Jim,

I’m about to appeal VA’s award of 10% for IHD. Their rationale was MET levels over 10 and EF in 50-55% range. MET levels were based on an incomplete stress test in 2008, which I am challenging. The last stress test I attempted was sometime in 2006, which ended abnormally with pain and discomfort. I’ve found medical studies disputing MET levels used as basis for elderly and for heart patients. I want to challenge MET and EF assumptions. I believe they should have used an EF of 46% that resulted from an angioplasty back in 2003 instead of a 2010 echocardiogram done by a tech. Are there studies available calling into question MET and EF derived from echocardiograms?

I’m a 67 year old Vietnam vet having undergone 5 vessel CABG years ago, followed by stent about 10 years ago. Three arteries are now 100% occluded. As you might expect, I have angina under various conditions.

Reply:

Your best bet is to seek an echo from a civilian source or a repeat echo from VA. Current readings will always be used over past readings. The EF will vary from year to year, sometimes improving, other times being worse. The idea is to use what is most current and likely to reflect your disability today, not the disability of the past.

Learn more on my web site at http://www.vawatchdogtoday.org/IHD.html