hypertension Is There Such A Rating

[Ricky]

My neurologist conducted a new MRI yesterday of my brain. He now says that I have severe "white matter disease" due to hypertension and DMII. The MRI was conducted as a result of my constant loss of balance which makes me fall to the right side and my now inability to reach and grab things with my right hand. When I reach for things my hand goes in circles and I miss the object by about six inches to the right. Is there a rating for White matter disease? It is basically lesions in the white matter portion of my brain from blood clots cause by the DMII that have travelled through my brain and successfully passed through without getting stuck and causeing a stroke.

Also just to give all of you guys a laugh. The balance problems caused a big blast at home. I was sitting on the pot about 4:30 am. when finished I attempted to get up. I lost my balance lunged forwarded and my head went through the bathroom wall. Boy did it hurt. My neck, shoulders and spine half way down my back. Xrays indicated that I jamed some disc. I can not move my head or shoulders due to the pain and I have a hell of a headache. Lessoned learned - be careful little grasshopper when getting off the pot. I guess it would be to much to ask for service connection of the neck injury. I bet the raters would get a good laugh from such a claim.

PS - that is why I am writing this post at 1:14 am I can not stand to lie in the bed due to the neck pain but you can bet your va check that I ain't going back to the potty for a while no matter how long I stay up. Oh about the damage to the bathroom wall - wife says she was thinking about a remodel job and I just gave her the incentive to have the project started. Just think ole Congressman Buyer thought I was just and old worn out vet without any purpose in life. Boy did I show him how I could use my head.

Ricky

Edited August 3, 2006 by Ricky

[timetowinarace]

§ 4.124a Schedule of ratings—neurological conditions and convulsive disorders.

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[With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves]

Organic Diseases of the Central Nervous System

------------------------------------------------------------------------

Rating

------------------------------------------------------------------------

8000 Encephalitis, epidemic, chronic:

As active febrile disease..................................... 100

Rate residuals, minimum....................................... 10

Brain, new growth of:

8002 Malignant.................................................. 100

Note: The rating in code 8002 will be continued for 2 years

following cessation of surgical, chemotherapeutic or other

treatment modality. At this point, if the residuals have

stabilized, the rating will be made on neurological residuals

according to symptomatology.

Minimum rating................................................ 30

8003 Benign, minimum............................................ 60

Rate residuals, minimum....................................... 10

8004 Paralysis agitans:

Minimum rating................................................ 30

8005 Bulbar palsy............................................... 100

8007 Brain, vessels, embolism of.

8008 Brain, vessels, thrombosis of.

8009 Brain, vessels, hemorrhage from:

Rate the vascular conditions under Codes 8007 through 8009, 100

for 6 months.................................................

Rate residuals, thereafter, minimum........................... 10

8010 Myelitis:

Minimum rating................................................ 10

8011 Poliomyelitis, anterior:

As active febrile disease..................................... 100

Rate residuals, minimum....................................... 10

8012 Hematomyelia:

For 6 months.................................................. 100

Rate residuals, minimum....................................... 10

8013 Syphilis, cerebrospinal.

8014 Syphilis, meningovascular.

8015 Tabes dorsalis.

Note: Rate upon the severity of convulsions, paralysis, visual

impairment or psychotic involvement, etc.

8017 Amyotrophic lateral sclerosis:

Minimum rating................................................ 30

8018 Multiple sclerosis:

Minimum rating................................................ 30

8019 Meningitis, cerebrospinal, epidemic:

As active febrile disease..................................... 100

Rate residuals, minimum....................................... 10

8020 Brain, abscess of:

As active disease............................................. 100

Rate residuals, minimum....................................... 10

Spinal cord, new growths of:..................................

8021 Malignant.................................................. 100

Note: The rating in code 8021 will be continued for 2 years

following cessation of surgical, chemotherapeutic or other

treatment modality. At this point, if the residuals have

stabilized, the rating will be made on neurological residuals

according to symptomatology.

Minimum rating................................................ 30

8022 Benign, minimum rating..................................... 60

Rate residuals, minimum....................................... 10

8023 Progressive muscular atrophy:

Minimum rating................................................ 30

8024 Syringomyelia:

Minimum rating................................................ 30

8025 Myasthenia gravis:

Minimum rating................................................ 30

Note: It is required for the minimum ratings for residuals

under diagnostic codes 8000-8025, that there be ascertainable

residuals. Determinations as to the presence of residuals not

capable of objective verification, i.e., headaches,

dizziness, fatigability, must be approached on the basis of

the diagnosis recorded; subjective residuals will be accepted

when consistent with the disease and not more likely

attributable to other disease or no disease. It is of

exceptional importance that when ratings in excess of the

prescribed minimum ratings are assigned, the diagnostic codes

utilized as bases of evaluation be cited, in addition to the

codes identifying the diagnoses.

