PEB/Heart Disease

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ifly223

PEB Forum Regular Member
I had a stent implant put in last April. Finally almost a year later I received my findings from the PEB. I was only given 10% disablility and severance. 10% seems very low to me for heart disease. I still have other blocked arteries that will require meds and periodic monitoring. Anyone know of others receiving such a low rating for heart disease?
 
What code were you rated under? Did you take a stress test (on a treadmill)? How may METS did they say you were able to perform? What did they write (if anything) as a basis for your rating?
 
I was rated at 7 mets on a non nuclear stress test. I have not been counseled ever with regards to an MMRB. I dont know what code I was rated under. I meet with my counselor on Monday at 1400 to verbally rather than a brief phone conversation to fully understand what San Antonio decided.
 
ifly223 said:
I was rated at 7 mets on a non nuclear stress test. I have not been counseled ever with regards to an MMRB. I dont know what code I was rated under. I meet with my counselor on Monday at 1400 to verbally rather than a brief phone conversation to fully understand what San Antonio decided.
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Also, please understand that in my NARSUM the Cardiologist had written that not only did I have a stent implant to correct a blocked artery, that there are two other arteries blocked at 40% and other non obstuctive diseased arteries. It was written in my NARSUM that this occured while on Active Duty. Not before coming back into military service.
 
If you are unfit, the criteria for 30% rating for your heart disease is "not greater than 7 METS." So, if you are at 7 METS, you should be retired.
 
May I inquire as to the nature of your heart disease? I am going through a MEB for heart disease as well and I took a nuclear stress test several months ago. I feel as if my condition has worsened since then, only reason I mention this is because my METS was up around 13 when I originally took the test I am not sure it would be up around that number anymore.

Have you asked your PEBLO about taking another stress test? This could be an avenue of demonstrating your condition has worsened and is deserving of a higher rating. I am not sure if you are too far along in the process to do this (I imagine the time constraint doesn't work too well with scheduling a second stress test) but it is worth a shot. Also, I was told by my PEBLO that even if I received a 0 or 10 percent rating for the valvular disease since the METS is too high - symptomatic mitral valve prolapse is grounds for an automatic 30 percent.

Now I am by no means attempting to indicate my PEBLO is the "wise man on the hill" but he has yet to give me bad information. In my case, I will find out when my results come back from Fort Sam. For you, I would recommend perhaps appealing for a FPEB, seeing if you could get a new stress test, and ensure that your connected conditions (artery blockage, etcetera) are properly documented in your medical record so there is no confusion with the decision-makers over at Fort Sam.

EDIT: After reading your response again I noticed I glanced over where you stated your related conditions were in the NARSUM. Do you have any additional documentation from a cardiologist describing these conditions? I am not sure what kind of weight supplementary evidence has with the PEB as I am new to this process like most people here. Perhaps that is something you should bring up with your PEBLO tommorow.
 
carnelli53 said:
May I inquire as to the nature of your heart disease? I am going through a MEB for heart disease as well and I took a nuclear stress test several months ago. I feel as if my condition has worsened since then, only reason I mention this is because my METS was up around 13 when I originally took the test I am not sure it would be up around that number anymore.

Have you asked your PEBLO about taking another stress test? This could be an avenue of demonstrating your condition has worsened and is deserving of a higher rating. I am not sure if you are too far along in the process to do this (I imagine the time constraint doesn't work too well with scheduling a second stress test) but it is worth a shot. Also, I was told by my PEBLO that even if I received a 0 or 10 percent rating for the valvular disease since the METS is too high - symptomatic mitral valve prolapse is grounds for an automatic 30 percent.

Now I am by no means attempting to indicate my PEBLO is the "wise man on the hill" but he has yet to give me bad information. In my case, I will find out when my results come back from Fort Sam. For you, I would recommend perhaps appealing for a FPEB, seeing if you could get a new stress test, and ensure that your connected conditions (artery blockage, etcetera) are properly documented in your medical record so there is no confusion with the decision-makers over at Fort Sam.

EDIT: After reading your response again I noticed I glanced over where you stated your related conditions were in the NARSUM. Do you have any additional documentation from a cardiologist describing these conditions? I am not sure what kind of weight supplementary evidence has with the PEB as I am new to this process like most people here. Perhaps that is something you should bring up with your PEBLO tommorow.
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I will not sign the PEB findings tomorrow. I will get them from my PEBLO and see an MEB lawyer. I simply went to an over 40 physical and they said my BP was up and told me to see my PA. She sent me on a cardiology consult. I had to see civilians for this because at the time Ft. Hood did'nt have a cardiology department as they do no. I made a mistake earlier. I am rated at 10 METS. However, earlier last year I was at 14 METS.
I went through all the normal tests and finally had a Heart Cath done. A 70% blockage was found and corrected with angioplasty and stent implant. Two other blockages were found at 40% and are being maintained with meds. In my NARSUM my military cardiologist also stated that I had other non obstructed diseased arteries.
 
