VA C&P report. Need input for condition rating

baliw1974

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Good day to each and everyone. I just need some insight on what percentage should I be getting from my referred condition and VA claim condition.

Referred Condition:
1. Spinal Stenosis, Lumbar- Flexion 30 deg, Extension 20 deg.
2. Dysthymic Disorder

VA Claimed condition:
1. Sleep Apnea with CPAP
2. Urinary frequency
3. Acute sinusitis
4. Hypertension
5. Costochondritis
6. Tension headache
7. Right Rotator cuff tendinopathy
8. Left Rotator cuf tendinopathy
9. Right foot extensor tendonitis
10.Left foot extensor tendonitis
11.Right wrist extensor tendonitis
12.Right ankle peroneal tendonitis
13.Left ankle peroneal tendonitis
14.Right knee medial meniscuc tear
15.Tinnitius
16.Type 2 Diabetes


This report is coming from my C&P exam. Any input is very very much appreciated.
 

Sascha Roberson

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Registered Member
Good day to each and everyone. I just need some insight on what percentage should I be getting from my referred condition and VA claim condition.

Referred Condition:
1. Spinal Stenosis, Lumbar- Flexion 30 deg, Extension 20 deg.
2. Dysthymic Disorder

VA Claimed condition:
1. Sleep Apnea with CPAP
2. Urinary frequency
3. Acute sinusitis
4. Hypertension
5. Costochondritis
6. Tension headache
7. Right Rotator cuff tendinopathy
8. Left Rotator cuf tendinopathy
9. Right foot extensor tendonitis
10.Left foot extensor tendonitis
11.Right wrist extensor tendonitis
12.Right ankle peroneal tendonitis
13.Left ankle peroneal tendonitis
14.Right knee medial meniscuc tear
15.Tinnitius
16.Type 2 Diabetes


This report is coming from my C&P exam. Any input is very very much appreciated.
Check this site out, it may give you some idea:
http://www.benefits.va.gov/warms/bookc.asp#c
 

maparker

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For the DoD rating, it depends on what conditions the PEB deems unfitting or contributes to unfitness. A lumbar conditon with forward flexion at 30 degress or less should equate to a 40% rating.

Mike
 

baliw1974

PEB Forum Regular Member
PEB Forum Veteran
Its kinda hard to use the VASRD link for most of the condition listed on my C&P exam diagnosis is not listed there.
 

Warrior644

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Its kinda hard to use the VASRD link for most of the condition listed on my C&P exam diagnosis is not listed there.
Understood and true. You will need to locate the medical conditions within the VASRD which closely relates to your current medical conditions via its symptomology.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 

gsfowler

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PEB Forum Veteran
Is this from the actual Narsum or the C&P exam? Were you given a copy of the actual C&P exam?

The two referred conditions:

Dysthymic Disorder (going to come down to your GAF score) You might be rated as TDRL with 50%
Spinal Stenosis, Lumbar- Flexion 30 deg, Extension 20 deg. 40%

Claimed conditions

1. Sleep Apnea with CPAP most likely 50% if CPAP use will continue for over 12 months
2. Urinary frequency goigg to depend on the documented voiding intervals
3. Acute sinusitis going to depend on the incapacitating episodes per year
4. Hypertension
5. Costochondritis may be rated as chronic pain or
6. Tension headache
7. Right Rotator cuff tendinopathy ROM
8. Left Rotator cuf tendinopathy ROM
9. Right foot extensor tendonitis ROM
10.Left foot extensor tendonitis ROM
11.Right wrist extensor tendonitis ROM
12.Right ankle peroneal tendonitis ROM
13.Left ankle peroneal tendonitis ROM
14.Right knee medial meniscuc tear ROM
15.Tinnitius 10%
16.Type 2 Diabetes depends on the restrictions of activities and/or hospitalizations/visits to physician.
 

baliw1974

PEB Forum Regular Member
PEB Forum Veteran
Is this from the actual Narsum or the C&P exam? Were you given a copy of the actual C&P exam?

