Received Rating Decision On Saturday, Have A Few Questions

[pilgrim01]

I received the brown envelope on Saturday. They gave me 30% for one claim and 10% for another (40% total). In reference to my other post about whether to do a NOD or Request for Reconsideration, how is the calculation done? I know it should be favorable for me to get additional disability due to my current back problems which I explained in my other post. I had a claim for numbness/tingling from my lower back down the back of my right leg. They gave me NOTHING for that claim! I went to the doctor again about a month ago (while waiting for a decision) and my NEW doctor had x-rays and a mri done. Back problems discovered, but the VA gave me nothing for that claim. Now, I need to do a Request for Reconsideration, right? So, let's say they give me another 10% (hopefully more) for my back, would they re-calculate 30%, 10%, 10% or would the re-calculate 40% and 10%? Please advise. Thanks!

My MRI results are too much to type but they do mention nerve roots, protrusions, etc.

Also, during my exam the doc said I had tinea pedis which is athlete's foot. :-) I didn't make a claim for it. Can I make a claim that now since the doc wrote that in is exam notes?

Edited March 23, 2009 by pilgrim01

[sharon]

§4.25 Combined ratings table.

Table I, Combined Ratings Table, results from the consideration of the efficiency of the individual as affected first by the most disabling condition, then by the less disabling condition, then by other less disabling conditions, if any, in the order of severity. Thus, a person having a 60 percent disability is considered 40 percent efficient. Proceeding from this 40 percent efficiency, the effect of a further 30 percent disability is to leave only 70 percent of the efficiency remaining after consideration of the first disability, or 28 percent efficiency altogether. The individual is thus 72 percent disabled, as shown in table I opposite 60 percent and under 30 percent.

(a) To use table I, the disabilities will first be arranged in the exact order of their severity, beginning with the greatest disability and then combined with use of table I as hereinafter indicated. For example, if there are two disabilities, the degree of one disability will be read in the left column and the degree of the other in the top row, whichever is appropriate. The figures appearing in the space where the column and row intersect will represent the combined value of the two. This combined value will then be converted to the nearest number divisible by 10, and combined values ending in 5 will be adjusted upward. Thus, with a 50 percent disability and a 30 percent disability, the combined value will be found to be 65 percent, but the 65 percent must be converted to 70 percent to represent the final degree of disability. Similarly, with a disability of 40 percent, and another disability of 20 percent, the combined value is found to be 52 percent, but the 52 percent must be converted to the nearest degree divisible by 10, which is 50 percent. If there are more than two disabilities, the disabilities will also be arranged in the exact order of their severity and the combined value for the first two will be found as previously described for two disabilities. The combined value, exactly as found in table I, will be combined with the degree of the third disability (in order of severity). The combined value for the three disabilities will be found in the space where the column and row intersect, and if there are only three disabilities will be converted to the nearest degree divisible by 10, adjusting final 5’s upward. Thus if there are three disabilities ratable at 60 percent, 40 percent, and 20 percent, respectively, the combined value for the first two will be found opposite 60 and under 40 and is 76 percent. This 76 will be combined with 20 and the combined value for the three is 81 percent. This combined value will be converted to the nearest degree divisible by 10 which is 80 percent. The same procedure will be employed when there are four or more disabilities. (See table I).

(:D Except as otherwise provided in this schedule, the disabilities arising from a single disease entity, e.g., arthritis, multiple sclerosis, cerebrovascular accident, etc., are to be rated separately as are all other disabling conditions, if any. All disabilities are then to be combined as described in paragraph (a) of this section. The conversion to the nearest degree divisible by 10 will be done only once per rating decision, will follow the combining of all disabilities, and will be the last procedure in determining the combined degree of disability. (Authority: 38 U.S.C. 1155)

Table I—Combined Ratings Table

[10 combined with 10 is 19]

10 20 30 40 50 60 70 80 90

19................... 27.......... 35.......... 43.......... 51.......... 60.......... 68.......... 76.......... 84.......... 92

20................... 28.......... 36.......... 44.......... 52.......... 60.......... 68.......... 76.......... 84.......... 92

21................... 29.......... 37.......... 45.......... 53.......... 61.......... 68.......... 76.......... 84.......... 92

22................... 30.......... 38.......... 45.......... 53.......... 61.......... 69.......... 77.......... 84.......... 92

23................... 31.......... 38.......... 46.......... 54.......... 62.......... 69.......... 77.......... 85.......... 92

24................... 32.......... 39.......... 47.......... 54.......... 62.......... 70.......... 77.......... 85.......... 92

25................... 33.......... 40.......... 48.......... 55.......... 63.......... 70.......... 78.......... 85.......... 93

26................... 33.......... 41.......... 48.......... 56.......... 63.......... 70.......... 78.......... 85.......... 93

27................... 34.......... 42.......... 49.......... 56.......... 64.......... 71.......... 78.......... 85.......... 93

28................... 35.......... 42.......... 50.......... 57.......... 64.......... 71.......... 78.......... 86.......... 93

29................... 36.......... 43.......... 50.......... 57.......... 65.......... 72.......... 79.......... 86.......... 93

