PyRAMID RULE

[usmcpana146]

What constitute a dominant condition in the VA pyramid rule?

How many condition can be a part of that pyramid?

[Navy04]

Welcome aboard,

 

Pyramiding consists of similar conditions that the VA groups together. For example most Mental health conditions are grouped together. I have PTSD, OCD, Depression, and Adjustment Disorder all granted as 70% PTSD. The VA states that all the conditions together affect the PTSD, therefore granted as 1. My Crohn's Disease, Barrett's Esophagus, GERD and other stomach issues again, all granted as 30% Crohn's Disease. Basically if they are Medically in the Same region of the body, similar in nature, or treated the same, then all of those conditions would fall under one. Now you can always submit for a Disability to be granted as Secondary, which I and others on Hadit have done with good success over the last few years. Now you can't submit your foot pain secondary to PTSD, sounds stupid but I had a Vet who tried, Lol. My Migraines and TBI are grouped as 50% for Migraines as Headaches can be secondary to TBI and multiple concussions. I hope this helps you my friend. I am no expert but I try to be as Honest with what I do know. Good luck and keep us posted. God Bless

[usmcpana146]

The Department Of Veterans Affair  rated me 10% pyramid  for all 3 respiratory condition. one of the conditions require low dose of steroid medication to increase to 30% the others requires  high dose. My physician recently prescribed low dose for the conditions that required me to obtain the increase. would I need to meet the requirements for all 3 condition in order to qualify for an increase?

[Gastone]

Good question but does it really matter at this point? You can't go any lower than the 10% Awarded for all (3) combined conditions, even if (1) all of a sudden became a (0%).

Is the "Low Dose Rx" in your VMC Medical Records? Print a copy of the VA Dr's "ClinicanTreatment Notes" concerning the SC'd condition and the requirement of the New Rx. Attach it as a Pdf to an official E-Ben FDC Claim for Increase of your existing 10% SC Respiratory Condition based on the attached VMC Treatment Note and Rx.

Let's now go hunting for BEAR, how is your Sleep Health since developing your SC Respiratory conditions? Any Snoring, choking or gaging? Daytime Somnolence (nodding off)?

Always a possibility that your relatively minor Respiratory conditions could either cause or exacerbate a Sleep Apnea DX, which then could be Nexus'd as a Secondary Condition. 

[usmcpana146]

22 minutes ago, Gastone said:

Good question but does it really matter at this point? You can't go any lower than the 10% Awarded for all (3) combined conditions, even if (1) all of a sudden became a (0%).

Is the "Low Dose Rx" in your VMC Medical Records? Print a copy of the VA Dr's "ClinicanTreatment Notes" concerning the SC'd condition and the requirement of the New Rx. Attach it as a Pdf to an official E-Ben FDC Claim for Increase of your existing 10% SC Respiratory Condition based on the attached VMC Treatment Note and Rx.

Let's now go hunting for BEAR, how is your Sleep Health since developing your SC Respiratory conditions? Any Snoring, choking or gaging? Daytime Somnolence (nodding off)?

Always a possibility that your relatively minor Respiratory conditions could either cause or exacerbate a Sleep Apnea DX, which then could be Nexus'd as a Secondary Condition. 

Thanks you Chief.  I already have an appeal (3years) pending for sleep Apnea secondary to my respiratory conditions and Rhinitis. Your information is greatly apreciated.

[DivComms]

To clarify points:

In the case of pyramiding, you will receive the highest rating of the bunch. For instance say you have 3 conditions that are similar in nature (as Navy04 stated).

Respectively say they are rated at 30%, 20%, and 20%. You will only get the highest, which will be 30%. If say in future the condition rated at 30% improves so it get lowered to 10% then the highest rating takes over, in this case 20%. But it also works the other way, so if one of those 20%s got rated higher, then the rating would become it.

[usmcpana146]

2 hours ago, DivComms said:

To clarify points:

In the case of pyramiding, you will receive the highest rating of the bunch. For instance say you have 3 conditions that are similar in nature (as Navy04 stated).

Respectively say they are rated at 30%, 20%, and 20%. You will only get the highest, which will be 30%. If say in future the condition rated at 30% improves so it get lowered to 10% then the highest rating takes over, in this case 20%. But it also works the other way, so if one of those 20%s got rated higher, then the rating would become it.

Thank you DivComm that's exactly the answer I was looking for. You have been very helpful.