8045 Brain disease due to trauma:

Purely neurological disabilities, such as hemiplegia,

epileptiform seizures, facial nerve paralysis, etc.,

following trauma to the brain, will be rated under the

diagnostic codes specifically dealing with such disabilities,

with citation of a hyphenated diagnostic code (e.g., 8045-

8207).

Purely subjective complaints such as headache, dizziness,

insomnia, etc., recognized as symptomatic of brain trauma,

will be rated 10 percent and no more under diagnostic code

9304. This 10 percent rating will not be combined with any

other rating for a disability due to brain trauma. Ratings in

excess of 10 percent for brain disease due to trauma under

diagnostic code 9304 are not assignable in the absence of a

diagnosis of multi-infarct dementia associated with brain

trauma.

8046 Cerebral arteriosclerosis:

Purely neurological disabilities, such as hemiplegia, cranial

nerve paralysis, etc., due to cerebral arteriosclerosis will

be rated under the diagnostic codes dealing with such

specific disabilities, with citation of a hyphenated

diagnostic code (e.g., 8046-8207).

Purely subjective complaints such as headache, dizziness,

tinnitus, insomnia and irritability, recognized as

symptomatic of a properly diagnosed cerebral

arteriosclerosis, will be rated 10 percent and no more under

diagnostic code 9305. This 10 percent rating will not be

combined with any other rating for a disability due to

cerebral or generalized arteriosclerosis. Ratings in excess

of 10 percent for cerebral arteriosclerosis under diagnostic

code 9305 are not assignable in the absence of a diagnosis of

multi-infarct dementia with cerebral arteriosclerosis.

Note: The ratings under code 8046 apply only when the

diagnosis of cerebral arteriosclerosis is substantiated by

the entire clinical picture and not solely on findings of

retinal arteriosclerosis.

------------------------------------------------------------------------

Miscellaneous Diseases

------------------------------------------------------------------------

Rating

------------------------------------------------------------------------

8100 Migraine:

With very frequent completely prostrating and prolonged 50

attacks productive of severe economic inadaptability.........

With characteristic prostrating attacks occurring on an 30

average once a month over last several months................

With characteristic prostrating attacks averaging one in 2 10

months over last several months..............................

With less frequent attacks.................................... 0

8103 Tic, convulsive:

Severe........................................................ 30

Moderate...................................................... 10

Mild.......................................................... 0

Note: Depending upon frequency, severity, muscle groups

involved.

8104 Paramyoclonus multiplex (convulsive state, myoclonic type):

Rate as tic; convulsive; severe cases......................... 60

8105 Chorea, Sydenham's:

Pronounced, progressive grave types........................... 100

Severe........................................................ 80

Moderately severe............................................. 50

Moderate...................................................... 30

Mild.......................................................... 10

Note: Consider rheumatic etiology and complications.

8106 Chorea, Huntington's.

Rate as Sydenham's chorea. This, though a familial disease,

has its onset in late adult life, and is considered a ratable

disability.

8107 Athetosis, acquired.

Rate as chorea.

8108 Narcolepsy.

Rate as for epilepsy, petit mal.

------------------------------------------------------------------------

[timetowinarace]

More specifically here is the code.

9305 Vascular dementia.

You only need to provide the nexus to Service connect wich your Doc has done.

§ 4.130 Schedule of ratings—mental disorders.

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The nomenclature employed in this portion of the rating schedule is based upon the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, of the American Psychiatric Association (DSM-IV). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in §4.125 through §4.129 and to apply the general rating formula for mental disorders in §4.130. The schedule for rating for mental disorders is set forth as follows:

------------------------------------------------------------------------

Rating

------------------------------------------------------------------------

Schizophrenia and Other Psychotic Disorders

------------------------------------------------------------------------

9201 Schizophrenia, disorganized type

9202 Schizophrenia, catatonic type

9203 Schizophrenia, paranoid type

9204 Schizophrenia, undifferentiated type

9205 Schizophrenia, residual type; other and unspecified

types

9208 Delusional disorder

9210 Psychotic disorder, not otherwise specified (atypical

psychosis)

9211 Schizoaffective disorder

------------------------------------------------------------------------

Delirium, Dementia, and Amnestic and Other Cognitive Disorders

------------------------------------------------------------------------

9300 Delirium

9301 Dementia due to infection (HIV infection, syphilis, or

other systemic or intracranial infections)

9304 Dementia due to head trauma

9305 Vascular dementia

9310 Dementia of unknown etiology

9312 Dementia of the Alzheimer's type

9326 Dementia due to other neurologic or general medical

conditions (endocrine disorders, metabolic disorders,

Pick's disease, brain tumors, etc.) or that are substance-

induced (drugs, alcohol, poisons)

