Ratings in 70/90 -- Must sign DA 199 on the 24th.. QUESTIONS!

A

at_a_canter

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
I have multiple questions ! Ill list all my rated stuff first. And Ill try to format for easier reading. I will also edit the post as questions are answered.
__________________________________________________________________
*1* 8045-9411 RESIDUALS OF TRAUMATIC BRAIN INJURY (TBI) WITH
POST TRAUMATIC STRESS DISORDER (PTSD) AND MAJOR DEPRESSIVE
DISORDER [Disability Evaluation System (DES)/PEB Referred]
Proposed DES Service Connected, *2* Gulf War, Incurred
70%

8511 RIGHT (DOMINANT) UPPER EXTREMITY RADICULOPATHY
Proposed DES Service Connected, Gulf War, Incurred
20%

8511 LEFT UPPER EXTREMITY RADICULOPATHY
Proposed DES Service Connected, Gulf War, Incurred
20%

5201-5019 RIGHT (DOMINANT) SHOULDER STRAIN (CLAIMED AS RIGHT
SHOULDER CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
10%

5242-5243 CERVICAL SPINE DEGENERATIVE DISC DISEASE (DDD) (CLAIMED AS
CERVICALGIA, NECK CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
10%

7399-7346 GASTROESOPHAGEAL REFLUX DISEASE (GERD)
Proposed DES Service Connected, Gulf War, Incurred
10%

5228 LEFT FIRST METACARPAL FRACTURE (CLAIMED AS LEFT HAND
CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
0%

5237 LUMBAR STRAIN (CLAIMED AS BACK CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
0%

*3* 6847 SLEEP APNEA
Proposed DES Service Connected, Gulf War, Incurred
0%

7599-7523 BILATERAL HYDROCELE (CLAIMED AS LEFT TESTICLE PAIN)
Proposed DES Service Connected, Gulf War, Incurred
0%

7805 RESIDUAL LINEAR SCAR
Proposed DES Service Connected, Gulf War, Incurred
0%

PROPOSED SERVICE CONNECTED COMBINED EVALUATION FOR DISABILITY EVALUATION
SYSTEM (DES) PURPOSES
90% (*4* Bilateral factor of 4.2 Percent for diagnostic codes 5019, 8511, 8511)

Proposed DES Not Service Connected Disabilities
5260 LEFT KNEE PATELLAR TENDINITIS (CLAIMED AS LEFT KNEE
CONDITION)
Proposed DES Not Service Connected, No Diagnosis

5276 BILATERAL FOOT CONDITION
Proposed DES Not Service Connected, No Diagnosis

6260 TINNITUS (CLAIMED AS RINGING IN EARS)
Proposed DES Not Service Connected, Not Incurred/Caused by Service

_______________________________________________________________________________________


1. My PTSD w/ MDD is combat-related. I also have a diagnosed TBI that is NOT combat-related and occured about 6 years after my deployments. Why are they rated together?

2. All my ratings say "Gulf War".. why?

3. Rated at 0%, it reads "Service records show a sleep study was conducted on April 28, 2014. Results from the studyshow an apnea-hypopnea index (AHI) of 5.9 (5-15 events per hour of sleep is indicative of mildsymptoms) and a diagnosis of sleep apnea. The record shows a CPAP study was recommended
but has not been conducted as of this da te. VA exam show your report of daytime somnolence
without falling asleep. No requirement for CPAP is shown. The examiner concluded there to
be no otherwise functional impairment. If you have medical evidence of more severe symptoms
or the requirement of a CPAP send it to us and this decision can be reconsidered. We have
assigned a noncompensable evaluation for your sleep apnea syndrome based on:
• A diagnosed disability with no compensable symptoms" By the time I got my CPAP findings stating I need a CPAP machine my packet had already been sent. DO I have to appeal (therefore delaying my seperation by months) in order for this to get a ratings increase?

My ratings would be the same even if they had rated it at the 30%, but I dont want to deal with the VA as a civilian when it comes to claims.. is there a way without appealing?

