Pacemaker questions?

M

Mac2815

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Registered Member
I may be getting a pacemaker in the near future due to sick sinus syndrome and I am wondering 1. Is this a M.E.B/P.E.B 2. If so how much of a % of disability is this. Thank you all for the help.
 
Yes they will med board you, and if it is only a pacemaker it is 30% (off the top of my head). Now if they put an AICD in, then it is 100%. So I would make sure you know what equipment they are going to use because you can see a dramatic increase in $.
 
Thanks for the quick response and yes mine is for sure going to be a pace maker to control sinus bradycardia. I am fortunate enough not to need an AICD.
 
I can't imagine that it would be 10%. Who wants to be the legislature who has to explain why a veteran had to pay 20K to get his pacemaker replaced 15 years after separation. No, I think the 30% sounds right based on the VASRD and on the assumption of future medical complications. I am also possibly getting a pacemaker for vaso vagal, after having a recorded asystole event in july. Yup, flatlined for 9 seconds...
 
Here are the codes for most "pacemaker" issues. You have to look at whether it is a "pacemaker" or an AICD...also, don't forget to consider the residual or other disability rated on METS and other criteria.

7011 Ventricular arrhythmias (sustained):

For indefinite period from date of hospital admission for initial evaluation
and medical therapy for a sustained ventricular arrhythmia, or; for
indefinite period from date of hospital admission for ventricular
aneurysmectomy, or; with an automatic implantable Cardioverter-
Defibrillator (AICD) in place........................................................................... 100

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent.......................... 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or; left
ventricular dysfunction with an ejection fraction of 30 to 50 percent............... 60

Workload of greater than 5 METs but not greater than 7 METs results in
dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray................................................................................... 30

Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or;
continuous medication required.......................................................................... 10

Note: A rating of 100 percent shall be assigned from the date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter.


7015 Atrioventricular block:

Chronic congestive heart failure, or; workload of 3 METs or less results
in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent.......................... 100

More than one episode of acute congestive heart failure in the past year,
or; workload of greater than 3 METs but not greater than 5 METs
results in dyspnea, fatigue, angina, dizziness, or syncope, or;
left ventricular dysfunction with an ejection fraction of 30 to
50 percent........................................................................................................... 60

Workload of greater than 5 METs but not greater than 7 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of
cardiac hypertrophy or dilatation on electrocardiogram,
echocardiogram, or X-ray................................................................................... 30



Workload of greater than 7 METs but not greater than 10 METs results
in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous
medication or a pacemaker required................................................................... 10

Note: Unusual cases of arrhythmia such as atrioventricular block associated with a supraventricular arrhythmia or pathological bradycardia should be submitted to the Director, Compensation and Pension Service. Simple delayed P-R conduction time, in the absence of other evidence of cardiac disease, is not a disability.


7018 Implantable cardiac pacemakers:

For two months following hospital admission for implantation or
reimplantation................................................................................................... 100

Thereafter:

Evaluate as supraventricular arrhythmias (DC 7010), ventricular
arrhythmias (DC 7011), or atrioventricular block (DC 7015).
Minimum............................................................................................................. 10

Note: Evaluate implantable Cardioverter-Defibrillators (AICD’s) under DC 7011.

7010 Supraventricular arrhythmias:

Paroxysmal atrial fibrillation or other supraventricular tachycardia, with
more than four episodes per year documented by ECG or Holter
monitor................................................................................................................ 30

Permanent atrial fibrillation (lone atrial fibrillation), or; one to four
episodes per year of paroxysmal atrial fibrillation or other
supraventricular tachycardia documented by ECG or
Holter monitor.................................................................................................... 10
 
Oh, and the METS test administered is often faulty. That is a whole other issue.
 
wow what crap is that, well at least it is 10% and not nothing, Jason is it still the standard that you get put on TDRL for 18 months after a pacemaker?
 
I would say it depends on the facts of the case (i.e., how long the pacemaker has been implanted at time of PEB, overall prognosis (and recommendation of NARSUM/physicians), which branch (I think the AF is more likely to find PDRL than other branches), other conditions and their ratings, and probably other factors that impact overall outcome).
 
Jason,
I just got diagnosed with POTS and I am getting a pacemaker because of unexplained asystole events that I have been having 3-6 times a year since 2006. I have other conditions as well. Currently I just recieved my MEB decision of my appeal after being in the IDES system for 18 month. I was given a Return to Duty and my profile went from a PULHES of 333113 to 131111. The MEB doctor was adamant that I did not have syncope. They never interogated my implanted recorder that showed a 9 second flat-line in July. Currently my Congressman has just sent a formal request to the Army Liason General's Office asking for a full review of my MEB and for parts of my medical file to be stricken from record due to improper procedures. I am just trying to figure out what this whole pacemaker thing will result in. I have lost most faith in our military disability system...
 
