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Compensable Condition Missed From C&p Exam

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Guest Morgan

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I was just reviewing my husband's very first rating decision and noticed the C&P exam notes for the Reasons and Bases section. The VA examiner named two compensable secondary conditions, but only one was rated. The two have overlapping symptoms, as systemic conditons often do, but they have different diagnostic codes. Two sentences are quoted, and each sentence mentions one of the conditions. Should both have been rated, even if we didn't mention both? Actually, we didn't mention either of them, but we did file a claim for the primary condition to which they both are secondary.

Also, with the one rated, the VA failed to apply the "next higher evaluation" rule. The disability picture is more closely related to the next higher rating because the symptom from the criteria for the lower rating is described as the "beginning" of this symptom, but the C&P examiner called the condition "chronic" and described the symptom as it is when it is well established. Is that a CUE?

Carrie

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Carrie,

Many times a veteran will have 2 or more conditions that have many of the same symptoms. Sometimes they can be compensated for both, sometimes not. For example, I copied this directly from 38 CFR 4.114...

Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.

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