On July 28th, 2017, the VA published proposed changes to the ratings of the Genitourinary System, but they withdrew those proposed changes in March of this year because there were errors in the rating criteria.
Today, October 15th, 2019, the VA published their revised proposal for changes to the ratings of the Genitourinary System. Since it will be too confusing to discuss the differences between the original proposal as well as the differences between the current system, I am only going to focus on the changes that will occur if these new proposed changes go into effect. If curious, you can find the original proposal here.
With each set of proposed changes, the VA allows a period in which comments can be submitted. The VA then takes each comment into consideration and makes any additional changes that are warranted before publishing the final ruling.
We encourage you to submit any comments you might have on these proposed changes to us either by commenting on this post or by contacting us through our website. All comments must be received by December 1st, 2019. We will then compile all of your comments into a single report and submit it on your behalf to the VA, just as we did for the other sections (see the Female Reproductive System Comments). This is a great opportunity to really make a difference, so please let us know your thoughts.
The following are the VA’s new proposed changes to the ratings for the Genitourinary System. The changes to the current system are fairly extensive, so I’ll walk through them, one at a time.
For each condition, the small, indented parts are the codes as they are right now. Click on the links to be taken to the discussion of that code on our site. After the current code, I’ll discuss the proposed changes and the VA’s justification.
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The Urinary Rating Systems remain exactly the same. No changes proposed.
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All Urinary Conditions (codes 7512, 7515, 7516, 7517, 7518, and 7519) are staying the same, except:
-Current- Code 7542: A Neurogenic Bladder occurs when a person looses control over urination because of damage to the nerves or the brain. This condition is rated on the Urinary Rating System.
-Proposed- Code 7542: A Neurogenic Bladder occurs when a person looses control over urination because of damage to the nerves or the brain. This condition is rated on either the Urinary Rating System or as a Urinary Tract Infection, whichever gives the higher rating.
The only change to this code is allowing it to be alternatively rated as a urinary tract infection. This is because neurogenic bladders have a high rate of urinary tract infections, so if that is the predominant disability and would offer a higher rating, that should be an alternative rating option.
-NEW Proposed Code- Code 7545: Diverticulum of the bladder occurs when the wall of the bladder weakens and a portion protrudes, creating a pouch. This causes urine to get trapped in the pouch, leading to voiding dysfunction and/or infection. It can be rated either on the Urinary Rating Systems or as a Urinary Tract Infection, whichever is the main disability.
The VA proposes to add this new code to cover diverticulum of the bladder. Currently, there aren’t any codes that truly reflect the disability of this condition. Thus it needs its own code.
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-Current- The ratings:
A 30% rating is given if the condition causes regular infections that require hospitalization 3 or more times a year, or if it requires serious continuous treatment.
A 10% rating is given if the condition requires regular drug therapy, 1 or 2 hospitalizations a year, or if it requires serious continuous treatment.
If any of these conditions that are rated as urinary tract infections also cause renal problems, then only one or the other can be rated. If the renal problems are more severe, then the condition should be rated under the renal rating system.
-Proposed- The ratings:
A 30% rating is given if the condition causes regular infections that require a stent or nephrostomy tube to be implanted for drainage, if the condition requires hospitalization 3 or more times a year, or if it requires serious continuous treatment.
A 10% rating is given if the condition requires suppressive drug therapy for 6 months or more, or 1 or 2 hospitalizations a year.
A 0% rating is given if the condition is recurrent and requires treatment of suppressive drug therapy for less than 6 months or antiobotic therapy, and does not require hospitalizations.
If any condition rated as a urinary tract infection also causes renal problems, then only one or the other can be rated unless they are diagnosably separate with clearly separate symptoms. If the renal problems are more severe, then the condition should be rated under the renal rating system (see new one below).
The changes to the 30% simply specify that the infection must require drainage by more than a catheter in order to be rated at this level. Catheter drainage does not require surgery and rarely requires significant hospitalization.
The changes to the 10% more clearly define the required treatment. The VA argues that suppressive drug therapy for at least 6 months suggests a significant chronic condition appropriate for this rating level.
A 0% rating was added to enforce that anything less than the requirements for the 10% should be given a 0%.
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Conditions Rated As Urinary Tract Infections
Code 7501 for abscess of the kidney remains the same.
