31 Comments:

At February 2, 2017 at 11:09 PM ,  Unknown said...

I wanted to know if you have degenerative arthritis can you only be rated for this if your knees are unstable? I thought this was suppose to rated separately for instability

 

At February 6, 2017 at 9:20 AM ,  Military Disability Made Easy said...

Arthritis can be rated no matter what. And you are correct that instability can be rated separately. They are not dependent on each other. Check out our arthritis blog:

http://blog.militarydisabilitymadeeasy.com/2014/05/rating-arthritis-for-military-disability_12.html

 

At February 8, 2017 at 12:00 PM ,  J Helms said...

If the VA has you on narcotic pain meds and mussel relaxers is this a factor for your disability rating?

 

At February 14, 2017 at 12:56 PM ,  Military Disability Made Easy said...

Not unless the condition they treat is rated on treatment methods or if they cause additional conditions. Any conditions they cause will be eligible for rating.

 

At March 19, 2017 at 7:03 PM ,  Unknown said...

Dr why is the pinhole exam done on C and P exams and I am nearsided and was exposed to battery acids while working in supply as a USAF airman. Is this common and I am in a work in process on battery acid claims

 

At March 24, 2017 at 8:38 AM ,  Military Disability Made Easy said...

The pinhole test is used to determine if your loss of vision is caused by a disease or other condition that could develop into blindness if not prevented. The doctor was probably checking to see what conditions the battery acid burns caused.

As long as you have proof of battery acid burns to your eyes, then you'll definitely be eligible for disability compensation.

 

At April 3, 2017 at 7:54 PM ,  Unknown said...

Hi Dr.,
My med board just got the first approval and was sent to the VA for ratings. I was just diagnosed with Rheumatoid Arthritis so it isn't in my unfitting conditions, and also on my narsum states I have generalized tonic clinic seizures, which is wrong since my med board took a year to get to this point I am diagnosed with myoclonic epilepsy. Is this something to fight at the formal board or shoul/can it be recalled and corrected.

 

At April 6, 2017 at 4:55 AM ,  g allen said...

Hi Dr.
My Question pertains to a disability service connected for pes planus (Bilateral) I received a bilateral rating of 10% in 1994 and received 10% payments since but it was brought to my attention that this is a bilateral issue and should fall under the bilateral add together plus 10% which should render a rating of 21% for total of 20% am I understanding that correctly?

 

At April 6, 2017 at 10:02 AM ,  Military Disability Made Easy said...

Definitely talk to your PEBLO about this asap. Depending, they should be able to get this adjusted on the VA claim and have the correct conditions recorded. The most important thing is to ensure that they have the medical records that show the official diagnoses.

 

At April 6, 2017 at 10:18 AM ,  Military Disability Made Easy said...

This is tricky. Because they are rated as a whole, instead of separately, it could be interpreted that they are not individually ratable. One of the rules for the 10% bilateral factor is that each side must be independently ratable. Since only one rating is given for both, they don't have their own, and so it could be interpreted as not being independently ratable.

That being said, it could also been argued that if only one foot was affected, it would still be rated 10%, so each would independently qualify if the other wasn't affected. Thus they should be considered independent although they share a rating.

It's tricky. There isn't a set rule that states whether or not you should qualify for the bilateral factor. It's ultimately up to interpretation of the rater. You may be successful appealing, but may not.

 

At April 19, 2017 at 6:33 PM ,  Bill C said...

Hi,
I was diagnosed with sleep apnea in the 1990's. I recently found out that my condition is a service connected diagnosis. I am currently receiving VA compensation for several disability ratings totaling 90% in reality I am actually 130% disabled. I was wondering what percentage would be considered for the diagnosis of sleep apnea using the VA math.

Thanks,
Bill C.

 

At April 22, 2017 at 4:36 PM ,  Unknown said...

Hello Dr. just had a question see if you could help me. I'm 60% disabled had a parachute injury in 1992 end up messing up my back my hips I have 40% for my back/ herniated disc T11 - T12 , Radiculopathy lower R/L 10%-10% Chronic hip strain L/ R 10% 10% so many years later I've been having problems with my scapula and shoulder in my knees how can I tie this together my existing in jury's
thank you guys
Read more

 

At April 25, 2017 at 10:43 AM ,  Military Disability Made Easy said...

