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    • New guy here!
      Alright, so now, it is Memorial Day, I've got to break this habit of daily e-bennies check, strangely enough, today was the day that the status had changed to "Requested Documents are Past Due." I am just assuming that this is the C&P from QTC a little over two weeks ago...I should follow up with and give them a call (QTC) right? 482 Days since I submitted an ITF, and 326 days since my claims have been received. I know that I'm probably/possibly not done with C&P exams at this point either, especially since the evidence on hand for the issues I'm claiming for SC aren't descriptive like the Encyclopedia Britannica Of which, are only buddy statements. *tap* *tap* *tap*....at least it's being taken care of now instead of 20+ years down the road (for this initial process anyways) Oh, and to anyone who didn't know, this is not my first filing. I went through the IPEB/IDES/MEB while on AD. Naive as I had been, it was still wrong for those people who were assigned to help and guide a young buck through a portal to hell like they did, and probably still do to this day. I'm curious now though, to any information regarding persons who have also been through CL's MEB and found themselves backtracking claims to collect errors or input overlooked claims/injuries.
    • Miss Figured EED?
      Note: some of these dates maybe off..I need my C-file to compare the EED. And how they gave the EED. From what date did they start it is my main question. if they said they started it from 1998  that is CUE  because I know they didn't.....the first time this disability arose is when I had emergency surgery from the VAMC for Appendix surgery.I was sent to..the Audiology & Doc did a hearing test on me  and that was back in the 80's He stated my hearing was bad enough to receive Compensation and hearing aids...but I was working and never consider filing a claim until it got worse  in 1997..1998 is when I first filed for  the noise indused hearing loss...and tinnitus.....the tinnitus shows to be awarded a year before the hearing loss...which is all untrue  they awarded the tinnitus when I won the DRO Hearing.2002/and awarded the IU IN 2003..if they have all these records  the records will show I am right..if they don't have these records in my C-file  something is up with that...its not that much retro for them to be shredding these records if that's the case? I remember Flip mention they cheated me out of years of retro  on the 50% as well as the IU BEING PAID AT THE 100% Rate. But these dates I put up here is just my recollection from my memory and they could be off   so I need my C-file to do anything  if the VA is correct on the dates and I have no evidence to raise a fuss..Then yeah I will not file a Claim or reopen to fix this  EED I am Contesting sinse I seen that 1998 start date for the 50%. I do have an ITF open started  back in Jan of this year. If i get my C-file and these records can prove my evidence is right and VA Cue...I will submit the INT...so hope I GET MY c-file in time.?? So hopefully by the time I get my C-file  I hope Asknod is crediting with his Aurthrozition/Certified to help Veterans.   ..............Buck
    • Miss Figured EED?
      forgot to suggest...you can ask them for an Audit. Then again they make a lot of audit errors. I got an audit after Regional Counsel Cued them on a claim I had that they refused to apply the proper regs to. In the audit however, it revealed that although they had to pay me 28 thousand, they forgot somehow an  additional 11 thousand too.  I sent them my handwritten calculations and they fixed that error very fast. They didn't want the Regional Counsel calling another CUE on them. Audits are deceiving because they look like the were done right. I have personally experienced however that VA does not know how to add,subtract, multiply ,or divide, in addition to being unable to read.
    • Miss Figured EED?
      Ms Berta the Veteran is me  and this was for my Military as Noise Ind used Hearing loss  and it has got so profound  it keeps me from doing my job I was trained to do after 25 years or so. I believe you and Flip help me with this claim back then here on Hadit...Flip and I corresponded by email back then and he talk with my spouse on the phone. Flip was the one that mention they messed up big time on the EED...ABOUT 18.000.00 Worth...but I was so happy I won the claim I forgot to submit the NOD...as Flip was upset pretty good that I choose a DAV SO to go with me to my DRO Hearing...if I had known now what I didn't know back then  things would be a lot different. Flip is enjoying his life now and got off Hadit...I hate to ask him for his help...I have my C-file on order...This has nothing to do with my recent PTSD Claim. altho they did give me SMC S1  H,B. and  rating at 100% I can't do anything until I get my C-FILE  and even then some of my records of this  may  may not not be  be there...since they took off that 1998 50% rating on myhealthvet.   .............Buck
    • Miss Figured EED?
      Buck if the whole search page comes up, the hadit links here  should answer your questions: http://community.hadit.com/search/?type=all&q=Date+eNTITLEMENT+aROSE+ssdi I think I used my husband's example there...If not...he had a claim in process for higher rating of his 30% PTSD.1994.And a Section 1151 claim. He applied for SSDI. Early 1993. They awarded first for the 1151 stroke but I prepared reconsideration because they (SSDI) didn't consider his PTSD. I found a regulation in their SSA manual that said they were supposed to consider all disabilities.He died with 2 claims pending. When VA finally got his PTSD SSDI award ,because it was dated during the same year he had filed for higher SC rating, they (VA) gave him, a very favorable EED of 1991, the same date of the SSDI PTSD award.The award came in 1997. 100% P & T for SC PTSD. He had been dead by then for 3 years. He never even knew the 1151 claim he filed had not only been won but that I filed FTCA as well. The "Date Entitlement Arose " is what Broncovet means. The posts I made in the search link are more detailed.      
