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Confused - Appeal to BVA or Higher Level Review EED
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BAM_
Hello Vets. Long time reader, first time posting. I hope I can get some advice on my situation as many of you have helped me over the years without even knowing. Thank you!
History - I submitted a claim January 19, 2016 for Increase to SC Ankylosing Spondylitis (Thoracolumbar) Rated at 20%, New Claim - Hip Pain secondary to Ankylosing Spondylitis and Leg Pain secondary ankylosing spondylitis. C&P March 11, 2016, Decision March 24, 2016. No increase for AS (20%) and denied for all secondary claims
Filed NOD February 03, 2017
Opted in to RAMP July 27, 2018 with the RAMP Claim Nov, 25, 2018. C&P January 30, 2019, Decision March 8, 2019. Granted 50% Unfavorable Thoracolumbar Spine, 10% Right Hip, 10% Left Hip secondary to Ankylosing, denied leg / knee pain. My EED of January 30, 2019, not what I was expecting
Present - I was going over my C&P exams trying to understand why my EED wasn't January 19, 2016, since that is when I put in the original claim. I also wanted to know what was the difference between the March 11, 2016 exam and the January 30th, 2019 exam that got me the increase for my Thoracolumbar and both Hips being rated since they used the same XRAYS and MRI in both exams.
Well I noticed that on the March 11, 2016 exam the examiner answered:
9. Ankylosis ----------- Is there ankylosis of the spine? [X] Yes [ ] No [X] Favorable ankylosis of the entire thoracolumbar spine
This is from the January 30th, 2019 exam and I was awarded 50%
9. Ankylosis ----------- Is there ankylosis of the spine? [X] Yes [ ] No [X] Unfavorable ankylosis of the entire thoracolumbar spine
It seems like they should have at the very least increased my SC Ankylosing Spondylitis to 40% from 20% on the March 24, 2016 decision based on the spine ratings. But they didn't give me an increase.
So I wasn't sure what to do and took this information to my County Veteran service organization and they put in an NOD BVA appeal. When I didn't see my appeal showing up on VA.GOV I called them and they said they gave my appeal form my POA VFW, ok so I call the VFW and they confirm they submitted it, fine.
My BVA appeal shows up and I had a question about it so I called my VSO at the VFW and ask my question and then say: "Oh you don't want a BVA appeal for this, we need to cancel this appeal and put in for a Higher Review request"
This is where I'm at two weeks ago they had me sign a form VA FORM 21-4138 canceling my BVA appeal and submitted VA FORM 20-0996 Decision Review Request: Higher Level Review.
I'm so confused if this was the right approach. Any advice would be much appreciated. If you all think I should post my decision letters to really help, I can do that as well.
Here are the spine ratings:
Rating
Cervical Spine
Thoracolumbar Spine
100%
Entire spine frozen in an unfavorable
position.
50%
Entire thoracolumbar spine frozen in an unfavorable
position.
40%
Entire cervical spine frozen in an unfavorable
position.
Flexion measures 30° or less.
-OR-
Entire thoracolumbar spine frozen in a favorable
position.
30%
Flexion measures 15° or less.
-OR-
Entire cervical spine is frozen in a favorable
position.
20%
Flexion measures more than 15° but not more than 30°.
-OR-
Combined ROM is 170° or less.
Flexion measures more than 30° but not more than 60°.
-OR-
Combined ROM is 120° or less.
10%
Flexion measures more than 30° but less than 45°.
-OR-
Combined ROM is between 175° and 340°.
Flexion measures more than 60° but less than 90°.
-OR-
Combined ROM is between 125° and 240°.
0%
Flexion measure 45° or more.
-OR-
Combined ROM measures 340° or more.
Flexion measures 90° or more.
-OR-
Combined ROM measures 240° or more.
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