RATING CODE SHEET DECODER TEMPLATE

Date reviewed:
Source file:

Service-connected condition list:
1. Condition:
   Diagnostic code:
   Current rating:
   Effective date:
   Static? yes / no / not listed / unknown
   Notes:

2. Condition:
   Diagnostic code:
   Current rating:
   Effective date:
   Static? yes / no / not listed / unknown
   Notes:

Prior denials listed:
1.
2.
3.

Bilateral factor clue:
SMC clue:
Combined rating shown:
Representative/POA listed:
Service periods listed:

Possible review items:
- rating looks low? yes / no / unknown
- effective date issue? yes / no / unknown
- secondary issue clue? yes / no / unknown
- diagnostic code question? yes / no / unknown
- prior denial to decode? yes / no / unknown

Top 3 next moves:
1.
2.
3.
