Preparing a Winning Claim before the Department of Veterans Affairs

Size: px
Start display at page:

Download "Preparing a Winning Claim before the Department of Veterans Affairs"

Transcription

1 Preparing a Winning Claim before the Department of Veterans Affairs 8/11/2014 Gallian Welker & Beckstrom, LC

2 Introduction. The VA is arguably one of the largest bureaucracies in human history. Currently, the VA has 850,000 active claims, 500,000 of which are more than 18 months old. Efforts to streamline the process have run into significant bureaucratic resistance. 8/11/2014 2

3 Introduction, cont. Most current claims are from veterans of the Vietnam era, who waited 20 years or more to make their claims. Thus, their claims (i) are more remote from their injuries, (ii) the evidence is difficult to obtain and (iii) the nexus between their injuries and their serviceconnected disabilities are more difficult to prove. 8/11/2014 3

4 Introduction, cont. The veterans of the more recent wars are not waiting as long to document and file their claims. Thus, their claims (i) are more recent, (ii) the documentation is more modern and accessible and (iii) the nexus between their injuries and their disabilities is easier to prove. In addition, the more recent veterans high a higher survival rate and their injuries and disabilities can be more complex; i.e. Traumatic Brain Injuries (TBI). (It isn t the same as having a finger shot off.) 8/11/2014 4

5 Introduction, cont. The Bottom Line is that there is going to be a tidal wave of claims at the same time that the VA is trying to clear the decks of the old, outstanding claims. 8/11/2014 5

6 Eligibility. Entitlement is based upon a two-party contract at time of enlistment, that in the event that the veteran is injured during service, the VA will provide (i) medical treatment for those injuries and (ii) compensation for service-connected injuries. 8/11/2014 6

7 Character of Discharge. Honorable eligible for all benefits. General (Honorable lite) eligible for most benefits. Other Than Honorable grey area where VA has discretion as to which benefits to assign. Dishonorable ineligible for most benefits. Bad Conduct ineligible for any benefits. Insufficient period of service under 24 months, generally ineligible for any benefits. 8/11/2014 7

8 VA Duty to Assist. The VA s mission is to honor the contract in a non-adversarial manner. The Duty to Assist requires the VA to identify the viable claims from the record, even if the veteran didn t make the claim. The Duty to Assist includes the requirement to account for the veteran s own inability to contribute to the development of the claims. 8/11/2014 8

9 Compensation Compensation replacement income for diminution in ability to engage in gainful employment. In-service injury there must be evidence in the service medical records of the original injury; The Veteran must have a current disability know the diagnostic codes; Chronicity there can be no intervening causes that overshadow the original injury. 8/11/2014 9

10 Improved Pension Improved Pension economic backstop for veterans who have no service-connected disability. Means tested inquiry into both income and assets. Qualifications served during time of war and is over 65 or totally disabled (if under 65). 8/11/

11 Medical Claims. Orthopedic injuries. Organic injuries. Agent Orange related diseases. Secondary Claims. Be sure to find the ICDM (Diagnostic Code) which matches the symptoms or condition. 8/11/

12 Psychological injuries. PTSD. Secondary Claims. 8/11/

13 Extraordinary Benefits. TDIU Total Disability based upon Individual Unemployability. Housebound Assistance. Aid & Attendance. 8/11/

14 Timeline. Original Claim filing of the Original Claim at the VA Regional Office (VARO) establishes the Effective Date. Jurisdiction is vested in the VARO of the state where the Veteran resides. 8/11/

15 Timeline, cont. The Rating Decision - The VARO will issue a Rating Decision that catalogues the documentation reviewed and the rationale for the decision. 8/11/

16 Timeline, cont. Notice of Disagreement (NOD) - The Veteran has 1 year to file a Notice of Disagreement (appeal). Acknowledgement of NOD - The VARO will give the Veteran the option of having a DRO by a higher level rating officer at the same VARO or sending the appeal directly to the Board of Veterans Appeals. The VARO will issue a Statement of the Case and/or a Supplemental Statement of the Case (after DRO and before transmitting to the BVA). 8/11/

17 Re-opened Claims. Re-opened Claims. There is no limit to the number of re-opened claims that a veteran can file, but each successive re-opened claim must be based upon new and material evidence that was not considered in previous Rating Decisions. 8/11/

18 Appeal to Board of Veterans Appeals (BVA). The BVA is the highest level of appeal within the VA. Usually involves an in-person hearing, in either the Regional Office or Washington DC; or a teleconference from a local office. 8/11/

19 Court of Appeal for Veterans Claims (CAVC). First level of non-va review. The CAVC has very strict timelines and filing requirements, along with filing fees. 8/11/

20 Federal District Court (DC). Second level of non-va review. 8/11/

21 Getting Help with the Process. There is a large amount of poorly developed claims, over-proven claims, shotgun claims and spurious claims that are clogging the system. The VSO s (God Bless Em) are really overworked and do the best they can. But they don t work for the VA and can t be blamed for the VA s errors. Congress has statutorily barred private attorneys from being compensated for work on Original Claims, but you can always ask for pro bono assistance. 8/11/

22 Documentation. You need the Veteran s service and medical records from: NPRC- National Personnel Records Center Individual Service Branch Records Centers Veteran s C-file (claims file) from the VA Regional Office or a local VA Business Office. 8/11/

23 Medical Evidence VA treatment records from VAMC (Veterans Administration Medical Center) and CBOC (Community Based Outpatient Clinic). Be specific about the diagnostic codes that apply to the medical conditions. Private treatment records. C&P exams (Compensation and Pension). Nexus Exams - Independent medical examinations. 8/11/

24 C&P exams (Compensation and Pension). Upon the filing of a claim, the VA will send the Veteran to VA-retained doctors or experts to render an opinion regarding disability, based upon an examination and a review of the C- File. 8/11/

25 Nexus Exams - Independent medical opinions. The Veteran has the option of obtaining an independent medical opinion regarding disability, based upon an examination and a review of the C-File. The VA is rather unforgiving of nexus exams if the C-File was not reviewed. 8/11/

26 Writing a Good Appeal. Know your case. Know the medicine. Know the VA! 8/11/

27 Buddy Statements The VA gives precious little weight to Buddy Statements. To be useful, such statements need to be: Credible believable, based upon personal knowledge; and Competent reliable, based upon training and experience. (If your buddy isn t a doctor, they can t give a credible statement about most medical issues.) 8/11/

28 What Does It Mean to Win? The VA will make monthly payments to the Veteran for the rest of their life, with some exceptions. The VA will make a one-time payment of retroactive benefits, from the effective date of the Original Claim, until the date of the Rating Decision that granted the benefits. 8/11/

29 Documents needed. VA SF 180 to obtain service duty and medical records. VA 3288 to obtain a copy of the C-file. A HIPPA Release to obtain copies of private medical records. 8/11/

30 Correspondence. Be sure to keep copies of all letters sent to the VA. Be sure to put the date on everything you send. Be sure to put your claim number on the top of each page. Be sure to keep a copy of everything you receive from the VA, along with the envelope that it came in. 8/11/

31 Calendaring. Make sure to have a written calendar to keep track of deadlines. 8/11/

32 Conclusion You can do it! Take charge and do as much of the work as you can! Ask for help. Don t believe everything you read and hear. Don t give up! 8/11/

