Posted on Nov 12, 2023
Just got 0% rating from VA for chronic rhinitis under the Pact Act. I thought this was supposed to be presumptive. Any suggestions?
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Posted 1 y ago
Responses: 17
For a claim to be service-connected, you need to show:
1) You have a disabling condition (i.e., medical documentation);
2) That you were serving in the military (active duty, on military orders as a reservist, etc.), possibly during a specified time period or location;
3) That a linkage between the two exists. This can either be by showing that the disabling condition developed while on military service or that there was a proximate cause that occured during your service if you developed the condition after your discharge.
For a presumptive condition, you normally have to show that you were at a specified location during a certain time period and/or that you were serving in the military during a certain timeframe and that you have a disabling condition (items #1 and #2). If you show that, then the linkage is assumed to have been service-connected.
In your case, under the PACT Act all you needed to prove was that you served in those specified locations during the specified timeframes* and the service connection is established (it is presumed that if you have a condition it was caused by your service at those locations during that time-frame).
That's one part.
The second is to determine HOW disabling the condition is to the veteran. From your description, it sounds that the chronic rhinitis was deemed as service-connected, but that you were rated as 0% disabling.
Look at the notice the VA sent you, there should be a condition code on it that will match up to a determination*. There should be a detailed explanation on how the adjudication was made* that it was 0% (0% rating is called a "non-compensable disability"). 0% means "you have it, but it doesn't impact you at the moment. If it develops further, file a supplemental claim for reevaluation".
Bottom line - the medical evidence that was evaluated didn't show that your rhinitis was disabling to any degree.
On the positive side, a non-compensable disability does bring with it eligibility for many VA benefits*.
If you disagree with that rating, then you can have it go through the Decision Review process* (used to be called the "Appeals process"). You'll have three options - Supplemental Claim, Higher-level review, or to take it to an Appeals Board.
Are you working with someone (state veterans affairs representative, representative from a VSO, etc) or are you doing the claim yourself? If the later, you really should talk connect with a representative as they will be knowledgeable in your options and can give you the best 'real-time' advice on what to do.
--------------------------------------------
* PACT Act eligibility for presumptive exposure to burn pits:
● Service in any of these locations on or after September 11, 2001: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or the airspace above any of these locations
● Service in any of these locations on or after August 2, 1990: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, The United Arab Emirates (UAE), or the airspace above any of these locations
* Disability ratings are covered in Subpart B, of Part 4, to Chapter I in the Title 38 Code of Federal Regulations - https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B
* The PROCESS the adjuacator follows is laid out in the VA's manual - https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/ [login to see] 01018/content/ [login to see] 80967/M21-1-Part-V-Subpart-iii-Chapter-4-Section-A-Respiratory-Conditions
* Decision Reviews and appeals - https://www.va.gov/decision-reviews/
* Non-compensable disability benefit eligibility - https://www.va.gov/resources/non-compensable-disability/
1) You have a disabling condition (i.e., medical documentation);
2) That you were serving in the military (active duty, on military orders as a reservist, etc.), possibly during a specified time period or location;
3) That a linkage between the two exists. This can either be by showing that the disabling condition developed while on military service or that there was a proximate cause that occured during your service if you developed the condition after your discharge.
For a presumptive condition, you normally have to show that you were at a specified location during a certain time period and/or that you were serving in the military during a certain timeframe and that you have a disabling condition (items #1 and #2). If you show that, then the linkage is assumed to have been service-connected.
In your case, under the PACT Act all you needed to prove was that you served in those specified locations during the specified timeframes* and the service connection is established (it is presumed that if you have a condition it was caused by your service at those locations during that time-frame).
That's one part.
The second is to determine HOW disabling the condition is to the veteran. From your description, it sounds that the chronic rhinitis was deemed as service-connected, but that you were rated as 0% disabling.
Look at the notice the VA sent you, there should be a condition code on it that will match up to a determination*. There should be a detailed explanation on how the adjudication was made* that it was 0% (0% rating is called a "non-compensable disability"). 0% means "you have it, but it doesn't impact you at the moment. If it develops further, file a supplemental claim for reevaluation".
