applejack Posted June 9, 2009 Share Posted June 9, 2009 is there a rating under cht35 for chronic pain/or chonic pain disorder anyone knows? Link to comment Share on other sites More sharing options...
carlie Posted June 9, 2009 Share Posted June 9, 2009 applejack, Welcome to Hadit. I think you are referring to 38 CFR. Hope this helps a vet. carlie http://ecfr.gpoaccess.gov/cgi/t/text/text-....13&idno=38 § 4.59 Painful motion. With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Muscle spasm will greatly assist the identification. Sciatic neuritis is not uncommonly caused by arthritis of the spine. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. Crepitation either in the soft tissues such as the tendons or ligaments, or crepitation within the joint structures should be noted carefully as points of contact which are diseased. Flexion elicits such manifestations. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. Carlie passed away in November 2015 she is missed. Link to comment Share on other sites More sharing options...
c&p man Posted June 9, 2009 Share Posted June 9, 2009 applejack, Welcome to Hadit. I think you are referring to 38 CFR. Hope this helps a vet. carlie http://ecfr.gpoaccess.gov/cgi/t/text/text-....13&idno=38 § 4.59 Painful motion. With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Muscle spasm will greatly assist the identification. Sciatic neuritis is not uncommonly caused by arthritis of the spine. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. Crepitation either in the soft tissues such as the tendons or ligaments, or crepitation within the joint structures should be noted carefully as points of contact which are diseased. Flexion elicits such manifestations. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. With musculoskeletal ratings there is no rating for pain persay. Rating is weighted towards range of motion in which painful motion is supposed to be considered. Neurological deficits are rated seperately but again pain is used as one of the indicators of a problem and is not necessarily "rated". The long and short of it is the amount of pain you suffer from does not determine your rating. The limitation/s that you face from your disablility do. If you are on pain meds that interfere with your ability to work that can be considered under the category of individual unemployability. If a doctor has determined you have chronic depression due to service connected pain that is rateable. If you have pain issues I highly suggest meeting with a pain management specialist, however, they are not going to provide a "rating for pain". As always, if someone with more knowledge notices a glaling error in this advice please chime in/correct. I hope this helps. Link to comment Share on other sites More sharing options...
HadIt.com Elder allan Posted June 9, 2009 HadIt.com Elder Share Posted June 9, 2009 Disability Examination Worksheets Mental Disorders (Except initial PTSD and Eating Disorders) Examination http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm ************************************************************ 9422 Pain disorder Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name...100 Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships...70 Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships...50 Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)...30 Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication...10 A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication...0 ****************************************************************** DeLuca v. Brown, 8 Vet.App. 202 (1995) (No. 94-242) (With respect to the question of whether 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5201 (limitation of motion of the arm) subsumes 38 C.F.R. § 4.40, the Court observes that range of motion undoubtedly can be affected by pain in certain situations, and a limitation of motion due to pain might indeed be reflected in a rating under that rating code. However, section 4.40 specifically refers to disability due to lack of normal "endurance", provides for a rating to be based on "functional loss . . . due to . . . pain", and states that "a part which becomes painful on use must be regarded as seriously disabled." Furthermore, section 4.40 provides that "t is essential that the [rating] examination . . . adequately portray the . . . functional loss." Accordingly, because DC 5201 provides for a rating solely on the basis of loss of range of motion, "[t]he Court holds that DC 5201 does not subsume 38 C.F.R. § 4.40, and that 38 C.F.R. § 4.14 [avoidance of pyramiding] does not forbid consideration of a higher rating based on a greater limitation of motion due to pain on use including during flare-ups." The Court also holds that DC 5201 does not subsume 38 C.F.R. § 4.45.) DeLuca v. Brown, 8 Vet.App. 202 (1995) (No. 94-242) (Because the April 1990 VA examination relied upon by the Board in denying the veteran's claim for an increased rating for his left shoulder disability merely recorded the range of motion at that time, and did not indicate consideration of the factors cited in 38 C.F.R. § 4.40, and required by section 4.40 to be considered and portrayed in the rating examination, as to functional loss on use or due to flare-ups, the Court concluded that a remand to the Board was required for the purpose of obtaining a new medical examination which complies with the requirements of section 4.40, and the medical examiner must be asked to express an opinion on whether pain could significantly limit functional