Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • hohomepage-banner-2024-2.png

  • 27-year-anniversary-leaderboard.png

    advice-disclaimer.jpg

  • donate-be-a-hero.png

  • 0

VA compensation calculation

Rate this question


Cds6389

Question

I need some help and a second person to look at my service connected disabilities, I calculated I am 100% (combined ratings table) i accounted for the bilateral factor in regards to my tinnitus also. My issue is that the VA hasn't increased my rating to 100% even in my notification letter, everything says I'm at 90%. I used IRIS to ask if they could have miscalculated but have yet to receive a response.  My service connected disabilities are as follows;

Major depression, single episode with social anxiety 70%

Unspecified anxiety and depression 50%

Right knee strain 10%

Bilateral tinnitus 10%

Right elbow arthritis  10%

Right shoulder torn labrum 10%

Left elbow painful motion 10%

Left elbow arthritis  10%

Left cubital tunnel syndrome 10%

Right elbow painful motion 10%

Left shoulder strain 10%

Right cubital tunnel syndrome 10%

Edited by Cds6389
Spelling
Link to comment
Share on other sites

Recommended Posts

  • 0

I think you are only allowed one mental health diagnosis, so I believe you keep the 70 and lose the 50.  Also, some of those 10's look like the bilateral factor would apply.  I think the 90% is probably accurate.

Link to comment
Share on other sites

  • 0

What if the two mental disabilities have separate diagnostic codes? I guess I'll just have to wait for a response from my IRIS inquiry. Thanks for the help! Much appreciated 

Link to comment
Share on other sites

  • 0
  • Content Curator/HadIt.com Elder
9 hours ago, Cds6389 said:

What if the two mental disabilities have separate diagnostic codes? I guess I'll just have to wait for a response from my IRIS inquiry. Thanks for the help! Much appreciated 

It's not necessarily the type of mental disabilities or DC, but the actual impact on your professional and social well-being that determines your rating. You can be diagnosed for multiple MH issues, but you will still only have one rating.

Link to comment
Share on other sites

  • 0

It's just confusing because the 70% and 50% both show up as service connected disabilities with separate ratings, symptoms and different impairments that affect my social life, relationships, occupation and daily routine.. I also looked at my online health records in reference to my compensation exam for an increased rating, the question-air filled out by the c&p examiner states that there is a definite difference between symptoms of the two ratings which warrant a new and separate service connected rating. Do they normally leave the previous rating there on the list of disabilities?  I'm very aware that ebenefits is slow as mud but I also know that the VA had about a 30% error rate with compensation claims. 

Edited by Cds6389
Link to comment
Share on other sites

  • 0
  • Content Curator/HadIt.com Elder
On 2/18/2016 at 6:34 PM, Cds6389 said:

It's just confusing because the 70% and 50% both show up as service connected disabilities with separate ratings, symptoms and different impairments that affect my social life, relationships, occupation and daily routine.. I also looked at my online health records in reference to my compensation exam for an increased rating, the question-air filled out by the c&p examiner states that there is a definite difference between symptoms of the two ratings which warrant a new and separate service connected rating. Do they normally leave the previous rating there on the list of disabilities?  I'm very aware that ebenefits is slow as mud but I also know that the VA had about a 30% error rate with compensation claims. 

Normally, for MH ratings you could be diagnosed with a number of MH maladies and the VA would provide ratings based on the severity of the symptoms.

Let's assume the VA did assign separate SC ratings of 70% and 50%, but used the higher of the two (70%) for your combined rating.

That leaves you with one 70% rating and ten 10% ratings.

70 + 10 = 73
73 + 10 = 76
76 + 10 = 78
78 + 10 = 80
80 + 10 = 82
82 + 10 = 84
84 + 10 = 86
86 + 10 = 87
87 + 10 = 88
88 + 10 = 89 which rounds up to 90%

But look at the MH rating criteria - specifically Note 2 at the bottom. I think that they really did use the 70% instead of the 50% and dismissed the 50% as pyramiding. Go through your award letter carefully and see if they mentioned doing this.

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#se38.1.4_1130

Quote

§4.130   Schedule of ratings—Mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (see §4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in §4.125 through §4.129 and to apply the general rating formula for mental disorders in §4.130. The schedule for rating for mental disorders is set forth as follows:

9201   Schizophrenia

9202   [Removed]

9203   [Removed]

9204   [Removed]

9205   [Removed]

9208   Delusional disorder

9210   Other specified and unspecified schizophrenia spectrum and other psychotic disorders

9211   Schizoaffective disorder

9300   Delirium

9301   Major or mild neurocognitive disorder due to HIV or other infections

9304   Major or mild neurocognitive disorder due to traumatic brain injury

9305   Major or mild vascular neurocognitive disorder

9310   Unspecified neurocognitive disorder

9312   Major or mild neurocognitive disorder due to Alzheimer's disease

9326   Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder

9327   [Removed]

9400   Generalized anxiety disorder

9403   Specific phobia; social anxiety disorder (social phobia)

9404   Obsessive compulsive disorder

9410   Other specified anxiety disorder

9411   Posttraumatic stress disorder

9412   Panic disorder and/or agoraphobia

9413   Unspecified anxiety disorder

9416   Dissociative amnesia; dissociative identity disorder

9417   Depersonalization/Derealization disorder

9421   Somatic symptom disorder

9422   Other specified somatic symptom and related disorder

9423   Unspecified somatic symptom and related disorder

9424   Conversion disorder (functional neurological symptom disorder)

9425   Illness anxiety disorder

9431   Cyclothymic disorder

9432   Bipolar disorder

9433   Persistent depressive disorder (dysthymia)

9434   Major depressive disorder

9435   Unspecified depressive disorder

9440   Chronic adjustment disorder

General Rating Formula for Mental Disorders

   Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0

9520   Anorexia nervosa

9521   Bulimia nervosa

Rating Formula for Eating Disorders

   Rating
Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding. 100
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year. 60
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year. 30
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year. 10
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes. 0

Note 1: An incapacitating episode is a period during which bed rest and treatment by a physician are required.

Note 2: Ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. Ratings under diagnostic codes 9520 and 9521 will be evaluated using the General Rating Formula for Eating Disorders.

(Authority: 38 U.S.C. 1155)

[79 FR 45100, Aug. 4, 2014]

 

 

 

Link to comment
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
×
×
  • Create New...

Important Information

Guidelines and Terms of Use