Arthritis

U

USMC2002

PEB Forum Regular Member
Registered Member
Hello all, any help or guidance on this topic would be greatly appreciated. I requested a FPEB to argue for a higher rating based on new evidence and (maybe) missed evidence.

Short Question: I currently have arthritis in two of my joints in my shoulder. Degenerative arthritis of acromioclavicular joint (diagnosed before trauma), and arthritis in my glenohumeral joint (diagnosed after the trauma). Does that count as multi-joint arthritis? Do I rate a higher evaluation for multiple joints being affected.

Longish Background: The history of my injury is as follows, an X-Ray and MRI confirmed I had degenerative arthritis in my shoulder. I received an injection that became infected resulting in septic arthritis; identified 4 weeks later; received 5 surgeries over 5 weeks. As a result, I have tons of issues with the shoulder to include glenohumeral chondral loss, full-thickness; subacromial bursal effusion; acromioclavicular degenerative change; supraspinatus tendinosis. It has been two years, and I have osteoarthritis in my glenohumeral joint, and degenerative arthritis in my acromioclavicular joint.


Lastly, here are the resources I have used to find the answers:

1. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014413/M21-1-Part-V-Subpart-iii-Chapter-1-Section-C-Arthritis?articleViewContext=article_view_related_article#3

2. Federal Register :: Request Access (Might have to right click and open in new window or new tab, it is the ecfr.gov website)

3. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014407/M21-1-Part-V-Subpart-iii-Chapter-1-Section-A-Painful-Motion-and-Functional-Loss?articleViewContext=article_view_related_article#2a

4. http://cptraining.vba.va.gov/C&P_Training/Job_Aids/Medical_EPSS.htm (unable to open, but is a resource to explain multi-joint arthritis)




Thank you for your time,

USMC2002
 
Last edited:
USMC2002 said:
Hello all, any help or guidance on this topic would be greatly appreciated. I requested a FPEB to argue for a higher rating based on new evidence and (maybe) missed evidence.

Short Question: I currently have arthritis in two of my joints in my shoulder. Degenerative arthritis of acromioclavicular joint (diagnosed before trauma), and arthritis in my glenohumeral joint (diagnosed after the trauma). Does that count as multi-joint arthritis? Do I rate a higher evaluation for multiple joints being affected.

Longish Background: The history of my injury is as follows, an X-Ray and MRI confirmed I had degenerative arthritis in my shoulder. I received an injection that became infected resulting in septic arthritis; identified 4 weeks later; received 5 surgeries over 5 weeks. As a result, I have tons of issues with the shoulder to include glenohumeral chondral loss, full-thickness; subacromial bursal effusion; acromioclavicular degenerative change; supraspinatus tendinosis. It has been two years, and I have osteoarthritis in my glenohumeral joint, and degenerative arthritis in my acromioclavicular joint.


Lastly, here are the resources I have used to find the answers:

1. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014413/M21-1-Part-V-Subpart-iii-Chapter-1-Section-C-Arthritis?articleViewContext=article_view_related_article#3

2. Federal Register :: Request Access (Might have to right click and open in new window or new tab, it is the ecfr.gov website)

3. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014407/M21-1-Part-V-Subpart-iii-Chapter-1-Section-A-Painful-Motion-and-Functional-Loss?articleViewContext=article_view_related_article#2a

4. http://cptraining.vba.va.gov/C&P_Training/Job_Aids/Medical_EPSS.htm (unable to open, but is a resource to explain multi-joint arthritis)




Thank you for your time,

USMC2002
Click to expand...
Did you talk to legal first? If adding a condition its FPEB. If its upping a rating for a condition already found unfit that would be a VARR and not a FEB.

Also, its not too late to talk to a private attorney for an initial consultation. You might be able to to find one that will take your case. Not everyone will want to take a case this late but some do.
 
@USMC2002

@Provis is correct. Adding new conditions must be done via the FPEB and requesting a higher disability rating for conditions already found unfitting must be done via a VARR. Unless you are going through the LDES or coming back from the TDRL, the DoD has ZERO to do with rating, they just cut and paste from the VA decision letter or code sheet.

I hope this helps.

S/f,

Joel

Disclosure: I was a Marine JAG, Active Duty and Reserve IPEB & FPEB attorney, federal government civilian FPEB & TDRL-focused attorney at the Navy PEB, and now a private attorney focused solely on IDES cases. This post is meant as procedural insight only and should not be construed as legal advice related to a specific case or a legal analysis of facts thereof.
 
Thank you, it kind of helps. My original question was about how different joints in the same region affected with different types of arthritis is rated by the VA, but now I have other concerns.

