diabetes Va Ratings Seem To Have Disappeared

[Stan n Pam]

I'll try to explain this – I feel like I need to tell you all that have responded that I have a pretty healthy case of good 'ole ADD. I really struggle reading, especially instructions – so keep that in mind when I don't seem to click right a way on something – I'm a visual learner….so if you guys wouldn't mind drawing a few pictures now and then, that would probably help a lot……. Just kidding J …but if they could be in color……..

In going thru the ROI packet that was printed on 10.10.06 – there are some discrepancies that I need help understanding –

It shows Stan as having a 60% disability rating. It is broken down like this:

"CONSULT REQUEST" (is the title on the top of the page) page 53

Provisional Diagnosis: PTSD CHRONIC SEVERE

Eligibility: SERVICE CONNECT ED 50% to 100% VERIFIED

Total S/C %: 60

FOREARM MUSCEL INJURY 30% S/C

FACIAL SCARS 0% S/C

DIABETES MELLITUS 10% S/C

POST-TRAUMATIC STRESS DISORDER 10% S/C

ARTERIOSCLEROSIS 0% S/C

ARTERIOSCLEROSIS 0% S/C

PARALYSIS OF SCIATIC NERVE 10% S/C

PARALYSIS OF SCIATIC NERVE 10% S/C

Then……………………..

On October 12, 2006 Stan received notice that his disability had been increased to 70% - and that breaks down like this:

….decision on your claim for service-connected compensation received on December 29, 2005….

….Payment start date: Jan 1, 2006 for increased service-connected compensation evaluation; monthly entitlement amount $1,280.00 this includes an additional amount for your spouse, Pamela…..

….We determined that the following conditions were related to your military service, so service-connected has been granted…

<H1 style="MARGIN: 0in 0in 0pt">Medical Description percent assigned effective date</H1>Bilateral hearing loss 0% May 19, 2006

Tinnitus 10% May 19, 2006

…..we determined that the following service-connected conditions have worsened, so we granted an increase in your assigned percentage:…..

<H1 style="MARGIN: 0in 0in 0pt">Medical Description old % new% assigned effective date</H1>Diabetes mellitus, type 10% 20% Dec 20, 2005

II w/nuclear cataracts

Residuals, shell fragment 30% 40% Dec 20, 2005

Wound, right arm

Scar, fragment wound, right and left periorbital areas 0% assigned

…….we denied entitlement to the 100% rate because it wasn't shown that you are unable to work as a result of your service-connect disabilities……

My question here is: What happened to the previous ratings on these:

POST-TRAUMATIC STRESS DISORDER 10% S/C

PARALYSIS OF SCIATIC NERVE 10% S/C

PARALYSIS OF SCIATIC NERVE 10% S/C

Another question is: I wonder where the heck that 10% rating on the PTSD came from in the first place? I'm still in the process of going thru papers so I may find that out – Stan is hoping to be rated 100% on PTSD (his VA doctors seem to think that is a distinct possibility, we'll see) – if that happens will he lose the ratings on everything else? Will they all be absorbed into one single diagnosis of PTSD? I have a problem with that! He was shot serving his country before he developed PTSD! To me everything should be absorbed into that rating. Maybe I'm being too emotional here and I probably haven't thought this thru enough, but most of the time my first instincts seem to be the right ones. ….BUT… then on the other hand – I do have to realize who we are dealing with here!!!! The VA and The Government…….. 'nough said.

Thanks for any direction anyone can give me on this,

Pam

If you need any more background – I'd be happy to supply it – one thing about this board that is so cool, is, that everyone has their own dirty laundry, and we all have to hang it out to dry sometime – and this seems to be the best place to do that.

[Vike17]

Pam,

When a veteran files an increase for some of their service-connected disabilities, the VA will only address those disabilities on the rating decision. Your husbands other conditions i.e. PTSD and sciatic nerve and any other service-connected disabilities he didn't request an increase, didn't disappear, they're still in his file. That's why he's now receiving a combined rating of 70% instead of the 60% he previuosly had. If those other disabilities just disappeared, your husband wouldn't be getting a combined rating of 70%. Now having said that, sometimes when a veteran files for an increase on some, but not all, of their disabilities, the VA may decided to look at the one they didn't ask for an increase. This doesn't happen all the time but from time to time they do; especially if the veteran was scheduked for a re-exam in the futer anyways. If the VA does decided to look at those disabilities, they will alos be listed in the rating decsion.

"Another question is: I wonder where the heck that 10% rating on the PTSD came from in the first place"

Apparently at some point in time in the past your husband filed a claim with VA and they subsequently awarded service-connection for it.

"Stan is hoping to be rated 100% on PTSD (his VA doctors seem to think that is a distinct possibility, we'll see) – if that happens will he lose the ratings on everything else? Will they all be absorbed into one single diagnosis of PTSD? I have a problem with that! He was shot serving his country before he developed PTSD! To me everything should be absorbed into that rating"

Did your husband request an increase for his PTSD? If not, he should and send the regionl office the treatment records from that doctor! Each disability rating per bodily etoilogy will be retained and then combined according to the Combined Ratings Table in §4.25 for one over all disability rating. keep in mind the VA does not add the disabilities together, they combine them using a formula from what is called something like the whole man concept, which would really too complicated to expain here in this post.

I thing I did notice was you stated there was two 10% ratings for the sciatic nerve. Was this just a typo? The reason why I ask is normally that isn't allowed under "pyramiding," meaning two disabily ratings for the same disability. Could you clarify that?

