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Help - Schedule Of Ratings—musculoskeletal System

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carlie

Question

Have hearing on Sept 18th.

Issue : Increased Rating for SC'd Bursitis DC 5019 -

The VARO granted SC at zero percent,for R shoulder Bursitis on Rating Decision dated 6/14/2002,

with an effective date of 8-26-1999.

Reasons and Bases:

SMR's reveal that the veteran was seen for treatment of right shoulder after injury

to her neck and shoulder area. X-rays revealed a normal shoulder.

VA examination dated 2-28-02 from VAMC finds that the veteran has chronic bursitis and that it is more likely than not due to her injury in service. X-rays done in conjunction with the exam shows bones and soft tissue are within normal limits, impression normal. The examiner finds that she has full range of motion: flexation of 180 degrees, extant rotation 90 degrees, internal rotation 90 degrees. The abduction is 180 degrees. She has normal development and no muscle wasting.

Normal distal pulses. She does have decreased sensation to the interior lateral aspects of her upper arm only. Lower arm has normal sensation to the soft and sharp and her hands are also normal. She has normal strength and range of motion. The range of motion is with consideration of pain, weakness, lack of endurance.

In the absence of limited or painful motion an evaluation of 0 % is assigned effective the original date of claim, 8-26-99.

I filed a timely NOD on this and requested a rating of 10 % for DC 5019 Bursitis.

I feel 10 % should be granted due to:

The diseases under diagnostic codes 5013 through 5024 will be rated on limitation of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002. 5003 Arthritis, degenerative (hypertrophic or osteoarthritis):

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations20

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups10

Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive.

MY QUESTION:

I am understanding this to mean that DC 5019 is to be rated as

Arthritis - Degenerative and that,

When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion,...

Should I be rated at 10 % for this or am I understanding this wrong ?

Thanks for your responses.

carlie

Carlie passed away in November 2015 she is missed.

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  • HadIt.com Elder

"The examiner finds that she has full range of motion"

Nope, Carlie. Nada.

sorry

"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

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"The examiner finds that she has full range of motion"

Nope, Carlie. Nada.

sorry

Larry,

Please explain, this is what I need to be able to understand.

When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion,...

Thanks,

carlie

Carlie passed away in November 2015 she is missed.

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  • Moderator

Carlie, I am not an expert but here is my opinion. According to your post you were awarded 0% for pain. The examiner stated: "The examiner finds that she has full range of motion and She has normal strength and range of motion. The range of motion is with consideration of pain, weakness, lack of endurance." In other words you do have pain but you do not have limited or painful motion. Meaning there is pain there but there is no pain in motion or none that the examiner noted. The examiner also did not note any limitation of motion. If I am wrong or just totally confused I hope you or someone else would correct me.

Also sorry

Edited by pacmanx1

My intentions are to help, my advice maybe wrong, be your own advocate and know what is in your C-File and the 38 CFR that governs your disabilities and conditions.

Do your own homework. No one knows the veteran’s symptoms like the veteran. Never Give Up.

I do not give my consent for anyone to view my personal VA records.

 

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  • HadIt.com Elder
Larry,

Please explain, this is what I need to be able to understand.

When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion,...

Thanks,

carlie

Sometimes, not often, maybe once a year, I run across something that I can't make sense out of.........................but, suffice it to say, if you ain't got the pain, then you ain't got the $gain$ and if you ain't got the swing then you ain't gonna hear the CA-CHING!

"limited motion", that's where it's ALL at

"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

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  • HadIt.com Elder

I concur with Larry. If you had limitation of motion that was greater than full, but less than that outlined in the ten percent criteria, then this rule would apply. The statement that you must overcome in your records is "full range of motion."

Edited by rentalguy1

90%, TDIU P&T

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  • HadIt.com Elder

Carlie, Oh, I see the BVA. Just wondering do you have constant ROM issues or variable episodes? Is there anything in your SMRs that show other measurements of ROM? Have you been in traction lately for your neck, did that include a shoulder evaluation?

I too have shoulder bursitis, the rain reminds me and I don't have limitations everyday, just often, especially with putting on seatbelts, lifting laundry or hanging curtains.

Thinking the best for ya,

Cg'up2009!

Edited by cowgirl

For my children, my God sent husband and my Hadit family of veterans, I carry on.

God Bless A m e r i c a, Her Veterans and their Families!

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