9327 Organic mental disorder, other (including personality

change due to a general medical condition)

------------------------------------------------------------------------

Anxiety Disorders

------------------------------------------------------------------------

9400 Generalized anxiety disorder

9403 Specific (simple) phobia; social phobia

9404 Obsessive compulsive disorder

9410 Other and unspecified neurosis

9411 Post-traumatic stress disorder

9412 Panic disorder and/or agoraphobia

9413 Anxiety disorder, not otherwise specified

------------------------------------------------------------------------

Dissociative Disorders

------------------------------------------------------------------------

9416 Dissociative amnesia; dissociative fugue; dissociative

identity disorder (multiple personality disorder)

9417 Depersonalization disorder

------------------------------------------------------------------------

Somatoform Disorders

------------------------------------------------------------------------

9421 Somatization disorder

9422 Pain disorder

9423 Undifferentiated somatoform disorder

9424 Conversion disorder

9425 Hypochondriasis

------------------------------------------------------------------------

Mood Disorders

------------------------------------------------------------------------

9431 Cyclothymic disorder

9432 Bipolar disorder

9433 Dysthymic disorder

9434 Major depressive disorder

9435 Mood disorder, not otherwise specified

------------------------------------------------------------------------

Chronic Adjustment Disorder

------------------------------------------------------------------------

9440 Chronic adjustment disorder

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to 100

such symptoms as: gross impairment in thought

processes or communication; persistent delusions

or hallucinations; grossly inappropriate behavior;

persistent danger of hurting self or others;

intermittent inability to perform activities of

daily living (including maintenance of minimal

personal hygiene); disorientation to time or

place; memory loss for names of close relatives,

own occupation, or own name.......................

Occupational and social impairment, with 70

deficiencies in most areas, such as work, school,

family relations, judgment, thinking, or mood, due

to such symptoms as: suicidal ideation;

obsessional rituals which interfere with routine

activities; speech intermittently illogical,

obscure, or irrelevant; near-continuous panic or

depression affecting the ability to function

independently, appropriately and effectively;

impaired impulse control (such as unprovoked

irritability with periods of violence); spatial

disorientation; neglect of personal appearance and

hygiene; difficulty in adapting to stressful

circumstances (including work or a worklike

setting); inability to establish and maintain

effective relationships...........................

Occupational and social impairment with reduced 50

reliability and productivity due to such symptoms

as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic

attacks more than once a week; difficulty in

understanding complex commands; impairment of

short- and long-term memory (e.g., retention of

only highly learned material, forgetting to

complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and

mood; difficulty in establishing and maintaining

effective work and social relationships...........

Occupational and social impairment with occasional 30

decrease in work efficiency and intermittent

periods of inability to perform occupational tasks

(although generally functioning satisfactorily,

with routine behavior, self-care, and conversation

normal), due to such symptoms as: depressed mood,

anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory

loss (such as forgetting names, directions, recent

events)...........................................

Occupational and social impairment due to mild or 10

transient symptoms which decrease work efficiency

and ability to perform occupational tasks only

during periods of significant stress, or; symptoms

controlled by continuous medication...............

A mental condition has been formally diagnosed, but 0

symptoms are not severe enough either to interfere

with occupational and social functioning or to

require continuous medication.....................

----------------------------

[Berta]

A.K.A transcient cerebral ischemia-

they can call this many things-

The important thing to consider is what residuals you have that are ratable-

For example- Rod suffered numerous ischematic attacks- revealed on autopsy as lesions and some missing white matter-

One doc said it aggravated his PTSD -they ignored that statement-Dr Bash found this was all due to his diabetes mellitus that they never treated-

However it profoundly affected his balance and vision- as evidenced by VA Employee physical and drivers license -20/20 vision there without glasses until Aug 1988-then medical evidence and EEOC case showed his vision had been impaired--

(VA said (EEOC case)he could not read the diet cards right or do the menu right-he couldn't see this stuff after these attacks well enough to do it-)

My point is that they rate the residual disability-anything ratable that the loss of white matter or ischemia causes-

[timetowinarace]

I'm not sure how it would be rated in this circumstance.

In my situation, head trauma, it does not matter how many or severity of residuals without the diagnoses of dementia. A 10% rating is the highest rating possible for brain trauma and residuals, not to be combined with ANY other rating unless there is a diagnoses for multi-infarct dementia. With the diagnoses, I was rated on the general formula for rating mental disorders, thus getting me to 100%. Still, my residuals are not rated but suposedly considered in the rating.

I seen in the ratings below that this aplies to some othe neurological conditions as well.

Time

Edited August 4, 2006 by timetowinarace

[carlie]

Rick,

Glad the wife gets the bathroom redone. Wouldn't the VA have to rate your neck and back injury as secondary to already SC disability.

carlie