VA Compensation Appeals for Chronic Conjunctivitis – Everything You Need to Know

If you developed chronic conjunctivitis while on active duty for the U.S. military, you should be entitled to receive benefits for your condition. However, chances are high that the U.S. Department of Veterans’ Affairs (VA) denied your claim instead of giving you the chronic conjunctivitis veterans benefits you deserve.

A VA disability advocate can study your chronic conjunctivitis benefits claim, decipher why VA denied it, and file an appeal on your behalf. Call (888) 373-4722 today for more information.

How VA Rates Your Chronic Conjunctivitis

Chronic conjunctivitis is a term used to describe any conjunctivitis that lasts more than four weeks, according to the Mayo Clinic. The VA would use their rating criteria for chronic conjunctivitis if your conjunctivitis condition is not trachomatous.

How VA Rates “Active” Chronic Conjunctivitis

If your chronic conjunctivitis is “active,” VA provides a rating for your condition based on “either visual impairment due to the particular condition or on incapacitating episodes, whichever result in a higher evaluation.”

VA defines an incapacitating episode as “an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes.”

Incapacitating Episodes: General Rating Formula for Diseases of the Eye

• 60% rating: “With documented incapacitating episodes requiring 7 or more treatment visits for an eye condition during the past 12 months”
• 40% rating: “With documented incapacitating episodes requiring at least 5 but less than 7 treatment visits for an eye condition during the past 12 months”
• 20% rating: “With documented incapacitating episodes requiring at least 3 but less than 5 treatment visits for an eye condition during the past 12 months”
• 10% rating: “With documented incapacitating episodes requiring at least 1 but less than 3 treatment visits for an eye condition during the past 12 months”

How VA Determines Your Rating for Visual Impairment Veterans’ Benefits.  VA evaluates your visual impairment based on three factors:

1. Impairment of visual acuity
2. Impairment of visual field
3. Impairment of muscle function

Based on the above breakdown, VA evaluates where your vision falls within these categories and then matches your condition with the appropriate rating.

Importantly, the minimum rating for active non-trachomatous chronic conjunctivitis is 10 percent.

How VA Rates “Inactive” Chronic Conjunctivitis

If your chronic conjunctivitis is “inactive,” the VA will rate your condition based on “residuals, such as visual impairment and disfigurement (diagnostic code 7800).”

VA rates skin disfigurement (under diagnostic code 7800) as follows:

• 80% rating: “With visible or palpable tissue loss and either gross distortion or asymmetry of three or more features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with six or more characteristics of disfigurement”
• 50% rating: “With visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with four or five characteristics of disfigurement”
• 30% rating: “With visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with two or three characteristics of disfigurement”
• 10% rating: “With one characteristic of disfigurement”

Eight Characteristics of Disfigurement

The diagnosis code 7800 identifies eight characteristics of disfigurement for use in determining the above disability ratings:

• “Scar 5 or more inches (13 or more cm.) in length.
• Scar at least one-quarter inch (0.6 cm.) wide at the widest part.
• Surface contour of scar elevated or depressed on palpation.
• Scar adherent to underlying tissue.
• Skin hypo-or hyper-pigmented in an area exceeding six square inches (39 sq. cm.).
• Skin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding six square inches (39 sq. cm.).
• Underlying soft tissue missing in an area exceeding six square inches (39 sq. cm.).
• Skin indurated and inflexible in an area exceeding six square inches (39 sq. cm.).”

Determining Your Benefits Based on VA’s Disability Rating for Your Chronic Conjunctivitis

Once VA has rated your disability, anywhere from 10 to 100 percent, it determines your benefits based on where your rating falls on VA’s pay schedule.

VA Benefits Pay Schedule (as of December 2019) for single veterans with no dependents

• 10% disability rating: $142.29 per month
• 20% disability rating: $281.27 per month
• 30% disability rating: $435.69 per month
• 40% disability rating: $627.61 per month
• 50% disability rating: $893.43 per month
• 60% disability rating: $1,131.68 per month
• 70% disability rating: $1,426.17 per month
• 80% disability rating: $1,657.80 per month
• 90% disability rating: $1,826.96 per month
• 100% disability rating: $3,106.04 per month

Know the Three Elements You Must Have in Your VA Benefits Appeal

If something went wrong in your initial claim or appeal, you need to take extra care in filing your appeal if you want a different outcome. Begin by knowing what the VA expects to see in your appeal.

Three Required Elements for a Successful Visual Impairment Benefits Appeal

1. A current diagnosis of chronic conjunctivitis
2. A specific event you experienced while on active duty in the U.S. military that resulted in injury or trauma. You can satisfy this requirement if your chronic conjunctivitis began while you were in the service.
3. A “nexus” (direct “cause and effect” connection) between the event and your diagnosis

A veterans’ disability advocate can help you assess which of the requirements you have not yet met and work with you in presenting your case to the VA.

Why You Should Appeal a Denied Claim for Chronic Conjunctivitis Veterans Benefits

You served your country without question. You suffered an injury as a result of fulfilling your patriotic duties. You deserve compensation for these injuries.

Do not let a VA benefits claim denial make you give up. Appeal your denial or underrating. If you squirm at the thought of taking on multiple levels of review for your denied veterans’ disability claim, you should consider working with a veterans’ disability advocate to handle the process for you.

See How a Veterans’ Disability Advocacy Group Can Help You Today: (888) 373-4722

Call a disability advocacy group today to prepare your appeal for your chronic conjunctivitis veterans’ benefits claim denial. Look for an advocacy group that has walked this ground and knows how to navigate the “fine print” that peppers this process. Disabled Vets may be able to help you. Call (888) 373-4722.