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Vync

Cue, Reconsideration, Or Nod?

Question

I recently was awarded an increase in my TMJ rating from 10% to 20% based on reduced range of motion.

My C&P exam (03/2010) and previous dental exam (12/2009) both indicated I had limited lateral excursion of 3 mm, but the rater indicated it was 33 mm. I should have received an additional and separate 10% rating for limited lateral excursion.

What is my best option here? CUE, reconsideration, or NOD?

Here is the VA regulation:

§4.150 - Schedule of Ratings - Dental and Oral Conditions

9905 Temporomandibular articulation, limited motion of:

Inter-incisal range:

0 to 10 mm 40

11 to 20 mm 30

21 to 30 mm 20

31 to 40 mm 10

Range of lateral excursion:

0 to 4 mm 10

Note: Ratings for limited inter-incisal movement shall not be combined with ratings for limited lateral excursion

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4 answers to this question

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I recently was awarded an increase in my TMJ rating from 10% to 20% based on reduced range of motion.

My C&P exam (03/2010) and previous dental exam (12/2009) both indicated I had limited lateral excursion of 3 mm, but the rater indicated it was 33 mm. I should have received an additional and separate 10% rating for limited lateral excursion.

What is my best option here? CUE, reconsideration, or NOD?

Here is the VA regulation:

§4.150 - Schedule of Ratings - Dental and Oral Conditions

9905 Temporomandibular articulation, limited motion of:

Inter-incisal range:

0 to 10 mm 40

11 to 20 mm 30

21 to 30 mm 20

31 to 40 mm 10

Range of lateral excursion:

0 to 4 mm 10

Note: Ratings for limited inter-incisal movement shall not be combined with ratings for limited lateral excursion

I think you should file a NOD and bring this info to the raters attention. I recommend a DRO hearing so you can present and explain your case.

JMO,

Bergie

Edited by *Bergie*

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The standards you have to meet for a CUE are so great any other available option is better. If your only option is a CUE then that is what you use, but only then.

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I would Request a Reconsideration.Or you could ask them to CUE themselves.(or both)

Mark your calendar for the NOD deadline in case they don't act on it during the year time frame for the NOD.

Send the request with a proof of mailing and put on the letter and envelope Attention to: and then put the initials that appear in the upper right hand code next to reply to.

State exactly what you told us and tell them to rate you per the Schedule of Ratings enclosed (and enclose the reg you put here)and copy of the medical evidence (My C&P exam (03/2010) and previous dental exam (12/2009) both indicated I had limited lateral excursion of 3 mm, but the rater indicated it was 33 mm.)

This could be a mere typo from the rater and if it is they could quickly correct it.

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PS - a GREAT reason why everyone should request copies of all C & P exams.

If a C & P exam says one thing and an SOC says something completely different this is a clear and unmistakable error on the VA's part.

Just by calling their attention to this error should get it fixed either way you choose to go.

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