the results were contradictory. One test said ischemia and the other test said AOK. What the hell.

I am grateful for the new conditions being added to the slowly growing list of conditions attributed to Agent Orange Exposure. Most of these GI's are at/near or well over 60 yrs old. Yes, some will benefit, but it will be too late for others. DIC for dependents, sure. When you have time--take a look at the huge list of conditions under "study" of possible relation to Agent Orange. *I really wonder how many more conditions could/should be immediately added as service connection to compensate these aging Vet's.(?). Also, let us not forget the many widow's that will continue to suffer because of the lengthy procedures to add the conditions. Please don't get me wrong, I am grateful these additional conditions were recently added. However, sometimes I feel like they (govt) will periodically throw us a "bone" to quiet us down for awhile. Could it be a few more thousand soldiers, sailors, airmen, and marines must die, before more conditions are granted service connection? Perchance is the govt looking at saving $$$$$$$$???

John,

I had a 90% blockage of the LAD and they incerted a medicine coated stint back in Jan of this year.

My heart Dr. would only write that a short note that said I had CAD and the presence of diabetes is felt to be a contributing factor.

Bill

Billy2

I think that note from your doctor is weak, but the association between CAD and DMII is stong in the literature. A decent IMO doctor should be able to write a good letter for you. The doctor needs to make the link between CAD and the DMII. Now that ischemic heart disease is presumptive for AO that may be enough to get you service connected on its own. The link between PTSD and CAD is also in the literature, but I don't think it is as obvious as between DMII and CAD. The VA's adding ischemic heart disease to the list for AO could mean a lot to you. It might mean a earlier effective date as well. The VA putting ischemic heart disease on the AO list could open up the flood gates.

VMO

You really posted an indictment of the VA. They are guilty as charged in your post. They are waiting for us to die off as a cohort of vets. The quicker we die the quicker they can get us off the books unless there is a DIC claim. I think it is about the money. Sick Vietnam vets are way down on the priority list under corrupt Afghan war lords for funding. Most of the population were not even alive when we were in Vietnam.

I know the feeling. At least we are resting while we go through it. You are not alone, LarryJ

I have a Question. My Husband died last June of "Coronary Artery Atherosclerosis" and was a Vietnam Vet, I applied for Dic benefits, as he was discharged with a 20% disability of Hypertention (High Blood Pressure) My question is: Since he died of a Heart attack is that gonna be considered AO, or am I just gonna have to hope that they relate his Hypertention to cause of death. How long does it usually take to hear something once paperwork has been filed with the VA for Dic benefits?

I am not getting a direct "Answer" I know about the 'Ischemic heart disease" are they going to look at "Atherosclerosis" the same way?? Just want a Yes or No answer to my above question.
Thank-You

Atherosclerosis is also a form of coronary artery disease. Coronary artery disease is synonymous with Ischemic Heart Disease. For VA purposes, if you have coronary artery disease, you have Ischemic Heart Disease. Ischemic Heart Disease was defined by The VA in a case involving a participant in WW II in June 2000. Below is the link.



http://www4.va.gov/vetapp00/files2/0017299.txt



Atherosclerosis is defined in the below link from a medical viewpoint.



http://surgery.about.com/od/beforesurgery/...rosclerosis.htm





From this VA landmark case, and the supporting medical definition of Atherosclerosis, I would be inclined to believe that Atherosclerosis falls within the overall category of Ischemic Heart Disease. Therefore, my vote is....................YES, if the death certificate shows such as the cause of death.

Iagree that the IHD regs should be comparable to the atherosclerosis regs.

But we cannot determine what the Ischemic heart disease regulations will actually be- I check daily for them at the Federal Register. They will have 60 days for public comment and vets as well as SOs , reps and vet lawyers will surely comment on them if they seem to limit IHD in any way that would leave out IHD veterans.

My husband died with IHD but the claim was for undiagnosed Diabetes causing the IHD.His Heart disease was also undiagnosed and untreated.Neither IHD ,CAD or DMII appeared in his med recs.

In order to succeed with my DIC claims (I have awards of DIC) I had to study CAD and atherosclerosis affects to heart and brain.

So there is no doubt in my mind that IHD is in fact atherosclerotic heart disease (CAD)but only when the actual regs are published can anyone determine what those regs will be.I am cautiously optimistic that IHD will be rated same as Atherosclerosis. This is why VA is accepting AO IHD claims but cannot begin to fully process and rate those claims as they need the new regs to do that.

