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50-Year-Old VA Disability Rating System Just Now Being Fully Revised

by U.S. Medicine

March 12, 2012

By Stephen Spotswood

WASHINGTON — For more than 50 years, the VA Schedule for Rating Disabilities (VASRD) has been the mechanism for determining how much disability compensation is provided to veterans. While the system has seen minor adjustments over time, a sweeping revision has never been attempted — until now.

VA is drafting a new VASRD, which, among other things, will put the rating system for mental-health conditions on par with the system for physical disabilities. According to legislators, veterans’ advocates and officials in charge of revising the system, the current schedule results in regular undercompensation of veterans with mental-health conditions, such as PTSD. 

varatingsystemveteran_unemployment1.jpg

The VASRD, which is divided into 15 body systems containing more than 700 diagnostic codes, establishes disabilities by assigning percentages in 10% increments on a scale from 0% disabled to 100% disabled. Ratings are based on the average impairments to a veteran’s earning capacity.

In 2004, Congress created the Veterans’ Disability Benefits Commission, which conducted a two-year analysis of the benefits and services available to veterans. The commission concluded that the rating system needed updating and that the rating schedule is outdated.

The commission recommended that the schedule incorporate advances in medical and rehabilitative care, as well as a greater appreciation of certain disabilities, including PTSD.

“We should not be satisfied with a World War II-era system for rating and evaluating veterans’ disabilities,” said Rep. Jon Runyan (R-NJ), chairman of the House VA Subcommittee on Disability Assistance and Memorial Affairs at a recent hearing. “The more-recent updates to diagnostic criteria for newer types of injuries, such as TBI, were a step in the right direction. However, I believe it is our duty to be vigilant in pressing for continued revision reflecting the continued advances and understanding in medical care and treatment.”

Difficulty Holding Jobs

Runyan’s opinion echoes that of veteran service organizations (VSOs). A survey conducted by the Wounded Warrior Project (WWP) found that, of more than 5,800 servicemembers and veterans wounded since 2001, more than 2,300 reported that mental-health issues made it difficult to obtain employment or hold jobs, and two-thirds reported that emotional problems had substantially interfered with their ability to work.

More than 62% were experiencing depression, and only 8% had not experienced mental-health concerns since deployment.

“The biggest challenge we see is to make the rating system for mental-health conditions as fair as possible,” said Frank Logalbo, WWP’s national service director. “Deep flaws in VA’s rating criteria pose real problems for warriors bearing psychic combat wounds.”

 Logalbo’s opinion is backed up by hard research. A panel convened by the Institute of Medicine in 2007 characterized VA’s schedule of ratings for mental disorders as far too general of an instrument to properly assess PTSD disability, and said that VA needs ratings criteria specific to PTSD.

VA has acknowledged that its ratings system, especially the mental health portion of it, needs thorough revision. Beginning in October 2009, VA began a comprehensive revision and update, one body system at a time, of its rating schedule.

Retired Lt. Gen. James Terry Scott, chairman of VA’s Advisory Committee on Disability Compensation, admitted to legislators that veterans with mental-health problems were getting short shrift when it came to their disability ratings.

“Analysis shows that veterans suffering from mental disabilities were undercompensated across the board,” Scott told legislators. “One of the things we’re looking at is how to change the rating schedule to recognize that.”

“What I think we’re going to see is that the degree of disability associated with PTSD is going to be recognized in terms of a higher disability rating [after the schedule’s revision],” Scott said. “You’ll see more people suffering from the more severe PTSD rated at 100%, as opposed to the lower percentage the current criteria seems to place them.”

One of the other areas the revision is targeting is the legalese inherent in the ratings process. According to Tom Murphy, Veterans Benefits Administration’s director of compensation services, VA plans to simplify the process, including the language.

“We realize that our notification process has a lot of legal explanation in there,” Murphy said. “We’re in a pilot phase right now where we’re simplifying that. We’re putting things into plain English, so we can explain it to veterans in such a way that you don’t need a legal degree to interpret.”

Each of the 15 body systems being revised in the VASRD will be published as a draft in the Federal Register and opened for public comment. If the comments are extensive, the draft will be revised and republished.

“A little extra time now will save us significant time [later],” Murphy said.

The full revision is expected to be finished by 2016.

PTSD Compensation and Military Service

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22 Comments

  • Greg Thompson says:

    What are we to do when I just notified that two of my medicines will no longer be able to prescribed via my telehealth LPN? I live over 50 miles to the closest psychiatrist. Sounds like we will take the brunt again like always.

  • Greg Thompson says:

    What are we to do when I just notified that two of my medicines will no longer be able to prescribed via my telehealth LPN? I live over 50 miles to the closest psychiatrist. Sounds like we will take the brunt again like always.