Bottom line - the medical evidence that was evaluated didn't show that your rhinitis was disabling to any degree.
On the positive side, a non-compensable disability does bring with it eligibility for many VA benefits*.
If you disagree with that rating, then you can have it go through the Decision Review process* (used to be called the "Appeals process"). You'll have three options - Supplemental Claim, Higher-level review, or to take it to an Appeals Board.
Are you working with someone (state veterans affairs representative, representative from a VSO, etc) or are you doing the claim yourself? If the later, you really should talk connect with a representative as they will be knowledgeable in your options and can give you the best 'real-time' advice on what to do.
--------------------------------------------
* PACT Act eligibility for presumptive exposure to burn pits:
● Service in any of these locations on or after September 11, 2001: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or the airspace above any of these locations
● Service in any of these locations on or after August 2, 1990: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, The United Arab Emirates (UAE), or the airspace above any of these locations
* Disability ratings are covered in Subpart B, of Part 4, to Chapter I in the Title 38 Code of Federal Regulations - https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B
* The PROCESS the adjuacator follows is laid out in the VA's manual - https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/ [login to see] 01018/content/ [login to see] 80967/M21-1-Part-V-Subpart-iii-Chapter-4-Section-A-Respiratory-Conditions
* Decision Reviews and appeals - https://www.va.gov/decision-reviews/
* Non-compensable disability benefit eligibility - https://www.va.gov/resources/non-compensable-disability/
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COL Randall C.
SPC Wesley Parker - You're obviously bitter based on a bad interaction or not being able to prove something to the VA, and because of that you seem to be looking to grind an axe with someone.
"Someone like me" gave an answer to the poster about why he might have been rated at 0% as well as information why a VA adjudicator might have made that decision.
My response was obviously for his specific situation, but if you want to discuss how the VA rates Hypertension*, by all means, please share and the community (myself included) will try to help you if we can.
-----------------------------
* https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/ [login to see] 01018/content/ [login to see] 14520/M21-1-Part-V-Subpart-iii-Chapter-5-Cardiovascular-System-Conditions
"Someone like me" gave an answer to the poster about why he might have been rated at 0% as well as information why a VA adjudicator might have made that decision.
My response was obviously for his specific situation, but if you want to discuss how the VA rates Hypertension*, by all means, please share and the community (myself included) will try to help you if we can.
-----------------------------
* https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/ [login to see] 01018/content/ [login to see] 14520/M21-1-Part-V-Subpart-iii-Chapter-5-Cardiovascular-System-Conditions
M21-1-Part-V-Subpart-iii-Chapter-5-Cardiovascular-System-Conditions
{{metaDescription}}
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SPC Wesley Parker
I'm very well acquainted with how the VA rates compensation for hypertension but that doesn't make it right. From what I've been able to determine the VA has awarded 0% compensation to over 80% of hypertension claims by Vietnam vets. Many of us old timers believe that people like you are stalling until we die off, so you won't have to bother with us anymore. Just keep dazzling us with statistics until we're no longer around to make a fuss! I've paid my dues and I deserve better!!!
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COL Randall C.
SPC Wesley Parker - "People like me" are individuals that try to help other veterans. Sometimes the answer helps and sometimes the answer is something they don't want (or refuse) to hear.
"People like me" are individuals who have no connection to the VA, but try to help others navigate though the bureaucracy of that organization by sharing the information we've learned.
"People like me" are ones that try to help rather than lashing out blindly because they internalized a response given to someone else.
Your claim of "the VA has awarded 0% compensation to over 80% of hypertension claims by Vietnam vets" is a bit off. It's 80% (actually 82.1%) of recent PACT Act claims for Hypertension, not all hypertension claims by Vietnam vets. However you do have a good point regarding the high incidence of non-compensatory ratings.
To meet a rating higher than 0% is straightforward. The attached chart shows how the rating is determined. To have a rating above 0% you need to show a history of having a diastolic pressure predominantly equal or greater than 100 or a systolic pressure predominantly equal or greater than 160. "Predominantly" for the VA means that the readings were taken two or more times on at least three different days with most of those readings being in the different categories as shown.
