lumbosacral Someone Explain These In Layman Terms Please

[SpcDearman]

I am getting ready for another C&P examination (number 3) for my shoulders and am doing a bit of research. I am getting tired of constantly being in pain and want to get this resolved correctly the first time. Can someone explain the following for me please? I am not the dullest pencil in the box but not the sharpest.

(f) Pain on movement, swelling, deformity or atrophy of disuse. Instability of station, disturbance of locomotion, interference with sitting, standing and weight-bearing are related considerations. For the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle are considered major joints; multiple involvements of the interphalangeal, metacarpal and carpal joints of the upper extremities, the interphalangeal, metatarsal and tarsal joints of the lower extremities, the cervical vertebrae, the dorsal vertebrae, and the lumbar vertebrae, are considered groups of minor joints, ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are considered to be a group of minor joints, ratable on disturbance of lumbar spine functions.

I have multiple tears in my supraspanatis (lol i KNOW i messed that one up) along with a rotator cuff tear and hills sachs deformitiy. I also have a bankhart lession on one shoulder and am attempting to see what type of rating is the minimum and maximum. I have below shoulder level raising of my arms and even that level is painful. Oh, and by the way, all of you Northerners need to take back this cold front. Its killing me. Fifty one degrees in Texas in the Fall. Unheard of.

Ok just this instant my shoulders started spasming. I know why. Stress. I barely made it to work this morning and just figured out that I have both sets of keys. Now to unlock this left knee and miss 1.5 hours of work. hey I can look at it as my rehab time lol.

[SpcDearman]

let me try and be more specific. This is actually the part that I need explained.

For the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle are considered major joints; multiple involvements of the interphalangeal, metacarpal and carpal joints of the upper extremities, the interphalangeal, metatarsal and tarsal joints of the lower extremities, the cervical vertebrae, the dorsal vertebrae, and the lumbar vertebrae, are considered groups of minor joints, ratable on a parity with major joints.

Does this mean that if you have injuries to the shoulder (major) then it gives more clout than say carpaltunel (minor)?

[71M10]

That whole paragraph relates to ratings for arthritis. Arthritis has ratings for range of motion, but also it can be rated on just having having it in multiple joints. That paragraph clarifies as what counts for a joint. The verbiage in it prevents you from counting two vertabral joints in the same spinal segmant as two joints for rating purposes. Another example would be the xray shows arthritis in two of my metatarsal joints (in same foot). That does not qualify me for a 10% rating, or the 20% rating with occassional incapacitating episodes.

The specific section from the rating schedule is:

5003 Arthritis, degenerative (hypertrophic or osteoarthritis): Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below: With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations 20 With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups 10 Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion. Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive.

Edited October 8, 2012 by 71M10

[SpcDearman]

i really appreciate this. Now, please consider the below that I added. i have one more question. if i have arthritis and those deformities would they consider this two seperate issues or would this be pyramiding. my problem is not just the arthritis in the shoulder but actually nerve damage that spreads down to my fingers once I "pop (which is probably dislocating) " my shoulders. It actually feels as if something is grinding and catching and thats when thjere is a tingling sensation that radiates to my fingers. i apologize if I am being vague.

[SpcDearman]

i really appreciate this. Now, please consider the below that I added. i have one more question. if i have arthritis and those deformities would they consider this two seperate issues or would this be pyramiding. my problem is not just the arthritis in the shoulder but actually nerve damage that spreads down to my fingers once I "pop (which is probably dislocating) " my shoulders. It actually feels as if something is grinding and catching and thats when thjere is a tingling sensation that radiates to my fingers. i apologize if I am being vague.

I do apologize but i meant when i pop it there may be a relocating of my shoulder. I cannot even complete a circle with my arms. remember the exercise where you put your hands out parallel to the ground and rotate your arms in small shoulders? I would literally die from pain if I attempted that. Actually, i cannot do it due to my shoulder "locking up" at one point.

[71M10]

It clearly states in the arthritis ratings section that you cannot get the 10% or 20% arthritis rating for a Joint or group of minor joints and a rating based on range of motion.

[71M10]

The nuerological deficit is actually a secondary condition, so it will not be pyramiding. However, you will need a diagnosis, and a nexus statement conecting it to your SC injury.