tdiu Disability Rating For Cervical Spine

[Charleese]

Hi all,

My husband's BVA decision states residuals of a herniated cervical disc and discectomy are the result of service connected residuals of a left tibia fracture. It also states under ORDER that Entitlement to service connection for residuals of a cervical disc herniation and discectomy as secondary to srvice-connected residuals of a left tibia fracture is granted. They sent it back to RO to be rated.

? What %age do you think RO will give him for this.

My husband current rating is 60% and he has applied for TDIU and was denied by RO.

However, BVA states in their decision: "With respect to the Veteran's claim for TDIU,, the claim is inextricably intertwined with the grant of service connection for a cervical spine disability discussed above. After implkementing the Board's grant of service connection, the RO should readjudicate the claim for TDIU. The Board notes that the Veteran's residuals of a left tibia fracture, left knee recurrent subluxation, and left knee tender scar are disabilities of a common etiology, and therefore meet the schedular criteria for a grant of TDIU under 38 C.F.R. Section 4.16(a)."

? Do you think RO will now grant him TDIU PT. 3 doctors have given IMO's stating that he is unemployable because of these injuries.

Thanks in advance for your replies.

[jbasser]

They most likely (Or SHould) rate his neck as Traumatic Arthritis under the 4.71. Thee is a diagnostic code for Cervical Fusion. What levels did he have fused. It also applies another rating if he has radiculopathy issues in his shoulders, arms.

The ratings are based on his range of motion. Since he has been examined, you can compare his actual ROM from the exam to the listed ROM parameters in the title 38 cfr 4.71a.

I think this is enough to put him over the IU hump. especially if he has neuroligical invilvement.

J

Edited November 4, 2010 by jbasser

[Charleese]

Fusion and plating was done at the C3-C4 level His BVA decision states: "On July 30, 2008 the Veteran fell injuring his neck while getting out of a car. Over a three week period, he experienced progressive quadripaersis and in August 2008 was admitted to a private hospital and diagnosed with a severe cervical disc herniation. A cervical discectomy was performed nd the Veteran demonstrated improved leg, aqrm aand hand function. The most recent records from the Veteran's private physician included a December 2009 MRI report showing numerous central disc protrusions along the cervical spine with central canal narrowing. Therfore, the record establishes the presence of a current cervical spine disability."

The only ROM that was done was done on his service connected left knee in June of 2010 boy his othropedic doctor and he states: The patient, on examination, has old well-healed scars over the left knee. Range of motion of the knee is about 10 degrees to about 80 degrees. He has good alignment. Both knees have crepitus. The right knee has more crepitus and pain on the medial side. Varus knee deformity on the right is noted. Sensory examination is intact. Reflexes are trace bilaterally. Dorsalis pedis pulse is 2+. What this means I do not know. He goes on to state that the patient had x-rays taken today in the office, standing films, show severe patellofemoral arthritis and milder femorotibial arthritis. He has also patellofemoral arthritis on the right knee and primarily medial joint arthritis on the right knee. Impression: The patient's pain is more severe in the left knee than the right.At the present time, the patient is unemployable since ambulation for any long periods of time bothers him and he cannot stand for a long period of time, anything longer than 20 minutes of the timeand also, when he sits in one position for a while, his legs start to cramp up and bother him as well as pain in the lower back, so he has got to get up and move.

He's in chronic pain from the hurting of both of his shoulders. He put claim in for them but they had not acted on it as of yet.

Also when you say: "I think this is enough to put him over the IU hump. especially if he has neuroligical involvement

WHAT RATING %AGE DO YOU THINK THAT RO WILL GIVE HIM WHICH WOULD MAKE HIM OVER IU HUMP.

Please all, continue to answer these questions.

[jbasser]

I MEANT HIS RANGE OF MOTION FOR THE CERVICAL SPINE IN COMPARISON TO THE CRITERIA LISTED BELOW?

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.

[Papa]

When I went through my C&P the Doctor had me go through all these bending motions, and I did not do very well. He also noted that I had a problem dressing with just a chair. But, the funny thing is that he said he was not scheduled to examine my back. Was he checking for something else?

Papa

[Stu Pidasso]

I have an injury to that effected my left foot and ankle and has caused stress fractures in my Tibia, the injury occured from a parachute jump that did not land so well . Well I also have cervical spine damage. I did not get a percentage for it when I started my first claim in 2005 because I had never complained about the injury while I was in the Army. So VA gave me 0% but gave me 10% for the acquired flat foot which was caused by damage to the ankle. I just figured what ever back pain I was having was do to me not being able to stand correctly or walk normally. I was told after my first C&P exam in 2005 that I definatley had damaged my spine. I was told that I would have to prove that the injury not only occured while in the Army, but that it was caused by a particular event and not just an added complication of the ankle. I do know that it seems no matter what the problem is the more you get treated for it and the more documentation you have for your treatments the better chance you have of getting considered for compensation. Paper trails seem to be the name of the game.

[jbasser]

I have an injury to that effected my left foot and ankle and has caused stress fractures in my Tibia, the injury occured from a parachute jump that did not land so well . Well I also have cervical spine damage. I did not get a percentage for it when I started my first claim in 2005 because I had never complained about the injury while I was in the Army. So VA gave me 0% but gave me 10% for the acquired flat foot which was caused by damage to the ankle. I just figured what ever back pain I was having was do to me not being able to stand correctly or walk normally. I was told after my first C&P exam in 2005 that I definatley had damaged my spine. I was told that I would have to prove that the injury not only occured while in the Army, but that it was caused by a particular event and not just an added complication of the ankle. I do know that it seems no matter what the problem is the more you get treated for it and the more documentation you have for your treatments the better chance you have of getting considered for compensation. Paper trails seem to be the name of the game.

Stu, you may be looking at secondary conditions from an abnormal gait.

In order to prove this, one would need to put it together to make it feasable. First, one should gather all medical information. go seek an IMO and have the Doc to review the entire history, Xrays, Etc.

The Doc can write an opiion and a nexus to your secondaries and put them into a medical prespective.

There is one Doc who is really good at this that I am aware of.

Dr Craig Bash. He is a Neuro Radiologist and he can put it together for you. The only negative I have seen is that he is a little pricey, but I have witnessed his work for 12 years and he is effective at all VA levels.

J

Edited December 3, 2010 by jbasser