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donews

Peripheral Neuropathy - Va Rating Schedule

12 posts in this topic

Does anyone know the proper rating or diag code for this?

Anyone else here have Peripheral Neuropathy? What rating code did they give you?

Donewsome

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I'm assuming it is due to IVDS, so it would be 5243-(dx code for whatever nerve is affected)

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Thank you both for your replies.

The reason I was searching for more input is I think they have me rated wrong or atleast under the wrong code.

The gave me SC for Peripheral Neuropathy as secondary to my DMII.

They said it was not in the Rating Schedule so they rated it with the next closest disease.

They are rating me for Paralysis of the Sciatica Nerve. The have me rated at 10% and basically unless I become unable to walk at all I can't get an increase past 10% for each leg. Because the qualifications to get increased in Paralysis of the Sciatica Nerve mostly have nothing to do with my actual condition, therefore I can't show medical evidence of an increase.

I really think they have me under the wrong catagory and just need to find some alternative to suggest to them.

I take Neurontin (Gabapentin) also. I take 6 x 300 mg each day for a total 1800 mg each day.

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The reason I was searching for more input is I think they have me rated wrong or atleast under the wrong code.

The gave me SC for Peripheral Neuropathy as secondary to my DMII.

They said it was not in the Rating Schedule so they rated it with the next closest disease.

They are rating me for Paralysis of the Sciatica Nerve. The have me rated at 10% and basically unless I become unable to walk at all I can't get an increase past 10% for each leg. Because the qualifications to get increased in Paralysis of the Sciatica Nerve mostly have nothing to do with my actual condition, therefore I can't show medical evidence of an increase.

I really think they have me under the wrong catagory and just need to find some alternative to suggest to them.

There is no specific diagnostic code for peripheral neuropathy, and the common practice is to rate it in analogy to paralysis of the affected nerve. Most raters will analogize it to paralysis of the common peroneal nerve, but your rater used the sciatic nerve. It doesn't mean that you cannot get a higher evaluation, it depends entirely upon the rater. Some will go up to 20 percent, and even more, but there must be significant objective evidence of disease. Symptoms such as complete loss of protective sensation in a stocking distribution (documented on objective examination), recurrent ulceration, stuff like that are indicators that a higher evaluation would be warranted. Also, if electrodiagnostic studies were to show moderate or severe peripheral neuropathy, you would have an excellent case for a higher rating.

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Donewsome,

I also have periphial neuropathy due to DMII. My codes are 8521 for lower-8515 for upper.

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I will be appylying for periphial neuropathy of the ulnar nerve and common peroneal nerve. Where and how sould I start? Should I have a private doctor do an exam? Hope to hear from someone. I need advice.

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