-Current- Code 7525: Chronic Epididymo-orchitis is pain in the epididymis. If the pain is caused by tuberculosis, it is rated as nonpulmonary tuberculosis.
-Proposed- Code 7525: The following chronic infections are all rated under this code: epididymitis (infection/inflammation of the epididymis), prostatitis (infection/inflammation of the prostate gland, urethritis (infection/inflammation of the urethra), and orchitis (infection/inflammation of the testicles—one or both). If the condition is caused by tuberculosis, it is rated as nonpulmonary tuberculosis.
-Current- Code 7527: Prostate Gland conditions (any) are either rated as urinary tract infections or by the urinary rating system, whichever better defines the symptoms of the condition.
-Proposed- Code 7527: Prostate Gland conditions (all except prostatitis) and bladder outlet obstruction are rated under this code either as urinary tract infections or under the urinary rating system, whichever better defines the symptoms of the condition.
The VA recognized that there were quite a few infections that were not technically covered under the current codes, and so decided to add them in order to avoid improper analogous ratings. Thus, now code 7525 covers four conditions instead of just epididymitis. All of these conditions should have been rated under this code anyway, since they cause similar symptoms, but now it is official. No change in how they are rated.
For code 7527, they decided to move prostatitis to 7525 because it is closer to the other infections covered by that code. All other prostate conditions are still covered under this code. The VA also decided to add bladder outlet obstruction because it is often caused by a prostate condition and can produce similar symptoms. Thus, it needs the option to be rated as a urinary tract infection as well.
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-Current- A 100% rating is given if at least one of the following is present:
– The condition requires regular dialysis.
– The body cannot perform any physical activity because of persistent edema or because of albuminuria.
– A BUN of more than 80 mg/dL.
– A creatinine level of 9 mg/dL or more in the blood.
– A severely decreased functioning of the kidneys or other organs due to kidney dysfunction.
An 80% rating is given if one or more of the following is present:
– Persistent edema and albuminuria with a BUN of 40 to 80 mg/dL.
– A creatinine level of 4 to 8 mg/dL in the blood.
– Overall poor health with symptoms like lethargy, weakness, anorexia, weight loss, or the inability to exert much energy.
A 60% rating is given if one or more of the following is present:
– Constant albuminuria with some edema.
– A definite decrease in kidney function.
– Hypertension with the average diastolic pressure (the smaller number on the bottom in the blood pressure reading) of 120 or more.
A 30% rating is given if one or more of the following is present:
– Hypertension with the average diastolic pressure (the smaller number on the bottom) of 100 or more, or with the average systolic pressure (the larger number on top) of 160 or more.
– Albumin is present in the urine with either hyaline and granular casts or red blood cells.
A 0% rating is given if:
– Hypertension with the average diastolic pressure of less than 100, or with the average systolic pressure of less than 160.
– Albumin and casts are present in the urine with a history of nephritis.
-Proposed- In order to qualify for ratings 30%-100%, a chronic kidney disease must be diagnosed.
A 100% rating is given if at least one of the following is present:
– A GFR (glomerular filtration rate) less than 15mL/min/1.73 m2 for a minimum of 3 consecutive months
– The condition requires regular dialysis.
– A kidney transplant has been performed
An 80% rating is given if the GFR is between 15 and 29 mL/min/1.73 m2 for a minimum of 3 consecutive months
A 60% rating is given if the GFR is between 30 and 44 mL/min/1.73 m2 for a minimum of 3 consecutive months.
A 30% rating is given if the GFR is between 45 and 59 mL/min/1.73 m2 for a minimum of 3 consecutive months
A 0% rating is given in the following symptoms are present for at least 3 consecutive months, even if a chronic kidney disease has not yet been diagnosed:
– The GFR is between 60 and 89 mL/min/1.73 m2 and there are recurrent red blood cell casts, white blood cell casts, or granular casts
– The GFR is between 60 and 89 mL/min/1.73 m2 and there are abnormalities in the kidneys structure (cysts, obstruction, etc.)
– The GFR is between 60 and 89 mL/min/1.73 m2 and the albumin/creatinine ratio (ACR) is 30 mg/g or more
Note: Both estimated GFR (eGFR) and creatinine based approximations of GFR will be accepted for GFR ratings as long as they are calculated by a qualified physician.
