First some background info:
I have an existing service connected disability (left knee @ 30%) and am now diagnosed with a degenerative lumbar scoliosis condition with several compromised discs and severe radiculopathy. I have submitted an intent to file form to connect this lumbar condition to my knee disability. The theory is that years of left leg instability has caused the lumbar scoliosis condition. A private orthopedic specialist is providing a NEXUS letter for the connection (which in his opinion is very strong). I'm being treated mostly on the private side, though the lumbar condition has also been documented at my last couple of VA yearly physicals. The prognosis is not great, the lumbar region is unstable and I am soon headed for a surgical decision (2 or 3 level lumbar fusion to stabilize the spine).
How best to proceed with secondary claim? Should I submit what I have now (multiple diagnoses with supporting MRI's, NEXUS letter from a private specialist) and put off any surgery - get rated prior to surgery? Or proceed with surgery and add that to the secondary claim?