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New Form For Dr's To Fill Out For Ihd Claims


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12 replies to this topic

#1 stillhere

 
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Posted 15 October 2010 - 07:08 AM

The link below is to the new form questionnaire for VA claims supporting IHD.


http://www.vba.va.go...tyexams/IHD.pdf

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#2 Berta

 
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Posted 15 October 2010 - 08:16 AM

THANKS stillhere-

I understood months ago that this form woud be sent to most AO IHD claimants who have private medical care for their IHD and filed AO IHD claims.

The form mentions right up top that if the private doctor charges a fee for filling this out, the VA will not reimburse.

for reference:

Dyspnea means shortness of breathe

angina-chest pain defined within http://www.nlm.nih.g...lus/angina.html

Syncope fainting or loss of consciousness as defined in http://my.clevelandc...ic/syncope.aspx

I wonder if I should fill this form out myself. I am the one who diagnosed and proved my husband's heart disease for FTCA case. :wacko:

This is an interesting form because it says that ECHO is only necessary when EKG and chest X ray reveal IHD.

An EKG can often state ischemia right on top of the strip yet the VA will also accept a "limited" ECHO to determine "left ventricular dimension,wall thickness and ejection fraction."

This form seems very concise on VA's part-I just hope the C & P docs also will use a similiar format.

#3 Berta

 
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Posted 23 October 2010 - 11:56 AM

The actual regs and the form stillhere posted seem to rule out other secondary conditions such as stroke and HBP as potentially due to the IHD:


According to Harrison's Principles of Internal Medicine (Harrison's
Online, Chapter 237, Ischemic Heart Disease, 2008), IHD is a condition
in which there is an inadequate supply of blood and oxygen to a portion
of the myocardium; it typically occurs when there is an imbalance
between myocardial oxygen supply and demand. Therefore, for purposes of
this regulation, the term ``IHD'' includes, but is not limited to,
acute, subacute, and old myocardial infarction; atherosclerotic
cardiovascular disease including coronary artery disease (including
coronary spasm) and coronary bypass surgery; and stable, unstable and
Prinzmetal's angina. Since the term refers only to heart disease, it
does not include hypertension or peripheral manifestations of
arteriosclerosis such as peripheral vascular disease or stroke.

http://www.regulatio...A-2010-VBA-0005


However-wit clear ct medical evidence there are secondarys that should be claimed such as:

Embolic ischaemic stroke is more frequent in patients with atrial fibrillation (80%), myocardial infarction, prosthetic valves, rheumatic heart disease and larger artery atheroma (artery-artery embolus). Most emboli are of atherosclerotic origin, and may partially or temporally obstruct cerebral arteries causing TIAs.5 Embolisms tend to be multifocal and may produce small haemorrhages around the obstruction.

archives.who.int/prioritymeds/report/.../stroke.doc

I was quite surprised this AM to see how many POWs with IHD (who were service connected for it) subsequent developed strokes and the VA denied the stroke as secondary to their SC IHD. These were old claims and there is more info on the net these days as to the relationships of IHD to stroke.

Embolic strokes are strokes from clots that form usuaully in the heart, and if the Pt has IHD, then atherosclerosis has most likely compromised the arteries ,casng a clot to form (emboli) that can go to the brain and then cause CVA.

Not all CVAs are embolic and not all are due to IHD. I see that claimants who do claim IHD with stroke as secondary will need a strong medical opinion to support the nexus.

Maybe this info will help someone.

#4 buickx

 
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Posted 23 October 2010 - 06:49 PM

Is this form to be filled out by IHD vets who have filed their claims already, and had their c/p's ?

#5 Lorraine

 
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Posted 23 October 2010 - 11:32 PM

I'm wondering the same thing about Vet's who have already filed claims for IHD/AO. My husband did not receive this form from Seattle RO, but he filed last NOV09' and it looks like the form didn't come out until May2010. He had a C & P and was sent for an Echo in lieu of a stress test so they already have this information.

I absolutely do NOT agree with the statement refuting hypertension, strokes, peripheral vascular disease not being related to IHD! VA has been adamant about hypertension not being a AO presumptive so feel they are protecting that decision with this statement.

I like the form for its brevity and concisemness. If the treating cardiologist is willing to state that the Vet has IHD and they've served time in VietNam it SHOULD be a done deal, then the rating will all depend on the severity of the disease determined by the Mets level, ejection fraction,presence of history of CHF, etc. Will save reviewers/raters lots of time if the cardiologists are willing to fill this out. They won't be having to search through years of clinical visit notes for documentation.

I'm curious as to whether the section that states "Provide only diagnoses that pertain to IHD" doesn't provide the format to include such things as Hypertension, CVA(stroke), etc.? if the doctor states these other diagnoses are caused from IHD?
This could get very interesting.

Lorraine

#6 Lorraine

 
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Posted 23 October 2010 - 11:33 PM

I'm wondering the same thing about Vet's who have already filed claims for IHD/AO. My husband did not receive this form from Seattle RO, but he filed last NOV09' and it looks like the form didn't come out until May2010. He had a C & P and was sent for an Echo in lieu of a stress test so they already have this information.

I absolutely do NOT agree with the statement refuting hypertension, strokes, peripheral vascular disease not being related to IHD! VA has been adamant about hypertension not being a AO presumptive so feel they are protecting that decision with this statement.

I like the form for its brevity and concisemness. If the treating cardiologist is willing to state that the Vet has IHD and they've served time in VietNam it SHOULD be a done deal, then the rating will all depend on the severity of the disease determined by the Mets level, ejection fraction,presence of history of CHF, etc. Will save reviewers/raters lots of time if the cardiologists are willing to fill this out. They won't be having to search through years of clinical visit notes for documentation.

