Did they get the rating right? Shoulder injury.

[ArtilleryApex]

So I got my rating back for a shoulder injury (20%). Have yet to get the letter, but a little concerned on a few things. Long story short.. Shoulder injury turned into one civilian surgery then 2 from the VA. The VA reconstructive surgery had a hamstring graft that left the front of my leg numb.

Anyways doing a little digging myself this is what I came up with. Please forgive my ignorance on the matter.

Code 5201

Range of motion. I definitely cannot raise my arm more than 45-50 degrees to the front or side without pain and I was evident during the C&P. 

Figured it would be at least 20%

Code 5203

AC Separation. I had a class IV separation and it looks like it was listed that way under my rated disabilities. (left shoulder, grade 4 acromioclavicular separation, status post surgical removal of outer third of left clavicle with graft) 

20% Looks like this is what my rating was for.

Clavicle/Scapula bones broken. Did not count much on this as my clavicle was shaved off on the tip during surgery. Left quite the gap, but not technically 'broken' so I was just curious on this.

Would have been 10%

Painful Motion 

"Minimum Rating must be given" - Not sure what this means. I suppose as long as you get a % with one or the other it would apply here as well.

Scars

I have about 7-8 endoscopy scars followed by a large hideous one after the graft. I got 0%. Not sure how the scars work.

 

I started a new claim to file for nerve damage. The front of my shin where they harvested the hamstrings is completely numb and I get splints on that leg from just walking. Then my long thoracic nerve has been paralysed causing pain and a wing scapula that has not gotten better from years of physical therapy. Not quite sure what to expect from these.

However I just feel like 20% for the shoulder injury (before the nerve damage claim) is a little low. I will follow up with the letter results when they come in. Just curious if anyone else has an opinion on this?

 

[ArtilleryApex]

Ok so should I appeal or wait for my nerve damage claim for the same shoulder to have the ROM on that rating? Would it be on both since technically they can be separate claims?

[vetquest]

 would appeal now.  That gets you a docket number and lessens the wait you will have for the BVA.  Remember, appeals now take years and the sooner the better. The VA will lowball you sometimes and it takes the BVA to get your correct rating.  I would definitely also apply for the damage done to the leg when they removed ligaments. 

It is best to read your decision very carefully and see where they might have erred and then use this in the appeal.  You may be interested in getting an IMO from a friendly civilian doctor who understands VA terminology if you can. 

Edited December 17, 2018 by vetquest

[ArtilleryApex]

Well it looks like I got the shaft. Got 20% for the A/C separation and it looks like the Dr. said my range of motion was completely normal. We even had a conversation about how bad it was. I have never seen such a big mistake made on an exam ever. He even gave me advice and felt bad... So how the hell did he put normal?!? I was thinking about getting a second opinion and appealing...

However you can pyramid in nerve damage secondary to the shoulder injury. So I guess my next question is that extra percent I would have had for my shoulder claim could go on the nerve damage claim because I am assuming you cannot double up on both? Any experience on this?

[wirat]

Well this might be late, but I would;

1) Research what each disability is defined as before you claim it and articulate it using those symptoms. I don't think it is a lie, it is what the VA rating terminology is. If you use different words to describe something it is left up to their interpretation. 

2) If you got rated 0% on something like a scar that is painful, file for an increase instead of a NOD. This will cause another C&P that will focus on the pain. Now you have the service connected element out of the way. If you file a NOD you will be burning up a challenge on that disability. Save the NOD for when/if the claim for increase fails. It worked for me.

For example, I filed for scarring that was painful and got 0% because the examiner put NO on the painful question. (That's another story)  When I got the results instead of a NOD I just immediately filed for an increase, got another exam with a VA Dr, and at that appointment I really went over the pain issue which was the focus of the entire exam. He said there was no question and I got 10% for it after that exam. No appeal required.

3) When you go for the C&P make sure you go over the exam results with the provider. Take hand written notes. Ask them what they are going to report, what their measurements are, etc. It helps them too so that they form a mental conclusion in their head. I bring my wife along and have her sit in there so the provider knows there is a witness. I think this may have prevented the issue with my painful scars during the first exam. 

I have a grade V AC separation from decades ago. Back then they only gave me 10% for arthritis. I was young, dumb and full of."...". I didn't know any better and trusted that must be what you get for this injury.

When I later discovered there was a separate disability for the AC injury alone at 20%, I was really shocked and felt betrayed at how they could not have given me that rating from the start. It's a prima facie injury, either you have it or you don't. Like an amputation. That was years ago for me, but now I am learning and trying to get it corrected.

I would read over that site Military Disability Made Easy...they have all the ratings in plain English with pictures that make it easy to understand. Go there and write down everything you think applies to you. You may find you are missing something or are claiming something under the wrong disability. I did. 

Edited March 26, 2019 by wirat