VA Disability Benefits for Heart and Cardiovascular Conditions
VA Disability Benefits for Heart and Cardiovascular Conditions
This week, CCK LIVE breaks down the topic of heart and cardiovascular conditions, such as hypertension and coronary artery disease, for VA compensation.
Table of Contents:
0:58 Most Common VA Cardiovascular Conditions
2:00 Direct Service Connection for Heart Conditions
2:44 Agent Orange Presumption for Heart Conditions
4:20 Hypertension Agent Orange Presumption?
7:18 Secondary Service Connection for Heart Conditions
9:28 Rating Heart Conditions: Metabolic Equivalents Test (METS)
11:51 Totally Disabling Symptoms of Heart Conditions
14:10 Hypertension and VA Disability Ratings
18:44 VA’s Proposed Changes to Heart Ratings
20:00 Temporary 100% Ratings: Heart Attacks, Pacemakers, Cardiac Defibrillators, Heart Transplant, Value Replacement
22:04 Question from the Audience: Obesity and Heart Conditions
23:00 Medications and Heart Conditions
24:30 Individual Unemployability (TDIU) for Heart Conditions
25:24 Closing Thoughts
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Content
0 -> good afternoon and welcome to CCK live
2.58 -> and happy Halloween my name is jena
5.1 -> Zellmer joining me today are Emma
7.14 -> Peterson and Cortney Ross and today
9.45 -> we're going to be talking about heart
11.4 -> conditions and other related
13.009 -> cardiovascular conditions as always if
16.44 -> you have any questions please feel free
18.48 -> to leave them in the comment box below
20.369 -> we'll do our best to answer them and
22.32 -> we'll also be posting links to
24.57 -> additional information that can be found
26.49 -> on our website at C CK law comm so let's
31.679 -> get right into it nearly 1 million
33.989 -> veterans have service-connected
35.719 -> cardiovascular conditions so you know
38.489 -> this is a very timely and relevant topic
41.01 -> I would say that they're most commonly
42.96 -> rated at 10 percent and so even though
46.32 -> they're not always the most compensable
51.03 -> rated disabilities that doesn't
53.37 -> necessarily mean that they're not
54.48 -> important so Emma can you talk to us a
57.6 -> little bit about what the most common
59 -> cardiovascular conditions veterans can
61.43 -> have and get surface skated for sure so
64.409 -> one of the big ones that we talk about a
67.409 -> lot not just in the context of diseases
69.51 -> in general but Agent Orange presumptions
71.43 -> is coronary artery disease also known as
74.67 -> ischemic heart disease so a lot of
76.77 -> veterans who were exposed to herbicides
78.439 -> ended up developing this disease and can
80.85 -> get that presumptively
81.869 -> service-connection
82.759 -> but a lot of veterans just end up
84.81 -> developing CAD your later in life either
87.119 -> again due to service or due to other
89.189 -> conditions that are service-connected
90.54 -> and the other very common one that we
93.36 -> see a lot of is hypertension so both of
96.03 -> those are probably the two most common
97.979 -> heart conditions that we see with our
100.38 -> clients great and um you know first
103.2 -> we're going to talk a little bit about
103.979 -> different ways to get service-connected
105.299 -> for these cardiovascular conditions and
107.82 -> then we'll go into the ratings but we
110.31 -> have a lot of information on our website
112.14 -> and I'm sure we've done several Facebook
113.82 -> lives in the past about a second of a
116.49 -> direct service connection but Courtney's
118.92 -> you just want to give us a quick
119.969 -> refresher on how a veteran can get
122.85 -> direct service connection for a heart
124.71 -> condition yep
125.759 -> so you'll need a diagnosed heart
127.829 -> condition and then you'll need an
130.11 -> in-service event or illness so it could
132.3 -> be what Emma suggested of exposure to
134.61 -> herbicides and service or it could be
136.47 -> that you actually had an onset of
137.64 -> symptoms of your heart conditioning
139.14 -> service and then you'll need a medical
141.48 -> nexus so of likely a medical opinion
143.91 -> linking your currently diagnosed a heart
146.489 -> condition to that event or illness in
148.83 -> service great and I think that this is a
151.92 -> good time to kind of delve in a little
154.23 -> bit more into that Agent Orange
155.58 -> presumption that you both discussed
157.41 -> so you know we have direct service
159.599 -> connection where you can use that that
