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Recently separated - dealing with disc bulge issues & VA next

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aoneinsun

Question

Hi,

I’ve been recently separated as a USAF Captain from active duty due to reduction in force, and I am new to this realm. (I was not medically separated.) I’d sure appreciate some advice.

 

Background

While on active duty, I suffered a bulging disc and had a lot of left hip discomfort after some long runs at the unit’s physical training sessions. They called it piriformis syndrome and gave me physical therapy sessions at the base clinic, muscle relaxers, & some pain killers. I’ve long had an issue with my low back which have been well documented throughout my career, and have paid for a chiropractic care out of my own pocket (Tricare does not cover chiropractor) for 10 years to keep my back in decent shape. I was identified as having a mild curve (scoliosis) before joining the service in fact.

I suspected something more was wrong since I felt more discomfort in the back (in addition to the left hip), and so I asked for an MRI of my back. That is when they found a 5mm disc bulge at L4-L5, pushing into the nerve root there.

The base physical therapy sessions (and some off base message work) did help my left hip muscles loosen, but I was still having left hip pain and back pain. So I did just go through round two of physical therapy off base (about 14 PT sessions). I couldn’t straighten either leg during their straight leg exam. I’m slightly better afterwards but still having about the same issue with what I believe is a bulging disc that is the main culprit for the pain in the hip. I’ve never had any shooting pain down the leg thank goodness. But recently I’ve also had some feeling of pin pricks sticking me in the toes of my left foot while driving, which I think is a bit of sciatica. I’ve also recently had mild twitching episodes/muscle spams, which happen intermittently on my left side.

Since I limp and favor my right side, it has been taking all my weight. Recently, I have noticed my right knee has been hurting, and my right ankle too, with my right ankle hurting to lift up too far (angling the right ankle up to the right to far results in an interesting pop sound, which hurts).

My 6 months of Tricare benefits post-separation are over, and I’m meeting with the VA doctor for an initial exam in early December. I am wondering how this will unfold. Here are a few of my questions:

  • While standing I have very limited ability to step forward with my left foot (if keeping my left leg straight). I also cannot quite lift my right leg up fully (if keeping the right leg fully straight). I believe this is because of the bulging disc, and sciatic pain that results (felt in the left hip which prevents me from stepping forward very much without going into pain). If I have this issue with BOTH left and right legs, would bilateral factor come into play, or are they likely to say that is all because of the bulging disc (which is what I really think)? I researched and found that limited motion of the hip seems like the most applicable rating along with some radiculopathy (sciatica). Is that the most applicable for rating purposes?

  • They had done an MRI of my left hip, and the MRI came back normal. But I think something may be going on with the hip such as trochanteric bursitis (though I’m no Doctor), since the remaining pain is along the outside of the left hip, and not just the buttock. There is also constant ache deep in the left hip,

  • Should I ask the VA Doctor for examination of the left hip in particular?

  • I assume they will give me a cane to help take the pressure off my right side. I have full range of motion of the right knee, but it has a wired feeling (as though it has been twisted), and it hurts to flex while bearing weight, and it hurts with certain motions. Would this be ratable as secondary to (caused by) the back issue which has forced me to put all this extra weight on the right knee over 8 months? Since I still have full range of motion, is the pain with motion all that must be evident for the knee to be rated more than 0%? Or is pain AND limited motion required for the knee to be rated above 0%?

  • As to the right ankle, I cannot lift my toes up much (dorsiflexion). I think this falls under code 5271: If the ankle is not frozen, but limited in motion.  If I lift the ankle up too much it pops, and that hurts. It aches in general. Apparently, the ankle is considered a major joint. If it only has pain and nothing else in this major joint, would that result in a rating higher than 0%? Or is BOTH pain and limited motion required for the ankle to be rated above 0%?

  • I cannot bend down to touch my toes. In fact I cannot bend over much at all without feeling pain in the left hip. I think that will fall under 5237: Lumbosacral or cervical strain. (I certainly cannot bend over more than 30 degrees, which is certainly ratable.) Is 5237 the most applicable for rating purposes? 

  • For any of the tests the VA will ask me to do, must I go into pain to ascertain the maximum range that I can flex to? I intend to stop flexing before pain and let the VA examiner know of the pain.

With these various issues, should I consult an attorney up front? Are there good attorneys or really, really knowledgeable people about this unfolding process to really get good advice? Who would you recommend?

I appreciate any advice and thoughts for pointing me in the right direction for the best help.

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...at some stage, not sure when though, others will chime in I'm sure, aoneinsun, you'll probably be able to claim your other side as a 'secondary' see'n that your other side has been bearing all the weight, etc to compensate for your side with the most limitations

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