The two referred conditions:

Dysthymic Disorder (going to come down to your GAF score) You might be rated as TDRL with 50%
Spinal Stenosis, Lumbar- Flexion 30 deg, Extension 20 deg. 40%

Claimed conditions

1. Sleep Apnea with CPAP most likely 50% if CPAP use will continue for over 12 months
2. Urinary frequency goigg to depend on the documented voiding intervals
3. Acute sinusitis going to depend on the incapacitating episodes per year
4. Hypertension
5. Costochondritis may be rated as chronic pain or
6. Tension headache
7. Right Rotator cuff tendinopathy ROM
8. Left Rotator cuf tendinopathy ROM
9. Right foot extensor tendonitis ROM
10.Left foot extensor tendonitis ROM
11.Right wrist extensor tendonitis ROM
12.Right ankle peroneal tendonitis ROM
13.Left ankle peroneal tendonitis ROM
14.Right knee medial meniscuc tear ROM
15.Tinnitius 10%
16.Type 2 Diabetes depends on the restrictions of activities and/or hospitalizations/visits to physician.
gsfowler, Yes this is coming from the actual C&P exam. my GAF score is 50-55 and I have no idea what that number means. All of my condition that has ROM are all in normal range. Would I still be rated for pain?
 

Warrior644

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gsfowler, Yes this is coming from the actual C&P exam. my GAF score is 50-55 and I have no idea what that number means. All of my condition that has ROM are all in normal range. Would I still be rated for pain?
Yes, if certain CFR criteria are applicable to your medical conditions. For example:

Right knee medial meniscus tear:

If you have painful motion of the knee, then 38 CFR 4.59 allows consideration of functional loss due to painful motion to be rated to at least the minimum compensable rating for a particular joint. If validated, then the minimum compensable evaluation of 10 percent will be assigned.

Left and Right ankle peroneal tendonitis:

If you have painful motion of the ankles, then provisions of 38 CFR 4.40 and 4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown, 8 Vet. App. 202 (1995) will be considered and possible be warranted.

Similarly, your other medical conditions should have the aforementioned provisions applied if warranted. Otherwise, the ROM measurement is the primary provision used by the DoVA D-RAS for rating purposes.

Thus, possessing well-informed knowledge is truly a powerful equalizer.

Best Wishes!
 

baliw1974

PEB Forum Regular Member
PEB Forum Veteran
Warrior644, thank you for your input. Do you know anything about GAF score? If you do what would be 50-55 score means in regards to rating?
 

Warrior644

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Does anybody know what a GAF score 50-55 means in regards to disability percentage
Warrior644, thank you for your input. Do you know anything about GAF score? If you do what would be 50-55 score means in regards to rating?
You are welcome! No worries; it's all good! :)

Global Assessment of Functioning (GAF) is a 100-point tool rating overall psychological, social and occupational functioning of people over 18 years of age and older. The GAF excludes physical and environment impairment. The GAF is included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) in the section on multi-axial assessments.

Specifically to your question, a GAF score with range of 51 to 60 refers to moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers). Reference the attachment to view additional detailed information.

From my experiences within the DoD IDES MEB/PEB process to date, upon receipt of your IPEB findings beware of the DoVA D-RAS trying to underrate your PTSD rating due to the GAF score only. IAW 38 CFR Part 4.129, a minimum 50% evaluation is required with the establishment of a future examination for six months after separation for mental disorders due to traumatic stress.

Moreover, the application of the GAF score only in the determination of "reason for decision" by the DoVA PTSD rating is in direction violation of eCFR, Title 38, Part 4, Subpart B, 4.126(a). The Electronic Doe of Federal Regulation states "The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination."

To that extent, if you have objective documentation accurately describing your PTSD symptoms which fall within the 70% to 100% rating criteria, then it would be in your best interest to request an IPEB appeal and/or a one-time DoVA reconsideration of PEB referred unfit conditions only.

Thus, I quite often comment that "possessing well-informed information is truly a powerful equalizer."

Best Wishes!
 

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