bilateral hip condition va rating

Under the law, subsection 1114(s) benefits are not available to a Veteran whose 100 percent disability rating is based on multiple disabilities, none of which is rated at 100 percent disabling. In May 2013, the Veteran underwent another VA examination. Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive. By using this information, you understand that there is no attorney-client relationship created by you reading or using the information contained on this website or in this newsletter, article, or blog. 1B. A 10% rating for carpal tunnel on your left hand and a 60% rating for instability on your right hand would qualify for the Bilateral Factor and probably put you into 100% TDIU range. The Veteran stated that, since his last VA examination, he had had increasing pain that limited his walking, standing, and sex life. During a VA examination that same month, the Veteran reported hip pain with baseline discomfort at approximately 1-2 on the 10 point pain scale, with flare-ups at approximately 6-7. we represent clients nationwide. Op. So, the less the knee can bend, the higher the rating will be. 1155, 5107(b) (West 2014); 38 C.F.R. The above ratings cannot be combined with ratings based on limitation of motion of the same joint. You dont pay us unless you win, so you have nothing to lose! How The VA Rates Hip Conditions Under 38 CFR 4.71a, the VA evaluates conditions of the musculoskeletal system. His February 2010 X-ray evaluations showed no fracture or dislocations. You only need one rating on each upper extremity to qualify. Veteran could walk without a limp. The Veteran reiterated his complaints during a preventative health screening in September 2015. you viewed to avoid repetition. 4.22 - 4.23 - Rating of Disabilities Aggravated by Active Service/Attitude of Rating Officers. See Rice v. Shinseki, 22 Vet. If you have received a letter from the VA detailing all of your approved ratings, or if you are trying to find out how much youll get per month for your disability caused by your time in the military, you can use our free VA Ratings Calculator. And if you have a disability on both sides of your body, the VA will use what's known as the bilateral factor in these calculations. Bilateral means affecting both sides. The additional 10% of the combined rating only applies to arm and leg bilateral disabilities. He cited rest as the alleviating factor. An example of this would be a right elbow condition and a left wrist condition or a right knee condition and a left ankle condition. VA has a "well-established" duty to maximize a claimant's benefits. Calculating your combined disability rating . Initial Rating for Left Hip Disability Disability ratings are determined by applying the criteria set forth in the VA Schedule of Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. Copy this embed code to share the infographic on your own site. Updated: February 23, 2023 The life of a soldier inherently invites physical exertion and wear-and-tear injuries. 38 C.F.R. Major joints include the shoulder, wrist, elbow, hip, knee, and ankle while minor joints include toes, fingers, spine, and sacroiliac. App. 4.1. OFA FCI (European) BVA (UK/Australia) SV (Germany) Excellent: A-1: 0-4 (no >3/hip) Normal: Good: A-2: 5-10 (no >6/hip) Normal: Fair: B-1: 11-18: Normal: Borderline: B-2: 19-25: Fast Normal: Mild: C: 26-35: Noch Zugelassen: Moderate: D: 36-50: Mittlere: Severe: E: 51-106 . FINDINGS OF FACT Chicago, IL: 332 S. Michigan Avenue, Floors 8 and 9, Chicago, IL 60604 App. 1. The examiner described the Veteran's range of motion for his hip as 0-125 degrees flexion, 0-30 degrees extension, 0-25 degrees adduction, 0-45 degrees abduction, 0-60 degrees external rotation, and 0-30 degrees internal rotation. These cookies allow the website to remember choices you make to give you better functionality and personal features. If a veteran has a disabling condition affecting his right arm, and then his left arm becomes disabled, he isseverely limitedin his ability to function. App. Finally, we invite you to contact us and we welcome your calls, letters and electronic mail. 38 C.F.R. App. In light of the evidence of record showing pain, limitation of motion, interference with sleep, and difficulty with walking and standing, the Veteran's left hip disability has been most consistent with the 30 percent rating available under that Code for marked hip disability throughout the period on appeal. It should be noted that words "slight," "moderate" and "marked" as used in the various Diagnostic Codes are not defined in the VA Schedule for Rating Disabilities. During that same month, the Veteran obtained a VA orthopedic consult for his left hip pain. These cookies do not store any personal information. Copyright 2023 Woods and Woods, LLC | PO Box 1287 Evansville, IN 47706. When a veteran has adisabilitythat affects both arms, both legs, or paired skeletal muscles, their overall combined rating must reflect whats known as the bilateral factor. The Veteran's thigh extension has only once been limited to 5 degrees extension during his May 2013 VA examination. 