You have a very valid DIC claim under Nehmer COurt Order (O exposure) for his heart disease as well as for DIC due tio the inservcice HBP is you can provce this was chronic to the exten that a doctor has stated his HBP from service was directly related to the conditions of his death.( Causing or contributing to death)

I feel you could raise both potentials for DIC here. But it appears you have formally filed the 21-534 form.

The VARO will send you a VCAA letter if they need more info or evidence.

They are not adjudicating these new AO presumptive claims yet but could start the pre determination process on them.

I hope in your case you made it clear that the CAD comes under the new proposed Ischemic heart disease regulations.

As to the time limit your DIC claim will take-

I had issues involving malpractice.

My 1151 DIC took a little over 3 years and my recent DIC direct AO SC death award took almost 7 years.

In the case of the 3 new presumptives-VA has fast letters on how to adjudicate these claims.There is absolutely no reason why these presumptive claims should take years and years.

The lawyers at NVLSP want to hear from any vet or widow (via email at their site) who is filing under the new AO presumptives.

They won the Nehmer decision that controls these AO claims.

They want to make sure that the VA does not attempt to withhold any retro due the vet or survivors on any favorable AO award.

With a million claims in the system and with the new regulations still pending-your DIC claim will take time
but should not take years and years.You have the evidence they need for a reasonably fast award for DIC but no one can really tell how long a claim will take.



WHat VARO do you deal with?

Do you have a vet rep as your POA?

You know there are no medical studies funded by the VA to determine the affects of agent orange. The VA uses other people's studies to make determinations about which diseases are presumptive for AO. The VA is completely passive in its examination of agent orange science. They are quietly waiting for an army to die. The VA has never funded research into the affects of AO on the children and grandchildren of vets. Do children of AO vets have medical problems? Don't ask the VA because they are not funding studies to find out. If the IOM finds out twenty years from now that the children of AO vets are dying younger than their peers maybe the VA will look into that research. Of course it will be too late.

[quote name='JRW' date='Jan 14 2010, 08:50 PM' post='185113']
Atherosclerosis is also a form of coronary artery disease. Coronary artery disease is synonymous with Ischemic Heart Disease. For VA purposes, if you have coronary artery disease, you have Ischemic Heart Disease. Ischemic Heart Disease was defined by The VA in a case involving a participant in WW II in June 2000. Below is the link.



http://www4.va.gov/vetapp00/files2/0017299.txt



Atherosclerosis is defined in the below link from a medical viewpoint.



http://surgery.about.com/od/beforesurgery/...rosclerosis.htm





From this VA landmark case, and the supporting medical definition of Atherosclerosis, I would be inclined to believe that Atherosclerosis falls within the overall category of Ischemic Heart Disease. Therefore, my vote is....................YES, if the death certificate shows such as the cause of death.




[Thank you Berta and JRW for responding to my Question, I am on 7months of waiting just to hear anything, since I filed my claim. Thank-you for reinforcing my beliefs, at least I feel encouraged to keep on waiting the waiting game. Do you think SMOKING is gonna be a factor, as, cause of death was "Coronary Artery Atherosclerosis", with Old myocardial infarct and smoking is marked. Thanks for your in-put.

I am not aware of lifestyle or family history having an effect on illnesses that are on the Agent Orange list. Smoking is a lifestyle. If that continues to be the case (and I think it will), I would believe that smoking would not figure in to the diagnosis especially, with him being a Vietnam veteran.

If you think about it, Type II diabetes (also on the Agent Orange list) can be a result of lifestyle and or family history illness. But, if you are a Vietnam veteran, and you are diagnosed with this illness, your lifestyle and or family history is not taken into account.

Julie2,

For what its worth, it appears to me that Vietnam veterans with an Agent Orange claim go through much faster, if their illness has already been medically diagnosed by outside doctors, prior to submitting the claim. In your case, it is clearly noted on the death certificate. If the regulations for the three new illnesses continue to follow in the path of the previous 12 illnesses on the list, I would think that you all you will need to do is just set back and let your claim speak for itself. Your claim, to me, looks "cut and dried."

Unfortunately we still have no IHD ,Parkinsons, or Hairy Cell B regs proposed in the Federal Register-

It concerns me that this is taking so long for them to develop regs on Secretary SHinseki's announcement for these 3 new AOs.

