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Spine Injury!


SSGmajik
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Question

I need some help! I have some posts on here and there have been a few that are willing to help and I’m sorry that I have not listed more of the issues that I am having, but hopefully it’s not too late for some advice. I served from 02/1997 to 09/2005. I had my first surgery on my back in 12/2004 and then I was medically discharged in 09/2005 for my spine injury. I filed my initial claim in 12/2005 and received my first rating 06/2007, 10% for my neck and 10% for my lower back. I had two more surgeries in 06/2007 and 07/2007 and filed for an increase in 08/2007 and received a rating in 10/2007 (surprisingly quick)! I received an increase of 10% for my lumbar which brought now to 20% and my neck stayed at 10%. I then filed for another increase in 10/2007 stating that my condition deserved higher rating; I mean I could hardly move. I received an increase in 04/2008 for my lumbar, it was increased to 40%! I then filed for secondary conditions listed below in 04/2008. I thought they would rate the arthritis and most of the conditions listed below when I initially filed, but to no surprise they did not! I have done this all on my own and I have learned that I have been taking the long way around, but my vet rep was no help to me. He would not listen to what was wrong with saying just file for an increase and they will see the evidence, and obviously they did not! I am seeing a mental health doctor for my depression in dealing with my chronic pain and just everything else that I have to deal with in my back. I have been going to the VA regularly for my back at least 2-3 times a month for the past year. I am on Gabapentin, oxycodone, etolodac, and two medications for headaches and migraines that I can not remember the names. I recently filed for another increase for the conditions below and the VA denied all of them except that they deferred a rating for my scar from my microdiscectomy surgery. I have had 4 MRI’s (3 on my Lumbar and 1 on my cervical) and they all showed my condition getting worse. On the first MRI on my lumbar it showed bulging discs and some mild stenosis, that was about it. Then the next showed it getting worse and worse as listed in the conditions listed below. The VA said that it is not getting worse. I had a C&P in 03/2008 for my increase that I got in 04/2008 and I was measured at 5 degree forward flexion. Then when I got my letter for this increase they said I had 40 degree forward flexion, but the thing was I never had a C&P for my lower bacl on this one! There were notes from 2007 that said I had 40 degree forward flexion, but that was 2007 and I had the latest measurements in 2008! That tells you how close they really look at the documentation! Please help I have more info if someone can help!

Here is some of the issues that I have…….

1.) Facet arthropathy (arthritis)

2.) Spinal Stenosis in my Cervical and Lumbar spine (Moderate to severe grade) spine

3.) Bulging discs in my Cervical and Lumbar spine

4.) Scoliosis

5.) Osteophytes and/or Bone-spurs in my Cervical and Lumbar spine (Moderate to severe grade) spine

6.) Scar from the microdiscectomy surgery approximately three inches in length. Two RFA (Radio Frequency Ablation) surgeries on my L3-L4, L4-L5, L5-S1.

7.) Spondylolisthesis in my Lumbar and Cervical (Moderate to severe grade) spine

8.) Migraines that occur at least one every seven days due to the chronic pain, medication and the difficulty to sleep.

9.) Degenerative Disc Disease (Moderate to severe grade) has developed in both my cervical and lumbar levels of spine.

10.) Nerve damage in my lower back caused chronic radiating pain down through my right leg and foot; as a result, the muscles in these locations have deteriorated somewhat. Occasionally, I get the same pain in my left leg.

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Just moving it to the top of the message board incase anyone missed it. Please help!

SSGmajik

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Here is some of the issues that I have…….

1.) Facet arthropathy (arthritis)

2.) Spinal Stenosis in my Cervical and Lumbar spine (Moderate to severe grade) spine

3.) Bulging discs in my Cervical and Lumbar spine

4.) Scoliosis

5.) Osteophytes and/or Bone-spurs in my Cervical and Lumbar spine (Moderate to severe grade) spine

6.) Scar from the microdiscectomy surgery approximately three inches in length. Two RFA (Radio Frequency Ablation) surgeries on my L3-L4, L4-L5, L5-S1.

