cervical strain Proceedings To Reduce Ratings, Must Read...38 Cfr 5.10

[rpowell01]

I have read a ton of stuff here on hadit. What is most important about this topic is I have read about how people are locked in at the 10 year mark and 20 year mark. Well attached with this topic is the true answer, thanks to JBasser for pointing me in the right direction.

There is a 5 year PROTECTION and I have YET to read a 10 year PROTECTION in this regulation. This attachment is the REAL DEAL and it needs to be added to hadit some how some way for others to be able to find it. I have highlighted many important aspects of the 5 year protection rule and the process of the Reduction of Ratings....

I will let everybody know that that ONE C&P Exam CANNOT be a basis for a REDUCTION. By this regulation the VA must look at the OVERALL HISTORY. So, in my case the VA wants to reduce my ratings of Cervical Spine and Lowback. On the decision letter they are basing this ONLY on the C&P Exam. Sorry but this is ILLEGAL and they CANNOT proceed in doing this. They are changing my true diagnostic of Cervical Strain to Cervical DDD and Lumbar Strain to Lumbar DDD. Most people don't know the DC they put on these letters are not the real DC, a lot of times. Example: The my original DC on the Decision Letter in 1996 showed "Cervical Spine Pain" but the VA computers actually show "Cervical Strain", see the difference. So, just by this alone it shows that my issues are actually getting WORSE not better. History actually shows that just 4 years ago I didn't have these problems like I to currently have and I am not just talking about the radiculopathy. I am talking about waking up every morning and it taking me 3 hours to get out of bed because my neck and back are in a lot of pain, it didn't show me taking 3200mg of Gabapentin and 300 of Tramadol per day, it doesn't show that I was getting treated for radiculopathy in my arms and legs, ALL like it is today. Again OVERALL HISTORY.....

So, the VA MUST look at the OVERALL HISTORY of the medical issues at hand and NOT just on one C&P Exam. BTW all my previous C&P exams I have had from 2010 to now, actually 3 of them for my neck and back, didn't show anything getting BETTER....

Now let me tell you this true story that happened today. I was on the phone with JBasser and he swore up and down that there is a 5 year rule. So, after I left of delivering my NOD and Request for Hearing letters I decided to drop in over at the State of Florida Veterans Service Office. I talked with an officer there and I asked him about the 10 year rule ( I said 10 because that is what I have heard) about being locked on on ratings. His reply was "You are locked in at 20 years for ratings and 10 years for service connection." I come home and actually found the regulation online. So, this will tell you that some of these VSOs don't know much of nothing and are worse than the VA raters themselve....Oh, but he did say if I can get Dr. Bash to do a DBQ on my neck and back that should be sufficient. Well I am going to hopefully get them done by Dr. Bash whenever I fly up there and I am going to use it at the hearing. But most importantly I will have my copy of 38 CFR 5.10 "Proceedings To Reduce A Rating"

This policy might be on here but I can't find it....

Document deleted at request of admin...

Edited June 24, 2013 by rpowell01

[rpowell01]

I don't understand what you mean by "Criteria" carlie? What I wrote is all they stated about the proposed reductions carlie. Please explain the criteria.

EDIT:

If you mean the "WHY" they are proposing a reduction then its reads:

•Range of motion within normal limits.

That is it...

Is this what your looking for?

EDIT II:

If you are talking about "Measurements"...There are NO measurements listed on my C&P Exam. This is the actual measurements the C&P Examiner is SUPPOSE to write down or somehow record. There are NONE on my C&P exam.

The Decision Letter for the Proposed Reduction doesn't even mention ANY measurements whatsoever except what the measurements are for 0% which is a standard workflow process they do. They do this on all the Decision Letters I have and state that a higher rating isn't warranted unless blah measurements and these measurements are this. But lettter doesn't mention any measurements the C&P examiner supposedly did.

There is NO measurements whatsoever on what the C&P examiner is saying.

Here is the thing, like I have stated since DAY 1 of the exam, my wife was in the room, she was my eyes and ears. She swore to me that the examiner placed the GENO METER up to my head and NOT one time did she adjust it. She set the arms to one place before I started the ROM and they didn't move whatsoever. Both back and Neck. It has been my complaint that the C&P Examiner didn't RECORD the measurements and I am going to bring this up at this hearing. What are they HIDING? They are trying to appear to hide Dr. Bash's IMO...And hide the fact that my neck, thoracic and lumbar have progress so fast in the past 3 years alone that they know I should be P&T. There is without a doubt I should be P&T. You don't all of a sudden start to have radiculopathy without something going on in the spine. And, on top of this you don't start having bladder and bowel incontinence at the same time the radiculopathy started. It has taken me a long time to admit the bowel issues and that is my prideful arrogance but I should pay for it. Luckily I the Tampa VA has finally started noticing how bad my issues are and are making appointments left and right so I can get the DOCUMENTATION the Regional Office is looking for on the bladder and bowel issues.

Edited June 27, 2013 by rpowell01

[broncovet]

How long have you had your rating? This is important because what you want to do is to show that the proposed reduction is improper. If your rating is has been effective more than 5 years, then it will be considered "stabilized".

If your rating has been in effect LESS than 5 years, it will be easier for the VA to reduce you. Use 38 CFR as your weapon, and cite the regulation that they failed to comply with while trying to reduce you.

Many times this means refuting the VA's "reasons and bases".

[carlie]

I don't understand what you mean by "Criteria" carlie? What I wrote is all they stated about the proposed reductions carlie. Please explain the criteria.

Criteria - as in what you posted from the Schedule of Rating . . .

Your prior decision showed what criteria must be met for the various

XX percentage evaluations.

The rating criteria for your issue is not limited to ROM.

carlie

[rdawg]

if they change you from degenerative disc disease to lumbar strain, is that considered a reduction? Still based on rom, my percentage stayed the same but I think they changed my code to deny me for secondary issues like siatica. Still waiting on that decision.

[rpowell01]

If you are rated under IVDS then its based on ROM but they are other things within that which can waive the ROM as I wrote:

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

Myself I WAS changed from Cervical and Lumbar Strains to DDD...Its all still rated under IVDS. You can't connect Radiculopathy to a strain but you can connect radiculopathy to DDD. See the difference and why they have change the DC? Its still under IVDS...

If person who has crepitus in the cervical spine, isn't that also the same as abnormal kyphosis? This is how I am reading it from the couple of medical books I have and what I found on the internet. I do know I have reversed lordosis. This was first known back on the MRI in 2007 and its getting worse....Heck the C6 Vertebra is actually tilted to the opposite side to where it should be...

Edited June 28, 2013 by rpowell01

[sambo808]

If you are rated under IVDS then its based on ROM but they are other things within that which can waive the ROM as I wrote:

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

Myself I WAS changed from Cervical and Lumbar Strains to DDD...Its all still rated under IVDS. You can't connect Radiculopathy to a strain but you can connect radiculopathy to DDD. See the difference and why they have change the DC? Its still under IVDS...

If person who has crepitus in the cervical spine, isn't that also the same as abnormal kyphosis? This is how I am reading it from the couple of medical books I have and what I found on the internet. I do know I have reversed lordosis. This was first known back on the MRI in 2007 and its getting worse....Heck the C6 Vertebra is actually tilted to the opposite side to where it should be...

IVDS is not only rated on limitation in range of motion you can also get evaluation based on incapacitating episodes under DC 5243:

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 With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months 10 Note(1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. Note(2): 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.

In addition, to above VA by law should also consider an extra-schedular criteria if your back condition is bad enough but do not fall within the VA diagnostic codes.