I'm requesting an FPEB because the description of my main condition is inaccurate. The condition I was referred to the board for is typically not long term, and not something I would suffer from for the rest of my life. In fact, I've been recovering from it for a while, and the real condition was practically ignored in the Findings of the PEB Proceedings and in the VA Proposed Rating. I believed that listing the conditions in the VBA 21-526, discussing them during my VA exam, and them being included in my medical records would result in my unfit conditions being updated. That didn't happen. I tried to have my referred condition updated when the process began but I was told I'd have to start the PEB from the beginning, I also tried to have it updated when I was given my IPEB findings and requested an IMR to have additional disqualifying conditions added. I was advised against adding/updating that condition then.

I want the condition to be accurately annotated because I'd hate for the mistake to be caught later and I'd have to deal with any negative consequences at that time (I may be paranoid, but it's not without reason). I have additional evidence in support of the condition and its effects.

For the remaining unfit conditions, evidence from my medical records were missed, and I have additional evidence to support my claim.

I guess my question now is do I have to wait for the Formal Board to handle these concerns or could I present them sooner (how should/does that work)?

If I have to wait for my Formal Board, and they include the missed/inaccurate diagnoses related to the unfit conditions can I request a VA reconsideration?
Or does the DoD send the updated report to the VA, and my percentages are updated?

I understand that the DoD copies the findings from the VA, but I don't understand the relationship between the DoD and the VA after a FPEB.

I have been confused about a lot during this process, and as a result I've made costly mistakes regarding my time and money. Any clarification would be greatly appreciated.

Thanks,

SAR
 
USMC2002 said:
Thank you, it kind of helps. My original question was about how different joints in the same region affected with different types of arthritis is rated by the VA, but now I have other concerns.

I'm requesting an FPEB because the description of my main condition is inaccurate. The condition I was referred to the board for is typically not long term, and not something I would suffer from for the rest of my life. In fact, I've been recovering from it for a while, and the real condition was practically ignored in the Findings of the PEB Proceedings and in the VA Proposed Rating. I believed that listing the conditions in the VBA 21-526, discussing them during my VA exam, and them being included in my medical records would result in my unfit conditions being updated. That didn't happen. I tried to have my referred condition updated when the process began but I was told I'd have to start the PEB from the beginning, I also tried to have it updated when I was given my IPEB findings and requested an IMR to have additional disqualifying conditions added. I was advised against adding/updating that condition then.

I want the condition to be accurately annotated because I'd hate for the mistake to be caught later and I'd have to deal with any negative consequences at that time (I may be paranoid, but it's not without reason). I have additional evidence in support of the condition and its effects.

For the remaining unfit conditions, evidence from my medical records were missed, and I have additional evidence to support my claim.

I guess my question now is do I have to wait for the Formal Board to handle these concerns or could I present them sooner (how should/does that work)?

If I have to wait for my Formal Board, and they include the missed/inaccurate diagnoses related to the unfit conditions can I request a VA reconsideration?
Or does the DoD send the updated report to the VA, and my percentages are updated?

I understand that the DoD copies the findings from the VA, but I don't understand the relationship between the DoD and the VA after a FPEB.

I have been confused about a lot during this process, and as a result I've made costly mistakes regarding my time and money. Any clarification would be greatly appreciated.

Thanks,

SAR
Click to expand...
Have you been rated yet? If the unfitting condition is 30% or more you may want to take a good long look at what a medical retirement affords you. If found fit that doesn't guarantee you to hit 20 years for a regular retirement or to be found unfit later on with the same ratings. Know what your chances are to succeed and all the possible outcomes. Many Soldiers who argue for a fit finding get a worse outcome due to minimizing their conditions but still being found unfit.
 
@USMC2002

Technically speaking, yes: you must wait for the FPEB to address your issues. However, private counsel regularly submit IPEB reconsiderations requests, but these requests (in the Navy/Marine Corps PEB world) are generally forwarded to the FPEB members for consideration, depending on the timing of submission. You must understand that the Navy officially did away with IPEB reconsiderations years ago. They exist in a sort of grey area. This is why assigned government counsel don't submit them: they don't have the bandwidth because IPEB reconsiderations are not baked into the workflow for caseload assignments anymore. This is especially true when it comes to cases involving evidence that is not overwhelmingly clear.

In the end, if the FPEB adds/updates your condition and it must be rated under a different VA diagnostic code, the PEB will send it to the DRAS as a "President Directed VARR." Thus, you maintain your one-time VARR.

Frankly, issues as complex and work intensive that come to a head simultaneously at the FPEB level are always challenging.

I’m pulling for you.

S/f,

Joel

Disclosure: I was a Marine JAG, Active Duty and Reserve IPEB & FPEB attorney, federal government civilian FPEB & TDRL-focused attorney at the Navy PEB, and now a private attorney focused solely on IDES cases. This post is meant as procedural insight only and should not be construed as legal advice related to a specific case or a legal analysis of facts thereof.
 
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