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Clarification On This Rating Statement Please


asheth007

Question

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5

The diseases under diagnostic codes 5013 through 5024 will be rated on limitation of motion of affected parts, as arthritis, degenerative

The reason I am asking is because I was rated 40%(max) for inflammatory myopathy because they don't have specific code for inflammatory myopathy it was rated analgous to fibromyalgia. I am worried that if I try to increase in rating they will change my inflammatory myopathy rating to polymyositis which is specifically the inflammatory myopathy that I do have. When I was going through my PEB the legal attorney at JAG told my that they look at myositis like arthitis and that it's rated by motion even if assisted. So for example if I can't lift my arm on it's own power but can lift it assisted then they could possibly give me nothing for it. Now if I lift it and have pain or pain prevents me from lifting it then that is different and taken into consideration.

What I hate about this is that polymyositis doesn't usually have pain associated with it when trying to move a limb or body part it's just flat out weak to weak to elevate. Still I could end up with a lesser rating it's almost like they don't understand the disease I feel. Myositis can be rated all the way to 100% were as fibromyalgia maxes at 40% I am at 80% overall so I am worried that the exam phase will totally screw me because of how they rate myositis. Am I understanding it correctly?

Edited by asheth007
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  • HadIt.com Elder

I am not familiar with myositis, but am intimately familiar with fibromyalgia because I have it. I am not rated for either, but am definitely interested in the results you get from your claim and the feedback from other members. I wish you the best of luck. Hang in there!

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  • HadIt.com Elder

"The reason I am asking is because I was rated 40%(max) for inflammatory myopathy because they don't have specific code for inflammatory myopathy it was rated analgous to fibromyalgia."
"
"Myositis can be rated all the way to 100% were as fibromyalgia maxes at 40%"

Where did you find the 100% rating for myositis at ?

I found this in the VA SRD:
"The diseases under diagnostic codes 5013 through 5024 will be rated on limitation of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002." which included myositis."

The same description you gave, but I found nothing as to the 100% for myositis.

It could be a factor however in part of a TDIU rating ( paid at 100%)

So far the only BVA case I found is this one...it might not help you at all but I didnt want to forget it, because maybe it could have some relevance as we know more about your claim.

http://www.va.gov/vetapp03/files/0334366.txt

What is the breakdown of the 80% you have now?

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Hello Berta the breakdown of my 80% is:

40% inflammatory myopathy rated analgous to fibromyalgia

20% right shoulder osteoarthitis

10% Denerative Disc Disease lower back

50% Sleep Apnea

I could have read it wrong since the diseases in 5013 through 5024 have nothing listed next them I assumed that they could go all the way up to 100%. Am I misunderstanding this part? I clearly see fibromyalgia rated as 40% for max.

It could be possible that they would rate my myositis as a seperate piece to my inflammatory myopathy but inflammatory myopathy is just the general term to cover the 3 types of myositis polymyositis and dermatomyositis and inclusion body myositis. Maybe I am over thinking it all and trying to play doctor somewhat.

You can see here http://www.ninds.nih.gov/disorders/inflammatory_myopathies/detail_inflammatory_myopathies.htm

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  • HadIt.com Elder

I saw that article this AM when I googled your condition,,,,

there are many other med articles on it on the net as well.

I just googled Social Security inflammatory myopathy

http://www.disabilitysecrets.com/conditions-page-2-20.html

And this popped up:
In part:

"If your polymyositis has progressed to the point that you cannot work, you will likely qualify for Social Security Disability benefits."

"Polymyositis is chronic inflammation of the muscles in your body, a form of chronic inflammatory myopathy. It weakens the skeletal muscles, which control movement in your body. Polymyositis is a progressive disease that will get worse over time, causing more and more limitations on your ability to function."
http://www.disabilitysecrets.com/conditions-page-2-20.html

You stated:
"What I hate about this is that polymyositis doesn't usually have pain associated with it when trying to move a limb or body part it's just flat out weak to weak to elevate."

That is why I asked if you are employed or if you had applied for SSDI, and claimed TDIU.

TDIU is paid at the 100% rate of comp.

Also , my husband was rated long ago for muscle weakness in his extremities due to residuals from a 1151 stroke.

I need to look further into this because I wonder if they should have rated the muscle weakness as separate from the inflammatory myopathy.

I sure hope others chime in because I am not familiar with this condition and you stated:

"Maybe I am over thinking it all and trying to play doctor somewhat."

We all in essense have to play doctor sometimes.....and do as much research on our disabilities as we possibly can.

These men and women here know how the VA, even if they claim an obvious secondary condition to a prime SC condition, will often have to get an IMO from a real doctor if they get some bogus C & P exam crap that will not link the two,medically, but the evidence clearly shows that they should.

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