Help with disability calculation

Discussion in 'Disability' started by Major Don, Jun 3, 2008.

  1. Major Don

    Major Don New Member

    Likes Received:
    0
    Trophy Points:
    0
    I just received my rating decision. However, I cannot combine the individual ratings to arrive at the combined rating they provide -- and yes, I am using the combined ratings table.

    My ratings are as follows: sleep apnea (50%), healed fracture, right hip (30%), acne/folliculitis on face, neck, chest, back & legs (10%), vitreous syneresis, left eye (10%), tinnitus (10%), hypertension (10%), anxiety disorder (10). The combined ratings table combines these ratings to 84%, which should be rounded down to 80%. However, the rating decision letter rates me at 90% disabled!

    The only thing I can figure is that they added a bi-lateral factor for my acne on my legs combined with my hip fracture. Is this possible? If so, this seems to be an absurb reason for granting an extra 10%. Is there anything else I'm missing?
  2. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    I don't know how you combined but I come up with 80% exactly.

    sleep apnea (50%)
    right hip (30%)
    acne/folliculitis (10%)
    left eye (10%)
    tinnitus (10%)
    hypertension (10%)
    anxiety disorder (10)

    50 combined with 30 is 65%
    65 combined with 10 is 69%
    69 combined with 10 is 72%
    72 combined with 10 is 75%
    75 combined with 10 is 78%
    78 combined with 10 is 80%

    I also don't know how the VA could come up with 90% either. The VA uses a computer to write the decision and also to calculate the combined rating. All they do is input the individual awards and the letter will show which ones were awarded and the combined rating. It has never been known to make a mistake if the list of conditions is correct. It also does bi-lats automaticly but in order to make a bilat award for the legs, there would have to be a separate award for each leg. What you told us and what is in your award appear to be different things.
  3. Major Don

    Major Don New Member

    Likes Received:
    0
    Trophy Points:
    0
    I made a mistake in listing my disabilities in the original email. The rating for acne was 30%. Does this give you 84%?

    Thanks for trying to help. I have written a letter to the ratings board to try to get this explained.
  4. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    sleep apnea (50%)
    right hip (30%)
    acne/folliculitis (30%)
    left eye (10%)
    tinnitus (10%)
    hypertension (10%)
    anxiety disorder (10)

    50 combined with 30 is 65%
    65 combined with 30 is 76%
    76 combined with 10 is 78%
    78 combined with 10 is 80%
    80 combined with 10 is 82%
    82 combined with 10 is 84%

    Yes, that comes to 84% which would round to 80%

    I suspect you have another award that isn't apparent. Call the toll free number 1-800-827-1000 and ask them to enumerate all your awards. The folks on the toll free number are not trained to track a claim but they do have access to the VA computer and can tell you of your awards.
  5. Major Don

    Major Don New Member

    Likes Received:
    0
    Trophy Points:
    0
    I have called the VA (the same number you provided) and when I asked them how they calculated the 90%, all they could do is emunerate my awards. Their listing matches mine. However, I will call and reconfirm. Thanks again!
  6. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    The folks answering the Toll Free number have a very limited ability to answer questions that require them to make judgment calls or evaluate your status. Their purpose is to help folks file basic claims and provide forms. They have no training to do anything else.

    Years ago, before computers, VA decision makers actually calculated the combined rating using the Combined Ratings Table. It has been so long now since they've done that, that most decision makers can no longer know how. I doubt the guy you talked to even had an idea of what you were talking about.

    About the only person that can answer most questions regarding your claim is the decision maker and you don't get to talk with him. If you did, he wouldn't have time to work on your claim. This is why it's always best to have a VSO when you can find a good one. They usually have a counterpart working at the RO and are on a first name basis with the man working your claim. They have access to the VA computer, can pull your c-file and look and they can walk over and chat with the decision maker.

    Try asking the IRIS query system for your answer. These folks have more training and more time to answer your question. Go here:

    https://iris.va.gov/Scripts/iris.cfg/php.exe/enduser/cci/ask_1.php?p_sid=x*hmWs5j&p_lva=&p_sp=&p_li=
  7. Major Don

    Major Don New Member

    Likes Received:
    0
    Trophy Points:
    0
    This is the response I received from the IRIS query system:

    This makes a little more sense:

    30 (hip replacement) combined with 30 (acne/folliculitis) is 51%
    Add a bilateral factor of 10% (5.1) is 56%
    56 combined with 50 is 78%
    69 combined with 10 is 80%
    72 combined with 10 is 82%
    75 combined with 10 is 84%
    78 combined with 10 is 86%, which rounds up to 90%

    Either way, I'm not complaining, as I'm getting a rating that is a lot higher than I expected (which is probably a very unusual thing!).

    My question now is, why wasn't this "bilateral factor" documented in my Rating Decision Letter?

    Thanks for all your help, TCM!
  8. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    This makes no sense at all. The bi-lateral factor applies to "paired extremities". The hip is considered a lower extremity but acne/folliculitis???? Unless this is on your right leg, someone has screwed the pooch. I'd put the money in the bank and spend the intrest. Make sure you document all of this. I'd be willing to put money on the VA looking to reclaim the excess in years to come.
  9. Major Don

    Major Don New Member

    Likes Received:
    0
    Trophy Points:
    0
    The rating letter documents that the acne/folliculitis disability is on my face, arms, chest, back and legs. Does this make more sense?
    That is exactly why I am pursueing this now -- I don't what someone rechecking my claim and telling me I owe a bunch of money back to the VA!

    BTW, the email from the IRIS system is the first time I've seen a diagnostic code for any of my disabilities! My rating decision letter provided no diagnostic codes. What makes this interesting is that my rating decision letter described one of my disabilities as acne/folliculitis, which I assumed to be "7828 Acne" from the 38 CFR Book C Schedule for Rating Disabilities, but the email from the IRIS system implies that this disability is actually "7806 Dermatitis or eczema." In actuality, this particular disability is manifested as both acne/folliculitis and dermatitis/eczema, but it makes me wonder if I am mis-interpreting any of my other disabilities...
  10. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    The only thing you can do at this point is keep asking questions and document the results. Get names on telephone calls and write a close synopsis of the conversation along with date/time. This will help you show a good faith effort if problems develop.

Share This Page