1155; 38 C.F.R. Veterans Law VA Disability Rating for Hip Pain August 18, 2020 Updated: November 12, 2021 What is Hip Pain? II. 38 C.F.R. Here, the rating criteria assignable for a marked hip disability reasonably describe the Veteran's disability level and symptomatology as they consider factors including the Veteran's limited motion due to pain, and provide for a higher rating for additional or more severe symptomatology than is shown by the evidence as the rating criteria would provide a higher rating should the Veteran's range of motion decrease due to his left hip disability. They may be used by those companies to build a profile of your interests and show you relevant advertisements on other websites. The most probative evidence of record indicates that the Veteran's left hip internal derangement has been manifested by marked hip disability throughout the appeals period. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the appellant or obtained on his behalf be discussed in detail. For a single veteran with no dependents, that is about a $245 per month difference. See 38 C.F.R. 2000) and Timberlake v. Gober, 14 Vet. All evidence must be evaluated in arriving at a decision regarding an increased rating. Rice v. Shinseki, 22 Vet. The Veteran saw an orthopedist again in September 2012. However, those provisions should only be considered in conjunction with the diagnostic codes predicated on limitation of motion. The disability does not have to be the same on both sides of your body. See Schafrath v. Derwinski, 1 Vet. (Explain your findings and reasons in the remarks section) Side affected: ICD Code: Date of diagnosis: Osteoarthritis, hipRight Left BothRight: Left: 38 C.F.R. 2. This website adheres to the W3Cs AA Accessibility guidelines. The math gets even more complicated when a veteran has service-connected conditions that are bilateral in addition to service-connected disabilities that arent bilateral. 4.45 (2015). Let's talk about your VA disability benefits. 38 C.F.R. Lastly, the VA examiner opined that the Veteran would be unable to perform significant work due to his inability to stand or sit for significant periods of time without pain. Disability ratings are determined by applying the criteria set forth in the VA Schedule of Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. However, on physical examination, the orthopedist noted that the Veteran had mild tenderness with both internal and external range of motion endpoints but did maintain good internal and external range of motion. I. The Bilateral Factor adds 10% of 44% which is 4.4%. Feel free to call us at (866) 232-5777 anytime. Other applicable, general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability, 38 C.F.R. These cookies collect information about how you use our website. 4.10, 4.40, 4.45, 4.59 (2015). Inspired in helping our soldiers, she joined the Hill & Ponton team to practice veterans' disability law. Contact ustoday for a free case evaluation. Knee Conditions Recognized by VA Knee pain is rated under different diagnostic criteria according to 38 CFR 4.71a, Schedular Ratings, Musculoskeletal System. all count as part of the leg, so if you have something that deserves a 10% rating or more on each leg, your leg disability qualifies for the Bilateral Factor addition. Duties to Notify and to Assist 4.71a, Diagnostic Code 5003, Note (1) (2015). Thus the Board finds that a grant of TDIU, based on left hip disability alone dating from August 16, 2012, is warranted. It's probably the number one example that can manifest as different diagnoses. The Veteran suffered no pain on palpation and his muscle strength was normal for bilateral hip flexion, hip abduction, and hip extension. You could also receive service connection for hip . Veterans Law VA Disability Benefits for Hip Pain Secondary to Knee Pain May 11, 2022 Knee pain is very common among veterans, often due to the physicality of military service. In this case Diagnostic Code 5299 refers to the left hip internal derangement disability, while the more specific Diagnostic Codes 5253 and 5255 refer to impairment of the thigh and impairment of the femur respectively. I have 0% service-connected disability for trochanteris pain syndrome/bursitis, right hip (also claimed as secondary to back condition) and the same for the left hip. 242, 251 (2011); see also Bradley v. Peake, 22 Vet. 38 C.F.R. Pursuant to the October 2015 remand, the Veteran's VA treatment records were updated and associated with his claims file and a new VA examination was afforded the Veteran in November 2015. 