33

34

35

36

37

38

39

40

41 Appendix B to Part 4.--Numerical Index of Disabilities Diagnostic Code No. THE MUSCULOSKELETAL SYSTEM Acute, Subacute, or Chronic Diseases 5000 Osteomyelitis, acute, subacute, or chronic Bones and Joints, tuberculosis Arthritis, rheumatoid (atrophic) Arthritis, degenerative (hypertrophic or osteoarthritis) Arthritis, gonorrheal Arthritis, pneumococcic Arthritis, typhoid Arthritis, syphilitic Arthritis, streptococcic Arthritis, other types (specify) Arthritis, due to trauma Bones, caisson disease Bones, new growths, malignant Osteoporosis, with joint manifestations Osteomalacia Bones, new growths, benign Osteitis deformans Gout Hydrarthrosis, intermittent Bursitis Synovitis Myositis Periostitis Myositis ossificans Tenosynovitis Fibromyalgia. Prosthetic Implants 5051 Shoulder replacement (prosthesis) Elbow replacement (prosthesis) Wrist replacement (prosthesis) Hip replacement (prosthesis) Knee replacement (prosthesis) Ankle replacement (prosthesis). Combination of Disabilities 5104 Anatomical loss of one hand and loss of use of one foot Anatomical loss of one foot and loss of use of one hand Anatomical loss of both hands Anatomical loss of both feet Anatomical loss of one hand and one foot Loss of use of both hands Loss of use of both feet Loss of use of one hand and one foot. Amputations: Upper Extremity Arm amputation of: 5120 Disarticulation Above insertion of deltoid.

42 5122 Below insertion of deltoid. Forearm amputation of: 5123 Above insertion of pronator teres Below insertion of pronator teres Hand, loss of use of. Multiple Finger Amputations 5126 Five digits of one hand. Four digits of one hand: 5127 Thumb, index, long and ring Thumb, index, long and little Thumb, index, ring and little Thumb, long, ring and little Index, long, ring and little. Three digits of one hand: 5132 Thumb, index and long Thumb, index and ring Thumb, index and little Thumb, long and ring Thumb, long and little Thumb, ring and little Index, long and ring Index, long and little Index, ring and little Long, ring and little. Two digits of one hand: 5142 Thumb and index Thumb and long Thumb and ring Thumb and little Index and long Index and ring Index and little Long and ring Long and little Ring and little. Single finger: 5152 Thumb Index finger Long finger Ring finger Little finger. Amputations: Lower Extremity Thigh amputation of: 5160 Disarticulation Upper third Middle or lower thirds. Leg amputation of: 5163 With defective stump Not improvable by prosthesis controlled by natural knee action At a lower level, permitting prosthesis Forefoot, proximal to metatarsal bones Foot, loss of use of Toes, all, without metatarsal loss Toe, great.

43 5172 Toes, other than great, with removal of metatarsal head Toes, three or more, without metatarsal involvement. Shoulder and Arm 5200 Scapulohumeral articulation, ankylosis Arm, limitation of motion Humerus, other impairment Clavicle or scapula, impairment. Elbow and Forearm 5205 Elbow, ankylosis Forearm, limitation of flexion Forearm, limitation of extension Forearm, flexion limited Elbow, other impairment Radius and ulna, nonunion Ulna, impairment Radius, impairment. Wrist 5213 Supination and pronation, impairment Wrist, ankylosis Wrist, limitation of motion. Limitation of Motion Multiple Digits: Unfavorable Ankylosis: 5216 Five digits of one hand Four digits of one hand Three digits of one hand Two digits of one hand. Multiple Digits: Favorable Ankylosis: 5220 Five digits of one hand Four digits of one hand Three digits of one hand Two digits of one hand. Ankylosis of Individual Digits: 5224 Thumb Index finger Long finger Ring or little finger. Limitation of Motion of Individual Digits: 5228 Thumb Index or long finger. Spine

44 5230 Ring or little finger Vertebral fracture or dislocation Sacroiliac injury and weakness Lumbosacral or cervical strain Spinal stenosis Spondylolisthesis or segmental instability Ankylosing spondylitis Spinal fusion Degenerative arthritis Intervertebral disc syndrome. Hip and Thigh 5250 Hip, ankylosis Thigh, limitation of extension Thigh, limitation of flexion Thigh, impairment Hip, flail joint Femur, impairment. Knee and Leg 5256 Knee, ankylosis Knee, other impairment Cartilage, semilunar, dislocated Cartilage, semilunar, removal Leg, limitation of flexion Leg, limitation of extension Tibia and fibula, impairment Genu recurvatum. Ankle 5270 Ankle, ankylosis Ankle, limited motion Subastragalar or tarsal joint, ankylosis Os calcis or astragalus, malunion Astragalectomy. Shortening of the Lower Extremity 5275 Bones, of the lower extremity The Foot 5276 Flatfoot, acquired Weak foot, bilateral Claw foot (pes cavus), acquired Metatarsalgia, anterior (Morton's disease) Hallux valgus Hallux rigidus Hammer toe Tarsal or metatarsal bones Foot injuries, other. The Skull 5296 Loss of part of Removal of. The Ribs

45 5298 Removal of. The Coccyx MUSCLE INJURIES Shoulder Girdle and Arm 5301 Group I Function: Upward rotation of scapula Group II Function: Depression of arm Group III Function: Elevation and abduction of arm Group IV Function: Stabilization of shoulder Group V Function: Elbow supination Group VI Function: Extension of elbow. Forearm and Hand 5307 Group VII Function: Flexion of wrist and fingers Group VIII Function: Extension of wrist, fingers, thumb Group IX Function: Forearm muscles. Foot and Leg 5310 Group X Function: Movement of forefoot and toes Group XI Function: Propulsion of foot Group XII Function: Dorsiflexion. Pelvic Girdle and Thigh 5313 Group XIII Function: Extension of hip and flexion of knee Group XIV Function: Extension of knee Group XV Function: Adduction of hip Group XVI Function: Flexion of hip Group XVII Function: Extension of hip Group XVIII Function: Outward rotation of thigh. Torso and Neck 5319 Group XIX Function: Abdominal wall and lower thorax Group XX Function: Postural support of body Group XXI Function: Respiration Group XXII Function: Rotary and forward movements, head Group XXIII Function: Movements of head. Miscellaneous 5324 Diaphragm, rupture Muscle injury, facial muscles Muscle hernia Muscle, neoplasm of, malignant Muscle, neoplasm of, benign Sarcoma, soft tissue. THE EYE Diseases of the Eye

46 6000 Uveitis Keratitis Scleritis Iritis Cyclitis Choroiditis Retinitis Hemorrhage, intra-ocular, recent Retina, detachment Eye, injury of, unhealed Eye, tuberculosis Retina, localized scars Glaucoma, congestive or inflammatory Glaucoma, simple, primary, noncongestive New growths, malignant, eyeball New growths, benign, eyeball and adnexa Nystagmus, central Conjunctivitis, trachomatous, chronic Conjunctivitis, other, chronic Ptosis unilateral or bilateral Ectropion Entropion Lagophthalmos Eyebrows, loss Eyelashes, loss Epiphora Neuritis, optic Cataract, traumatic Cataract, senile, and others Aphakia Accommodation, paralysis Dacryocystitis Eyelids, loss of portion Lens, crystalline, dislocation Pterygium Keratoconus. Impairment of Central Visual Acuity 6061 Anatomical loss both eyes Blindness, both eyes, only light perception. Anatomical loss of 1 eye: 6063 Other eye 5/200 (1.5/60) Other eye 10/200 (3/60) Other eye 15/200 (4.5/60) Other eye 20/200 (6/60) Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Blindness in 1 eye, only light perception: 6067 Other eye 5/200 (1.5/60) Other eye 10/200 (3/60) Other eye 15/200 (4.5/60) Other eye 20/200 (6/60) Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12).