    • Miss Figured EED?
      The EED was giving back to 1999 the year I stopped working because the DRO Quoted  We gave you an EED The date you fist filed for increase &the year you show to stop working However SS Records  shows I stopped working in 1997 & I stopped working in 1997 because I could no longer work for reasons of my SC Disability  and then I  Filed a claim ...and the EED was only for the 50%  ok they Adjusted that  and it was around 10.000 at the time  but should that went back to the date Service Connection was established? on my healthvet they showed I was 50%in 1998...I never got paid for that  and they only went back to 1999  as for as I can til. Now they took that off my healthvet...I was going to print it off but waited to late and now that is not showing up in my healthvet. I did take a screen shot and sent to Asknod to look at.  but we all know the VA makes errors and could have been a typo on there part.
    • Miss Figured EED?
      "Shouldn't they have went back to 1998  the date the vet was Service Connected?" No The established medical evidence at that time, per the VA, warranted the "0" However they might have committed a CUE in 1998 and had enough medical evidence to warrant at least 10% or more.  Still not enough info here to even guess. We don't know if the "0" was for the same thing they finally awarded the SC for. " I recommend this Veteran be reduced  at 0%compensation and with draw his Service connection Completely......Sign Dr  xxxxxxx  30 years experienced Medical Dr. " If that is verbatim ,that is an incredible statement even for a VA doctor to make. Can the veteran join us here and let us see his last decision?  
    • New VA Malpractice stats from reporter
      Broncovet Its good to hear your VAMC has a good Audology Dept I will never use mine Local VMC Until a Certain ENT Dr leaves. if I happen to see him no telling what I might do to him. For some lying and bad problems he caused me during my claim process...I can't stand to look at him. I go about 300 miles to my old West Tx Big Spring VAMC for my hearing problems and to get new Aids.
    • PTSD Denied NSC - Schizophrenia NSC
      You are most welcome. :o) Does he refuse psych treatment? Schizophrenia is a serious illness, but patients can often enjoy substantial improvement with treatment. With the NSC 50% rating for schizophrenia, he can receive free treatment at a VAMC or VA outpatient clinic.  When was he discharged? @THOMAS89031's point about continuity of symptoms is an important one. I've done several C&P exams with vets who were not diagnosed with schizophrenia in service but who began to manifest symptoms shortly after service. Schizophrenia usually starts with prodromal symptoms before progressing to the full-blown disorder, so if those symptoms can be identified as beginning during military service, and then continuity of symptoms can be demonstrated, then the veteran should be service-connected. (Of course, the ultimate decision is up to VBA or the BVA, as you know.) He might very well also suffer from PTSD, but it will help to see what the C&P examiner said about that. Yes, being wounded by an explosive booby trap is certainly a traumatic stressor. It sounds like they are not disputing that fact, but are instead saying that he is not displaying PTSD symptoms (or not many) currently.  You really need a psychiatrist or psychologist with experience conducting C&P exams, otherwise they won't know what kind of information VBA needs to determine service connection. Also, keep in mind that when a doctor completes a DBQ, he or she is declaring him or herself to be an expert witness, offering an expert witness opinion in a federal legal proceeding. Consequently, psychologists and psychiatrists who know what they are doing will devote sufficient time to conduct a thorough, evidence-based evaluation, and write a cogent report to support their diagnosis and opinion(s). So, you're talking at least 5, and as many as 10 hours for a good evaluation and report. At anywhere from $150 to $300 per hour (psychiatrists usually charge more), you're looking at $750 to $3000 for a well-written, persuasive report.  A potentially effective, but less expensive option is a "report critique", in which the psychologist or psychiatrist reviews all the relevant records, and then critiques the C&P exam report, pointing out deficiencies particularly with regard to following established VA guidance for C&P exams, and professional standards for such evaluations. Such a critique can support a request for reconsideration and a new C&P exam. If granted, the critique puts the new C&P examiner on notice that they better conduct a thorough, evidence-based evaluation consistent with VA guidance and relevant professional standards ... because you (and your experts) are watching.  Keep us posted!  All the Best, Mark  
    • Curious
      Hi Everyone! Would Like To Say Happy Memorial Day To My Fellow Comrades And All The Fallen Veterans For Paying The Ultimate Price Of Life! I Went On Ebennie Friday, May 27, 2016 And Seen Where My Claim Went To PDA. I Originally Filed For Three (3) Contentions: hysterectomy, bilateral foot condition and cervical radiculopathy. I received both C&P examinations on May 13, 2016 for hysterectomy and bilateral foot condition, but have not received one for the cervical radiculopathy. Have there ever been a situation where the rater may possibly rate the cervical radiculopathy along with the other two, if I have sufficient evidence in my records?

