marinejay

BroncoVet, Thanks for the amazing info, it was a lot to digest, but I'll just have to do my research and this will definitely help me get started in the right direction.

Some help guys???????Please

Post the whole exam with your personal info hidden. It's hard to give a good answer with out reading the whole exam.. 't

Ryan, YOu are right and I went ahead and filed my appeal the week after I got my award letter. Right now my appeal for the effective date is in ebenefits and now I'll just have to wait and see. I talked to my VSO at the DAV and she said that I may have to get evidence showing or have a doctor state that I was injured since 2006 when I started my initial claim. My argument was, if my appeal stated that I met the requirements for 40% through the entire appeal, when did the DRO use my IME from 2013 to determine my effective date. Now I'll just have to wait and see what the VA does.

I've attached a copy of my Appeal and Decision award letter. I highlighted the important parts of both letter. Let me know what you guys. Think.. VA Decision & Appeal Award Letter..pdf

Thanks Guys. Now that I remember, in May of 2013 was when I had Dr. Bash do and IME (Independent Medical Exam) and the BVA letter states "Range of Motion testing by a private examiner in 2013, which considered pain, fatigue, weakness and decreased endurance on repeat testing" and was made after initial and after 3 repetitions with notation of additional losses, " see May 2013 Dr. C.B report. This supports the veteran's statements of additional functional loss due to pain and flare ups in support of a higher rating." and I guess the R.O used this as my effective date. So I guess I can also say I won my appeal on Dr. Bash IME, and as a matter of fact Dr. Bash 2013 IME helped me win my 3 claims (total of 10 conditions I think) via appeals after getting denied via the original claim. (ie upper neck 20%, bilateral radiculopathy 20% each, sleep apnea 50%, (MDD 50%, his opinion along with my va pysc who was the director of the dept b4 he left help me win, it also helped that my c&p doc was one of his resident student so he pretty much rubber stamped it.) and bilateral lower radiculpathy 10% each). So it looks like I may be going back to Dr. Bash for an IMO this time to support an early effective date and hopefully he doesn't try to charge me alot of money. My other thing is, since the BVA letter clearly states in the conclusion of Law "throughout the entire period on appeal, the criteria for a disability rating of 40% have been meet". which began in 2006 means nothing huh! Thanks for your replies every one.

Hi All, IT's been a while since i posted but I need some help form the experts regarding a BVA decision. Here is a quick cliff notes version of my appeal for increase for back (IVDS) In December 2006, I put in a claim for an increase for my back which was rated at 20%. In December 2007, The VA denied my claim but revised the rating from low back strain, to Degenerative joint disease and radicular symptoms of the lower extremities. I then asked for a denovo review and was denied, so I decided to appeal to the BVA, in 2008. Fast forward to 2012 and I finally got a docket number, my claim sat for another four years until I had my hearing in June 2016. In November 2016, the BVA granted me an increase from 20 to 40%. So I'm like good! finally won something. In the Conclusion of Law, it states "Thoughout the entire period on appeal, the criteria for a disability rating of 40% for degenerative joint disease, strain and IVDS of the lumber spine have been met. So I kept checking e-benefits to see when they will were going to update my rating. On January 5, e-benefits was finally updated and the RO made the effective date for the back increase May 13, 2013. That was the day I had my first C&P for my bilateral lower sciatica. I had evidence from before showing that my condition has worsened but the R.O made the effective day in May 2013, which makes me loose 7 years of back pay. I haven't gotten the R.O letter as yet to see what it says, but I DEFINITELY plan to appeal the effective date. My question is: Shouldn't my effective date been December 2006 from when I put in the claim? The BVA letter clearly stated that "throughout the entire period on appeal, the criteria for a disability rating of 40% have been meet". I want to know why they made the effective date May 2013. Based on the BVA, do i have a good chance of winning my appeal for the EED. PLEASE HELP..