161.94 -> three-step process and get a nexus but
164.19 -> under the Agent Orange presumption
165.65 -> there's an easier way to get service
168.45 -> connection at least for CAD right now is
170.25 -> that right Emma yes so for a CAD -
172.829 -> ischemic heart disease if you can show
175.62 -> that you were exposed to an herbicide
176.849 -> whether it be in Vietnam Thailand or now
181.319 -> for our blue water veterans with a new
183.87 -> legislation if you can show that your
185.64 -> Coast and herbicide and you have a
187.11 -> current diagnosis you don't need that
188.73 -> Nexus evidence it's going to be
190.019 -> presumptively service-connected so that
192.75 -> eliminates part of the burden in terms
195.03 -> of getting service connection mm-hmm and
197.25 -> I think um the VA has different time
201.15 -> periods during which you know it's
203.19 -> already established that Agent Orange
206.16 -> was was used in those different areas so
209.31 -> the dmz vietnam and blue water etc and
213.48 -> so i'm you know to the extent that you
215.73 -> you mentioned if you can show a lot of
218.04 -> times just by serving in those areas
221.28 -> that has been enough to demonstrate that
223.38 -> you were exposed to Agent Orange and so
225.18 -> I would really recommend checking out
228.18 -> our website there's a lot of information
230.519 -> about the new blue water legislation
232.799 -> that you just mentioned which is that
234.299 -> essentially extends that presumption to
236.7 -> veterans who were serving in the Navy
239.489 -> who actually didn't set foot on the
241.769 -> ground in Vietnam but we're still
243.51 -> exposed to Agent Orange and so that just
246 -> lets lessens the burden for veterans to
249.06 -> demonstrate because I think it would be
250.319 -> it'd be pretty hard to show that you
252.359 -> were exposed to Agent Orange you
255.22 -> and so you mentioned that that's just
256.93 -> for CAD or for ischemic heart disease
260.38 -> what about hypertension so hypertension
262.96 -> historically has not been well sort of
266.35 -> it is not currently one of the
268.6 -> presumptive conditions for
270.22 -> service-connection however in 2018 the
273.49 -> National Academy of Sciences which does
275.35 -> these annual or biannual reviews of the
279.13 -> evidence linking certain conditions to
281.26 -> herbicide exposure finally indicated
284.05 -> that there was sufficient evidence
285.46 -> linking the development of hypertension
287.32 -> with Agent Orange exposure there was a
289.78 -> lot of rumblings and a lot of
291.81 -> communication coming out of VA
293.53 -> indicating that hypertension was going
295.36 -> to be added as a presumptive condition
297.1 -> and then that just stalled out
300.07 -> talks about that or really we don't
304.09 -> really know too much more about when
305.89 -> that's gonna be added as a presumptive
307.21 -> cailli ongoing sometime in the future
309.48 -> you know we certainly hear it next
311.92 -> couple months and a couple months and
313.75 -> it's it sort of come up in the news
315.16 -> again lately so feel free to google that
317.17 -> if you're interested to see what's going
318.94 -> on lately with the hypertension
320.26 -> presumption but unfortunately it is not
323.11 -> a presumptive condition now just because
325.63 -> it's not presumptive doesn't mean you
327.64 -> can't get it service-connected with some
329.2 -> medical Nexus evidence and certainly
331.78 -> that opinion report from the National
333.82 -> Academy of Sciences is very persuasive
336.04 -> so submitting that getting together with
338.68 -> your representative your via so whoever
341.68 -> you work with on your claim to either
344.68 -> submit that report or submitting it to
347.56 -> your doctor to look at and then
348.94 -> providing a nexus opinion certainly
351.22 -> could be a path to getting you
352.54 -> service-connected for hypertension yeah
354.58 -> and I think it's really important for
357.3 -> example this National Academies report
361.89 -> even though it's fairly well known the
366.67 -> board isn't going to necessarily need to
368.95 -> discuss it unless you and your
371.71 -> representative you know submit it and
373.72 -> make an argument about why it should be
376.93 -> considered in support of your claim
379.24 -> there has been some case law recently
381.22 -> about you know what the board should be
383.47 -> um should know about despite it