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rpowell01

Thoracolumbar....

19 posts in this topic

It is my understanding that the VA rates the Thoracolumbar as one segment. Basically this means if one part of the Thoracic spine is messed up and later on in life the lumbar starts to mess up then it is suppose to be rated as the same as if it was the thoracic spine because there is no Thoracic and lumbar separation in the diagnostic codes...Correct?

I've been looking at all my stuff and I think I missed something and so has the VA of course. After the accident in service it was my thoracic spine area that gave me huge problems. Then within a year all the pain progressed to my lower back and cervical spine. While in service the XRays showed degenerative changes in my thoracic spine. I was medically discharged for mechanical lower back pain (trust me if I knew then what I knew now, they should have retired me because of my cervical spine also)....

Fast forward to today. I currently have Osteoarthritis in CSpine, Thoracic Spine and Lumbar Spine. But in my Thoracic Spine you can see the vertebrae basically deteriorating, I think its called Schmorl's nodes which are small protrusions of vertebral disk tissue that bulge through the ends of weakened vertebrae.

In 2011, after realizing the VA never connected nor even mentioned my Thoracic Spine issues I file a claim on that particular issue. Well the C&P examiner said that it was an inservice diagnosis and that it was 100% service connected.

So, if my thoracic spine is serviced connected with current Osteoarthritis should the VA have SC'd my Osteoarthritis/DDD in my Lumbar with the same claim when in fact they knew I had DDD back then and I had a similar active claim and since they are ONE segment? This is like saying we if a person had two breaks in one bone and they SC'd one break but not the other.

Here is the definition of Thoracolumbar:

1. Of or relating to the thoracic and lumbar parts of the spinal column.
2. Of or relating to the thoracic and lumbar nerves.
3. Of or relating to the sympathetic division of the autonomic nervous system.
I could be wrong but the VA should have rated both as one?
They are Preparing a Decision on my current claims but I do have a NOD by DRO actively in with them. I did submit a Dr. Bash IMO for the NOD and the active claims. I am hoping they will combine both of them together on making a decision, I can just hope.
If they don't couldn't this argument be one of the many arguments that I have I can use if I have to or when I go see the DRO for the NOD if I have to go that far?

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Let me add one more to that and extend the question. I have radiculopathy in both my legs and feet. Since the Thoracolumbar is considered one as written by definition: Of or relating to the thoracic and lumbar nerves, should they also have had rated the radiculopathy as part of the Thoracolumbar. It is my understanding by all the BVA case I have read the RO's and C&P examiners are NOT suppose to pick and chose and separate the Thoracolumbar....

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You can chime in on this but I think JBasser answered my question:

"Sharon, the c spine is rated separate. The Thoracic and lumbar spine are combined. The VA uses the term thoracolumbar that is a combination of the two.


General Rating Formula for Diseases and Injuries of the Spine(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):With or without symptoms such as pain (whther or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or diseaseUnfavorable ankylosis of the entire spine100Unfavorable ankylosis of the entire thoracolumbar spine50Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine40Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine30Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis20Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height."

So it seems the RO raters are doing their own thing instead of going by the Diagnostic Codes. Its okay I am ready for them at the NOD by DRO if I have to go that far....

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There is ambiguity in the regulation (suprised?).

§ 4.45 The joints.

[redacted to save space]

(f) Pain on movement, swelling, deformity or atrophy of disuse. Instability of station, disturbance of locomotion, interference with sitting, standing and weight-bearing are related considerations. For the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle are considered major joints; multiple involvements of the interphalangeal, metacarpal and carpal joints of the upper extremities, the interphalangeal, metatarsal and tarsal joints of the lower extremities, the cervical vertebrae, the dorsal vertebrae, and the lumbar vertebrae, are considered groups of minor joints, ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are considered to be a group of minor joints, ratable on disturbance of lumbar spine functions.

