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allan
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Posts posted by allan
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Hello Angela,
This is where I think I found it,
Allan
September 12, 2002 M21-1, Part VI
Change 92
CHAPTER 2. RATING ACTIVITY--GENERAL
2.07 EVALUATION OF EVIDENCE
The rating specialist has responsibility to recognize the need for evidence in relation to a claim. The members have responsibility to determine admissibility of and the weight to be afforded evidence that is presented, the need for additional evidence, and the need for physical examination. If all the evidence is favorable, the claim must be granted. (See Beaty v. Brown, 6 Vet. App. 532 (1994).)
a. Probative Value. The rating specialist will determine the probative value of medical or lay testimony. Accept evidence at face value unless contradicted by other evidence or sound medical or legal principles. In the presence of questionable or conflicting evidence, further development may be needed to corroborate testimony to include, if in order, field examinations and/or social surveys to obtain transcripts of original or other appropriate records. Rating decisions must clearly explain why evidence is found to be persuasive or unpersuasive. Decisions must address all the evidence and all of the claimant's contentions.
b. Medical Opinions. Medical conclusions must be supported by evidence in the file. Rating specialists cannot refute with their own unsubstantiated medical conclusions medical evidence submitted by the claimant. Recognized medical treatises or an independent medical opinion may be cited to support a conclusion. Such evidence, when relied upon, must be identified in the decision.
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Contacting someone for congressional help, may delay your claim as much as two yrs.
Overflow?, Ready to rate?, Appeals center = no action. It is in limbo, untill the AMC, passes it off to another regional office that will pump out false, twisted remarks as a reason to deny.
In order to avoid this, you can send in a waiver of your rights to review by a lower agency, THE APPEALS CENTER or regional office.
If you want it reviewed by the BVA instead, you must send a waiver in, asking that this be done.
After nearly 10 yrs of this, im sending in a waiver, anytime I get a remand, starting now.
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Theres atleast a yrs wait at the Appeals Center in DC.
When they get a VARO rating officer open they can send it to, it will take about a yr for them to order another C&P,(you do not have to be present). They simply send what information they choose to a medical consultant that contracts with the Dept of Veterans affairs, somewhere in the country.
Each time they do this, you will need to have another "favorable" medical opinion, to rebut their pack of BS.
Doctor shopping? That would be my guess.
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TS,
nothing can stop your spouce from having a a tablet, to keep a written journal of what was said during examinations, exspecally C&P's, hearings, meetings with SO's, etc.
Your spouce does NOT have to leave the room. I've had doctors ask her to leave right away, and than do nothing but ask questions, only she keeps track of & has the answers to. Medications? Whats been order, what needs refilled, effects of meds, etc.
I had one C&P examiner, push my wife back out a door & said your not allowed.
My wife & both my daughters have medical power of attorney. I understand they DON'T keep these at the, VAMC.
After 10 yrs, mine seems to have disapeared.
Appointments can be made with the VAMC's, team "Social Worker" for the forms & assistance in filing out the forms, for "Medical Power of Attorney", Living Wills, etc.
I have nothing but respect for the Social Workers at the VAMC's i've been to.
Veterans having problems with facility staff, in need of lodging, etc. they are the ones to contact.
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Hello TS,
To answer your questions. Yes to all 5 questions.
Claim has been before the appeals center since 2002 & in limbo at the Appeals Center for nearly a yr, in "ready to wait" status after being remanded from the BVA for St Petes violation of viewing & giving weight to primary evidence.....Three IMO's from Dr Bash.
Claim for Multipl Sclerosis was decided on in 2005, but is pending untill the AMC finishes refusing the evidence.
They've been handling my claim like this since 1997.
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Hello Ricky,
Qoata? No, I don't think they actually have a qoata. It just feels that way sometimes. Personally, I believe they try to get as many as they can denied, but a few always seem to slip through.
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I hope it pases Spike.
I have the feeling, that any funding for Vets that needs his signiture, he'll veto.
I also feel that congress needs to include in their bills, protection rights of veterans.