If you DO have medical records showing that, then you were obviously given a wrong rating. If that is the case, you should work with a VSO and have them submit a "CUE" claim (Clear and Unmistakable Error).
Keep in mind that a non-compensatory rating means that it IS service-connected but that it hasn't met the criteria for a higher rating. Because it is a service-connected condition, that means you may be eligible for a number of benefits* from the VA including health care, vision care, prescriptions, etc.
Additionally, if there are any other conditions that have developed because of your hypertension (such as heart disease, kidney or eye problems, changes with memory or understanding, dementia, etc.), then you have the basis of a "secondary service-connected" (SSC) claim*.
Of course, this are just some comments from "people like me" based on the information I was able to glean from your above comments.
------------------------------------------------
* VA benefits someone with a non-compensatory rating are eligible for - https://www.va.gov/resources/non-compensable-disability/
* Secondary service-connected claim - a claim for a new disability that's linked to a service-connected disability you already have. You can file a secondary claim to get more disability benefits for a new disability that's linked to a service-connected disability you already have - https://www.va.gov/disability/how-to-file-claim/when-to-file/
"People like me" are individuals who have no connection to the VA, but try to help others navigate though the bureaucracy of that organization by sharing the information we've learned.
"People like me" are ones that try to help rather than lashing out blindly because they internalized a response given to someone else.
Your claim of "the VA has awarded 0% compensation to over 80% of hypertension claims by Vietnam vets" is a bit off. It's 80% (actually 82.1%) of recent PACT Act claims for Hypertension, not all hypertension claims by Vietnam vets. However you do have a good point regarding the high incidence of non-compensatory ratings.
To meet a rating higher than 0% is straightforward. The attached chart shows how the rating is determined. To have a rating above 0% you need to show a history of having a diastolic pressure predominantly equal or greater than 100 or a systolic pressure predominantly equal or greater than 160. "Predominantly" for the VA means that the readings were taken two or more times on at least three different days with most of those readings being in the different categories as shown.
If you DO have medical records showing that, then you were obviously given a wrong rating. If that is the case, you should work with a VSO and have them submit a "CUE" claim (Clear and Unmistakable Error).
Keep in mind that a non-compensatory rating means that it IS service-connected but that it hasn't met the criteria for a higher rating. Because it is a service-connected condition, that means you may be eligible for a number of benefits* from the VA including health care, vision care, prescriptions, etc.
Additionally, if there are any other conditions that have developed because of your hypertension (such as heart disease, kidney or eye problems, changes with memory or understanding, dementia, etc.), then you have the basis of a "secondary service-connected" (SSC) claim*.
Of course, this are just some comments from "people like me" based on the information I was able to glean from your above comments.
------------------------------------------------
* VA benefits someone with a non-compensatory rating are eligible for - https://www.va.gov/resources/non-compensable-disability/
* Secondary service-connected claim - a claim for a new disability that's linked to a service-connected disability you already have. You can file a secondary claim to get more disability benefits for a new disability that's linked to a service-connected disability you already have - https://www.va.gov/disability/how-to-file-claim/when-to-file/
Non-compensable disability | Veterans Affairs
If you receive a 0% disability rating for a service-connected condition, we call this a non-compensable disability. It means you can’t get disability compensation (payments) for this condition. But you may be eligible for other VA benefits. Find out what benefits you qualify for with a 0% disability rating and if you can file for an increased disability rating.
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SPC Wesley Parker
Thank you for your response to my comment but I can't pay bills with statistics. I wish you the very best.
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Same for me, they said because I did not require surgery to fix it, I couldn't get a higher rating.
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Too many people thinking that the PACT act is going to be the deciding factor in disability claims. The rating structure of each condition HAS NOT changed. The PACT just says you can service connect based on being exposed, by being in one of the locations listed. The presumption is that the exposure can be used as casuing a condition, you still need to have the condition to the extent specified in 38 USC
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