47 Vision in 1 eye 5/200 (1.5/60): 6071 Other eye 5/200 (1.5/60) Other eye 10/200 (3/60) Other eye 15/200 (4.5/60) Other eye 20/200 (6/60) Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Vision in 1 eye 10/200 (3/60): 6075 Other eye 10/200 (3/60) Other eye 15/200 (4.5/60) Other eye 20/200 (6/60) Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Vision in 1 eye 15/200 (4.5/60): 6075 Other eye 15/200 (4.5/60) Other eye 20/200 (6/60) Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Vision in 1 eye 20/200 (6/60): 6075 Other eye 20/200 (6/60) Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Vision in one 1 20/100 (6/30): 6078 Other eye 20/100 (6/30) Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Vision in 1 eye 20/70 (6/21): 6078 Other eye 20/70 (6/21) Other eye 20/50 (6/15) Other eye 20/40 (6/12). Vision in 1 eye 20/50 (6/15): 6078 Other eye 20/50 (6/15) Other eye 20/40 (6/12). Impairment of Field Vision: 6080 Field vision, impairment Scotoma. Impairment of Muscle Function: 6090 Diplopia Symblepharon Diplopia, limited muscle function. THE EAR 6200 Chronic suppurative otitis media Chronic nonsuppurative otitis media.

48 6202 Otosclerosis Peripheral vestibular disorders Meniere's syndrome Loss of auricle Malignant neoplasm Benign neoplasm Chronic otitis externa Tympanic membrane Tinnitus, recurrent. OTHER SENSE ORGANS 6275 Smell, complete loss Taste, complete loss. INFECTIOUS DISEASES, IMMUNE DISORDERS AND NUTRITIONAL DEFICIENCIES 6300 Cholera, Asiatic Visceral Leishmaniasis Leprosy (Hansen's Disease) Malaria Lymphatic Filariasis Bartonellosis Plague Relapsing fever Rheumatic fever Syphilis Tuberculosis, miliary Avitaminosis Beriberi Pellagra Brucellosis Typhus, scrub Melioidosis Lyme disease Parasitic diseases Lupus erythematosus HIV-Related Illness Chronic Fatigue Syndrome (CFS). THE RESPIRATORY SYSTEM Nose and Throat 6502 Septum, nasal, deviation Nose, loss of part of, or scars Sinusitis, pansinusitis, chronic Sinusitis, ethmoid, chronic Sinusitis, frontal, chronic Sinusitis, maxillary, chronic Sinusitis, sphenoid, chronic Laryngitis, tuberculous Laryngitis, chronic Laryngectomy, total Aphonia, complete organic Larynx, stenosis of Pharynx, injuries to Allergic or vasomotor rhinitis Bacterial rhinitis Granulomatous rhinitis.

49 Trachea and Bronchi 6600 Bronchitis, chronic Bronchiectasis Asthma, bronchial Emphysema, pulmonary Chronic obstructive pulmonary disease. Lungs and Pleura Tuberculosis Ratings for Pulmonary Tuberculosis (Chronic) Entitled on August 19, 1968: 6701 Active, far advanced Active, moderately advanced Active, minimal Active, advancement unspecified Inactive, far advanced Inactive, moderately advanced Inactive, minimal Inactive, advancement unspecified. Ratings for Pulmonary Tuberculosis Initially Evaluated After August 19, 1968: 6730 Chronic, active Chronic, inactive Pleurisy, active or inactive. Nontuberculous Diseases 6817 Pulmonary Vascular Disease Neoplasms, malignant Neoplasms, benign. Bacterial Infections of the Lung 6822 Actinomycosis Nocardiosis Chronic lung abscess. Interstitial Lung Disease 6825 Fibrosis of lung, diffuse interstitial Desquamative interstitial pneumonitis Pulmonary alveolar proteinosis Eosinophilic granuloma Drug-induced, pneumonitis & fibrosis Radiation-induced, pneumonitis & fibrosis Hypersensitivity pneumonitis Pneumoconiosis Asbestosis. Mycotic Lung Disease

50 6834 Histoplasmosis Coccidioidomycosis Blastomycosis Cryptococcosis Aspergillosis Mucormycosis. Restrictive Lung Disease 6840 Diaphragm paralysis or paresis Spinal cord injury with respiratory insufficiency Kyphoscoliosis, pectus excavatum/carinatum Traumatic chest wall defect Post-surgical residual Pleural effusion or fibrosis Sarcoidosis Sleep Apnea Syndromes. THE CARDIOVASCULAR SYSTEM Diseases of the Heart 7000 Valvular heart disease Endocarditis Pericarditis Pericardial adhesions Syphilitic heart disease Arteriosclerotic heart disease Myocardial infarction Hypertensive heart disease Hyperthyroid heart disease Supraventricular arrhythmias Ventricular arrhythmias Atrioventricular block Heart valve replacement Coronary bypass surgery Implantable cardiac pacemakers Cardiac transplantation Cardiomyopathy. Diseases of the Arteries and Veins 7101 Hypertensive vascular disease Aortic aneurysm Aneurysm, large artery Aneurysm, small artery Arteriovenous fistula, traumatic Arteriosclerosis obliterans Thrombo-angiitis obliterans (Buerger's Disease) Raynaud's syndrome Angioneurotic edema Erythromelalgia Varicose veins Post-phlebitic syndrome Cold injury residuals Soft tissue sarcoma. THE DIGESTIVE SYSTEM 7200 Mouth, injuries Lips, injuries.

51 7202 Tongue, loss Esophagus, stricture Esophagus, spasm Esophagus, diverticulum Peritoneum, adhesions Ulcer, gastric Ulcer, duodenal Ulcer, marginal Gastritis, hypertrophic Postgastrectomy syndromes Stomach, stenosis Stomach, injury of, residuals Liver, injury of, residuals Liver, cirrhosis Cholecystitis, chronic Cholelithiasis, chronic Cholangitis, chronic Gall bladder, injury Gall bladder, removal Colon, irritable syndrome Amebiasis Dysentery, bacillary Colitis, ulcerative Distomiasis, intestinal or hepatic Enteritis, chronic Enterocolitis, chronic Diverticulitis Intestine, small, resection Intestine, large, resection Intestine, fistula Peritonitis Rectum & anus, impairment Rectum & anus, stricture Rectum, prolapse Ano, fistula in Hemorrhoids Pruritus ani Hernia, inguinal Hernia, ventral, postoperative Hernia, femoral Visceroptosis Neoplasms, malignant Neoplasms, benign Liver disease, chronic, without cirrhosis Hernia, hiatal Pancreatitis Vagotomy Liver transplant Hepatitis C. THE GENITOURINARY SYSTEM 7500 Kidney, removal Kidney, abscess Nephritis, chronic Pyelonephritis, chronic Kidney, tuberculosis Nephrosclerosis, arteriolar Nephrolithiasis Hydronephrosis Ureterolithiasis Ureter, stricture Cystitis, chronic.

52 7515 Bladder, calculus Bladder, fistula Bladder, injury Urethra, stricture Urethra, fistula Penis, removal of half or more Penis, removal of glans Penis, deformity, with loss of erectile power Testis, atrophy, complete Testis, removal Epididymo-orchitis, chronic only Prostate gland Malignant neoplasms Benign neoplasms Renal disease, chronic Kidney transplant Renal tubular disorders Kidneys, cystic diseases Atherosclerotic renal disease Toxic nephropathy Glomerulonephritis Interstitial nephritis Papillary necrosis Renal amyloid disease Disseminated intravascular coagulation Renal involvement in systemic diseases Neurogenic bladder. GYNECOLOGICAL CONDITIONS AND DISORDERS OF THE BREAST 7610 Vulva, disease or injury Vagina, disease or injury Cervix, disease or injury Uterus, disease or injury Fallopian tube, disease or injury Ovary, disease or injury Uterus and both ovaries, removal Uterus, removal Ovary, removal Ovaries, atrophy of both Uterus, prolapse Uterus, displacement Pregnancy, surgical complications Fistula, rectovaginal Fistula, urethrovaginal Breast, surgery Malignant neoplasms Benign neoplasms Endometriosis. THE HEMIC AND LYMPHATIC SYSTEMS 7700 Anemia Agranulocytosis, acute Leukemia Polycythemia vera Thrombocytopenia Splenectomy Spleen, injury of, healed Hodgkin's disease Adenitis, tuberculous.