Any false statements made on the behalf of a federal employee, in order to deny benefits, should be a felony offence.
Veterans seeking care & benefits for PTSD, should not have to have their soul wounded twice, in order to recieve them.
How, does a veteran on patrol in a war zone, get his claim for PTSD denied on the basis, he wasn't actually in combat?
How many of these students do you think will be harrased over seeking care for their PTSD, called liers, fakers, or have their experiences dismissed as,"NOT IN ACTUAL COMBAT" or trying to cheat the govenment out of funding?
Every student at that school will be alowed to have free treatment for PTSD. Even if they were on vacation at the time.
Veterans? They can expect anything to be said to them or about them in order to discourage them from recieving benefits.
Think these students will have any trouble finding attorneys to represent them, if they were treated like our returning troops?
If bills don't contain laws protecting veterans, veterans will continue to take their lives out of frustration & taking a back seat to funding this war.
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Hello TS,
I'll tell you what the DRO said when I asked him to read into the record, what a C&P's favorable opinion said.
He said I can submit any evidence I want, "but" it is the VA that, "chooses" what evidence is evidence of weight.
If they refuse to recognize favorable evidence at the VARO or DRO review, you may have to wait until your at the BVA or Court of Veterans appeals level, before you receive anything resembling, " due process of law".
They will sit on it, until cornered & forced to list it. More then likely the evidence(favorable Opinion) will be consistently misquoted throughout the SOC or SSOC.
It no longer surprises me to see such friendly & helpful people, lie, & twist facts ito something they call due process, in order to meet their quota of denied benefits for the month.
The main agenda of the Veterans Affairs, be it health care or benefits, is to provide the benefit with as little use of funding as can be possibly done, without being thrown in jail for it. Since that seldom happens, That leaves the door opine for just about anything.
Unless you are extremely lucky to get an honest evaluation of your evidence by a RO claims officer, DRO or whatever, that doesn't listen to the bean counters, then theres a chance you may be at this for some time.
Another thing to consider, is theres a war that needs paid for.
If the glass gets low from one source, than you squeeze it from another source you have more control over.
Those of us that suffer the most, will be the easiest for these vultures to pick on.
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USED OIL IN BUNKER FUEL:
A REVIEW OF POTENTIAL HUMAN HEALTH IMPLICATIONS
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Hello Tbird,
The site looks absolutely wonderful.
Im using IE7 & can view everything just fine.
Color scheme makes it easy on the eyes.
Thanks for all your hard work Tbird.
Allan
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Your sure welcome TS.
I hope it helps.
.........Allan
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>Does VA have to pay their medical bills because the ER was closed?
Hello Berta,
I can say from experience, that the VAMC ER, can refuse to treat you, even if they're open for business, than refuse to pay for an ER bill from a non-VA hospital if you seek treatment elsewere.
They can withhold your medicines untill you get a brain hemorage from it, than refuse to treat you or pay for their injuries.
If the Spokane ER was still opin at night, it would still be a risk to go their anyway if it was an emergency. First thing their going to ask you is, "is this service connected"????? If it is, they will try to put you off until the clinic opens. If its not, don't expect much in the way of treatment.
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Thanks for the input Pete.
I often go through my folders & grab something i've saved.
I pulled this from my Hadit.com folder of saved information for Vets.
I would once again like to thank whomever created it.
Allan
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NOD Notice of Disagreement SAMPLE
[ Date ]
Department of Veterans Affairs
[ Address of Regional Office ]
Attention: [ Your Claim Number ] – [ In Reply to: (right hand corner of rating decision) ]
Dear Sir,
I received a rating decision dated [ Date ]. Consider this letter to be an official “Notice of
Disagreement” (NOD) regarding the following disability:
1) ……
I am requesting a “De Novo Review” by a new Decision Review Officer.
I will be awaiting your reply.
Sincerely,
[ Full Name ]
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[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of July 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR14.631]
[Page 538-539]
TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS
PART 14--LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS--Table
of Contents
Sec. 14.631 Powers of attorney.
