Valvular Disease MEB Update

carnelli53

Moderator
PEB Forum Veteran
Registered Member
Hello again,

I just wanted to shoot an update and ask a question or two. I was diagnosed with aortic stenosis, aortic insufficiency, bicuspid aortic valve, and mitral valve prolapse (all symptomatic). I had my MEB physical today and told the PA that I also had trouble sleeping through the night (which I do). The NARSUM from the doctor can't be done until after a sleep study.

But anyway, in the copy I was given it states 'aortic stenosis rehumatic with insufficieny' and 'prolapsing mitral valve leaflet syndrome'. How are these rated by the Army or VA? I can't make sense of the rating system for the stenosis and insufficieny, I know I had between an 8 and 10 METS. I can't find anything on mitral valve prolapse.

I was also wondering the timeframe once the NARSUM is completed. How long does the IPEB process take? If I agree to their findings how long after that? If I don't agree to their findings what is the timeframe on the formal PEB?

I know my questions are probably asked one hundred times over for various individuals but I appreciate any points here. Thanks much.

Addendum: The physical also determined I do not qualify for military service.
 
I am not sure why the ratings for heart conditions isn't up in the conditions area as that is where I got ours. Below is the section on valve disease let me know if you want the whole section.

Ryan had a valve replacement a year ago so if you ever have any questions let us know. We are waiting for our results from the IPEB after a year and a half! Good luck and make sure you take care of yourself.
Theresa

[FONT=&quot]§4.104 Schedule of ratings—cardiovascular system.[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot]Diseases of the Heart[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] Rating[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot]Note 1[/FONT][FONT=&quot]: Evaluate cor pulmonale, which is a form of secondary heart disease, as part of the pulmonary condition that causes it.[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot]Note 2[/FONT][FONT=&quot]: One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used.[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot]7000[/FONT][FONT=&quot] Valvular heart disease (including rheumatic heart disease): [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] During active infection with valvular heart damage and for three [/FONT]
[FONT=&quot] months following cessation of therapy for the active infection ...................... 100 [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] Thereafter, with valvular heart disease (documented by findings on [/FONT]
[FONT=&quot] physical examination and either echocardiogram, Doppler [/FONT]
[FONT=&quot] echocardiogram, or cardiac catheterization) resulting in: [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] Chronic congestive heart failure, or; workload of 3 METs or less [/FONT]
[FONT=&quot] results in dyspnea, fatigue, angina, dizziness, or syncope, [/FONT]
[FONT=&quot] or; left ventricular dysfunction with an ejection fraction of [/FONT]
[FONT=&quot] less than 30 percent........................................................................................... 100[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] More than one episode of acute congestive heart failure in the past [/FONT]
[FONT=&quot] year, or; workload of greater than 3 METs but not greater than [/FONT]
[FONT=&quot] 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, [/FONT]
[FONT=&quot] or; left ventricular dysfunction with an ejection fraction of [/FONT]
[FONT=&quot] 30 to 50 percent.................................................................................................. 60 [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] Workload of greater than 5 METs but not greater than 7 METs results [/FONT]
[FONT=&quot] in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of [/FONT]
[FONT=&quot] cardiac hypertrophy or dilatation on electro-cardiogram, [/FONT]
[FONT=&quot] echocardiogram, or X-ray................................................................................... 30 [/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot] Workload of greater than 7 METs but not greater than 10 METs results [/FONT]
[FONT=&quot] in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous[/FONT]
[FONT=&quot] medication required............................................................................................ 10 [/FONT]
[FONT=&quot] [/FONT]
 
Thanks for the info, I really appreciate it. Just a curiousity question, what if the METS is over 10 on a stress test? There is another guy getting out right now with a similar condition and his METS is 13.5.

Also...I notice there is nothing on mitral valve prolapse. I've looked through the VA Ratings over and over. I know this condition is in AR 40-501. I know it is also rated if symptomatic, which mine is. Any suggestions?
 
Quick question, I saw some information that confused me. If you are rated under 30 percent and have less than three years of service, are you still eligible for severance pay under the 2 x years of service x average base pay formula? Thanks again.
 
Yes, the minimum number of years calculation is 3 years, so that equates to a minimum of 6 months base pay.
 
So with 24 months of service and a rating under 30 percent would constitute 6 months base pay? I'm terrible with numbers I apologize for not tracking you clearly Jason.
 
No problem. Yes, the severance calculation would be 6 months of base pay.
 
This is just a question I am throwing out there due to the fact that I can find no actual rating for this condition in the VASRD: Prolapsing Mitral Valve Leaflet Syndrome (symptomatic).

This condition is listed on my phase 2 physical, along with the other conditions I have already mentioned before. I have googled searched the web, this site, hadit.org, among other veteran's disability forums and can not find any kind of rating criteria for it. It is not listed in the VASRD anywhere in the 70xx section (Cardiovascular System) so I am unsure if they use METS to rate this condition (honestly I hope they don't).

Due to being stonewalled by the apparent lack of information in the resources I normally utilize, I went back to the VASRD in the reply Mandy posted earlier in this thread and noticed:

Note 1[FONT=&quot]: Evaluate cor pulmonale, which is a form of secondary heart disease, as part of the pulmonary condition that causes it.[/FONT]

So I did a little research on what this entails. I am not a doctor and cannot make much sense of how this evaluation can objectively determine a rating. If anyone has experience or knowledge of how this is evaluated by the PEB I would appreciate your insight.
 
Top