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Detonator

Insomnia - Combined Rating

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Detonator    0

I left the Army in 1995 with 20% lower back, 10% left knee meniscus, and 20% right knee PCL deficiency following surgery (50% total). Last year, I asked for an increase on my left knee, right knee and requested a secondary service connection for insomnia due to chronic pain.

Today, I received a letter stating that they denied any increase for my knees but did grant service connection for my insomnia (it dates back to 1998) and awarded 10%. However, the letter states the VA does a combined rating and will not increase past my 50%.

So what does the 10% service connection for my insomnia mean? I was hoping to get at least a 12 month back dated check for the 10% but it doesn't sound like I will get anything.

If someone could explain how this service connection for insomnia will help me....please let me know.

Also, the way they worded the decision, it makes it sound like I'm lucky they didn't decide to reduce my 50%. Amazing!

Any insight would be helpful!

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14 answers to this question

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Detonator    0

The letter states we do no add the individual percentages of each condition to determine your combined rating. Also under the insomnia decision, because apparently my doctor didn't put in there that insomnia effects my employment, it has some significance. Even though I only work one day a week (Part time job) and just recently began seeing a therapist for depression side effects.

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Detonator    0

Also, if my insomnia condition continues to worsen....since it is service connected now....could I get that temporary total disability? Could my VA Sleep Doctor request that?

Sorry to keep adding questions...I'm just a bit frustrated with that letter. It didn't come at a good time! :rolleyes:

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vaf    4

Detonator, ratings are awarded in increments of 10% (10%, 20%, 30%, etc.). They are also combined with your other ratings, not parsed out and rated separately, or retroactively. What the VA appears to be stating is that even though they've added 10% for the insominia rating, when combined with your other ratings and compared to the Combined Ratings Table in 38 CFR Part 4, it wasn't enough to increase your ratings or payments. A higher rating might have done so, but again, everything is combined and measured through that Combined Ratings Table. There's a calculator on the home page of hadit. Plug in your ratings for your separate conditions and see what you get.

http://www.hadit.com/Service_Connected_Rating_Calculator

You can file a Notice of Disagreement, get the doctor to clarify his staement saying that you can't work, and while you're at it, file for TDIU (unemployability). Again, there's a lot of information mentioned on the home page here that should help direct you.

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john999    676

I would try and work the insomnia and chronic pain into a depression claim. You can get a greater percentage rating for depression than insomnia alone. Are you seeing a psychiatrist about your chronic pain and insomnia. If you can't work file for TDIU. Just about eveyone who has chronic pain does suffer from some depression.

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trailblazer    0

Detonator, I received the same answer on 7-14-08. MY initial rating for DMI II was 40% and hypertinsion was defered on the initial rating pending an additional C&P exam. I was awarded 10% sc for the hypertinsion but my combined rating remained at 40% ( Quote from th rater. We do not add the indiviual percentages of each condition to determin your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions) The way I understand the rating calculator 50% plus 10% gives you a total rating of 55%. If it had been 55.5% it would have been rounded up to 60% total rating. In my case 40% plus 10% equals 46% rounded up to 50%. I am with you, I don't understand this and I am still looking for an explanation. I am sure someone on HADIT can handle that.

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Ricky    1

55 will round up to 60 percent. VA math is hard to understand. It is based upon the fact that if you have a 40 percent rating then you are still 60 percent good/well/capable. If you then apply for another disability and they give you a 10 percent rating for that disability, it is matched against you good/well percentage which would be 10 percent of 60 percent which equals 6 percent. It is then added to you bad side of 40 percent which equals 46 percent. Meaning you are actually 46 percent disabled and now only have 54 percent of good left in you. However, for pay purposes the 46 is rounded to 50 percent and they pay you at the 50 percent level.

Now if you apply for another disability and say they award you another 10 percent disability for it - they take this new 10 percent from the 54 percent good you have left which equals 5.4 percent. This 5.4 percent is now added to your bad side of 46 which equals 51.4 which is rounded down to 50 percent so you get paid at the 50 percent rate, therefore there is no change in your payments. The statement in the rating decision is just to remind you that, for example a person with a current 60 percent rating who just got a 10 percent rating will not get a total rating of 70 percent, the new rating will be 64 percent so there will be no change in the monthly payment cause the 64 percent rating is rounded down to 60 percent and the vet was already being paid at 60 percent. The award of the new 10 percent rating is simply a building block to a higher rating and could mean the difference of getting or not getting of DIC for the dependents if the vet happened to die of something associated with the new 10 percent rating.

See it is kinda complicated and silly but that's the way it is.

Forgot to ask - what disability code did they rate the insomina under?

Edited by Ricky

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