Vike 17

[Berta]

Vike is correct -they have to not only have a formal claim for higher increase of the PTSD but also evidence that it has increased in severity-

I noticed they did state chronic and severe-so there must be evidence there already beyond the 10%-

that can be Nodded-(Notice of Disagreement)---then again could it be NOdded ?-hope Vike comes back-

can you NOD part of a decision where no formal claim for increase was raised?

Did he ever ask for higher PTSD rating?

something here is really sticking out to me-

DMII % was raised-but what was the rating for the nuclear cataracts- and how could a DMII vet have cataracts (I assume they are definitely due to the DMII) if they did not rate the atherosclerosis as service connected too at a ratable % beypnd "0"?

DMII can cause atherosclerosis which also can cause cataracts-

I have vets who have this progression of their DMII.These are secondary conditions of their SC Diabetes. But their claims were specifically for the rating of these secondary conditions.

Even the VBM makes the point of the nexus between these conditions and also the VA training letter on DMII does too.

Is your husband unemployable due to his service connected conditions?

Does he get SSA for his service connected conditions?

Did he ever had an ECHO test to determine what level of atheosclerosis he really has?

Did he in fact ask for increase in the % for atherosclerosis?

Has any doctor said he was unemployable due to his service connected conditions-

I will attach a TDIU form- if he believes and can prove with medical evidence, that his service connected conditions render him unemployable.

TDIU is the same $ as the 100% rate.

Interesting- they considered 100% but did not infer TDIU-----

Did the initial claim request 100%?

TDIU_form.pdf

Edited January 28, 2007 by Berta

[Stan n Pam]

Berta and Vike17 -

I read your responses and I soooo appreciate the time you take to share your expertise and knowledge!!!

I will get back to you on the answers as soon as I can take time to figure them out :P I told you I'm ADD and boy what a bummer when I have to sort this kind of stuff out - the good thing is that when it finally sinks in I actually do 'get it' B) just takes me a little longer than most

My kids are going to be here in a few mins for the afternoon so I'll work on this tonight - one thing I can answer - the duplication on the syatic nerve was not a typo on my part - it may have been on the VA's part, but it was on the document - and was repeated in several other areas

But pretty much the info that I did give was taken directly off of the official documents from the VA - wish I could just scan them and send it to you - I spent hours last night composing and retyping things for this request and then I go to cut and paste it to the message board and it gets all jumbled up - I thought it might even be hard for anyone to read it -

Should I ask the 'geeks' how to transfer info? or is it something simple that I'm missing?

Thanks!!!!

Pam

[Berta]

Pam- I was wondering too about the sciatic nerve ratings-

I sure learned something- sciatic nerve problems sure can be very serious-

I found this BVA case- the veteran got 80%

from: http://www.va.gov/vetapp97/files2/9714927.txt

"FINDINGS OF FACT

1. The veteran has been awarded the highest schedular

rating, 80 percent, for injury to the right sciatic nerve,

effective from the date of her separation from service.

2. The rating schedule is not inadequate to rate the

veteran’s disability from injury to the right sciatic nerve,

which is not so exceptional or unusual as to require

extraschedular consideration."

If the sciatic nerve rating should be higher this is something to file NOD on-

In this more recent decision the rating schedule appears-

III. Rating in Excess of 40 Percent for Disability of the

Right Sciatic Nerve

Disability ratings are determined by applying the criteria

set forth in the VA Schedule for Rating Disabilities (Rating

Schedule), found in 38 C.F.R. Part 4 (2001). The Board

attempts to determine the extent to which the veteran's

service-connected disability adversely affects his ability to

function under the ordinary conditions of daily life, and the

assigned rating is based, as far as practicable, upon the

average impairment of earning capacity in civil occupations.

38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. §§ 4.1, 4.10

(2001).

Paralysis of the sciatic nerve warrants an 80 percent

evaluation if it is complete; with complete paralysis of the

sciatic nerve, the foot dangles and drops, no active movement

of the muscles below the knee is possible, and flexion of the

knee is weakened or (very rarely) lost. Incomplete paralysis

of the sciatic nerve warrants a 60 percent evaluation if it

is severe with marked muscular dystrophy, a 40 percent

evaluation if it is moderately severe, a 20 percent

evaluation if it is moderate or a 10 percent evaluation if it

is mild. 38 C.F.R. § 4.124a, Diagnostic Code 8520.

The veteran contends that the disability of his right sciatic

nerve meets the criteria for a 60 percent evaluation under

Diagnostic Code 8520. For the purpose of this decision, the

Board will assume that this is true. However, the veteran is

also in receipt of a separate 60 percent evaluation under

38 C.F.R. § 4.71a, Diagnostic Code 5293, which provides a 60

percent evaluation for pronounced intervertebral disc

syndrome with persistent symptoms compatible with sciatic

neuropathy with characteristic pain and demonstrable muscle

spasm, absent ankle jerk or other neurological findings

appropriate to the site of the diseased disc, with little

intermittent relief.

Since Diagnostic Codes 5293 and 8520 both involve the sciatic" etc----

from:http://www.va.gov/vetapp01/files03/0127363.txt

[Pete53]

How convienient but if the VA will not address all the other disabilites why did they review my 100% for Panic and 30% for Pes Planus when I asked for a rating for tinnitus a couple of years ago.

I am 100% P&T by the way.

[Vike17]

Pete,

Like I've said before regardless of one's rating, if the veteran re-opens any of their claims the VA can take a look see at any of the other disabilities, even if those disabilities are designated P&T. This even happened to me back in 1997. I wouldn't worry about it, if the disability is truely still at 100% disabiling, the VA isn't gong to create more work for themselves by going through the hassle of doing a proposal to reduce ect...

Vike 17