(a) A power of attorney, executed on either Department of Veterans
Affairs Form 23-22 (Appointment of Veterans Service Organization as
Claimant's Representative) or Department of Veterans Affairs Form 2-22a
(Appointment of Attorney or Agent as Claimant's Representative), is
required to represent a claimant, except when representation is by an
attorney who complies with Sec. 14.629© or when representation by an
individual is authorized under Sec. 14.630. The power of attorney shall
meet the following requirements:
(1) Contain signature by:
(i) The claimant, or
(ii) The claimant's guardian, or
(iii) In the case of an incompetent, minor, or otherwise
incapacitated person without a guardian, the following in the order
named--spouse, parent, other relative or friend (if interests are not
adverse), or the director of the hospital in which the claimant is
maintained; and
(2) Shall be presented to the appropriate Department of Veterans
Affairs office for filing in the veteran's claims folder.
(b) Questions concerning powers of attorney shall be referred to the
Regional Counsel of jurisdiction for initial determination. This
determination may be appealed to the General Counsel.
©(1) Only one organization, agent, or attorney will be recognized
at one time in the prosecution of a particular claim. Except as provided
in Sec. 14.629© and paragraphs ©(2) and ©(3) of this section, all
transactions concerning the claim will be conducted exclusively with the
recognized organization, agent, or attorney of record until notice of a
change, if any, is received by the Department of Veterans Affairs.
[[Page 539]]
(2) An organization named in a power of attorney executed in
accordance with paragraph (a) of this section may employ an attorney to
represent a claimant in a particular claim. Unless the attorney is an
accredited representative of the organization, the written consent of
the claimant shall be required.
(3) Legal interns, law students, and paralegals may assist in the
preparation, presentation, or prosecution of a claim under the direct
supervision of a claimant's attorney of record designated under
Sec. 14.629©, or an attorney who is either employed by or an
accredited representative of an organization named in a power of
attorney executed in accordance with paragraph (a) of this section.
However, prior to their participation, the claimant's written consent
must be furnished to the Department of Veterans Affairs. Such consent
must specifically state that a legal intern, law student, or paralegal
furnishing written authorization from the attorney of record or the
organization named in the power of attorney may have access to the
claimant's records and that such person's participation in all aspects
of the claim is authorized. The supervising attorney, or an attorney
authorized under Sec. 14.629©(2), must be present at any hearing in
which a legal intern, law student, or paralegal participates.
(d) A power of attorney may be revoked at any time, and an attorney
may be discharged at any time. Unless a claimant specifically indicates
otherwise, the receipt of a new power of attorney shall constitute a
revocation of an existing power of attorney. If an attorney submits a
letter of representation under Sec. 14.629 regarding a particular claim,
or a claimant authorizes a person to provide representation in a
particular claim under Sec. 14.630, such specific authority shall
constitute a revocation of an existing general power of attorney filed
under paragraph (a) of this section only as it pertains to, and during
the pendency of, that particular claim. Following the final
determination of such claim, the general power of attorney shall remain
in effect as to any new or reopened claim.
(e) The authority which a power of attorney provides may be
continued for a reasonable time after the death of the claimant, to
determine whether the claim will be continued by a new claimant and
whether a new power of attorney will be executed.
(Authority: 38 U.S.C. 5902, 5903, 5904)
[43 FR 46535--46537, Oct. 10, 1978, as amended at 53 FR 52421, Dec. 28,
1988]
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-CITE-
18 USC Sec. 1505 01/19/04
-EXPCITE-
TITLE 18 - CRIMES AND CRIMINAL PROCEDURE
PART I - CRIMES
CHAPTER 73 - OBSTRUCTION OF JUSTICE
-HEAD-
Sec. 1505. Obstruction of proceedings before departments, agencies,
and committees
-STATUTE-
Whoever, with intent to avoid, evade, prevent, or obstruct
compliance, in whole or in part, with any civil investigative
demand duly and properly made under the Antitrust Civil Process
Act, willfully withholds, misrepresents, removes from any place,
conceals, covers up, destroys, mutilates, alters, or by other means
falsifies any documentary material, answers to written
interrogatories, or oral testimony, which is the subject of such
demand; or attempts to do so or solicits another to do so; or
Whoever corruptly, or by threats or force, or by any threatening
letter or communication influences, obstructs, or impedes or
endeavors to influence, obstruct, or impede the due and proper
administration of the law under which any pending proceeding is
being had before any department or agency of the United States, or
the due and proper exercise of the power of inquiry under which any
inquiry or investigation is being had by either House, or any
committee of either House or any joint committee of the Congress -
Shall be fined under this title or imprisoned not more than five
years, or both.