ifly223 said:
I will not sign the PEB findings tomorrow. I will get them from my PEBLO and see an MEB lawyer. I simply went to an over 40 physical and they said my BP was up and told me to see my PA. She sent me on a cardiology consult. I had to see civilians for this because at the time Ft. Hood did'nt have a cardiology department as they do no. I made a mistake earlier. I am rated at 10 METS. However, earlier last year I was at 14 METS.
I went through all the normal tests and finally had a Heart Cath done. A 70% blockage was found and corrected with angioplasty and stent implant. Two other blockages were found at 40% and are being maintained with meds. In my NARSUM my military cardiologist also stated that I had other non obstructed diseased arteries.
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I think that is the best action you can take. I'm at Benning and I had to see a civilian cardiologist as well for all my diagnoses. The METS rating system is ridiculous for the cardiovascular system, it doesn't account for a lot of things. 7 to 10 METS gets you 10 percent according to the VA Ratings which is prepostorous. You should be looking at additional ratings for these arteries, but what kills me about all this is that the entire cardiovascular rating system is all based on METS. DoD instruction implicitly instructs the PEB not to 'pyramid' what can be considered clinically related conditions which leads to a case like yours being evaluated as if you were cured by this one magical stent.

It's almost as if the PEB received your case, saw you had blockage and then had a stent implanted, ignored your other arterial issues as connected to the original one that was surgically repaired, referenced the METS chart in the VASRD, saw 7 to 10, and threw 10 percent at you. Now pop smoke and get out of here! Absolutely ridiculous.

I agree with your protest be sure to update us tommorow after you visit your PEBLO and any legal counsel you meet with. I'm curious to know how this will all pan out for you. Good luck.
 
carnelli53 said:
I think that is the best action you can take. I'm at Benning and I had to see a civilian cardiologist as well for all my diagnoses. The METS rating system is ridiculous for the cardiovascular system, it doesn't account for a lot of things. 7 to 10 METS gets you 10 percent according to the VA Ratings which is prepostorous. You should be looking at additional ratings for these arteries, but what kills me about all this is that the entire cardiovascular rating system is all based on METS. DoD instruction implicitly instructs the PEB not to 'pyramid' what can be considered clinically related conditions which leads to a case like yours being evaluated as if you were cured by this one magical stent.

It's almost as if the PEB received your case, saw you had blockage and then had a stent implanted, ignored your other arterial issues as connected to the original one that was surgically repaired, referenced the METS chart in the VASRD, saw 7 to 10, and threw 10 percent at you. Now pop smoke and get out of here! Absolutely ridiculous.

I agree with your protest be sure to update us tommorow after you visit your PEBLO and any legal counsel you meet with. I'm curious to know how this will all pan out for you. Good luck.
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I will keep you updated. I signed the NARSUM on Tues. and had the results from the PEB phoned to me from my PEBLO on Fri. Its as if they did'nt even take time to look at everything.
They want us out so they can get new soldiers in. Im in 3rd Bde, 1st Cav and they made a big mistake. There were many soldiers undergoing MEB and were not sent to WTU. Instead they were made to go to field exercises. This had back fired on them since they are now deployed and are short on personnel.
 
I have the number of the MEB/PEB Outreach Counsel here at Ft. Hood. I confirmed on my NARSUM that I can only acheive up to 7 METS and no more. Therefore the rating should be 30%. After meeting with my PEBLO today about my PEB findings I will contact the counselor and start the appeal process. Thanks to the information found here I wont get screwed over.
 
ifly223 said:
I have the number of the MEB/PEB Outreach Counsel here at Ft. Hood. I confirmed on my NARSUM that I can only acheive up to 7 METS and no more. Therefore the rating should be 30%. After meeting with my PEBLO today about my PEB findings I will contact the counselor and start the appeal process. Thanks to the information found here I wont get screwed over.
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Hopefully they can help you out. Sounds like the PEB tried to shortchange you with an ambiguity in the VASRD language (5 but no greater than 7 METS = 30% / 7 but no greater than 10 METS = 10%). I assume the best course would to be to show that you are in fact under 7 METS in reality, i.e. when performing physical activity. This is a perfect example of the failure in the VASRD cardiac ratings. Good luck to you.
 
Got a call from my PEBLO yesterday. My military cardiologist and the PEB finally got together and got things straightened out. Here's the kicker though. I went from 10% with severance to being placed on TDRL. My next evaluation will be Aug. 2010. I will be 47 at that point.LOL What where they thinking. From what I understand its a minimum of 50% and max of 75% while on TDRL.
 
I am scheduled for a Cardiac work up at FT Gordon, they have me going for a echocardiogram and a meeting with the Cardiologist and thats it . you would thibk I would be sceduled for a METS test or stress test. I am having to Fly to Ft Gordon and really dont want to go back. Mt MEB is at FT Stewart but they said the dont have a Cardiologist their?
 
When I went through a MEB/PEB at Fort Benning, there was no cardiologist there either. However, I was treated by a civilian cardiologist off-post via TRICARE (he performed the echo/stress test, etc.).

I would seek this route in your case as well, it makes things infinitely easier when only having to travel a few minutes off-post for appointments. For diagnostic purposes, it is also easier to have all your tests done through one office. One thing that is not discussed in this post (which is interesting to review, as I was in the middle of my MEB at the time) is the impact an ejection fraction can have on cardiovascular ratings. Ejection fraction is estimated by your cardiologist and can be observed from an echo (becomes more accurate with a TEE) - my METS was over 10 but ejection fraction in the 30-50 range. The PEB ended up retiring me with a 60% rating.

What type of heart disease have you been diagnosed with? I have a congenital heart defect - bicuspid aortic valve.
 
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