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VA Ankylosing Spondylitis Ruling #101630
12/31/05 03:03 PM
12/31/05 03:03 PM
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Virginia
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mmparker Offline OP
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For those who follow this board, you have read about the issue with how the military disability boards rate ankylosing spondylitis, per the VASRD, for disabled service members being medically separated or retired.

The VASRD, DOD and service regulations all have requirements to rate the disease for the active process of the disease (code 5002) and for the residual effects caused by the disease (5200 series of codes). In 2003, the VA modified the of the 5200 series codes from spinal injuries and diseases. The intent was to make the criteria more objective and to give more distinction as to the cause of the residual damage. At that time, the VA introduced code 5240, ankylosing spondylitis. The 5240 criteria only covered the spinal range of motion issues associated with the disease.

The Army and the Air Force PEB's have since erroneously extrapolated the intent of this new code to now be the only criteria required to rate ankylosing spondylitis. (I have yet get any information on how the Navy/Marines are rating AS since the change.) The Army/USAF PEB's now feel they are no longer obliged to considerer the rating criteria for the systemic and constitutional aspects of disease, (covered under code 5002). This has a severely detrimental effect on the disabled service member, as often the ratings under 5002 would be high enough to lead to retirement vice separation.

A recent case in point was that of SAA member, SPC(R) Linwood Hoffman. In 2003 he was placed on temporary disability retirement for ankylosing spondylitis with a 40% rating under code 5002. This year, during a mandatory periodic review, the Army PEB rating SPC Hoffman at 20% under code 5240 even though his condition has worsened since 2003. This ruling means he will lose his disability retirement and benefits to include his and his family's health care coverage. Bear in mind that the VA DoD, nor any of the Services, have established policy stated that consideration under code 5002 was no longer required for rating Ankylosing Spondylitis disabilities given the 203 changes. The Army PEB opined that the had to follow the VASRD, the intent of the 2003 VA change eliminated 5002 consideration, and the regulations and policies (to include their own) just needed to catch up. While point one is correct, the last two points could not be further from the truth.

I have been monitoring the VA board of Appeals database ( http://www.index.va.gov/search/va/bva.html ) for cases that might address this subject and demonstrate current VA requirements for ankylosing spondylitis ratings. A recently posted 2005 case has spoken. While the entire case is available by citation number at the link above, the key aspects of the decision are below:

Citation Nr: 0518317 Decision Date: 07/05/05 Archive Date: 07/14/05

THE ISSUE Entitlement to an increased rating for ankylosing spondylitis (formerly characterized as spondylolysis with spondylolisthesis of L5, S1), currently rated as 40 percent disabling.


CONCLUSION OF LAW:

The criteria for a rating in excess of 40 percent for ankylosing spondylitis (formerly characterized as spondylolysis with spondylolisthesis of L5, S1) have not been met. 38 U.S.C.A. § 1155 (West 2002);

38 C.F.R. § 4.71a, Diagnostic Codes 5002, 5292, 5293, 5295 (as in effect prior to September 23, 2002);

38 C.F.R. § 4.71a, Diagnostic Code 5293 (as in effect from September 23, 2002 through September 25, 2003);

38 C.F.R. § 4.71a, Diagnostic Codes 5002, 5240, and 5243 (effective from September 26, 2003).

Note: The 5293 and 5243 codes were for the service member’s intervertebral disc syndrome related to his service connected ankylosing spondylitis

The VA Board of Appeals have clearly stated that the LAW requires that 5002 criteria be considered when rating Ankylosing Spondylitis post the introduction of VASRD code 5240.

I have passed this information on to the DoD action officer who is currently investigating military ankylosing spondylitis disability cases and I will pass it on to the VA policy personnel as well.

Mike

Re: VA Ankylosing Spondylitis Ruling #101631
01/14/06 09:43 PM
01/14/06 09:43 PM
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Sir Sly Offline
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Thanks for this info, I have recently been medially retired from the USMC under the 40% rating but my VA rating came back at 10%, I was looking for someone in the DC metro area to talk to about appealing this decision or am I stuck with this rating?