-SOURCE-
(June 25, 1948, ch. 645, 62 Stat. 770; Pub. L. 87-664, Sec. 6(a),
Sept. 19, 1962, 76 Stat. 551; Pub. L. 91-452, title IX, Sec. 903,
Oct. 15, 1970, 84 Stat. 947; Pub. L. 94-435, title I, Sec. 105,
Sept. 30, 1976, 90 Stat. 1389; Pub. L. 97-291, Sec. 4(d), Oct. 12,
1982, 96 Stat. 1253; Pub. L. 103-322, title XXXIII, Sec.
330016(1)(K), Sept. 13, 1994, 108 Stat. 2147.)
-MISC1-
HISTORICAL AND REVISION NOTES
Based on title 18, U.S.C., 1940 ed., Sec. 241a, (Mar. 4, 1909,
ch. 321, Sec. 135a, as added Jan. 13, 1940, ch. 1, 54 Stat. 13;
June 8, 1945, ch. 178, Sec. 2, 59 Stat. 234).
Word "agency" was substituted for the words "independent
establishment, board, commission" in two instances to eliminate any
possible ambiguity as to scope of section. (See definitive section
6 of this title.)
Minor changes were made in phraseology.
-REFTEXT-
REFERENCES IN TEXT
The Antitrust Civil Process Act, referred to in text, is Pub. L.
87-664, Sept. 19, 1962, 76 Stat. 548, as amended, which is
classified generally to chapter 34 (Sec. 1311 et seq.) of Title 15,
Commerce and Trade. For complete classification of this Act to the
Code, see Short Title note set out under section 1311 of Title 15
and Tables.
-MISC2-
AMENDMENTS
1994 - Pub. L. 103-322 substituted "fined under this title" for
"fined not more than $5,000" in last par.
1982 - Pub. L. 97-291 struck out first two paragraphs which
provided, respectively, that whoever corruptly, or by threats or
force, or by any threatening letter or communication, endeavored to
influence, intimidate, or impede any witness in any proceeding
pending before any department or agency of the United States, or in
connection with any inquiry or investigation being had by either
House, or any committee of either House, or any joint committee of
the Congress, and whoever injured any party or witness in his
person or property on account of his attending or having attended
such proceeding, inquiry, or investigation, or on account of his
testifying or having testified to any matter pending therein, would
be subject to the penalty set forth in the last paragraph, and in
the fourth paragraph substituted "any pending" for "such" after
"law under which", and substituted "any" for "such" before
"department" and before "inquiry".
1976 - Pub. L. 94-435 struck out "section 1968 of this title"
after "Antitrust Civil Process Act", inserted "withholds,
misrepresents" after "willfully", "covers up" after "conceals",
"answers to written interrogatories, or oral testimony", after "any
documentary material", and "or attempts to do so or solicits
another to do so;" after "such demand".
1970 - Pub. L. 91-452 inserted reference to section 1968 of this
title.
1962 - Pub. L. 87-664 substituted section catchline "Obstruction
of proceedings before departments, agencies, and committees" for
"Influencing or injuring witness before agencies and committees"
and punished the willful removal, concealment, destruction,
mutilation, alteration or falsification of documents which were the
subject of a demand under the Antitrust Civil Process Act if done
with the intent to prevent compliance with a civil investigative
demand.