  • Skip P says:

    I would like to see the VA system compensate Veterans fairly based on all conditions. It starts with a veteran receiving a fair and unbiased C&P exam. They have contractors performing these exams whom don’t have passion and consideration for the veterans and their condition. Much needs to be done to make the system better however it all starts with a C&P exam after the claim is filed. If the veteran is not getting a fair assessment of their condition then what do you expect the ending result to be.

    CLAIM DENIED!!!

  • Emil J. says:

    I am a medical professional and happen to have a full, total and permanent disability with the VA secondary to combat wounds in Vietnam. I am starting to manifest a skin condition known as Schamberg’s Disease which is also known as Pigmented Purpuric Dermatosis. I was exposed heavily to agent orange in Vietnam in I Corps and the A Shau Valley. The Veterans Administration Schedule for Rating Disabilities was written 50 years ago and is terribly outdated. It is supposedly being revised and it is supposed to be done by what they term ” 2016. ” It is a literal tragedy how the VA and the system that is supposed to support the needs and conditions of the veterans and their service connected disabilities, procrastinates with the efficient mechanism being in place to assure the veterans get the comprehensive care they need. It is pitiful for me to have realize my physical well being has been dependent on a rating system created during WWII and that doesn’t even address modern day combat-related disabilities and medical conditions. It is a real joke.

  • Emil J. says:

    I am a medical professional and happen to have a full, total and permanent disability with the VA secondary to combat wounds in Vietnam. I am starting to manifest a skin condition known as Schamberg’s Disease which is also known as Pigmented Purpuric Dermatosis. I was exposed heavily to agent orange in Vietnam in I Corps and the A Shau Valley. The Veterans Administration Schedule for Rating Disabilities was written 50 years ago and is terribly outdated. It is supposedly being revised and it is supposed to be done by what they term ” 2016. ” It is a literal tragedy how the VA and the system that is supposed to support the needs and conditions of the veterans and their service connected disabilities, procrastinates with the efficient mechanism being in place to assure the veterans get the comprehensive care they need. It is pitiful for me to have realize my physical well being has been dependent on a rating system created during WWII and that doesn’t even address modern day combat-related disabilities and medical conditions. It is a real joke.

  • Erica says:

    Even though this article is from 2012,it has still not been updated! FACT: Complex Regional Pain Syndrome (CRPS/RSD) in the VA Rating System we are told even as of Nov 2015 to use analogous codes for this disease! When this disease was as you know Dr Buckenmaier CRPS does spread either while in the military or after wards or from surgeons nicking ones nerve. Chronic Fatigue Syndrome (CFS) & Fibromyalgia are in the VARSD yet one from the US Civil War ID by a US Army Union Dr is not???? Some VA-ROs 1 has given 1 vet 100% for whole body CRPS while others low-ball at 10% for the same whole body CRPS This needs to be fair all across the USA as well! The Veterans CRPS Community was told it would be in the VARSD in Jan 2016, yet nothing to date sadly for all of us & those currently being medically retired due to CRPS. Thanks for any help on this disease & subject.

  • Erica says:

    Even though this article is from 2012,it has still not been updated! FACT: Complex Regional Pain Syndrome (CRPS/RSD) in the VA Rating System we are told even as of Nov 2015 to use analogous codes for this disease! When this disease was as you know Dr Buckenmaier CRPS does spread either while in the military or after wards or from surgeons nicking ones nerve. Chronic Fatigue Syndrome (CFS) & Fibromyalgia are in the VARSD yet one from the US Civil War ID by a US Army Union Dr is not???? Some VA-ROs 1 has given 1 vet 100% for whole body CRPS while others low-ball at 10% for the same whole body CRPS This needs to be fair all across the USA as well! The Veterans CRPS Community was told it would be in the VARSD in Jan 2016, yet nothing to date sadly for all of us & those currently being medically retired due to CRPS. Thanks for any help on this disease & subject.

  • Derek Peeples says:

    I am a United States Naval veteran. I was honorably retired after sustaining five injuries from 2009-2010 and developing a severe case of Complex Regional Pain Syndrome. Through the VASRD no rating code even exists to compensate veterans for CRPS despite the condition being known to exist since the American Civil War. Across the nation through the Veterans Benefit Administration the lack of a VASRD rating code has impacted tens of hundreds of veterans claims in recent years. I personally have appealed such matter with VA Secretary McDonald and his staff. I had a response back from VBA Director Murphy on the matter that the VA was “working to updated the VASRD.” Back in 2012 despite that a code was promised to be added and the VASRD be updated no such code was established. Our government and the VA looking at the greater picture given the promise, obligation and mission thereof owe BILLIONS in back compensation to disabled veterans who had their claims either wrongly denied or were given ratings that medically were not supportive to compensation codes. The VA should do away with the VASRD and use what the medical profession uses ICD-10-CM for coding all the VA would have to update would be ratings specific to each code set. Using a “Google Cloud” VASRD-ICD-10-CM that can be accessed at all VA Regional Offices nationwide as well as on the Internet for use for veteran advocates and veterans would be but beneficial to all parties and would be more fair practice than the current code system. – V/r, Derek G. Peeples, USN Ret., Medical Insurance Coding and Billing Professional

