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Help - Help - Need More Help

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carlie

Question

HELP - I'm not ashamed or shy to ask.

OK - how about this theory.

***** STEP 1

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.

The date on the VA's cover letter to me (with the Rating Decision) is June 20,2002.

REASONS AND BASES:

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

***** STEP 2

§ 3.157 Report of examination or hospitalization as claim for increase or to reopen.

(b) Claim. Once a formal claim for pension or compensation has been allowed or a formal claim for compensation disallowed for the reason that the service-connected disability is not compensable in degree, receipt of one of the following will be accepted as an informal claim for increased benefits or an informal claim to reopen. In addition, receipt of one of the following will be accepted as an informal claim in the case of a retired member of a uniformed service whose formal claim for pension or compensation has been disallowed because of receipt of retirement pay. The evidence listed will also be accepted as an informal claim for pension previously denied for the reason the disability was not permanently and totally disabling.

(1) Report of examination or hospitalization by Department of Veterans Affairs or uniformed services. The date of outpatient or hospital examination or date of admission to a VA or uniformed services hospital will be accepted as the date of receipt of a claim. The date of a uniformed service examination which is the basis for granting severance pay to a former member of the Armed Forces on the temporary disability retired list will be accepted as the date of receipt of claim. The date of admission to a non-VA hospital where a veteran was maintained at VA expense will be accepted as the date of receipt of a claim, if VA maintenance was previously authorized; but if VA maintenance was authorized subsequent to admission, the date VA received notice of admission will be accepted. The provisions of this paragraph apply only when such reports relate to examination or treatment of a disability for which service-connection has previously been established or when a claim specifying the benefit sought is received within one year from the date of such examination, treatment or hospital admission.

***** STEP 3

Keeping in mind now - that in the following C&P -

R shoulder bursitis is ALREADY SC'd at zero % -

zero % due to the absence of limited or painful motion,

date I was notified of this rating was June 20,2002 - just 5 days short

of one year from the date of this C&P (3.157)

(o) Increases

( 38 U.S.C. 5110 ( a ) and 5110 ( b )( 2 ) , Pub. L. 94–71, 89 Stat. 395; §§ 3.109, 3.156, 3.157 )—

(1) General.

Except as provided in paragraph (o)(2) of this section and §3.401(b), date of receipt of claim or date entitlement arose, whichever is later. A retroactive increase or additional benefit will not be awarded after basic entitlement has been terminated, such as by severance of service connection.

(2) Disability compensation. Earliest date as of which it is factually ascertainable that an increase in disability had occurred if claim is received within 1 year from such date otherwise, date of receipt of claim.

C&P dated 7/15/2003

Examining provider: Hirschfield, Jan

Approved By: Dr. Sutton 07/29/2003

REMARKS:

It is my medical opinion that her cervical neck symptoms of pain and discomfort,

and an upper neck, upper shoulder scapula trapezius Rhomboid area is definitely

related to the three traumatic events from her military experience.

(trapezius

[trəpē′zē·əs] Etymology: Gk, trapezion, small tablea large, flat, triangular superficial muscle of the shoulder and upper back. It arises from the occipital bone, the ligamentum nuchae, and the spinous processes of the seventh cervical and all the thoracic vertebrae. It acts to rotate the scapula upward; adduct, raise, or lower the shoulder; and retract the shoulder. rhomboid /rhom·boid/ (rom´boid) [Gr. rhombos rhomb +-oid ] having a shape similar to a rectangle that has been skewed to one side so that the angles are oblique.)

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.

Now - will this get me my danged 10 % - with the effective date retro'd ?

carlie

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  • HadIt.com Elder
http://www.va.gov/vetapp96/files1/9600868.txt

In a March 1988 rating decision, the RO awarded the veteran

service connection for bursitis of his right shoulder, based

on the veteran’s service medical records which showed a

diagnosis of right shoulder bursitis in service in 1986. A

10 percent disability evaluation was assigned for this

disorder, based on the findings of a January 1988 VA

examination, which showed that the veteran had full range of

motion of his right shoulder, with slight discomfort on

palpation of his right subdeltoid bursa, and complaints of

intermittent aching and pain in the right shoulder.

Pain is stated in the C&P that was ordered after my NOD was filed in a request for increase.

The way I understand the reg as it should pertain to me is,

It is the intention to recognize actually painful, joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint which should be 10 %.

carlie

Yup, Carlie, if pain is notated in your last C&P (and forgive me if I missed it, or if I don't look it up right now.....but, I'm to busy being sick. But, yah, if yu have pain noted in your C&P, then you should (should, I said) you should be rated at 10% minimum. MINIMUM! If the pain does not allow you any flexion at all, then it could, conceivably, be rated as equal to the same as a completely ankyloised (completely STIFF) major joint or two mino.......yada, yada. So, according to how MUCH pain and where this pain begins in the ROM measurements as to whether it stays at the minimum of 10% or where on the goniometer it resides.

I'm going to bed..........you should win at least the 10%.........back to your EED.

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OK, as long as the pain is there. Some times when a veteran file a NOD it is not really rated, it is just rubber stamped with the same stupid decision. I am in the same boat with my EED where I received a copy of VA letter to my private doctor requesting information, my doctor's statement that he treated and diagnosed me at the time but when I filed the NOD for the EED, VA did not even look at what I sent them. I sent them a copy of their on crap and they still denied me. I appealed and the BVA sent it right back to them to reconsider and adjudicate.

Edited by pacmanx1
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Yes-the doc mentioned pain in the C & P and of course since it supported the claim the raters never considered it.

This decision sure can be fought Carlie.

Is it the De Luca factor that says they have to consider pain?I will check on that tomorrow.

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I sure do appreciate all the help.

You would probably never know it but I have a terrible time staying focused.

I leave town tonight for a funeral and will be back FRI PM

and will be looking forward to your continued help and support.

carlie

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