386.89 -> potentially not being in
387.969 -> record and so it's always just good to
389.409 -> be on the safe side and if you think
391.599 -> that there are some medical literature
393.279 -> out there that would support your claim
395.519 -> just you know talk to your your VSO or
399.489 -> your attorney about potentially you know
401.679 -> submitting that as part of your claim
404.169 -> and making potentially an argument about
406.089 -> why it should help you and in support of
409.839 -> your claim and so that's something to
411.879 -> note and so studies like the NIH report
415.119 -> are really helpful and so you know we
417.189 -> you could find information on our
418.509 -> website about that as well so Courtney
421.419 -> we talked about direct service
423.189 -> connection we've talked about
424.119 -> presumptive service connection but is
426.879 -> there another way that veterans could
429.579 -> potentially get service connected for
430.959 -> heart conditions that maybe aren't
432.549 -> directly related to service or aren't
434.319 -> related to an Agent Orange exposure yes
436.689 -> so veterans may be service-connected
439.179 -> secondary to a condition that they're
441.399 -> already service-connected for and I'll
443.469 -> give you some examples to kind of
444.669 -> provide some context to that so there's
447.639 -> medical literature literature that
449.469 -> supports if a veteran is maybe already
451.299 -> service-connected for a condition like
452.889 -> diabetes it's possible that diabetes
455.589 -> could cause a heart condition or
457.529 -> aggravate maybe a heart condition of the
460.209 -> veteran already has and if you're able
462.399 -> to show that through medical evidence a
464.679 -> veteran can also be service-connected
465.819 -> for heart condition that way another
468.159 -> common example is PTSD or other types of
471.61 -> anxiety inducing psychiatric conditions
474.579 -> literature also supports that there's a
476.709 -> connection between those psychiatric
478.299 -> conditions and how they might impact or
480.219 -> cars are caused rather hard conditions
483.749 -> certain types of medication that you
486.309 -> might be taking to treat
487.629 -> service-connected conditions could also
489.669 -> have possible impacts on your heart
491.499 -> condition so these are all different
493.479 -> things that you want to consider if you
494.979 -> have a heart condition and you're trying
496.569 -> to find a way to link it to or you think
500.469 -> it's due to your time in service
501.789 -> it may not be directly due to your time
504.069 -> in service but it may be related to a
505.509 -> condition that you have as a result of
507.309 -> your time
508.3 -> and we've done Facebook labs and we have
510.19 -> a lot of information on our website
511.09 -> about secondary service connection and
513.34 -> what you need to demonstrate in order to
516.16 -> you know meet that standard since it is
519.34 -> a little bit different than direct
520.6 -> service connection but the good thing to
522.76 -> know is that you don't necessarily need
524.32 -> a heart condition in service you can you
526.39 -> know potentially get a heart condition
528.4 -> after service related to some other
530.29 -> service panting disability and so it's
532.93 -> important to kind of talk to your rep
535.75 -> and potentially your doctor and kind of
537.97 -> explore all different avenues of service
540.19 -> connection because just because you
541.33 -> can't prove one doesn't necessarily mean
543.28 -> you can't get service-connected so so
546.61 -> those are kind of the different ways
547.6 -> that veterans with cardiovascular
550.57 -> conditions can demonstrate service
553.27 -> connection so let's go on and let's just
555.58 -> assume that VA has already you know
559.15 -> acknowledged that a veteran has a
561.01 -> service-connected heart condition let's
563.71 -> talk about kind of ratings so Emma do
566.44 -> you want to talk about Metz or metabolic
569.89 -> equivalent tests sure so the way that
573.97 -> the cardio of the Rivier heart
576.31 -> conditions like I mentioned before CAD
578.71 -> are rated it's based on a series of
581.05 -> tests that the examiner most likely will
583.42 -> perform your private doctor could
584.89 -> perform them too
586.36 -> really they test just sort of the
587.98 -> efficiency and function of your heart so
