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back in 2006 I was given rating of 60% for degenerative disc disease of lumbar spine with status post laminectomy and lumbar fusion. I received a letter from the VA stating my diagnosis is changed to IVDS of lumbar spine s/p laminectomy and lumbar fusion with scar and degenerative disc disease. The closest analogous peripheral nerve is the deep peroneal nerve. Remarks for the VA Dr. the effect of the condition on the claimant's daily activity is severe. Question: What does this mean and will my rating go down or will it increase. Thanks, Kevin
They should have informed you of any change. Our resident lumbar spine expert, Rentalguy will chime in an give you some detailed info on your issue.
kevin, this just did not just come out of the blue did it? Are you in the middle of anther claim or did you have an appeal on the 2006 claim? Basically, you need to actively maintain proof of emergency room/walk-in visits and/or orders for bed-rest by the treating Dr for your back issues.
Your rating most likely will be reduced. You were most likely initially given the 60% rating after the surgery because of the doctor prescribed bedrest necessary for your recuperation. Since that is no longer in effect, and in the absence of six weeks of doctor prescribed bed rest in the last twelve months, you will have to be rated based upon range of motion under dx code 5243. Since you had a fusion, your spine is fixed in position. Do not let them try to tell you have any range of motion, because the surgery itself dictates that you do not. Unless the surgery went horribly wrong, your thoracolumbar spine should be fixed in the anatomical nuetral position, which translates to "favorable ankylosis." Under the general formula for rating conditions of the spine, favorable ankylosis of the thoracolumbar spine equals a rating of 40%. Now if the surgery left your spine fixed in any position other than anatomical nuetral, that would be a rating of 50%. I would try to find a doctor who could either prescribe six weeks or more of bed rest very soon, or find a doc who can prove that your spine has unfavorable ankylosis.
Regarding the peroneal nerve and radiculopathy; they don't like to give very high ratings for radiculopathy. The VA Training Letter on IVDS states that the majority of rating for nerve damage should be fixed at 10%, with severe cases being assigned a 20% evaluation. I don't know exactly where they come up with this at, but the highest ratings for lumbar radiculopathy involve a foot drop and weakened motion below the knee, and can go up to 80% when rated under dx code 8520 (sciatic nerve). The highest rating for dx code 8521 (external popliteal nerve/common peroneal) is 40% with a foot drop. The majority of IVDS sufferers have sciatica, which means that they should be rated under dx code 8520. Do your best to get a doc to give you a written diagnosis of sciatica, and to accurately note any loss of sensation, loss of strength, loss of movement, and muscle atrophy.
If you need more information regarding spine claims, please click on the spine claim repository link in my signature.
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