These are by far the biggest changes proposed. The VA feels that the current renal ratings are based on out-dated medical tests and other vague standards. The glomerular filtration rate is now the medical standard used to measure how well kidneys are filtering the blood. As it is a more accurate test of kidney health, the VA proposes to use it as the standard for rating criteria.
The VA recognizes that the additional rating criteria is necessary to ensure that the full picture of the disease is taken into account for rating purposes. This is especially important for the 0% ratings, as a high GFR may not mean that the kidney isn’t impaired and causing symptoms. Thus additional symptoms are taken into account to reflect the increased risk for the development of chronic kidney disease.
The 100% rating for individuals post-kidney transplant is another important addition.
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Renal (Kidney) Conditions
The following conditions will still be rated on the renal rating system, but the new one proposed above.
Code 7500 for nephrectomy remains the same.
Code 7502 for nephritis remains the same, except that the note stating that only nephritis or a heart disease caused by the same condition (note both) could be rated is now extended to ALL renal conditions. So…
NEW NOTE FOR ALL RENAL CONDITIONS:
Renal disease is often closely related to heart diseases. If renal disease is present and a heart disease is present and both are caused by the same general condition, then only one rating can be given even though there are two organs affected by the condition. Only the condition that rates the highest is used. The heart disease can, however, be rated separately if one kidney was removed because of renal disease but the remaining kidney is healthy. Then the heart disease warrants its own rating and the removed kidney can receive its own rating under code 7500. The heart disease could also be rated separately if the renal disease is severe enough to need regular dialysis.
All renal conditions are often closely related to heart conditions, so to limit this rule to just cases of nephritis doesn’t make sense. If the heart condition is caused by the same thing as the renal condition, then it applies.
Code 7504 for pyelonephritis remains the same.
Code 7507 for nephrosclerosis remains the same.
Code 7530 for any kidney disease that requires regular dialysis remains the same.
Code 7531 for a kidney transplant remains the same.
Code 7532 for renal tubular conditions remains the same.
-Current- Code 7533: Any cystic disease of the kidney is rated under this code. A cyst is a sac most often containing fluid that can grow anywhere in the body. Many do not cause problems, but some can seriously affect the functioning of the organs.
-Proposed- Code 7533: Any cystic disease of the kidney is rated under this code. A cyst is a sac most often containing fluid that can grow anywhere in the body. Many do not cause problems, but some can seriously affect the functioning of the organs. Some conditions rated under this code include poycystic diseases, uremic medullary cystic disease, medullary sponge kidney, Alport’s syndrome, cystinosis, primary oxalosis, Fabry’s disease, and more.
Again, the VA is just adding more conditions to this code to make sure that they are rated under the most appropriate code.
-Current- Code 7534: Atherosclerotic renal disease (also known as renal artery stenosis or atheroembolic renal disease) is a condition where the artery to the kidney narrows and decreases the blood flow to the kidney.
-Proposed- Code 7534: Atherosclerotic renal disease (also known as renal artery stenosis, atheroembolic renal disease, or large vessel disease) is a condition where the artery to the kidney narrows and decreases the blood flow to the kidney.
Similarly, the VA just wants to make sure that large vessel disease is properly rated under this code.
Code 7535 for toxic nephropathy remains the same.
Code 7536 for glomerulonephritis remains the same.
-Current- Code 7537: Interstitial nephritis occurs when the spaces between the tubules in the kidney swell. This reduces the ability of the kidneys to filter blood.
-Proposed- Code 7537: Interstitial nephritis occurs when the spaces between the tubules in the kidney swell. This reduces the ability of the kidneys to filter blood. This code also covers gouty nephropathy(the decrease of kidney function caused by high levels of uric acid due to gout) and disorders of calcium metabolism (the inability to properly metabolize calcium).
The VA feels that code 7537 is the best rating option for gouty nephropathy and disorders of calcium metabolism and so adds them here.
Code 7538 for papillary necrosis remains the same.
-Current- Code 7539: Renal amyloid disease is caused by the buildup of protein in the kidney, which may result in the kidney not being able to filter blood.
-Current- Code 7541: Renal Involvement in other conditions. So, if the kidneys are affected by conditions like sickle cell anemia, lupus, or diabetes, it can be rated separately from those conditions.
-Proposed- Code 7539: Renal amyloid disease is caused by the buildup of protein in the kidney, which may result in the kidney not being able to filter blood.