This part of 38 CFR clearly indicates they are seperate segements. for ratings based on arthritis only they would be rated seperately. For IVDS you could generate seperate ratings for each segement provided that the incapacitating episodes were distinct and seperate for each segment.

If you have khyposis or scoliosis in your thoracic spine segment you should be able to get service connection for the lumbar segment and cervical segment under:

§ 4.59 Painful motion.

With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Muscle spasm will greatly assist the identification. Sciatic neuritis is not uncommonly caused by arthritis of the spine. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. 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. Crepitation either in the soft tissues such as the tendons or ligaments, or crepitation within the joint structures should be noted carefully as points of contact which are diseased. Flexion elicits such manifestations. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.

I forced my cervical SC with this citation since my throracic spine has khyposcoliosis (kyphosis and scoliosis). Next time my file is open I will push for seperate SC for my lumbar spine(no ratings increase) since a C&P physician when discussing radiculopathy indicated my lumbar spine wasn't SC therfore radiculopathy was a mute point. Because my evidence was weak I didn't push it, but I am gathering evidence and we will be putting this in the stack if they ever try to reduce or open up my ratings again.

Best regards,

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The problem I have had was that they VA serviced connected me with "Cervical Spine Pain" and Mechanical Lower Back Pain"....So, I had to get Dr. Bash on the case and look at everything. He basically quoted word for word from medical journals that linked the trauma/injury and that I had DDD/Osteoarthritus/DJD throughout my whole spine.

I actually have a NOD by DRO in whenever they denied my DDD/Osteoarthritis, basically trying to get them to change the Diagnostic Code to the next level in my spine but they denied it even though one C&P examiner said I had degenerative changes in my thoracic spine on XRay while in the military.

They don't seem to understand that since 1. The Xrays showed degernative changes and 2. The C&P Examiner said I had Degenerative Changes in my Thoracic Spine that it was in fact service connected I have them by these two things.

You can separate the Thoracic and Lumbar even for being rated. So this means that if I now have DDD/Osteoarthritis in my lumbar like I do in my thoracic spine then they MUST service connect the radiculopathy in my legs, feet and toes.

Its all good, I can't wait to have my NOD by DRO, unless the decide to take the NOD by DRO and combine it with my current claims because of Dr. Bash's letter.

Finger crossed and I have actually started to write up a huge report for the NOD. And I am writing up my rebuttal to the current C&P exam along with witness statement from my wife.

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Eventually someone (DRO, BVA, CAVC) will understand that they are entitled to form their own opinions, but not facts.

It sounds like you have some good strong facts on your side. Eventually the VA will have to deal with them. What they hope to do is stall, demoralize, confuse with the goal of you not filing a timely appeal or accepting their lowball rating. They are hoping you make a mistake!

Hang in there and best regards,

Edited by 71M10

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Oh I got them with that C&P Examiner back in 2011 stating my thoracic spine was a cause and with Dr. Bash's IMO I will prevail.

They just want to play the "Lets see how stupid this guy is" game and I am prevailing IMHO...

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Don't know what this will mean to the VA but what I'm wondering is what percent ill get for my MRI diagnoses...

- THORAC/LUMBOSACRAL NEURITIS/RADICULITIS

- DDD LUMBAR SPINE

- LUMBAR DISC DISPLACEMENT

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Don't know what this will mean to the VA but what I'm wondering is what percent ill get for my MRI diagnoses...

- THORAC/LUMBOSACRAL NEURITIS/RADICULITIS

- DDD LUMBAR SPINE

- LUMBAR DISC DISPLACEMENT

Please don't post the same thing in different forums

and start a new topic.

Thanks

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I have mild degeneration in my t12 and t11 I hurt my back numerous times but never went to sick call, so I don't have anything noted in my smr. Will the va grant sc if you told the c and p doc about your pain prior to ets and they are currently still developing your claim. I have x rays showing degeneration of my lower thoracic spine. I'm only 33 and never injured my back prior to my 3 years in the infantry.

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I have mild degeneration in my t12 and t11 I hurt my back numerous times but never went to sick call, so I don't have anything noted in my smr. Will the va grant sc if you told the c and p doc about your pain prior to ets and they are currently still developing your claim. I have x rays showing degeneration of my lower thoracic spine. I'm only 33 and never injured my back prior to my 3 years in the infantry.

i would say most likely not. If you don't have the Inservice medical documentation they won't make that leap for you. They are notorious for this. Look through your records maybe you are overlooking something, that happens with the timespan I between your injury and when you decide to pursue a claim. Edited by arng11

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Leadbelly, If you have xray evidence of arthritis within service or the first year afterwards, service connection should be no problem!