3. App. Then in February 2013, the Veteran underwent an MRI, which showed a tear of the superior labrum of his left hip; transitional bump at the lateral margin of the femoral head; and a herniation pit in the femoral neck. The following steps illustrate how this veterans final combined rating will be calculated taking the bilateral factor into account: Overall, the bilateral factor has the effect of increasing a veterans combined rating. The 31% is the result of rounding 30.8% to the nearest whole number. In an October 2010 rating decision, the Milwaukee RO increased the Veteran's left hip disability rating to 10 percent, effective February 11, 2010. The Bilateral Factor Can Help Your VA Disability Rating If a veteran has service-connected injuries to matching limbs on both sides of his or her body, he or she qualifies for an extra percentage of rating called the Bilateral Factor. The Bilateral Factor affects VA disability ratings involving both arms or both legs. To get the veterans final combined rating we combine the 31% with the veterans back condition rated at 40%. App. This guide will break down the basics of the bilateral factor and how it relates to your VA disability claim. (You dont have to add it if you are using our calculator.) Confidential or time-sensitive information should not be sent through this form. 30% Disability rating: Veterans who cannot lift their non-dominant arm more than 25 degrees. This firm has been excellent at obtaining my disability claim. 4.26, the bilateral factor is: a partial disability results from disease or injury of both arms, or of both legs, or of paired skeletal muscles, theratings for the disabilitiesof the right and left sides will be combined as usual, and 10% of this value will be added before proceeding with further combinations.. Initial Rating for Left Hip Disability 122, 128-30 (2000). Copyright 2023 Chisholm Chisholm & Kilpatrick LTD. All Rights Reserved. This gives us 58.6, or 60%. You dont have to add it if you are using our calculator. The Veterans Administration recognizes this, so veterans with disabilities that affect both sides are compensated at a higher rate than disabilities to just one side. In his December 2010 substantive appeal (VA Form 9), the Veteran requested a Board hearing before a Veterans Law Judge sitting at the RO. 4.17 - Total Disability Ratings for Pension Based on Unemployability and Age of the Individual. Under the rating criteria pertaining to impairment of the thigh, a 10 percent rating is warranted if there is limitation of rotation of the affected leg so that the Veteran cannot toe-out more than 15 degrees or if there is limitation of adduction so that the Veteran cannot cross legs. 4.45 (2015). Department of Veterans Affairs Regional Office in Milwaukee, Wisconsin 2. His hip joint spaces were normal and there were no bone lesions. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a May 2010 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Diego, California, which awarded service connection for left hip internal derangement and assigned a noncompensable disability rating, effective February 11, 2010. The Veteran has never been diagnosed with a flail hip joint, and is therefore disqualified from being evaluated under Diagnostic Code 5254. He described having difficulty getting around the campus of his school and having some limitations to what he could do around the house, though he could still care for himself. Feet, knees, thighs, calves, buttocks, etc. App. 3.102, 3.156(a), 3.159, and 3.326(a) (2015). Asking for SMC in addition to your other claims is a good idea. The Veteran stated that his "hip is constantly either hurting or popping." This duty to maximize benefits requires VA to assess all of a claimant's disabilities to determine whether any combination of disabilities establishes entitlement special monthly compensation (SMC ) under 38 U.S.C.A 1114. VA published a proposed rule to revise the regulations involving the musculoskeletal system within VASRD on August 1, 2017 (82 FR 35719). This example shows how powerful the bilateral rating can be. See Bradley, 22 Vet. App. According to the rating criteria, if the knee can straighten, but can't bend all the way, it is rated under 5260. It should also be noted that use of terminology such as "marked" by VA examiners and others, although an element of evidence to be considered by the Board, is not dispositive of an issue. That rating is the highest available under that Code based on hip disability. Please call for an appointment before visiting: Mail Processing Center: P.O. 2. In these instances, the ratings will be combined, for the left and right sides, and 10 percent will be added. 