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nanaeris

Dc Codes

Question

I had been rated at 20% for bilateral knee disability under DC 5260. When I asked for a increase the VA sent me for a C&P exam. The Examiner stated my bilateral leg extension was limited to 20 degrees which under DC 5261 would give me a 30% disability. The VA denied my claim for an increase. My question is if I had already been rated under DC 5260 but the C&P examiner stated leg extension was limited to 20 degrees should the VA rate me under the DC 5261 which would give me 30%? I also had a surgery to remove partial torn medial menicus. I pointed out to the VA this should be given a seperate rating. Also the Examiner stated my bilateral knee disability has severe impact on work and daily living. This is the information I put on my NOD. Am I correct in my assumption? What the VA did when I pointed this information out was send my case back to a rating specialist for review. Is this a good sign or will I have to take this farther to the next level? Any input would be greatly appreciated.

Thanks again,

nanaeris

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I would say this is a good sign-

I see the NOD as the first formal avenue of attack and I believe more claims could be resolved sooner if the claimant raised exactly why the decision was wrong in the NOD- refering directly to the medical evidence and the proper rating citations-as you did.

I had 1 of my claims, one of my husband's claims, and my daughters DEA decision altered quickly by doing that right in the NOD.

But that meant I was lucky enough to get someone who actually read the NOD.

A generic NOD that simply says I disagree with the decision dated XXXX without any specific reason for disagreement sets VA up for a SOC -that can be responded to with the same evidence that, maybe, if it has been sent with the NOD, could have changed the decision sooner.

I got a decision in 2010 based on a BVA award that was all wrong and I asked them to Cue themselves ( 2 or 3 times).It still isnt right but I have another way to get it right.It was sent to a special reviewer in response to my requests.

If the VA has clearly committed a CUE in a decision, then this too is another way of perhaps getting a faster and proper decision.

I got a second DRO review in 2005 (but same DRO unfortunately) by asking VA to CUE itself but the DRO still ignored my evidence.

In my BVA award the BVA noted how the VARO had ignored probative evidence that had been in my file for ,by then ,6 years.

I think you sure did the right thing.

Edited by Berta

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