Unfavorable Decision

[allansc2005]

Afternoon folks, hope all is well.

 

I posted this question/concern a few weeks ago, but it seems to have fizzled out, got lost in cyberspace...something?

 

Back on 12/23/2020 I had requested an increase for degenerative disc disease, lumbar spine(previously rated as chronic low back syndrome under DC 5237) currently at 20%, effective date 01/30/2008.

 

Went to my C&P exam, doctor did the usual bend and reach, range of motion(ouch)..on my lower back, and because of the pain, he stopped in the middle of the exam because I was in pain, stepped over to his computer and pulled up my medical records, turned to me and said "Mr.__, I see you have Issues with your entire spine, especially with your lower lumbar.., and I see no need to put you through anymore of these movement and motion tests..."

I grabbed my cane. the doctor helped me stand up, and I left the office.

Last week, I got my decision: Evaluation of degenerative arthritis of the spine with intervertebral disc syndrome, which is currently 20 percent disabling, is continued.

UM OK, but I never had a rated disability for the above, nor did I ask for one, I asked for an increase, as stated in my first paragraph dated 12/23/2020!

 

Now, under my newest rated disabilities, they inserted the new decision stated above, and totally omitted my Rated Disability from 01/30/2008!

It just vanished, gone.., never had it!

 

So, is this a Clear and Unmistakable Error-CUE, or reason for a Higher Review(Formerly NOD)?

As a footnote, I'm TDIU P&T.

 

Thanks,

 

Allan 2-2-0 HOOAH!

 

 

 

 

 

 

 

 

[Carl the Engineer]

OK, I keep re-reading it and I think I got it.

They change the name of your disability (same disability, different name) and your rating stayed the same, no increase, and with a current date of the new claim.

Your old disability with a date of 2008, disappeared.

Yes?

Hamslice

 

Edited February 23, 2021 by Hamslice
cause I can

[allansc2005]

@Hamslice, correct!

 

My C&P results are on the way, but I know for a FACT the doctor examined me for degenerative disc disease, LUMBAR spine, a condition I was rated for back in 2008.

 

So the VA totally erased the ABOVE off of my Rated Disabilities, and inserted degenerative arthritis of the spine with intervertebral disc syndrome, with the same 20% I had for the ABOVE Rated Disability! 

So Hamslice, is this a Clear and Unmistakable Error-CUE, or is this to be filed for a Higher Review(formerly known as NOD)?

Please keep in mind, my request for increase was for degenerative disc disease, LUMBAR spine...

 

 

[Carl the Engineer]

I know less than nothing about CUE's, so someone else will have to opine on that.

The bottom line is that they changed the name of your already service connected condition previously rated at 20%, when a increase was requested, and then gave you a new "EED" based on the date of claim for the increase, with no rating increase.

So, it looks wrong to me.  But I don't know how to fix it.  You could call Betty and see what she has to say.  It could be an easy fix.

The 20% rating is, as stated earlier, about the drop off point for lumbar (lower back pain) with the VA unless there are some complex issues.  Part of the higher ratings have "bed rest" which is not prescribed as of late.  They need to change the reg regards bed rest, in my opinion,

Good luck,

Hamslice

 

[Buck52]

Just my 2 cents and opinion

I think the VA does whatever the hell they want to...I know they can call a veterans disability something when its first rated   and the the veteran files for increase on that disability later on as it worsens...Well the VA checks this veteran rather or not he has medical evidence from a private Dr or not   its the C&P Dr's that tend to screw up these things  and whatever the C&P Dr says  or checks in the DBQ Boxes  that's what they go by   and this is when the disability gets a new name.

   ...if you have Back surgery and then go back to have another back surgery  this will change the old disability   I know it don't make a lick of sense  but that's what happens ,  they make there on name up for the disability.ect,,,,,ect,,,..now on  some certain disability's they can't go in there and change the name of the disability  like hearing loss   they can't change the name of that disability  hearing loss is just what it is  hearing loss  but on certain disability's  when a Veteran ask for increase  this is when they change up things  and take away the disability the veteran use to have when ask for increase..

They say when we have a disability then were not considered whole...for ever disability we have and given a rating percent   then this makes us that much more non-whole   as a human being.

When this happens  its best for the Veteran to educate themselves with the disability rating criteria  and not let this happen   and also its best to know what pyramiding is on a disability  or a double stacked disability.

My opinion why they take a disability away and call that same disability something else  is because that disability normally will be a lesser rating...save money that way and the Dr's /RATERS GETS A FAT BONUS CHECK. (JMO)

[allansc2005]

Hamslice, Buck, bronco...

 

I can tell you one thing for SURE, the C&P exam results will not match the decision I got, and that's a fact.

 

I just talked to the doctor who conducted the C&P exam, he conducted the range of motion, bending, stretching.., measurements for LUMBAR conditions as I requested for my increase, NOT measurements for degenerative arthritis of the spine...

 

@bronco, the issue here is about changing my original Rated Disability from 2008, giving me a C&P exam for what increase I asked for-LUMBAR spine(which I got), then turning around and inserting that NEW Rated Disability minus the % AND omitting what the doctor found during the C&P exam.  

[63Charlie]

 

Often the VA evaluates similar disabilities(symptomology) under a particular diagnostic code even if they change the ICD-10 diagnosis.

What were the VA diagnostic code(s) you were rated under from the original, and the later decision?

Edited February 24, 2021 by 63Charlie