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Army/ VA surgery


praned1983

Question

Does anyone know if you can put in a claim for when you have surgery. The reason I ask I am schedule to have back surgery next month with the VA. I am scared shitless. But I want to know if you can put a claim for 2 surgeries or scars. My first surgery was when I was in the Army 10 years ago I had all 4 of my wisdom teeth taken out.

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  • HadIt.com Elder

If you are SC for your back, then go ahead and get look at filing for convalescence:
http://www.benefits.va.gov/COMPENSATION/claims-special-convalescence.asp

 

Like you, the Army also removed all four of my wisdom teeth when I was on active duty ages ago. The act of having all four wisdom teeth removed -- by itself -- does not qualify for a compensable rating, but pain and problems kept me going. When I originally filed, they denied me and gave that reason. I appealed and then they came back and denied again saying the surgery was elective. I appealed again and the BVA sent me for a C&P exam. Of course, the x-ray showed nothing, but I did have limited ROM and pain. I was sent for an arthrogram and that proved that the surgery was bungled. They granted SC because the oral surgeon said that the cause was the surgery and the effect was limited ROM and pain. Initially, I was granted 10%, then later I filed for increases to 20% and 30%.

 

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#se38.1.4_1150

9905   Temporomandibular articulation, limited motion of:  
Inter-incisal range:  
0 to 10 mm 40
11 to 20 mm 30
21 to 30 mm 20
31 to 40 mm 10
Range of lateral excursion:  
0 to 4 mm 10
Note—Ratings for limited inter-incisal movement shall not be combined with ratings for limited lateral excursion  

 

Keep in mind  that inter-incisal range is vertical opening/closing and lateral excursion is horizontal left/right movement. Even if you get SC for both axis', you will only get the a single rating under 9905, which would be the higher of the two.

If you have other problems related to this, like headaches, you can file secondary for those.

 

Regarding scars from the surgery, I know I have some decent ones inside my mouth, but never considered filing for them. Not sure if it is possible, but might be worth a shot. I know mine get tight and ache periodically.

I hope this helps!

Edited by Vync
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  • HadIt.com Elder

Surgical scars are compensable. But, there as always, are some gory details.

Are the scars painful ?

Are they superficial or deep ? The VA likes to say that all the scars are superficial, even if the underlying surgery went through multiple layers of flesh, tissue, muscle, and bone.

(I.E. CABG) 

There can be a length requirement, as well as a disfiguring factor.

 

When I hit the VA with an NOD/appeal, they reversed course. The old/new law bit applied. But, they rated all scars at 0%, and then surgical scars as a compensable %.

????

 

 

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  • HadIt.com Elder

That just does not seem to make much sense, but then again, we're talking about the VA...

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