In addition, renal involvement in other systemic conditions is rated under this code. This includes renal involvement in conditions such as lupus, sickle cell disease, Henoch-Schonlein syndrome, and other systemic conditions.
-Proposed- Code 7541: Renal involvement in diabetes mellitus is rated under this code. So if a veteran is diagnosed with either type I or type II diabetes, and it causes a decrease in renal function, it would be rated under this code.
For these two codes, the VA basically combined them all under code 7539. They only left diabetes mellitus separate because they wanted to be able to more accurately track the rate of this condition in the veteran population. Thus code 7541 is now just for renal involvement in diabetes.
-NEW Proposed Code- Code 7544: Renal disease caused by viral infections, such as HIV and Hepatitis B or C, are rated under this code. This code includes renal disease caused by the treatment of such viral infections as well.
The VA proposes to add a new code to specifically cover diseases caused by viral infections. While this code is not limited to HIV and Hepatitis B or C, for other viral infections to qualify, there must be regular clinical proof that the infection itself or its treatment causes kidney disease. For this reason, Hepatitis A is not included as there is clinical proof that it does not cause kidney disease.
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Code 7509 for hydronephrosis remains exactly the same.
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-Current- Code 7508: Nephrolithiasis (also known as kidney stones) is the presence of stones in the kidney or ureter. These stones block the flow of urine through the tubes. This condition is rated as hydronephrosis unless stones are repeatedly formed and it requires either drug therapy, diet therapy, or removal surgeries or procedures 3 or more times each year. If this is the case, it is rated 30%. Otherwise, rate as hydronephrosis.
-Current- Code 7510: Ureterolithiasis is the presence of stones in the ureter. These stones can block the flow of urine through the tubes. This condition is rated as hydronephrosis unless stones are repeatedly formed and it requires either drug therapy, diet therapy, or removal surgeries or procedures 3 or more times each year. If this is the case, it is rated 30%. Otherwise, rate as hydronephrosis.
-Proposed- Code 7508: Nephrolithiasis (also known as kidney stones) is the presence of stones in the kidney. Ureterolithiasis is the presence of stones in the ureter. Nephrocalcinosis is the buildup of calcium in the kidneys that can lead to stone formation. These stones block the flow of urine through the tubes.
If stones are repeatedly formed and it requires removal surgeries or procedures 3 or more times each year, it is rated 30%. Otherwise, rate as hydronephrosis.
The VA proposes combining codes 7508 and 7510 into a single code since both deal with the formation of stones that block the urinary tract. They also suggest adding nephrocalcinosis to this code to ensure its proper rating. The ratings for this would mostly stay the same, but dietary and drug treatments for stone have not proven pertinent to this condition, so they suggest removing them.
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Code 7511 for ureteral stricture remains exactly the same.
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-Current- Code 7520: If half or more of the penis is removed, then it is rated 30%. This condition can also be rated under the urinary rating system if that can result in a higher rating than 30%.
-Current- Code 7521: If the glans is removed, it is rated 20%. This condition can also be rated under the urinary rating system if that can result in a higher rating than 20%.
-Proposed- Code 7520: If half or more of the penis is removed, then it is rated 30%. This condition may qualify for SMC-K as loss of use of a creative organ.
-Proposed- Code 7521: If the glans is removed, it is rated 20%. This condition may qualify for SMC-K as loss of use of a creative organ.
The VA proposes to remove the option to rate these conditions as urinary dysfunction since most of the circumstances around urinary dysfunction (like leakage, use of a pad, etc.) don’t really apply. These both, however, might qualify for Special Monthly Compensation, Category K (SMC-K) since they may result in the loss of use of the creative organ, if it no longer can function in that way.
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-Proposed- Code 7522: Erectile dysfunction, for any reason, is rated 0%. This condition may qualify for SMC-K as loss of use of a creative organ.
This is the change that is going to cause the most waves. The VA proposes to no longer rate erectile dysfunction at all. They justify this change by claiming that they offer compensable ratings for conditions that interfere with the veteran’s ability to work. Erectile dysfunction does not interfere with the veteran’s ability to work, and so should not be rated more than 0%.
This condition may, however, still qualify for Special Monthly Compensation, Category K (SMC-K) since it is considered loss of use of a reproductive organ.
