C&P tomorrow

[SPO]

So I will am heading to my in person C&P tomorrow.  This claim is for arthritis (analogous to Rhuematoid).   This is round 2 for this condition,  I'm pretty sure I was a little to friendly with the last examiner and it didn't help things. I'm sure it has been covered many times before, but any suggestions on how to handle this exam. 

[ShrekTheTank]

You need to hit all the points that apply as they will be grading you off of these:

Code 5002: Rheumatoid arthritis is the destruction of the soft tissues in a joint because of swelling.

Regardless of how many joints are affected, if the arthritis is severe enough that you cannot function, but are completely incapacitated and bedridden, then it is rated 100%.

If there is significant weight loss, anemia, and overall severe decrease in health but not complete incapacitation, or if severe incapacitating episodes happen 4 or more times a year, then it is rated 60%.

If there is a definite decline in overall health, or if incapacitating episodes happen 3 or more times a year, then it is rated 40%.

One or two episodes a year rates 20%.

These ratings cannot be used in addition to ratings for limited motion. One or the other. Any rheumatoid arthritis less severe than noted above is just rated upon its symptoms, such as limited motion. In these cases individual joints can be rated. So, if three joints are involved, but there are no incapacitating episodes, all three can be rated separately on limited motion. A minimum of 10% is given for every joint that at least has pain with motion.

Notice the Episode count, as it look like this will be a major factor in the decision.  They are looking to find out how bad it is.  They are not looking for hospital visits.  They are looking to see the affect it has on your life!  So when you go in there you need to talk about how bad it is and how it affects your every day life!

[SPO]

since my condition is still in early stages it has not been incapacitating.  I'm pretty sure it will then be rated on the residuals for each joint.  I'm not sure how to convince the examiner that it hurts to move each joint at a certain point.  Last time I tried to tell the examiner when it hurt and she basically said nothing was wrong with me.

[ShrekTheTank]

These ratings cannot be used in addition to ratings for limited motion. One or the other. Any rheumatoid arthritis less severe than noted above is just rated upon its symptoms, such as limited motion. In these cases individual joints can be rated. So, if three joints are involved, but there are no incapacitating episodes, all three can be rated separately on limited motion. A minimum of 10% is given for every joint that at least has pain with motion.

You need to tell them each joint which has pain with motion.  Remember it is not how far you can go but if it is painful or not!

[pacmanx1]

One of the basic things to remember is to be respectful and try to answer all the questions honestly.  If you are having one of your best days and the nurse/doctor ask, how are you doing? Don't lie, just tell them that you are glad that you made it or that you are hanging in there. Saying that you feel good can be used against you.  If asked to do motions, don't go beyond your limit, it will only cost you later in pain and or maybe your decision.  Best wishes

Moderators if this is a double post please delete one.

[SPO]

Had my C&P this morning.  The examiner seemed to be somewhat knowledgeable on the condition and said she didn't understand why I wasn't service connected in the first place.  She said she knows that it causes pain in a lot of joint and that she was going to give an opinion that all my joints are service connected.  However, actual physical exam left a lot to be desired.   Pushed my through on range of motion a couple times and I'm totally unsure how this will play out as far as rating percentages are concerned.  She did say she knows these conditions don't cause actual range of motion loss in most cases.  So hopefully she notes a least painful motion so I don't end up with a 0% and have to keep fighting.

[63Charlie]

5 minutes ago, SPO said:

Had my C&P this morning.  The examiner seemed to be somewhat knowledgeable on the condition and said she didn't understand why I wasn't service connected in the first place.  She said she knows that it causes pain in a lot of joint and that she was going to give an opinion that all my joints are service connected.  However, actual physical exam left a lot to be desired.   Pushed my through on range of motion a couple times and I'm totally unsure how this will play out as far as rating percentages are concerned.  She did say she knows these conditions don't cause actual range of motion loss in most cases.  So hopefully she notes a least painful motion so I don't end up with a 0% and have to keep fighting.

The majority of the C&P examiners in the Orlando area are incompetent, biased, and liars.

These chuckleheads have cost me thousands in benefits.

It seems that the few examiners that ARE honest don't last very long 

Edited July 7, 2020 by 63Charlie