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    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
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    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

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Navy89

Grouping Conditions

Question

I have a rating for 10% for:. right knee patellofemoral syndrome, claimed as gout and iliotibial band syndrome

Is it common for VA to group conditions, can these be separated?

Thanks for the assist...

 

 

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Maybe, but I thought that there was only 1 rating per system, with the worst (or most advantageous to veteran) taking precedent. 

 

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this is a good question, but I am assuming something happened to your knee to cause iliotibial band syndrome?  Do you have two different disabilities in your knee?  Do you have gout?  

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50 minutes ago, Navy89 said:

I have a rating for 10% for:. right knee patellofemoral syndrome, claimed as gout and iliotibial band syndrome

Is it common for VA to group conditions, can these be separated?

Thanks for the assist...

 

 

Gout is a form of arthritis caused by high levels of uric acid in the body. Gout falls under diagnostic code 5017, but it is supposed to be rated under 5002 Atrophic Rheumatoid Arthritis. Gout must be rated seperately.

5017 Gout.

The diseases under diagnostic codes 5013 through 5024 will be rated on limitation of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002.

 

5002 Arthritis rheumatoid (atrophic) as an active process

With constitutional manifestations associated with
active joint involvement, totally incapacitating.................................................... 100 

Less than criteria for 100% but with weight loss and anemia
productive of severe impairment of health or severely
incapacitating exacerbations occurring 4 or more times a 
year or a lesser number over prolonged periods.................................................... 60

Symptom combinations productive of definite impairment of 
health objectively supported by examination findings or
incapacitating exacerbations occurring 3 or more times a year................................ 40 

One or two exacerbations a year in a well-established diagnosis............................. 20 
For chronic residuals:

For residuals such as limitation of motion or ankylosis, favorable or unfavorable, rate under the appropriate diagnostic codes for the specific joints involved. Where, however, the limitation of motion of the specific joint or joints involved is noncompensable under the codes a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5002. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.

Note: The ratings for the active process will not be combined with the residual ratings for limitation of motion or ankylosis. Assign the higher evaluation.

 

IBS and PFS involving the knee can't be seperated, BUT keep in mind that the opposite knee eventually will begin to cause you problems, on a secondary basis caused by your Left Knee.

Your left knee can also cause hip and lower back problems, eventually, as well. 

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14 hours ago, shrekthetank1 said:

this is a good question, but I am assuming something happened to your knee to cause iliotibial band syndrome?  Do you have two different disabilities in your knee?  Do you have gout?  

Yes, I have gout and attacks in most if not all my joints.  I was just curious as to why there is a group of three and gout, I would think is not in the family.

allergic rhinitis 0% Service Connected   08/01/2009
right elbow gout 10% Service Connected   11/02/2009
right hip degenerative arthritis 10% Service Connected   04/12/2010
right knee patellofemoral syndrome, claimed as gout and iliotibial band syndrome 10% Service Connected   08/01/2009
left knee gout 10% Service Connected   11/02/2009
gout, left foot 0% Service Connected   11/02/2009
gout, right foot 0% Service Connected   11/02/2009
facial hyperpigmentation claimed as melasma and cholasma faciei 30% Service Connected   08/01/2009
post operative bunionectomy scar, right great toe 0% Service Connected   08/01/2009
left elbow bursitis/strain also claimed as gout 10% Service Connected   08/01/2009
right hallux valgus post bunionectomy 10% Service Connected   08/01/2009
hypertension 0% Service Connected   08/01/2009
left hallux valgus 0% Service Connected   08/01/2009

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Just now, Navy89 said:
allergic rhinitis 0% Service Connected   08/01/2009
right elbow gout 10% Service Connected   11/02/2009
right hip degenerative arthritis 10% Service Connected   04/12/2010
right knee patellofemoral syndrome, claimed as gout and iliotibial band syndrome 10% Service Connected   08/01/2009
left knee gout 10% Service Connected   11/02/2009
gout, left foot 0% Service Connected   11/02/2009
gout, right foot 0% Service Connected   11/02/2009
facial hyperpigmentation claimed as melasma and cholasma faciei 30% Service Connected   08/01/2009
post operative bunionectomy scar, right great toe 0% Service Connected   08/01/2009
left elbow bursitis/strain also claimed as gout 10% Service Connected   08/01/2009
right hallux valgus post bunionectomy 10% Service Connected   08/01/2009
hypertension 0% Service Connected   08/01/2009
left hallux valgus 0% Service Connected  

08/01/2009

 

as you can see, there are several grouped together...which probably should be listed separately

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