lipro

I have a question about rating for the c spine, I got my claim back and they took my conditions 5241 Spinal fusion, 5238 Spinal stenosis, 5239 Spondylolisthesis and 5242 Degenerative arthritis of the spine and combined all of them into a rating of 20%, I am fused at c6-c7 only with plating and hip bone. Should they have combined all of these or rated seperate? After reading note 6 I would think it should have been seperate. Any help would be great for an appeal or increase in rating. Thanks Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability. 5235 Vertebral fracture or dislocation 5236 Sacroiliac injury and weakness 5237 Lumbosacral or cervical strain 5238 Spinal stenosis 5239 Spondylolisthesis or segmental instability 5240 Ankylosing spondylitis 5241 Spinal fusion 5242 Degenerative arthritis of the spine

This is right out of the VA employee handbook, its an older version 2002 so I am sure the rates are double now in 2008, I bring this up as I saw the news report about the VA doctor in Texas sending out the email telling everyone to deny the PTSD claims as it would cost to much. what they really wanted to get across is that it would cut into thier annual bonus checks. According to the White House Office of Personnel Management, roughly three of every four senior officials at the VA have received some kind of bonus each year. In recent years, the payment amount has steadily increased from being one of the lowest in government - $8,120 in 2002 - to the most generous - $45,000 now. Established ranges are as follows: <H1 style="MARGIN: 0in 0in 0pt">SERVICE CHIEFS AND EQUIVALENT POSITIONS </H1>Physician Range Dentist Range $4,500 - $15,000 $4,500 - $15,000 (for agreements effective after November 1, 2000) $1,000 - $5,000 (for agreements effective prior to November 1, 2000) IX-G-2 APRIL 15, 2002 VA HANDBOOK 5007 PART IX APPENDIX G CHIEFS OF STAFF AND EXECUTIVE GRADE ASSIGNMENTS Physician Range Dentist Range $14,500 - $25,000 $14,500 - $25,000 (for agreements effective after November 1, 2000) $1,000 - $8,000 (for agreements effective prior to November 1, 2000) <H4 style="MARGIN: 0in 0in 0pt">DIRECTOR GRADE </H4>Physician Range Dentist Range $ 0 - $25,000 $ 0 - $25,000 (for agreements effective after November 1, 2000) $0 - $8,000 (for agreements effective prior to November 1, 2000) 7. RANGES OF RESPONSIBILITY PAY FOR VA CENTRAL OFFICE ASSIGNMENTS Established ranges are as follows: <H4 style="MARGIN: 0in 0in 0pt">VACO PHYSICIANS </H4>Position Physicians Dentists Under Secretary for Health $45,000 Deputy Under Secretary for Health $40,000 Associate Deputy Under Secretary for Health $35,000 Assistant Under Secretary for Health $30,000 $30,000 (for agreements effective after November 1, 2000) $10,000 (for agreements effective prior to November 1, 2000) IX-G-3 VA HANDBOOK 5007 APRIL 15, 2002 PART IX APPENDIX G Position Physicians Dentists Deputy Assistant Under Secretary for Health $27,500 $27,500 (for agreements effective after November 1, 2000) $10,000 (for agreements effective prior to November 1, 2000) Service Director $25,000 $25,000 (for agreements effective after November 1, 2000) $1,000- $8,000 (for agreements effective prior to November 1, 2000) Deputy Service Director $20,000 $20,000 (for agreements effective after November 1, 2000) $1,000- $8,000 (for agreements effective prior to November 1, 2000) Executive Grade $14,500 - 25,000 $14,500 - 25,000 (for agreements effective after November 1, 2000) $1,000- $8,000 (for agreements effective prior to November 1, 2000)

I would try and include something that says if they are going to make you go through another C and P that the doctor must be Board Certified and Lic in the state that the C and P is going to be done in. Most of these doctors are not certified or up to date like the requirements for a civ. doctor, That is why they are so old and make so many mistakes. they may have been good doctors at some point in life, but time has passed them by and they should not be performing exams in the first place.

The big problem I see from reading everyone's stories and my own is that there is no QA at the Rating Officer level or anywhere in the claims process. The GAO does not inspect any of the R O work and all I can find is a program called STAR unit which is based out of Nashville, TN and has a total of 15 people assigned to monitor the 57 regional offices. The annual requirement is to sample 120 claims from each office which equal only 6,840 case files being checked for the entire nation. How many of you think your case is one of those files being looked at? To me this is the key pit fall in the claims process and if we veterans do not get this changed to an acceptable Quality Assurance program then we will never achieve quality results from the Rating Officers. My own story is one of total disbelief; I had surgery at Bethesda Naval in 2006 to remove a nodule that turned out to be carcinoma. I was on active duty at the time and filed my claim under the new BDD program, when I got my decision letter from the VA my cancer claim was denied mainly due to the fact that the path report stated carcinoma and no where in the report was there any mention of cancer. For everyone who does not know carcinoma is cancer and there is not a path report in the world that says cancer on it, they list the exact type of cancer. If a QA program had been in place this would have never occurred, it would have been caught and I hope training would have been conducted with the RO to correct his knowledge of cancer terms. We really need to come up with a better process and get it done or we will never have quality from the VA.