RUREADY, I work, but my back affects my ability to work, i constantly have to sit down or stand up. I work in an office so it kills me when i sit all day. I had Dr. Bash do a IME for me back in May 13, and his measurements were the following. Flexion/extension 20/10 L/R rotation 20/20 L/R lateral bending 10/10 I want to see how the rate this and I'll keep you guys updated.

Hello everyone, I am just curious at what I looking at for compensation. I am currently SC 20% for back and 10% for right radiculopathy. I am looking to get SC for left radiculopathy and an increase in my back. Thoughts please. My thoughts. I get SC for bilateral readiculopathy @ 10% each and back stays the same at 20%. my goal is to get 30-40% for back. Important sections are in bold to cut through the silt.... LOCAL TITLE: C&P EXAMINATION STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: AUG 07, 2015@08:00 ENTRY DATE: AUTHOR: EXP COSIGNER: URGENCY: STATUS: COMPLETED Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire Name of patient/Veteran: Indicate method used to obtain medical information to complete this document: [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes [X] No If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with a thoracolumbar spine (back) condition? [X] Yes [ ] No Thoracolumbar Common Diagnoses: [ ] Ankylosing spondylitis [ ] Lumbosacral strain [X] Degenerative arthritis of the spine [ ] Intervertebral disc syndrome [ ] Sacroiliac injury [ ] Sacroiliac weakness [ ] Segmental instability [ ] Spinal fusion [ ] Spinal stenosis [ ] Spondylolisthesis [ ] Vertebral dislocation [ ] Vertebral fracture Diagnosis #1: Degenerative joint disease, lumbar spine, with bilateral sciatica ICD code: 721.3, 724.3 Date of diagnosis: 2003 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's thoracolumbar spine (back) condition (brief summary): 35 y/o male on active Marine Corps service 1998-2002 as enlisted aviation operations specialist. Currently works full-time as office manager, doing mostly desk work and sometimes teleworking from home. Gets his medical care usually via the VA, but also has a private doctor. Approx 2000 he injured his back while doing heavy lifting on his ship. Since then he has had recurrent back pain that has now become continuous. Currently while sitting at rest he says his low back pain is about 7 out of 10. If he sits for an hour, or walks or does yard work for about 45 min, then the pain gets up to 9-10 and takes several hours to return to baseline with rest. With the pain flares he describes reduced range of motion and weakness but not incoordination. The pain often radiates down the back of both legs, and also sometimes causes tingling and numbness. No bowel or bladder difficulties. No back surgery. Current meds: ibuprofen, vicodin, baclofen, gabapentin. Also uses an electrical stimulator intermittently. Has seen a chiropractor and physical therapy with modest temporary relief. Currently walks for exercise. In the past year has had to take off from work about 12 days because of back pain. b. Does the Veteran report flare-ups of the thoracolumbar spine (back)? [X] Yes [ ] No If yes, document the Veteran's description of the flare-ups in his or her own words: If he sits for an hour, or walks or does yard work for about 45 min, then the pain gets up to 9-10 and takes several hours to return to baseline with rest. With the pain flares he describes reduced range of motion and weakness but not incoordination. The pain often radiates down the back of both legs, and also sometimes causes tingling and numbness. c. Does the Veteran report having any functional loss or functional impairment of the thoracolumbar spine (back) (regardless of repetitive use)? [X] Yes [ ] No If yes, document the Veteran's description of functional loss or functional impairment in his or her own words. If he sits for an hour, or walks or does yard work for about 45 min, then the pain gets up to 9-10 and takes several hours to return to baseline with rest. With the pain flares he describes reduced range of motion and weakness but not incoordination. The pain often radiates down the back of both legs, and also sometimes causes tingling and numbness. 3. Range of motion (ROM) and functional limitation -------------------------------------------------- a. Initial range of motion [ ] All normal [X] Abnormal or outside of normal range [ ] Unable to test (please explain) [ ] Not indicated (please explain) Forward Flexion (0 to 90): 0 to 60 degrees Extension (0 to 30): 0 to 20 degrees Right Lateral Flexion (0 to 30): 0 to 20 degrees Left Lateral Flexion (0 to 30): 0 to 20 degrees Right Lateral Rotation (0 to 30): 0 to 30 degrees Left Lateral Rotation (0 to 30): 0 to 30 degrees If abnormal, does the range of motion itself contribute to a functional loss? [X] Yes (please explain) [ ] No If yes, please explain: Difficulty bending forward to reach. Description of pain (select best response): Pain noted on exam and causes functional loss If noted on exam, which ROM exhibited pain (select all that apply)? Forward Flexion, Extension, Right Lateral Flexion, Left Lateral Flexion Is there evidence of pain with weight bearing? [ ] Yes [X] No Is there objective evidence of localized tenderness or pain on palpation of the joints or associated soft tissue of the thoracolumbar spine (back)? [X] Yes [ ] No If yes, describe including