Back And Sciatic Nerve Questions

[parsavers]

Guys and Gals,

I'm new to the board but I thought that I would jump right in with a question. I am currently rated at 20% for a back condition. I have had two back surgeries, one laminectomy and one discectomy. During my last event, either during surgery or the injury itself, I suffered nerve damage. One year after surgery, the VA didn't think the nerve damage warrented anything. I requested another exam (about three years after surgery) because I feel like I'm losing a lot of strength in my leg. That being said, during the C/P exam, the examiner stated that she notices a slight foot drop during walking, loss of some reflex and also noted that my left leg (dominated side) thigh was about two inches smaller than the right leg, calfs measured the same in diameter. Anyone have any idea what I should be expecting as far as a rating on this? Apparently, my information went to the rating board on April 24 and still no decision. Like most of you, the waiting is brutal.....

[kryptos]

I am rated at 60% which is for L4 fracture paralysis of sciatica nerver both legs i got 10 % for my nerve damage 40 % for my back and 10% for scars. It all depends on when the check you if you get numbess in your legs and if it impairs your ability to walk normal. well as far as my case went.

[yoggie2]

I am rated at 40% for DDD/IVDS broken back in 92 and took me on out 95 filed for an increase 2 years ago and was denied. Depends on where you live and what your C&P says. MY C&P was great went well stated my problems while I was there. Then I get my C&P and it was almost a totally disaster and screw job. Get a copy of the C&P at the ROI office and these folks here can tell you more. So its really hard to give you real good sound advice here with out knowing what was said in that C&P then your picture can become more clearer to you on what to look for, you can pick it up now for sure.......Good Luck friend

[rentalguy1]

According to the C&P service training letter on IVDS, 20% is the max that they will award for sciatic nerve neuropathy. Ten percent is the normal award. This is, unless, there is complete paralysis of the nerve, and I think the regs say that is a 30% award (could be 50%...can't remember off the top of my head).

[Teac]

I am rated under the old rules which states nerve damage and muscle degeneration is part and parcle of the back injury 60% plus a K award for drop foot.

I don't think you will get much more than 20% for your back regardless of the fact you have had surgery. Based on what you said about your drop foot you might get 10%. Now these are just my guesses based on what you said, I am no doctor.

Under the new rules it is much harder to get a 60% rating because you are rated under limitation of motion or medically documented

Incapacitating Episodes. And your are rated seperatly for siatiac nerve damage and drop foot. I have posted the ratings below:

The Spine

General Rating Formula for Diseases and Injuries of the Spine

(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating

Intervertebral Disc Syndrome Based on Incapacitating Episodes):

With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease

Unfavorable ankylosis of the entire spine................................................................... 100

Unfavorable ankylosis of the entire thoracolumbar spine............................................... 50

Unfavorable ankylosis of the entire cervical spine; or, forward flexion

of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of

the entire thoracolumbar spine...........................................................................

..... 40

Forward flexion of the cervical spine 15 degrees or less; or, favorable

ankylosis of the entire cervical spine........................................................................ 30

Forward flexion of the thoracolumbar spine greater than 30 degrees but not

greater than 60 degrees; or, forward flexion of the cervical spine greater

than 15 degrees but not greater than 30 degrees; or, the combined range of

motion of the thoracolumbar spine not greater than 120 degrees; or, the

combined range of motion of the cervical spine not greater than 170 degrees;

or, muscle spasm or guarding severe enough to result in an abnormal gait

or abnormal spinal contour such as scoliosis, reversed lordosis, or

abnormal kyphosis........................................................................

......................... 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not

greater than 85 degrees; or, forward flexion of the cervical spine greater than

30 degrees but not greater than 40 degrees; or, combined range of motion of

the thoracolumbar spine greater than 120 degrees but not greater than 235

degrees; or, combined range of motion of the cervical spine greater than

170 degrees but not greater than 335 degrees; or, muscle spasm, guarding,

or localized tenderness not resulting in abnormal gait or abnormal spinal

contour; or, vertebral body fracture with loss of 50 percent or more of the

height..........................................................................

........................................... 10

Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.

Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.

Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range of motion is normal for that individual will be accepted.

Note (4): Round each range of motion measurement to the nearest five degrees.

Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.

Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.

5235 Vertebral fracture or dislocation

5236 Sacroiliac injury and weakness

5237 Lumbosacral or cervical strain

5238 Spinal stenosis

5239 Spondylolisthesis or segmental instability

5240 Ankylosing spondylitis

5241 Spinal fusion

5242 Degenerative arthritis of the spine (see also diagnostic code 5003)

5243 Intervertebral disc syndrome

Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under §4.25.

Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes

With incapacitating episodes having a total duration of at least 6 weeks during the

past 12 months..........................................................................

....................................... 60

With incapacitating episodes having a total duration of at least 4 weeks but less than

6 weeks during the past 12 months..........................................................................

.......... 40

With incapacitating episodes having a total duration of at least 2 weeks but less than

4 weeks during the past 12 months..........................................................................

.......... 20

With incapacitating episodes having a total duration of at least one week but less than

2 weeks during the past 12 months..........................................................................

.......... 10

Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.

Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.

Sciatic nerve.

8520 Paralysis of:

Complete; the foot dangles and drops, no active movement possible

of muscles below the knee, flexion of knee weakened or (very

rarely) lost............................................................................

................................ 80

Incomplete:

Severe, with marked muscular atrophy.................................................................. 60

Moderately severe ................................................................................

............... 40

Moderate........................................................................

..................................... 20

Mild ................................................................................

................................ 10

[rentalguy1]

Teac is correct, and you must be rated under the new guidelines if you filed after they went into effect. If the reg changed while your claim was being adjudicated, then whichever criteria is more favorable to the vet is the one that they use.

[parsavers]

Guys and Gals,

I got a call from the VA today and he stated that I had been approved for a 10% increase (will be 30%) but also said that they are sending me to see a specialist for something. Have any of you ever heard of this? I wonder what else it could be for? My previous disability was at 20% for DDD. I can only speculate that is potentially isn't a good thing. From my experience, if they want you to see a specialist, they are usually trying to avoid giving you a higher rating. Please comments people....