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JustGettingStarted

Might be doing first NOD - advice appreciated

Question

I am considering doing my first NOD. I received 20% for peripheral neuropathy (pain and tingling in my arms and hands) secondary to Cervical Spondylosis (narrowing of the spinal openings in my neck) for both my left and right sides in February 2017. I just received a copy of my C-File that I requested back in July 2016, and it has the C&P exam that was done on me for the peripheral neuropathy. In the C&P exam, I was clearly rated for SEVERE pain on my non-dominant side and moderate numbness and tingling on my dominant side.  

I was given a 20% rating for mild conditions on both left and right side, but from the DBQ the doctor submitted it looks like I should have been given severe to moderate ratings, which would be 40% for my dominant side and 30% for my non-dominant side.

Do I file a NOD and request a DRO review?  

Am I missing a reason why the VA only gave me 20% on each side?  I have attached screen shots from the DBQ.  

Code 8710: Neuralgia of the upper radicular group. Neuralgia cannot be rated higher than moderate, even if it is severe. If the condition is moderate, it is rated 40% for the dominant and 30% for the non-dominant. If it is mild, it is rated 20% for either arm.

This is the quote from my decision package:

"Service connection for left upper extremity radiculopathy (peripheral neuropathy) has been
established as related to the service-connected disability of cervical spondylosis.
● We have assigned a 20 percent evaluation for your left upper extremity radiculopathy
(peripheral neuropathy) based on: • Mild incomplete paralysis of the minor extremity
● Although the lower radicular group and middle radicular group nerves were shown to be
affected, only one evaluation is allowable in this case. This rating is based on the highest
rated nerve.
● A higher evaluation of 30 percent is not warranted for paralysis of the middle radicular
nerve group unless the evidence shows nerve damage is moderate.
● Service connection for left upper extremity radiculopathy (peripheral neuropathy) is granted
with an evaluation of 20 percent effective May 11, 2016, the day we received your intent
to file, with your completed application received on October 29, 2016. VA examination
conducted in support of your claim notes that your noted radiculopathy is related to your
service connected cervical spondylosis."

Severe pain - page 116.png

Moderate Pain.jpg

Edited by JustGettingStarted
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One of the most glaring and annoying problems with initial ratings is the fact that the VARO has a bad habit of not awarding the correct percentage.

If it were me, I would write back to the VARO and explain the correct percentage was not awarded. Include the C&P findings, the rating criteria, and explain why their initial rating was not correct. Keep in mind that the NOD clock is ticking. If they do not fix it, be sure to file an official NOD before the NOD clock expires.

Good luck!

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You did what a lot of others fail to do -- ensure the VA rated you correctly. Congratulations on taking that extra step of not letting the VA get one over on you.

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Vync,

Thanks, but how do I go about just writing the VARO and requesting they change the decision?  Is this the same as requesting reconsideration which according to some info I've seen doesn't really exist?  Do I do it through eBenefits or postal service?

Thanks for your support.

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If you don't have one, it's time to start using a VSO-Rep.

What is the Date of the PN Secondary Award? How much time do you have left to NOD the Decision?

A knowledgeable VSO-Rep could file an "Official Request for Review" of the "RECENT" Award Decision, attaching any missed Med documents supporting the SC Increase. You could get the increase in a couple of months if warranted.

Keep in mind, the "Request for Review" does not stop the NOD Filing Deadline, don't miss IT.

Semper Fi

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Thanks Gastone.

The date of the letter on the secondary PN is 10 Feb 2017, so I have some time to file a NOD.  

I was lucky getting the C&P exam info when I did.  I requested a copy of my C-File last July so I could review my disabilities from when I retired in 2009 and I just received it yesterday.  The C&P exam from my October claim for secondary PN was in there.  I have looked for my C&P exams in Bluebutton, but they only show up when done at a VA Center and not a contract clinic (huge foul I think).

I have a DAV VSO that is 7 hours away in St Petersburg.  He is the second one I have had and I am not impressed.  The first one said he submitted a CUE back in October and whenever I would ask for a status he would tell me I wouldn't hear anything until it was closed.  I was nervous because I thought it would show up in eBenefits at least that it had been submitted, but there was nothing.  I finally called the VA myself and they said they had never received a CUE from my VSO.  The VSO claimed the VA ignored it.  I don't know who to believe.  Then I was assigned another VA VSO without asking, and he doesn't seem any more responsive.  I may have to try my county VSO but I live in a small county and he is part time with limited hours.

The medical documentation isn't really missing - the VA has the DBQ with the "moderates to severes" on it.  Do I need to just point out what was under their noses or provide new evidence?

I have continued treatments.  I used Tricare to see a neurologist and had injections in my neck after the C&P exam.  That provided some relief, but it is temporary.  The pain is gradually coming back and it is known that the injections only last up to 6 months normally.  I also continue to see a chiropractor and massage therapist under Choice at my neurologist's urging (she even wrote a script which I sent to VA to get renewed under Choice).

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