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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey, guys. It's Leah Bee here from Prestige Veteran Medical Consulting. I am a US army veteran, physician assistant, and former compensation and pension examiner. So if you've ever looked at your VA disability rating for a heart or respiratory condition and wondered what are meds and why do they matter, this video is for you. So today, we're gonna break down what meds are, how they've been used in VA ratings, and how they are currently used in VA ratings, and what you can expect during a mets based exam.
Leah B:So what are mets? Mets stands for metabolic equivalence of CASK. It's a way to measure how much energy or oxygen your body uses during physical activity. One MET is the amount of energy used when you're resting, like sitting quietly as activity increases, so do your METs levels. So for example, light activities like dressing or eating use about one to three Metz.
Leah B:Moderate activities like walking briskly or lightly, or doing lighthouse work uses around four to six Metz. More strenuous activity like jogging, climbing stairs, or heavy lifting can reach seven METs or higher. In short, METs measure your exercise tolerance, how much effort your body can handle before your you experience fatigue, shortness of breath, or chest pain. So how the VA uses mets in disability ratings? The VA uses mets to help determine the severity of cardiovascular and some pulmonary conditions, including things like coronary artery disease, or ischemic heart disease, heart failure, valvular heart disease, hypertensive heart disease, certain arrhythmias.
Leah B:Your METs level helps the VA assign a rating under diagnostic code for whatever that condition is, under the schedule of cardiovascular disabilities. So here's a general idea of how METs levels correspond to disability ratings, but actual actual codes may vary slightly depending on diagnosis. Okay? So at the 100% level rating, veterans that have symptoms such as heart failure or an activity of three mets or less cause fatigue, shortness of breath, chest pain, or dizziness. The 60% rating level is when activities are at the four to five mets level and cause those same symptoms or if there's evidence of certain structural heart diseases or reduced ejection fraction.
Leah B:The 30% rating is when symptoms occur with activities at six to seven mets, for example, while walking briskly, climbing one plate of stairs, or mowing the lawn. The 10% rating level is when symptoms only appear when more strenuous activity around eight to 10 mets such as jogging or heavier workload occur. Essentially, the lower your mets level, the more severe your condition is gonna be, and likely the higher functional impact that you're gonna have and the higher your potential rating is gonna be. So for METs testing, what can you expect? So during a C and P exam or a medical evaluation, your METs may be measured, one of two ways.
Leah B:So you can have an exercise stress test on, like, a treadmill or a bike. You can walk or pedal while your heart rate, blood pressure, and oxygen use are monitored. The test measures how much physical activity you can perform before you start developing symptoms like shortness of breath, chest pain, dizziness, or fatigue. There there can also be interview based METs testing, or estimates. If you can't safely do a stress test, for example example, due to mobility or cardiac risk, the examiner may estimate your METs level based on your daily activity tolerance.
Leah B:They'll ask you about things like what you can do comfortably, things like walking distances, climbing stairs, or doing chores, and then they're gonna match those activities to the approximate METs levels. Either method helps gauge your functional capacity, how limited you are in daily life due to your heart or respiratory condition. So understanding mets, and other cardiac evidence. Right? So mets are just one piece of the puzzle.
Leah B:The v also considers additional objective data, like your ejection fraction from an echocardiogram. That's a very non again, it's objective. So it's based on measurements of how much of that, you know, how much is your heart pumping out in each beat. Right? So BNP or other levels can be like, different biomarkers can be measured for heart failure.
Leah B:Imaging, results like cardiac cath or CT angiography and documented symptoms like edema, fainting, or fatigue. Together, this evidence paints a picture of how your heart functions and how much your condition impacts your ability to work and live comfortably. So some things to consider when you're preparing for, your exam based on your meds. So if you've if you have an upcoming C and P exam involving meds, you might wanna bring a list of your current medications, especially for heart or lung conditions. Be honest about your activity limitations.
Leah B:Don't downplay your symptoms. Tell the examiner what happens during regular activities, not just on your best days. Report any recent hospitalizations or test results so they can be added to your record. Stop the test immediately if you feel chest pain, dizziness, or shortness of breath. Your safety always comes first, and and make sure that you're articulating that to the health care professional that you're seeing.
Leah B:You know, make sure that you consider working with an accredited legal professional. So if you've had a MET space exam and your results don't seem to reflect your true condition, it can help to work with an accredited VA representative. These include people like VA accredited attorneys, agents, and veteran service officers who understand how medical evidence, including METs levels, translate into disability ratings. You can find accredited professionals during the VA's, by using the VA's official database at va.gov/0gc/apps/accreditation or through organizations such the d a such as the DAV or the Disabled American Veterans, the American Legion, Veterans of Foreign War, or the VFW, or you can just check out your local veteran service office. They can help you challenge inaccurate results or submit new evidence, including, independent medical opinions or, other details that may be important if your MET's estimate seems inconsistent with your limitations.
Leah B:So MET's testing just plays a super key role in how VA rates most heart conditions and some lung conditions, but it's not the only factor. Understanding how these measurements work can help you better advocate for yourself during exams and throughout the claims process. So I hope this video was helpful to to some of you guys. Please like and subscribe. We've got a ton of other cardiac and, pulmonary related videos.
Leah B:If you'd like to see specific conditions, and how these MET scores can apply, please check those out. And as always, thank you for watching. K. See you guys later.