589.75 -> one big one that is included in most of
592 -> the diagnostic criteria for heart
594.43 -> conditions are the Met testing the
596.05 -> metabolic equivalents tests otherwise
598.39 -> known as exercise testing so it measures
600.81 -> the energy cost on your heart for doing
604 -> different physical activities and it
605.71 -> also measures when in sort of how
607.78 -> strenuous of an activity you're doing
609.48 -> you start to feel symptoms so if you're
612.73 -> walking and you already are out of
614.23 -> breath and feeling I can't say this word
617.83 -> to say by like dyspnea dis Nia yeah
620.53 -> Davina essentially shortness of breath
622.36 -> yes it's just worrying yeah too many
624.91 -> confidence well I think this is really
627.19 -> helpful to you because you know a lot of
628.48 -> times veterans are looking at these
629.95 -> rating criterias right you don't even
631.27 -> know what these things
632.42 -> right and so you know shortness of
634.639 -> breath rocking your alien shortness of
637.519 -> breath obviously that's gonna result in
639.379 -> a low Mets rating because at that low
644.6 -> level you're already feeling the
646.49 -> symptoms so what they do is the higher
649.22 -> the Mets rating the more efficient the
650.72 -> more functioning your heart is and the
652.249 -> lower your disability rating is going to
654.559 -> be so look at shortness of breath
657.019 -> fatigue and China which is heart pain
658.97 -> dizziness fainting loss of consciousness
661.569 -> and then also they consider the
663.74 -> medications that you might have to take
665.18 -> to maintain maintain your condition
668.029 -> mm-hmm I think um it's really important
670.939 -> to kind of in in cases like this where
673.639 -> the rating criteria is pretty objective
676.149 -> you know it requires an examiner to
679.279 -> either interview you or do an exercise
681.079 -> based test and then make a determination
682.85 -> based on on those tests what level
686.54 -> you're at it's really important to you
689.059 -> know talk to your doctor and talk to
690.649 -> your rep you know provide evidence about
694.249 -> kind of the daily activities they you
697.22 -> struggle with due to your cardio
698.829 -> vascular disease and so Courtney do you
702.74 -> want to kind of talk about you know I
704.36 -> mentioned earlier a lot of veterans are
706.129 -> only rated at 10 percent but you know
707.929 -> there's obviously a broad spectrum what
711.559 -> are kind of the symptoms that are that
713.42 -> VI considers totally disabling like what
715.79 -> are the things that it's gonna look for
717.759 -> when veterans are submitting an
719.809 -> increased rating claim yeah so similar
721.939 -> to what mo was alluding to if you are on
725.509 -> doing physical activity that's just
728.48 -> something like shower showering or
730.67 -> walking one block or just while you're
733.999 -> getting dressed you're starting to
735.499 -> suffer from some of those symptoms so
737.209 -> the shortness of breath the chest pain
739.85 -> the fatigue those are the kind of things
742.189 -> of the better excuse me the VA is gonna
744.079 -> look forward to say that your heart
745.79 -> condition is totally disabling chronic
748.819 -> congestive heart failure is another
750.439 -> thing that VA will consider in terms of
752.839 -> granting you a total disability
756.01 -> yeah so anywhere between that spectrum
758.6 -> so if you can walk let's say a mile or
761.09 -> two but you still feel shortness of
762.59 -> breath maybe that's a 10% rating but if
764.39 -> you really can't do anything without you
766.58 -> know needing to stop a lot you need help
769.07 -> maybe dressing or eating or anything
770.33 -> like that um that's something that VA is
773.03 -> going to consider and so it's really
774.29 -> important to tell VA you know what what
778.79 -> issues you're having and be really
780.5 -> upfront
781.55 -> don't try to minimize any of the
783.44 -> experiences that you have because you
785.96 -> want to make sure that you're getting
786.89 -> the compensation I think that's really
788.81 -> important because sometimes due to the
790.88 -> severity of your heart condition doing
792.65 -> an actual Metz testing an actual
794.21 -> exercise test is not gonna be indicated
796.07 -> mm-hmm so they'll do interview based
797.9 -> MEPs testing and in that interview
799.82 -> they'll ask you what happens after you