30................... 37.......... 44.......... 51.......... 58.......... 65.......... 72.......... 79.......... 86.......... 93

31................... 38.......... 45.......... 52.......... 59.......... 66.......... 72.......... 79.......... 86.......... 93

32................... 39.......... 46.......... 52.......... 59.......... 66.......... 73.......... 80.......... 86.......... 93

33................... 40.......... 46.......... 53.......... 60.......... 67.......... 73.......... 80.......... 87.......... 93

34................... 41.......... 47.......... 54.......... 60.......... 67.......... 74.......... 80.......... 87.......... 93

35................... 42.......... 48.......... 55.......... 61.......... 68.......... 74.......... 81.......... 87.......... 94

36................... 42.......... 49.......... 55.......... 62.......... 68.......... 74.......... 81.......... 87.......... 94

37................... 43.......... 50.......... 56.......... 62.......... 69.......... 75.......... 81.......... 87.......... 94

38................... 44.......... 50.......... 57.......... 63.......... 69.......... 75.......... 81.......... 88.......... 94

39................... 45.......... 51.......... 57.......... 63.......... 70.......... 76.......... 82.......... 88.......... 94

40................... 46.......... 52.......... 58.......... 64.......... 70.......... 76.......... 82.......... 88.......... 94

41................... 47.......... 53.......... 59.......... 65.......... 71.......... 76.......... 82.......... 88.......... 94

42................... 48.......... 54.......... 59.......... 65.......... 71.......... 77.......... 83.......... 88.......... 94

43................... 49.......... 54.......... 60.......... 66.......... 72.......... 77.......... 83.......... 89.......... 94

44................... 50.......... 55.......... 61.......... 66.......... 72.......... 78.......... 83.......... 89.......... 94

45................... 51.......... 56.......... 62.......... 67.......... 73.......... 78.......... 84.......... 89.......... 95

46................... 51.......... 57.......... 62.......... 68.......... 73.......... 78.......... 84.......... 89.......... 95

47................... 52.......... 58.......... 63.......... 68.......... 74.......... 79.......... 84.......... 89.......... 95

48................... 53.......... 58.......... 64.......... 69.......... 74.......... 79.......... 84.......... 90.......... 95

49................... 54.......... 59.......... 64.......... 69.......... 75.......... 80.......... 85.......... 90.......... 95

50................... 55.......... 60.......... 65.......... 70.......... 75.......... 80.......... 85.......... 90.......... 95

51................... 56.......... 61.......... 66.......... 71.......... 76.......... 80.......... 85.......... 90.......... 95

52................... 57.......... 62.......... 66.......... 71.......... 76.......... 81.......... 86.......... 90.......... 95

53................... 58.......... 62.......... 67.......... 72.......... 77.......... 81.......... 86.......... 91.......... 95

54................... 59.......... 63.......... 68.......... 72.......... 77.......... 82.......... 86.......... 91.......... 95

55................... 60.......... 64.......... 69.......... 73.......... 78.......... 82.......... 87.......... 91.......... 96

56................... 60.......... 65.......... 69.......... 74.......... 78.......... 82.......... 87.......... 91.......... 96

57................... 61.......... 66.......... 70.......... 74.......... 79.......... 83.......... 87.......... 91.......... 96

58................... 62.......... 66.......... 71.......... 75.......... 79.......... 83.......... 87.......... 92.......... 96

59................... 63.......... 67.......... 71.......... 75.......... 80.......... 84.......... 88.......... 92.......... 96

60................... 64.......... 68.......... 72.......... 76.......... 80.......... 84.......... 88.......... 92.......... 96

61................... 65.......... 69.......... 73.......... 77.......... 81.......... 84.......... 88.......... 92.......... 96

62................... 66.......... 70.......... 73.......... 77.......... 81.......... 85.......... 89.......... 92.......... 96

63................... 67.......... 70.......... 74.......... 78.......... 82.......... 85.......... 89.......... 93.......... 96

64................... 68.......... 71.......... 75.......... 78.......... 82.......... 86.......... 89.......... 93.......... 96

65................... 69.......... 72.......... 76.......... 79.......... 83.......... 86.......... 90.......... 93.......... 97

66................... 69.......... 73.......... 76.......... 80.......... 83.......... 86.......... 90.......... 93.......... 97

67................... 70.......... 74.......... 77.......... 80.......... 84.......... 87.......... 90.......... 93.......... 97

68................... 71.......... 74.......... 78.......... 81.......... 84.......... 87.......... 90.......... 94.......... 97

69................... 72.......... 75.......... 78.......... 81.......... 85.......... 88.......... 91.......... 94.......... 97

70................... 73.......... 76.......... 79.......... 82.......... 85.......... 88.......... 91.......... 94.......... 97

71................... 74.......... 77.......... 80.......... 83.......... 86.......... 88.......... 91.......... 94.......... 97

72................... 75.......... 78.......... 80.......... 83.......... 86.......... 89.......... 92.......... 94.......... 97

73................... 76.......... 78.......... 81.......... 84.......... 87.......... 89.......... 92.......... 95.......... 97