I'm curious as to whether the section that states "Provide only diagnoses that pertain to IHD" doesn't provide the format to include such things as Hypertension, CVA(stroke), etc.? if the doctor states these other diagnoses are caused from IHD?
This could get very interesting.

Lorraine

#7 Berta

 
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Posted 24 October 2010 - 07:25 AM

The form is for IHD vets, who have private cardiac care, to have their private doctors fill out.

I would think if the vet formally claims secondary disabilties directly due to the AO IHD that should be stated on the form as such by the doctor and then the doctor might need to give a medical rationale at some point so maybe they should do that on the form too as to the association of the veteran's IHD to any secondary conditions.

Question for anyone:

IHD can cause embolisms (clots) that form in the heart and travel to the brain causing cerebral vascular stroke.However there are many other reasons for stroke so a CVA claimed as secondary to IHD will need strong medical evidence of the type of CVA it is and the etiology-

On my husband's ECHO the doctor states "there were no clots seen on this study" , and the ECHO was done 3 weeks after he had a catastrophic embolic stroke.

Does the VA make this sort of statement on every ECHO as to whether any clots were seen?

#8 jbasser

 
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Posted 24 October 2010 - 09:57 AM

Echos are actually an ultrasonic procedure that requires a separate reading by a Doctor. These tests are really an educated guess compared to an actual angiogram or Cardiac Catherization.

The strip of echo films are permanent record and if you have access to them, you can have another Doc read them and the results may be different.

Stuff gets missed constantly.

For example, a CT scan will not show a recent event like a stroke on the day it happens but a few days down the road it shows it.

They told my buddy he has a congenital disease that caused his aortic stenosis. I told him to conceed it but to also let them know that when they repaired the Aorta, they also bypassed 2 other arteries so he is eligible for service connection for IHD.

If anyone has or thinks they have IHD, you need to get the OR reports as it is a play by play of what is going on through an actual looksee at your insides. No test can do this and the VA can never dispute this record.

J

#9 Lorraine

 
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Posted 24 October 2010 - 12:57 PM

The form is for IHD vets, who have private cardiac care, to have their private doctors fill out.

I would think if the vet formally claims secondary disabilties directly due to the AO IHD that should be stated on the form as such by the doctor and then the doctor might need to give a medical rationale at some point so maybe they should do that on the form too as to the association of the veteran's IHD to any secondary conditions.

Question for anyone:

IHD can cause embolisms (clots) that form in the heart and travel to the brain causing cerebral vascular stroke.However there are many other reasons for stroke so a CVA claimed as secondary to IHD will need strong medical evidence of the type of CVA it is and the etiology-


Berta
My husband's recent Echo thru QTC made no mention of embolisms(clots)
Lorraine
On my husband's ECHO the doctor states "there were no clots seen on this study" , and the ECHO was done 3 weeks after he had a catastrophic embolic stroke.

Does the VA make this sort of statement on every ECHO as to whether any clots were seen?



#10 buickx

 
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Posted 24 October 2010 - 06:47 PM

Again...does this form apply to vets who have filed for IHD only, and have completed their c/p back in Feburary?

#11 stillhere

 
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Posted 25 October 2010 - 06:35 AM

Again...does this form apply to vets who have filed for IHD only, and have completed their c/p back in Feburary?



This form is for private cardio doctors to fill out. It helps them provide the information that the VA is looking for to support a claim for IHD.

Of course the doctors notes and DX will still be a part of your official medical records but this was created by the VA to help the doctors and vets relay the requirements that the VA in particular is looking for.

Nothing more nothing less.

If you have private care I would make this part of your package. If you have already filed and your claim is deemed ready to rate then depending on your decision I would use this for a reconsideration if denied and a higher rating if you are low balled by the VA.

#12 Berta

 
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Posted 25 October 2010 - 09:28 AM

"If you have private care I would make this part of your package. If you have already filed and your claim is deemed ready to rate then depending on your decision I would use this for a reconsideration if denied and a higher rating if you are low balled by the VA."

That is an Excellent point stillhere and this form also could be used if a vet with VA health care needs to use an IMO doctor to support his/her claim for AO IHD if VA low balls or denies.

With VA Watchdog closing it's hyperspace doors in February and without the continued extraordinary work of Larry Scott (Tbird posted this info here today)
I don't know how we advocates and vets/widows will get a pulse on the AO IHD claims processing situation.Let alone anything else that goes on in inner VA circles.
It is quite possible Jim Strickland will post any info he has as to how these claims get going after the CRA 60 day waiting period.

Larry Scott has consistently given us the nitty gritty of the VA-always giving us information that he thoroughly checks out first.

Jim's excellent work will continue. Tbird posted the links to Jim Strickland's claims sites.

This is sad news for the vast veteran's community on the internet because we have lost an Icon and advocate of the hghest merit!!!!!

#13 stillhere

 
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Posted 25 October 2010 - 11:05 AM

Thank you Berta I do like to help our vets stay on top of these issues as much as possible.

I also just posted a link to another new website that is coming to help with these 3 conditions.

Unfortunately or fortunately depending on how your perspective is. The web and many veterans are becoming more and more comfortable dealing with issues and our government.

Sites like VA Watch dog and yes even Hadit may take a look at what they bring to the table and if there is still a need.

it seems this happens more and more in our society replacing our I think needed helping each other and replaced by a generic help all site!




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