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Code 7505 for tuberculosis of the kidney remains exactly the same.
Code 7523 for atrophy of the testicles remains exactly the same.
Code 7524 for removal of the testicles remains exactly the same.
Code 7528 for malignant cancer remains exactly the same.
Code 7529 for benign tumors remains exactly the same.
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-NEW Proposed Code- Code 7543: Varicocele (enlarged veins in the scrotum) and hydrocele (the build-up of fluid around the testicles) are both rated 0% under this code. These conditions may qualify for SMC-K as loss of use of a creative organ if they result in infertility.
The VA proposes adding a new code to cover varicocele and hydrocele—both conditions that are not currently addressed in the VASRD. These conditions do not interfere with the ability of the veteran to work, and so the VA proposes only a 0% rating. However, if they lead to infertility, they would qualify for SMC-K.
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Question: I'm have 30% rating under Code 7508 Nephrolithiasis, have had kidney stones in past but no longer have. But have the rating approved under diet therapy. If the approved changes go into effect, removing the diet therapy, will I loose this rating?
ReplyDeleteUntil the final changes are published, it's impossible to predict how these rules will affect current ratings. In most cases, the changes are applied to new claims and do not change current ratings unless those conditions are submitted to for an increased evaluation or review in the future. It is possible that once these final changes are published, it includes a regulation to apply to all cases, not just new ones. But we won't know until they are published.
DeleteIf they do do that, then since diet therapy is not longer included, your condition would then be rated under code 7509 for hydronephrosis.
I posted here in the past about varicoceles and hydroceles GU has found since leaving service in 2000.
ReplyDeleteThe issue of not causing pain is untrue.
When they fill and swell the pain is acute and walking is a burden. Now granted the infertility has already occured from this, but it does impede working after (for me anyway) 4 hours and takes resting/laying 4 or so to go away to a somewhat normal feel.
Driving is impeded too dependent on the distance/bumps aggravate the time in car with force on the right side.
Just saying.
I am rated for ED 00%
SMC-K1 for Infertility
But for the continuous PAIN and UNCOMFORT nothing!
But we know that because it was not an option for a claim!
But I do agree with the Proposed Code for ED 7522.
DeleteUnless you are in the other entertainment business and can prove it. With video. :) :)
As stated initially the MAX proposed rating for Code 7543 should be 10% with the frequency and pain and size references as objective evidence for such since (as in my case) it gets really bad and does interfere with working.
DeleteBut 10% MAX is what I do believe would suffice, as its primarily recorded at the VA anyway during the physical exams. And you can tell if some one is faking.
Great feedback on the ratings for code 7543. It definitely does not take into account the affect of pain on the ability to function in daily life. We'll make sure to submit your feedback to them, and hopefully get a positive response.
DeleteI totally disagree with the proposed code for ED. This is a severe set back for most men who sacrifice for years in the armed services; multiple deployments, stress, depression, loneliness, trauma, GB status; etc. and not able to maintain an erection is service-connected and deserves to remain rated. Most men and I'm included didn't have this issue prior to entry to service. We didn't choose for our productive organ to not perform. This isn't a condition to simply say deal with it. Every man situation is different and should be considered as such. I have suffered for years with severe ED issues and wholeheartedly will continue to voice my opinion and argue this condition is just as serious as whole body reproductive parts and should remained rated and continuance of SMC-K1 as well. This is a serious condition. Please revisit. Thanks.
DeleteThanks for your thoughts. Unfortunately, the VA has already ended their period for acceptance of comments, so we are unable to submit yours to them. Hopefully others have expressed similar thoughts and will be able to affect the final rating changes positively.
DeleteDear Sir,
ReplyDeleteI'm currently service connected for hearing loss with a 0% rating.C&P exam revealed the following:LEFT EAR, decimal loss of 33 with speech discrimination of 86%. RIGHT EAR, decimal loss of 38 with speech discrimination of 82%. I requested a hearing test from my primary physician and was referred to a ENT practice.The resulting audiogram showed: LEFT EAR, decimal loss of 33 with a speech discrimination of 72%. RIGHT EAR, decimal loss 35 with speech discrimination of 80%. Is a rate increased warranted? How should I proceed?...date of rating decision is approaching one year deadline in January. Called VA, was told to make "an intent to file, which I did, then submit 21-526EZ form, have not done this. Would it be better to make an appointment with area VA clinic audiologist and talk with them (ENT audiologist recommended doing this). Really confused... any suggestions/advice would be appreciated. Thank you.
