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diablogun

New To Forum, Exam Upcoming On Psoriasis And Arhtritis

Question

Hi all,

I'm a new guy, and I've been perusing the posts, but haven't seen much about my condition. Next Tuesday I am going to my ratings physical (is it called this?) to have my service connected disabilities rated. I have Psoriasis and associated Psoriatic arthritis, and am wondering what I can expect from the rating. I have been on immunosuppressive drugs for more than 3 years for the Psoriasis, so according to the schedule that should be 60%?

For the arthritis, I have it in my back, knees, wrists, hands, and to a lesser extent in 1 shoulder and both ankles. Does anyone have any idea if they lump these all together, as it seems to indicate under ratings code 5002? Any information offered is much appreciated, I am pretty new to this process.

Thank you in advance :-)

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http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

These are the blank C & P exams- which is what I think you mean by the ratings physical.

There might be something there that shows you what to expect.

Also the BVA web site has claims similiar to your condition and if you put psoriasis and arthritis into the BVA search engine they will come- I saw 4 for 2008 but the weather affected my connection-

I see that you are 90% SC- are you able to work- and if not have you applied for TDIU and SSA?

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http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

These are the blank C & P exams- which is what I think you mean by the ratings physical.

There might be something there that shows you what to expect.

Also the BVA web site has claims similiar to your condition and if you put psoriasis and arthritis into the BVA search engine they will come- I saw 4 for 2008 but the weather affected my connection-

I see that you are 90% SC- are you able to work- and if not have you applied for TDIU and SSA?

Hello :-)

I put 90% because I had to put something when I registered. I am assuming 60% for the psoriasis and perhaps 60 or 70 for the arthritis, which would make it 90%. I can presently work, though the arthritis causes constant pain, I will put off the IU as long as I can hold a job. If the time comes that working is too difficult, is that the time that I should put in for SSA? I hope I never have to do that. Anyway, thank you for the information :-)

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Diablogun,

I filed a claim in March 2007 for both Psoriatic Arthritis and psoriasis, I was rated at 60% in May of this year (60% for psoriatic arthritis and 10% for psoriasis). I have filed a NOD because I have taken on Methrotrextate (immunosuppressive drug) every week for the past three years to treat both, if successful my rating for psoriasis should increase to 60%. Also I filed my first claim almost 17 years after my discharge from active duty.

Here's what was in my rating letter:

Psoriatic Arthritis:

We have granted your claim for service connection for your psoriatic arthritis because evidence shows that this disability developed as a result of the inservice psoriasis. We have assigned a 60 percent evaluation effective March 21, 2007, the date we received your claim treatment records from your private physicians show that you have been treated for this condition since early 2006. The records show that you have been treated with methotrexate with significant relief of symptoms. Your disease remains in the active phase. In 2007 you underwent surgery for significant left wrist disability. VA examination shows that both wrists elbows and hands are affected as well as the ankles and feet. You have flares about every month or two lasting for 1 to 2 days, relieved by Celebrex and rest. There is some loss of motion in the elbows, wrists, knees, feet and hips. There is no ankylosis. The hands show boutonniere deformity of all fingers except the thumb and little finger on the left. There is a gap between the finger and proximal transverse crease of hand of the left of 1 to 2 inches. On the right there is no gap. Range of motion of the right thumb is from 0 to 20 degrees and on the left from 0 to 30 degrees. There was no painful motion. The examiner states that this condition is due to the psoriasis incurred during military service.

An evaluation of 60 percent is assigned for an active process with weight loss and anemia productive of severe impairment of health, severely incapacitating exacerbations occurring four or more times a year, or a lesser number over prolonged periods. A higher evaluation of 100 percent is not warranted unless there is a totally incapacitating process with constitutional manifestations and active joint involvement.

Since there is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination.

Psoriasis:

We have granted your claim for service connection for psoriasis because service medical records show that this condition began during military service. We have assigned a 10 percent evaluation effective March 21, 2007, the date we received your claim. Your service treatment records show that your psoriasis began on your knees in 1987. Subsequent to service you have continued to receive treatment in the form of topical creams and corticosteroid (Cordran) tape. VA examination shows that currently the psoriasis covers 18 percent of exposed areas and 15 percent of non exposed areas. The face is normal with scaly psoriasiform lesions over the elbows and also the dorsal surface of the hands. The skin on the body is within normal limits. An evaluation of 10 percent is assigned for evidence of at least 5 percent, but less than 20 percent, of the entire body, or at least 5 percent, but less than 20 percent, of exposed areas affected, or; intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period. A higher evaluation of 30 percent is not warranted unless the record shows 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12- month period.

