vlb-all-products

vlb-c-file-manual


  • Topics

  • Member Statistics

    • Total Members
      16,106
    • Most Online
      3,604

    Newest Member
    OIFusmc
    Joined
  • Forum Statistics

    • Total Topics
      61,548
    • Total Posts
      397,219
  • Posts

    • Killemall, The Regional office used the examination for re-evaluation as the C&P.  I discovered this as it was annotated in my medical notes that I was able to view via Blue Button in MyHealEVet. The rating ended up being:
      50% Bi-Lateral Hearing Loss / Word Recognition
      10% Tinnitus
      =VA math 55%, rounded up to 60%.
      This is a fair and accurate representation of my SC hearing loss and how it effects my life and work. However, the PTSD-MST claim was denied without the use of a C&P, as I did not officially report the crime while in the Army back in 1984.  The rater simply made an incorrect decision, which was absolutely devastating to me.  I don't expect the rater to fully understand how this could happen to a man and not be officially reported. No one deserves to understand that first hand.  It took me a few months to write up a short statement of disagreement as instructed by my VSO.   Interestingly, the VA (Medical / Physiological) division of the US Government, consisting of Clinical Psychiatrists and other experts in the field, believe I need intensive and specific treatment for my PTSD-MST.  So on November 6th, I will be heading to another VA inpatient PTSD facility located in Virginia for seven weeks.   This particular program is a tertiary referral center which has a division that specializes specifically on male MST cases like mine, which the Regional Office rater said does not exist due to lack of documentation. This matter will now last for many more painful years and I vow to never give up, just like when this unthinkable crime against me was committed.  I apologize for going off topic. BTW, this is the place I am headed to in November:  http://www1.va.gov/directory/guide/facility.asp?ID=116    
    • I recently learned how donating blood was good for (many people, not everyone)  Men, especially, tend to have too much iron.  (Women lose Iron from menstration, so its rarely a problem for women to have too much iron)  If you have too much iron, its bad for your health, it can even be life threatening.   http://www.mayoclinic.org/diseases-conditions/hemochromatosis/home/ovc-20167289 I was a bit suprised they would "take" my blood after I read about the health benefits of donating blood.   I answered all the questions honestly, and they took my blood.  They did a iron test, first, to see if my iron was low. (finger poke).    I donated blood locally, NOT through VA.   Remember, VA has to get you to sign a consent form to get medical information about you other than the VAMC's.      Here are a few health benefits of donating blood:  It reduces cancer risk, is heart healthy, and can be good for other organs also, especially for men with hi iron.   I read where "old blood" is "sticky" and tends to clot.  When you give blood, your body makes more "new" blood, which is slicker and is less likely to form blood clots.   Of course, you dont want to donate blood too often.  My area only allows you to donate whole blood every 56 days.  (2 months).    http://www.medicaldaily.com/why-donating-blood-good-your-health-246379
    • http://www.nbc.com/saturday-night-live/video/copy-machine/n10022 "making copies", the Richmeister the copy machine guy, FWIW, Hamslice    
    • We dont know your PCP, so we dont know if she will help.  But, you need to seek treatment for ED for 2 reasons. First, for your wife, and secondly for the money.  (SMC K).  If you could do the Wild Monkey before the PTSD meds, and the Wild Monkey Dance is gone now, then that is a pretty obvious link.   If you want compensation for SMC K, you need it documented.  So you should start with your PCP.  If your PCP does not have experience/does not treat ED, then you should ask for a referral to someone who does.  
    • I like the ideas of how to safeguard your medical and service records.  I still employ a paper/electronic system.  I like the combo approach with redundancies.  Believe you me it has come in handy several times already and once BVA hearing approaches, well I have a few green cards with the Regional Office and Evidence Intake Centers signature all over it.  Can't deny an item wasn't received if you have a signature to prove it.  Not to give cudos to the VA but the e-filing of claims through e-benefits has not failed me yet, well other than consistent access but you can see and load both ways on submitted evidence.  Confirmation of submission and acceptance are a nice facet.   Still even in this digital world, I would suggest the same in regards to records.  Keep a hardcopy, have one on a drive, jump drive, online server, and for kicks throw a media copy in a safety deposit box.  You never know. The one thing I would suggest with the online methods is to make sure the encryption and back up redundant systems are to your satisfaction and meet new technological standards.





oldvet

Metatarsal Arthritis

12 posts in this topic

How is VA supposed to rate this? As arthritic joints or a foot injury? I have been cited as having a "foot injury" under 5284. and therefore rated as a 0 because it does not meet the moderate condition. If the Xray shows arthritis of the metatarsal joints shouldn't that be rated as such?