7.) Spondylolisthesis in my Lumbar and Cervical (Moderate to severe grade) spine

8.) Migraines that occur at least one every seven days due to the chronic pain, medication and the difficulty to sleep.

9.) Degenerative Disc Disease (Moderate to severe grade) has developed in both my cervical and lumbar levels of spine.

10.) Nerve damage in my lower back caused chronic radiating pain down through my right leg and foot; as a result, the muscles in these locations have deteriorated somewhat. Occasionally, I get the same pain in my left leg.

Greetings,

By no means am I an expert, I have spine issues in appeals on an initial rating of 40%. Below is the link to 38 CFR part 4, which details how they rate your individual disabilities.

http://ecfr.gpoaccess.gov/cgi/t/text/text-...1.5&idno=38

Your rating for damage (disability) to your back is entirely based on ROM unless you are service connected for Intervertebral disc syndrome (code 5243), which allows you to be rated on incapacitating episodes which is essentially defined as bed rest perscribed by a physician. Unless you have six weeks of documented (medical provider ordered) bed rest the highest basic rating for you back will be 40% per segement, unless you have complete ankylosis (spine segment completely fused, one vertebrae left with movement and they will deny you)

Of the ten items you listed all are coverd in the basic rating except for: Scar, headaches, and nerve damage. I am currently fighting with VA over my nuerological problems. It has been an uphill battle to get them to recognize them since I have persued it completely in-house with VA. On a re-exam a wonder doc ran the end of a reflex hamer against my legs and asked if I could feel that. I truthfully answered yes and got a VA exam that indicates no secodary neurologic symptoms. The top of my foot is still numb, I limp, and have siatica but two seconds with a reflex hammer and they indicate Im golden. IF YOU CAN AFFORD AN OUTSIDE OPINION GET ONE. I Guess I am going to have to go see my PCP everytime stuff flares up instead of living with it. Suffering in silence without them seeing someone has treated you will get you a denial.

The rating codes for your nerve damage are "Diseases of the Peripheral Nerves" Much of these ratings are subjective. Key to getting your claim for radicular neuropathy will be an EMG and nerve conduction tests (cant get them to give me them).

If you have a restrictive lung disease it may be attributable to your scoliosis, but you will need a medical opinion on that.

I hope this gets you in the right direction.

Best regards,

Tyler

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I suggest you get an IMO. Send your MRI disks to the Doctor. Your best bet would be Craig Bash. He can read the reports and put your claim together.

There are other Neuro Docs out there but Bash is the expert when it comes to the spine,

J

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Thank you for the advive jbasser and Tyler. I will try to contact Craig Bash and hopefully make some progress in the right direction. Can you be rated for pain? I read an article on the "Deluca VS Brown" case that I thought if you had painful motion of joints and spine that you can receive a rating for pain. Is that correct? Also, the facet arthropathy is arthritis. Why don't you receive a rating for arthritis? Any help is greatly appreciated! Again, thank you!

SSGmajik

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Thank you for the advive jbasser and Tyler. I will try to contact Craig Bash and hopefully make some progress in the right direction. Can you be rated for pain? I read an article on the "Deluca VS Brown" case that I thought if you had painful motion of joints and spine that you can receive a rating for pain. Is that correct? Also, the facet arthropathy is arthritis. Why don't you receive a rating for arthritis? Any help is greatly appreciated! Again, thank you!

SSGmajik

Pain is only evaluated in the context of range of motion. For instance I can forward flex 25 degrees, but at 20 degrees I have increased pain. They should be noting both measurements and your rating should be based on where it becomes painful. The real irony of it is most people with back problems have constant pain and when you are talking about pain on motion it is just an intensification.

Arthritis is rated on range of motion, if you have no loss of range of motion you can get a rating for two or more affected joints. Since the spine is essentially rated on range of motion multiple problems are still only eligible for one rating per segment.

Getting VA to service connect and rate the secondary conditions is probably the best place to focus your efforts.

Best regards,

Tyler

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Thank you for the clarification. I will focus all my efforts on my secondary conditions and hope for the best. The battle is just beginning. Thanks again! - SSGmajik

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