cannot determine METs states that LVEF testing evaluate based on attributable to an SC renders a more accurate LVEF shown on cardiovascular finding regarding examination. disability due to the cardiovascular effects of NSC manifestations alone conditions cannot determine METs does not state that resolve reasonable attributable to an SC LVEF testing renders a doubt in the Veteran’s cardiovascular more accurate finding favor and evaluate disability due to the regarding based on the evidence effects of NSC cardiovascular that is most conditions manifestations advantageous to the Veteran. n. Granting SC If additional arteriosclerotic manifestations are subsequently diagnosed in a for Veteran with SC hypertension, SC on a secondary basis through the Arteriosclerotic relationship to hypertension for any of the following Manifestations Due to cerebral arteriosclerosis or thrombosis with hemiplegia Hypertension nephrosclerosis of the kidneys with impairment of renal function, or myocardial damage or coronary occlusion of the heart. A claim for benefits is required to adjudicate a secondary SC Important: claim for any of the arteriosclerotic manifestations. Notes: Do not address SC for the above-listed cardiovascular conditions through the relationship to the hypertension when a sympathetic reading of the claims does not show a claim for SC for a heart condition. Arteriosclerosis occurs with advancing age without preexisting hypertension, and may occur in some younger individuals who are predisposed to arterial changes. The existence of arteriosclerosis does not imply/indicate prior hypertension. For more information on References: secondary SC, see M21-1, Part IV, Subpart ii, 2.B.5 intent to file and informal claims, see M21-1, Part III, Subpart ii, 2.C.1 reopened claims, see M21-1, Part III, Subpart ii, 2.D, and claims for increase, see M21-1, Part III, Subpart ii, 2. E. o. Effective The effective date of any grant of SC for arteriosclerotic manifestations Dates of secondary to hypertension is the date of claim or date entitlement arose, Arteriosclerotic whichever is later. Manifestations Granted Arteriosclerotic manifestations are not considered a worsening of Important: Secondary to hypertension. Therefore do not apply Hypertension
cannot determine METs attributable to an SC cardiovascular disability due to the effects of NSC conditions states that LVEF testing renders a more accurate finding regarding cardiovascular manifestations alone evaluate based on LVEF shown on examination. cannot determine METs attributable to an SC cardiovascular disability due to the effects of NSC conditions does not state that LVEF testing renders a more accurate finding regarding cardiovascular manifestations resolve reasonable doubt in the Veteran’s favor and evaluate based on the evidence that is most advantageous to the Veteran. n. Granting SC for Arteriosclerotic Manifestations Due to Hypertension If additional arteriosclerotic manifestations are subsequently diagnosed in a Veteran with SC hypertension, SC on a secondary basis through the relationship to hypertension for any of the following cerebral arteriosclerosis or thrombosis with hemiplegia nephrosclerosis of the kidneys with impairment of renal function, or myocardial damage or coronary occlusion of the heart. Important: A claim for benefits is required to adjudicate a secondary SC claim for any of the arteriosclerotic manifestations. Notes: Do not address SC for the above-listed cardiovascular conditions through the relationship to the hypertension when a sympathetic reading of the claims does not show a claim for SC for a heart condition. Arteriosclerosis occurs with advancing age without preexisting hypertension, and may occur in some younger individuals who are predisposed to arterial changes. The existence of arteriosclerosis does not imply/indicate prior hypertension. References: For more information on secondary SC, see M21-1, Part IV, Subpart ii, 2.B.5 intent to file and informal claims, see M21-1, Part III, Subpart ii, 2.C.1 reopened claims, see M21-1, Part III, Subpart ii, 2.D, and claims for increase, see M21-1, Part III, Subpart ii, 2. E. o. Effective Dates of Arteriosclerotic Manifestations Granted Secondary to Hypertension The effective date of any grant of SC for arteriosclerotic manifestations secondary to hypertension is the date of claim or date entitlement arose, whichever is later. Important: Arteriosclerotic manifestations are not considered a worsening of hypertension. Therefore do not apply
11-10-15_Key%20Changes_M21-1III_iv_4_SecE.docx