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Rated For Lumbar Spondylolisthesis W/o A Code


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A slipped disk would be rated under IVDS. title 38 part 4. muscleskeletal. Disorders of the spine.

J

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  • HadIt.com Elder

5239 Spondylolisthesis or segmental instability

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.

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I thought there was another older rating criteria other than the training letter on IVDS from 2002. Anyone have the criteria prior to 2002. I think I have the option to use the older criteria or the newer one which ever results in the higher rating.

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The new IVDS rating of Sept 26, 2003 is within this long BVA decision:

http://www.va.gov/vetapp08/files2/0810164.txt

I think anyone with this type of claim should read the part abpout Hart V Mansfield as to "staged ratings"-basically meaning that in many claims the VA must cdetermine a rating by stage of disability from time claim was filed up to decision.

"Here, although the RO provided additional VCAA notice in May

2006, the RO did not subsequently go back and readjudicate

the claim in a subsequent SSOC. So, in essence, based on the

above caselaw, the timing defect in VCAA notice was not

rectified."

This vet was denied by the BVA even though there was VCAA error yet this claim gives considerable info as to the IVDS ratings.

NVLSP (VBM 2007 edition)makes the point that the new reg and DC of 5243 "removed the subjective determination as to whether the IVDS is 'mild','moderate,' or 'severe'.

NVLSP believes, as they state, that this has made IVDS claims even more difficult for veterans.

They advise that each separate spinal segment should be evaluated separately as well as to consider any neurological symptoms are evaluated and "combined with the orthopedic manifestations to ensure the highest possible rating." (pages 336-337)

DC codes can be from 5235 to 5242 for neurological and orthopedic manifestations.

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  • HadIt.com Elder

The only time that the RO can use either "old" criteria, or "new" criteria is when the rating criteria changes during an active claim. If you claim was active backin in 2002-03, then they could use whichever one is more beneficial. If you have a new claim that is currently working, then it will have to be rated under the new criteria.

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Rentalguy

My claim was reopened in Nov, 2001 and a decision from the AMC was rendered in Feb 2008.

The claim was active in 2002-03.

I m looking for the old rating criteria.

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