Jim,
I just found your sight and started to read some of the issues people were dealing with. I am writing because my husband was in the army reserves, he was on high blood pressure medicine in 2004 when he was sent to Iraq the first time. When he was supposed to go back on deployment in 2009 they sent him home from Fort Dix tellin him he had an enlarged heart and basically to get it checked out when he got home.
He went and had and echo and they said they did not see anything wrong. Through the grace of God he ended up getting a full body cat scan in Nov. 2011 and they found a thoracic aortic aneurysm, which was at the root, they had to actually cut out his aorta and replace it with a patch. We applied to VA for benfits in Feb 2012 we just received the paperwork saying he had 100% disability and he would be reevaluated at 6 months. When he was reevaluated they are now saying that they are proposing to reduce this to 30% and we don't understand why.
Nothing has changed since his 1st appt. he will have a restriction for the rest of his life that he cannot lift more than 50 lbs. I was also curious about the sf 95 because he obviously was misdiagnosed with the enlarged heart in 2009. Any information or advice you can give would be greatly appreciated. We were also wondering if he appeals this reccomendation for dropping from 100 to 30 do they have to keep paying us at 100 until the appeal process is done. Thanks
Reply:
It sounds as if he was awarded a service connection for hypertension. Hypertension (high blood pressure) is know to cause, contribute to or aggravate such vascular diseases as the thoracic aortic arch aneurysm. Thus, when the aneurysm was diagnosed, it was service connected as a secondary condition. The link or nexus between hypertension and vascular disease is well established.
Then he had surgery. Once a treatment is performed, the condition no longer exists. The veteran is allowed a 3 to 12 month recuperative rating after surgery...that rating is always 100%. That is a temporary assignment.
It follows that the condition is "cured" so he can't be rated for that any longer. Thus, after the recuperative period, he is then rated for any debilitating effects of the treatment or the disease. These post-treatment conditions may include scarring or other lasting ill effects of the surgery or other treatments. These post treatment conditions are called residuals by VA.
There isn't much to appeal unless the ratings for the follow up should be combined with others. For example, if he had a coronary artery bypass during the operation or if his aortic valve was replaced, those would be additional ratings. If he has congestive heart failure, that may be an additional rating.
We use the Schedule for Rating Disabilities to determine what the law allows. In this case we find;
7110 Aortic aneurysm:
If five centimeters or larger in diameter, or; if symptomatic, or; for indefinite period from date of hospital admission for surgical correction (including any type of graft insertion) 100%
Precluding exertion 60%
Evaluate residuals of surgical correction according to organ systems affected.
Note: A rating of 100 percent shall be assigned as of the date of admission for surgical correction. 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.
You may find this at http://www.benefits.va.gov/warms/bookc.asp
So...it appears that VA has determined that his residual conditions are totaling up to a 30% rating. I'm not at all sure that you have a claim for misdiagnosis. Aortic aneurysms are very difficult to diagnose and to overlook that isn't unusual. A cardiac echo typically won't show the aortic arch. You would have a heavy burden of proof if you claimed such a thing.
You may want to check with an attorney who specializes in such cases just in case. There are many who advertise on my web site. Please have a look here http://www.vawatchdog.org/how-to-hire-a-veterans-law-attorney.html
The bottom line is that your experience is typical and unless I'm missing something, it is well within the law. Unless he is very ill and hasn't recuperated very well, there isn't much room to claim 100% for an extended length of time. I often advise veterans that to have a condition doesn't mean that you're disabled by it. VA disability, when it works like it should, compensates veterans for disabling conditions to the degree the veteran is disabled. Many Americans undergo such surgeries and live on to lead full and productive lives.