53 7714 Sickle cell anemia Non-Hodgkin's lymphoma Aplastic anemia. THE SKIN 7800 Burn scar(s) of the head, face, or neck; scar(s) of the head, face, or neck due to other causes; or other disfigurement of the head, face, or neck Burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are deep and nonlinear Burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are superficial and nonlinear Scar(s), unstable or painful Scars, other Dermatitis or eczema Leishmaniasis, American (New World) Leishmaniasis, Old World Lupus erythematosus, discoid Tuberculosis luposa (lupus vulgaris) Dermatophytosis Bullous disorders Psoriasis Exfoliative dermatitis Malignant skin neoplasms Benign skin neoplasms Infections of the skin Cutaneous manifestations of collagen-vascular diseases Papulosquamous disorders Vitiligo Keratinization, diseases Urticaria Vasculitis, primary cutaneous Erythema multiforme Acne Chloracne Scarring alopecia Alopecia areata Hyperhidrosis Malignant melanoma. THE ENDOCRINE SYSTEM 7900 Hyperthyroidism Thyroid gland, toxic adenoma Thyroid gland, nontoxic adenoma Hypothyroidism Hyperparathyroidism Hypoparathyroidism Cushing's syndrome Acromegaly Diabetes insipidus Addison's disease Pluriglandular syndrome Diabetes mellitus Malignant neoplasm Benign neoplasm.

54 7916 Hyperpituitarism Hyperaldosteronism Pheochromocytoma C-cell hyperplasia, thyroid. NEUROLOGICAL CONDITIONS AND CONVULSIVE DISORDERS Organic Diseases of the Central Nervous System 8000 Encephalitis, epidemic, chronic. Brain, New Growth of 8002 Malignant Benign Paralysis agitans Bulbar palsy Brain, vessels, embolism Brain, vessels, thrombosis Brain, vessels, hemorrhage Myelitis Poliomyelitis, anterior Hematomyelia Syphilis, cerebrospinal Syphilis, meningovascular Tabes dorsalis Amyotrophic lateral sclerosis Multiple sclerosis Meningitis, cerebrospinal, epidemic Brain, abscess. Spinal Cord, New Growths 8021 Malignant Benign Progressive muscular atrophy Syringomyelia Myasthenia gravis Residuals of traumatic brain injury (TBI) Cerebral arteriosclerosis. Miscellaneous Diseases 8100 Migraine 8103 Tic, convulsive Paramyoclonus multiplex Chorea, Sydenham's Chorea, Huntington's Athetosis, acquired Narcolepsy The Cranial Nerves Fifth (trigeminal), paralysis Seventh (facial), paralysis Ninth (glossopharyngeal), paralysis Tenth (pneumogastric, vagus), paralysis Eleventh (spinal accessory, external branch), paralysis.

55 8212 Twelfth (hypoglossal), paralysis Neuritis, fifth cranial nerve Neuritis, seventh cranial nerve Neuritis, ninth cranial nerve Neuritis, tenth cranial nerve Neuritis, eleventh cranial nerve Neuritis, twelfth cranial nerve Neuralgia, fifth cranial nerve Neuralgia, seventh cranial nerve Neuralgia, ninth cranial nerve Neuralgia, tenth cranial nerve Neuralgia, eleventh cranial nerve Neuralgia, twelfth cranial nerve. Peripheral Nerves 8510 Upper radicular group, paralysis Middle radicular group, paralysis Lower radicular group, paralysis All radicular groups, paralysis Musculospiral nerve (radial), paralysis Median nerve, paralysis Ulnar nerve, paralysis Musculocutaneous nerve, paralysis Circumflex nerve, paralysis Long thoracic nerve, paralysis Sciatic nerve, paralysis External popliteal nerve (common peroneal), paralysis Musculocutaneous nerve (superficial peroneal), paralysis Anterior tibial nerve (deep peroneal), paralysis Internal popliteal nerve (tibial), paralysis Posterior tibial nerve, paralysis Anterior crural nerve (femoral), paralysis Internal saphenous nerve, paralysis Obturator nerve, paralysis External cutaneous nerve of thigh, paralysis Ilio-inguinal nerve, paralysis Soft-tissue sarcoma (Neurogenic origin) Neuritis, upper radicular group Neuritis, middle radicular group Neuritis, lower radicular group Neuritis, all radicular group Neuritis, musculospiral (radial) nerve Neuritis, median nerve Neuritis, ulnar nerve Neuritis, musculocutaneous nerve Neuritis, circumflex nerve Neuritis, long thoracic nerve Neuritis, sciatic nerve Neuritis, external popliteal (common peroneal) nerve Neuritis, musculocutaneous (superficial peroneal) nerve Neuritis, anterior tibial (deep peroneal) nerve Neuritis, internal popliteal (tibial) nerve Neuritis, posterior tibial nerve Neuritis, anterior crural (femoral) nerve Neuritis, internal saphenous nerve Neuritis, obturator nerve Neuritis, external cutaneous nerve of thigh Neuritis, ilio-inguinal nerve Neuralgia, upper radicular group.

Compensation. Service-Connected Disability or Death Benefits

Compensation. Service-Connected Disability or Death Benefits Compensation Service-Connected Disability or Death Benefits The Compensation program provides tax-free monthly benefits to Veterans in recognition of the effects of disabilities caused by diseases, events,

More information

ANNUAL BENEFITS REPORT

ANNUAL BENEFITS REPORT Patriotism is not a short frenzied burst of emotion, but the long and steady dedication of a lifetime. -Thomas Jefferson U.S. Department of Veterans Affairs Veterans Benefits Administration ANNUAL BENEFITS

More information

Medical Surgical Nursing (Elsevier)

Medical Surgical Nursing (Elsevier) 1 of 6 I. The Musculoskeletal System Medical Surgical Nursing (Elsevier) 1. Med/Surg: Musculoskeletal System: The Comprehensive Health History 2. Med/Surg: Musculoskeletal System: A Nursing Approach to

More information

List of Qualifying Conditions

List of Qualifying Conditions List of Qualifying Conditions Cancer Conditions 1) Adrenal cancer 2) Bladder cancer 3) Bone cancer all forms 4) Brain cancer 5) Breast cancer 6) Cervical cancer 7) Colon cancer 8) Colorectal cancer 9)

More information

Range of Injury Scale Values

Range of Injury Scale Values Range of Injury Scale Values Civil Liability Regulations 2014 SCHEDULE 4 Range of Injury Scale Values (summary) Item Injury ISV Range Part 1-Central Nervous System and Head Injuries 1 Quadriplegia 75 100

More information

Evaluating muscle injuries and residuals of shell fragment and gunshot wounds

Evaluating muscle injuries and residuals of shell fragment and gunshot wounds Evaluating muscle injuries and residuals of shell fragment and gunshot wounds Training conducted by: Michael Fishman and Sandrine Fisher 1 Objectives To become familiar with the application of the rating

More information

Department of Veterans Affairs 4.71a. [29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978; 67 FR 48785, July 26, 2002] Rating

Department of Veterans Affairs 4.71a. [29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978; 67 FR 48785, July 26, 2002] Rating Department of Veterans Affairs 4.71a [29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978; 67 FR 48785, July 26, 2002] 4.71a Schedule of ratings musculoskeletal system. ACUTE, SUBACUTE, OR