location, severity and relationship to condition(s): Mild-moderately tender over lumbar spines and paralumbar muscles. b. Observed repetitive use Is the Veteran able to perform repetitive use testing with at least three repetitions? [X] Yes [ ] No Is there additional loss of function or range of motion after three repetitions? [ ] Yes [X] No c. Repeated use over time Is the Veteran being examined immediately after repetitive use over time? [ ] Yes [X] No If the examination is not being conducted immediately after repetitive use over time: [ ] The examination is medically consistent with the Veteran's statements describing functional loss with repetitive use over time. [ ] The examination is medically inconsistent with the Veteran's statements describing functional loss with repetitive use over time. Please explain. [X] The examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss with repetitive use over time. Does pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time? [ ] Yes [ ] No [X] Unable to say w/o mere speculation If unable to say w/o mere speculation, please explain: Per patient history, pain, weakness, fatigability or incoordination could significantly limit functional ability during flare-ups or when the joint is used repeatedly over time. However I am unable to quantify the degree of reduced range of motion during the flare-ups because I don't observe them, and the patient's description is a widely variable estimate and also depends on subjective factors such as individual pain tolerance. It would be speculation for me to quantify an additional range of motion loss that might occur during flare-ups or repeated use. d. Flare-ups Is the exam being conducted during a flare-up? [ ] Yes [X] No If the examination is not being conducted during a flare-up: [ ] The examination is medically consistent with the Veteran's statements describing functional loss during flare-ups. [ ] The examination is medically inconsistent with the Veteran's statements describing functional loss during flare-ups. Please explain. [X] The examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss during flare-ups. Does pain, weakness, fatigability or incoordination significantly limit functional ability with flare-ups? [ ] Yes [ ] No [X] Unable to say w/o mere speculation If unable to say w/o mere speculation, please explain: Per patient history, pain, weakness, fatigability or incoordination could significantly limit functional ability during flare-ups or when the joint is used repeatedly over time. However I am unable to quantify the degree of reduced range of motion during the flare-ups because I don't observe them, and the patient's description is a widely variable estimate and also depends on subjective factors such as individual pain tolerance. It would be speculation for me to quantify an additional range of motion loss that might occur during flare-ups or repeated use. e. Guarding and muscle spasm Does the Veteran have guarding or muscle spasm of the thoracolumbar spine (back)? [X] Yes [ ] No Muscle spasm: [X] None [ ] Resulting in abnormal gait or abnormal spinal contour [ ] Not resulting in abnormal gait or abnormal spinal contour [ ] Unable to evaluate, describe below: Localized tenderness: [ ] None [ ] Resulting in abnormal gait or abnormal spinal contour [X] Not resulting in abnormal gait or abnormal spinal contour [ ] Unable to evaluate, describe below: Guarding: [ ] None [ ] Resulting in abnormal gait or abnormal spinal contour [X] Not resulting in abnormal gait or abnormal spinal contour [ ] Unable to evaluate, describe below: f. Additional factors contributing to disability In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: Interference with sitting 4. Muscle strength testing -------------------------- a. Rate strength according to the following scale: 0/5 No muscle movement 1/5 Palpable or visible muscle contraction, but no joint movement 2/5 Active movement with gravity eliminated 3/5 Active movement against gravity 4/5 Active movement against some resistance 5/5 Normal strength Hip flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Knee extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle plantar flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle dorsiflexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Great toe extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 b. Does the Veteran have muscle atrophy? [ ] Yes [X] No 5. Reflex exam -------------- Rate deep tendon reflexes (DTRs) according to the following scale: 0 Absent 1+ Hypoactive 2+ Normal 3+ Hyperactive without clonus 4+ Hyperactive with clonus Knee: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Ankle: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ 6. Sensory exam --------------- Provide results for sensation to light touch (dermatome) testing: Upper anterior thigh (L2): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Thigh/knee (L3/4): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Lower leg/ankle (L4/L5/S1): Right: [ ] Normal [X] Decreased [ ] Absent Left: [ ] Normal [X] Decreased [ ] Absent Foot/toes (L5): Right: [ ] Normal [X] Decreased [ ] Absent Left: [ ] Normal [X] Decreased [ ] Absent 7. Straight leg raising test ---------------------------- Provide straight leg raising test results: Right: [X] Negative [ ] Positive [ ] Unable to perform Left: [X] Negative [ ] Positive [ ] Unable to