lumbosacral Back Pain Worsening, denied increase?

[jwesley]

lumbosacral spine strain with mild thoracic scoliosis

20%

Service Connected

^^^ My current diagnosis... this was proven with an x-ray. My pain scale is at a 7, I went to the Examination for an increase and she seen how much pain I was in and how bad my muscles were swollen on the one side and she called it a "Flare up" even though I have this pain constantly and consistently every day all day. I can't even bench press half my weight with out it pinching and hurting enough to make me about drop the weight. They denied my increase, what more can I do to receive proper diagnosis and care? The doctors seem to brush me off, I seen a chiro for approximately six months and I am unable to receive a MRI because I have an AICD implant. I don't even know where to begin to try and get this fixed.

Any input is appreciated!

[Andyman73]

Yes, had an emg a few months ago to test the nerve conduction below my knees.  The first part was the electroshock part was fun! Not so much. But when she tapped my main nerve for the listen only part...felt like a charley horse!!! Both sides, she actually hit the nerve and boy did that really hurt! 

[Hoppy]

Is IVDS an issue on your back claim. If so keep reading. Also see

Citation Nr: 1536438 Decision Date: 08/26/15 Archive Date: 09/04/15 DOCKET NO. 09-19 478

The following information has been on my computer for many years.  I think it still applies.

From a VA training manual   1. How is IVDS rated?


a. IVDS that is primarily disabling because of periods of acute symptoms that require bed rest according to the cumulative amount of time over the course of a year that the patient is incapacitated, i.e., requires bed rest and treatment by a physician, is evaluated at 60 percent if there are incapacitating episodes of at least six weeks total duration during the past 12 months; at 40 percent if there are incapacitating episodes of at least four but less than six weeks total duration during the past 12 months; at 20 percent if there are incapacitating episodes of at least two but less than four weeks total duration during the past 12 months; and at 10 percent if there are incapacitating episodes of at least one but less than two weeks total duration during the past 12 months.

Many years ago I did a lot of research on the bed rest issue and found very little.  I do all my research by reading BVA cases.  WARMS will not tell you how the laws are interpreted. The BVA decisions include a summary of the medical evidence and the application of the laws.  When doing my BVA research, I only found one claim that was awarded 60% using the bed rest criteria..  I found tons that were denied because there was no prescribed bed rest. The claim that was awarded was for a VA clinician (MD) who kept a log of days missed from work and he wrote a prescription for himself for bed rest to cover the days he missed work.

 

A veteran who posted on hadit asked his VA primary care doctor for a prescription for bed rest and the doctor told him that the bed rest was not part of the treatment for a back condition.  It would not surprise me if there are VA clinicians who make up excuses not to write bed rest prescriptions because they are anti compensation doctors.

 

 

http://en.wikipedia.org/wiki/Bed_rest

 

Bed rest is commonly prescribed in the following cases.

 

For sufferers of acute pain in the spine or joints; for example, in the case of backache the unloading of the corresponding spinal segment decreases the intradiscal pressure, and it would bring relief in cases such as compression of spinal nerve. The prescribed duration of bed rest vary and opinions differ.

 

 ______________________________________________________________________________________________________________

 

There was another veteran on hadit who wrestled with the bed rest issue.

 

He got letters from his doctor saying that he had been placed on bed rest in excess of six weeks during the last year. A DRO challenged the doctor’s assessment. The DRO wanted a more detailed explanation of the bed rest. The DRO told the veteran that he did not believe that he went an entire six-week period without getting out of bed. The DRO’s definition of bed rest was a requirement that you could not get out of bed at all. This DRO could be an idiot. The problem is that his decision to delay the claim or worse yet someone at the BVA might agree with them.  I guess this DRO did not know the difference between bed rest and strict bed rest.  Maybe the DRO just makes up requirements that are not beneficial to claims. Bed rest prescription should be made ongoing by the doctor and not based on a rehash of historical events.  Getting the doctor to write letters showing that a history of bed rest was applicable has not worked.

 

 

http://medical-dictionary.thefreedictionary.com/bed+rest

 

 

bed rest

 

restriction of a patient's activities, either partially or completely. A person on strict bed rest must remain in bed at all times. Many patients are placed on bed rest with bathroom privileges and are permitted to ambulate to a toilet in the bathroom.

 

 _________________________________________________________________________________________________________________

I have not seen anything in any VA case requiring that strict bed rest is necessary for rating under code 5243.

 

 

By the way I have felt your pain. I have been incapacitated by disc disease pain which required bed rest every day for flares lasting one year in 2012 and two years in 1997 and 1998. However not service connected.  Also the flares resolved to the point where I could return to playing golf and hit drives 300 yards.

 

 

Edited November 3, 2015 by Hoppy

[rpowell01]

 

I remember the first EMG I had back in 2013 on my legs. Man O' Man that was the worse pain. Then earlier this year I could barely feel the EMG being conducted. Why? Because the VA decided not to touch my back and now I have a lot of loss of sensation and feeling to touch. I don't go outside anymore because ants would bite me and I wouldn't feel it until a minute into the bite. By that time the damage is done and man did the pain kill me afterwards. Its really weird how we as humans can lose sensation and feelings but we can still feel the nerve pain. Its really weird. BTW because of the VAs Neurosurgeon not wanting to touch me I now have POLYNEUROPATHY which basically means my nerve walls are damage now in both my legs, permanently, do to the constant compression at my L5-S1. 

 

Folks please take care of yourself and your spine because the worse pain there is, is nerve pain and its not fun.

[Andyman73]

Even tho it's been about 3 months since the EMG, I still get flashes of pain in my lower legs from where she had tapped my nerve trunk, for the listening part of the test.  Like my Father says "Hurt so fine!" I have been burnt by stoves and fire, but that pain in my legs....it was making me feel sick to my stomach, my whole body was feeling it. Felt like a charley horse cramp on crack!  She wanted me to move my foot, so she could hear if the signals were going down, I told her I can't move it, it wasn't responding, the pain was locking it up. I was hollering at her to move the needle, when she did, then it was okay.  Both sides!!! She hit the same spot, dead on, both legs!  She was checking for nerve conduction and impingement from the knees on down.  I have a bulging disc at my L5-S1, with moderate to severe narrowing of the neural foramina. 

I do have an active claim for radiculopathy for both legs.

[rpowell01]

Andy you know I now remember that days following this year's EMG I was in severe pain. Yes it felt like fire or a tattoo gun, burning and ice cold feet.

 

The very first time I ever had an EMG was back in 2010 or 2011 on my arms. This was at Bay Pines and they didnt use needles but were ring type stuff they put on each finger. My kids were in the room with me and they loved it and laughed so hard. Every time he shocked me my whole body jumped off the table. I felt the shock down my spinal cord. But it was funny because my kids laughed so hard and loved seeing me go through that shocking type of pain.

[Andyman73]

rpowell01,

Kids, aren't they great!?!

Within a few days of my EMG, I started getting a buzzing sensation in both legs, but from my waist on down.  It feels like the pins and needles you get when your arm or leg falls asleep, and then you move it and the blood flow resumes.  Funny thing is...it's pulsating like my heart beat, but on a 4 beat cycle....every 4th heart beat.  Sometimes when I'm driving, or when I first stand up from sitting....very weird.