More information

Guidelines for the table of injuries. For injuries on or after 2 November 2005

Guidelines for the table of injuries. For injuries on or after 2 November 2005 For injuries on or after 2 November 2005 Background Changes to the Table of injuries (TOI) were made in 2005 and are now adopted by the Medical Assessment Tribunal at Q-COMP. The major differences between

More information

Phoenix Remembrance Life

Phoenix Remembrance Life Phoenix Remembrance Life W e You Asked New Printer- Friendly Design! D e l i v e r e d Field Underwriting Guide For agent use only. Not for distribution to the public as sales literature. Phoenix Remembrance

More information

Limited Pay Policy (L-222B) - Underwriting Guidelines

Limited Pay Policy (L-222B) - Underwriting Guidelines Limited Pay Policy (L-222B) - Underwriting Guidelines 1 Addiction/Abuser Drug - Past or Present Presently Recovered - AA for last 2 years 2 Aids 3 Alcoholic Presently Recovered - AA for last 2 years 4

More information

Critical Illness with Term Assurance

Critical Illness with Term Assurance AIG Life Critical Illness with Term Assurance Our comprehensive Critical Illness with Term Assurance delivers more value and quality to the customer and their family than ever before. It is designed to

More information

Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario

Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Page 1 Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Injury Descriptions Developed from Newfoundland claim study injury definitions No injury Death Psychological

More information

Annual Benefits Report

Annual Benefits Report To care for him who shall have borne the battle and for his widow, and his orphan - Abraham Lincoln Department of Veterans Affairs Veterans Benefits Administration Annual Benefits Report Fiscal Year 2009

More information

SUPER CARE CRITICAL ILLNESS PROTECTOR

SUPER CARE CRITICAL ILLNESS PROTECTOR SUPER CARE CRITICAL ILLNESS PROTECTOR At ACE Life, we are committed to helping our valued customers achieve financial security and have a peace of mind through our comprehensive range of life insurance

More information

Description Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99

Description Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99 Natural death Description Code Recommendation Description Code All natural death 001-799 IPH All natural death A00-R99 Infectious and parasitic diseases 001-139 CDC, EUROSTAT, CBS & VG Infectious and parasitic

More information

Current Diagnosis Codes

Current Diagnosis Codes Current Diagnosis Codes ICD Code DMBA 034.0 075 242.90 244.9 272.0 272.4 274.0 285.9 300.0 300.5 309.9 310.9 311 332.0 337.9 340 342.90 346.90 350.1 351.0 353.0 354.0 354.2 355.0 355.1 355.8 356.9 357.0

More information

(*) Awards for all burns include compensation for any residual scarring or pigmentation and take into account any skin grafting.

(*) Awards for all burns include compensation for any residual scarring or pigmentation and take into account any skin grafting. Table 1 Burns (*) Item Column (a) Level 1 4 2 5 3 6 4 6 5 7 6 8 7 9 8 11 9 12 10 12 11 13 12 14 13 15 Column (b) Injury Burns, with deep second degree, third degree, or full thickness burns affecting 70

More information

Systemic Health: Pathology

Systemic Health: Pathology Page 1 Systemic Health: Pathology A. General Health 2. Detailed history with regards to differential diagnosis of fatigue, weight loss, fever, headache, dizziness, and malaise 3. Presentations involving

More information

General Thoracic Surgery ICD9 to ICD10 Crosswalks. C34.11 Malignant neoplasm of upper lobe, right bronchus or lung

General Thoracic Surgery ICD9 to ICD10 Crosswalks. C34.11 Malignant neoplasm of upper lobe, right bronchus or lung ICD-9 Code ICD-9 Description ICD-10 Code ICD-10 Description 150.3 Malignant neoplasm of upper third of esophagus C15.3 Malignant neoplasm of upper third of esophagus 150.4 Malignant neoplasm of middle

More information

Application for a Medical Impairment Rating (MIR)

Application for a Medical Impairment Rating (MIR) STATE OF TENNESSEE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT Workers Compensation Division Medical Impairment Rating Program 220 French Landing Drive Nashville, TN 37243-1002 Phone (615) 253-1613 Fax

More information

One (1) single qualifying condition of either HIV/AIDS or a Serious Mental Illness (SMI)

One (1) single qualifying condition of either HIV/AIDS or a Serious Mental Illness (SMI) Eligibility Criteria for Health Home Services: Chronic Conditions New York State s Health Home eligibility criteria is as follows: Medicaid eligible/active Medicaid; and Two (2) or more chronic conditions;

More information

Certified Registered Nurse Anesthetist ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for CRNA s and Top 25 Codes

Certified Registered Nurse Anesthetist ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for CRNA s and Top 25 Codes Certified Registered Nurse Anesthetist ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for CRNA s and Top 25 Codes Chapter 2 Neoplasms (C00-D49) Classification improvements Code expansions Significant

More information

General Medical Examination

General Medical Examination General Medical Examination Name: Date of Exam: Place of Exam: SSN: C-number: Narrative: This is a comprehensive base-line or screening examination for all body systems, not just specific conditions claimed

More information

Enjoy a position of vantage, come what may.

Enjoy a position of vantage, come what may. Enjoy a position of vantage, come what may. prucrisis covervantage While you have achieved much in life and you and your family enjoy the benefits of success, there may be times when the unexpected happens.

More information

Phoenix Simplicity Index Life SM

Phoenix Simplicity Index Life SM Phoenix Simplicity Index Life SM Field Underwriting Guide Phoenix Simplicity Index Life is indexed universal life insurance underwritten on a simplified issue basis. There are no medical examinations,

More information

Medical Specialties Guide

Medical Specialties Guide Medical Specialties Guide Allergy And Immunology Specialists in this field treat disorders related to how the body reacts to foreign substances. They treat such things as seasonal allergies, eczema, asthma,

More information

ICD-9-CM coding for patients with Spinal Cord Injury*

ICD-9-CM coding for patients with Spinal Cord Injury* ICD-9-CM coding for patients with Spinal Cord Injury* indicates intervening codes have been left out of this list. OTHER DISORDERS OF THE CENTRAL NERVOUS SYSTEM (340-349) 344 Other paralytic syndromes

More information

Workplace Health, Safety and Compensation Commission of Newfoundland and Labrador. Permanent Functional Impairment (PFI) rating schedule

Workplace Health, Safety and Compensation Commission of Newfoundland and Labrador. Permanent Functional Impairment (PFI) rating schedule Safety and Compensation Commission of Newfoundland and Labrador Permanent Functional Impairment (PFI) rating schedule Safety and Compensation Commission of Newfoundland and Labrador Permanent Functional

More information

MRI EXAM CPT CODE REFERENCE

MRI EXAM CPT CODE REFERENCE I EXAM REFERENCE Use this reference to quickly determine the correct exam for your patients based on the indications described herein and the for the order. Creatine levels should be obtained prior to

More information

Request for Designated Doctor Examination Type (or print in black ink) each item on this form

Request for Designated Doctor Examination Type (or print in black ink) each item on this form Texas Department of Insurance Division of Workers Compensation 7551 Metro Center Drive, Suite 100 MS-603 Austin, TX 78744-1645 (512) 804-4380 phone (512) 804-4121 fax Complete, if known: DWC Claim # Carrier

More information

Data M. Möhner et al. Fb 937 BfAA 2001. Compiled by Sebastian Pflugbeil 09 / 2013. Gesellschaft für Strahlenschutz e.v. Dr. Sebastian Pflugbeil

