Matthew: Hello, and welcome to the Hill and Ponton Veterans video blog. I’m Matthew Hill.
Carol: I’m Carol Ponton.
Matthew: We’re here to talk to you today about heart claims. Ever since the VA passed the new legislation on Nehmer cases, or what we all know as Agent Orange cases, and finally admitted that Agent Orange causes heart disease, the number of heart claims has increased dramatically.
What we’ve been seeing at Hill and Ponton is, after the VA concedes that the veteran has heart disease, they’ve been underrating the veteran. Meaning, they say, “Okay, you have this,” but then they don’t rate it properly.
I just want to give you a quick synopsis on how the rating works. The VA looks to what are called METs. It’s a fancy medical term which essentially means what your energy equivalent is, what you’re able to do physically. There are two ways to measure METs. The first way is a nuclear stress test, which is essentially an objective way of doing that.
Carol: You actually are exercising, but they have all kinds of things hooked up to your body to see exactly how stressed your body is and how much it is able to work. You get a grade. You get how many METs you were able to achieve.
Matthew: The other way is for an examiner to subjectively assign METs just based on the examiner’s conversation with the patient, with the veteran. To give you a rundown, the VA groups the METs. The higher the METs, the more physically active you are, the healthier you are.
The VA says 1 to 3 METs, for example, the veteran receives 100% rating. I think 3 to 5 is 60% and 7 to 10 is 30% rating. But what they don’t tell the veteran is the VA examiner is given a sheet to fill out. That examiner is supposed to look at activities the veteran is doing.
For example, to show that a veteran’s METs are from 7 to 10, that would be the equivalent of being able to climb stairs quickly, moderately going on a bicycle ride, or jogging at six miles an hour. If you’re able to do that, you are rather healthy.
When you get down from 5 to 7 METs, the VA says, that’s equivalent of walking one flight of stairs, golfing without a cart, mowing your lawn with a push mower (the push mower being without a motor) and then doing heavy yard work.
What the VA examiner is supposed to do is check the box that reflects the lowest activity you as the veteran can do before you start getting symptoms of dizziness, of fatigue.
Carol: Shortness of breath.
Matthew: Problems like that. The problem I’ve seen with this is the veteran will go in and have an exam and the VA will check a box saying that he’s got 5 to 10 METs, saying that he can golf without a cart or he can push a mower without a motor.
I’ll talk to the veteran and I’ll say, “What’s the most active thing you do?”
They’ll say, “Sometimes I mow my lawn.”
I’ll say, “Okay. Was that a lawnmower without a engine?”
They’ll look at me and laugh and say, “No. I have a sit-on, ride-on lawnmower because I can’t walk very far.”
It’s important for you, when you go into these exams and they’re measuring what your rating should be that you are thinking about, “What is the most strenuous thing I can do in a physical activity standpoint without having the symptoms of fatigue or dizziness?”
Carol: Also, you need to think of the qualifications. If they answer, “Yes, I can mow my lawn,” it’s fine with the examiner. He just checks the box. You need to make sure that any qualifications to what you can do are noted and made very clear to the examiner: “But it has to be a riding lawnmower. Sometimes I can’t even do that because of the sun. I just become fatigued and I start getting chest pains.” Anything he asks you, if it’s something that’s “yes but,” make sure you go ahead and make sure you tell him all the limitations you have of that.
Matthew: On that note, I would strongly recommend for male veterans having heart pains that they bring their wives. I can’t tell you how many vets I’ve spoken with where they say, “Yeah, I can go out and mow my lawn,” and say it as if it was nothing, and then the wife will chip in and say, “Yes. But he’s in bed for the rest of the day.”
Matthew: I found that it’s very important to have a wife there or someone who sees the veteran on a day-to-day
basis because sometimes the vet doesn’t even realize his limitations.
Carol: Sometimes men don’t like to admit that there are some problems and it hurts them. That’s really not fair to anyone.
Matthew: As Carol says, they’re going to check a box. The VA examiner has more patients to see, other things going on. They’re not going to probe and see what’s really going on. It’s important that you think about that when going in. Even if you can do an activity, even if you can go out and jog, if that makes you have to go to bed for the rest of the day or it really destroys your physical abilities after that, you need to keep that in mind.
Thank you for joining us here on this blog about heart disease. It’s important to remember the least physical activity you do when you get symptoms and bring your spouse/significant other when you do go to the exam.