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Diagnostic Codes


carlie

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It should be listed on your blue sheet in your c-file.

Call the VA 800 # and ask what DIAGNOSTIC CODES you are rated

under, they SHOULD be able to provide this information.

To research the requirements for a certain percentage of evaluation

check out 38 CFR - Part 4.

http://ecfr.gpoaccess.gov/cgi/t/text/text-...fr4_main_02.tpl

jmho,

carlie

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and if the VA- in a final decision that you never appealed- used the wrong diagnostic code- to your detriment- and/or applied the wrong rating schedule-to your detriment-

(meaning they snookered you out of some comp)

this is a legal error raising to the level of CUE.

In Myler V Derwinski- the VA failed to apply the proper rating schedule and most surely gave the vet the wrong diagnostic code.decided in 1996 (I think) but Myler got retro back to 1953.

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No-

Only if the veteran was "in receipt of" or "entitled to receive" 100% P & T for SC for at lest ten years prior to death.

38 USC 1318 - this is an "as if" service connected death DIC award.

The VA is to considered this type of DIC in any case where they deny direct SC death and the veteran had a 100% disabling SC condition at time of death.

I would hope not too many widows or widowers have to support DIC by the "entitled to receive" basis-this is very difficult- as the spouse has to prove the vet should have been in receipt of total SC for ten years prior to death-based on medical evidence.

DIC is also awarded for deaths caused or contributed to by service connected disabilties,

also DIC is awarded under Sec 1151 awards.

There is also the one year rule and the one year POW rule too for DIC- this info is available here by a search

at hadit and is all within 38 CFR 3.22, as well as 38 USC 1318.

Also VBM has more detailed info and expands on DIC might possibly be obtained via Cue.

They give two examples but there is no case to cite on this facet of DIC.

"So what if fixing an inacurate code will not change the rating?"

if there was no financial detriment- in any rating or DC error- there is no basis for CUE claim.

In the CUE regs- at hadit-

the part :"manifestly altered outcome" - means-

if the CUE had not occured , the vet would have had decision generating more comp through higher rating or proper initial rating.

If the error cost the vet this "outcome"

a successful CUE claim can alter this outcome with more comp.

Edited by Berta (see edit history)
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So for DIC, my death would have to be directly from my SC condition? At least within the 10 year period. So would the code make a difference in the nexus between the cause of death and the SC condition? Or is it only important for rating purposes?

I just want to make sure everythin is as it should be, so my wife is not having to clean up a mess for benifits. (not that I expect such a thing, but sh$* happens)

Time

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The DCs diagnostic codes are only for rating purposes-

the Death certificate and autopsy findings are critical to DIC claims-

I always suggest autopsies and tell you family if you wish to be organ donor- then the autopsy is free (at least in NY it is if the Eye Bank calls you)and this sure gave me some piece of mind when Rod died- he was organ donor - (eyes and skin) and all bones.

Also an autopsy can be critical to a DIC claim as well as the death cert-

I think you are misunderstanding me on the DIC -but sorry- I probably explained it better in older posts.

If you go to the DIC link here at the VA it explains it all:

http://www.vba.va.gov/bln/21/Benefits/

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The reason I stress the importance of Diagnostic Codes is because if you don't know what

DC VA is rating you for then you don't know what must be documented for that evaluation.

Also, VA loves to lump disabilities together. Below is a prime example, VA could easily

grant 6204 at 10 % - claim got granted, vet accepts this without realizing their evidence

shows this should have been awarded 30%. Also, the vets records could certainly show

treatment and continuing supperation from Otitis Media -- Here DC 6204 clearly

shows that supperation is to be rated separetly, that would be another 10 % for the vet.

6204 Peripheral vestibular disorders:

Dizziness and occasional staggering........................... 30

Occasional dizziness.......................................... 10

Note: Objective findings supporting the diagnosis of

vestibular disequilibrium are required before a compensable

evaluation can be assigned under this code. Hearing

impairment or suppuration shall be separately rated and

combined.

It's hard to fight the enemy when you don't know what side their approaching from.

jmho,

carlie

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(386.01) Ménière’s disease, active, cochleovestibular

(388.01) Presbyacusis

(388.12) Hearing loss, noise-induced

(388.2) Hearing loss, sudden, unspec.

(388.31) Tinnitus, subjective

(388.4) Other abnormal auditory perception

(388.71) Otalgia, otogenic

(388.72) Otalgia, referred

(389) Deafness

This is from Wikipedia- no 388.30

but 388.30 Tinnitus, unspecified

from:http://www.pharma-lexicon.com/icd9codes.php

Both are excellent sources of info- the Pharma lexicon (medilexicon) is more specific.

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