With the new ships list -whereby some Brown Water vets can now attain AO comp and the pending HR2254 bill-(furure outcome still unknown) the VA might be adding up the potential costs of all this stuff in order to somehow circumvent some valid comp situations under all of these potential AO claims .

They also owe retro under Nehmer to many vets and widows under the 3 new presumptives as well as the new Brown Water situation.

Cripes no wonder the VA had to be given a fast letter to get off their butts on award payments they were holding back- as in the case of some of us here at hadit.

The odd part about that is even if an AO vet or their surviving spouse dies-Nehmer says they have to pay any Nehmer retro to the next of kin.There is No advantage under AO claims-to the VA- if the claimant dies.

I cannot fathom why VA would withhold AO retro but they have been doing that since the late 1990s when Nehmer was won by Beverly Nehmer and NVLSP.

Below is an excerpt taken from the Department Service Office Newsletter of an American Legion post. The link is also provided. This may (or may not) give us a better idea of when the new regulations for the three new agent orange illnesses may go into effect. This may have been published on this forum sometime in the past, I do not know.

I think the key statement in the overall context of this issue is when did the VA actually receive the National Academies Institute of Medical Report? Once that is established, then the law will apply, as to the final publication of the new regulations.



http://www.post3legion.com/DSO%20Newsletter/DSO%20Newsletter%20110109.htm


38 U.S.C. § 1116© (1) states that the VA should adhere to the following timeline when promulgating regulations to implement presumptive service connection for agent orange-related diseases:

• Not later than 60 days after the date on which the Secretary receives a report from the National Academy of Sciences, the Secretary shall determine whether a presumption of service connection is warranted for each disease covered by the report.

In this case, the Secretary determined that presumptive service connection was warranted for Parkinson's disease, ischemic heart disease and B cell leukemia on October 13, 2009.

• If the Secretary determines that a presumption is warranted, the Secretary, not later than 60 days after making the determination, shall issue proposed regulations setting forth the Secretary's determination.

If VA adheres to this requirement, they must issue proposed regulations by Saturday, December 12, 2009.

• Not later than 90 days after the date on which the Secretary issues any proposed regulations, the Secretary shall issue final regulations. Such regulations shall be effective on the date of issuance.

However, in Liesegang v. Secretary of Veterans Affairs, 312 F.3d 1368, 1378 (Fed. Cir. 2002), the Court indicated that there is no harmful error if the VA misses the specific deadlines under § 1116©(1), as long as final regulations are issued within 210 days of the date the VA receives a report from the National Academy of Sciences.



The most recent National Academies, Institute of Medicine Report, Veterans and Agent Orange: Update 2008 was released on July 24, 2009. Presuming that this is the date the VA "received" the report, the final regulations are required to be published no later than February 19, 2010, pursuant to Liesegang.

JRW- Thanks again for responding to my Smoking question. Good point you made about Diabetes too. You are absolutely right. I was reading somewhere that they were looking at smoking and obsity, but, since Hypertension was Service connected before 40 years of smoking, I should be alright. I filed for DIC before I even knew anything about "Ischemic Heart Disease" because "Atheroscerosis" is a Progression of Hypertension. The Pathologist wrote that his Hypertension is one direct caussitive factor in his resullant Heart Attack. So, I guess I just sit and wait on a letter of some kind. Don't know if I should tell the VA guy to file it as AO or just to leave it alone, already been 7 months and haven't heard a thing. Thanks again.

<<<< Don't know if I should tell the VA guy to file it as AO or just to leave it alone, already been 7 months and haven't heard a thing.>>>>

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Just to be on the safe side, I would discuss it with the VA rep. to help clarify that part of the question. It wouldn't hurt.

Julie 2
Thanks JRW I will go tommorrow and bring it to the VA guys attention. It's like after they have filed your claim, there done with you. I contacted him 2 months ago, and he said, Well, you'll know something before I do. He knows I don't know anything about this, I was the 2nd wife, 8years, and my husband did not talk to me about any of this, all he told me was his 2 brief cases contained important papers, and if anything happened to him, to look at them. So, my oldest daughter and I went down to the VA with the paper work, that's when I learned about DIC. He never spoke of it to me. Ex-wife got half his pension, so, he never put me on his half, guess he must of thought that DIC would pay me more, so why bother. He was right about that, as Dic will pay more than half his pension. Thanks, and real good talking to you.