Re: VA Ankylosing Spondylitis Ruling #101632
01/15/06 12:48 AM
01/15/06 12:48 AM
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mmparker Offline OP
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Were you discharged for AS? If so under what rating code? If AS and 40%, I need to talk with you as soon as possible.

Thanks,

Re: VA Ankylosing Spondylitis Ruling #101633
01/15/06 03:22 AM
01/15/06 03:22 AM
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Sir Sly Offline
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Yes it was a discharge due to AS.


Last edited by Chris Miller; 06/30/09 02:23 PM. Reason: Poster requested change - removal of contact info,
Re: VA Ankylosing Spondylitis Ruling #101634
01/15/06 01:02 PM
01/15/06 01:02 PM
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Clayton, NC
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I too was discharged about 3 yrs ago from the US Army with service connected AS. I got a VA disability rating of 10% at time of discharge.
I have been seeing the VA and obtaining my meds through them. I have done a bit of moving around (from Savannah, GA to Raleigh, NC) so as of now I am transitioning from one VA to another. I have a appointment to be screened by a Dr. in Feb.so as of now I am in transition and have no primary care physician..
My AS has gotten worse in the past few years. I have questined the 10% disability rating since I was assigned it.. as it sure does not make sence. I am sure disqualified from more than 10% of the jobs out there! How does the VA justify a 10% rating? I intend to try and get a review of my condition. Hopefuly this will result in a higher disability rating?
I am currently taking the meds: Arthrotec75, Darvocett, Morphine sulifate 15mg.
Feel free to contact me @ SgtYates@msn.com if you should need more info.


Scott
Re: VA Ankylosing Spondylitis Ruling #101635
01/15/06 03:08 PM
01/15/06 03:08 PM
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Georgia
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MIgrunt Offline
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Gonzo, you need to prepare for an appeal. Were you just routinly discharged upon serving your time or were you medically seperated? Get with a local DAV rep or even a local VFW. Both have trained personnel who can help with writing an appeal. Make sure you have all your records. Make copies of everything. Make sure you tell your doc in FEB every little detail, no matter how trivial it may seem to you. Your military job definitely would have aggrivated your condition. Good luck and keep checking here for updates.

Re: VA Ankylosing Spondylitis Ruling #101636
01/28/06 08:07 PM
01/28/06 08:07 PM
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I am new here, but I am in the process of getting back a decision for AS.
I got out of the Marine Corps in JAN 2001 and I did get the antrhax series. I got out undiagnosed and with 0% service connected on my lower back.
Finally the VA diagnosed me with AS and just recently Reiter's. I have put in my paper work for an increase of disability for AS.
Needless to say I am sweating this decision. Not looking forward to the appeals process--if necessary.
My doctor at the VA told me that he had a guy come out of desert storm with 10% service connected disability and not for AS. He was diagnosed with AS by the VA and got 100%.

Re: VA Ankylosing Spondylitis Ruling #101637
01/29/06 12:18 AM
01/29/06 12:18 AM
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mmparker Offline OP
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Riplinger,

Welcome aboard!

Re: VA Ankylosing Spondylitis Ruling #101638
01/29/06 04:05 AM
01/29/06 04:05 AM
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I put this up on another thread thinking this is important to at least read:
The scary thing about Anthrax series is I came down with AS symptoms right after I got my first shot. It took seven years to get diagnosed with AS though.
I recently read a account of a pilot that fought the DOD for retirement pay and won. He conviced a federal court that anthrax had something to do with arthritis flare ups right after he got the shots. Here is the link:
http://www.gulfwarvets.com/anthrax_courtdecision.htm

Re: VA Ankylosing Spondylitis Ruling #101639
02/01/06 05:29 PM
02/01/06 05:29 PM
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acehigh Offline
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One thing to remember when you go for your rating diagnosis is to keep yourself AS qualified. My records showed that the primary reason the military booted me was because of AS. Without that I probably wouldn't have had the rating I got. If you get the VA to show you are deffently a AS factor you can use that in your case.

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