John, hang in there, several other Soldiers feel the same way you do. I am at the point where our military medical is questionable itself, but for now i will just go with the flow and eventually get the results i deserve, you should also use your resources and one of them is the ombudsman if you feel you are not getting a fair decision. I hope that helps.
 
The ombudsman was useless, my appeal was elegant and heavy, it too was useless, the Northern Regional Medical Command IG was useless, hopefully the inquiry from Congress will help. The funny thing is my PCM is putting me in for another MEB as soon as I send him the results indicating my need for a pacemaker
 
My Congressional Inquiry has had some legs. Obviously this was spurred on by the fact that the inquiry pointed towards an incompetence of medical care and the entire cardiology department at John's Hopkins agreed that the best course of action was to implant a pacemaker. So I just had the surgery on Wednesday, I am recovering OK. On the previous day the LTC in charge of the MEB at Ft Meade called my electrophysiologist to ask if my surgery was really "necessary." I mean seriously, tricare approved a 40K procedure that was approved by 7 cardiologists who are all from the nations #1 ranked hospital for the last 20 years (John's Hopkins), and this guy waits to question the surgeon the day before the procedure? Get real. My JAG just sent a letter to my commander expressing her opinion that I would be much better served in the CBWTU since it would move my future MEB/PEB to Ft Eustis and not back to Ft Meade... fingers crossed. Oh and the final diagnosis for the pacemaker was sick sinus syndrome. My last asystole pause was 9 seconds...
 
Hope the surgery and your recovery goes well! Best of luck to you with everything!
 
Jason said:
Hope the surgery and your recovery goes well! Best of luck to you with everything!
Click to expand...
A bit of hillarity just occured. I just came back to work after my con leave for my pacemaker surgery. My doctor is in the process of submitting paperwork for yet another MEB and we are trying to get me into the CBWTU. I was just informed this morning that my brigade is trying to chapter me on "failure to qualify with my weapon". I was RTD on my last MEB in FEB, still with my profile stating I am unable to fire my weapon.

I have not qualified with my weapon since MAR 2010, but I have been on a constant profile for possible loss of conciousness, deeming me unable to fire my weapon. This is just their MANTRA now, find a guy FIT and find him UNNATAINABLE at the same time to save the ARMY money.

If the BAR is accomplished before 28 May than the commander will have full authority over my chapter, if it is done after 28 May I will have 10 years active duty and it will have to go to a board at HRC. My DR and JAG are trying to get me into the CBWTU-VA. The LTC for that unit has been very supportive, I hope this helps spurr that along. Its sad that a RED number on a QTB slide is more important that a Soldiers longterm health and welfare.
 
Good news, just got my preliminary and I have been found unfit by the PEB. It only took 775 days for them to figure this out. They found me unfit for 2 out of 15 conditions. Sinus Node Disfunction/pacemaker and what they are calling irritable bowel disorder/disease.

Jason, I have a question though. On my VA C&P the doctor quantified my hypothyroidism with all the definitions found in the 100% rating... should I expect the same on the rating itself?
 
John Bittner said:
Good news, just got my preliminary and I have been found unfit by the PEB. It only took 775 days for them to figure this out. They found me unfit for 2 out of 15 conditions. Sinus Node Disfunction/pacemaker and what they are calling irritable bowel disorder/disease.

Jason, I have a question though. On my VA C&P the doctor quantified my hypothyroidism with all the definitions found in the 100% rating... should I expect the same on the rating itself?
Click to expand...

It sounds like you should...but you have to look to the VA proposed rating decision letter to know what they find. Good luck!
 
got my rating back. 20% for the pacemaker just because there was a slight enlargment of the heart. with everything else that they found on my C&P exam i ended up with 50% DOD and 80% VA with 1 condition still being concidered by the VA.
 
My husband is active duty USAF and has been in for a little over 10 years. He has recently been diagnosed with Sinus Arrest, Sinus Bradycardia, Ventricular Tachycardia, and he has a first degree AV Block. He had to wear the moniter for just shy of 30 days and had a stress test and echocardiogram done. They implanted a Pacemaker last Monday. We are just wondering what happens next and what we can expect to come from all this. We never in a million years thought this would ever happen, especially not at 31 years old. He is in the Plumbing shop of CE Squadron. Can anyone tell me where we go from here??? Does this mean they will make him get out? If so, what kind of benefits will he have after that? Any input is much appreciated. We feel like our world has been turned upside down!
 
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