Hi Bill -

It depends on what the sleep apnea is rated for independently. Once you find your rating for sleep apnea, then you combine it to your other ratings using VA Math.

You can find the rating here:

http://www.militarydisabilitymadeeasy.com/therespiratorysystem.html#sleep

And VA Math rules here:

http://www.militarydisabilitymadeeasy.com/vamath.html

 

At April 25, 2017 at 10:45 AM ,  Military Disability Made Easy said...

You can apply to have your additional conditions added as secondary conditions. The key is to have your doctor write a NEXUS letter that states that your additional conditions are "more likely than not" caused by your service-connected conditions. You then submit it and all medical evidence with VA form 21-526b.

http://www.militarydisabilitymadeeasy.com/vaform21-526b.pdf

 

At May 3, 2017 at 7:23 AM ,  Steve C. said...

Dr. Johnson,
I'll be retiring after 26 years next March. I have been diagnosed with arthritis in both knees, my shoulder and my hip (X-rays documentation of all). They are all painful but the pain is currently controlled through the use of the NSAID Voltarin. How should the VA rate my joints since the pain is controlled?
Thanks for your time,
-Steve

 

At May 4, 2017 at 11:13 AM ,  Military Disability Made Easy said...

Hi Steve - All arthritis is rated on painful motion or limited motion. If there isn't any limited motion or pain, then you'll just be given a 0% rating. This can be increased in the future if the symptoms worsen.

 

At May 25, 2017 at 5:58 PM ,  Unknown said...

Was wondering if the below law applies here, reads to me that medications that control pain should not be considered since there would be pain without the medication.

42 U.S. Code § 12102 - Definition of disability
(E)
(i) The determination of whether an impairment substantially limits a major life activity shall be made without regard to the ameliorative effects of mitigating measures such as—
(I) medication, medical supplies, equipment, or appliances, low-vision devices (which do not include ordinary eyeglasses or contact lenses), prosthetics including limbs and devices, hearing aids and cochlear implants or other implantable hearing devices, mobility devices, or oxygen therapy equipment and supplies;

 

At May 25, 2017 at 6:10 PM ,  Unknown said...

Here is an applicable recent case remanded for repeat va exam with the court specifically stating to disregard pain controlled by medication, the way it reads to me.

https://www.va.gov/vetapp15/Files3/1522063.txt

 

At May 30, 2017 at 12:59 AM ,  Unknown said...

Thank you for your response. One last question for you. If you have 3 or more episodes of gout can you file for disability rating as secondary to degenerative arthritis?

 

At May 31, 2017 at 11:27 AM ,  Military Disability Made Easy said...

Hi Sean -

You're correct that this law applies for general public health, but the VA is ruled by their own sets of laws.

While I personally agree that this definition should be the general rule, it definitely does not apply to VA cases.

For example, the VA rates hearing loss on the levels of hearing loss without a hearing aid (agrees with 42 U.S. Code § 12102). However, the VA rates vision loss based on CORRECTED vision, so vision with contacts or glasses. It's definitely not consistent or necessarily fair, but it is the way it works.

The basic idea for the VA is that if the condition is fixed so that it no longer impedes daily life or limits the ability to function fully, then it isn't a disability.

For pain, however, there isn't a definitive with or without medication rule. In most cases it is just whether or not there is pain with motion. So, to make sure that the VA properly records that you are in pain with motion, don't take pain medications before going to your exams. That way, they can see the reality of your condition.

 

At June 5, 2017 at 1:34 PM ,  Military Disability Made Easy said...

Gout is an inflammatory arthritis, not a degenerative arthritis, so most medical professionals would not consider gout to be caused by degenerative arthritis. Especially since it is caused by uric acid, not degeneration. Because of this, it is highly unlikely that the VA will grant gout as secondary to degenerative arthritis. If you can get a physician to claim that they are connected, that might be enough to persuade the VA, but I think it unlikely.

 

At June 5, 2017 at 8:32 PM ,  Unknown said...

Doc,
I remember back when I was initially rated for my knees, the C&P dr had me squat and rise as part of the test. I am looking to get an increase in my rating as I have audible grinding in my knees and cant rise from a squatting position at all now. Basically, I can go down but getting back up is impossible without going to my knees and finding something to work at pulling myself back up. I'm also on crutches or or in a motorized wheelchair (both issued by the VA) for inability to walk without my right leg buckling at the knee.