ability during flare-ups or when the arm is used repeatedly over a period of time. "Because DC 5201 provides for a rating solely on the basis of loss of range of motion, these determinations should, if feasible, be 'portray[ed]' (§ 4.40) in terms of the degree of additional range-of-motion loss due to pain on use or during flare-ups.") DeLuca v. Brown, 8 Vet.App. 202 (1995) (No. 94-242) (With respect to the Board's determination that 38 C.F.R. § 4.45 did not provide for an increased rating above 20 percent for the veteran's service-connected left shoulder disability because "[w]eakened movement and excess fatigability usually are associated with muscle injury"; because "ncoordination is usually associated with disease or injury affecting the peripheral nerves"; and because this veteran's disability was not associated with "nerve injury" or "muscle injury, as such, to the left shoulder girdle", the Court held that the Board's reading of section 4.45 could not be sustained in that the plain language of that provision indicates that "[w]eakened movement", "[e]xcess fatigability", and "ncoordination" do not refer solely to muscle and nerve conditions. Accordingly, in the examination ordered on remand, the Court notes that the medical examiner should be asked to determine whether the left shoulder joint exhibits weakened movement, excess fatigability, or incoordination, and, if feasible, these determinations should be expressed in terms of the degree of additional range-of-motion loss due to any weakened movement, excess fatigability, or incoordination.) DeLuca v. Brown, 8 Vet.App. 202 (1995) (No. 94-242) (In a case involving a claim for an increased rating above 20 percent for a service-connected left shoulder disability, it was held by the Court that a remand was required because the Board's statement of reasons or bases did not adequately explain how pain on use was factored into its evaluation of the veteran's disability in terms of limitation-of-motion equivalency under 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5201 (limitation of motion of the arm).) Voyles v. Brown, 5 Vet.App. 451 (1993) Hatlestad v. Derwinski, 3 Vet.App. 213 (1992) Quarles v. Derwinski, 3 Vet.App. 129 (1992) Schafrath v. Derwinski, 1 Vet.App. 589 (1991) Lichtenfels v. Derwinski, 1 Vet.App. 484 (1991) Bailey v. Derwinski, 1 Vet.App. 441 (1991) Ferguson v. Derwinski, 1 Vet.App. 428 (1991) (No. 90-472) (38 C.F.R. § 4.40--functional loss due to pain, and 38 C.F.R. § 4.59)Martin v. Derwinski, 1 Vet.App. 411 (1991) (No. 90-343) (38 C.F.R. § 4.59) Ferraro v. Derwinski, 1 Vet.App. 326 (1991) (No. 90-444) (functional loss due to pain) abnrgr88 1 Link to comment Share on other sites More sharing options...
HadIt.com Elder john999 Posted June 9, 2009 HadIt.com Elder Share Posted June 9, 2009 You have to remember that VA considers chronic pain disorder to be an emotional disorder like PTSD or depression. The physical parts of the pain disorder are so intertwined with psychological factors they treat it as if you have a mental disorder. I am SC for chronic pain and some emotional problems, but it all comes to 70%. abnrgr88 1 Link to comment Share on other sites More sharing options...
HadIt.com Elder LarryJ Posted June 9, 2009 HadIt.com Elder Share Posted June 9, 2009 To answer your question, yes there is a recognized disability called Chronic Pain Syndrome, and it falls under the mental/psychiatric realm. I can't remember the Diagnostic Code number right off the top of my head. And, it has nothing to do with "painful motion" as covered in a couple of the answers to your question. The "painful motion" that is referred to is considered a disability of the muscular/skeletal system and is covered in the ortho section of the diagnostic codes. The Chronic Pain Syndrome can be caused by anything that can cause "chronic" pain, be it muscles, joints, migraines, cancer, etc. "It is cold and we have no blankets. The little children are freezing to death. My people, some of them, have run away to the hills, and have no blankets, no food; no one knows where they are-perhaps freezing to death. I want to have time to look for my children and see how many of them I can find. Maybe I shall find them among the dead. Hear me, my chiefs! I am tired; my heart is sick and sad. From where the sun now stands, I will fight no more forever." Chief Joseph Link to comment Share on other sites More sharing options...
HadIt.com Elder allan Posted June 9, 2009 HadIt.com Elder Share Posted June 9, 2009 Im confused & trying to get a claim for Chronic Pain Syndrome set up for the VARO. Am I to understand that pain with motion, can not be the cause or contribute to Chronic Pain Syndrome? If this is the case I doubt i'll get much of an award. My pain is chronic without moving, but made far worse when I do. So they wouldn't consider this than? Link to comment Share on other sites More sharing options...
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applejack
is there a rating under cht35 for chronic pain/or chonic pain disorder anyone knows?
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Disability Examination Worksheets Mental Disorders (Except initial PTSD and Eating Disorders) Examination http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm ***********************
john999
You have to remember that VA considers chronic pain disorder to be an emotional disorder like PTSD or depression. The physical parts of the pain disorder are so intertwined with psychological factors
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