4. What is this?


*** END OF RATINGS QUESTIONS ***


Below is my pay information. If someone can help me understand how much a month I can expect, with CRSC I would appreciate it. Married w/ Child

_______________________________________________________________________________________

http://imgur.com/qvKJRhW


I took a stab at it, but im probably wrong...

$2153(army) - $1962 (va) = $191

$191 army and $1962 VA every month?









Again I appreciate any and all help~





 
Last edited:
at_a_canter said:
I have multiple questions ! Ill list all my rated stuff first. And Ill try to format for easier reading. I will also edit the post as questions are answered.
__________________________________________________________________
*1* 8045-9411 RESIDUALS OF TRAUMATIC BRAIN INJURY (TBI) WITH
POST TRAUMATIC STRESS DISORDER (PTSD) AND MAJOR DEPRESSIVE
DISORDER [Disability Evaluation System (DES)/PEB Referred]
Proposed DES Service Connected, *2* Gulf War, Incurred
70%

8511 RIGHT (DOMINANT) UPPER EXTREMITY RADICULOPATHY
Proposed DES Service Connected, Gulf War, Incurred
20%

8511 LEFT UPPER EXTREMITY RADICULOPATHY
Proposed DES Service Connected, Gulf War, Incurred
20%

5201-5019 RIGHT (DOMINANT) SHOULDER STRAIN (CLAIMED AS RIGHT
SHOULDER CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
10%

5242-5243 CERVICAL SPINE DEGENERATIVE DISC DISEASE (DDD) (CLAIMED AS
CERVICALGIA, NECK CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
10%

7399-7346 GASTROESOPHAGEAL REFLUX DISEASE (GERD)
Proposed DES Service Connected, Gulf War, Incurred
10%

5228 LEFT FIRST METACARPAL FRACTURE (CLAIMED AS LEFT HAND
CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
0%

5237 LUMBAR STRAIN (CLAIMED AS BACK CONDITION)
Proposed DES Service Connected, Gulf War, Incurred
0%

*3* 6847 SLEEP APNEA
Proposed DES Service Connected, Gulf War, Incurred
0%

7599-7523 BILATERAL HYDROCELE (CLAIMED AS LEFT TESTICLE PAIN)
Proposed DES Service Connected, Gulf War, Incurred
0%

7805 RESIDUAL LINEAR SCAR
Proposed DES Service Connected, Gulf War, Incurred
0%

PROPOSED SERVICE CONNECTED COMBINED EVALUATION FOR DISABILITY EVALUATION
SYSTEM (DES) PURPOSES
90% (*4* Bilateral factor of 4.2 Percent for diagnostic codes 5019, 8511, 8511)

Proposed DES Not Service Connected Disabilities
5260 LEFT KNEE PATELLAR TENDINITIS (CLAIMED AS LEFT KNEE
CONDITION)
Proposed DES Not Service Connected, No Diagnosis

5276 BILATERAL FOOT CONDITION
Proposed DES Not Service Connected, No Diagnosis

6260 TINNITUS (CLAIMED AS RINGING IN EARS)
Proposed DES Not Service Connected, Not Incurred/Caused by Service

_______________________________________________________________________________________


1. My PTSD w/ MDD is combat-related. I also have a diagnosed TBI that is NOT combat-related and occured about 6 years after my deployments. Why are they rated together?

2. All my ratings say "Gulf War".. why?

3. Rated at 0%, it reads "Service records show a sleep study was conducted on April 28, 2014. Results from the studyshow an apnea-hypopnea index (AHI) of 5.9 (5-15 events per hour of sleep is indicative of mildsymptoms) and a diagnosis of sleep apnea. The record shows a CPAP study was recommended
but has not been conducted as of this da te. VA exam show your report of daytime somnolence
without falling asleep. No requirement for CPAP is shown. The examiner concluded there to
be no otherwise functional impairment. If you have medical evidence of more severe symptoms
or the requirement of a CPAP send it to us and this decision can be reconsidered. We have
assigned a noncompensable evaluation for your sleep apnea syndrome based on:
• A diagnosed disability with no compensable symptoms" By the time I got my CPAP findings stating I need a CPAP machine my packet had already been sent. DO I have to appeal (therefore delaying my seperation by months) in order for this to get a ratings increase?

