Hi Jim,
Thank You for all that you do.
I have been trying to find information on Parkinson's disease in the 38 CFR Book C, Schedule for Rating Disabilities. I am doing some research for an Agent Orange related claim and have not been able to find any break-downs for ratings. My friend is currently receiving a 20% disability rating for this disease. He is in the advanced stages and I am trying to assist in increasing his rating. Is there someplace else I should be looking?
Reply:
(This is a very complex question. In the interest of providing you with the best answer, I asked a senior RVSR to respond. VAWatchdog is thankful for this thorough, prompt reply and we genuinely appreciate the good work that so many VA employees are doing.)
Hi Jim,
Neurological conditions are the hardest to rate and where mistakes are frequently made because of lack of experience. Most RVSR’s do not know how to take a constellation of symptoms ( tremors, bradykinesia, fasciculations, balance problems) and put them together to give the Veteran the appropriate evaluation.
Parkinson’s Disease is evaluated under diagnostic code 8004 (paralysis agitans). It has a minimum evaluation of 30% so if the Veteran is receiving a 20 percent evaluation, there is an error there already. Neurological conditions that have minimum evaluations mean that the Veteran can get no less than that evaluation and it is usually assigned to someone who has very minimal symptoms. Once the symptoms become more pronounced, the Veteran is to be evaluated based on the specific body systems affected. Let me give you the basic breakdown:
Upper extremity issues (tremors, weakness, etc) should be rated under diagnostic code 8513-all radicular groups. Although it says “all radicular groups” it means all for the upper extremities only.
Lower extremity issues (same as upper) is usually rated under diagnostic code 8520 (sciatic nerve-this nerve is not specific to Parkinson’s Disease but it covers the entire leg so it is the most appropriate to use)
Dysphagia or dysarthria should be evaluated under diagnostic code 8210-the 9th cranial nerve .
Facial muscles ( which frequently affect those with Parkinson’s) are rated under diagnostic code 8207-7th cranial nerve.
Cognitive disorders are rated under diagnostic code 9327- Organic mental disorder, other (including personality change due to a general medical condition)
Bladder incontinence-usually neurogenic bladder- is rated under diagnostic code 7542.
Bowel problems are rated under diagnostic code 7332-Rectum and anus, impairment of sphincter control.
Most Veterans with advanced Parkinson’s Disease have major problems in the first 5 areas and easily reach the 100 percent evaluation with the potential for special monthly compensation at some level.
I probably told you more than you ever wanted to know about Parkinson’s Disease but wanted to give you an understanding of the full range of frequently rated issues for someone with advanced Parkinson’s disease.
(Signed)
VA RVSR/QRS