perform 8. Radiculopathy ---------------- Does the Veteran have radicular pain or any other signs or symptoms due to radiculopathy? [X] Yes [ ] No a. Indicate symptoms' location and severity (check all that apply): Constant pain (may be excruciating at times) Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Intermittent pain (usually dull) Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Paresthesias and/or dysesthesias Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Numbness Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe b. Does the Veteran have any other signs or symptoms of radiculopathy? [ ] Yes [X] No c. Indicate nerve roots involved: (check all that apply) [X] Involvement of L4/L5/S1/S2/S3 nerve roots (sciatic nerve) If checked, indicate: [ ] Right [ ] Left [X] Both d. Indicate severity of radiculopathy and side affected: Right: [ ] Not affected [X] Mild [ ] Moderate [ ] Severe Left: [ ] Not affected [X] Mild [ ] Moderate [ ] Severe 9. Ankylosis ------------ Is there ankylosis of the spine? [ ] Yes [X] No 10. Other neurologic abnormalities ---------------------------------- Does the Veteran have any other neurologic abnormalities or findings related to a thoracolumbar spine (back) condition (such as bowel or bladder problems/pathologic reflexes)? [ ] Yes [X] No 11. Intervertebral disc syndrome (IVDS) and episodes requiring bed rest ----------------------------------------------------------------------- a. Does the Veteran have IVDS of the thoracolumbar spine? [X] Yes [ ] No b. If yes to question 11a above, has the Veteran had any episodes of acute signs and symptoms due to IVDS that required bed rest prescribed by a physician and treatment by a physician in the past 12 months? [ ] Yes [X] No 12. Assistive devices --------------------- a. Does the Veteran use any assistive device(s) as a normal mode of locomotion, although occasional locomotion by other methods may be possible? [ ] Yes [X] No 13. Remaining effective function of the extremities --------------------------------------------------- Due to a thoracolumbar spine (back) condition, is there functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis? (Functions of the upper extremity include grasping, manipulation, etc.; functions of the lower extremity include balance and propulsion, etc.) [X] No 14. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ----------------------------------------------------------------------- a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [X] Yes [ ] No If yes, describe (brief summary): Able to sit for the interview. Gait is normal. Limits his back ROM due to pain. b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: No response provided 15. Diagnostic testing ---------------------- a. Have imaging studies of the thoracolumbar spine been performed and are the results available? [X] Yes [ ] No If yes, is arthritis documented? [X] Yes [ ] No b. Does the Veteran have a thoracic vertebral fracture with loss of 50 percent or more of height? [ ] Yes [X] No c. Are there any other significant diagnostic test findings and/or results? [X] Yes [ ] No If yes, provide type of test or procedure, date and results (brief summary): MRI,SPINE LUMBAR W/O CONT. Exm Date: MAR 20, 2015@19:14 INDICATION: Back pain radiating down the right more than left leg. COMPARISON: Lumbar spine MRI 2/11/2003. Lumbosacral spine x-rays 1/14/2014. TECHNIQUE: MRI of the lumbar spine including: sagittal and axial T1 and fast-T2. Sagittal fast-STIR. FINDINGS: This report assumes five lumbar-type vertebral bodies. Lumbar spine alignment is preserved. Vertebral body heights and disc space heights are preserved. Normal disc signal. No developmental narrowing of the spinal canal. Diffusely abnormal T1-dark marrow signal, similar to 2003. The tip of the conus medullaris is at L1; the conus medullaris and nerve root of the cauda equina have an unremarkable appearance. At L1-2, no spinal canal or neural foraminal narrowing. At L2-3, no spinal canal or neural foraminal narrowing. At L3-4, no spinal canal or neural foraminal narrowing. At L4-5, diffuse disc bulge. Minimal spinal canal narrowing. Mild bilateral facet arthropathy. Minimal bilateral neuroforaminal narrowing. At L5-S1, disc bulge with small superimposed central protrusion. Bilateral facet arthropathy with small posteriorly oriented in facet joint cyst on the right. Mild bilateral neural foraminal narrowing, left greater than right. Within the limits of this examination, no infrarenal abdominal aortic aneurysm. Impression: 1. Minimal multilevel facet arthropathy without evidence of neural impingement. 2. Persistent diffusely abnormally dark T1-marrow signal. This is nonspecific but can seen with smoking, anemia, hematopoietic or hyperplastic marrow or marrow dyscrasias; neoplastic lymphoproliferative conditions would be unlikely to remain stable in appearance since 2003. 16. Functional impact --------------------- Does the Veteran's thoracolumbar spine (back) condition impact on his or her ability to work? [X] Yes [ ] No If yes describe the impact of each of the Veteran's thoracolumbar spine (back) conditions providing one or more examples: Avoid heavy lifting. 17. Remarks, if any: -------------------- Veteran was informed that this evaluation is for compensation and pension purposes only, and he/she is to return to his/her treating clinician for regular medical care.

