WVSERVER

It can be a crazy process,keep your head up.

Praying that they pop there head out and get moving.

Rick thanks for the kind words

Thanks for all the reply's and kind words. US VET wishing you a speedy and positive adjudication.

Thanks it was a big hurdle.

Glad to see it the documentary Wounded Platoon that was made by PBS discuss this very fact. Best quote was from a full bird who said as the best I remember it, they(Solder) came to us from society this way now we turn them back to society to fix. http://www.pbs.org/wgbh/pages/frontline/woundedplatoon/

Do not go off meds this is a very bad idea, they will take meds into account.

Found out that the VA moved me from 70 to 90 on this issue wont know how they did until I receive the letter

Just Found out that the VA moved me from 70 to 90% on this I don't know why or how until I get my letter. I suspect something was also remanded because they kept the claim open and moved to gathering of evidence.

Congratulations way to hang in there.

Went to pending decision approval today

Just went to decision approval

http://www.uscourts.cavc.gov/documents/Pacheo_12-389_17july2014.pdf

Straight from 38 CFR §4.23 Attitude of rating officers. It is to be remembered that the majority of applicants are disabled persons who are seeking benefits of law to which they believe themselves entitled. In the exercise of his or her functions, rating officers must not allow their personal feelings to intrude; an antagonistic, critical, or even abusive attitude on the part of a claimant should not in any instance influence the officers in the handling of the case. Fairness and courtesy must at all times be shown to applicants by all employees whose duties bring them in contact, directly or indirectly, with the Department's claimants.

If you have a strong DBQ from the outside I would say it would cover up any negative remarks of the C&P examiner. The VA had made negative marking on my C&P concerning Tinnitus but I had a letter from an outside ENT and was granted service connection even thought the examiner marked less then likely. Never give up hope especial when you already have medical evidence from a reputable source.

Great Post very informative I took in so much information there is smoke coming from my ears I look like uncle Fester.

Interesting find about the service of Pilipino Guerrillas http://www.uscourts.cavc.gov/documents/Tagupa11-3575.pdf

Know I know why it takes more then 21 day to process incoming mail at my VARO. http://www.va.gov/oig/pubs/VAOIG-14-03644-225.pdf

Did I scrub these too much for anyone else to weight in

Thank you for the post. I have been trying to gain more knowledge about this very subject.

At this point I always expect the unexpected. My current one went from under review to prep for decision back to gathering of evidence in a 3 day period after my C&P. It used to get me down but at this point I expect it. Hang in there I am sure it will be favorable.

unfortunately this went back to gathering of evidence today. I figure there was something they did not like about the C&P as I already submitted all the evidence I had with a statement in support of claim via ebennys.

unfortunately this went back to gathering of evidence today, I figure there was something they did not like about the C&P because I all ready downloaded all the evidence I had VIA ebeenies along with a statement in support of claim. I almost got lucy had my C&P on Friday went to prep for decision on Monday then to Gathering of evidence on Tuesday

