Question:
Hello Sir, I recently had a surgery for an artificial disc replacement and was hospitalized for a few weeks after. There is not currently a rating for a prosthetic implant in the spine, but areas such as the shoulder, elbow, wrist, and ankle allow for a 100% rating for one year following implantation, after the initial month following a hospital discharge. Replacement of the hip and knee allow for a 100% rating for four months following implantation. (Prosthetic Implants and Resurfacing, diagnostic codes 5051-5056). I have submitted for my temporary 100% for what my surgeon estimates is a 3-6 month recovery, but how can I get the VA to consider my spine’s new titanium addition as with other areas of the body?
Jim's Reply:
You tell VA just what you told me and you ask for extraschedular consideration. The VA is prepared to step outside the box and give some thought to why you're saying what you're telling them. That things change in health care happens all the time and VA adapts the ratings schedule to fit settings just like you speak to.
If you can have your doctor agree with you in notes to your chart and record, that will have a lot of impact. If the provider tells the same story you do this should be a chip shot.
Be prepared to appeal. This is the VA you're dealing with and just because you make a logical argument doesn't mean you'll prevail the first time around. However, your logic is sound and if you are denied, I'd predict the appeal will go your way.
Good luck sir.