Numbness In Right Hand From Neck Issue.

[HSCM]

I have a question about one of my items. It is about my numbness in my right hand, arm, and up to my shoulder.

The VA said it doesn't require a separate rating. I talked to a friend of mine who did med boards in the CG, and said it should be rated separate.

I am looking for an opinion how much I might be looking at, and is it worth the time. Any advice would be great.

Below is what the VA said.

3. Service connection for degenerative disc disease, cervical spine, with right hand parasthesias is granted with a evaluation of 20 percent effective Jauuary 1,2011.

It should also be noted that the examiner found evidence of right upper extremity parasthesias; however, this condition does not warrant a separate compensable evaluation because the evaluation criteria for the spine takes into consideration radiating pain. In addition, you motor and reflex examinations were normal. Further, your sensory examination revealed normal vibration, position, and light touch sensation; however, there was decreased sensation to pinprick in your 4th and 5th fingers. These findings do not warrant a separate compensable evaluation.

[jbasser]

Look at your rating code.

If it is IVDS then I can see the VA trying to hide this.

If it is from Traumatic Arthritis, then this is wrong as all effected nerve groups are to be rated separately.

Basser

[HSCM]

It was rated 5243 Intervertebral disc syndrome. It looks like I might be able to do something with that. What is the range % for the numbness/pain in the hands, arms and shoulder?

[jvretiredvet]

Well, here are some generalized rantings and thoughts ... perhaps you may find some of them instructive .....

Secondary conditions 38 CFR 3.310(a) http://www.benefits....ART3/S3_310.DOC

Some general rating principles:

You are not service connected for a Diagnostic Code but for a condition, ie., the verbiage in the issue. DCs are used to evaluate the level of disability. Sometimes, a particular DC must be used. However, depending on the veteran's presentation, somewhat different rating criteria might be used than for another veteran.

If a condition is a "stand alone" condition, that is, not secondary to any service connected condition, it is appropriate to make it a separate issue and assign it's own percentage, even if that percentage is 0% . But, things may be a bit different if a condition is secondary to a service connected condition.

If the secondary condition is ratable 10% or higher, it is appropriate to make it a separate issue and assign the appropriate percentage.

However, if an acknowledged secondary condition must be evaluated currently as 0% disabling, it is appropriate to "wrap" that added disability into the base or root disability. That does not mean that the secondary condition isn't service connected, it is just that it does not warrant "a separate compensable evaluation".

Later, if you believe your condition has worsened, you file for an increase. It is determined that the right hand symptoms are worse, so the right hand issue can be "cut" from the root issue and made its own issue. I surmise the DC in your case might be the analogous code 5243-8516 (38 CFR 4.27 http://www.benefits....PART4/S4_27.DOC ) .

I talked to a friend of mine who did med boards in the CG, and said it should be rated separate. If you friend is referring to conditions which make or possible could make one ineligible for further service, this is prolly correct.

I have a question about one of my items. It is about my numbness in my right hand, arm, and up to my shoulder.

The VA said it doesn't require a separate rating. I talked to a friend of mine who did med boards in the CG, and said it should be rated separate.

I am looking for an opinion how much I might be looking at, and is it worth the time. Any advice would be great.

Below is what the VA said.

3. Service connection for degenerative disc disease, cervical spine, with right hand parasthesias is granted with a evaluation of 20 percent effective Jauuary 1,2011.

It should also be noted that the examiner found evidence of right upper extremity parasthesias; however, this condition does not warrant a separate compensable evaluation because the evaluation criteria for the spine takes into consideration radiating pain. In addition, you motor and reflex examinations were normal. Further, your sensory examination revealed normal vibration, position, and light touch sensation; however, there was decreased sensation to pinprick in your 4th and 5th fingers. These findings do not warrant a separate compensable evaluation.

[jbasser]

IVDS is a bear to rate.

The disks in the neck are cushions for the vertabrate to rest on and act as shock absorbers to the body.

Disks just don's start to disentegrate on their own, They have to have help.

Loss of Fluid is one cause but most causes is some type of issue with the Bony structure of the bertabrate like bone spurs that tare the disk and assist the process.

What you need to do is get an IMO from a Neurosurgeon, or even a Neuroradiologist to look at your MRI's and put it into perspective.

A history or timeline showing the cause of your disk disease. If it is bony structure that caused it, then ask the VA to rate it correctly.

Dont put too much faith into what a rater tells you medically. They are not qualified to diagnose or make any assumptions regarding medical diagnoses.

The bottom line when dealing with the VA is the following.

Nexus of a condition relation to service.

The chronicity of the condition

The regs used to adjudicate and rate the claim.

The regs are the tools to be rated correctly. The only thing that is confusing is the methods everyone uses to interpet them.

J

[HSCM]

Thank you everyone!

[rpowell01]

The most common cause of DDD is strain to the muscles. I am going to quote to you all from what is in the literature my IME wrote on my IMO. The VA will say they cannot speculate because its not in the literature. The reason why is because the VA is using RNs and PAs for C&P exams and this is hampering in giving true results. They should have examiners that are specialists or even MDs but they don't. Here is the written literature on DDD:

CERVICAL RADICULOPATHY

Cervical pathology may manifest with associated shoulder pain. The area of referred pain is along a dermatomal pattern consistent with the distribution of the dermatomal nerve roots. Isolation of the pain usually defines the exact location of the associated cervical pathology. It can be differentiated from shoulder pain on the basis of history, physical examination, EMG, cervical radiographs, and myelography or MRI when indicated. Because conditions causing cervical neck pain and conditions causing shoulder pain, such as calcific tendinitis and

cervical

radiculopathy

, may coexist, it is often difficult to distinguish which lesion is responsible for the symptoms. These conditions often can be differentiated by injection of local anesthetics to block certain components of the pain.

1. There are no available level one evidence studies (random double blind) studies that show that early spine injuries in a patient life do not lead to advanced for age spine arthritis and this type of study would be needed to refute the available peer reviewed clinically based literature (Turek). It is a well known medical principle that such an injury both precipitates and accelerates the onset of the degenerative process of the spine, Turek, beginning at page 1512 (and elsewhere):
   

As a result, the facets become sclerosed, and the same changes are observed in the notches. The facet articulations themselves develop degenerative changes, including narrowing of the joint space, loss of articular cartilage, scelrosis, irregularity, and osteophyte formation. These changes take place over a number of years.

Anything that suddenly or continually increases the superincumbent pressure stresses, will eventually cause the posterior fibers of the annulus to give way [producing a ruptured intervertebral disc]...

What is being said here is overtime a muscle strain/whiplash to the cervical spine causes the muscles to tear away from the joints. The joints beome loose and begin to move abnormally. Overtime this causes the disc to rupture or rip away from the vertebrae. Sometimes they bulge and other times they begin to leak out. This is what normally happens to people who have a cervical strain or whiplash. Now, you should be rated at least 20% for your right arm radiculopathy because the DDD is now affecting that nerve and this would be secondary. I don't know when your injury happened but it was 1994 whenever mine happen and I now have DDD with bulging and herniated discs and I am only 43. It was also noted in this IMO that you normally would see this on people who are 60-70 so the injury causes the progression of DDD. Its like having a spring that springs and never stops. They need to rate your accordingly to the regs and it doesn't seem like they have.

But JBasser is correct you need an IMO. Its will cost you big bucks but it will be worth it in the end.

Edited August 9, 2012 by rpowell01