Help

[tck5810]

First, let me apologize for the length of this post, but to me I'm in a confusing situation. I need some advice. I’ve been reading postings on this website for about 18 months and it has helped me to be knowledgeable to a great degree on dealing with the VA. I received a rating of 40% in August 2008. It included 20% Degenerative Disc Disease, post operative (I have had a double ANCF C4-5 in Feb 2007 and a double discectomy at the same level with mass lateral screw fixation in June 2008); 20% Left radial nerve dysfunction post-op; and 10% posterior neck scar, post-op.. This resulted from a worsening neck and left arm condition since an accident during Airborne Training in 1985. I retired from the Army in July 2003, but because of OPTEMPO and a federal civilian job offer that took me to Iraq as soon as I retired, I did not get my VA retirement physical. I know that was not a good idea and as my neck condition worsened I knew that I hadn’t done that, so I figured I would never be eligible for disability. A friend convinced me otherwise, and so in the period between the two surgeries and during a particularly painful period I filed my first claim on-line, which led to the results above.

During my second surgery in 2008, I sustained a nerve injury that gives me continuous pain down the left side of my neck, in my left arm and also my hand. My palm is numb (and to me it seems to be worsening as time goes by and it gets harder to use it when I need any grip at all) and the top of my hand and my lower arm has hyper sensitivity that makes it hurt to most touching. Right after my surgery I work up feeling pain in my left hand which was laying against a bed rail. My surgeon told me that the nerves had snapped when the laminae bones were removed because my spinal stenosis was putting so much pressure on them. He told me that was the source of the pain and sometimes the pain went away in about a year of healing. It’s now 18 months later and the pain has actually gotten worse over time. Between November and December I was home from work (I have a 90 minute driving commute) 4 days because it hurt so bad. Anyway, the pain is still there, I believe because of it I have less range of motion than I did immediately post surgery. I deal with pain on a level of 8-9 daily, and the pain medications I’m given blunt only a small portion of it.

I have had numerous visits back with my surgeon, and have even had a spinal cord stimulator implanted; although it gives me minimal support because by the time I had received it the scar tissue was already too much for them to get up as high as they wanted to put it in my spine. The surgeon has told me there’s not much more he can do. He gave me a diagnosis of Complex Regional Pain Syndrome. I work at a medical research organization, and in checking with them, they also said there’s just not much out there to help it. The nerves are injured and few medications help. Perhaps they’ll regenerate or not. So I deal with that daily, and it has not gotten better.

In September 2008 a friend of mine convinced me that since I had never had the complete VA physical to file again, but this time through a VSO, which I did. I met with my VSO that month and we went through my entire active duty medical record and then she filed the claim. I knew that she was going out on pregnancy leave in two days, but she gave me another person’s phone number who I could work with. As luck would have it, she never came back, and I let the case linger until finally in mid-December I called back and was told that my file was complete but was with the CRDP office at the VA RO. She said if I didn’t hear anything back by this coming week, to call her back. During the intervening time between filing and calling her, I had another physical with the QTC doctor in August 2009, which I expected this time to be more in depth since I had claimed other service connected conditions in my second claim (which was not so much a NOD to the first one, but a complete new filing to me). The second exam was actually shorter than the first and the doctor took no range of motion measurements at all. He had some blood drawn and took a lower back x-ray and sent me on my way. I also was sent to get a barium swallow and endoscopy for my GERD.

That was the last I heard until today when I received my new rating. I want to preface this with saying I’m not trying to be greedy, because I did receive a 70% rating, up from my earlier 40%. (I never felt the pain of the off set, because the Army granted me the CRSC benefit since the original problem started during Airborne School). Here’s what my new rating gives me: GERD 30%, Migraines 10%, Lumbar Degenerative Disc Disease 10%, and Left Radial nerve dysfunction 20%. That adds up to 70%, so I was fine. I read a few pages further and saw that the 20% I had initially received from the first claim for Degenerative Disc Disease, post op would stay where it was for 2 months, but on 1 April it would be reduced by 10%, since the QTC doctor reported I was doing much better and my ROM was better than during my first exam. They only problem was that this rating was not included int he chart of rated conditions, which to me looks like it doesn't even play into the 70% rating. A quick backtrack...I only received a cursory glance on ROM during my QTC exam, and that from across the exam room. Still, I don’t know how he could have even concluded I was doing better given what I told him of my symptoms and the number of times I had been back to see my surgeon post-op; and even the lack of success from the spinal implant.

That 10% reduction I was told would lower my overall rating of 70% back to 60% beginning 1 April unless I filed an appeal. Of course that made me angry just because I know I’m not better than I was when seen by the first QTC doctor, and in fact I think I’m worse as far as symptoms go. The next thing I did was to read both ratings side by side, and then I noticed that neither the degenerative disc disease nor the neck scar are even addressed within the 70% in my second ratings letter. I know that they were both addressed at exam time, because QTC took a picture of my neck scar and had me move my neck.

