lumbosacral Had Degenerative Disc Disease Changed To Lumbosacral Sprain

[hawkcrewchief]

This is what I got for SC Aircraft accident which hurt my back

The evaluation of chronic lumbosacral sprain, previously diagnosed as degenerative disc disease is increased from 0 to 10% disabling.

Va exam results dated Dec 08, from the VAMC noted your medical history relating to your low back disability. The examiner noted your current subjective complaints of increased low back pain with radicular pain toy your left lower extremity and decreased motion. The physical examination your gait and posture were normal. The examiner noted range of motion testing of your thoracolumbar spine was normal with flexion to 90 degrees, extension to 30 degrees, right lateral flexion to 30 deg left lateral flexion to 30 deg right lateral rotation to 30 deg and left lateral rotation to 30 deg. The report noted objective evidence of painful motion and tenderness. The examiner noted there was no additional range of motion loss due to pain, fatigue, weakness, lack of endurance, or incoordination following repetive use. The neurological portion of the exam was normal. X-ray was normal. The provided was chronic lumbosacral sprain.

----That was fine I guess untill I noticed that I am really in pain doing regular things at work, so my PC doc at the VA went ahead and ordered an MRI to see whats going on...? And here it is...

Findings: The alignment of the lumbar spine appears normal. Vertebral bodies are normal in height. Loss of normal disc signal seen at T11/T12 and L4/L5 levels, where mild disc space reduction is also noted.

There is a mild broad-based disc ostephyte complex seen at the T11/T12 level, indenting the ventral aspect of the cord, without any obvious cord compression.

On the axial images, at the L4/L5 level, a mild broad-based disc bulge with a posterior annular tear is noted (sounds bad?) causing mild central canal stenosis w/out significant exiting nerve root compression. Remainder of the levels are unremarkable.

-Have I just claimed the wrong thing???

-Would this new evidence prove there is more than a strain there and require an increase?

-Do I file an NOD, and if I do what do I state?

-Im a bit confused, is my back ok?

Thanks in advance!

Edited March 29, 2009 by hawkcrewchief

[Vync]

Below I have posted the ratings for spine disabilities. RentalGuy is correct that most of them are based on limited ROM or IVDS/bedrest. However, if you have abnormal spine curvature,  abnormal gait, or guarding, you may qualify for a rating higher than 10%.

Keep in mind that you can have two separate spine ratings because the VA rates based on spine segments:
1. Cervical/neck
2. Everything else (thoracolumbrosacral)

Pain can be rated separately in a few ways.
1. If the pain extends into a limb related to a SC spine segment, you can file a claim for radiculopathy.
2. Mental health rating secondary to SC spine disability.
3. A recent court ruling allows filing claims for SC pain if it causes severe financial hardship.

If your disabilities have worsened, examine the rating criteria and compare to your medical records to see if you can file for an increase. If your medical records within the past 12 months qualify for a higher rating, use them. You may get an earlier effective date which might help increase your combined rating or produce retro money.

Don't discount side effects of medication to treat SC disabilities. Example: You are prescribed NSAIDs to help with your pain. X years later, you develop GERD. File for GERD secondary to the side effects of medication to treat your SC disabilities.

Additionally, does pain negatively impact intimacy? File a claim for ED. It will not add directly to your rating, but is granted as SMC-K award which means a little more than $100/month extra.

I can personally relate to chronic and near constant spine pain. Here are some options aside from filing for SC disabilities or increases which may help.
1. Try physical therapy. It does help.
2. Epidural pain blocks can help, but are not guaranteed to work.
3. Chiropractic adjustments
4. Acupuncture
5. If overweight, try to lose weight because it may help take pressure off of your spine
6. Visit the VA pain doctor or neurology. They can prescribe medication to help quiet activity on the nerves and reduce pain.
7. Ask your doctor about using a cane/walker, back brace (in brief duration), heating pad/ice packs, TENS unit, or an Alpha-Stim unit.
 

I hope this information is helpful

 

The link below also contains all the other SC rating criteria and related regs. Scroll to top for table of contents. Search for words to learn more.

§4.71a   Schedule of ratings—musculoskeletal system.

Quote

Rating
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 (whther 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.

 

 

 

[ruby]

Strain has a time limit

[dwight]

I'm currently rated at 10 percent for my lumbar DDD, but i recently had surgery for Radiculopathy w/sciatica. I have a QTC on this Friday Mar 6 for increase in Lumbar DDD and radiculopathy w/sciatica. So does the VA consider my issues as repaired and I want receive any benefits since I chose surgery to relieve pain? The sciatica was put in as a new claim, but the surgery has relieved the pain down my left side. I've been out of work for 3 weeks, but can return 6 weeks after surgery to full duty.

Please advise how to handle upcoming QTC.

[bwilson]

I am at a loss at how to claim my entire spine in one claim. I had arthritis in my knee in service and was to be med boarded, but was not. Have complaints of back pain after 10 months of being on couches in service as I was being returned to full duty. I have over 20 years of VA x-rays, MRIs and CTs showing how the curve in my lower back and neck have vanished with the common L5/S1 an C5/C6 nerve damage.  I made the mistake of allowing the VA to do two shoulder surgeries in one they took part of my bone and had it tested and it can back as reactive arthritis. 

[bwilson]

On 5/21/2018 at 11:28 PM, Richard Ballard said:

OK so I had pancreatectomy in 2003 due to an impacted goldstone 2/3 of my  Pancreas was removed I am type one diabetes with very large scars continued diarrhea stomach problems Constant back and shoulder pain I recently received a Nexus letter from my  endocrinologist related to my service in the gulf war.  Any suggestions or advice from anyone

Wow,  I hate this I had my pancreas damaged in service was in the hospital for a month in 1987 and still not given a rating for the hell I have gone through, thanks to one navy surgeon not completing his paper work. I refused that Whipple procedure. You may want to research bone loss due to steatorrhea diarrhea plus heart disease from hyper high trigralites and LDL/HDL if you can service connect. If you had RUQ pain in service you have a wonderful chance. 

[hawkcrewchief]

I am in pain EVERYDAY and I have to be tough enough to admit I am a bit scared now. Please advise what do I do...???? :)

Edited March 29, 2009 by hawkcrewchief