Can You Be Rated At 100% Comp And Still Have Be

[jecsb4]

All,

I have a question that I don't remember comming across. Can you be rated 100% by the VA and still allowed to have a job? Or do they expect you to not work, because you are rated at 100%

I am not sure what the other issues arise with 100% such as IU.

Thanks,

Joe

[Vike17]

"Dementia and cognitive disorders are viewed as physical disorders by the VA and fall under a different ratings criteria"

Dementia and cognitive disorders are are rated uner diagnostic codes 9300 through 9327, which are then rated under the schedule for mental disorders!

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)

Vike 17

[Jay Johnson]

From a medical standpoint dementia and cognitive impairment are physical in nature 99% of the time and the VA views them as such. Now, there may not be a special category for those ailments to fall into, but it would be assumed that one will not get better with dementia and it would also be assumed that dementia is a disease that almost always gets progressively worse with age. PTSD does not fall into either of those categories (though I would argue that fact).

Dementia is most often associated with al zheimers and old age in general. Essentially, it is a deterioration of the brain. Cognitive functions can improve in purely psychological cases, but considering that the cognitive impairment is linked to dementia I would say that this is almost certainly a progressive, "physical" disorder.

Raters aren't stupid and they realize the difference (as do the docs), so don't think that they can't/won't make exceptions for cases that do not fit into the typical mold, but we're talking about something well outside of the norm. Most of the mental cases are PTSD related and, as such, ones ability to work is key. PTSD is an anxiety disorder so, by VA terminology, how can one be 100% anxious, yet lead a normal, productive work life?

BTW, you'll notice that each of the codes vike linked were of a physical nature; the problem is that the VA just hasn't made a proper category for them yet and there's a general prejudice in the field of medicine towards injuries that can be observed but not seen (IE - brain injuries). This does not mean, however, that raters and doctors are going to treat them the same as PTSD just because they are lumped into that category.

[Jay Johnson]

Vincent van Gogh was a prolific painter during the period he sliced his ear off and was hospitalized, all the way until he shot himself in the chest. He was a total wreck "occupationally and socially" yet still very, very productive.

Artistic expression is not something most of us can do, nor would I deem it normal employment. Beethoven, Tchaikovsky and brahms were all "crazy", yet were some of the best composers the planet has ever seen. Robert Schumann was put in a mental ward at the end of his life. In fact, I would say that "good" art comes from pain and suffering and is often linked to people with mental disorders. Tchaikovsky's issues were that he was gay living in a homophobic world (likely molested as a kid), which was more common than you think in those days. Beethoven was believed to be bipolar and brahms had severe OCD.

But, does this mean we can write the next fur elise? Probably not:-) So, unless you have some super-genius latent talent that you haven't told us about, I wouldn't hold your breath to be the next Van Gogh........

Unless you're painting homes, "art" is not work.

Edited June 17, 2007 by Jay Johnson

[Vike17]

BTW, you'll notice that each of the codes vike linked were of a physical nature; the problem is that the VA just hasn't made a proper category for them yet and there's a general prejudice in the field of medicine towards injuries that can be observed but not seen (IE - brain injuries). This does not mean, however, that raters and doctors are going to treat them the same as PTSD just because they are lumped into that category"

No, the conditions listed with DC's 9300 through 9327 may seem they are related to physical disabilities. However, they are rated according to the mental disability rating schedule because of the residuals that particular condition produces i.e. the condition affect the mental aspect of the person. Furthermore, the VA has made a proper catogory for them, hence the section of mental disorders set aside for them. Keep in mind the VA pays compensation for the residuals of a mental disability, disease, or injury, not the diagnosed condition in and of itself!

As far as brain injuries i.e. post concussion syndrom, the rating schedule specificaly states uner DC 8045;

8045 Brain disease due to trauma:

Purely neurological disabilities, such as hemiplegia, epileptiform seizures, facial nerve paralysis, etc., following trauma to the brain, will be rated under the diagnostic codes specifically dealing with such disabilities, with citation of a hyphenated diagnostic code (e.g., 8045–8207).

Purely subjective complaints such as headache, dizziness, insomnia, etc., recognized as symptomatic of brain trauma, will be rated 10 percent and no more under diagnostic code 9304. This 10 percent rating will not be combined with any other rating for a disability due to brain trauma. Ratings in excess of 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absence of a diagnosis of multi-infarct dementia associated with brain trauma.

This means that if a veteran is suffering from a post traumatic brain injury and he/she has subjective complaint, or complaints only substantiated by the veterans own accounts, the rating schedule calls for a 10% rating on that basis under DC 9304. If the veteran has more than just subjective complaints, which actually physically affect another body system, then the rating schedule calls for a seperate evaluation under that particular DC that coincides with the said findings.

Vike 17

[Jay Johnson]

I understand that, but that's not the point. The codes you listed have a physiological basis; whereas, your typical "mental" disorder does not (again, I would argue this, but in current medical terminology this is the case).

I'm not going to argue this with you further...I am in this field and you are not; try asking a doctor.

But, since you insist only playing semantics, here is the definition of dementia out of my abnormal psychology book:

Dementia (and other cognitive disorders) - Problems caused by known damage to the brain, including alzheimer's diseases, strokes and other physical trauma to the brain.

In fact, dementia is not even covered in abnormal psychology because it is not a "psychological disorder"; rather, it's a PHYSICAL one. If I know this as a student in psychology, I'm thinking the psychiatrists are well aware of this fact too (as are the raters). They get lumped under "mental disorders" because the VA's ratings system is antiquated and biased.

P.S. - That definition is out of the DSM-IV-TR by the way.

Edited June 17, 2007 by Jay Johnson

[sixthscents]

OK, I've read enough to think that this topic is heading south. Listen, while we may all have opinions it is simply the CFR 38, and the raters whom we must deal with. Personally I cant see how someone rated 100% CAN be working, but that is a PERSONAL observation and opinion, not a regulatory one. I am rated vastly more than that, and even when I was still TDIU for the short period I was, I would never have actually considered working, though to be honest I wish I could.

ANYWAY... this topic will do the following or be closed....

A. Take a MUCH more objective and less hostile tone... We all have beliefs, we do NOT have the right to inflict them upon others.

B. Address the original issue of the thread topic

If it does not, I'm going to have to shut it down...

Please remember, we are here to help each other, and while our opinions may vary wildly we still must keep the foremost in our minds when posting. If you are upset do NOT immediately shoot back a reply... wait and take a day if necessary to mull over what was said, THEN reply. DO NOT defame others in your posts... I KNOW thats hard (pot calling the kettle, but I have reformed) but it doesnt need to happen here.

Also, we have several honest to Gosh EXPERTS, not guys like me who know alot about CFR 38, and common stuff but people who actually worked for the VA and trained others in rating... I would generally tend to lend credence to their comments, considering that while CFR 38, and M21-1 lend guidance raters often DO make judgement calls, and an ex-rater could tend to guide us in HOW they will make the call and what they would base it upon......

So, lets not attacks these people for telling us what their EXPERIENCE tells them is the most likely senario.... even if its not what we want to hear...

Edited June 18, 2007 by sixthscents