Can You Help?

[silverdollar22]

Just wanted some input on my chances for an increase form the 10% I get now for my Low Back Pain with Menimal Degenerative Changes of Left Sacroiliac Joint. The last time i put in for an increase i was denied and told i was getting better even though all of this was in my va med. records. From reading this forum and other research I know where i messed up at and it was my ROM test. I didn't understand just how this test effects your claim and i tried my best to touch my toes even though i was in bad pain. I have recently applied for an increase again, waiting for C&P, but according to this info in my records what can i expect? Any info would be helpful.

TD-ADULT 01/01/2008 Augusta,ga

Comments: est date per client

ST - SKIN TESTS

No data available

IMPRESSION

1 HTN- good control, cont meds 2 Hypercholestrolemia- cont simvastatin

fLP pending 3 Low back pain- disc protusion & spinal stenosis at L3-4

,L4-5, L5-s1, using brace , pain meds,will write muscle relaxant,

waiting on disability rating 4 numness- gabapenntin

PLAN

FUTURE APPOINTMENTS

10/17/2013 09:30 PCT(A)-DR SHARMA

11/14/2013 15:30 DERMATOLOGY SPECIAL (JOHNSON)

Future Recall Dates:

^@@^

Return to Clinic:10 month

I want to update you on your recent x ray results:

x ray shows degerative arthritis . continue medication . If you want , will

refer for physical therapy

Thank you for your service to our country.

Sincerely,

SAROJ B SHARMA M.D.

Primary Care Service Line

Charlie Norwood VA Medical Center

Date/Time:

Report:

MRI of the lumbar spine on 08/04/11:

Technique: Examination is performed with sagittal, axial and

axial oblique T1 and T2-weighted images, and sagittal STIR fat

suppressed T2 images. There are no prior examinations for

comparison.

Findings: There is normal alignment of the lumbar spine, with no

retrolisthesis or spondylolistheses. Lumbar spinal canal is of

normal caliber. Lower thoracic spinal cord and conus medullaris

are normal in signal and appearance, with the conus tip ending in

a low position at the inferior endplate L2. Cauda equina appears

normal.

Lumbar intervertebral discs from T11-12 through L2-3 demonstrate

normal height, contour and signal intensity, with no evidence of

intervertebral degenerative disc disease.

L3-4 intervertebral disc shows a broad based annular protrusion

centrally, abutting the ventral surface of the thecal sac, shown

best on axial T2-weighted image 28. There is no associated canal

stenoses or black out recess compromise.

L4-5 level demonstrates intervertebral degenerative disc signal loss and mild disc space narrowing, with broad-based disc

osteophyte complex producing ventral surface thecal sac

flattening. There is mild narrowing of the lateral recesses

bilaterally, more on the right. There is mild facet joint and

ligamentum flavum hypertrophy, shown best on axial T2-weighted

image 38.

L5-S1 level shows advanced disc space collapse, degenerative disc

signal loss and broad-based osteophyte from the inferior endplate

L5 projecting within the ventral epidural space, with an

underlying small extruded disc herniation just to the right of

midline as shown on axial oblique T2 weighted image 5. No thecal

sac compression or exiting nerve root compromise is detected.

Modic type II subchondral fatty bone marrow replacement is also

present at L5-S1.

Impression:

Lumbar disc disease at L5-S1, L4-5 and L3-4 as described above.

Low position of a conus medullaris tip ending at the inferior

endplate L2.

Somewhere else in my file it states that i have severe DDD and buldging discs at L3-L4, L4-L5,L5-SI.

THANKS FOR THE HELP

eric

[TiredCoastie]

From what I've read here and experienced myself with my knee, it's all about pain and ROM without it. Best advice I've read is go to the pain then stop with an ROM test.

With my last claim for my knee, I included my own statement clarifying that despite the PT making comments in her reports about me getting better, I was really still in pain and required a signficant regime of injections, prescription pain relief creams, daily stretching, etc to be functional and still with pain. It may have helped...went from SC & 0% at my initial claim to 40% on the latest claim.

Would imagine the C&P for your back would work the same way.

[silverdollar22]

Thanks Tiredcoastie,

Yeah, i've gathered as much from reading this forum. On my next C&P I won't struggle to push past the pain like a dummy . I'll lift some weights and run a mile or two before my C&P that way I'll be good to go ! I was still wondering what the opinion would be as far as my rateing for my claim? My pain would put me at mabe 20% forward and more than likely the same side to side. I'm also claiming the pain and numbness running down my legs. Thanks again for the reply.

[TiredCoastie]

Best advice for the potential ratings comes from 38 CFR 4. If you browse through the Musculoskeletal System, you'll probably find what you're looking for:

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr;sid=a34209ce32e8019cca6afeca5950bfa9;rgn=div5;view=text;node=38%3A1.0.1.1.5;idno=38;cc=ecfr#38:1.0.1.1.5.2.98

I don't know your conditions well enough to be able to pick out the right pieces, but you will if you see them.