Yes, the more recent results qualify for a 10% rating. Check out the Hearing Loss Rating System for details:
Deletehttp://www.militarydisabilitymadeeasy.com/theears.html#system
You can submit for an increased evaluation on a new Claim. The VA made the correct decision based on the information they had at the time, so you cannot appeal their decision. Instead, you can submit a new claim for an increased evaluation based on the more recent evidence. They may want to reexamine you themselves as well.
http://www.militarydisabilitymadeeasy.com/vadisabilityclaim.html
I have been rated for service connected Type 2 Diabetes . I now have COPD and Sleep Apnea which I use a CPAP machine every night. Can I claim both of these conditions as secondary to my diabetes, or would it be best for me to claim them as stand alone issues.
ReplyDeleteThere is research that shows a relationship between diabetes and COPD, but none definitively prove that diabetes is the direct cause of COPD, although it can worsen it or increase the likelihood of it. If you can provide sufficient evidence in your case that your COPD (and sleep apnea) are a direct result of your diabetes, then your claim can be successful. You would need solid medical research as well as strong NEXUS letters from your physicians.
DeleteIf you are unable to provide enough evidence that the COPD is secondary to your Diabetes, then you can only apply for COPD and Sleep Apnea independently if you can prove their service-connection in another way.
http://www.militarydisabilitymadeeasy.com/service-connected.html
http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html
I have some questions myself, as a female and getting ready to update my claim, was at 80% for stress incontinence, had a prolapsed uterus, and eczema. Now I am 60% bc of I recv a hysterectomy (trying to fix my prolapsed uterus problem and painful sex problems, and maybe even bladder hopefully!!)however it made my bladder problem worse, now have to catheterize myself several times a day, and I no longer have a prolapse uterus of course, I am also now sexual dysfunctionally, and I also have some atrophy walls in my vagina. Now this maybe a bit much for some of you fellows, but looking at updating my stuff I feel a little slighted as some of this when it really comes to the real personal stuff either I am not understanding or seems a little slighted. Sorry just needed to vent I guess. :(
ReplyDeleteSee Mental Health about this also, as far as the dysfunctional issues with not having a fixed normal relationship due to the health issues aggravating sexual.
DeleteAnd its not to much to understand. I have 20% depression due to this issue with erection pain and sexual relations as the main reason, and neurological as the secondary issues 10%.
Scarring may be another dependent on how they classify it.
That's all I can add from what I know.
The incontinence should be rated at 30% because of the catheter use. A total hysterectomy is rated 50% and would put you at a combined 70%, so I'm assuming that you had a partial hysterectomy (just the removal of the uterus) which is rated 30%. This would put you at a combined 60%.
Deletehttp://www.militarydisabilitymadeeasy.com/femalereproductive.html#loss
http://www.militarydisabilitymadeeasy.com/thegenitourinarysystem.html#urinary
The vaginal atrophy only qualifies for a 0% rating unless it requires constant treatment, however you do qualify for SMC-K for infertility.
http://www.militarydisabilitymadeeasy.com/specialmonthlycompensation.html#k
As for additional ratings, the VA will rate all secondary conditions, like mental health, scarring, if they result in a compensable level of disability.
http://www.militarydisabilitymadeeasy.com/mentaldisorders.html
http://www.militarydisabilitymadeeasy.com/scars.html
In 2006 I had a kidney to be removed because the VA said I had a cancer spot on it. the kidney was working fine but after 2 mri's and a biopsy they said the cancer was so far in it had to be removed. After the kidney was removed the autopsy could not find the cancer. I have high blood pressure and my creatine levels are higher than before the removal. I was diagnosed with PTSD in 2014 and was rated at 70%, until last year I held a job but my PTSD got the best of me. I have tried to apply for Unemployablity but was denied. Can I get any kind of rating for my kidney loss to get me rated at 100 since now my PTSD has caused me to not be able to keep a job.?