52375 (1999) (the logic of Bradley suggests that if a Veteran has a schedular total rating for a particular service-connected disability and subsequently claims TDIU for a separate disability, VA must consider the TDIU claim despite the existence of the schedular total rating and award SMC under section 1114(s) if VA finds the separate disability(ies) support a TDIU rating independent of the other 100 percent disability rating). 111, 115 (2008). The Veteran filed his notice of disagreement in June 2010, claiming his hip pain was getting progressively worse. The Veteran's flexion, internal rotation, and abduction were all restricted and painful. In November 2013, the Veteran's physical therapist summarized his eight treatment sessions noting that there were initial improvements in his pain symptoms, but the pain returned when they started gentle strengthening. Lets look at this step by step with an example. For the purpose of rating disability from arthritis, the hip is considered a major joint. If you have multiple disability ratings, we use them to calculate your combined VA disability rating. Importantly, the bilateral factor can be combined to achieve the schedular rating requirements for TDIU, or total disability based on individual unemployability. 38 U.S.C.A. 38 C.F.R. We'd love to keep you informed of VA news, disability claims progress, and other things that affect the veteran community. COMBINED RATING: 0% COMBINED RATING OF ALL VA CONDITIONS: 30% ANALYSIS SUMMARY: Chronic Bilateral Hip Pain. Houston, TX: 2925 Richmond Ave, 12th Floor, Houston, TX 77098 Why Hire CCK for Your VA Disability Appeal? Anything that will help the rating to be fair counts in your DIC (Dependency and Indemnity Compensation) claim. App. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. Sign up for our weekly email newsletter to stay updated on VA news, policy changes, and more. The Veteran served on active duty from April 2008 to July 2008 and from February 2009 to February 2010. Some of the common knee conditions covered by diagnostic codes are as follows: On VA examination in November 2015, the Veteran noted minimal improvements since his hip surgery. The specific diagnostic code for bursitis of the shoulder is 5201. When you visit web sites, they may store or retrieve data in your web browser. Phoenix, AZ: One Renaissance Tower, Two North Central Avenue, 18th & 19th Floor, Phoenix, AZ 85004 4.27. Inquiry will be directed to these considerations: (a) less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up, contracted scars, etc. He found that the Veteran had no additional functional impairment due to pain, no pain on three repetitions of use, and no fatigue, weakness, lack of endurance, or incoordination. Each side is rated individually and then 10% of their combined rating is added as the bilateral factor. According to the official definition found in the Code of Federal Regulations (C.F.R.) Factors to be considered are the veteran's education and employment history and loss of work-related functions due to pain. Diagnostic Code 5000: Osteomyelitis, acute, subacute, or chronic: Department of Veterans Affairs. yet assertive representation for our clients. ); (b) more movement than normal (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc. How Do I Increase My VA Disability Rating? Analysis They may also be used to keep track of what [products, video, links, etc.] Updated: January 26, 2023 Common Foot Conditions Among Veterans Injury, overuse, or inflammation of the bones, ligaments, or tendons in the foot can cause debilitating pain and discomfort. ); (c) weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc. He also reported having flare-ups. However, there was no muscle atrophy. Military service-related injuries on any part of the body can ultimately cause stress on the hips. Thats an increase of over $300 per month thanks to the bilateral factor. Find out if it can help you get a higher VA rating. 