hypertension Bilateral Factor/single Disease Entity

[pat100]

Hello All:

I need help computing the bilateral factor. I have read 4-25 Combined Rating Table until I am brain dead. I'm normally good at military/va regs but for some reason I am having problems with this. Please do not only quote the regs because this will not help me.

My husband who is a 21 year navy retired vet, was awarded 100% sc for stage 3b cancer in April of 2006. This week we recieved notification that the Va is proposing to drop his cancer disability from 100% to 60% with an overall rating of 90%. Since it has been over 6 months since his last chemo treatment, the Va can re-eval and lower his cancer percentage. But I need to know if their math is correct. The following is a list of his disabilities:

Colon cancer: 60%

Depression : 30%

Neuropathy Rt hand: 10%

" Lt hand: 10%

RT Foot: 10%

Lt Foot: 10%

Scars Colon Surgery: 10%

Port a cath implant: 10%

The above listed disabilities are all arising from a single disease entity i.e. colon cancer. The Neuropathy should be computed as bilateral four estremities per 4.26 bilateral factor.

He also has received awards not related to the cancer and they are as follows:

Asthma: 30%

Reflux: 10%

Hypertension: 10%

I love Va Math which in my husband's case 200%=90% combined rating. Anyway if someone a lot smarter than me could double check the va math using the bilateral factor for four extremities per 4.26 it would be most appreciated. And how does the single entity come to play into computation?

At this point we don't know what to do. Is their math correct? Should we appeal (They keep requiring the same c&p exams over and over ie 3 colon exams within one year and my husband is getting upset with all the bull) or should he just put in for unemployability? He put in for unemployability in 2006 but it was drop without a decision because they awarded him the 100%. I feel that we shouldn't do anything until we know if their computations are correct so if someone could double check their figures and show me how you did it, it would be greatly appreicated.

Thank You,

Pat

[poolguy11550]

Pat- I agree VA math is fuzzy at best. The bilateral factor is one of the most poorly applied and understood aspects by raters and veterans alike, but it is the raters duty to accurately rate the bilaterial factor when first found. Rarely happnes. Your husbands hands and feet are both qualified under the bilateral factor, the trouble is that you are going to have to claim 1. bilateral hand neuropathy and 2. bilateral foot neuropathy. Yes you may have to do the C&P exam all over again for this- but you will win.

The correct math: 10% R hand + 10% L hand= 20% + 10% value of the two together under the bilaterial factor= 22%

I have seen this inconsistany applied nearly everytime. Often 10%+10%= 20% or 10+10+10BF=30% also very commond.

How is your husbands elbows? Knees? The bilaterial factor adds up all conditions on the both arms/hands & both feet/legs.

Edited December 9, 2008 by poolguy11550

[pat100]

Pat- I agree VA math is fuzzy at best. The bilateral factor is one of the most poorly applied and understood aspects by raters and veterans alike, but it is the raters duty to accurately rate the bilaterial factor when first found. Rarely happnes. Your husbands hands and feet are both qualified under the bilateral factor, the trouble is that you are going to have to claim 1. bilateral hand neuropathy and 2. bilateral foot neuropathy. Yes you may have to do the C&P exam all over again for this- but you will win.

The correct math: 10% R hand + 10% L hand= 20% + 10% value of the two together under the bilaterial factor= 22%

I have seen this inconsistany applied nearly everytime. Often 10%+10%= 20% or 10+10+10BF=30% also very commond.

How is your husbands elbows? Knees? The bilaterial factor adds up all conditions on the both arms/hands & both feet/legs.

[tancho]

Greetings!

I used one of the VA Calculators and below show the results. It appears actual rating is 92% rounded up to 90%.

For BILATERALS FIRST WHICH ARE: Neuropathy Rt hand: 10%;" Lt hand: 10%;RT Foot: 10%; and Lt Foot: 10%

1/////10%

2/////10%

3/////10%

4/////10%

9/////38%/////(BILATERAL TOTAL)

-------------------------------------------

Adding Bilateral Total (9)to rest below:

/////RATING/////COMBINED RATING

9/////38%////////(BILATERAL TOTAL)

1/////60%/////75%

2/////30%/////83%

3/////30%/////88%

4/////10%/////89%

5/////10%/////90%

6/////10%/////91%

7/////10%/////92%

TOT//198%/////92%

[pat100]

Pat- I agree VA math is fuzzy at best. The bilateral factor is one of the most poorly applied and understood aspects by raters and veterans alike, but it is the raters duty to accurately rate the bilaterial factor when first found. Rarely happnes. Your husbands hands and feet are both qualified under the bilateral factor, the trouble is that you are going to have to claim 1. bilateral hand neuropathy and 2. bilateral foot neuropathy. Yes you may have to do the C&P exam all over again for this- but you will win.

The correct math: 10% R hand + 10% L hand= 20% + 10% value of the two together under the bilaterial factor= 22%

I have seen this inconsistany applied nearly everytime. Often 10%+10%= 20% or 10+10+10BF=30% also very commond.

How is your husbands elbows? Knees? The bilaterial factor adds up all conditions on the both arms/hands & both feet/legs.

I'm not sure that I am replying in the correct format.

My husbands elbows and knees are fine, it's just his hands and feet that the chemo really affected. He can't grip things, burns himself if he tries to cook, can't stand the cold, feet are numb and hurt at the same time and the va only awarded him 10% for each. Anyway, do I still computer the largest disabilities first and then compute the 22% in order of degree of disabilities.

Thanks so much for your reply.

[poolguy11550]

Bilateral factor is only added up for the two sides of the same body area-I.e. hands/arms and all %s are combined with 10% of the combined value added to the final rating. Hands/arms are separate from legs/feet.

[poolguy11550]

correct- the largest %'s to the smallest. I was inquiring because it is not uncommon for elbows and knees/legs to have some neurological issues due to cancer treatment also and these could be added into the bilateral factor if rated.