Hey do not want to be a kill joy, but any time in Febuary for final rules is a
sad joke.

The VA seems be not be concerned of the rules.Who is going to make them
follow the law?

When the Federal Registary is posted the VA proposed rules, these rules
sit there for 60 days, during this time feel free to comment, which is very easy to do
.
After the 60 days, the time starts to finalize the rules, they have 30 days for this activity.

This process by law, the VA ignores

Try this site to locate the proposed rules, good luck.

http://www.regulations.gov/search/Regs/home.html#home



^{********************************************************************************
*******}

Julie-the DIC regulations can be quite extensive -they should be here under the DIC forum-as to a link to the criteria.

Also the VA web site has lots of survivors information.

Have you received a VCAA letter yet? or even a letter conforming ther receipt of the 21-534 clam?

If he was incountry Vietnam vet and died due to IHD contributing or causing death (and it is listed on the deth certificate- it is possible -with a fully filled out 21-526 that VA is holding your claim to await these new regulations.It wou;d not hurt to make sure they know that this is now a potential AO DIC claim.

The 1-800-827-1000 reps
or an Iris inquiry (sent via the VA web site under their "contact us" area might give you some status as to this DIC claim.

Or at least an acknowledgement that they got it.

I had to tell my fprmer POA reps about th Haas case-they had not heard of it- sometimes these reps never use the internet to see what s what in the veterans community and dont read the C & P bulletins and FAst Letters from VA well.

Your rep should have definitely received a Fast letter copy by now of the 3 proposed new AO presumptives.

The veterans community got word of this the same day the Secretary decided to add them to the AO list.

"Ex-wife got half his pension, so, he never put me on his half, guess he must of thought that DIC would pay me more, so why bother. He was right about that, as Dic will pay more than half his pension. "

Was this a VA wartime pension?

What disability was he awarded the pension for?

What was his SC rating in hs lifetime for-if he had a service connected rating?

Julie2
Hi Berta, Thanks for all the info, I called 800 number, and my Dic claim has been done, as of Jan. 13, 2010, but, the girl on the phone couldn't tell me the decision, she said I would be recieving a letter. My husband served 23 years Viet-nam and Persion Gulf. Retired with SC 20% Hypertension. Death Certificate states "Coronary Artery Athersclerosis" with Old mycardial Infart, and smoking was marked. I talked to my VA guy, and he said that the three new ones have not been added yet, probably take a couple years. The new Secretary did not add them as the old Sec. had added in the past. So, if I get a denied letter, guess I'll have a long wait ahead of me. Just hopeing that I don't. Oh, I also had a letter from Pathologist that stated, his hypertension was one direct caussitive factor of his resulltant heart-attack. So, what do you think?

Julie2, Berta please look above I responded.

"I also had a letter from Pathologist that stated, his hypertension was one direct caussitive factor of his resulltant heart-attack. So, what do you think?"

with SC in effect already for HTN this is excellent evidence for SC HTN contributing to his death.

I had probative evidence too when I filed my AO death claim and then obtained good IMOs as well- and the VARO ignored all that and denied me-for 6 years -

The BVA however read my evidence and awarded.

Hopefully they based their decision on all of your evidence and maybe this could be an award letter coming-

It is impossible to know what the VA will do -even with good evidence.

If they deny you -I would ask them to reconsider based on Secretary Shinseki's new proposed regs-if I were you-

(unless they already considered that and still denied)

or had some other adequate reason- it is hard to know what they will do.

Julie2
Thanks Berta, I will keep you all posted, when I recieve my letter. Hopefully it will be soon and Good news!!!

I asked a doc recently about the difference between CAD and ischemic heart diease. They stated something like this:

* Coronary Artery Disease primarily affects the Arteries only

* Ischemic Heart disease can be anywhere in the heart.

* Ischemia is basically a term for cells that lack oxygen and eventually die which prevents the heart from working properly and can cause heart attacks.

* CAD can generally be defined as blocked and/or harndened arteries.

* How these are similar is that the Hardened arteries are generally ischemic in nature (i.e. plaque build up in arteries causes a lack of oxygen to the cells of the artery walls which then become ischemic).



So CAD is generally IHD in nature, but IHD isn't necessarily CAD becuase IHD is anywhere in the heart not just in the arteries does that make sense!