60+20=60?new Exam By Original C&p Examiner

[cannoncocker]

Below is the redacted version of the letter I received as a result of a very recent Decision Review Officer action, which leads me to 2 questions:

These are my questions

1. “Your overall or combined rating remains 60% effective April 22, 2008. We do not add the individual percentages of each condition to determine your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions.” In English and standardized math how in the world did they come up with the 60 plus 20 equals 60 since they didn’t seem to pull the pyramid card out?

2. If 60 plus 20 equals 60 what would be the point of another exam, utilizing the same examiner by the way, that denied me in the first place due in no small part because of the numerous discrepancies in his original C&P Exam and the MRI/Consult/Physical Therapy/IME exam findings, which pretty much agreed? It would be relatively difficult to ignore or disagree with an MRI image it would seem to me. So why another exam for severity since 60 plus whatever equals 60?

DEPARTMENT OF VETERANS AFFAIRS

We made a decision on your appeal.

This letter tells you about your entitlement amount and payment start date and what we decided. It includes a copy of our Rating Decision that gives the evidence used and reasons for our decision, We have also included information about additional benefits, what to do if you disagree with our decision, and who to contact if you have questions or need assistance.

What We Decided

Service connection for XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXis granted with an evaluation of 20 percent effective April 22, 2008.

The above action is considered a full grant of this benefit sought on appeal.

An examination will be scheduled at once to evaluate the severity of your service connected XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. You will receive notification regarding the date and time of your exam in a separate letter.

Your overall or combined rating remains 60% effective April 22, 2008. We do not add the individual percentages of each condition to determine your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions.

Your compensation payment of XXXXXXXX will continue unchanged.

Any hunches would be greatly appreciated. Actually I have spoken to an Attorney and I seem to be out of my depth here.

[Vync]

Hey cannon,

Here's the SC calculator here at hadit:

http://www.hadit.com/service_connected_dis...calculator.php/

As you see...

60% + 20% = 68% (rounds up to 70%)

Call the 1-800-827-1000 number and talk with the puppet on the phone. Ask them to confirm your individual and combined SC percentages.

[cannoncocker]

I can't tell you how much that helps. I am on that right now!

[cannoncocker]

Hey there Vync, you were 100% right, I just failed to give you all the required info, specifically from highest to lowest:

30 sinus tachycardia

20 lumbar

10 tinitus

10 L foot

10 R Foot

10 Hypertension

0 R high frequency hearing

= 63.26

So you led me to exactly the right spot but I just hadn't put all the neccessary information.

Doesn't seem right somehow but thems the rules as far as I know.

Thank you Vync and to the lady at the 1000 number because she honestly took the time and effort to lead me through the process so thanks to all.

Still think a lawyer is probably in my best interest given my history with that particular Dr.

[Vync]

Glad to help.

One thing also to know. Some SC ratings are bilateral. If one is, then it actually will say bilateral on it. For example, I am SC for bilateral conjunctivitis at 10%. The Hadit SC calculator does not factor in the bilaterals. My understanding is that you calculate a rating for all bilateral conditions, just like you do the regular ones, then multiply the combined value by 1.1. In my case, the 10% bilateral equates to an 11% rating. Afterwards, the bilateral combined value is calculated in with any non-bilateral values, to produce your final SC rating. Somewhere here on this site is a link to a spreadsheet that is supposed to allow you to do this calculation. If any of your ratings are bilateral,then it is best to go that route instead.

You might want to call back to the 1-800 number and check on it.

Also, i assume the 60% rating was based on the conditions you just listed (30/20/10/10/10/10). Was the additional 20% from your initial post factored into this or is it separate? If it was factored in (20 lumbar), then your 60% rating is correct. If it is something new or different (not an increase from one of your 10% ratings), then the calculator shows you should have a 70.6% rating. Of course, all of this is if you have NO bilateral ratings.

[cannoncocker]

This is getting on the complicated side but if you can bare with me here is how I am rated and if you would please take a look and see if you think it is calculated right.

I will say too that the lady at the VA was so much help if they all were that helpful there wouldn't be near the traffic on these sites as there is. She actually had never even heard of hadit and was curious as to how I even knew about it which like probably alot of us is by way of Google. Good on her, and you both.

Here is the most recent rating break down:

1. Service connection for sinus tachycardia is granted with an evaluation of 30 percent effective April 22, 2008.

2. Service connection for lumbar strain with radiating pain through buttocks and down legs is granted with an evaluation of 20 percent effective April 22, 2008. Changed from granted 22 April 2008. This is the result from a DRO decision reached on 17 March 2008. (If I had it to do again I would have done exactly what I had done all these years is just plain deal with it.

3. The disability of hallux valgus left, status post bunionectomy with pes planus is changed to pes planus and plantar fasciitis left foot, status post bunionectomy with scar. The 10 percent evaluation is continued.

4. The disability of hallux valgus right, status post bunionectomy with pes planus is changed to pes planus and plantar fasciitis right, status post bunionectomy with scar. The 10 percent evaluation is continued.

5. Service connection for bilateral tinnitus is granted with an evaluation of 10 percent effective April 22, 2008.

7. The disability of atrial hypertension with cardiac arrhythmia is changed to separately evaluate hypertension and heart disorder. The 10 percent evaluation for hypertension is continued.

8. Hearing loss increase disability o% but service connected. 17 June 2009. I believe it is refering to right side high frequency.

So that is all of me and that is one biateral using their own exact language.

Thank you Vync, and I wish I could convey how much trouble that DRO appeal mess was to end up meaning diddly it's almost funny!

[cannoncocker]

OK I've been trying to wrap my head around this till tomorrow so I have this:

1. 30 sinus tachycardia

2. 20 lumbar (First claim submitted April 2008/denied June 2008/Denied August 2009-New DRO Grant 17 March 2010)

3. 10 tinitus (bilateral) X 1.1 = 11

4. 10 L foot

5. 10 R Foot

4&5 Pyramid = 10% total

6. 10 Hypertension

7. 0% R high frequency hearing

= 90%

or

with pyramid factoring

X 1.1 = 81%

Obviously I am doing something wrong. I have the L and R Feet pyramided to 10% instead of 20%. Still the VA has me rated at 60%. I can call 1-800-827-1000 Tuesday or IRIS the quetion but if anybody can tell me where my thinking has gone wrong that would be quite helpful.

The only new items are:

2. 20 lumbar (First claim submitted April 2008/denied June 2008/Denied August 2009-New DRO Grant 17 March 2010)

3. 10 tinitus (bilateral) X 1.1 = 11 granted June 2010

I have found no spreadsheets that are relevant to this and clueless for the rest of this.

Edited March 30, 2010 by cannoncocker