I just wanted to share an earlier effective date appeal success. I dont want to write a novel, so I'll give the cliff notes version. I had put in a claim for right shoulder impingement 2nd to my left claim back in 2004. It got denied and I let the 1yr appeal date slip pass me. I re-submitted my claim back in 2006, it got denied in 08, I appealed in 09. After my claim sat in limbo for 3yrs I finally had an exam in Jun-12, I had submitted an IMO from Dr. Bash with my appeal and they granted me compensation in Sept 12. My rating was 0% from 06 to Jun 12 and 10% from Jun -12 when I had my c&p exam. I was pissed b/c i thought the correct rating should have been 10% from 2006 when I filed my initial claim instead of Jun 2012 when I had my exam.. I then submitted an appeal for the effective date in June 2013, and on Thursday I got a big suprise white envelope in the mail saying my 10% was granted from 2006, instead of 2012. Last nite I say a direct deposit for over 15k. I must say God is good b/c I'm in the process of closing on a house and the money will be used to replinish my Emergency Fund. THANK YOU JESUS

Happy for u brother, update us on the outcome.

Brother, you are really F-up but Based on the above you WILL NOT get service connected for your back. The Examiner stated that your condition was less likely (<50%) than not related to your service. Based on what was written, you never went and got your back checked out while you were in the military. You will need an IME or IMO (Independent Medical Exam/Opinion) stating that your injury was related to your service. Good Luck and sorry bout the bad news.

Thank you everyone, it was a long and hard battle.

Yea that's what I kinda figured. I am thinking they will keep me at 20 or raise me to 30. I am not familar with the back DBQ's. THANKS again.

as Jesusplay stated, you are looking @70%. with the possibility of automatic U.I. If you don't put in for it as soon as you get your rating. I think you may even get 100% if you are not currently or you cant hold a steady Job.