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That is exactly the thing. I don't. But as I understand things the va has the duty to assist the veteran in developing the claim. I filed this claim in September 2003 two months prior to my gets. After I gets I got a letter stating that my claim was deferred for additional development, had the va developed my claim would have had evidence but they didn't and it is now 11 years later. I would have also had evidence after I got out but I made to much to qualify for va or state insurance but not enough to afford private insurance. So right now the va acknowledged that my claim is outstanding and has again deferred it for additional development. I have Dr x rays from my chiropractic doc showing he degeneration in the area where I have pain.

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So since the va never developed this claim shouldn't the finding of my next c and p be considered.

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I am a bit of a pessimist and a realists. You and I or just say we as claimants are going to have to realize that the VA is not our friend. They are not going to make it easy on us. They are an insurance company of sorts, plain and simple. They are going to try to tear up the validity of your claim, attack your character, blame it on something other than your military service, such as genetics or some type of willful misconduct on your part. Yes the law is on our side, yes there are regulations that state this is how things are supposed to be, however, if that were the case there wouldn't be the need for an appeals process. There would not be a need to seek appellate review and furthermore there wouldn't be the need to take this up to through the court system. It is what it is. The sooner you realize that the real enemy is the VA system, the sooner you will be in conquering your new enemy. Not trying to be dramatic. I am just stating how it is. The weapons you have now are law, regulation, and evidence so it would behoove all of us to use them strategically and without remorse. This IS our reality and this IS our new WAR!!!!

JMHO from the heart.

Edited by arng11

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I totally agree with and see what you are saying. Thank you for your input. I will have to play their game this September is 11 years since I filed the claim. I'm hopeful that the va will order a c and p and x rays and see the degeneration and link the degeneration with my claim of lower back pain from 2003 since they should have ordered and c and p in 2004. But like you said this is dog eat dog so any input is greatly appreciated.

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I totally agree with and see what you are saying. Thank you for your input. I will have to play their game this September is 11 years since I filed the claim. I'm hopeful that the va will order a c and p and x rays and see the degeneration and link the degeneration with my claim of lower back pain from 2003 since they should have ordered and c and p in 2004. But like you said this is dog eat dog so any input is greatly appreciated.

I don't want to break the bad news to you on this. But in case you haven't figured it out. The time to have appealed that bogus decision was during the first year while in the NOD period. Since that time has long expired you are out of look getting any retro. There is a chance, that if you have everything they had at the time of the decision, and can prove that your conditions should have been rated higher, and prove that they did not follow the law, then you might be able to call a CUE. Clear and unmistakable error. However, with saying that, the process of CUE is lengthy and a crapshoot. Plus, you, as the veteran, don't have the law on your side as you do at the beginning of any claim. CUE is an ugly animal, although possible to win, it is a long drawn out battle. I am not trying to kill your hopes. I am just trying to prepare you for the BS! Ask around on here. Berta has some CUE templates and you can research on your own some of the decisions that the BVA and CAVC has made. There are plenty of Supreme court decisions as well. The amount of firepower you have and use is totally on you. The law, regs, and precedent set by the courts are your weapons. Evidence is your artillery and truth are your smart bombs. Hit them every which way you can.

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So they can shoot down a claim because they never made a decision and too much time has passed?

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personally I never read about an initial claim taking that long to get rated and decided on. But you are 30% right? I can tell you will get lowballed as most of us do. They will probably give you a 10% for IVDS of 1 vertebrae and unless you have 6 weeks I believe of incapacitating episodes you will not make the higher rating. Check the CFR though. I don't recall the exact specifics. Degenerative arthritis will either land you 10 to 20 % for each major subgroup but thoracic and lumbar are rated as one. Then there is the range of motion part of the regs. Greater than 60 less than 85 10%. Greater than 30 but less than 60 20%. Check out CFR diagnostic codes 5235 and so forth that you give you a good start.

I have mild degeneration in my t12 and t11 I hurt my back numerous times but never went to sick call, so I don't have anything noted in my smr. Will the va grant sc if you told the c and p doc about your pain prior to ets and they are currently still developing your claim. I have x rays showing degeneration of my lower thoracic spine. I'm only 33 and never injured my back prior to my 3 years in the infantry.

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