My ratings would be the same even if they had rated it at the 30%, but I dont want to deal with the VA as a civilian when it comes to claims.. is there a way without appealing?

4. What is this?

*** END OF RATINGS QUESTIONS ***

Below is my pay information. If someone can help me understand how much a month I can expect, with CRSC I would appreciate it. Married w/ Child
_______________________________________________________________________________________
http://imgur.com/qvKJRh
I took a stab at it, but im probably wrong...

$2153(army) - $1962 (va) = $191

$191 army and $1962 VA every month?

Again I appreciate any and all help~
Click to expand...

In response to your specific inquiry, I offer feedback as follows:

A1. In my opinion, it seems that the DoVA D-RAS could not separately distinguish your PTSD medical condition from your mTBI medical condition as (some likely) reported by the DoVA C&P clinician results. If you believe this is not the case, then you will not to submit a DoVA appeal with medical evidence/medical documentation validating that both medical conditions should have been evaluated and rated separately.

A2. At this time, I can't recall the exactly verbiage but it seems to be a DoVA D-RAS standard procedural process when a military medical condition is evaluated as military service-connected (e.g., compensable or non-compensable) in a given period of military service.

A3. Was Sleep Apnea determined to be an "unfit for duty" medical condition by the DoD IDES PEB? If no, then you will need to submit a DoVA NOD appeal upon becoming a military veteran for an opportunity to have the DoVA rating re-evaluated and potentially changed. If yes and you want to have an opportunity for an increased DoD rating, then you would need to request a FPEB hearing and/or submit a VARR request albeit your departure from active duty military shall be delayed for sure!

A4. In accordance with 38 CFR 4.26 Bilateral factor, it states as follow:

"When a partial disability results from disease or injury of both arms, or of both legs, or of paired skeletal muscles, the ratings for the disabilities of the right and left sides will be combined as usual, and 10 percent of this value will be added (i.e., not combined) before proceeding with further combinations, or converting to degree of disability. The bilateral factor will be applied to such bilateral disabilities before other combinations are carried out and the rating for such disabilities including the bilateral factor in this section will be treated as 1 disability for the purpose of arranging in order of severity and for all further combinations. For example, with disabilities evaluated at 60 percent, 20 percent, 10 percent and 10 percent (the two 10's representing bilateral disabilities), the order of severity would be 60, 21 and 20. The 60 and 21 combine to 68 percent and the 68 and 20 to 74 percent, converted to 70 percent as the final degree of disability.
(a) The use of the terms “arms” and “legs” is not intended to distinguish between the arm, forearm and hand, or the thigh, leg, and foot, but relates to the upper extremities and lower extremities as a whole. Thus with a compensable disability of the right thigh, for example, amputation, and one of the left foot, for example, pes planus, the bilateral factor applies, and similarly whenever there are compensable disabilities affecting use of paired extremities regardless of location or specified type of impairment.
(b) The correct procedure when applying the bilateral factor to disabilities affecting both upper extremities and both lower extremities is to combine the ratings of the disabilities affecting the 4 extremities in the order of their individual severity and apply the bilateral factor by adding, not combining, 10 percent of the combined value thus attained.
(c) The bilateral factor is not applicable unless there is partial disability of compensable degree in each of 2 paired extremities, or paired skeletal muscles."

A5. In reference to your CRSC calculation inquiry, I shall defer to other PEB Forum members to potentially provide their sound insightful feedback at this point in time.

With that all said, please take care, get well, and continue to enjoy life! :cool:

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

Best Wishes!
 
reference Q1:

The clinical presentation of TBI and PTSD are very similar. It is difficult to parse between the two. From a treatment perspective it is important to parse the symptoms, but from a benefit perspective not so much.
 
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