Does Anyone Really Know How They Rate Parkinson's

[shakeyswife]

I have tried to figure out how the VA is rating Parkinson's Disease, and I am having much difficulty deciphering the rating schedule. I have done a little bit of research, but just can not seem to grasp how PD is really rated. I have read 30% initial rating, we know this is true.

My question is, once they start rating all the other aspects/secondaries does that initial 30% stay and combine with all the secondaries or do they disregard the initial 30% and just rate on all the "secondaries"?

I have tried to do some research but I'll I seem to come up with is contradiction, in the way PD has been rated. It appears as though some raters add the secondaries to the 30% and some do not. Even with research of some of the citations, I am still unable to comprehend how the VA is rating this disease.

[shakeyswife]

How they rated his PD: shortened it a bit:

Right upper extremity (dominant) (claimed as bradykinesia, tremor, muscle rigidity, and fatigue. 40% moderate

Left upper extremity (claimed as bradykinesia, tremor, muscle rigidity and fatigue. 30% moderate

Right lower extremity (claimed as bradykinesia, tremor, muscle rigidity, fatigue and cramps. 40% moderate

Left lower extremity (claimed as bradykinesia, tremor, muscle rigidity, fatigue. 40% moderate

Postural impairment (claimed as stooped posture) 20% moderate muscle disability

This disability is not specifically listed in the rating schedule; therefore, it rated analogous to a disability in which not only the functions affected, but anatomical localization and symptoms are closely related.

Impairment in speech and swallowing has been established as related to the service-connected disability of Parkinson's Disease.

A noncompensable evaluation is assigned.

We have assigned a noncompensable evaluation for your tenth (pneumogastric, vagus) cranial nerve, based on mild incomplete paralysis.

Erectile dysfunction (claimed as sexual dysfunction) has been established as related to PD.

Anosmia (loss of sense of smell) has been established. A noncompensable evaluation is assigned.

A higher evaluation of 10% is not warranted unless the evidence shows complete sensory loss.

Impairment of cranial nerve 5, right (mastication/chewing) has been established as related to PD. A noncompensable evaluation is assigned.

A higher evaluation of 10% is not warranted unless the evidence shows nerve damage is moderate.

Same as above for left side.

Cranial nerve 7, right (claimed as loss of automatic movements) hypomimia. A noncompensable evaluation is assigned.

Based on mild incomplete paralysis of the right side of the face.

Same for left.

Constipation (claimed as bowels) denied. The rationale provided is that your constipation symptoms are attributed to your non-VA use of oxycontin for pain management for non-service connected spine conditions. etc, etc.....

Neurogenic bladder. denied. The VA examiner opined that your urinary symptoms to include hesitancy and increased frequency are related to benign prostatic hypertrophy (BPH) not due to PD. (I disagree with this, neurogenic bladder and an enlarged prostrate share the same symptoms).

Mild cognitive impairment that was checked on the DBQ for PD....Your Nov examination provided the dx of PTSD with depressive disorder. Later mental health examinations performed on Jan 27, added the diagnosis of dementia, as due to Parkinson's, that is 100% disabling. All service connected mental health conditions are evaluated together as one mental health disability (dementia, PTSD and depressive disorder) to avoid pyramiding of symptoms. Therefore, the disabilities of dementia, PTSD and depressive disorder are evaluated as one disability, and assigned a 100% evaluation.

"The VA examiner noted additional Parkinson's symptoms that are addressed separately in this decision." "Also there appears to be cognitive impairment as due to Parkinson's Disease noted on several basic assessments of Parkinson's. However, the psychiatric examiner provided no Axis-1 diagnosis of cognitive impairment. In addition, additional claimed issues of sleep impairment and depression are related as symptoms to your now service connected PTSD. Thus, these issues will not be further addressed under Parkinson's Disease."

Entitlement to special monthly compensation for loss of use of a creative organ have been met.

Entitlement to special monthly compensation for Housebound criteria being met is granted.

They also sent a 21-4138. "Please tell on the enclosed Statement in Support of Claim, that you want to file a claim for aid and attendance and return the form to the address at the top of the letter. We recommend you return the form as soon as you can, in order to ensure the earliest possible payment date, if an award is authorized. Should I pursue this???????

Edited March 27, 2014 by shakeyswife

[warren]

I don't completely understand the special monthly compensation. I believe aid and attendance would replace housebound and your payment would be higher. I believe you can receive training to take care of shakey and be paid for it. go to the va site or asknod.com and look up special monthly compensation. Tell Shakey, that God loves him and God has prepared a place for individuals that believe (faith) a 100% in the Gospel of Christ (plus nothing else), They will be no more suffering and I'm looking forward to that. Please, see www.lesfeldick.com

GOD BLESS