I read through the knee DBQ but didn't see anything that resembled the test I was originally put through and also don't see anything designating a way to rate the inability to walk without extreme assistance.

Appreciate any guidance!

 

At June 12, 2017 at 9:40 AM ,  Military Disability Made Easy said...

Your knee wasn't rated on that test, so don't read too much into it.

The knees are rated primarily on limited motion, so that is most likely where your original rating came from. Crepitus (grinding) is a sign of arthritis, which is rated on limited motion.

http://www.militarydisabilitymadeeasy.com/kneeandleg.html#limo

If your motion has decreased, then you'll probably have your rating increased.

More than that, the presence of instability will definitely be an increased rating. Instability (buckling) can be rated separately, so you'll receive an additional rating for this.

http://www.militarydisabilitymadeeasy.com/kneeandleg.html#too

There aren't ratings for the use of assistive devices, however, the VA will look at your overall condition and attempt to rate it according to your level of disability.

 

At July 2, 2017 at 11:19 AM ,  Unknown said...

I received stress fractures in both thighs in boot camp in 1989. I was never given time off to heal. Since then I've had problems with my legs,hips and back. Could there be a connection and do I have any type of claim for the stress fractures?

 

At July 5, 2017 at 11:56 AM ,  Military Disability Made Easy said...

It's possible that your conditions are connected to the stress fractures. You can submit a VA Disability Claim for them with the remaining conditions as secondary. The key to your claim being successful is to clearly establish connection between your current conditions and the stress fractures. To do this, you need to get a NEXUS letter from your physician that clearly states that he believes that your current conditions are "more likely than not" a direct result of your service-connected stress fractures.

 

At July 15, 2017 at 9:51 AM ,  Unknown said...

Hello, Dr. Johnson,
My husband served 15 months in Iraq 2006-2007. He was in multiple IEDs and has been battling the VA for disability since he was discharged in 2008. He currently only receives 40% disability (10% tinnitus and 30% PTSD). In 2015 he started losing feeling in his arms and was diagnosed with bilateral carpal tunnel. He had surgery on both wrists, and also had surgery on both elbows because his nerve testing indicated that he was also experiencing neuralgia there. The surgeries were not overly successful and the VA has denied disability on these claims twice (we now have a lawyer working on an appeal, but it has been approximately 2 years with no word!). Earlier this week he had an MRI because he has been having severe lower back pain for 6+ months. He was diagnosed with degenerative arthritis of his lumbar and sacral spine, has diffuse bulging discs, mild to moderate degenerative discs, mild to moderate hypertrophic facet joints, moderate bilateral neuroforaminal stenosis, and narrowing of the spinal canal without significant compression of nerves. He is only 33 so I can't imagine this is "normal aging." Since 2015 he has been unable to work, we have had to file bankruptcy, and we are just fed up with the whole VA process. He has also been denied state disability. What are your suggestions to help get VA disability approval. We still have to notify the lawyer of the recent results of his MRI, but since he hasn't claimed his back issues in the past, I am assuming this would be a new claim and not added to his appeal that is in-process. Thank you for your help!

 

At July 16, 2017 at 6:04 PM ,  M. Dunlap said...

In December 2013 I received a combined disability rating of 40%: 20% osteochondritis dessican of medial femoral condyle w/osteoarthritis of left knee, 10% tarsal tunnel syndrome of left foot, and 10% right ankle sprain w/osteoarthritis. I also claimed for carpal tunnel syndrome as it was annotated in my medical records. However, it was denied as it was determined to not be related to my military service. I'm not sure where they believe it came from as I was only 19 years old when I joined the service. I thought of appealing the carpal tunnel but decided to accept the determination.

I have not seen a doctor for my conditions since I left the service in 2001. I was told by my military doctors that I should use ibuprofen, avoid any activities that caused pain, and plan to have surgery in the future. Luckily, I was able to be a stay at home mom since my separation so I could follow their advice and just maintain.