Data M. Möhner et al. Fb 937 BfAA 2001. Compiled by Sebastian Pflugbeil 09 / 2013. Gesellschaft für Strahlenschutz e.v. Dr. Sebastian Pflugbeil Health insurance certificate in the WISMUT mine 1985 1989 and comparison with German Democratic Republic (GDR, East Germany) reference data 1989 for s and for selected diagnoses (ICD-9 numbers) 100%: WISMUT

More information

Human Body Vocabulary Words Week 1

Human Body Vocabulary Words Week 1 Vocabulary Words Week 1 1. arteries Any of the blood vessels that carry blood away from the heart to all parts of the body 2. heart The muscular organ inside the chest that pumps blood through the body

More information

Patient Medical History

Patient Medical History Cardiovascular Abnormal Electrocardiogram Aortic Stenosis Atrial fibrillation Cardiac arrest Chest pain Congestive heart failure Heart valve replacement Hypertension Murmur Heart attack Palpitations Peripheral

More information

Medicare Supplement Plans Underwriting and Administration Guide

Medicare Supplement Plans Underwriting and Administration Guide Medicare Supplement Plans Underwriting and Administration Guide 024227 (09-2011) Table of Contents Introduction....1 Underwriting Concepts...1 Coverage....1 Eligibility Requirements...1 Eligibility Considerations...1

More information

We understand you want support right from the beginning

We understand you want support right from the beginning PROTECT We understand you want support right from the beginning PRUearly stage crisis cover Should an illness strike, the earlier it is diagnosed, the easier it is to manage and the higher the chances

More information

Covers 60 major critical illnesses. Covers 11 minor critical illnesses. ManuMulti Care

Covers 60 major critical illnesses. Covers 11 minor critical illnesses. ManuMulti Care It s a difficult subject to think about, but part of planning for the future is being prepared for the unexpected. Critical illness can happen to anyone, at any time. And it s an unfortunate fact, but

More information

RHEUMATOLOGY ICD-10 CROSSWALK

RHEUMATOLOGY ICD-10 CROSSWALK RHEUMATOLOGY ICD-10 CROSSWALK ICD is revised periodically and is currently in its tenth edition and will be implemented in the United States on October 1, 2015. There is an annual minor update and three-yearly

More information

Dallas Neurosurgical and Spine Associates, P.A Patient Health History

Dallas Neurosurgical and Spine Associates, P.A Patient Health History Dallas Neurosurgical and Spine Associates, P.A Patient Health History DOB: Date: Reason for your visit (Chief complaint): Past Medical History Please check corresponding box if you have ever had any of

More information

Patient Information. Name: Social Security Number: Birth date: Email: Address: Phone #: House: Cell: Work: Primary Care Physician: Address:

Patient Information. Name: Social Security Number: Birth date: Email: Address: Phone #: House: Cell: Work: Primary Care Physician: Address: Patient Information Name: Social Security Number: Birth date: Age: Email: Address: Phone #: House: Cell: Work: Primary Care Physician: Phone #: Date Last Visit: Address: Emergency Contact: Emergency Phone

More information

Medicare Supplement Plans Underwriting and Administration Guide

Medicare Supplement Plans Underwriting and Administration Guide Medicare Supplement Plans Underwriting and Administration Guide 024266 (10-2012) Table of Contents Introduction....1 Underwriting Concepts...1 Coverage....1 Eligibility Requirements...1 Eligibility Considerations...1

More information

Specifications and Calculations

Specifications and Calculations ARCON 23(1) IRP Calculator Software Specifications and Calculations To be used with the revised Permanent Disability Evaluation Schedule, policy and additional factors guide, which came into effect August

More information

Closed Sub-TOI: L08.000 Life - Other Co Tr Num: BANRD-01 State Status: Approved-Closed

Closed Sub-TOI: L08.000 Life - Other Co Tr Num: BANRD-01 State Status: Approved-Closed Project Name/Number: / 01 Filing at a Glance Company: Banner Life Insurance Company SERFF Tr Num: FNBL-126416557 State: Arkansas TOI: L08 Life - Other SERFF Status: Closed-Approved- State Tr Num: 44441

More information

IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider

IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider 1. IKHLASlink Comprehensive Critical Illness Benefit Secure Takaful Rider Securing life uncertainties. With IKHLASlink Comprehensive

More information

DISEASES OF THE MUSKULOSKELETAL SYSTEM AND CONNECTIVE TISSUE

DISEASES OF THE MUSKULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISEASES OF THE MUSKULOSKELETAL SYSTEM AND CONNECTIVE TISSUE ARTHROPATHIES AND RELATED DISORDERS (710 719.9) 710 DIFFUSE DISEASES OF CONNECTIVE TISSUE 710.0 SYSTEMIC LUPUS ERYTHEMATOSUS 710.1 SYSTEMIC

More information

Health declaration for occupational disability insurance or life insurance that covers occupational disability

Health declaration for occupational disability insurance or life insurance that covers occupational disability The English translation has no legal force and is provided to the customer for convenience only. The Dutch health declaration should be filled in. Health declaration for occupational disability insurance

More information

Colossus Important Diagnoses. Instructions for How to List Diagnoses

Colossus Important Diagnoses. Instructions for How to List Diagnoses 1 Colossus Important Diagnoses Instructions for How to List Diagnoses 1. Only list diagnoses on HCFA-1500 or CMS-1500 billing forms 2. Use as many billing forms/pages as necessary (4 diagnoses per billing

More information

ORANGE COUNTY EYE INSTITUTE

ORANGE COUNTY EYE INSTITUTE ORANGE COUNTY EYE INSTITUTE *Note: It is the patient s responsibility to file insurance claims if we are not contracted with your insurance company. *Note: Be aware that most medical insurance plans do

More information

Medical conditions that preclude entry

Medical conditions that preclude entry Medical conditions that preclude entry If you have or have had any of the conditions listed below, it means that you do not meet the current medical standard required to enter RAF service: Eye disorders

More information

Sports Health Insurance. application for sports players

Sports Health Insurance. application for sports players Sports Health Insurance application for sports players Here to Help We hope you will find this application form easy and straightforward to complete but if you require any assistance the General & Medical

More information

Rheumatology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Rheumatology

Rheumatology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Rheumatology Rheumatology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Rheumatology Chapter 12: Diseases of Skin and Subcutaneous Tissue ICD-10-CM introduces a new term, androgenic alopecia. Pressure

More information

ICD-10 Provider Preparation

ICD-10 Provider Preparation ICD-10 Provider Preparation After browsing this slide deck, the viewer will become more familiar with the following information: What are the origins of ICD-10? Why transition to ICD-10? Why ICD-10 matters.

More information

APPENDIX D INTERJURISDICTIONAL COMPARISON EXPLANATORY NOTES

APPENDIX D INTERJURISDICTIONAL COMPARISON EXPLANATORY NOTES The interjurisdictional comparison at Appendix C looks at how the ratings in the current British Columbia ( BC ) Permanent Disability Evaluation Schedule ( PDES ), the Additional Factors Outline ( AFO

More information

PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015

PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015 PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015 Laboratory data is to be submitted for discharges in the following conditions: 1. Heart Attack

More information

SERIOUS ILLNESS COVER

SERIOUS ILLNESS COVER WITH OUR COVER YOU ARE MORE LIKELY TO GET A PAYOUT VITALITY.CO.UK/LIFE Vitality s Serious Illness Cover offers protection against serious illnesses as well as advanced or life threatening ones THE AVERAGE

More information

Asteron Life Business Insurance

Asteron Life Business Insurance Asteron Life Business Insurance What lump sum covers are available with Asteron Life Business Insurance? Life Cover Life Cover pays a lump sum of money if you pass away or become terminally ill. Total

More information

MRI Ordering Guide: MRA/MRV TO SCHEDULE AN APPOINTMENT: CALL (860) 714-XRAY (714-9729) or FAX REQUISITION TO (860) 714-8002

