Hi Jim,
What would you estimate the compensation percentage would be for a veteran whose heart stopped , was revived by EMT's , had 5 stents put in arteries , takes 10 plus pills a day and still contends with chest pain and weakness ? I am 64 years old and earned a CIB in Vietnam in 1970 and a CAB in Iraq in 2005.
Thank you for all you do for veterans !
Reply:
None of the factors you mention have anything to do with the final rating for ischemic heart disease (IHD).
A rating for Ischemic Heart Disease (IHD) is made by measuring the efficiency and function of the main pumping chamber of the heart...the left ventricle. There are a number of tests that can be used to determine the cardiac output. The 2 most frequently used by VA are the METS test and the echocardiogram test. These tests can become very complex very quickly. Different doctors believe in different tests so there isn't much consistency throughout VA.
When we measure the efficiency of the heart muscle by echo, the output of the left ventricle is measured as a percentage. This is called the ejection fraction or EF. A normal reading is somewhere around 50% to 65%. If the permanent damage to the heart is serious, the heart may not pump efficiently and that number will drop below 50%. The lower the number, the sicker the heart and the higher the compensation will be for it.
If a man has had an event like you describe and has suffered a cardiac arrest and had multiple stents inserted, his heart may have recovered to a point where it is actually working pretty efficiently. If his numbers are above that 50% mark, his compensation will be very low. If the numbers from testing fall below the 50% mark, the veterans compensation will be higher according to how damaged his heart is.
If the veterans EF measures 30% or below, he is entitled to a 100% rating. If the EF number is between 30% and 50%, the rating should be 60%. From there, depending on a number of other factors, there are further ratings of 30% and 10% for hearts that aren't quite as damaged by the disease.
You may want to have a look at the rating schedule for heart disease here http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_104.DOC