Got Copy Of C&p Exam.

[blackbird]

Hello Veterans,

I finally got a copy of my exam done in September of this year. If you read my earlier post after the exam, I wasn't sure the examiner took enough time ( only about 10-15 min) for the exam. Below is some of the facts he stated;

Referenced 1996 L4-L5 disc surgery,

1998 L4-L5 fusion,

2007 L2-L3 disc surgery,

2009 L2-L3 disc surgery again.

Flexion is 0-50

Extension 0-10

Side to side bending 0-20

Rotation 0-25

No change on repetition, and pain at end of all ranges tested.

Sensation deminished but present to light touch under two toes,

Deep tendon reflexes are grade 1+ at knees and ankles.

Toes are downgoing ???

IMPRESSION:

Lumbar Degenerative Disc Disease. I have been asked for an opinion if the patient's disc disease is at least as likely as not etiologically related to his time in the military. We have clear notes from the military indicating that he developed back pain radiating to his left leg. He under went L4-L5 laminectomy and discectomy at this time. Postoperatively, he continued to have some back pain with radicular features. It is noted that the patient had a positive straight leg raise on the left and was mildly weak in the left leg. Given this, I would state that regarding his back pain, his current back pain is most likely caused by or a result of his time spent in the military.

Any opinions on this and possible total rating guess would be appreciated. (I know it would be an educated guess). Claim dates back to May of 2004.

Thanks for your time,

Blackbird

[LarryJ]

That's a "good" C&P.

As to what the VA RO rater will rate you at, percentage-wise, is a crap-shoot.

Read the diagnostic codes and the percentages (they are all listed here on the board, first page).

[john999]

That's a good c&p and like Larry says the actual percentage rating is a crap shoot. If Rental guy was here he could probably tell you a better guess on percentage based on your ROM. The main thing is to get SC'ed. Once you are SC'ed you could file for chronic pain disorder, depression due to a general medical condition and a few other things that come to mind. Even a 10% rating blows open the doors of the vault. You never get true compensation for what you have lost, but SC is the route to more money.

[kw34]

BB,

I think you are in there.

Good Luck!

[jbasser]

Your range of motion under rating code 5241 for spinal fusion.

Your forward flexion Rom of 50 is in the 20 percent category. It would have been higher if it was 30 degress or less.

I see a 20 percent rating and possibly a Radiculpathy rating for the nerves. This may have to be challenged as the examiner did not spacifically state the nerve involved and the RO may not try to find out.

J

[Vync]

It would be interesting to look up the thoracolumbar C&P exam and see if they actually followed it...

[halos2]

Was this C&P done by a physician or nurse practioner? Doesn't read like a Dr may have done it. If you have been fighting this claim since 2004, someone has really done an injustice to you to the MAX!

The documentation from this exam is definitive in your favor. In reading your post I see where your original incident occured in-service with pain radiating to the left leg. You underwent L4-L5 laminectomy and discectomy in-service...Post op pain continued with radicular features( pain continued for how long)...was the pain complaints and radiation recorded in your discharge physical?

Was this the surgery from 1996? I read the further surgery's and dates and presume the VA was given all surgery notes, as well as continual treatment notes throughout these years since. So not only have you presented the evidence of a military injury, you have also of further surgerys, and now(C&P) evidenced is PAIN in all ranges tested, with many limitations noted in flexion, extension, and "toes are down going" this sounds like FOOTDROP to me.

Have you noticed tripping, falling more now? With footdrop your toes do pitch in a downward fashion as well as your foot, and many times one would receive an afo for this to put in their shoe/shoes if bilateral, to keep the foot as near 90% as possible.

Have you received one?

I just cannot see how a rater could have possibly denied this claim...low-balled yeah, but denied there is no way they could have read the complete c-file.

You did present all of the continual treatments/surgery's records with your initial file right?

Well hopefully the rater will have the ability to read/comprehend/evaluate/grant this claim. Looks like enough jacking around has already been done. Stay with this.

Do you work? Did you put in for SSDI if unable to? Do you utalize a VSO? Maybe you will get a nice christmas present from the VA related to this claim. Good luck.