In 2010, I had bones removed from several toes on each foot as part of a hammertoe surgery. Currently, I have issues with extreme numbness in both feet and both hands. I can barely feel my feet at all. I have to watch my feet as I walk so that I know where I am placing them. As a result, I trip a lot and frequently sprain my ankles and feet and re-injure my knee. I also have to watch my hands while typing or doing other tasks. I frequently lose my grip on objects.

Can I re submit my claim as my conditions are now worse? Can I also claim the carpal tunnel even though it was previously denied? If so, what is the procedure that I follow as I do not have any doctor documentation evidence of the worsening conditions?

Thank you,
M.Dunlap

 

At July 19, 2017 at 2:11 PM ,  Military Disability Made Easy said...

Hi Jennifer -

You have a really tough case, and I unfortunately do not think that there is going to be a successful resolution in your husband's favor.

The laws that determine whether or not a condition is service-connected requires that the condition be officially diagnosed within 1 year of service (by 2009 for him). Since both his arms and his back weren't diagnosed until years later, it legally does not qualify based on the general rules for service-connection.

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

The only other option is for his conditions to qualify as Gulf War Syndrome. Gulf War Syndrome symptoms can qualify as long as they manifest to 10% before the end of 2016. However, neither his arms or his back qualify as Gulf War Syndrome since they have a definitive diagnosis: Carpal Tunnel Syndrome, degenerative arthritis, etc. Gulf War Syndrome is only a collection of unrelated, undiagnosable symptoms. It does not include clearly diagnosable conditions.

http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#gulf
http://www.militarydisabilitymadeeasy.com/gulfwarsyndrome.html

Because of the situations involved in your husband's case, your husband's current conditions do not qualify for VA Disability. It is most likely that the appeal is going to be denied. The only way to have his conditions accepted would be for the courts to make exceptions to the laws in place, and the only court with the authority to do that is the US Court of Appeals for Veterans Claims. This is the highest court of appeals, and you cannot apply to this court until you have appealed to all lesser courts. And there is no guarantee that they will judge in his favor either.

http://www.militarydisabilitymadeeasy.com/isyourratingwrong.html#va

Ultimately, with the laws as they are, his conditions do not meet the requirements.

 

At July 19, 2017 at 2:23 PM ,  Military Disability Made Easy said...

Yes, any conditions rated by the VA can be increased if they worsen in the future. You just need to submit the following form and they'll call you in for new exams.

http://www.militarydisabilitymadeeasy.com/vaform21-526b.pdf

Do note, however, that none of your diagnosed conditions that are rated by the VA necessarily cause hammertoe. In order for that to qualify, you will have to show proof that it is directly caused by one of your service-connected conditions. A NEXUS letter from your physician stating that your hammertoes were "more likely than not" caused by your tarsal tunnel syndrome will be essential. This is NOT a usual connection, however, so your doctor may not agree and you may not be able to provide this proof.

But any of the conditions that were rated and have worsened can definitely be applied for.

As for reopening your carpal tunnel, you will have to submit a new claim for this. Unless you can provide additional evidence of its connection to your service, there is a chance that it will be denied again. When was it first diagnosed? As long as it was diagnosed within 1 year of separation and you have medical records to prove this, you should be good to go.

It is always beneficial to have medical evidence other than the VA exam, but it is not required. Definitely submit everything you have from your surgeries if claiming the hammertoes. It might be a good idea to go ahead and see doctors for your other conditions as well to make sure they are thoroughly documented.

 

At July 19, 2017 at 8:20 PM ,  M. Dunlap said...

I will need to check my records re: hammertoe being caused by my pre-existing conditions. If the doctor stated it in the records, do I still need a Nexus letter?

The carpal tunnel was discovered at an appointment for my knee in 1990. I was given a test where they put probes into my wrists and sent electricity through them. I was told that I had carpal tunnel. It was never brought up again. Will the test and acccompaning record be enough evidence to submit a new claim?

Is there a way for me to get a copy of my military medical records? Due to hospital issues, I wasn't apply to get a copy before I separated.

Thank you,
M. Dunlap

 

At July 26, 2017 at 10:14 AM ,  Military Disability Made Easy said...

That evidence might be enough. Clearly, the more evidence you can submit, the better.

You need to contact the medical records department at the medical facility at the last place you were stationed. They may no longer have your records at the facility, but they can tell you which storage facility they sent them to so that you can then get a copy.

 

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