C& P Exams Joint And Spine Impairments Fw: Vets Disability Benefits: Va Ignoring Court Decision?

[Guest allanopie]

Hello Folks,

i can't remember if this has been posted before, but know this efftects many of us. So here it is again, if it has been.

fwd: from "Colonel Dan"

Date: Wed, 19 Oct 2005 16:38:35 -0500

Subject: [VeteranIssues] C& P Exams joint and spine impairments FW: Vets Disability Benefits: VA Ignoring Court Decision?

"Keep on, Keepin' on"

Dan Cedusky, Champaign IL "Colonel Dan"

See my web site at:

http://www.angelfire.com/il2/VeteranIssues/

Change your email address when needed by signing in at

http://groups.yahoo.com/group/VeteranIssues/

Forward to other veterans, tell them to Sign up at:

http://groups.yahoo.com/group/VeteranIssues/join

If you have claims in based on joint and spine impairments, then you should

review

All the info below, and also talk to your VSO about a new exam, and make

sure

, in addition to the range-of-motion limitations specified in VA's

regulations, that the Doctor include info on any

additional functional limitations that may occur during "flare-ups" or

following "repetitive use" because

of painful motion, weakened movement, excess fatigability (or lack of

endurance), or incoordination

Below info is from a Recent GAO Report request by Rep Lane Evans, IL with

the web site

For it sent to be by Pentagonmaverick@aol.com, Bob Sawallesh -

http://www.pentagonmaverick.com/

GAO: Veterans' Disability Benefits: VA Could Enhance Its Progress in

Complying with Court Decision on Disability Criteria. GAO-06-46, October 12,

2005.

http://www.gao.gov/cgi-bin/getrpt?GAO-06-46.

Exams for joint and spine impairments are among

the exams that regional offices most frequently request, and in 2002, VA

found that 61 percent of the exam reports for such impairments did not

provide sufficient information for regional offices to make decisions

complying with disability criteria mandated by the U.S. Court of Appeals

for Veterans Claims in DeLuca v. Brown, 8 Vet. App. 202 (1995).

In DeLuca, the court held that when federal regulations define joint and

spine impairment severity in terms of limits on range of motion, VA claims

adjudicators must consider whether range of motion is further limited by

factors such as pain and fatigue during "flare-ups" or following repetitive

use of the impaired joint or spine. Whenever VA regional offices ask VA

medical centers to conduct joint and spine disability exams, the medical

centers should prepare exam reports containing the information mandated

in DeLuca. You asked that we determine VA's progress since 2002 in

ensuring that its medical centers consistently prepare joint and spine exam

reports containing the information required by DeLuca.

To determine disability severity, VA claims adjudicators

must use medical criteria published in federal regulations.

For certain musculoskeletal disabilities, such as joint and

spine impairments, the regulations specify range-of-motion

limitations that adjudicators must use to determine severity.

. However, the U.S. Court of Appeals for Veterans Claims

held in DeLuca that, in addition to the range-of-motion

limitations specified in VA's regulations, adjudicators also

must consider any additional functional limitations that may

occur during "flare-ups" or following "repetitive use" because

of painful motion, weakened movement, excess fatigability

(or lack of endurance), or incoordination.

Ensuring that joint and spine exam reports meet the DeLuca

requirements is important. Otherwise, a claims adjudicator

may not assign an appropriate severity rating for a veteran's

condition.

. Under VA's quality review standards, a joint or spine exam

report satisfies the DeLuca "repetitive use" criteria if the

exam report indicates the extent, if any, and the number of

degrees, if possible, to which range of motion is additionally

limited by pain, fatigue, weakness, or lack of endurance

following repetitive use. The additional functional loss may

be stated in terms of either degrees of loss of motion or the

additional percentage of loss of motion.

Under VA's quality review standards, a joint or spine exam

report satisfies the DeLuca "flare-up" criteria if the report

either states the claimant does not experience any flare-ups

or provides a description of the flare-ups.

However, many joint and spine exam reports still do not

comply with the DeLuca criteria, and VHA's 21 VISNs vary

widely in the percentage of exams that satisfy the DeLuca

criteria.

In its 2002 baseline review of disability exam report quality,

CPEP found that about 61 percent of VHA's joint and spine

exam reports did not contain the information required by

DeLuca.

. However, by May 2005, the percentage of joint and spine

exam reports not containing the information required by

DeLuca had declined substantially from 61 percent to 22

percent. (See table 1.)

some case's to review

http://www.va.gov/vetapp95/files5/9522071.txt - 9kb

58%

Decision Date: 10/31/95 Archive Date: 01/17/96 DOCKET NO. In the recent case

of DeLuca v. Brown, 94-242 (U.S. Vet. D.C. SPICKLER Member, Board of

Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures

Improvement Act, Pub ...

_____

http://www.va.gov/vetapp95/files5/9521614.txt - 6kb

57%

Decision Date: 10/30/95 Archive Date: 10/27/95 DOCKET NO. 5. The RO should

in light of DeLuca v. Brown, No. I. SHERMAN Member, Board of Veterans'

Appeals The Board of Veterans' Appeals Administrative Procedures Improvement

Act, Pub ...

_____

http://www.va.gov/vetapp95/files5/9523600.txt - 8kb

57%

Decision Date: 11/24/95 Archive Date: 11/27/95 DOCKET NO. 3. The RO should

in light of DeLuca v. Brown, No. I. S. SHERMAN Member, Board of Veterans'

Appeals The Board of Veterans' Appeals Administrative Procedures Improvement

Act, Pub ...

_____

http://www.va.gov/vetapp95/files5/9523584.txt - 5kb

57%

Decision Date: 11/22/95 Archive Date: 11/22/95 DOCKET NO. 5. The RO should

in light of DeLuca v. Brown, No. I. S. SHERMAN Member, Board of Veterans'

Appeals The Board of Veterans' Appeals Administrative Procedures Improvement

Act, Pub ...

_____

From: Pentagonmaverick@aol.com [mailto:Pentagonmaverick@aol.com]

Sent: Tuesday, October 18, 2005 8:10 PM

To: Pentagonmaverick@aol.com

Subject: Vets Disability Benefits: VA Ignoring Court Decision?

Vets Disability Benefits: VA Ignoring Court Decision?

GAO: Veterans' Disability Benefits: VA Could Enhance Its Progress in

Complying with Court Decision on Disability Criteria. GAO-06-46, October 12,

2005.

http://www.gao.gov/cgi-bin/getrpt?GAO-06-46.

Bob Sawallesh - http://www.pentagonmaverick.com/

[Guest phubai70]

Allan - thanks, I must have missed it the first time. I still have to digest all of it but I believe this info may help with my nod on additional physical claims...

thanks