Just want to post my exams to see what you guys and gal think, these exams were from Friday Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire Name of patient/Veteran: SECTION I: ---------- 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes[ ] No If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Major Depressive Disorder with Anxious Distress ICD code: 296.32 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): n/a 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes[X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[X] No[ ] Not shown in records reviewed 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[ ] No[X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes[ ] No[X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ a. Medical record review: Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes[ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes[X] No If no, check all records reviewed: [X] 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 [X] Other: previous exam, decision narrative b. Was pertinent information from collateral sources reviewed? [ ] Yes[X] No MENTAL STATUS: Appearance: casually dressed, adequately groomed Activity: normal, no psychomotor agitation or retardation Attitude: pleasant, polite, cooperative Speech: fluent, coherent Mood: depressed Affect: worried, mood congruent Perception: no hallucinations Thought flow: logical, goal directed Thought content: no delusions Thoughts of harm: no suicidal/homicidal ideation Level of consciousness: alert Oriented: to all spheres Attention: fair Current Suicide Risk Factors: _X____ Does not have thoughts of suicide or self harm at this time _X____ Does not express feelings of hopelessness or helplessness at this time Current Suicide Assessment: _X____ Low: Patient judged NOT to be at significant risk for self-harm d. Relevant Legal and Behavioral history (pre-military, military, and post-military): Denied e. Relevant Substance abuse history (pre-military, military, and post-military): Denied f. Other, if any: n/a 3. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Panic attacks that occur weekly or less often [X] Chronic sleep impairment [X] Disturbances of motivation and mood Behavioral observations: worried 4. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [X] Yes[ ] No If yes, describe: reduced concentration, restlessness, irritability, fatigue 5. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No 6. Remarks (including any testing results), if any: --------------------------------------------------- On August 4, 2014, VA published an interim final rule, RIN 2900-A096 - Mental Disorders and Definition of Psychosis for Certain VA Purposes to update regulations in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The publication of this interim final rule indicates that a diagnosis of a mental disorder must conform to the standards set in the DSM-5. As of August 28, 2014 all examinations must be conducted utilizing DSM-5. Examiners no longer need to comment on DSM-IV diagnostic criteria if DSM-5 diagnostic criteria is not met. The GAF score is not used in DSM-5. **************************************************************************** Medical Opinion 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 reviewed? Yes If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: VHA medical records MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Is the Veteran's recurrent major depression a continuation of the complaint/note in service? b. Indicate type of exam for which opinion has been requested: DBQ Mental Disorder TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. c. Rationale: Veteran's current symptoms are the same symptoms noted while in the service. His symptoms are ongoing and are considered a continuation of the same disorder. ************************************************************************* ------------------------------------------------------------------------- ========================================================================= Date/Time: 19 Sep 2014 @ 1300 Note Title: COMPENSATION AND PENSION EXAMINATION Location: MARTINSBURG VAMC Signed By: CANETE,LUCILA Z Co-signed By: CANETE,LUCILA Z Date/Time Signed: 19 Sep 2014 @ 1600 ------------------------------------------------------------------------- LOCAL TITLE: COMPENSATION AND PENSION EXAMINATION STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: SEP 19, 2014@13:00 ENTRY DATE: SEP 19, 2014@16:00:13 AUTHOR: CANETE,LUCILA Z EXP COSIGNER: URGENCY: STATUS: COMPLETED Fibromyalgia Disability Benefits Questionnaire Name of patient/Veteran: Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [X] Yes[ ] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: vbms efile; VAMC 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with fibromyalgia? (This is the condition the Veteran is claiming or for which an exam has been requested) [X] Yes [ ] No [X] Fibromyalgia Date of diagnosis: 2005 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's fibromyalgia condition: 33 years old USAirforce veteran from 2000 to 2006, is here for a C&P evaluation on his current condition of fibromylagia. In 2003, he started coming unexplained fatigue which described coming with similar symptoms when one suffers from flu-like symptoms when one developes generalized muscle soreness, insides of both legs, thighs, shoulder and neck areas and medial side of both arms and achiness of both hands (described it as fatigue feeling). When he would wear the body armour, he feels that his entire body feels sore and touch of the armor which is heavy makes him feel the soreness. More noticeable over the medical surfaces of the thighs. During his active service he worked with Nuclear Program at Minot, Airforce Base, North Dakota he is on strict monitoring due to the sensitivity concern of the program. (Perosonal Reliability Program). Around the same year 2003 the Base physician and several times 2003-2004. He was tried on Amytriptylline 25 mg po hs which helped X 2 months only to return back to his initial symptoms. 6 months before he left the USAirforce, he had sleep study done which confirmed sleep apnea which he wears CPAP to date. It seemed to help his drowsiness during the daytime but it has not affected his sensation of muscle soreness. He had a medical board but was honorably discharged. He was recommended not eligible to re-enlist and or serve the remaining 2 years of inactive reserve. He has been coming here at Martinsburg VA since 2012 for scheduled Compensation & Pension Evaluation. He has been placed on Sertraline for depression which did not help his body pain. It has been discontinued and not on any medications. He sees the Pain Mgmt for his neck complaints and have an appointment for PT regarding the rest of his body pains. Reviewed vbms STRS efile: 11/10/2005: Routine Physical Examination Note on his active problem list: Mylagias/Myositis (Non-specified) Multiple progress notes/Behavioral Clinic: Mild Depression 2003/ Major Depression 2005/ Involutional Melancholia 2005. Medications: Amitriptylline 25 mg po qd (prescribed to problems with Depression) No specific mention that this was given for fibromyalgia. 1/25/2005 Progress notes: Mentioned that member was seen prior for fibromyalgia which responded well to Elavil a hs. Mention about implication for his work statys (PRP) using Elavil. There as a discussion with Dr. Higgins who mentioned that the medication causes no limiting side effects, and is not being used for anti-depressant purposes, that this case does not automatically require PRP suspension. Memorandum from XXXXwritten by TODD P Huhn, CAPT, USAF, MC XXXXXhas been seen for symptoms consistent with fibromylgia, a condition of chronic muscle pain. He responded very well to medication for this which he takes at night. This is not being used as an anti-depressant medication. After conferring with the AFSPC PRP medical consultant, Lt. Col Higgins, we concurred that Sra XXX was medically cleared to take this medication and maintain his PRP clearance. Routine H&P by an outpatient primary care provider at Martinsburg VA 7/18/2014: LOCAL TITLE: PHYSICIAN, PRIMARY CARE/OUTPATIENT CLINIC STANDARD TITLE: PRIMARY CARE PHYSICIAN NOTE DATE OF NOTE: JUL 18, 2014@08:59 ENTRY DATE: JUL 18, 2014@09:01:34 AUTHOR: VU,PETER D EXP COSIGNER: URGENCY: STATUS: COMPLETED CHIEF COMPLAINT: chronic neck strain w/ headache PRESENT ILLNESS: said he has chronic neck strain and occasional tension headache w/o any trauma or injury. pt said he needs clearance to participate in walk for wellness at home. pt gained some wt w/ BMI >35. Today,PT denies any SI or HI,fever,chills,sob,cp, productive cough, n/v,abdominal pain,vision problems, weakness, dizziness,headache, change of bm,orthopnea, palpitation,syncope, LOC, urinary or stool incontinence, hematuria or hematochezia. PAST HISTORY: Active problems - Computerized Problem List is the source for the following: 1. Recurrent major depression (SNOMED CT 66344007) 09/30/13 ASGHAR,ALI 2. Nonallopathic lesions of rib cage 3. Pain in Thoracic Spine 05/09/13 NEFF,SHAWN M 4. Somat Dysfunc Thorac Reg 05/09/13 NEFF,SHAWN M 5. Somat Dysfunc Cervic Reg 04/09/13 NEFF,SHAWN M 6. Cervicalgia 04/09/13 NEFF,SHAWN M 7. Headache 8. Hyperlipidemia 01/24/13 VU,PETER D 9. SUBJECTIVE TINNITUS 01/23/13 SHALLIS,JULIE B 10. Depression 01/18/13 VU,PETER D 11. GERD 01/18/13 VU,PETER D 12. Anxiety 01/18/13 VU,PETER D 13. Cholelithiasis 01/18/13 VU,PETER D 14. Hx of tobacco user in remission 01/18/13 VU,PETER D 15. OSA on c-pap 01/18/13 VU,PETER D 16. Hx of tinnitus 01/18/13 VU,PETER D 17. Irritable Bowel Syndrome PHYSICAL EXAM: GENERAL: ambulatory, awake, alert, oriented x3,nad, pleasant,obese young man. HEENT: PERRLA. Clear oropharynx and tympanic membrane. no sinus tenderness. no cervical adenopathy. NECK: No bruits or stiffness. Good ROM w/o difficulty but mild discomfort on rotation and moderate trapezius muscle stiffness on palpation. CHEST: Chest normal shape and symmetrical.No masses,tenderness or other abnormalities LUNGS: Clear, no crackles, wheezing, or rhonchi. HEART: RSR, no murmurs, no gallop ABDOMEN: obese. Soft, non tender, positive bowel sounds, liver and spleen are not palpable. No rebound tenderness to palpation. BACK: No cva tenderness or point tenderness.slr negative. EXTREMITIES: No edema. Good ROM w/o pain or difficulty. Good muscle strength and tone plus well developed muscle. nl sensation and good radial pulse and capillary refill. NEUROLOGICAL: Cranial nerve intact, no focal deficit, ambulatory w/o difficulty. ASSESSMENT: - Hx of chronic neck strain: discussed and full explaination about his condition and booklet about neck given w/ instruction for home exercise. increase flexeril to 10mg qhs prn w/advise of side effects and continue heating pad alternate w/icepack. pt already was tx by PT, chiropractor and pain school in past. pt said he does not want to be on pain medication. pt had xray of neck in past was negative. -hx of IBS: Discussed and tx w/ bentyl 10mg bid and metamucil and f/u GI as directed. -hx GERD: on prilosec -hx Depression/anxiety: stable and denies any SI or HI. f/u w/ MHC as directed. -hx of OSA:stable on C-pap b. Is continuous medication required for control of fibromyalgia symptoms? [ ] Yes [X] No c. Is the Veteran currently undergoing treatment for this condition? [ ] Yes [X] No d. Are the Veteran's fibromyalgia symptoms refractory to therapy? [X] Yes [ ] No 3. Findings, signs and symptoms ------------------------------- Does the Veteran currently have any findings, signs or symptoms attributable to fibromyalgia? [X] Yes [ ] No a. Findings, signs and symptoms (check all that apply): [X] Widespread musculoskeletal pain [X] Fatigue [X] Sleep disturbances [X] Headache [X] Depression [X] Irritable bowel symptoms For all checked conditions, describe: Musculoskeletal symtpoms: 1) constant sensation of 'muscle fatigue/sore'on both anterior thighs, skin feels sore over the medial portion of both thighs, localized sensitivity(soreness) over the specific medial portion of both arms, bilateral scapular muscles and back of his neck. 2) Feels tired even if he has not done anything but can still do his routines both at home and at work. 3) He feels no motivation, problems with concentration, crying for no reasons, feels anxiety and hx/o bouts of panic attack and chest pain while in the active service. Diagnosed with Depression while in the active service and was not placed on medication because he wants to continue working with Nuclear Program. Taking a anti-depressants will disqualify him from that program. He was evaluated by a psychologist. He was receiving regular psychological therapy while in the active service. He is currently seen by psychologist here at Martinsburg VA and received Cognitive Therapy and currently on the HOPE Program (Group Therapy). No medications for depression given to date. 4) Hx/o IBS and is service connected for IBS. Takes Dicyclomine BID. He said his current meds seem to help him. b. Frequency of fibromyalgia symptoms (check all that apply): [X] Constant or nearly constant c. Does the Veteran have tender points (trigger points) for pain present? [ ] Yes [X] No 4. Other pertinent physical findings, complications, conditions, signs and/or symptoms ----------------------------------------------------------------------------- Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis section above? [ ] Yes [X] No 5. Diagnostic testing --------------------- Are there any significant diagnostic test findings and/or results? [ ] Yes [X] No 6. Functional impact --------------------- Does the Veteran's fibromyalgia impact his or her ability to work? [ ] Yes [X] No 7. Remarks, if any: ------------------- He now works both patroling and now in the office. He has so far able to carry on his duties as a security officer. Physical examination today revealed: (-) direct tenderness on palpation over the occipital, supraspinatus, sternal, knees. He points to overall sensation of soreness on his neck area, and localized sensitivity on the bilateral thigh muscles and linear medial thigh bilaterally and medial areas on both arms. Strength 5/5 all throughout. Sensory are all WNL both upper and lower extremeties. **************************************************************************** Neck (Cervical 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 reviewed? [X] Yes [ ] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: vbms efile; VAMC 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 [ ] 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 cervical spine (neck) condition? [X] Yes [ ] No Cervical Spine Common Diagnoses: [ ] Ankylosing spondylitis [X] Cervical strain [ ] Degenerative arthritis of the spine [ ] Intervertebral disc syndrome [ ] Segmental instability [ ] Spinal fusion [ ] Spinal stenosis [ ] Spondylolisthesis [ ] Vertebral dislocation [ ] Vertebral fracture Diagnosis #1: Cervical Strain (Cervicalgia) ICD code: 847.0 Date of diagnosis: 2002-2003 2. Medical history ------------------ Describe the history (including onset and course) of the Veteran's cervical spine (neck) condition (brief summary): 33 years old USAirforce veteran from 2000 to 2006, is here for a C&P evaluation on his neck condition. In 2002-2003, he start noticing when he works out his posterior neck feels sore. He said he has problems wearing the ballistic helmet. He feels localized soreness on the back of his head and also localized sensation of soreness over the parietal portion of his head. He was referred while in the active service to PT. In 10/25/2004. MRI of his neck was carried out which showed very minor disc bulge C5-C6 and C6-C7 levels, not felt to be of significance. Stretching exercises while in PT helped. But sit-ups and turning it wrong and bending it a lot seems to accentuate the neck soreness. He described his constant low level soreness 2-3/10. It feels tight most of the time. He has upcoming schedule for PT related to the neck but also to his complaints of his wholebody pain. 3. Flare-ups ------------ Does the Veteran report that flare-ups impact the function of the cervical spine (neck)? [ ] Yes [X] No 4. Initial range of motion (ROM) measurements --------------------------------------------- a. Select where forward flexion ends (normal endpoint is 45 degrees): [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [X] 45 or greater Select where objective evidence of painful motion begins: [X] No objective evidence of painful motion [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 or greater b. Select where extension ends (normal endpoint is 45 degrees): [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [X] 45 or greater Select where objective evidence of painful motion begins: [X] No objective evidence of painful motion [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 or greater c. Select where right lateral flexion ends (normal endpoint is 45 degrees): [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [X] 45 or greater Select where objective evidence of painful motion begins: [X] No objective evidence of painful motion [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 or greater d. Select where left lateral flexion ends (normal endpoint is 45 degrees): [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [X] 40 [ ] 45 or greater Select where objective evidence of painful motion begins: [X] No objective evidence of painful motion [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 or greater e. Select where right lateral rotation ends (normal endpoint is 80 degrees): [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 [ ] 50 [ ] 55 [ ] 60 [ ] 65 [X] 70 [ ] 75 [ ] 80 or greater Select where objective evidence of painful motion begins: [X] No objective evidence of painful motion [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 [ ] 50 [ ] 55 [ ] 60 [ ] 65 [ ] 70 [ ] 75 [ ] 80 or greater f. Select where left lateral rotation ends (normal endpoint is 80 degrees): [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 [ ] 50 [ ] 55 [ ] 60 [ ] 65 [ ] 70 [ ] 75 [X] 80 or greater Select where objective evidence of painful motion begins: [X] No objective evidence of painful motion [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 [ ] 50 [ ] 55 [ ] 60 [ ] 65 [ ] 70 [ ] 75 [ ] 80 or greater g. If ROM does not conform to the normal range of motion identified above but is normal for this Veteran (for reasons other than a cervical spine (neck) condition, such as age, body habitus, neurologic disease), explain: No response provided. 5. ROM measurements after repetitive use testing ------------------------------------------------- a. Is the Veteran able to perform repetitive-use testing with 3 repetitions? [X] Yes [ ] No b. Select where post-test forward flexion ends: [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [X] 45 or greater c. Select where post-test extension ends: [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [X] 40 [ ] 45 or greater d. Select where post-test right lateral flexion ends: [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [X] 40 [ ] 45 or greater e. Select where post-test left lateral flexion ends: [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [X] 45 or greater f. Select where post-test right lateral rotation ends: [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 [ ] 50 [ ] 55 [ ] 60 [ ] 65 [X] 70 [ ] 75 [ ] 80 or greater g. Select where post-test left lateral rotation ends: [ ] 0 [ ] 5 [ ] 10 [ ] 15 [ ] 20 [ ] 25 [ ] 30 [ ] 35 [ ] 40 [ ] 45 [ ] 50 [ ] 55 [ ] 60 [ ] 65 [ ] 70 [X] 75 [ ] 80 or greater 6. Functional loss and additional limitation in ROM --------------------------------------------------- a. Does the Veteran have additional limitation in ROM of the cervical spine &

Had my C&Ps Friday, this moved to prep for decision today.