The VA recently announced that they have determined 8 diseases are presumptively caused by consuming the contaminated drinking water at the Camp Lejeune base. Veterans with one of these eight diseases who served at Camp Lejeune between August 1, 1953 and December 31, 1987 will not have to prove that their condition was caused by service. Although it will now be easier for veterans with one of the eight conditions to get that condition service connected, it is important to focus on ensuring that the VA assigns the correct rating. Today, we will look at how the VA rates Parkinson’s disease and how you can ensure that you are receiving all of the benefits you are entitled to.
Parkinson’s – An Overview
Symptoms of Parkinson’s disease may vary from person to person. The early warning signs of Parkinson’s are usually mild, and may even go unnoticed. Symptoms may include the following:
- Tremor: This usually begins in a limb, often in the hand or fingers. One common characteristic of Parkinson’s is experiencing a tremor in the hand when it is relaxed/at rest.
- Slowed Movement (bradykinesia): This occurs over time. Parkinson’s can reduce your ability to move, making even simple tasks difficult and time consuming. Examples of slowed movement include steps becoming shorter when you walk, finding it difficult to get out of a chair, dragging of the feet when walking.
- Rigid Muscles: Stiffness in your muscles can occur in any part of the body. This can limit your range of motion and cause pain.
- Loss of Automatic Movements: This would include experiencing a decreased ability to blink, smile, or swinging of the arms when walking.
- Impaired Posture and Balance: Posture becomes stooped, or you find it harder to balance.
- Speech Changes: This includes speaking softly, quickly, slurring words, or hesitating before speaking. Speech can also become more monotone rather than usual changes in tone.
- Writing Changes: Difficulty writing, and writing may appear small.
Parkinson’s disease is often accompanied by additional problems. These include:
- Thinking Difficulties: For example, dementia or other cognitive problems. This usually occurs in the later stages of Parkinson’s disease.
- Depression and Emotional Changes: Some examples of emotional changes that occur with Parkinson’s may include depression, fear, anxiety, or loss of motivation.
- Swallowing Problems: These may develop as the Parkinson’s progresses. Examples of problems include excess saliva in the mouth because of slowed swallowing.
- Sleep Problems: These include waking up frequently throughout the night, waking up early, or falling asleep during the day.
- Bladder Problems: For example, inability to control urine or difficulty urinating
- Constipation: This is caused by a slower digestive tract.
- Blood Pressure Changes: Sudden drop of blood pressure when standing
- Sense of Smell Problems: Difficulty identifying certain odors.
- Fatigue: The specific cause of fatigue in those with Parkinson’s isn’t always known.
- Sexual Problems: Some people notice a decrease in sexual desire or performance.
The VA’s Rating Criteria for Parkinson’s
The VA frequently messes up ratings for Parkinson’s disease. However, by following three simple steps, you can make sure you are receiving the correct rating. To begin, the three steps are:
- Look to diagnostic code 8004 for the minimum Parkinson’s disease rating.
- Evaluate the symptoms you experience due to Parkinson’s and whether there are ratings available for those symptoms.
- Combine the ratings of each symptom along with the minimum rating found in step #1.
Let’s look at each step in a little more detail. Parkinson’s is rated under the diagnostic code 8004, Paralysis agitans. This diagnostic code assigns a 30% rating if the veteran has ascertainable residuals. Before getting into the rating, it is important to understand what ascertainable residuals are. Ascertainable residuals are symptoms that can be seen, or that a non-medical expert can observe. Examples of ascertainable residuals include things such as your gait, tremors, speech, loss of smell, dementia, etc. If you have symptoms such as these (but not limited to these examples) then you should at least have a 30% rating for Parkinson’s. If the VA assigned anything less than 30% you know they made an error right away.
The next step of the rating process involves rating each of the ascertainable residuals separately. This is where the VA often makes mistakes. Instead of considering the residuals, the VA stops at the 30% rating without looking at the symptoms a veteran is suffering from. The 30% rating should be the starting point for the VA when rating Parkinson’s rather than the ending point. A good place to look for a general overview of things the VA looks at when evaluating Parkinson’s would be the Disability Benefits Questionnaire (DBQ form). This can be found here. The form lists the symptoms mentioned above along with the secondary problems associated with Parkinson’s. Here are some of the diagnostic codes to look to when evaluating the symptoms and secondary problems:
- Tremors, rigidity, stooped posture, and slowed movement can affect the upper and/or lower extremities.
- For upper extremities look to diagnostic codes 8513-8515
- For lower extremities look to diagnostic code 8520.
- Difficulty swallowing: diagnostic code 7203
- Speech Problems: diagnostic code 8210
- Facial Muscle Paralysis: diagnostic code 8207
- Cognitive Problems: diagnostic code 9310 or 9326
- Bladder Problems: diagnostic code 7542
- Bowel Problems: diagnostic code 7332
Remember, each symptom and/or residual needs to be rated individually on top of the 30% minimum rating. Also, as Parkinson’s progresses keep in mind that you may need to file a claim for an increased rating. You may also need to file claims for any new symptoms/residuals that you develop as the disease progresses.
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