Question:
Hi Jim: I read your mailbag every week; thank you for all the assistance it provides. My question is I just received my disability claim back and received 10% for CAD (Vietnam/A.O.) My echocardiogram showed mild left atrium dilatation (5.3cm compared to normal value of 3.0-4.0. The VASRD has a 30% rate for dilatation. What am I missing? Unless they are referring to the left ventricle and not the heart in general.
Jim's Reply:
Thanks for your kind words. The VA rates Coronary Artery Disease (CAD - also called Ischemic Heart Disease - IHD) by the impact the disease has on the left ventricle (LV) of the heart. The LV is the big pump of the 4 chambers of the heart and is the most affected part of the heart when we're talking about ischemia or a lack of fresh blood supply to the muscle of the heart itself. The ability of the LV to pump is measured in METS or by Ejection Fraction. When we look at The Schedule For Rating Disabilities, we find section 4.100 - 4.104 - The cardiovascular System and from there we drill down to 7005 Arteriosclerotic heart disease and you can see that there is no reference made to any other chambers of the heart. In other words, in the opinion of the VA, the findings of a mild left atrial dilation isn't associated with your IHD rating and is an incidental finding.