Vasovagal Syncope since 2nd Iraq

Hello, I just began my IDES last week and am new to the forum. I read previous posts about syncope and had a few of questions. First, after researching how vasovagel syncope has been coded through VA typically through this forum (correct me if I'm wrong) but it seems like it would be regarded as paralysis to the 10th cranial nerve (8210), which maxes out at 50%, how does a 60% rating occur with the same titled diagnosis? Second, whats the difference between service-connected and combat related-I mean I started having this condition right after my second deployment to Iraq, along with other issues (lack of sleep, back pain, and bad headaches), will any of that be taken into consideration? I'm really inclined to think if I hadn't gone to Iraq I would be normal like the rest of my family that wasn't exposed to the things I was. But I'm no doctor, so I don't know if this condition is typically seen that way to the VA. Can this be considered combat-related? 3rd, sometimes I feel like my conditions are worsening, I went from 3 episodes in three months no profile, to 2 episodes this month w/ profile, last one happend two weeks ago. The question is will I recieve sceptism by continually reporting throughout MEB if they continue, or will these episodes be taken into consideration towards %. Actually, this is the same for my sleep issues, and headaches, does it matter if I report them now that MEB has already begun? Also, I have to say I am somewhat apprehensive with the process, I noticed one person posted they recieved 0% in this forum yet others anywhere from 30-60% for vasovagal syncope. I understand this condition occurs by habitually passing out at least once or twice a month. Not just feeling like they're going down but actually going out cold. How can the ratings differ so much when having such a diagnosis recorded I 'd assume would disqualify many occupations that the average healthy person could apply for (fireman/police/laborer etc) upon release from active sevice? It just seems there should be a more thorough system to determine the effects. I get essentially no early warnings of when the episode is about to happen, and it can be caused now by merely walking at times. I am on anti-depress meds to mitigate syncope for past 10 days, but dosage only goes out for 30 days, if I don't have any episodes while using meds, how is that judged effective or not? I think this is a lot of info for now, any advice is greatly appreciated!


PEB Forum Veteran
Registered Member
The should evaluate you for your symptoms. A single condition may cause a host of issues and hence be associated with multiple ratings. There may be multiple ways of rating a symptom, i.e. if the nerve problem is causing extreme dizziness/fainting/etc. they may opt to rate it under Meniere's syndrome, which describes the same basic thing and rates up to 100%. Whichever describes the problem and gives the best rating should be chosen, but studying the VASRD can be important so you can argue with them if they get it wrong.

All conditions should be reported so they can be rated, not just the ones making you unfit. You will file a claim with the VA for all conditions, the ones that don't cause you to be unable to do your job will be part of the VA rating.

Service connected means the condition is shown to be related to your service.
Combat related means the condition is shown to be related to a qualifying event, which included:
Combat Action - Contact with the enemy
Simulating War - Training event that replicates a war scenario
Instrumentality of War - Piece of equipment that is unique to the military causes the injury
Hazardous Duty - Happened during a particular hazardous thing associated with the military, i.e. combat flight maneuvers, combat jump, etc.

Drawing a relationship from your condition to a qualifying event is really left to the docs depending on your specific history and what is known about the development on your condition. Many times this answer can be wrong due to the lack of timely medical detection, not much can be done about that. They can't really guess at the cause, it needs to be a reasonable conclusion from the facts.

It is not at all unusual for disabilities to preclude you from certain career fields or positions. The compensation is for that difficulty, as well as problems with earning and advancement. There are arguments on both sides, that the compensation isn't enough or too much. They will give additional compensation should it prove to make you unable to obtain any career. They will also offer Voc Rehab to give you training for a new career field more in line with what you are now capable of.

Not sure what to say about judging medication effectiveness. Welcome to the land of the broken. The process of dealing with docs is more art than science. You just have to find a way to express if it seems to have a good, bad or no effect on your condition as well as your overall health and then go from there.
Thanks for the insight. I see why my PEBLO strongly recommended legal advice before deciding whether to agree/disagree with findings. Whats interesting is that to my understanding the legal advice offered here at F.T. Hood comes from the same office that the NARSUM is created, not to question anyone's professionalism, but seems like its not unreasonable to believe theres a potential conflict of interest. On the other hand, outside any given military base, how likely is anyone to find a legal office familiar with the VASRD process? Looks like regardless of circumstances we are forced to put extraordinary trust in the docs.
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