EFFECTIVE DATE OF 1982 AMENDMENT
Amendment by Pub. L. 97-291 effective Oct. 12, 1982, see section
9(a) of Pub. L. 97-291, set out as an Effective Date note under
section 1512 of this title.
EFFECTIVE DATE OF 1976 AMENDMENT
Amendment by Pub. L. 94-435 effective Sept. 30, 1976, see section
106 of Pub. L. 94-435, set out as a note under section 1311 of
Title 15, Commerce and Trade.
-SECREF-
SECTION REFERRED TO IN OTHER SECTIONS
This section is referred to in sections 201, 1515 of this title;
title 29 section 1111.
-End-
-
Bellezza v. Principi, 16 Vet. App. 145 (2002)
The appellant appealed a BVA decision denying entitlement to reimbursement by VA for the cost of previously unauthorized medical services he received from the Southwest Florida Regional Medical Center. The veteran was transferred to that facility from North Collier Hospital for evaluation and treatment of a myocardial infarction. He stayed at the Southwest Florida facility for five days. A VA physician opined that there was a high probability that the veteran's emergency condition had resolved prior to the transfer but that, without information from the North Collier facility, he was unable to make this determination.
The VAMC disapproved the claim for reimbursement because "care and services were not rendered in a medical emergency of such nature that delay would have been hazardous to life or health." A private physician opined (1) that the veteran had been in a life-threatening situation at the time of the transfer, (2) that the North Collier facility was unable to provide the necessary care, and (3) that transferring the veteran to the nearest available facility was in his best interest.
On appeal to the Board, the BVA stated that the opinions of private physicians have little probative value and that only VA physicians are empowered to decide when a medical emergency ends.
The Court rejected the BVA's view that the opinions of private physicians had little probative value and vacated the BVA's decision. The Court cited to 38 C.F.R. ' 17.121, which requires the VA physician to decide when a medical emergency ends "based upon sound medical judgement." The Court interpreted this phrase in the regulation to require that the VA physician must consider and account for the opinions of private physicians. Thus, the BVA also has the obligation to consider whether the VA physician exercised sound medical judgement in writing his opinion. In a concurring opinion, Chief Judge Kramer observed that, on remand, the BVA is obligated to consider the benefit of the doubt rule.
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Federal Register: March 20, 2007 (Volume 72, Number 53)]
[Rules and Regulations]
[Page 12983-13016]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr20mr07-9]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 4
RIN 2900-AM60
Schedule for Rating Disabilities; Appendices A, B, and C
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is revising its
Schedule for Rating Disabilities, Appendices A, B, and C to include all
current diagnostic codes. Appendix A is also amended to include all the
diagnostic code historical information since the last review.
DATES: Effective Date: This amendment is effective April 19, 2007.
FOR FURTHER INFORMATION CONTACT: Trude Steele, Regulations Staff
(211D), Compensation and Pension Service, Veterans Benefits
Administration, Department of Veterans Affairs, 810 Vermont Avenue,
NW., Washington, DC 20420, (202) 273-7210.
SUPPLEMENTARY INFORMATION: The Schedule for Rating Disabilities, 38 CFR
Part 4, Appendices A, B, and C have not been updated since July 1,
1988. These Appendices are tools for users of the Schedule for Rating
Disabilities. The Appendices reflect changes to the diagnostic criteria
in the Schedule for Rating Disabilities.
We have amended the Appendices to add changes to the Schedule for
Rating Disabilities since the Appendices were last updated.
Additionally, we removed language in Appendix A that showed when a
diagnostic code was updated to correct spelling, revise text, or other
additional changes, which had no impact on the disability code. Those
changes were incorporated within the text when amended. All diagnostic
codes in Appendix A will now be categorized by when they were added,
removed, whether the criterion was amended, and whether the disability
evaluation was amended. We will continue to include the date for
historical purposes. We revised Appendices B and C to provide the
current diagnostic codes and disability terminology. We will continue
to update the Appendices as the Schedule for Rating Disabilities is
revised.