I understand the VA additive factors so that 50% can add up to only 40% on a rating, but it seems to me that I’m having 10% reduced on a 20% that is not even given to me this second time around. I hope that doesn’t sound confusing. The RO makes note of the 20% deep in the letter but it is not in the chart of ratings, which doesn’t make sense. It seems to me that they should have taken my first rating 40% and added the new disabilities, each separate issues adding to 50%, which would have given me 90%, then if the RO felt a need to decrement, it should have been from that level to 80%. I think I'd have to write another page or two to give the complete picture, and I know this is long already.

I don’t know that I’ve done a good job of describing the history and current issue, but I hope so. To me it looks like somebody started the rating and then someone else picked up mid-stream, deciding to separate out all of my early ratings as individual, then not adding two back in, but taking off 10% from one of the two leftover ratings and then subtracting that 10% of of the 70% to put me at 60% come April 1st. So I need some guidance from some of the knowledgeable folk out there who may have some experience with a problem like this. Where do I go from here. Help!

[tck5810]

Broncovet,

I'm working with my VSO rep, at least I hope so. I was supposed to get an email from her Wed. or Thursday,but nothing came. I will have to call her back Monday. Anyway, to your point. You're right they are trying to downgrade a rating for Cervical Disc Degeneration from 20% to 10% based on bogus measurements by the QTC doctor who made no measurements at all, unless he was using Kentucky windage from across the room.

Before my second filing I had a rating of 40% (20% neck, 20% L. arm, and 10% scar disfigurement). When I got my second rating, aside from the new ratings (adding up to 50%, but all from different body systems), I was told I would maintain my 20% L. arm rating, but would be downgraded on my neck rating, but there was no mention of the neck scar I was awarded for in my earlier filing. Anyway, it seems to me that since I had a 40% rating, that should have been added on to my 50%, for at least a new baseline start of 90%. From there, they could have then made their argument about the neck. Then I'd only have that to challenge.

I have no idea what happened with the scar rating, especially since they addressed the other two prior ratings. I know they had to have looked at it, because they took a digital picture.

On another issue, even if they dowgraded me on my neck to 10% and dropped the scar, I still have 20% on my arm. If I had never filed on my neck and only my arm, it seems I'd have the 20% rating, so I can't see why they'd reduce my overall rating for those two problems to 10%, if only one was reduced, even with the VA math that's done. So I guess I have much to disupute.

I've thought about requesting a hearing, just so I can understand whatever logic it was they followed, because it doesn't make sense in my ratings letter. Like I think I wrote below, it looks like one person started working it then it transferred to someone else, and nobody did any check to see if the logic tracked. SO...to my way of thinking I should have nothing less than 70%, and then addin in the scarring, I should be at 80%. I could almost live with that, except I no that the QTC doctor could not possibly have been able to determine I had improved based on his exam of me. In fact, I ended up going to the Emergency Room Tuesday with severe pain in the left side of my neck, which then ended up keeping me at home this past Wed-Friday. Today is the first day that the pain wasn't so bad.

One good piece of news I received today was that VA/DFAS had finally finished my CRSC review (based on my prior 40% rating) and I was told I'm owed just shy of $7K (the army had already given me its share ($3600). That was a nice belated Christmas present.

tck

[LarryJ]

As a very basic argument:

Cervical Disc Degeneration (DDD) does NOT, by it's very descriptive name---------it DOES NOT "get better""improve", etc. HEll, it's DEgenerative, not REgenerative.

How the heck some quack (no dissin' the ducks, ducks are good) could state that your DDD is getting better is beyond even a VA-induced miracle!

Arthritis (which is, essentially, what DDD really is) does not cure itself, nor can any of the miracle workers at the VA cure it, otherwise we'd all be HAPPY.

Myself included.

Ya might just want to point that out to them.

Edited January 10, 2010 by LarryJ

[jbasser]

Each nerve should be rated separately.

Radial is one rating and Ulnar would be another rating.

The Palm of your hand is most likely the Ulnar nerve.

Dont let the rate an arm, they need to rate the nerve.

Radial and Ulnar. both separate.

J

[tck5810]

Thanks for the replies. LarryJ, I never really thought of it in the stark terms you provide. I also have lower back problems from the same airborne school accident, for which I've been rated at 10%. Again, no factoring in for pain, and the loss of dexterity I have standing to long, doing any type of work requiring bending (like yard work), or sports which I no longer can do. I will keep what you wrote in mind as that problem gets worse.

I guess because I have a plate in front of my spine with a fusion, and two rods and 4 screws holding the back of the same area together, I almost thought it could get better. Of course it doesn't because the pain in that area across my shoulders and down my left arm and hand are constant. As the day wears on, it's really painful, and then I get to face my 90 minute commute on the DC beltway.

I also never thought of ratings by each nerve. Can that be done?? How about progressively worse pain?

Tck