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Monday, November 10, 2014

Claiming Conditions for VA Disability

Last week, I received a really good question that I think deserves some further discussion.

When filling out the VA Disability Claim form, should I list every condition I have, even if multiple conditions affect the same body part?

Yes! Definitely list every single DIAGNOSED condition that you have. If you are unsure whether or not the condition is officially diagnosed, you might as well list it.

It is true that for many body parts, only one VA Disability Rating will be given for the overall functioning of that body part. So even if you have multiple diagnosed conditions affecting that body part, they may only give you a single rating for it. It’s better, though, for them to decide this after considering all of your conditions than for them to only give one rating since only one condition was listed on the claim.

There may be a VARSD Principle or other obscure regulation somewhere that you’re unaware of that makes an exception in your case and allows multiple conditions to be rated. If you don’t list all the conditions, then you won’t get the full disability compensation you deserve.

For example, a muscle condition and a nerve condition in the foot can both be rated if they affect different functions in the foot. Let’s say a veteran has a muscle condition that affects muscle Group XII in the foot. This group controls the ability of the foot to flex upward. The veteran also has damage to the Tibial Nerve which affects the ability of the toes to spread and close. Both conditions affect the foot, but since one affects the toes only and the other affects the flexion of the foot only, then both can be rated separately. But if the veteran does not list both conditions on the form, he won’t get ratings for both eligible conditions.


Regardless of the conditions, it is always the best option to list every condition separately on the VA Disability Claim form.

11 comments:

  1. Sir,

    Is there a supplemental form I can fill out when I have used up all of the space in section 9, page 7, of the VA Form 21-526 EZ? I am retiring from the Marines in about 10 months, and I still have conditions I would like to list, but I have ran out of space on the 21-526EZ. Thank You.

    ReplyDelete
    Replies
    1. Hi Eric -

      Are you doing a paper application or an electronic one? If paper, just add an attachment with all the remaining conditions. At the end of section 9, just state "see attachment for remaining conditions" or something along those lines.

      If you're applying online, there should be a place somewhere on the application that allows you to add any additional information. In that box, simply put "Additional conditions to claim" and list the conditions.

      Hope this helps!

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  2. Sir,

    Thank you very much. Your time and assistance are much appreciated. I am submitting a paper copy through my VSO in my local area.

    Thanks Again!

    ReplyDelete
  3. Sir,

    I was at the TBI clinic about 18 months ago for some memory loss and organizational issues I was having. They put me through about 4 days straight of testing with mostly cognitive/memorization type stuff. They said my issues might stem from a history of minor concussions that I have had. They never told me that I had a TBI, but they listed my condition as "cognitive disorder". On my VA claim, should I list TBI, cognitive disorder, or memory loss, or all 3?

    Thank You

    ReplyDelete
    Replies
    1. I recommend only listing conditions that were actually diagnosed. If you put TBI, they are going to want to see evidence of a TBI diagnosis. Without one, they won't give you a rating for it. If you can get a TBI diagnosis from a VA physician, then you can list it, but without one, I wouldn't include it. You could, but they almost definitely wouldn't give you a rating for it. I would list cognitive disorder and memory loss. They will probably group the two together, but go ahead and list them separately.

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  4. I joined the Army reserves in 1986 and injured my knee during basic training. I was discharged from reserve duty in 1992. As I age my knee has continuously gotten worse and I recently had to have a partial knee replacement. I was told by a vet that I should be entitled to to some military disability since the initial injury happened during basic. hat do you think.

    ReplyDelete
    Replies
    1. As long as you can provide proof that your current condition is directly a result of that injury during basic, then yes, you can probably qualify. The key is proving service-connection. If you can submit the medical records from the time and a medical opinion from your current physician stating that your current condition is "more likely than not" the result of that initial injury, then you'll have a fairly strong case.

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  5. Dr Johnson,

    Can Code 5243 Intervertebral disc syndrome be rated based on "chronic manifestations" as opposed to PRESCRIBED incapacitating episodes? Is a chronic manifestation essentially a very lengthy and thorough record of back problems? I have that, as well as a diagnosis of Degenerative Disc Disease, which I think is the same as intervertebral disc syndrome?

    I'm basing some of this off of reading from https://www.federalregister.gov/documents/2002/08/22/02-21365/schedule-for-rating-disabilities-intervertebral-disc-syndrome

    Would it be wise or relevant for me to include the verbiage "intervertebral disc syndrome" when filing my claim?

    Much gratitude!

    ReplyDelete
    Replies
    1. Chronic manifestations cannot replace incapacitating episodes that require bed rest prescribed by a physician. The physician must prescribe bed rest to qualify for that rating system.

      Yes, DDD is a type of intervertebral disc syndrome. What condition is specifically diagnosed in your medical records? If you've been diagnosed with DDD, then claim DDD. If the medical records say IDS, the IDS. Only claim what is clearly diagnosed in your medical records.

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  6. I tore my MCL/ACL back in 2013 while running. When my dr. reviewed my MRI he said that I had very bad bone spurs. He asked if I had pain from my knees prior to this injury. I said Yes. He shaved the bone spurs during ACL/MCL repair and told me that my other knee is probably in the same condition. He asked if I ever ran on hard surfaces. I told him that I was prior service and he said it made sense, due to the conditions of my knee area. I was injured (right knee) during Basic Training while at Ft. Bliss (Summer 1987) and had to go on sick call to a clinic. How do I get these records to support my case? Do I even have a case?

    ReplyDelete
    Replies
    1. This is a tough situation. In reality, it is going to be pretty unlikely that the VA will grant disability for your conditions. The only thing that will be in your military medical record is the basic training knee injury, but your current knee condition can be clearly linked to your 2013 injury so that supersedes the earlier one.

      The VA won't rate conditions that aren't directly connected to military service. If it was first diagnosed more than a year after separation, they probably won't rate it.

      You can get a copy of your service records from the national archive:

      https://www.archives.gov/st-louis/military-personnel

      If they do not include your medical records, contact the clinic at the last place you were stationed. They can tell you what storage facility they sent your records to.

      If you find proof of your current conditions in your records, then it is worth a shot to apply. If you can prove service-connection, the VA will grant it.

      http://www.militarydisabilitymadeeasy.com/service-connected.html

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