Administrative Procedures Act
This final rule merely replaces inaccurate examples and does not
alter the content of the regulations. Accordingly, there is a basis for
dispensing with prior notice and comment and the delayed effective date
provisions of 5 U.S.C. 553.
Paperwork Reduction Act
This document contains no provisions constituting a collection of
information under the Paperwork Reduction Act (44 U.S.C. 3501-3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this final rule will not have a
significant economic impact on a substantial number of small entities
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. This final rule would not affect any small entities. Only VA
beneficiaries could be directly affected. Therefore, pursuant to 5
U.S.C. 605(b), this final rule is exempt from the initial and final
regulatory flexibility analysis requirements of sections 603 and 604.
Executive Order 12866
Executive Order 12866 directs agencies to assess all costs and
benefits of available regulatory alternatives and, when regulation is
necessary, to select regulatory approaches that maximize net benefits
(including potential economic, environmental, public health and safety,
and other advantages; distributive impacts; and equity). The Executive
Order classifies a ``significant regulatory action,'' requiring review
by the Office of Management and Budget (OMB) unless OMB waives such
review, as any regulatory action that is likely to result in a rule
that may: (1) Have an annual effect on the economy of $100 million or
more or adversely affect in a material way the economy, a sector of the
economy, productivity, competition, jobs, the environment, public
health or safety, or State, local, or tribal governments or
communities; (2) Create a serious inconsistency or otherwise interfere
with an action taken or planned by another agency; (3) Materially alter
the budgetary impact of entitlements, grants, user fees, or loan
programs or the rights and obligations of recipients thereof; or (4)
Raise novel legal or policy issues arising out of legal mandates, the
President's priorities, or the principles set forth in the Executive
Order.
The economic, interagency, budgetary, legal, and policy
implications of this final rule have been examined and it has been
determined not to be a significant regulatory action under Executive
Order 12866.
Unfunded Mandates
The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C.
1532, that agencies prepare an assessment of anticipated costs and
benefits before issuing any rule that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100 million or more (adjusted annually for
inflation) in any year. This final rule would have no such effect on
State, local, and tribal governments, or on the private sector.
Catalog of Federal Domestic Assistance Numbers and Titles
The Catalog of Federal Domestic Assistance program numbers and
titles for this final are 64.104, Pension for Non-Service-Connected
Disability for Veterans and 64.109, Veterans Compensation for Service-
Connected Disability.
List of Subjects in 38 CFR Part 4
Disability benefits, Pensions, Veterans.
Approved: March 2, 2007
Gordon H. Mansfield,
Deputy Secretary of Veterans Affairs.
0
For the reasons set out in the preamble, 38 CFR part 4 is amended as
set forth below:
PART 4--SCHEDULE FOR RATING DISABILITIES
The above information was taken in part from this link......
http://a257.g.akamaitech.net/7/257/2422/01...007/E7-4914.htm
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THE KNEE AND LEG Rating
5256 Knee, ankylosis of:
Extremely unfavorable, in flexion at an angle of 45° or more 60
In flexion between 20° and 45° 50
In flexion between 10° and 20° 40
Favorable angle in full extension, or in slight flexion between 0° and 10° 30
5257 Knee, other impairment of:
Recurrent subluxation or lateral instability:
Severe 30
Moderate 20
Slight 10
§4.71a Schedule of ratings—musculoskeletal system.
http://www.warms.vba.va.gov/regs/38CFR/BOO...ART4/S4_71a.DOC
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§4.59 Painful motion.
With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Muscle spasm will greatly assist the identification. Sciatic neuritis is not uncommonly caused by arthritis of the spine. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. Crepitation either in the soft tissues such as the tendons or ligaments, or crepitation within the joint structures should be noted carefully as points of contact which are diseased. Flexion elicits such manifestations. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.
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§4.46 Accurate measurement.
Accurate measurement of the length of stumps, excursion of joints, dimensions and location of scars with respect to landmarks, should be insisted on. The use of a goniometer in the measurement of limitation of motion is indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be accurately measured and reported.
