Sciatic Nerve Pain!

[81150 CAFB]

I am currently 4 months post op from L4-L5 fusion. I had a diskectomy performed on this same level in August 2009 and when in the Air Force in 1989. I am in the process of filing my claim (I have all of my records and 4 doctors letters). My question is regarding the section covering sthe sciatic nerve. It appears that the rating does not cover pain, just numbness, loss of use etc... I am still having severve sciatic pain in my left buttock, even after the surguries and the doc said that it might be stuck in some pain loop and it may be permanent. I have been on lyrica for about 2+ months with not much success. I am also having severe pain in my hip that goes to my knee and then if I do something I shouldn't it goes down my lateral leg to ankle and toes. Is there any rating for sciatic pain? I occasionally get some tingling in my foot and I do have deep nerve sensation loss (can feel light touch but not if you jab into my calf), but no paralysis. The sciatic nerve rating is so subjective...I just don't know what to expect.

I am applying for sciatica and I guess/hope that they will evaluate and rate properly based on my severe pain and limits.

Please respond if you can help.

81150

[81150 CAFB]

Looking at the codes and ratings I think I would be rated under neuritis. I will try to get the doc to see what he thinks since the pain is constant and hopefully get him to rate it specifically as severe/moderatly severe or what ever he thinks. I just don't know how the VA would rate it...based on his diagnosis? You can't really test a damaged nerve, it is pretty subjective and I am sure they would look at the ncs/emg that was fine but doesn't mean anthing for nerve damage at the root that causes constant pain-not the loss of use.

[john999]

American society and medical profession have a schizophrenic attitute toward pain. There is this moral judgement that is laid on you if you have pain that is not due to broken bone or bloody gash. On the other hand the VA, for instance, wants to treat your pain....yeah,right! If the VA can't see the actual result of some loss of use they tend to give low ratings for pain. I am SC'ed for chronic nerve pain. I get 10% for that but it is the real cause of many of my problems.

[81150 CAFB]

American society and medical profession have a schizophrenic attitute toward pain. There is this moral judgement that is laid on you if you have pain that is not due to broken bone or bloody gash. On the other hand the VA, for instance, wants to treat your pain....yeah,right! If the VA can't see the actual result of some loss of use they tend to give low ratings for pain. I am SC'ed for chronic nerve pain. I get 10% for that but it is the real cause of many of my problems.

What code did they rate you under. Seems pretty low when the nerve pain is very pain ful...ITS the NERVE!!! Honestly I don't know what to expect since it is subjective and causing the most pain. Hopefully the doc can do a good letter and they (VA) look at it properly and test(?)/exam for neuritis.

Found this -

Under 4.123 Neuritis they define as:

Neuritis, cranial or peripheral, characterized by loss of reflexes, muscle atropy, sensory distrubances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete, paralysis, see nerve involved for diagnostic code number and rating. The maximun rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatica nerve involvment, for moderately severe, incomplete paralysis.

Under 4.124 Neuralgia, cranial or periperal.

Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysi of the affected nerve.

My only problem is with neuritis is the constant pain - at times excruciating, but to my knowledge no loss of reflexes etc...

81150

Edited May 7, 2010 by 81150 CAFB

[john999]

If you don't have physical manifestations of the nerve pain you will get a low rating. I have the pain and some numbness in my feet and hands. I got 10% for each limb. You get more if you have some severe symptom that shows up on an MRI or X-ray. I don't remember the actual code but it is for PN. You get rated for pain as a symptom of some other disease. If they do an EMG and it shows major nerve damage you may get higher rating, but it won't be for just pain. They consider pain to be some nebulous symptom that is probably in your head.

[SLEDGE]

" You can't really test a damaged nerve, it is pretty subjective and I am sure they would look at the ncs/emg that was fine but doesn't mean anthing for nerve damage at the root that causes constant pain-not the loss of use."

A specialist examined me for 'nerve' problems, mainly because the VA refused, and he not only told me everything I was experiencing, including pain, he told me how long the problem had existed, accurately.

Before the exam he had no records to revue or even a conversation with me, we were strangers.

The plan was to 'discover' and document for treatment by 3 other specialties.

It's really amazing what they can tell about nerve damage these days outside the VA.

Even the VA told me not to drive because of the meds.

Then the VA scheduled 3 appointments for me at facilities that were over 200 miles from my residence.

sledge

[81150 CAFB]

Talked to neuro today and he said my nerve damage (as he would rate for my VA filing) is neuritis. He said that he is treating as permanent...next step is pain management (private). I will ask him at my next appointment to clarify some things in writing.

"The maximun rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatica nerve involvment, for moderately severe, incomplete paralysis."

I would hope to get him to rate as moderately severe.

81150