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      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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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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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 1 reply
    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
      • 7 replies
    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
      • 0 replies
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      • 11 replies
    • It's time to ask for help from the community. If you can help with a gift it would be very appreciated.

      Fund HadIt.com Veteran to Veteran LLC


      Give a financial gift to help with the upkeep of HadIt.com. HadIt.com is NOT a non profit. Gifts are not tax deductible, they are just gifts. 
      • 11 replies
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