4.27. Have you been affected by Camp Lejeune water contamination? Washington, D.C.: 1776 I Street, NW, 9th Floor, Washington, D.C 20006 280, 294 (2008) (finding that SMC "benefits are to be accorded when a Veteran becomes eligible without need for a separate claim"). Yes, and it might be your only chance. The VA examiner noted that the Veteran's hip pain was interfering with his school and other activities. Our law firm helps veterans and their family members obtain VA disability compensation, putting client relationships at the forefront of our practice. App. These in-service events can cause significant hip pain and sometimes lead to chronic disability. While in law school, Anne was a research fellow for a professor who provided free legal counsel for military personnel believed to have been wrongly accused while at war. VA Disability Rating with Bilateral Factor. Citation Nr: 1621722 The Veteran continued to endorse hip pain throughout his VA treatment records. Code of Federal Regulations (C.F.R.) The VA wont know how hard it is to wash your hair or feed your grandkids breakfast unless you tell them! For a free case evaluation with a member of our staff, call us at 800-544-9144. In January 2014, the Veteran submitted a statement to VA declaring that he could no longer work due to being physically unable because of pain in his left hip. The Board has considered whether the Veteran's left hip disability presents an exceptional or unusual disability picture as to render impractical the application of the regular schedular standards such that referral to the appropriate officials for consideration of an extraschedular rating is warranted. Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive. 4.2, 4.6. 38 CFR 4.26 - Bilateral factor. 3.350(i). Disabilities of the musculoskeletal system are primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. How Much Does Having Bilateral Disabilities Increase My Rating? This data may be used to help optimize our websites and make them easier for you to navigate. you may qualify for SMC (Special Monthly Compensation), VA Disability Bilateral Factor Calculator, Articles Explaining the VA Disability Application Process, What Veterans Can Do if They Cant Work Because of PTSD, Arthritis in your left hand and right elbow flexion pain. 280, 294 (2008); see also DVA Sum. Hip pain is a fairly common complaint among the general public and can cause a variety of additional problems and complications. App. A February 2010 VA examination showed no evidence of ankylosis. M. G. Mazzucchelli, Counsel INTRODUCTION Without these cookies, services you have asked for cannot be provided. Woods and Woods helps a lot of veterans appeal because you must provide new material when you appeal. Rachel Foster: Sure. 1114(s); 38 C.F.R. The following measurements are taken to determine the ROM of the hip: Flexion: Forward motion of the leg at the hip - like taking a step forward. 4.16(a). The therapist noted that the Veteran was prone to hip flexion tightness and internal and external rotation tightness. Disclaimer: This information is not legal advice. Gober, 14 Vet. Tucson, AZ: One South Church Avenue, 12th Floor, Tucson, AZ, 85701 5100, 5102, 5103, 5103A, 5106, 5107, and 5126 (West 2014); 38 C.F.R. The Veteran went to physical therapy in October 2012. However, the VA examiner was able to report that the Veteran did not have ankylosis, malunion or nonunion of the femur, a flair hip joint, or a leg length discrepancy. These ratings are assigned based on how much the knee can bend. App. The Bilateral Factor Can Help Your VA Disability Rating, Bilateral (both sides) Disabilities are More than Twice as Hard. 1114(s) is granted, effective August 16, 2012. Veterans Law Judge, Board of Veterans' Appeals Without the Bilateral Factor, the final rating would have been 43% rounded down to a 40% benefit, but with the Bilateral Factor, that 47% will be rounded up to a 50% rating benefit worth an additional $309.96 per month! Any other service-connected disabilities will be combined with the total bilateral rating (after adding 10 percent) in the traditional combining method. 3.102 , 3.350 (2015). 4.59 (2015). 1. He stated that flare-ups were unpredictable with no clear precipitating factors though they could occur with significant activity. Entitlement to a total disability rating for compensation based on individual unemployability (TDIU). The criteria for special monthly compensation at the housebound rate, effective August 16, 2012, have been met. To find out more, view our Privacy Policy. Subject to the law and regulations governing payment of monetary benefits, an initial 30 percent rating for left hip internal derangement is granted. The record shows that the Veteran has been precluded from securing and following substantially gainful employment by reason of his service-connected left hip disability from August 16, 2012, the date he met the schedular criteria for TDIU. However, as these increases did not represent a total grant of the benefits sought on appeal, the claim for increase remains before the Board. The therapist noted that the Veteran was complaining of worsening symptoms so that he could not use the treadmill. She also noted a tender superficial muscle in the left anterior hip. It just has to be contained to either your right and left upper body or your right and left lower body. Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are "equitable and just." Right foot with 3 toes amputated and left hip replacement. App. 57, 60 (1993). Special monthly compensation is payable where the Veteran has a single service-connected disability rated as 100 percent and (1) has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or (2) is permanently housebound by reason of service-connected disability or disabilities. 4.71a, Diagnostic Code 5003. Subject to the law and regulations governing payment of monetary benefits, entitlement to special monthly compensation at the housebound rate under 38 U.S.C.A. Citation Nr: 1736735 Decision Date: 08/31/17 Archive Date: 09/06/17 DOCKET NO. In April 2013 and again in October 2015, the Board remanded the appeal for additional development. Evidence of pain, weakened movement, excess fatigability, or incoordination must be considered in determining the level of associated functional loss, taking into account any part of the musculoskeletal system that becomes painful on use. 4.71a, Diagnostic Code 5010. The Veteran was exhibiting less movement than normal, pain on movement, and interference with sitting, standing, and weight-bearing on the left hip. App. Deland, FL: 1607 South State Road 15A Suite 12 Deland, FL 32720, Satellite Offices In the absence of limitation of motion, X-ray evidence of arthritis involving two or more major joints or two or more minor joint groups, will warrant a rating of 10 percent; in the absence of limitation of motion, X-ray evidence of arthritis involving two or more major joint groups with occasional incapacitating exacerbations will warrant a 20 percent rating. The bilateral factor recognizes the limitations caused by these disabilities and how they can impact the veteran. Such evaluations involve consideration of the level of impairment of his ability to engage in ordinary activities, to include employment, as well as an assessment of the effect of pain on those activities. The Veteran showed a reduction in muscle strength due to his service-connected condition to 4/5 or active movement against some resistance. See Bradley, 22 Vet. Research shows that certain foot conditions are significantly more prevalent in veterans versus nonveterans in the United States. Columbus, OH: 100 E. Campus View Boulevard, Suite #250, Columbus, OH, 43235 He also demonstrated evidence of pain at weight bearing but no objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. However, a veteran with a disability in both arms is able to do far less. The Veteran was not experiencing a flare-up at the time, and therefore, the VA examiner could not opine as to the effects of a flare-up. In an April 2015 written statement, the Veteran detailed his work history. Visit our website at cck-law.com. In some instances, this bump may mean the difference between qualifying for this benefit and not, as it could boost the veteran to the necessary 70 percent rating. 4.1. ) Contact us at (844) 567-1185. The VA examiner described the Veteran's range of motion as abnormal or outside of normal range. The 30 percent rating assigned based on marked hip disability contemplates some limitation of motion. This gives the veteran a bilateral factor of 2.8%. Richmond, VA: 7400 Beaufont Springs Drive, Suite 300, Richmond, VA, 23225 This is when the fibrous tissue along the bottom of your foot becomes inflamed. It can cause a great deal of pain in the . Bursitis of the Shoulder. This requirement is met when the Veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. A service-connected right shoulder at 20 percent disabling and a service-connected left elbow at 10 percent disabling combine to equal 28 percent. During reserve inactive duty training in June 2011, the Veteran reported experiencing sharp pain radiating from his hip to his knee and pain with internal and external rotation of the left hip. A veteran is considered more limited in daily life due to a bilateral disability because they cannot use the partnering disabled limb, hip, hand, etc. Extension: Backward motion of the leg at the hip - like taking a step backward. Under the Veterans Claims Assistance Act of 2000 (VCAA) VA has a duty to notify and assist a claimant in the development of a claim. Cincinnati, OH: 300 E Business Way, Suite 200, Summit Woods Corporate Center, Cincinnati, OH, 45241 San Jose, CA: 2880 Zanker Road, Ste.

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