801.77 -> walk the block what happens after you do
803.66 -> X Y and D so it's very important that
806.09 -> you are very clear about when you start
808.4 -> feeling these symptoms because they're
809.6 -> just gonna be estimating that I'm
810.83 -> actually gonna make you do the physical
813.08 -> exercise because it again it might be
814.67 -> that you're you know you're at the 80%
816.14 -> range and they're looking at a hundred
817.58 -> percent and it's just not safe to make
819.23 -> you start running on a treadmill right
821.33 -> so again if you're in that situation
822.47 -> make sure that you are explaining how
825.44 -> this impacts you in your day-to-day life
826.73 -> mm-hmm so that's for cardiovascular
831.32 -> conditions heart conditions you know in
834.56 -> the beginning we talked about how
835.85 -> there's CAD
837.35 -> or ischemic heart disease they're named
839.84 -> the same they're used interchangeably
841.64 -> which is sometimes a little bit
842.51 -> confusing but then we also have
843.8 -> hypertension and hypertension isn't
845.39 -> rated based on Matt's level so Courtney
848.78 -> do you want to talk a little bit about
849.59 -> how VA rates hypertension sure it's
852.23 -> rated based on your systolic in
854.41 -> diastolic um readings or pressure so you
858.98 -> know we've most of us have been to the
860.63 -> doctor where they put the little blood
862.67 -> pressure cuff on your arm and they
864.89 -> listen as they float up on your arm and
867.71 -> they listen for the two different ticks
869.66 -> and those two different ticks are
871.7 -> indicating where your systolic in your
874.28 -> diastolic pressure as and usually
876.32 -> they'll give you one number over the
878.48 -> other the diastolic pressure is the
880.88 -> bottom number and the systolic is the
882.47 -> top number so VA uses again its Frye
885.26 -> objective
886.089 -> uses those readings to determine what
888.459 -> your rating should be for Hyper ticking
891.309 -> yeah and I think despite the fact that
893.68 -> both Metz testing and hypertension
897.579 -> read high low pressure readings are both
899.23 -> objective I think there's that is really
901.54 -> hard to kind of use lay statements to
905.41 -> demonstrate that you meet a higher
907.569 -> rating it's really just based on what
909.879 -> that blood pressure reading says and so
912.519 -> um unfortunately there's just that's
915.009 -> just a higher yeah I think one thing to
917.41 -> keep in mind with hypertension that was
918.97 -> usually if your hypertension is so
920.86 -> severe that it warrants you a higher
923.079 -> rating for based on these rating for
925.269 -> care for hypertension typically you you
927.61 -> also have other medical conditions that
929.559 -> have developed from that including heart
931.93 -> conditions which can also develop
933.579 -> secondary to hypertension so while you
936.069 -> might not be able to be rated as highly
937.629 -> just for hypertension you know consider
940.209 -> what other conditions you have as a
941.889 -> result of your hypertension because you
943.629 -> may be able to get secondary circuits
945.1 -> connected
945.579 -> so there's connection and a higher
947.11 -> combined rating overall I think that's a
949.12 -> really good point and it's it's B A's
950.86 -> duty to kind of make those leaps the
955.329 -> connections between a disability and a
958.12 -> potential other ratings um you know it's
960.819 -> being suited to maximize a veteran's
962.41 -> ratings but you know it's always helpful
964.959 -> to help VA do their job you know make it
967.99 -> as easy as possible for them to grant
969.91 -> you the highest possible rating in it
972.459 -> and so if you can talk to your rough
973.87 -> about that and kind of you know look at
977.11 -> at the regs and look and see what other
979.929 -> potential compensation you might be
982.509 -> entitled to it's super easy if you just
984.939 -> kind of like give it all to VA and just
987.129 -> let them stamp it rather than relying on
990.759 -> them to correctly apply bla I think one
993.73 -> pitfall just backing up to service
995.29 -> connection to with hypertension that we
996.91 -> see is that the rating criteria requires
999.79 -> that the readings be taken over so goes
1001.74 -> in ways it's not just you had a one time
1003.809 -> high blood pressure reading therefore
1005.699 -> you have hypertension so a lot of times
