Looking For Copy Of Clinician's Guide Or C&p Manual From 1988

[71M10]

Greetings All:

I feel I have a strong case on a CUE, but recognize feeling isn't evidence. In my 1988 C&P for back injury they stated all my ROM were complete. They didn't use a Goniometer. I know that this in itself is not CUE. They measured my Chest expansion at one inch which from a lot of what I am seeing on the internet would constitute a limitation of motion (non-compensable). Since I had arthritis on the Thoracic spine x-ray at that time, I think this is clearly cue. Arthritis with any limitation of motion that is not compensable is to be rated at 10%. What I am missing is the guidlines in effect for C&P physicals at that time. SC and a 0% rating for a bone condition was the original result. The full rating decision (got a copy this year) said bone condition - thoracic strain with minimal degenerative arthritis.

Is this CUE or am I grasping at straws out of my irritation with the VA?

Best regards,

Tyler

[71M10]

Rating Decision and Physical attached.

I was only citing the first part of 5003 for joints limitation of motion that is not compensable. The second part of 5003 as I understand it does't require limitation of motion, but considers flare ups and requires multiple joints. They only x-rayed my thoracic spine in 1988! I didn't see the physical report until this year. I failed to be an effective advocate for myself in 1988 and probably have no recourse. It is a bit shocking to realize you had arthritis when you were 23 and they never told you.

Also of note on the physical (not CUE related ) Temp, low HCT reading, Low urobilinogen reading (wouldn't copy) and a chest expansion limited to one inch. I am seeing a doctor about a HLB-27A test and referal to reumatologist to explore Ankylosing Spondylitis ( along with back problems I have IBS, and for last 17-18 years an increased sensitivity to light) in sevice they did mutiple chest xrays and multiple Dr.s consulting before they ETSed me (all talking about shap/size of Aorta). I also had ECG in Korea the year before that was abnormal. After two internalist consults they decieded to accept my abnormal as normal for me. That is why I filed for a heart condition also that was never examined or discussed by VA. Both of those medical occurances are indicative of Ankylosing Spondylitis ( I know Misdiagnosis is not CUE).

Waiting on complete copy of SMR's and latest C-File

[Vike17]

71M10,

O.k., here's why the 0% rating is correct. According to your C&P exam you essentially had normal range of motion with forward flexion at 95 degrees. Remember that DC 5003 states;

"When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion"

So, since your lower back did not show limited range of motion at a non-compensable rate, but did show minimal artritis nonetheless, then a 10% is not warranted. Your back must have showed arthritis with limitation of motion at a non-compensable rate in order for a 10% rating to be applied under DC 5003.

Now after reading this, I would say it was a poor choice (or judgment call) on the rater back then to hyphenate it with 5099. The correct DC would have probably been 5003-5295. However, in this case it still doesn't rise to the level of a CUE. According to your C&P exam you would have been rated at 0% under either code. Also keep in mind that the Deluca Criteria, which is the pain, weakness fatigue ect.. due addional movments, didn't come into being until the early 1990's. So this would be a non factor also.

Vike 17

Edited June 27, 2007 by Vike17

[71M10]

71M10,

O.k., here's why the 0% rating is correct. According to your C&P exam you essentially had normal range of motion with forward flexion at 95 degrees. Remember that DC 5003 states;

"When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion"

So, since your lower back did not show limited range of motion at a non-compensable rate, but did show minimal artritis nonetheless, then a 10% is not warranted. Your back must have showed arthritis with limitation of motion at a non-compensable rate in order for a 10% rating to be applied under DC 5003.

Now after reading this, I would say it was a poor choice (or judgment call) on the rater back then to hyphenate it with 5099. The correct DC would have probably been 5003-5295. However, in this case it still doesn't rise to the level of a CUE. According to your C&P exam you would have been rated at 0% under either code. Also keep in mind that the Deluca Criteria, which is the pain, weakness fatigue ect.. due addional movments, didn't come into being until the early 1990's. So this would be a non factor also.

Vike 17

OK, Its the appropriate diagnostic code that is key, limited chest expansion (motion) is not something to be contemplated under evaluations for thoracic strain and pleural cavity injury which contemplates chest expansion was not a diagnostic code being considered.

Thank you for your efforts in helping me understand this.

Best regards,

Tyler