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How Should I File For Increase On Ddd?

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vetwife

Question

My husband was granted s/c for DDD in May 2010, He was also granted another issue and had other items remanded.

The BVA sent claim back to RO for rating.

RO rated DDD 10% in June 2010. & sent to AMC to deal with the rest.

The 10% rating for his DDD was low & it was based on a 2005 C&P (5+ yrs old at the time).

Since then x-rays have shown more damage & flexation is much less. As you know DDD is progressive

We wanted to request the higher DDD rating based on the above, but didn't want the rest of the claim to be taken out of the rating stack to work this claim, so we decided to wait until those were processed. Since we had a year to file a NOD, we thought that was the best route.....

It has been nearly a year & those are not processed.

Should we file the NOD or request for higher evaluation now (only have about 2 weeks until year is up) Or continue to wait & loose eed.

We don't want to loose the retro if the other claim gets low-balled, but don't want to slow things down anymore than they are....

Also, he has an appoint with a spine specialist next month, which I am certain will give us more evidence for the higher rating - but it is after the 1 yr mark. Could I send in the request for higher evaluation to keep the effective date & then send the new spine info after the exam?

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  • Moderator

You can always keep submitting information to support your claim so long as the claim or appeal is current. I would file to keep your date, and submit what you have, and keep submitting likewise, otherwise you are going to lose EED.

Good luck-rated 40% for Invertebral disc disease and 10% for residuals (sciatica). Remember, DDD evaluation is based on Range of Motion, but you can also file for the sciatic residuals if he has them and they are documented.

The Earth is degenerating these days. Bribery and corruption abound.Children no longer mind their parents, every man wants to write a book,and it is evident that the end of the world is fast approaching. --17 different possible sources, all lacking verifiable attribution.

B.S. Doane College, Mgt Info Systems/Systems Analysis 2008

M.S.Ed. Purdue University, Instructional Development and Technology, Feb. 2021

M.S. Purdue University Information Technology/InfoSec, Dec 2022

100% P/T

MDD

Spine

Radiculopathy

Sleep Apnea

Some other stuff

-------------------------------------------
B.S. Info Systems Mgt/Systems Analysis-Doane College 2008
M.S. Instructional Technology and Design- Purdue University 2021

 

(I AM NOT A RATER- I work the claims BEFORE they are rated, annotating medical evidence in your records, VA and Legal documents,  and DA/DD forms- basically a paralegal/vso/etc except that I also evaluate your records based on Caluza and try to justify and schedule the exams that you go to based on whether or not your records have enough in them to warrant those)

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My husband was granted s/c for DDD in May 2010, He was also granted another issue and had other items remanded.

The BVA sent claim back to RO for rating.

RO rated DDD 10% in June 2010. & sent to AMC to deal with the rest.

The 10% rating for his DDD was low & it was based on a 2005 C&P (5+ yrs old at the time).

Since then x-rays have shown more damage & flexation is much less. As you know DDD is progressive

We wanted to request the higher DDD rating based on the above, but didn't want the rest of the claim to be taken out of the rating stack to work this claim, so we decided to wait until those were processed. Since we had a year to file a NOD, we thought that was the best route.....

It has been nearly a year & those are not processed.

Should we file the NOD or request for higher evaluation now (only have about 2 weeks until year is up) Or continue to wait & loose eed.

We don't want to loose the retro if the other claim gets low-balled, but don't want to slow things down anymore than they are....

Also, he has an appoint with a spine specialist next month, which I am certain will give us more evidence for the higher rating - but it is after the 1 yr mark. Could I send in the request for higher evaluation to keep the effective date & then send the new spine info after the exam?

I would file a nod on what you disagree with in decision before the one year date.

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DDD can also be rated under IVDS based upon periods of incapacitation which can get you up to 60%....but they are strict with the wording. Periods of incapacitation only count with Dr prescribed bedrest. A note saying not to work is not acceptable. It must state bedrest. Also, if I read the information correctly, IVDS incorporates sciatica and other issues that are part and parcel of IVDS....basically you won't get a seperate rating for other connected issues if you are rated under periods of incapacitation (which is different from being rated under the more general sections of the spine).

What I like about being rated on incapacitating episodes is that it doesn't matter what type of day you are having when you are at the C&P exam (I got screwed by having a "Good Day" 13 years ago). Basically, you could bend over backwards....touch your toes and stand on one hand, but if you have doctor prescribed bed rest over the last 12 months, and diagnosed with IVDS, they will rate you in the method that gives you the higher rating.

Good Luck

Travis

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  • Moderator

The problem with incapacitation is that few doctors prescribe bedrest anymore, so getting to 60% based on that is rare. Usually 60% ends up being ankylosis of the spine, I am rate 40% for ROM and then 10% for sciatica in 1 leg. You can be rated for both legs (bilateral) but to get to 20% there must be evidence of paralysis of the sciatic nerve and foot drop.

The Earth is degenerating these days. Bribery and corruption abound.Children no longer mind their parents, every man wants to write a book,and it is evident that the end of the world is fast approaching. --17 different possible sources, all lacking verifiable attribution.

B.S. Doane College, Mgt Info Systems/Systems Analysis 2008

M.S.Ed. Purdue University, Instructional Development and Technology, Feb. 2021

M.S. Purdue University Information Technology/InfoSec, Dec 2022

100% P/T

MDD

Spine

Radiculopathy

Sleep Apnea

Some other stuff

-------------------------------------------
B.S. Info Systems Mgt/Systems Analysis-Doane College 2008
M.S. Instructional Technology and Design- Purdue University 2021

 

(I AM NOT A RATER- I work the claims BEFORE they are rated, annotating medical evidence in your records, VA and Legal documents,  and DA/DD forms- basically a paralegal/vso/etc except that I also evaluate your records based on Caluza and try to justify and schedule the exams that you go to based on whether or not your records have enough in them to warrant those)

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  • HadIt.com Elder

Yes, back doctors send you to their own PT clinics so they can get more money out of your insurance.

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Thanks, that is what I thought - don't want to loose the EED -

is it possible to send in the NOD, but request they wait until the other claim is rated before pulling it?

It has been over a year since granted & been waiting for a rating since. Hate to have it pulled out of the pile.

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