1007.949 -> we'll see folks that have a singular
1009.87 -> high blood pressure reading in service
1012.19 -> and then subsequent ratings are maybe
1013.899 -> normal but then they end up getting
1015.55 -> diagnosed with hypertension outside of
1017.35 -> service but that doesn't count as a
1019.69 -> diagnosis for VA purposes but again
1022.029 -> that's not to say that you can't still
1023.62 -> get service-connected by getting some
1025.089 -> medical evidence your doctor PCP to
1027.819 -> opine that that first reading was the
1029.409 -> start of your hypertension but that's
1031.78 -> just something to be aware of that you
1033.429 -> know just because you've had that one
1034.809 -> high blood pressure reading mmm-hmm
1037.03 -> a lot of times we'll see VA explain it
1039.22 -> away oh they were sick they were on cold
1041.26 -> medication they were stressed out
1043.209 -> subsequent readings were lower mm-hm
1045.579 -> they do require that it's over several
1047.169 -> days so just something to keep in mind
1048.76 -> it's not a barrier but it might be
1051.25 -> something that you face so just just be
1053.049 -> aware of that and I think yeah it's
1054.429 -> really helpful to look and see what VA
1056.65 -> actually considers hypertension because
1059.82 -> you know high blood pressure is kind of
1061.99 -> a range you know certain people are
1063.49 -> pre-hypertensive versus actually having
1066.28 -> hypertension and so it's important you
1069.4 -> know to keep up you can measure your
1071.53 -> blood pressure or self you can you know
1073.53 -> go I'm sure like CBS still has those and
1077.169 -> keep a journal of of what your blood
1079.929 -> pressure readings are and so that you
1081.7 -> can make sure that VA is getting a full
1084.19 -> picture of your actual disability and
1086.2 -> you're not getting shortchange just
1087.94 -> because you only go to a doctor one day
1090.75 -> great this is really helpful um just as
1093.789 -> a reminder if anyone has any questions
1095.35 -> please feel free to leave them in the
1097.39 -> comments box below we'd love to answer
1099.19 -> your questions we know that this is a
1101.08 -> really complicated area of law the heart
1104.08 -> I think is different than you know
1105.909 -> having a knee problem like because it's
1108.28 -> internal and so it lends a little bit of
1111.28 -> mystery so great let's move on so we've
1117.07 -> talked about kind of how VA rates heart
1120.76 -> conditions and hypertension now but VA
1123.19 -> is actually has proposed some changes to
1126.1 -> how they rate heart diseases and so
1129.4 -> Courtney do you want to kind of give a
1131.26 -> little overview about what VA is is
1133.539 -> gonna do in the future yeah so the
1135.549 -> proposed changes are really to make it
1137.799 -> so that the Mets testing it's going to
1139.48 -> be the primary way that they rate heart
1141.46 -> conditions so we've alluded
1143.53 -> just alluded to this throughout the
1144.94 -> broadcast but other things they look at
1146.68 -> in our part of the criteria are things
1148.66 -> like a measurement of ejection fraction
1151.12 -> of the left ventricle and then episodes
1153.7 -> of congestive heart failure so the
1156.64 -> proposed changes are proposing to do
1158.83 -> away with those things so to take them
1160.48 -> out of the criteria and really focus on
1162.87 -> them that's testing they're also
1165.37 -> proposing to clarify that do this yeah I
1170.04 -> also struggle someone could write in a
1172.39 -> comments how you would be this is really
1176.77 -> referring to breathlessness or show yeah
1178.96 -> I think that makes sense because then
1180.85 -> you won't require people to say
1182.83 -> basically yeah or look it up because
1184.99 -> that's not really a common phrase for
1187 -> something that is this common issue yes
1188.98 -> so it makes it a little bit clearer yes
1192.24 -> so we talked a little bit about you know
1195.64 -> how a veteran could potentially get a
1197.38 -> hundred percent reading under the
1198.49 -> reading criteria there are a couple
1200.08 -> other ways the veterans can get a
1201.52 -> hundred percent readings so Emma let's
1204.01 -> talk a little bit about temporary total
1205.87 -> ratings sure so if you have for example
1210.22 -> the big one is a heart attack you will
1212.92 -> be rated at a hundred percent for three
1214.51 -> months following that incident and then
