Question Concerning Possible Secondary Condition

[lt4ds]

I have a question about service connected and secondary claims

I have had 2 previous C & P exams for my back, knees and shoulder

I am currently rated:

40% for Traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease

20% Paralysis, incomplete, moderate, right sciatic nerve

10% tinnitis left ear

10% bilaterally knees for DJD

I have an appealable claim for left shoulder residuals from surgery post service for symptoms that manifested during service.

I recently had a 3rd C & P for a few other claims seemingly unrelated to any of the above listed claims. The examiner asked if I used my shoulders and arms more when lifting, sitting, raising from a sitting position, and other activities, and if I had headaches or tingling numbness in my hands. This C & P has resulted in numerous appointments, including an MRI for cervical spine that had a diagnosis of HNP (severe impingement) c5-c6, osteophytes(9mm), neuritis, and carpal tunnel. The MRI was listed as "STAT" on the appointment letter. I have an EMG/NVC scheduled for Upper Extremities. All of these have happened at a much faster pace than I have normally experienced with the VA.

I have a question about the cervical spine being considered secondary to the lumbar spine.

The original C & P specifically cited "no noted abnormalities of cervical or Thoracic spine".

The second C & P was dramtically different

Diagnosis:

Traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease

Paralysis, incomplete, moderate, right sciatic nerve, as likely as not secondary to service connected lumbar spine condition.

impacts:

decreased mobility, problems with lifting and carrying, pain

prevents: exercise, sports, recreation

severe: chores

moderate: shopping, traveling, bathing, dressing,

mild: toileting, grooming

none: feeding

My activities are severely limited as a result of the problems with my back, so my question is:

1. Likeliness of a rating for the cervical spine as secondary to lumbar spine, even if the C & P was not for my cervical spine.

2. If I do not recieve a rating for the problems with my cervical spine, should I start a claim.

I have assumed the back pain was natural with the arthritis and DDD so my cervical spine has never been a specific complaint to a doctor. It seems apparent that I have progressive issues with my spine over the previous 3 years

Note: All appointments for my lumbar problems and cervical spine have been with VA doctors.

Thanks for any and all responses.

[john999]

You need a medical statement that says your secondary condition is caused by your one of your primary SC conditions.

[lt4ds]

Ok, that leads to another question, can it be rated since it was found during a C & P exam, or will I have to get the medical statement stating it is related? Just not clear on that

[cooter]

"The second C & P was dramtically different"

What was the results on this?

Also, for a claim to succeed, you must have residual's effecting your cervical spine, such as; Pain, limited range of motion (ROM), etc. Anotherwords, just because MRI's show's defects, you must prove it effects you someway.

[john999]

I don't see anything in your c&p exams that say your cervical spine condition is related to your lumbar spine condition. I think you will need a medical statement explaining how the cervical spine is secondary to lumbar spine. Wait for your decision because maybe I am wrong and they will rate you for the cervical spine. Do you have anything in your records stating you had an injury to your neck or head in-service? I have a cervical spine issue and shoulder issues. They seem to blend together resulting in pain. I don't know where one begins and the other ends.

[lt4ds]

The first C & P specifically cited "no noted abnormalities of cervical or Thoracic spine".

The 2nd C & P was as follows:

Diagnosis:

Traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease

Paralysis, incomplete, moderate, right sciatic nerve, as likely as not secondary to service connected lumbar spine condition.

impacts:

decreased mobility, problems with lifting and carrying, pain

prevents: exercise, sports, recreation

severe: chores

moderate: shopping, traveling, bathing, dressing,

mild: toileting, grooming

none: feeding

The 3rd C & P

has resulted in a diagnosis of HNP c5-c6 broad left posterolateral disk/spur complex effacing the left ventrolateral CSF space along the left c6 root exit zone and causing severe left c6 foraminal impingement, lesser posterior and right posterolaterl disk/spur complexes causing mild narrowing od the cental AP canal diminsions to just under 9 mm and moderate right foraminal stenosis , DDD, Osteophytes, mild to moderate arthrosis in all joints, pain through neck and shoulders, neuritis. The examiner asked questions about guarding and using my upper body to avoid using my lower back, they seemes to think I was avoiding activity that ivolved my lower back and used my arms and shoulders to do things normally done with my lower back, lifting my body weight.

Abnormalties of spinal muscles, guarding, spasm, tenderness: yes

Description of abnormalities: tenderness ans spasms in cervical and lumbar paraspinous muscles

Evidence of spinal ankylosis: yes

location and position of ankylosis: lumbar spine ( neutral)

Cervical ROM

Active motion

Flexion: 0 to 30 degrees

extention: 0 to 30 degrees

left lateral flexion: 0 to 20 degrees

left lateral rotation: 0 to 30 degrees

right lateral flexion: 0 to 20 degrees

right lateral rotation: 0 to 60 degrees

objective evidence of pain on active ROM: yes

objective pain following repetitive motion: yes

additional limitations after 3 repetitions of ROM: unable to test due to pain

Right shoulder ROM

foward flexion: 120 degrees

abduction: to 120 degrees

internal and external rotation: to 80 degrees

extention: to 30 degrees

objective evidence of pain on avtice motion: yes

pain on motion after at least 3 repetitions of ROM: yes

additional limitations: no

Left shoulder ROM

forward flexion: 90 degrees

abduction: to 90 degrees

internal and external rotation: to 50 degrees

extention: to 30 degrees

objective evidence of pain on active motion: yes

pain on active motion after at least 3 repetitions of ROM: yes

"The second C & P was dramtically different"

What was the results on this?

Also, for a claim to succeed, you must have residual's effecting your cervical spine, such as; Pain, limited range of motion (ROM), etc. Anotherwords, just because MRI's show's defects, you must prove it effects you someway.

[lt4ds]

I don't have anything in my service medical records that I can recall that involved a head or neck injury other than migraine headaches. I did have several incidents involving my left shoulder, which I have an ongoing claim for. I eventually had surgery after service.

As you said, I thought I would have to have a medical statement connecting the cervical spine to the lumbar, but wasn't sure after the C & P and the examiner's question, and the resulting appointments specifically for the cervical spine. Since Mid July, I have had an appointment with my normal VA doctor for my cervical spine, an MRI, an appointment with Neurosurgery, and today I have a EMG/NCV scheduled. Just amazed at how quickly the appointments have been scheduled, and how short a time period between each 1 has been. If there was no possiblity of the cervical spine being rated as secondary to the lumbar spine, would the VA run all these tests? It seems to me that the VA is trying to establish the extent of problems as a function of rating the cervical spine, where if it was not related (secondary), they wouldn't invest the time and money into establishing the extent of disablility.

I don't see anything in your c&p exams that say your cervical spine condition is related to your lumbar spine condition. I think you will need a medical statement explaining how the cervical spine is secondary to lumbar spine. Wait for your decision because maybe I am wrong and they will rate you for the cervical spine. Do you have anything in your records stating you had an injury to your neck or head in-service? I have a cervical spine issue and shoulder issues. They seem to blend together resulting in pain. I don't know where one begins and the other ends.