New Eye Diseases and Rating Formulas for Incapacitating Episodes Added to VA Disabilities List

The VA’s ratings system is broken down into 15 body systems.  Since 2009 the VA has brought together experts to review and modernize each of these systems and update their Schedule for Rating Disabilities. Through this process several revisions were made which affect the rating of diseases of the eye including adding three new diagnostic codes. The new codes are diabetic retinopathy, retinal dystrophy and post-chiasmal disorders.

The VA also updated the definitions of incapacitating episodes for eye conditions. Under these new definitions an “incapacitating episode” is a period of severe symptoms that requires a visit to a physician for treatment. “Treatments” include medical procedures such as surgeries, laser treatments, and injections into the eye area. As is always the case with VA disability claims documentation is vitally important. Your visits, treatments, and the progress of your condition must be thoroughly documented in your medical records.

Disability ratings are based on the number of incapacitating episodes in a 12 month period. A 60 percent rating is given if there are incapacitating episodes requiring 7 or more treatment visits during that time. Five or six treatment visits means a 40 percent rating. A 20 percent rating is given if there are incapacitating episodes requiring 3 or 4 treatment visits. And finally a 10 percent rating is assigned if the incapacitating episodes require 1 or 2 treatment visits in a 12 month period.

The VA says that these changes are to “better align with modern medicine.”  But some groups who advocate for veterans say that the changes are “ultimately designed to reduce payouts to veterans with disabilities.” As with any change in VA regulations, only time will tell for sure what the impact will be.

If your vision is impaired to due disease or injury which occurred during your military service, here are few additional facts which may be helpful in your quest for VA disability benefits.

The most common eye conditions rated by the VA include impaired vision, blindness in one or both eyes, conjunctivitis, and unhealed injuries. But, there are several others and some are direct service connected disabilities while others are secondary.

Eye conditions are rated by the VA based on three main measurements; central visual acuity, visual field, and muscle function. Visual acuity tests determine how focused or blurry images are at different distances. The visual field test determines what your entire range of vision is that can be seen when looking at a fixed point straight ahead. The Muscle Dysfunction Rating System measures how well the muscles of the eye move. For example, limited muscle function in one or both eyes can cause double-vision.

Additional compensation—known as Special Monthly Compensation is awarded for blindness. For VA rating purposes, an eye is blind if it has 5 over 200 vision or worse, or if your field of vision is 5 degrees or worse.

For loss of vision or any other service-connected medical issue, we are here to fight for your rights. Call us at Cuddigan Law for a free, no-obligation appointment to evaluate your specific situation.

 

 

Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska