jenni2005

It happens all the time, sometimes more than once in the same day. It was probably missing s signature somewhere or they needed to double check something.

Jenni;
I filed my NOD back in November 2014 and last month on the great advice here I emailed the Office of the Under Secretary and I filed an IRIS online.  Within days I had the VA calling me saying my NOD basically "missed a step" and that it was sitting in "idle mode".  The lady I spoke to on the phone said she would get the RO office involved.  The next thing I knew, I had a call from the appeals office stating my hearing was scheduled and low and behold I received a letter a few weeks ago for my now upcoming DRO review hearing this Friday!
When you filed the NOD did you in fact request for a DRO review hearing?  Unless you did this they are not obligated to give you an "in person" hearing and they can actual decide the NOD with or without you present.....
Here is the email for the Office of the Under Secretary for Benefits:
OfficeoftheUnderSecretaryforBenefits@va.gov
https://iris.custhelp.com/ - this is the IRIS online info
It can't hurt to inquire!

Jenni the originating office is your Regional VA Office.  They hold the record then send it to the BVA in Washington, D.C. 
Here is a good synopsis of what happens:     http://statesidelegal.org/step-6-file-appeal

Hi, this is my first time on this website, I have been in the process of an appeal since 11/2011, I went through the american legion to help me with this and also my county veteran's office.  hoping to one day get a letter in the mail putting this to an end.  my next step which has been at this stage since last summer, is a "video interview" with the VA law judge.  My claim started 2009, the denied it initially and then thats when i asked for the american legion to help, submitted an appeal again, came back 0% service connected,  which took about a year or more, then I was awarded 10% and I appealed that in 11/2011, and that staged in stage on until 06/2015 and that's when I get the NOD, and then I returned the papers, and have been sitting in video mode since.  not sure what the next step is, I know it isn't right for it to take this long for people that sacrificed for their country!  hope you find out something  soon!! 

I found this link  it may help?
http://www.operationwearehere.com/EquineTherapy.html
...................Buck

You may want to ask for a pain management consult as well.  I had some steroid injections 2 or 3 times that didn't do shit for me.  But after that they did something called radio frequency ablation.  And that was a godsend for a few months the first time.  The last 3 times I did it was with very limited success.  But according to my doc the vast majority he performs the RFA on gets 1-2 years of relief from it.  Its a great alternative to surgery.  As mentioned earlier in this thread deciding to have surgery on your back is a big deal.  I have spoken to people who feel like a million bucks after, and others who have been worse.  Being I am only 37 I am holding out as long as possible before doing it so that I'm not having surgery every few years.
Fortunately I work for a small company with understanding owners.  If I can't get out of bed I just shoot them a text message letting them know that day is a bad one.  They always respond the same telling me to get some rest and come in when I feel better.  Anywhere else I think I would have been fired numerous times.  Missing 15-20 days a year because you cant get out of bed would get old for most place.
 
Personally if I were you I would go ahead and file for the increase.  And then just continue seeking treatment.  With the speed the ROs work at you may very well be 18 months into new treatments documenting the increased findings before they even look at your claim.

don't know if this will help. i had my first emg in 1992, along with my first lumbar spine mri. the mri showed i had a bulging disc and the emg confirmed radiculopathy. i don't remember when my last emg was. but i had an mri in may 2014, which showed 5 herniated discs, both foraminal and spinal stenosis, a grade one slippage of vertebrae, abnormallordatic curve, 2 torn discs and arthritis. i can braely walk from my living room to my bedroom without pain in my right lower extremity which shoots down my right leg. i start limping real bad and must sit for a few minutes before attempting to walk again.

Be careful with hyperextension of the lower spine.  That's where you lay on your stomach and bend backwards.  I was sent to Phys Therapy, and this is what they had me do.  I'm not s young un', 55, but the caution is valid at any age.
When they had me do this extension exercise, they used an excert from McKenzie self help books.  Lay on stomach, keep pelvis to the floor, so you don't do it like normal pushups, then you push up and lock your elbows straight.  The effect is like a sit up, but your hips stay as close the floor/on the floor.
 
Problems I had could have been prevented with a simple x ray, they would have seen if I had facet or disc space problems and they would have known that I should not be doing any type of hyperextension exercise at all, but they didn't do that.  My VA PCP didn't want to take the time to properly diagnose this, so she referred me to Phys Therapy for evaluation.   That's where they started me on extension exercises.
When I did this over a period of 2 weeks, I started getting tingling down my left leg.  After 4 weeks, the tingling turned to twitching, that ran from inside/above my left knee to my toes (my toes would be twitching so much that it would keep me awake at night).  After 8 weeks, muscle weakness started to set in.  At 10 weeks, I stopped exercise and walked in to see an MD because of sciatic pain in both legs set in, the muscle weakness turned into foot drop.  After I stopped, the condition kept advancing, and by 16 weeks I could not walk more than 1/2 block without muscle exhaustion in both legs, and had to use a prosthetic (AFO) so I would not trip over my toes when my left leg swung forward.
An xray would have revealed that I had a collapsed disc between L5 and S1, and this led to a deformity and sever arthritis in my facet joints. The result was that I had 3 more disc's that had been forced out to the rear, and the facets caused foramina stenosis that was causing damage to the nerves at 3 levels.  6 months after this happened I got an EMG (ouch, needles jammed deep into many muscles) that said this was a chronic condition (more than 90 days).  I'm not sure if the damage will be reversed, nor are the 3 surgeons I have spoken to.
 
So, the moral of the story is, get a proper medical evaluation before you do anything about your low back pain.  It might be as simple as a sore muscle or strained tendon, but if it is a herniated disc, or you are older and could have additional complications to deal with (facet joint issues like I did), its best to be safe, with both eyes wide open, than to go in blind and injure yourself far worse. 

Jenni can you do me a favor and lay down in the best on your stomach and bend your lumbar spine backwards. If you have increased pain in your buttocks then you most likely have DJD which is seen most on Xrays and CT Scans. MRIs have a harder time seeing this and this COULD be the reason why you are having the sciatica issues. I wish I could get a referrel to Orthopedics, I only was able get as far at Pain Management and all these did was put me on Oxycodone. Some VA MDs are very helpful but I blame it more on the facility because some facilities you can get the best care and some others you can't.
 
EDIT** I also want to say that MOST of the time the sciatica causes pain ALL the way down the leg or it starts in the buttocks and skips down into the feet or toes. MOST of the time whenever you see it just being in the buttocks then its muscle related or the joint to the left and right of the lumbar spine, it feels like a big muscle. This is just from what I read but again if the nerves are not being pinched a lot then it could be just in the buttocks.
 
Your situation sounds just like mine did from 1996-2010, muscles tighten up and you get pain down your buttocks. See if you can get an EMG because this will tell you a majority of the time if its a pinched nerve or muscles.
 
Get back with me on bending your lumbar area backwards by laying down in bed. If it hurts then this is most likely DJD instead of DDD which are two different things but the VA considers them the same, Osteoarthritis, which there is no cure or fix. Trust me I know, I've been dealing with the progression from normal DJD to now moderate to severe. Also get a CT Scan on your whole spine it will tell a lot about the facet joints.

You are probably right, you need to get a refferal to Orthopedics and let them check you out.

Well I have 20% for Lower Back issues, and 10% for nerve damage and tingling of the R Side. To be honest only thing that proves all these issues is MRIs and X Rays. I have had a lot over the last two years, and I am unable to tack pain meds due to Crohns Disease and 2 blood transfusions. I did not even put in a claim for the 10% Nerve damage, the VA caught it after the MRIs and awarded without me asking. You need to ask your VA Back Dr to request MRIs and X Rays. Good luck

Try getting an EMG's to check on the radicular symptoms, CAT scans, myleograms, disco grams and imaging with dyes can be very helpful. JMO

Adding on to pwrslm's post, if you do consider getting epidural pain block injections into your spine, please be aware that there is no guarantee that they will work. I have had moderate relief, but they wear off eventually.

Adding on to ARNG11's post, EMG's are not perfect. Different results are possible while laying down vs. sitting vs. standing. The effect of gravity matters. When you are vertical, additional weight can add extra stress on the nerves. Some docs are just in a hurry to get you out the door instead of doing a full assessment.

When you sleep, try sleeping on your side with a pillow between your knees. It can take the pressure off the nerve, depending on where it is impinging.

Research pain on motion (i.e. Delucca). For lower extremities, they are supposed to rate based on when pain begins, not how far your leg can be moved (i.e. torture). The catch here is that some docs are vague and note things like 'pain on motion'. Pain at ROM where motion begins tends to be rated at just 10%.

Lumbar strain is a general catch all for a problem. Under strict medical standards, its a tissue injury, affecting muscle and tendons/ligaments. In reality, it normally ends up being something else, but they classify it as a strain because that does not need X Ray or MRI, and unless there are more symptoms, its the easiest to treat, they give you a few pills, send you home, and that's it.

In LBP (low back pain) there are steps that all physicians should follow. First is med's, they do that because 80% of all back pain resolves on its own within weeks of onset. Generally, those are real back strains.

Second is physical therapy after 4-6 weeks without improvement, this is designed to strengthen the core, increase flexibility, and hopefully straighten the spine (chiro). Sometimes they want to give you shots into the spine (be careful with this). These first two are considered conservative treatment.

The third is surgery, and that you need to take careful consideration of because once they do it, historically, you will be back. Half of all back surgery patients are back in surgery within a few years.

A 10% rating on spine verifies you have pain on motion. They can verify that you have had this pain over an extended period of time without any improvement. It is time to go to your PCP and ask him/her directly for an X Ray and an MRI. You are going to need that to begin the documentation to establish an increase, as well as, adding on the nerve disorder (your sciatica) as a secondary condition.