Question:

Hi Jim, My question is about the pyramiding. I have a service connected broken clavicle with severe ac joint separation as well as a torn rotator cuff. Should both of these be rated under one rating? I get 10% right now.

Jim's Reply:

In a nutshell, pyramiding is rating the same or similar symptoms under different diagnostic codes. Without having your records in front of me I'd guess that your formerly broken clavicle is healed and not disabling. That we've had an injury such as a broken bone doesn't automatically produce a rating unless there are residual disabling components like non-union or deformity.
 

AC joint separations aren't generally viewed as disabling, that's another finding that may get a 0% rating if it is rated at all. The 10% rating for a torn rotator cuff is the lowest rating you can have for that condition and that tells me that you may have an opportunity to increase that to as much as 30%.
 

If the shoulder is causing you pain upon motion and limited movement because of pain, you can file for an increase. The schedule for what it takes for an increase can be found here. Good luck.

 

§4.14 Avoidance of pyramiding.

The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation and the evaluation of the same manifestation under different diagnoses are to be avoided.