I've got 9 years, looks like I am going to be diagnosed with Pulmonary Hypertension. Have already had a heart cath, and many other tests done. I have been to the ER over the past year many times. Lots of doctors visits.
I get out of breath very easy, heart pounds, tired all the time, right heart is enlarged, panic attacks (related to the condition). I have good days and bad. This disease only gets worse and I am already having trouble doing my job and can't pass the PT because of it.
I have a family and am wondering what am I looking at? A medical retirement? If so, what am I looking at as far as retirement pay? Any help would be appreciated.
You will be separated from the service at some point. I am very familiar with the disease, and my VA has a very good specialist.
What are your PFT numbers, so I can tell you the rating. You will probably be retired but because it is not considered a combat injury and you do not have 20 years, you will probably get 100% VA compensation. Also, you will get Tricare for your family, and at 100% Permanent and Total, your children get education assistance.
VA is about $2,800 a month tax free.
Thank you for responding Dave.
My PFT (pulmonary function test) shows mild to moderate COPD. I'm not sure of the numbers. My right heart is weak and dilated, apparently activity makes it worse.
I did look up the VA schedule of ratings and saw that Pulmonary Hypertension was 100%.
Is it safe to assume that I will be rated 100% for this? Is this in addition to my COPD?
From what I understand about this disease is that exercise/ strenous activity makes it worse and overworks your heart. Eventually this disease kills you.'
Also would like to say that I have never smoked.
They only rate one lung disease. Although pulmonary hypertension is a hybrid lung/heart disease, they will not rate COPD also. To get over 100%, you need unrelated diseases and they will not do that with these two diseases.
And to get SMC you need the 100% plus 60% additional, and they must be unrelated. Then you get an extra $300.
I know the disease. I have a lung disease and I know the PH expert at the VA/University Hospital.
I would expect that sometime in the near future your doctor will do an MEB to start the separation process.
Are you sure it is PH and not a heart problem? What testing have you had? The reason I ask is that a failed valve will produce the same results as PH. I know, my wife had to have a valve replaced.
Thank you again for responding and for all the helpful information.
The cardiologist and lung doctor both state there are increased pressures in the right aside and enlargement however there are no valve problems with my heart.
Have had other tests done echo's, right heart cath, and various CT scans with nuclear medicine.
Echo's and cath said high pressures in right side of my heart.
How long does the process take from reporting to Commanding officer to MEB and discharge?
That depends. It can take a few months or longer.
Does it matter what my PFT score is?
I understand that Pulmonary Hypertension affects the heart and lungs differently than a disease like COPD or emphysema. My capacity can be good, but exercise and strenous activity damages the heart and lungs further.
From what I read on the VA schedule of ratings, they give a 100% for a diagnosis of Pulmonary Hypertension regardless, is this correct?
From the VA website:
6817 Pulmonary Vascular Disease:
Primary pulmonary hypertension, or; chronic pulmonary thrombo-
embolism with evidence of pulmonary hypertension, right
ventricular hypertrophy, or cor pulmonale, or; pulmonary
hypertension secondary to other obstructive disease of pulmonary
arteries or veins with evidence of right ventricular hypertrophy or
cor pulmonale 100
Chronic pulmonary thromboembolism requiring anticoagulant therapy,
or; following inferior vena cava surgery without evidence of
pulmonary hypertension or right ventricular dysfunction 60
Symptomatic, following resolution of acute pulmonary embolism 30
Asymptomatic, following resolution of pulmonary thromboembolism 0
It also talks about how to rate conditons, and I noted that Pulmonary Hypertension diagnosed by echocardiogram and heart cath don't require further tests.
(d) Special provisions for the application of evaluation criteria for diagnostic codes 6600, 6603, 6604, 6825–6833, and 6840–6845.
(1) Pulmonary function tests (PFT’s) are required to evaluate these conditions except:
(i) When the results of a maximum exercise capacity test are of record and are 20 ml/kg/min or less. If a maximum exercise capacity test is not of record, evaluate based on alternative criteria.