  • Mike Jarrett says:

    I was notified by VBA that my service-connected disabilities met schedular criteria for Individual Unemployability. Yet when I filed for the IU I received very quickly a denial for IU because I did not meet schedular criteria for IU. I am so extremely confused along with my VSO from PVA who cannot give me any type of insight on the possibility of this denial since he has stated for years now that conditions do meet schedular criteria!! Anyone in the VBA system got anything on how this can be ?

  • Tiffany Parker says:

    Hi Erica,
    You seem to have a little understanding of the VA system and I am hoping you can help with my situation. I have a rare condition that is not in the schedule of ratings. How is an analogous decision made? I have a rare disease called NMO. I believe it is more analogous to MS because is shares more characteristics than it is to myelitis which I am currently assigned a code of 8010 for. NMO and MS have TM (myelitis) as a symptom. NMO and MS affect the spine and/or optical nerve. TM only affects the spine. NMO and MS are relapsing and TM is one time (rare time is may occur again). NMO is more severe than MS and TM. The only symptom I experienced caused by NMO was the induced TM. All are neurological conditions. Is a condition supposed to be determined to be analogous because they overall conditions are similar (NMO is more like MS) or is a condition that matches ONLY the symptom I experienced used to determine the analogous condition? I hope that made sense.

  • L T King says:

    Mr. Peeples,

    I know you posted only a handful of months ago, but I was wondering if anyone had ever given you more information of what the DoD was planning to do with CRPS ratings. I am currently active duty Navy and just received a diagnosis today of RSD/CRPS after a year of crippling pain and now a DVT due to the “temporary” fix of wearing a walking boot until the swelling/pain went away. My doctor didn’t say anything about whether this would impact my ability to continue serving, let alone get into anything about associated disability. Thanks in advance. v/r Lindsey King

  • L T King says:

    Mr. Peeples,

    I know you posted only a handful of months ago, but I was wondering if anyone had ever given you more information of what the DoD was planning to do with CRPS ratings. I am currently active duty Navy and just received a diagnosis today of RSD/CRPS after a year of crippling pain and now a DVT due to the “temporary” fix of wearing a walking boot until the swelling/pain went away. My doctor didn’t say anything about whether this would impact my ability to continue serving, let alone get into anything about associated disability. Thanks in advance. v/r Lindsey King

  • tewarehouse says:

    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.

  • James says:

    The VA failed to provide physical therapy after a total prosthetic ankle surgery causing my ankle to lock up. Nine months later my surgeon took me back in the operating room and manipulated my foot back and forth to break up the scar tissue. After this I started to have complex regional pain syndrome symptoms that as you know is without limitations when it comes to pain. The pain only got worse and then after my third total prosthetic ankle surgery was completed (Several Hours Long) they once again failed to provide physical therapy until eleven months after when they finally admitted me for six weeks of PT and after only eight days they sent me home telling me PT was not going to benefit me in any way. Just a few weeks later my surgeon told me that he thought that amputation would be the best thing to resolve the complex regional pain syndrome. This was now the second time that they had recommended me to have the amputation performed. Just a few weeks later the ortho doctor decided that he preferred I under go a new surgery to have a stimulator implant to resolve the CRPS that I did have yet it did not help and so just a few months after that my surgeon once again strongly recommend that I have my Right lower leg amputated. I had the amputation done and just as the ortho doctor predicted the complex regional pain syndrome type pain moved up my leg and it now persists from my stump to just above my knee. The pain doctors at the VA have still not been able to alleviate or decrease it’s maddening level of pain. The pain has no end and I cannot find anything to give me any degree of relief. I have pain all the time. It feels like my leg is on fire or it feels like I’m being electrocuted from my toes to just above my knee. Now for the past three years the very same type of pain has moved over to my left lower leg and foot. I just put in a claim for a new disability rating for the CRPS/RSD but I’m concerned that like the rest of my experience they will once again fail me. I’m service connected but this has never stopped them from making the right decision. If anyone has heard of anything that would help with the pain or a new code for CRPS disability from the VA I would love to hear about it.

    Many thanks to all.

  • flimjogot.com says:

    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.

