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Intervertebral Disc Syndrome - Incapacitating Episodes


TravHill
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Would like to say "Thanks for a wonderful site". I cannot believe how much information is available on this forum. I look forward to reading...and reading....and reading!

Now to my question.....

I am currently rated at 20% due to Intervertebral Disc Syndrome. I have had issues since my discharge in 99 from the Navy. Over the last 8 months, I have had significant issues and have requested a rerating (My C&P is scheduled for the 10th of January . Since May, I have had incapacitating episodes (under a DR's care and orders) for approx 9 weeks and believe that I should be at 60% based upon the VA manuals. This is not taking into account Sciatica, or neuropathy caused by the Interbertebral Disc Syndrome.

I went and met with a DAV Rep, and she told me...noway, no-how would the VA rate me at 60%. Most that I would get is 30% and that is only based upon limitations of my Range of Motion (and I had to basically had my entire spine fused together to get that). I asked her specifically on the incapacitating episodes rating and again she said that the best I could hope for would be a temp rating during that time period only. Basically that I MAY get the 60%, but it would only be for the 9 weeks that I was prescribed Bed-Rest and then it would go back down to my original 20%. I have re-read this section of the VA Rating Manual and it seems cut and dry, it doesn't mention temp ratings during the incapacitating periods, but states:

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%

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.

.......SO, Did I just get a bad/mis-informed DAV Rep, or is she correct? Any input or experience in this provision would be greatly appreciated.

Travis

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I think that your rep may be misinformed. I am rated 40% directy for IVDS, under the old code, then re-rated again under the new code. It's difficult to be rated for incapacitating episodes, since few doctors prescribe immobility for the condition anymore. My rating was based in part on ROM and in part on incapacitating episodes and absences from work. I was initially 40% just for this, but then was rated 10% for sciatica due to a subsequent claim. I was initially rated in 2002, then again in 2003 after they changed the rating code.

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There goes another one. I dont like it when VSO's hand out mis information. It makes them look bad. The regs changed a few years ago.

Ankylosis is no longer the issue as the regs are based on Incapacitating episodes.

You will be rated on periods of bed rest so your VSO is not up to date on the regs like a lot of poor folks out there.

Most likely not her fault, but her superior reps.

J

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Thanks for the responses. I am under the same impression that she was basically misinformed.

Travis

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Yes Travis, Do put in for your declining condition claim. Make sure you never tell them you are having a good day or less painful day...be real! You know with a back injury you never really have a good day, but continual pain you basically live with, however don't say you can live with the pain.

If one has a good or fair day and 6 terrible one's they will rate or decline to rate any increase on the 1 good day.

Sometimes one may have a new VSO who may not be versed in all of the regulations, especially one's that have changes in them.

As you are here @ hadit you know it is here you will find many suggestions others have used to assist with their claims. Ultimately we all want our fellow vets to receive the awards they are truely entitled to receive, so keep coming back and don't forget to use the search area too. Many valuable items are addressed there too.

Good luck with your claims in the future and keep us all posted on your journey.

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