(No. 41 9/25/06)
4.96- §4.96—Special provisions regarding evaluation of respiratory conditions 4.96-
(ii) When pulmonary hypertension (documented by an echocardiogram or cardiac catheterization), cor pulmonale, or right ventricular hypertrophy has been diagnosed.
(iii) When there have been one or more episodes of acute respiratory failure.
(iv) When outpatient oxygen therapy is required.
No, PFT does not matter with PHT. The rating will be based on how your diagnosis matches the criteria.
It has been a while since I posted. I've got over 10 years now.
Since I've been seeing civilian doctors,due to where I'm stationed (no military base nearby) nobody in the service has bothered to ask any questions about what's going on with me.
I don't have to do any PT in my job. I'm an E6. It's not required of me in the job I'm doing right now. If I did I would fail.
My mean pulmonary artery pressure at rest per the heart cath is 27. This was a year ago.
They put me on Xanax and Celexa for the panic attacks. Also, my COPD is at the 30% level per the chart for Disability Ratings. The panic attacks have quit since I am taking this medicine. I think the panic attacks are 30% as well, as I have them weekly without medicine. No drugs for the COPD, I refused the inhaler he wanted me to use due to side effects.
The lung doctor I'm seeing still wants me to keep having more echo's of my heart. He wants to monitor the condition to see if it gets worse. Having another one in a couple months.
I maintain my own medical record because of where I'm stationed.
I put all the information from the doctors in my medical record. I'm not hiding anything.
When they see the latest paperwork that diagnoses me with this disease, what is going to happen.
1351 - You don't say which branch of the service you are in, but I believe the time estimations I'll put out here apply pretty much across the board. The DoD and VA have been combining their disability ratings processes for MEBs for the past several years.
The system is less redundant (only one physical, done by the VA, for example - not one by the military branch then another by the VA) and only one disability rating. That's the good news. The bad news is that the process is now taking LONGER than before - up to two years from beginning of MEB to final separation from the military. Average is about a year now.
You really should get yourself to a MTF to get a permanent profile and initiate the MEB. Your condition will not go away, and if (God forbid) you should die while on active duty, your family's benefits are far less than if you had been medically separated - especially at 100% total and permanent.
Your civilian doctors have no knowledge or understanding of what an MEB means to your long-term financial well-being. They're treating you as just another civilian in a regular civilian job - and that is simply not the case.
You are shooting yourself in the foot by not moving forward into the MEB. Good luck to you.
Since my heart cath and echo's where all done by civilian specialists.
Will the military make me do them again by military doctors?
I really don't want to undergo the heart cath again.
Also, by looking at me, I look perfectly healthy. Would they actually give me 100% VA disability rating for my Pulmonary Hypertension?
The VA will give you a 0 to 30% given your description. Panic attacks are secondary to the lung disease, so they probably will not be rated as medications controls them.
They probably will do echos and not a cardiac cath until they are doing a MEB.
I thought Pulmonary Hypertension was automatically 100%?
I was just reading a BVA case, and it is not automatic 100%. Also, if you use the Social Security standards, your Mean pulmonary artery pressure would have to be greater than 40 mm Hg. At 27, you do not meet the standard of disability for 100%. Given the Severity Scale, 27 is not even mild - it is very mild.
Pulmonary Hypertension Severity Scales
Systolic pulmonary artery pressure
Normal : 18 to 25 mm Hg
Mild : 30 to 40 mmHg
Moderate : 40 to 70 mm Hg
Severe : >70 mmHg
And I assume you have secondary pulmonary hypertension as a result of the lung disease, so I think they will rate the lung disease severity but that is my guess. If you are fit for duty, then it is an non-issue at this time.
Dave and Cider, thank you for your help. You guys are great.
13511 - If your heart cath and other invasive studies are relatively recent (+/- a year), then you would not likely have to repeat them. If you have CD/DVD copies of those exams, that would also be very helpful to those looking at your case.
I don't blame you - those aren't the sorts of exams one likes to repeat too often!
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