Thanks,

oldvet

Share this post


Link to post
Share on other sites



I can think of three different dx codes that they could legitimately rate this condition under. The codes are 5003 (Arthritis, degenerative), 5017 (Gout), and 5020 (Synovitis). 5003 and 5020 use the same rating criteria. 5017 uses a different rating criteria that would be more advantageous to you, but doubtful that you could get the VA to rate it under this code as "analagous," since you have a actual diagnosis that matches a ratable diagnostic code. The rating criteria is:

5003 Arthritis, degenerative (hypertrophic or osteoarthritis):

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

With X-ray evidence of involvement of 2 or more major joints

or 2 or more minor joint groups, with occasional incapacitating

exacerbations 20

With X-ray evidence of involvement of 2 or more major joints

or 2 or more minor joint groups 10

Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

Note(2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic code 5013 to 5024, inclusive.

For the other two codes:

The diseases under diagnostic codes 5013 through 5024 Will be rated on limita­tion of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002.

5002 Rating criteria:

5002 Arthritis rheumatoid (atrophic) as an active process

With constitutional manifestations associated with

active joint involvement, totally incapacitating 100

Less than criteria for 100% but with weight loss and anemia

productive of severe impairment of health or severely

incapacitating exacerbations occurring 4 or more times a year

or a lesser number over prolonged periods 60

Symptom combinations productive of definite impairment of

health objectively supported by examination findings or

incapacitating exacerbations occurring 3 or more times a year 40

One or two exacerbations a year in a well-established diagnosis 20

For chronic residuals:

For residuals such as limitation of motion or ankylosis, favorable or unfavor­able, rate under the appropriate diagnostic codes for the specific joints involved. Where, however, the limitation of motion of the specific joint or joints involved is noncompensable under the codes a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5002. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.

Note: The ratings for the active process will not be combined with the residual ratings for limitation of motion or ankylosis. Assign the higher evaluation.

Share this post


Link to post
Share on other sites

Why would VA give me a zero percentage and say that I was rated under 5284 Foot injuries, other?

The examiner showed traumatic arthritis of the first metatarsophalangeal joint. The code on the worksheet shows 5299-5284. Am I missing something ?

Thanks,

oldvet

Share this post


Link to post
Share on other sites

Yeah...they played with the codes. You need to file a NOD and tell them to change the code to 5002 with at least a 10% rating. Tell them that this is a erroneous code, as the diagnosis has it's own code in 38 CFR 4.71a, and does not need to use a analogous code. Also tell them that 38 CFR 4.13 allows for chaging of erroneous codes.

Share this post


Link to post
Share on other sites

rentalguy1,

I believe that I need to go a similar route with my case except I'll use diagostic code 5003 due to traumatic injury. Is there a way that I can request and get a copy of my examiner's report? X-rays were taken of my hand and I'm interested in seeing whether or not any arthritis was noted. I have a suspicion that since I didn't specifically request compensation due to arthritis, even though I complained of pain, they may have ignored it and simply based their rating on what I put on the claim form...left hand fracture.

Share this post


Link to post
Share on other sites
Yeah...they played with the codes. You need to file a NOD and tell them to change the code to 5002 with at least a 10% rating. Tell them that this is a erroneous code, as the diagnosis has it's own code in 38 CFR 4.71a, and does not need to use a analogous code. Also tell them that 38 CFR 4.13 allows for chaging of erroneous codes.

Thanks rentaguy1 ! Appreciate the help!

oldvet

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now