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Diablogun,

I filed a claim in March 2007 for both Psoriatic Arthritis and psoriasis, I was rated at 60% in May of this year (60% for psoriatic arthritis and 10% for psoriasis). I have filed a NOD because I have taken on Methrotrextate (immunosuppressive drug) every week for the past three years to treat both, if successful my rating for psoriasis should increase to 60%. Also I filed my first claim almost 17 years after my discharge from active duty.

Here's what was in my rating letter:

Psoriatic Arthritis:

We have granted your claim for service connection for your psoriatic arthritis because evidence shows that this disability developed as a result of the inservice psoriasis. We have assigned a 60 percent evaluation effective March 21, 2007, the date we received your claim treatment records from your private physicians show that you have been treated for this condition since early 2006. The records show that you have been treated with methotrexate with significant relief of symptoms. Your disease remains in the active phase. In 2007 you underwent surgery for significant left wrist disability. VA examination shows that both wrists elbows and hands are affected as well as the ankles and feet. You have flares about every month or two lasting for 1 to 2 days, relieved by Celebrex and rest. There is some loss of motion in the elbows, wrists, knees, feet and hips. There is no ankylosis. The hands show boutonniere deformity of all fingers except the thumb and little finger on the left. There is a gap between the finger and proximal transverse crease of hand of the left of 1 to 2 inches. On the right there is no gap. Range of motion of the right thumb is from 0 to 20 degrees and on the left from 0 to 30 degrees. There was no painful motion. The examiner states that this condition is due to the psoriasis incurred during military service.

An evaluation of 60 percent is assigned for an active process with weight loss and anemia productive of severe impairment of health, severely incapacitating exacerbations occurring four or more times a year, or a lesser number over prolonged periods. A higher evaluation of 100 percent is not warranted unless there is a totally incapacitating process with constitutional manifestations and active joint involvement.

Since there is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination.

Psoriasis:

We have granted your claim for service connection for psoriasis because service medical records show that this condition began during military service. We have assigned a 10 percent evaluation effective March 21, 2007, the date we received your claim. Your service treatment records show that your psoriasis began on your knees in 1987. Subsequent to service you have continued to receive treatment in the form of topical creams and corticosteroid (Cordran) tape. VA examination shows that currently the psoriasis covers 18 percent of exposed areas and 15 percent of non exposed areas. The face is normal with scaly psoriasiform lesions over the elbows and also the dorsal surface of the hands. The skin on the body is within normal limits. An evaluation of 10 percent is assigned for evidence of at least 5 percent, but less than 20 percent, of the entire body, or at least 5 percent, but less than 20 percent, of exposed areas affected, or; intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period. A higher evaluation of 30 percent is not warranted unless the record shows 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12- month period.

Hi John,

I am assuming the arthritis will break down in the same fashion as yours. My heart goes out to you, this disease is horrible. Did you tell them of the methotrexate during your C&P? I don't really want to have to appeal. I am surprised they only rated you 10% knowing you had been on immunosuppressive drugs. I am bringing my prescriptions and letter from my private doctor about the Enbrel I have injected for the psoriasis for almost 4 years.

Please let me know anything you can about the examination for the arthritis; did they take x-rays? Did they test each joint? Are all of your joints affected? Thank you for any information you may have :-)

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Yes, I told the C&P doctor that I was on MTX for both, he even noted that I have seen a "enormous improvement on the skin" since I started taken MTX on my C&P report. The rating letter only mentions this for the arthritis.

All of my joints a affected, some are worse such as my wrists and knees.

The C&P Doc used the exam work sheets http://www.vba.va.gov/bln/21/Benefits/exams/index.htm for "Shoulder, Elbow, Wrist, Hip, Knee, and Ankle" and "Hand, Thumb, and Fingers". Yes they did X-rays for all joints and used a goniometer to measure the ROM of each joint. He will also ask you alot of questions on how each joint impacts your daily activities, work and how ofen you have flares.

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