1217.15 -> you'll be reevaluated based on your max
1219.43 -> testing and and seeing how severe the
1222.22 -> resulting condition is but for those
1224.47 -> three months after the heart attack you
1226.48 -> will get a 100% rating some other ways
1229.6 -> that you can get a temporary total
1231.49 -> rating so temporary hundred percent is
1234.55 -> if you've had a pacemaker installed
1237.4 -> they'll give that to you for two months
1239.05 -> following surgery and then rewrite you
1241.27 -> them see how severe the condition is
1243.69 -> there's something else out there now
1245.8 -> these days called an ICD or a CID which
1248.59 -> is an implantable cardiac defibrillator
1250.39 -> it's like a pacemaker in the same way it
1253.69 -> works the same way in that it senses
1255.19 -> when your heart is out of rhythm it's
1256.72 -> beating too fast or irregularly and but
1258.94 -> it gives you a shock kind of like the
1261.4 -> full-on defibrillator machines that you
1263.11 -> might see in your favorite medical drama
1265.78 -> better but it's implanted actually right
1268.24 -> into your heart if you have one of those
1270.67 -> that is a hundred percent
1273.26 -> rating the entire time the entire time
1275.69 -> so it is important to find out whether
1277.279 -> you are getting a pacemaker or an ICD
1280.309 -> because that makes a drastic difference
1281.51 -> in your rating if you have a heart valve
1285.26 -> replacement while being treated and then
1289.309 -> six months following that treatment that
1290.99 -> replacement will then get reevaluated
1293.269 -> and then finally a heart transplant
1296.26 -> percent for one year yeah and then
1298.82 -> re-evaluated based on your new heart so
1301.73 -> hopefully at that point things are much
1303.5 -> better yeah probably
1305.09 -> if things are going well you won't get a
1306.86 -> good rating and then finally as always
1314.929 -> we have to touch a little bit on TBI you
1317.809 -> so Courtney you want to give us a brief
1320.33 -> refresher on TVI you actually do we have
1322.97 -> a question before we get into tdiu let's
1325.58 -> answer this question so Hosea says would
1328.07 -> being overweight due to back problems
1329.799 -> and other issues affect the heart
1332.299 -> resulting in the in a condition that we
1335.149 -> can apply for compensation that is a
1336.799 -> really excellent question and I think
1339.2 -> that it it kind of relates back to
1342.429 -> secondary service connection so Courtney
1345.049 -> you want to touch on that yeah
1346.13 -> absolutely so yes but it would be so
1348.95 -> short and serve as an intermediate step
1351.32 -> for that secondary service connection so
1353.69 -> if you have a back condition that is
1355.88 -> already service connected and so
1358.549 -> disabling that it causes you to become
1361.13 -> obese and that obesity then results in
1363.83 -> your heart condition it's that middle
1366.74 -> step there that then makes that the
1368.24 -> obesity is the middle stuff there that
1369.74 -> connects your back service-connected
1371.45 -> back condition in the resulting heart
1373.519 -> condition so you can use that to link
1376.399 -> the two and then get service connection
1378.049 -> for the heart yeah also another way I
1380.419 -> mean this is not exactly the question
1382.01 -> but we talked about medications so if
1384.559 -> you're taking medications for the back
1385.94 -> pain that increase your blood pressure
1387.58 -> or long term medications long term
1391.25 -> steroid treatment could affect it and
1393.32 -> then also if you had
1397.75 -> I hope your medication use causes weight
1400.57 -> gain
1400.87 -> right that's what I what is the taking
1402.61 -> medication that causes weight gain that
1405.25 -> also could be the animator it's deaf but
1407.05 -> yes obesity can be the link between the
1409.57 -> two yeah so a few years ago VI and the
1413.8 -> court had made clear that you know you
1415.18 -> can't get a disability rating based on
1417.52 -> obesity but the a general council has
1420.43 -> come out and said they recognize that
1422.08 -> OBC it can be this step between a
1424.72 -> service county disability and another
1427.12 -> disability and so um it's a little
1430.15 -> unclear kind of how that relates like
1432.46 -> what the standard is between the service
1434.32 -> cognate condition and the obesity and
1436.09 -> then what the standard is between the