74................... 77.......... 79.......... 82.......... 84.......... 87.......... 90.......... 92.......... 95.......... 97

75................... 78.......... 80.......... 83.......... 85.......... 88.......... 90.......... 93.......... 95.......... 98

76................... 78.......... 81.......... 83.......... 86.......... 88.......... 90.......... 93.......... 95.......... 98

77................... 79.......... 82.......... 84.......... 86.......... 89.......... 91.......... 93.......... 95.......... 98

78................... 80.......... 82.......... 85.......... 87.......... 89.......... 91.......... 93.......... 96.......... 98

79................... 81.......... 83.......... 85.......... 87.......... 90.......... 92.......... 94.......... 96.......... 98

80................... 82.......... 84.......... 86.......... 88.......... 90.......... 92.......... 94.......... 96.......... 98

81................... 83.......... 85.......... 87.......... 89.......... 91.......... 92.......... 94.......... 96.......... 98

82................... 84.......... 86.......... 87.......... 89.......... 91.......... 93.......... 95.......... 96.......... 98

83................... 85.......... 86.......... 88.......... 90.......... 92.......... 93.......... 95.......... 97.......... 98

84................... 86.......... 87.......... 89.......... 90.......... 92.......... 94.......... 95.......... 97.......... 98

85................... 87.......... 88.......... 90.......... 91.......... 93.......... 94.......... 96.......... 97.......... 99

86................... 87.......... 89.......... 90.......... 92.......... 93.......... 94.......... 96.......... 97.......... 99

87................... 88.......... 90.......... 91.......... 92.......... 94.......... 95.......... 96.......... 97.......... 99

88................... 89.......... 90.......... 92.......... 93.......... 94.......... 95.......... 96.......... 98.......... 99

89................... 90.......... 91.......... 92.......... 93.......... 95.......... 96.......... 97.......... 98.......... 99

90................... 91.......... 92.......... 93.......... 94.......... 95.......... 96.......... 97.......... 98.......... 99

91................... 92.......... 93.......... 94.......... 95.......... 96.......... 96.......... 97.......... 98.......... 99

92................... 93.......... 94.......... 94.......... 95.......... 96.......... 97.......... 98.......... 98.......... 99

93................... 94.......... 94.......... 95.......... 96.......... 97.......... 97.......... 98.......... 99.......... 99

94................... 95.......... 95.......... 96.......... 96.......... 97.......... 98.......... 98.......... 99.......... 99

(Authority: 38 U.S.C. 1155)

[jbasser]

The severity of your back condition can only be awardded 60 percent under IVDS if you are prescribed bed rest or show totally incapicitating episdes. You can ask for an increase for Radiculopathy to the effected nerve roots. This depends ont he nerves involved. The rating criteria does state to rate the nerves separate. If they did not do this then you have a good arguement as long as the diagnosis of radicular signs or radiculopathy does exist. The Doc should provide a Nexus. If he or she has, then most likely the RO ignored it and low balled your claim. Athletes foot is a common condition. Were you treated in Service for it? It has to be nexused to an in service incident and a current condion, Getting a doc to nexus that one would be close to impossible since you can pick it up anywhere, Hotel Rooms, Showers, Anywhere the fungus can grow.

J

Edited March 24, 2009 by jbasser

[pilgrim01]

Jbasser, Thanks a million! Forgive my ignorance, but what is Nexus?

So, I when I file for the request fo reconsideration, I can file not only for the back problems, but I can also file a seperate claim(s) for the nerve root problems? I TOTALLY did not know that! I have a follow-up with my doctor on Thursday. Is there anything I should say/do?

As far as the athlete's foot is concerned, I didn't retire from the military until Nov 1st. I had my exam in October. Wouldn't it still be service-connected?

[broncovet]

A nexus is a statement by your doctor that you condition was likely due to military service. Normally, to "win" benefits you need the doctor to state, to the effect, there is a 51% or better chance that the military caused your condition.

Good nexus statements that win benefits are:

"Veterans condition most likely due to military service."

"Veterans condition at least as likely as not due to military service."

Some that dont work so well, which are likely to result in a denial are:

"Veterans condition may be caused by military service."

"Veterans condition could be caused by military service."

"Veterans condition might be caused by military service."

The VA considers these statemements speculative, and are LESS than 51%.

A nexus statement is NOT always required, some examples are:

1. Recently released from active duty..you are presumed to have been medically sound when you went into the military, except for conditions noted on your entrance medical exam.

2. Presumptive. There are a list of presumptive conditions. For example, if you served in Vietnam in certain periods of time, you are assumed to have been exposed to agent orange and if you get certain diseases, then they are presumptive and a docs nexus is not required.

2.

Edited March 24, 2009 by broncovet

[jbasser]

If it was diagnosed in service and it is recurring then you should have no problem if it is a rateable disability.

A Nexus is a Doctor stating a connection between a medical condition and a Veterans period of service.

Since you retired in November then you most likely will not need a nexus. They should rate on the info they already have.

Get a copy of your claims folder or c file and look for inferred issues.

J

Edited March 24, 2009 by jbasser

[pilgrim01]

Inferred issues?