Lower Back And Bilateral Lower Leg Radiculopathy Rating

[chiefhouse00]

Greetings

I was recently rated and got an increase rating for Lower Back and Bilateral Lower Leg Radiculopathy from 10% to 20%. I have a couple questions that I hope you can help me with. The increased rating was based on Range of Motion, Diabetic Peripheral Neuropathy of the lower extremities, and moderate sciatic nerve involvement

My C&P examination on 23 August 2013 indicated nerve roots involved (L4/L5/S1/S2/S3 nerve roots (Sciatic Nerve), Intervertebral Disc Syndrome (IVDS) of the thoracolumbar spine, reduced ROM, and the Veteran’s thoracolumbar spine condition impact his ability to work.

My question is, should Diabetic Peripheral Neuropathy be rated with DMII or Lower Back condition? And should Sciatic Nerve have a separate rating.

Best Regards

Chiefhouse

[chiefhouse00]

Greetings

Here are the results of my most recent lower back and lower extremities.

Evaluation of low back pain with mild degenerative changes currently evaluated as 10

percent disabling.

The evaluation of low back pain with mild degenerative changes is increased to 20 percent

disabling effective August 27, 2013, the date VA examination showed further reduced range of

motion of the thoracolumbar spine to warrant an increased evaluation. We could not assign an

earlier effective date because the examinations and medical records prior to the latest examination

did not indicate decreased range of motion, or spasms or guarding severe enough to cause

abnormal gait thereby warranting an increased evaluation.

VA examination dated August 27,2013 shows objective findings of flexion to 45 degrees,

extension to 5 degrees, lateral flexion to 10 degrees on each side, and rotation to 20 degrees on

each side, with painful motion. On repetition, flexion was further reduced to 40 degrees. There

were muscle spasms and guarding severe enough to cause abnormal gait. You report the back and

radicular pain affects standing, walking (only up to 114 block) and prolonged sitting (not more than

40 minutes).

V A treatment records show treatment for chronic back pain with mild to moderate decreased range

of motion. You take Tramadol, Gabapentin, and Nortriptilline. Records show you had an epidural

shot in 2007 at Tripler Army Medical Center.

The criteria for rating diseases and injuries of the spine apply 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. An evaluation of20 percent is granted for forward flexion of the thoracolumbar

spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of

the thoracolumbar spine is not greater than 120 degrees. A higher evaluation of 40 percent is not

warranted unless there is forward flexion of the thoracolumbar spine of30 degrees or less; or,

favorable ankylosis of the entire thoracolumbar spine.

Evaluation of right and left lower extremity radiculopathy (previously addressed as right lower

extremity neuropathy with decreased sensation) currently evaluated as 10 percent disabling.

We have increased the evaluation of your right lower extremity radiculopathy from 10 percent to

20 percent disabling effective August 27,2013, the date of the latest VA examination which shows

moderate radiculopathy. We could not assign an earlier effective date because the examinations

and medical records prior to the latest examination did not show symptoms indicative of moderate

nerve involvement thereby warranting an increased evaluation.

V A examination shows you have radiculopathy due to your lower back condition and diabetic

neuropathy of the lower extremities. Objective findings show moderate pain, moderate numbness,

and abnormal gait due to radiculopathy, as well as decreased reflexes, decreased light touch and

monofilament, decreased vibration sensation, absent cold sensation, and trophic changes of the

skin on both feet due to neuropathy. The examiner indicates moderate sciatic nerve involvement.

There is no evidence of muscle atrophy, loss of muscle strength or severe nerve involvement.

An evaluation of 20 percent is assigned for incomplete paralysis below the knee which is

moderate. A higher evaluation of 40 percent is not warranted unless there is evidence of

incomplete paralysis below the knee which is moderately severe.

THIS IS A PARTIAL GRANT OF BENEFITS SOUGHT ON APPEAL AND IS CONTINUED

ON APPEAL UNLESS YOU TELL US THIS DECISION RESOLVES YOUR APPEAL.

Best Regards

Chiefhouse

[meghp0405]

Unless diagnosed and service connected prior to an diagnosis of DMII, PN is evaluated as a secondary condition to DMII. Either way, its authorized it's own rating.

Edited October 13, 2013 by meghp0405

[chiefhouse00]

Greetings meghp0405

I was also granted 20% for DMII: Service connection for diabetes mellitus type II as secondary to the service-connected disability of hepatitis C.

"We have granted service connection for diabetes mellitus related to the service-connected disability of hepatitis C. VA examiner opined that your diabetes mellitus is at least as likely as not caused by your service-connected Hepatitis C due to islet cell destruction after treatment with Ribavirin and Interferon for Hepatitis C. The examiner noted difficulty controlling your diabetes with large and multiple doses of insulin suggesting islet cell dysfunction rather than the usual gradual pancreatic insufficiency.

We have assigned a 20 percent evaluation effective April 29, 2008, the date of claim for diabetes.The evaluation is based on diabetes requiring restricted diet, prescribed oral hypoglycemic medication and insulin (5 shots daily). The evidence does not indicate required regulation of activities by a physician, and you had less than two episodes of hypoglycemia per month, none requiring hospitalization. Complications of diabetes include mild peripheral neuropathy of the lower extremities only. Separate evaluations for right and left lower extremity peripheral neuropathy are not assigned because it is already accounted for in the evaluation for right and left lower extremity radiculopathy each at 10 percent disabling. An additional evaluation for the same extremities with the same functional impairments is considered pyramiding and not allowed by VA laws. Your Medical Center records show you are monitored for poorly controlled diabetes. Records show emergency room visit for symptomatic hyperglycemia in 2012. A higher evaluation of 40 percent is not warranted unless insulin, restricted diet, as well as regulation of activities are required."

I will request a rating increase consideration for Localization-Related (Focal) (Partial) Epilepsy and Epileptic Syndromes with Complications, and admission to the hospital for Diabetic Ketoacidosis on May 2012 for my DMII condition.

Best Regards

Chiefhouse

Edited October 17, 2013 by chiefhouse00

[63SIERRA]

have u had your kidney scanned , I had kidney cancer, after hep c and found out you are ALOT more likely to get kidney cancer if you have had hep-c. They service connected my residuals of kidney cancer, and removal of one kidney, as a result of hep c. 40 percent for hepc ,, 30 for the kidney cancer.

I had no idea I had kidney cancer, it was found my the ultrasound tech, by accident while checking my liver.

If va wont check, go somewhere and get your kidneys checked , its a silent killer, and the cancer grows and grows, then all hell breaks loose if they dont catch it in time., it can spread to the lungs, bones, ect.

[chiefhouse00]

Greetings

I was recently service connected at 20% for DMII back dated to 2008. I'm also 20% for Hep C since 2004. I will request an ultra sound done of my kidneys.

Service connection for diabetes mellitus type II as secondary to the service-connected disability of hepatitis C. We have granted service connection for diabetes mellitus related to the service-connected disability of hepatitis C. VA examiner opined that your diabetes mellitus is at least as likely as not caused by your service-connected Hepatitis C due to islet cell destruction after treatment with Ribavirin and Interferon for Hepatitis C. The examiner noted difficulty controlling your diabetes with large and multiple doses of insulin suggesting islet cell dysfunction rather than the usual gradual pancreatic insufficiency.

Thanks for sharing.

Best Regards

Chiefhouse