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A Little Confused On When To Request Increase In Psoriasis Rating


JustASquid

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I'm currently SC at 0% for psoriasis but have now been started on Humira for both that and psoriatic arthritis. I'll be submitting a claim for the arthritis as secondary to the psoriasis, along with a few small but well documented and developed claims.

I'm just not sure if I should request an increase on the psoriasis now, or the timing to do so if I add or submit it later. At the time of application I'll be right around the point of having been on Humira for at least 6 weeks during the previous 12 months so should reasonably be 30%. However, I will be on it continuously, barring any adverse reactions, so I will hit the near continous use over the previous 12 months while this claim would possibly still be in progress.

If I am awareded 30%, would I then submit evidence of near continuous use before at the 12 month mark as a reconsideration? Or, since at the time of the 30% it would be accurate would it be just yet another request for an increase? However, IF the claim is still in progress would they use two different effective dates with the 60% effective only when the requirements were actually met and 30% only back to the filing date?

I don't know why I can't wrap my head around it or figure it out. I've asked similar on other boards as well. I understand the importance of getting the effective date established so simply waiting until at 12 months would likely be a bad decision, but other than getting it submitted initially the likely rating itself will quickly change in a short time and not a static decision.

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Remember that there is no timeline to apply for an increase. Last year I was give 30% for PTSD, and less than a year later with my next claim, I was awarded 75% for PTSD. Only you knows when and if a condition gets worst, and if you are not receiving the max for that condition, then you have a right to request an increase. Good luck, and be careful with the Humira. I was on it back in 2012 for my Crohn's Disease, and it caused me to bleed out, resulting in my second Blood Transfusion.

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  • HadIt.com Elder

You should have a fairly high rating for being on humira and psoriatic arthritis. You should ask now.

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Thanks!!!

I also wasn't quite ready and it's the end of the month now so I should have everything in before the end of October anyway :)

Then I'll get to sit and wait, but oh well!

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