Dc-Codes Help Needed

[mos1833]

§ 4.27 Use of diagnostic code numbers.

The diagnostic code numbers appearing opposite the listed ratable disabilities are arbitrary numbers for the purpose of showing the basis of the evaluation assigned and for statistical analysis in the Department of Veterans Affairs, and as will be observed, extend from 5000 to a possible 9999. Great care will be exercised in the selection of the applicable code number and in its citation on the rating sheet. No other numbers than these listed or hereafter furnished are to be employed for rating purposes, with an exception as described in this section, as to unlisted conditions.

are symptons required for the the exceptions.of an unlisted condition, such as dc- 5299-5295

i got denied in 1984 , with this dc-code because they say it wasent showen as chronic on my smr

does this sound right, thanks

i thought it required at least a 10% rating

[71M10]

It sounds like they were indicating your problem was acute and had resolved without any residuals. How many times were you treated in service for the problem and do you have continuing recerent treatment shortly after discharge? Do your x-rays from service show any arthritis?

Best regards,

[mos1833]

thanks ,71m10

i guess my questions are , what residuals do they look for with a dc-5299

and whats the lowest rating for dc-5295

i didnt see a doctor til 8 years after i got out.

i think iam trying to build a c.u,e. starting from the first denial, thanks

[71M10]

The lowest rating for any disability can be 0% unless the regulation unequivically states a minimum rating of X.

You didn't answer how many times you were treated in service for your lubo-sacral strain? If this only showed up in your service treatment records once, and you wernt seen by a doctor for 8 years after service, you have a very difficult road ahead.

What basis are you planning on building your CUE on ? Disagreeing with their decsision on whether your condition was acute and resolved or chronic will go no where unless it is backed up by clear evidence the clinician was wrong. What evidence in your Sevice Medical Records are your smoking gun that they got it wrong?

Remember the CUE determination is based on the rules and medical knowledge of the time not now. Any medical information from after 1984 is not usable in proving/aguring CUE.

What were your measured ranges of motion in service, ETS physical, and VA exam?

Do you have xray evidence of damage?

Do you have physical therapy reports that describe an altered gait or altered spinal contour?

Do you have a copy of the rating schedule/regulations that were applicable in 1984?

Best regards,

Edited June 5, 2013 by 71M10

[mos1833]

thanks again.

i have posted several times on this claim,the cova just denied it , and then closed it , my lawyer quit ,and said i could re-open it with new evidence.

its already been a long road with many turnes i dont understand, if you should read all my posts youd go as crazy as i am.i thought the va never folled any of the rules in my claim,so before trying to re-open it with new evidence. i thought ide check if a c.u.e. would be better.

i know i need a doctors opinion in my favor to re-open , so iam saving up for that.

they do have some of my smr"s that show two injuries,and it does use the words chronic,no duty,bed rest,lite duty.

they say my exit exam show no problems, they dont have that because i didnt get one.

any way iam just checking for, and how to claim a c.u.e.

i filed a c.u.e. in 2002 but i guessed they missed it,cause nothing happend,sorry for ranting.

[71M10]

I don't think you are ranting, no apology necessary.

[mos1833]

§4.31 A no-percent rating.

In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.

[29 FR 6718, May 22, 1964, as amended at 58 FR 52018, Oct. 6, 1993]

how does dc- 5299 - 5295 relate to a compensable evaluation , what does the schedule say about dc-5299 ,thanks

i think this covers dc-5299

4.20 Analogous ratings.

When an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. Conjectural analogies will be avoided, as will the use of analogous ratings for conditions of doubtful diagnosis, or for those not fully supported by clinical and laboratory findings. Nor will ratings assigned to organic diseases and injuries be assigned by analogy to conditions of functional origin.

thanks

Edited June 12, 2013 by mos1833