[41 FR 11294, Mar. 18, 1976]
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§4.40 Functional loss.
Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. It is essential that the examination on which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part which becomes painful on use must be regarded as seriously disabled. A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like.
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§4.130 Schedule of ratings-mental disorders.
The nomenclature employed in this portion of the rating schedule is based upon the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, of the American Psychiatric Association (DSM-IV). 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:
Rating
SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS
9201 Schizophrenia, disorganized type
9202 Schizophrenia, catatonic type
9203 Schizophrenia, paranoid type
9204 Schizophrenia, undifferentiated type
9205 Schizophrenia, residual type; other and unspecified types
9208 Delusional disorder
9210 Psychotic disorder, not otherwise specified (atypical psychosis)
9211 Schizoaffective disorder
DELIRIUM, DEMENTIA, AND AMNESTIC AND OTHER COGNITIVE DISORDERS
9300 Delirium
9301 Dementia due to infection (HIV infection, syphilis, or other systemic or
intracranial infections)
9304 Dementia due to head trauma
9305 Vascular dementia
9310 Dementia of unknown etiology
9312 Dementia of the Alzheimer’s type
9326 Dementia due to other neurologic or general medical conditions (endocrine
disorders, metabolic disorders, Pick’s disease, brain tumors, etc.) or that are
substance-induced (drugs, alcohol, poisons)
9327 Organic mental disorder, other (including personality change due to a general
medical condition)
ANXIETY DISORDERS
9400 Generalized anxiety disorder
9403 Specific (simple) phobia; social phobia
9404 Obsessive compulsive disorder
9410 Other and unspecified neurosis
9411 Post-traumatic stress disorder
9412 Panic disorder and/or agoraphobia
9413 Anxiety disorder, not otherwise specified
DISSOCIATIVE DISORDERS
9416 Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple
personality disorder)
9417 Depersonalization disorder
SOMATOFORM DISORDERS
9421 Somatization disorder
9422 Pain disorder
9423 Undifferentiated somatoform disorder
9424 Conversion disorder
9425 Hypochondriasis
MOOD DISORDERS
9431 Cyclothymic disorder
9432 Bipolar disorder
9433 Dysthymic disorder
9434 Major depressive disorder
9435 Mood disorder, not otherwise specified
CHRONIC ADJUSTMENT DISORDER
9440 Chronic adjustment disorder
General Rating Formula for Mental Disorders:
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
EATING DISORDERS
9520 Anorexia nervosa
9521 Bulimia nervosa
Rating Formula for Eating Disorders:
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: An incapacitating episode is a period during which bed rest and treatment by a physician are required. (Authority: 38 U.S.C. 1155)
[53 FR 23, Jan. 4, 1988; 53 FR 1441, Jan. 19, 1988. Redesignated and amended at 61 FR 52700, Oct. 8, 1996]
Supplement Highlights reference: 19(1)
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http://www.warms.vba.va.gov/regs/38CFR/BOO...ART4/S4_130.DOC
Can You Bring Your Spouse & Tape/video Recorder To A C&p Exam?
in VA Disability Claims Research
Posted
>This way there is no surprise for the doctor, nor one for you when they say she cant come in.
I didn't realize it was a privalage at the examiners discression?
I was under the impression it was a RIGHT of all veterans to be attended to by their spouce.
Guess wen the examiner yelled my name & saw my wife of 33 yrs walk up with me he yelled again. "you can just have your lady friend sit down"
I walked straight to him & said,"my wife acompanies me, or I leave. It's your choice"? I didn't have any more disrespect after that.
Maybe the examiners need to get their crap together & learn a law governing, VETERANS RIGHTS. One of them says, that at "ALL" examinations, Veterans have the right to be accompanied by their spouce.
Maybe the examiner could learn to respect that right & extend a hand & introduce themselves. If they lack manners, maybe examining our dsabled vets isn't for them. Maybe washing dishes in some dive bar for minamum wage would be better?
Just a thought!