ReplyDeleteThe minimum rating for a kidney removal is 30% (which would get you to 80%) and you could potentially qualify for higher on the renal rating system, depending on your symptoms:
Deletehttp://www.militarydisabilitymadeeasy.com/thegenitourinarysystem.html#recon
http://www.militarydisabilitymadeeasy.com/thegenitourinarysystem.html#renal
Regardless, if your PTSD makes you unemployable you should meet all the requirements as long as you are able to submit sufficient proof. If the VA stated why they denied the claim, then you should be able to appeal if you can provide evidence they need to overturn the denial.
I applied for my social security last year when I was 61 yrs old and it was approved based on my 70% of PTSD from desert storm. From the time when I first got back from Desert Storm I didn't work for 8 years. The VA has all of my information. I have been working with my brother and we have appealed it. thanks
ReplyDeleteWith regards to the new proposed Renal rating system, is there an estimated date of when the VA will start implementing them?
ReplyDeleteUnfortunately, no. We won't know until they publish the final changes with an effective date.
DeleteMy husband, a Vietnam Vet on the Agent Orange Registry, has been treated for Diabetes because of AO for several years. He was diagnosed with a mass in his bladder (no symptoms) in Oct. 2019. VA schedules due to tests postponed the surgery to Feb. 10 to remove what they could of the cancerous tumor. VA surgeon said he needed a second surgery to try to make sure they removed all the tumor, but because he has swelling preventing them from getting into the bladder properly, they scheduled an ultrasound and sent us outside the VA for an MRI. We just finished those tests March 23 (again due to scheduling) and were ready to schedule the second surgery when the VA shut down “elective” surgeries due to Covid-19. No idea when they will do this surgery. We requested an outside consult to try to schedule the surgery. We have been turned down 3 times to allow us to go outside for the surgery. We don’t need VA permission, but aren’t sure what going outside does for future treatment of bladder cancer, which is notorious for recurrence. My husband's disability rating is 20% based on his diabetes alone. How do we get a review of his rating now with bladder cancer? Does going outside for this surgery change his quest for a change in his disability rating? Any news on the addition of bladder cancer to the presumptively caused list due to AO?
ReplyDeleteYou are in a tricky position. Treatment outside the system can definitely affect future ratings, as the VA cannot legally be held responsible for the results of medical treatment outside of their system that was not directly referred by them. We discuss this in more detail here:
Deletehttp://www.militarydisabilitymadeeasy.com/vasrdprinciples.html#outside
Because of Covid-19, many medical facilities are not doing elective procedures, so you may have a tricky time finding a facility that will do it anyway.
As for claiming this condition, "bladder cancer" as a general condition has not been added to the Presumptive List. Here are all conditions on the Presumptive List for Agent Orange exposure:
http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html#herbicide
There are some medical studies that show an association between diabetes and an increased risk of bladder cancer, so you may be able to claim the cancer as secondary to the diabetes (and some drugs used to treat diabetes). When you submit a claim for the bladder cancer, make sure to submit medical evidence and a NEXUS letter that supports the connection that is most strong in your case.
http://www.militarydisabilitymadeeasy.com/nexusletters.html
have the renal changes gone into effect yet?
ReplyDeleteNot yet. We'll blog about it and update our website as soon as they do.
DeleteAre there any studies that support sleep apnea as a secondary to Gerd?
ReplyDeleteThere is significant debate over whether sleep apnea causes GERD, the other way around, or if they simply make each other worse.
DeleteThis article discusses studies that show that both conditions could cause and/or worsen the other:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879818/
Has anyone tried to get a renal rating due to taking pantaprazole or an acid inhibitors for Gerd for several years? There are studies that link long term pantaprazole use and renal failure?
ReplyDeleteThere is evidence that prolonged use of pantaprazole can lead to kidney damage:
Deletehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958704/
As long as your pantaprazole usage reflects the amounts/lengths that have shown a casual relationship with renal failure, you can claim it. A NEXUS letter will strengthen your claim.
I'm rated 60% for kidney disease post kidney transplant and 30% for heart disease secondary to kidney disease for under 7 METS. I also have a dilated atrium. I have both native kidneys and do not required dialysis. Would the heart disease be considered seriously (markedly) decreased function because of the under 7 METS or dilated atrium?
ReplyDeleteFor the heart, a 30% rating is given with a 6-7 MET score. In order to rate higher, the MET score would have to be 5 or less, left ventricular dysfunction, or two or more episodes of congestive heart failure in the past year.
Delete