MRI Ordering Guide: MRA/MRV TO SCHEDULE AN APPOINTMENT: CALL (860) 714-XRAY (714-9729) or FAX REQUISITION TO (860) 714-8002 SAINT SAINT FRANCIS Hospital and Hospital Medical and Medical Center Center MRI Ordering Guide: MRA/MRV MRA Abdomen AAA (abdominal aortic aneurysm Dissection Mesenteric Ischemia MRA Abdomen With & Without

More information

Height FT IN Weight Married? Y / N Employed? Y / N

Height FT IN Weight Married? Y / N Employed? Y / N Name Patient # (PLEASE PRINT) Signature Date Height FT IN Weight Married? Y / N Employed? Y / N Previous Illnesses: Check all that apply AIDS, HIV, STD Epilepsy Pacemaker Alcoholism Eye/vision problems

More information

Critical Illness with Term Assurance

Critical Illness with Term Assurance AIG Life Critical Illness with Term Assurance Our comprehensive Critical Illness with Term Assurance delivers more value and quality to the customer and their family than ever before. It is designed to

More information

PATIENT INFORMATION INSURANCE INFORMATION

PATIENT INFORMATION INSURANCE INFORMATION (mm/dd/yyyy): Have you been to Physicians Urgent Care before? Yes No Arrival Time: If yes, when? Is this a follow-up to a previous visit: Yes No PATIENT INFORMATION Patient s First Name: Middle Name: Last

More information

ICD 9 Codes Version 28

ICD 9 Codes Version 28 0010 Cholera due to vibrio cholerae 0011 Cholera due to vibrio cholerae el tor 0019 Cholera, unspecified 0020 Typhoid fever 0021 Paratyphoid fever A 0022 Paratyphoid fever B 0023 Paratyphoid fever C 0029

More information

General & Medical. Personal Healthcare - Additional Applicants. adding new members to an existing policy

General & Medical. Personal Healthcare - Additional Applicants. adding new members to an existing policy General & Medical Personal Healthcare - Additional Applicants adding new members to an existing policy Here to Help We hope you will find this application form easy and straightforward to complete but

More information

Disability Evaluation Under Social Security

Disability Evaluation Under Social Security Disability Evaluation Under Social Security Revised Medical Criteria for Evaluating Endocrine Disorders Effective June 7, 2011 Why a Revision? Social Security revisions reflect: SSA s adjudicative experience.

More information

Pulmonary Associates of Richmond

Pulmonary Associates of Richmond Pulmonary Associates of Richmond Name: Address One: City: Home Phone#: Work Phone#: Cell Phone#: State: Zip: Sex: Social Security Number: Referring Doctor: of Birth: Employer: Primary Care Doctor: Employment

More information

Virginia Group Health Insurance Medical History Form

Virginia Group Health Insurance Medical History Form Section 1: To Be Completed by Employer EMPLOYER GROUP NAME REQUESTED EFFECTIVE DATE Section 2: Employee Information Employee Name: Employee Address: (street, city, state & zip) Name of Current Insurer/HMO:

More information

Major Depression: See Psychological and Emotional Disorders

Major Depression: See Psychological and Emotional Disorders Major Depression: See Psychological and Emotional Disorders Malignant Melanoma: A tumor of the skin. The action depends on the stage and depth of invasion of the tumor. with pathology report 0-2 years

More information

Patient & Medical Professional US Online Panel

Patient & Medical Professional US Online Panel Patient & Medical Professional US Online Panel Patient & Medical Professional US Online Panel Over 500K validated US online double opt-in panelists motivated to share their opinions in research! Since

More information

LCD for Erythrocyte Sedimentation Rate (ESR)

LCD for Erythrocyte Sedimentation Rate (ESR) LCD for Erythrocyte Sedimentation Rate (ESR) Applicable CPT Code(s): 85651 Sedimentation Rate, Erythrocyte; Non-Automated 85652 Sedimentation Rate, Erythrocyte; Automated ICD-9 Codes that Support Medical

More information

Chapter I Overview Chapter Contents

Chapter I Overview Chapter Contents Chapter I Overview Chapter Contents Table Number Contents I-1 Estimated New Cancer Cases and Deaths for 2005 I-2 53-Year Trends in US Cancer Death Rates I-3 Summary of Changes in Cancer Incidence and Mortality

More information

ANATOMY AND PHYSIOLOGY

ANATOMY AND PHYSIOLOGY ANATOMY AND PHYSIOLOGY Placement: First Year Theory - Anatomy: 60 Physiology: 60 Course Description -The course is designed to assist students to acquire the knowledge of the normal Structure of human

More information

We have made the following changes to the Critical Illness events covered under our group critical illness policy.

We have made the following changes to the Critical Illness events covered under our group critical illness policy. We have made the following changes to the Critical Illness events covered under our group critical illness policy. March 2015 Because everyone needs a back-up plan 7 New critical illness events added to

More information

Alameda Alliance for Heath ICD-9 to ICD-10 TRANSLATION CODES E10.10

Alameda Alliance for Heath ICD-9 to ICD-10 TRANSLATION CODES E10.10 DIABETES ICD-9 CM ICD-9 CM Volume 1 - Diagnosis Description ICD-10 CM - Diagnosis Code ICD-10 CM - Diagnosis Description 250.00 Diabetes mellitus without mention of complication, type II or unspecified

More information

MOLLOY COLLEGE DIVISION OF NURSING NURSE PRACTITIONER PROGRAMS. Study Guide for the Basic Physical Assessment Exam

MOLLOY COLLEGE DIVISION OF NURSING NURSE PRACTITIONER PROGRAMS. Study Guide for the Basic Physical Assessment Exam DIVISION OF NURSING S Study Guide for the Basic Physical Assessment Exam Questions will be based on following chapters in, Bickley, L.S. (2009). (10 th ed). Bates guide to physical examination and history

More information

Please advise if you have received the following documents with this application:

Please advise if you have received the following documents with this application: GROUP LONG TERM CARE INSURANCE APPLICATION Unum Life Insurance Company of America 2211 Congress Street Portland, Maine 04122 The policy for long term care insurance is intended to be a federally qualified

More information

Workman s Compensation

Workman s Compensation Workman s Compensation Name: Sex: Phone Number: Age: Address (Street/City/State/Zip) Name of Employer: Phone: Address of Employer (Street/City/State/Zip) Date and time of accident?: Where were you taken

More information

All notifications, trigger diagnosis, LCM reports, pre certification reports, etc. should be sent to: notifications@ihcrisksolutions.

