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INCAPACITATING PERIOD

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EDWIN

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If they deny (forget what your claim is about)

you can raise that point on appeal, if it was a reason for the denial.

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Hi Berta, my appeal is approved, I won the appeal of my case. But they used the incapacitating period of the C&P instead of using the one in the. NEXUS LETTER. Any input ??

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Congrats! I would check the VA Schedule of Ratings topic here and compare the rating % with what the ratings criteria is,for each % ,  because it might not make a difference.

If it does you can appeal the rating.

The diagnostic codes and the rating info is about half way down the scroll:

https://www.ecfr.gov/cgi-bin/text-idx?SID=e01889934e16ee0751373657d3b13a6e&mc=true&tpl=/ecfrbrowse/Title38/38cfr4_main_02.tpl

 

 

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Found it !!!,,,,,The C&P examiner stated 4 weeks incapacitating period and my NEXUS LETTER INDICATES  a period of 10 weeks. But VA took their decision based on the C&P examiner. What can be done ???

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Code 5243: Intervertebral disc syndrome is when a disc in the spine is dysfunctional. It can deteriorate, herniate, etc. This condition can either be rated under the general rating formula or based on incapacitating episodesincapacitating.bmp (below), whichever will give the higher rating. Now, if a disc in the cervical spine has this syndrome and another disc in the thoracolumbar spine also has it, then both the cervical spine and the thoracolumbar spine can be separately rated.

Formula for rating on Incapacitating Episodesincapacitating.bmp:

If within the last year you were on bed rest prescribed by your physician for 6 weeks or more, then it is rated 60%. If within the last year you were on bed rest for 4 to 6 weeks, it is rated 40%. Two to 4 weeks is rated 20%, and 1 to 2 weeks is rated 10%.

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