1437.32 -> obesity and the secondary condition and
1440.2 -> so I think it's really helpful if you're
1441.52 -> gonna be making those types of arguments
1443.29 -> to consults you're wrapping it there a
1445.6 -> VSO or an attorney and really make sure
1449.29 -> that they're doing research on what va
1452.89 -> is gonna require to demonstrate that
1455.29 -> link because it is so there's so many
1457.39 -> chains link in the chain yeah and so
1461.38 -> that's a really great question
1462.58 -> yeah great so let's go back to TDI you
1465.64 -> and I just talked to you Cortney so I'll
1467.5 -> go back to that and Emma can talk a
1470.62 -> little bit about TDI you so yes you ask
1473.59 -> you of course can get TDI you based on a
1475.63 -> heart condition and certainly heart
1478.84 -> conditions would impact your ability to
1480.67 -> do all kinds of work and if you're
1482.08 -> getting out of breath just showering and
1483.76 -> getting dressed you certainly aren't
1485.44 -> going to be able to do any type of
1486.49 -> physical or strenuous labor probably not
1488.71 -> even a desk job necessarily getting to
1490.75 -> and from work might just be impossible
1492.84 -> but you absolutely can apply for TDI you
1495.78 -> as part of an increased rating and for
1499 -> your service connected heart condition
1500.38 -> also in then in conjunction with other
1502.69 -> conditions that you have um so as always
1505.09 -> TDI you is on the table if you're a
1507.25 -> service type of disability is prevent
1508.87 -> you from being able to secure and follow
1511.18 -> a movie substantially gainful job yeah
1514.3 -> and we have a lot of information on TDI
1516.82 -> you and what VA considers when it's
1519.34 -> determining whether or not a veteran can
1521.16 -> you know obtain and maintain a job do
1524.59 -> anything
1525.4 -> that's one are you I think just all on
1527.53 -> TV or even a door closing but I'm just
1530.02 -> gonna say closing thought the heart
1531.79 -> conditions in general I think as you've
1534.01 -> heard throughout the broadcast there's
1535.24 -> many different ways that you can get
1537.3 -> possibly compensated for your heart
1539.29 -> condition so you just want to make sure
1541.96 -> that if you are suffering from our
1543.37 -> condition that you really take into
1545.05 -> consideration all of the different
1546.34 -> possible avenues like you've said a few
1548.74 -> times to talk to your rep or talk to
1551.95 -> your doctor to see if they can provide
1553.51 -> medical evidence and support of your
1555.04 -> case because it's not really one size
1557.679 -> fits all for each one
1559.66 -> mm-hmm yeah and I think you know going
1562.09 -> back to that talking to your doctor you
1564.1 -> know there are there are certain
1565.12 -> disabilities that you can get serviced
1567.34 -> catered for that are really you are
1569.35 -> competent as a layperson to describe and
1572.74 -> to you know say that you have a
1575.47 -> concerning condition but for heart like
1578.26 -> I said earlier it is a lot it's a little
1580.33 -> bit more complicated and so getting good
1582.79 -> evidence from your doctor to support
1585.28 -> your claim for service connection or
1586.75 -> your claim for an increased reading I
1588.01 -> would really suggest doing that any
1591.04 -> question
1592.44 -> lots of questions
1594.64 -> no I think that that's that's a fair
1596.95 -> point and like you mentioned the Hart's
1598.36 -> internal it's not like anywhere you can
1600.07 -> you know see how far do you spending
1601.66 -> right you can see like a swelling colon
1604.33 -> name right you can't see like your
1606.01 -> ejection fraction you can see your math
1607.75 -> testing so while all your lay evidence
1610.059 -> about your symptoms your breathlessness
1611.86 -> you know how it impacts your life is
1614.02 -> very valuable at the end of the day
1616.15 -> these are a lot of objective medical
1618.1 -> tests they're gonna perform and it might
1620.47 -> really box in your rating so you know
1623.53 -> don't be disheartened no pun intended
1624.94 -> but just know that this criteria is out
1629.559 -> there so talking with your doctor is
1631.059 -> very important mm-hmm great well thanks
1633.61 -> for joining us and again a happy
1634.75 -> Halloween I hope everyone stays safe and
1637.45 -> we'll see you next week
1647.33 -> you
Source: https://www.youtube.com/watch?v=0uDFwZ_tlfs