  • Derek Peeples says:

    I am a United States Naval veteran. I was honorably retired after sustaining five injuries from 2009-2010 and developing a severe case of Complex Regional Pain Syndrome. Through the VASRD no rating code even exists to compensate veterans for CRPS despite the condition being known to exist since the American Civil War. Across the nation through the Veterans Benefit Administration the lack of a VASRD rating code has impacted tens of hundreds of veterans claims in recent years. I personally have appealed such matter with VA Secretary McDonald and his staff. I had a response back from VBA Director Murphy on the matter that the VA was “working to updated the VASRD.” Back in 2012 despite that a code was promised to be added and the VASRD be updated no such code was established. Our government and the VA looking at the greater picture given the promise, obligation and mission thereof owe BILLIONS in back compensation to disabled veterans who had their claims either wrongly denied or were given ratings that medically were not supportive to compensation codes. The VA should do away with the VASRD and use what the medical profession uses ICD-10-CM for coding all the VA would have to update would be ratings specific to each code set. Using a “Google Cloud” VASRD-ICD-10-CM that can be accessed at all VA Regional Offices nationwide as well as on the Internet for use for veteran advocates and veterans would be but beneficial to all parties and would be more fair practice than the current code system. – V/r, Derek G. Peeples, USN Ret., Medical Insurance Coding and Billing Professional

  • tewarehouse says:

    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.

  • Mike Jarrett says:

    I was notified by VBA that my service-connected disabilities met schedular criteria for Individual Unemployability. Yet when I filed for the IU I received very quickly a denial for IU because I did not meet schedular criteria for IU. I am so extremely confused along with my VSO from PVA who cannot give me any type of insight on the possibility of this denial since he has stated for years now that conditions do meet schedular criteria!! Anyone in the VBA system got anything on how this can be ?

  • flimjogot.com says:

    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.

  • James says:

    The VA failed to provide physical therapy after a total prosthetic ankle surgery causing my ankle to lock up. Nine months later my surgeon took me back in the operating room and manipulated my foot back and forth to break up the scar tissue. After this I started to have complex regional pain syndrome symptoms that as you know is without limitations when it comes to pain. The pain only got worse and then after my third total prosthetic ankle surgery was completed (Several Hours Long) they once again failed to provide physical therapy until eleven months after when they finally admitted me for six weeks of PT and after only eight days they sent me home telling me PT was not going to benefit me in any way. Just a few weeks later my surgeon told me that he thought that amputation would be the best thing to resolve the complex regional pain syndrome. This was now the second time that they had recommended me to have the amputation performed. Just a few weeks later the ortho doctor decided that he preferred I under go a new surgery to have a stimulator implant to resolve the CRPS that I did have yet it did not help and so just a few months after that my surgeon once again strongly recommend that I have my Right lower leg amputated. I had the amputation done and just as the ortho doctor predicted the complex regional pain syndrome type pain moved up my leg and it now persists from my stump to just above my knee. The pain doctors at the VA have still not been able to alleviate or decrease it’s maddening level of pain. The pain has no end and I cannot find anything to give me any degree of relief. I have pain all the time. It feels like my leg is on fire or it feels like I’m being electrocuted from my toes to just above my knee. Now for the past three years the very same type of pain has moved over to my left lower leg and foot. I just put in a claim for a new disability rating for the CRPS/RSD but I’m concerned that like the rest of my experience they will once again fail me. I’m service connected but this has never stopped them from making the right decision. If anyone has heard of anything that would help with the pain or a new code for CRPS disability from the VA I would love to hear about it.

    Many thanks to all.

  • Skip P says:

    I would like to see the VA system compensate Veterans fairly based on all conditions. It starts with a veteran receiving a fair and unbiased C&P exam. They have contractors performing these exams whom don’t have passion and consideration for the veterans and their condition. Much needs to be done to make the system better however it all starts with a C&P exam after the claim is filed. If the veteran is not getting a fair assessment of their condition then what do you expect the ending result to be.

    CLAIM DENIED!!!

  • Tiffany Parker says:

    Hi Erica,
    You seem to have a little understanding of the VA system and I am hoping you can help with my situation. I have a rare condition that is not in the schedule of ratings. How is an analogous decision made? I have a rare disease called NMO. I believe it is more analogous to MS because is shares more characteristics than it is to myelitis which I am currently assigned a code of 8010 for. NMO and MS have TM (myelitis) as a symptom. NMO and MS affect the spine and/or optical nerve. TM only affects the spine. NMO and MS are relapsing and TM is one time (rare time is may occur again). NMO is more severe than MS and TM. The only symptom I experienced caused by NMO was the induced TM. All are neurological conditions. Is a condition supposed to be determined to be analogous because they overall conditions are similar (NMO is more like MS) or is a condition that matches ONLY the symptom I experienced used to determine the analogous condition? I hope that made sense.


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