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justrluk

Question

Good morning and Happy Thanksgiving to all at Hadit!

I need some advice: on a recent visit to the rheumatologist, I complained of worstening neck pain. The rheum ordered x-rays and in review, she stated that the osteophytes and narrowing were markedly worse than the last x-ray. She also ordered an MRI to see if there was any tissue being impacted. I haven't had the time to travel to the VAMC to get this done yet. My question: I am currently rated at 30% for DDD in this area. I can't seem to find the correct reference to the schedule of ratings for this issue. Can anyone lead me in the right direction?

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  • HadIt.com Elder

Do you know the code you are rated under?

The criteria for the C spine follows 2 different roads.

IVDS 5243

Traumatic Arthritis. 5242

IVDS is based on incapacitating episodes or bed rest

Traumatic arthritis is based on range of motion.

The effected nerves are to berated separately under Arthritis.

J

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Do you know the code you are rated under?

The criteria for the C spine follows 2 different roads.

IVDS 5243

Traumatic Arthritis. 5242

IVDS is based on incapacitating episodes or bed rest

Traumatic arthritis is based on range of motion.

The effected nerves are to berated separately under Arthritis.

J

J -

I'm pretty sure it's ROM under 5242. I'll pull out the original decision when I can.

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  • HadIt.com Elder

What kind of treatment do you plan to get besides PT and pills? Are you ready to go under the knife? I have similar problem. No cure for stenosis that I know of except surgery.

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I'm in the same boat. Neck getting worse. Scheduled for a consult with pain management. (been thru that clinic 3 times before for back - had spnal surgery, and neck last year, no help with epidural injections). Primary sent request in Oct.2012, appt. set for FEB. 2013! Crazy over booked under staffed at Bay Pines in Florida. Now some mysterious doc who I will never see, reviews everything (xray, MRI, therapy (traction), etc., and will decide if I get to see a neuro surgeon. Peyton Manning the football player probably had less damage and pain, and he was taken care instantly. He is luck he was never in the military, injured, and stuck with the VA.

So my advice is gather all documents, and file a claim yesterday, and when they deny you and have errors in their statement of case, appeal. Get back to us in 3-5 years and let us know how you made out. Sorry, but don't blame the messenger.

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I am also rated 30% for my neck and it is due to limited range of motion (ROM) due to DDD. To get any higher than 30% here is what the 38 CFR says:

(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 (whether 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

Unless your neck is totally incapacitated, I would think 30% is as much as you will get and another C&P examiner may say your ROM is greater than 15 degrees. From what I have seen, the VA is looking to reduce as many people as they can. Be careful and good luck!

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What kind of treatment do you plan to get besides PT and pills? Are you ready to go under the knife? I have similar problem. No cure for stenosis that I know of except surgery.

John -

I'm not there yet emotionally. It's constant and I'm waiting to talk to the rheum after the MRI to find the next course of action. Pills are all that I have at the moment.

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I'm in the same boat. Neck getting worse. Scheduled for a consult with pain management. (been thru that clinic 3 times before for back - had spnal surgery, and neck last year, no help with epidural injections). Primary sent request in Oct.2012, appt. set for FEB. 2013! Crazy over booked under staffed at Bay Pines in Florida. Now some mysterious doc who I will never see, reviews everything (xray, MRI, therapy (traction), etc., and will decide if I get to see a neuro surgeon. Peyton Manning the football player probably had less damage and pain, and he was taken care instantly. He is luck he was never in the military, injured, and stuck with the VA.

So my advice is gather all documents, and file a claim yesterday, and when they deny you and have errors in their statement of case, appeal. Get back to us in 3-5 years and let us know how you made out. Sorry, but don't blame the messenger.

Sonny -

No blame here. Just looking for those that are there or have been to see what my options might be. The increase will come second only if there is a real need per the CFR.

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I am also rated 30% for my neck and it is due to limited range of motion (ROM) due to DDD. To get any higher than 30% here is what the 38 CFR says:

(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 (whether 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

Unless your neck is totally incapacitated, I would think 30% is as much as you will get and another C&P examiner may say your ROM is greater than 15 degrees. From what I have seen, the VA is looking to reduce as many people as they can. Be careful and good luck!

Thanks, Mags -

I think I'll just stick to the medical treatment portion of all this. My ROM is getting worse, but I don't think it would warrent an increase in comp...The bump from 30 - 40% might not be worth the trouble.

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  • HadIt.com Elder

Justrluk

I am not there yet either. One doctor said I did not need surgery and one said I did. I have pain, but there is no sureness that even if they fix my herniation or stenosis that my pain will go away. I have pretty full ROM, but just this miserable pain running down from base of my neck to my shoulder and arm. It is DDD and slowly getting worse. I have pills and I have to restrict my activites. After reading about the surgery I can understand your not being there yet.

John

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