All notifications, trigger diagnosis, LCM reports, pre certification reports, etc. should be sent to: notifications@ihcrisksolutions. Dear Business Partner: Please take a few minutes to review the contents of our Claims Kit. It provides key instructions for identifying and reporting specific and aggregate claim information to IHC Risk

More information

For customers Friends Life Individual Protection. Childcover benefit

For customers Friends Life Individual Protection. Childcover benefit For customers Friends Life Individual Protection Childcover benefit Helping to protect the whole family Most parents don t want to think about what would happen if their child became critically ill. However,

More information

Common Pathology Diagnoses: ICD-9 to ICD-10 Mapping

Common Pathology Diagnoses: ICD-9 to ICD-10 Mapping PERFORMANCE THAT MATTERS NUMBER OF CODES 14,000 69,000 ICD-9 DIAGNOSIS CODES ICD-10 DIAGNOSIS CODES CODE STRUCTURE ICD-9-CM CODE FORMAT ICD-10-CM CODE FORMAT X X X X X X X X X X X X CATEGORY ETIOLOGY,

More information

Group 2: Critical Illness Benefits

Group 2: Critical Illness Benefits Group 2: Zurich s cover is designed to free yourself and your loved ones from the potentially devastating financial impact that follows diagnosis with a critical illness. 1. Level Term Life or Earlier

More information

NEW STUDENT-ATHLETE MEDICAL HISTORY FORM

NEW STUDENT-ATHLETE MEDICAL HISTORY FORM Student-Athlete Information NEW STUDENT-ATHLETE MEDICAL HISTORY FORM Name Date Birth SSN Sport Student ID Number Academic Class 1 Personal Physician s Name Phone # Person to Contact In The Event of Emergency

More information

New Jersey Department of Children and Families Policy Manual. Date: Chapter: C Case Management and Oversight Subchapter: 2 Services

New Jersey Department of Children and Families Policy Manual. Date: Chapter: C Case Management and Oversight Subchapter: 2 Services New Jersey Department of Children and Families Policy Manual Manual: CP&P Child Protection and Permanency Effective Volume: III Case Management Date: Chapter: C Case Management and Oversight Subchapter:

More information

The insurance company checked above (Company) is responsible for the obligation and payment of benefits under any policy that it may issue.

The insurance company checked above (Company) is responsible for the obligation and payment of benefits under any policy that it may issue. American International Life Assurance Company of New York* Home Office: 80 Pine Street, New York, NY 10005 The United States Life Insurance Company in the City of New York* Home Office: 830 Third Avenue,

More information

Your health is an asset. Don t let critical illness turn it into a liability.

Your health is an asset. Don t let critical illness turn it into a liability. Your health is an asset. Don t let critical illness turn it into a liability. 100% lump sum payout for critical illness1 including early stage My Early Critical Illness Plan Be financially prepared for

More information

CHAPTER 9 BODY ORGANIZATION

CHAPTER 9 BODY ORGANIZATION CHAPTER 9 BODY ORGANIZATION Objectives Identify the meaning of 10 or more terms relating to the organization of the body Describe the properties of life Describe the function for the structures of the

More information

2. Whenever possible, and reasonable, impairment ratings will be established strictly in accordance with the Rating Schedule attached as Appendix A.

2. Whenever possible, and reasonable, impairment ratings will be established strictly in accordance with the Rating Schedule attached as Appendix A. Section Policy 40 44.90.10 Section Title: Benefits Administration - Adjudication & Compensation Subject: Permanent Impairment Rating Effective Date: For decisions on or after January 1, 2015 GENERAL INFORMATION

More information

Asteron Life Personal Insurance

Asteron Life Personal Insurance Asteron Life Personal Insurance What lump sum covers are available with Asteron Life Personal Insurance? Life Cover Life Cover insurance pays a lump sum of money if you pass away or become terminally ill.

More information

[VETERANS BENEFITS: COMPENSATION & PENSION]

[VETERANS BENEFITS: COMPENSATION & PENSION] 2012 Missouri Veterans Commission Bonnie McNeill, Director Workforce Development, Veterans Service Program [VETERANS BENEFITS: COMPENSATION & PENSION] A simplified explanation of service connected disability

More information

Anesthesia ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Anesthesia and Top 25 Codes

Anesthesia ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Anesthesia and Top 25 Codes Anesthesia ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Anesthesia and Top 25 Codes Chapter 2 Neoplasms (C00-D49) Classification improvements Code expansions Significant expansions or

More information

NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only)

NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only) PAGE 1 NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only) 1. What is the main problem that you are having? (If additional space is required, please use the back of this

More information

ADVANCE NOTICE OF EXCESS CLAIM REPORT

ADVANCE NOTICE OF EXCESS CLAIM REPORT ADVANCE NOTICE OF EXCESS CLAIM REPORT Please provide the following information for claimants that 15,000 or more is expected to be paid on. Group Name: Pooling Point: Effective Date: Claimant Information

More information

Life Protection Quotation

Life Protection Quotation Life Protection Quotation Prepared For: Date: 03/06/2013 Life Type: Single Life Quote Type: Specified Illness Cover Only QUOTATION DETAILS Male, 43 (01/Jan/1970), Non-Smoker, Specified Illness 124000 Monthly

More information

Disability Evaluation Under Social Security

Disability Evaluation Under Social Security Disability Evaluation Under Social Security *14.09 Inflammatory arthritis. As described in 14.00D6. With: A. Persistent inflammation or persistent deformity of: 1. One or more major peripheral weight-bearing

More information

For customers Friends Life Individual Protection Critical Illness Cover. Critical Illness Cover. It s critical illness. And more.

For customers Friends Life Individual Protection Critical Illness Cover. Critical Illness Cover. It s critical illness. And more. For customers Friends Life Individual Protection Critical Illness Cover Critical Illness Cover It s critical illness. And more. It s critical illness. And 2 it s designed with your needs in mind. it covers

More information

Laboratory 1 Anatomical Planes and Regions

Laboratory 1 Anatomical Planes and Regions Laboratory 1 Anatomical Planes and Regions Goals: Define the anatomical position, including the application of the terms right and left. List and correctly use the major directional terms used in anatomy.

More information

Crisis Defender & Early Crisis Protector

Crisis Defender & Early Crisis Protector Crisis Defender & Early Crisis Protector MEDICAL Shield yourself with Prudential's comprehensive critical illnesses coverage! It s now a comprehensive crisis coverage with Crisis Defender & Early Crisis

More information

67 The Human Skeleton

67 The Human Skeleton 67 The Human Skeleton Skull SCIENCE EXPLORER Focus on Life Science Prentice-Hall, Inc. Clavicle (collarbone) Scapula (shoulder blade) Carpals Metacarpals Phalanges Femur Tibia Humerus Ulna Sternum (breastbone)

More information

Common Regional Nerve Blocks Quick Guide developed by UWHC Acute Pain Service Jan 2011

Common Regional Nerve Blocks Quick Guide developed by UWHC Acute Pain Service Jan 2011 Common Regional Nerve Blocks Quick Guide developed by UWHC Acute Pain Service Jan 2011 A single shot nerve block is the injection of local anesthetic to block a specific nerve distribution. It can be placed

More information

With our cover you are more likely to get a payout. Serious Illness Cover. pruprotect.co.uk

With our cover you are more likely to get a payout. Serious Illness Cover. pruprotect.co.uk With our cover you are more likely to get a payout Serious Illness Cover pruprotect.co.uk Serious Illness Cover PruProtect s Serious Illness Cover offers protection against serious illnesses as well as

More information

Chiropractic ICD 9 Code List

Chiropractic ICD 9 Code List Use of valid ICD 9 codes, billed with appropriate and corresponding CPT codes, benefits providers by facilitating treatment authorization and claims payment. The use of valid and appropriate codes also

More information

CONTENTS SECTION 1 FUNDAMENTALS 1 SECTION 2 DRUGS 75 SECTION 3 DIGESTIVE DISORDERS 109. A Guide for Readers Understanding Medical Terms

CONTENTS SECTION 1 FUNDAMENTALS 1 SECTION 2 DRUGS 75 SECTION 3 DIGESTIVE DISORDERS 109. A Guide for Readers Understanding Medical Terms CONTENTS A Guide for Readers xxxix Understanding Medical Terms xli SECTION 1 FUNDAMENTALS 1 1 The Human Body 2 2 Genetics 8 3 Making the Most of Health Care 17 4 Prevention 28 5 Exercise and Fitness 38

More information

ICD10 Chiropractic Diagnosis Codes

ICD10 Chiropractic Diagnosis Codes ICD10 Chiropractic Diagnosis Codes Disclaimer: When the ICD-10 code requires a 7th character, the code shown assumes "initial." Disclaimer: This information is based on the General Equivalency Mapping

More information