Systemic Djd (Future Djd In Other Body Joints)

[DICK HILL]

Hi All

I came across the following article on another web site. I have some questions at bottom of article.

05/16/2013 UPDATE: Comments from a senior RVSR/Rater

Hi Jim,

Some comments on the Veteran with the degenerative disc disease (DDD). DDD and DJD (degenerative joint disease) are 2 separate processes. If the Veteran received a 20 percent evaluation, that means his range of motion, with or without pain, fell into the 20 percent range. It does not matter how much pain there is, unless the C&P examiner finds that upon repetitive motion there is additional loss of range of motion that falls into the range of a higher evaluation, the Veteran will not get a higher evaluation. The Veteran can also get a higher evaluation if he has “incapacitating episodes” which are defined as period of bed rest prescribed by a physician (which rarely occurs with the level of medical technology today).

A person can have lumbar disc disease and never get cervical disc disease. Therefore, a spread of the disc disease from the lumbar to the cervical spine (neck) does not mean the cervical spine disease will automatically be granted service connection. The Veteran has to prove a secondary relationship between the lumbar and cervical spine disabilities. If the Veteran’s private physician indicates in his notes or in a DBQ that the cervical spine is related to the lumbar spine with a credible rationale, the Veteran should be granted service connection for the cervical spine. If a DBQ is completed, a VA examination is not required. Even if an exam is conducted and the VA examiner disagrees with that opinion, so long as the Veteran’s physician provides a credible rationale, the VA has to accept that opinion which is most favorable to the Veteran. This is the “reasonable doubt” regulation under 38 CFR 3.102. (I know everyone does not follow this rule but they should be).

DJD is somewhat different. DJD is also synonymous with arthritis and osteoarthritis (but not rheumatoid arthritis). There are two types of DJD for VA purposes: traumatic DJD and systemic DJD. Traumatic DJD occurs when the Veteran suffered an injury to a joint that over the years progresses to DJD. In this case, if the Veteran also develops DJD in other joints, there would be no entitlement to service connection for those joints unless a medical provider establishes one.

Systemic DJD occurs when the Veteran gets a diagnosis of DJD in service (or within one year after release from active duty) when there is no record or evidence of trauma to the joint. In this case, if the Veteran develops DJD in any other joint in the future, that joint is automatically subject to service connection. The diagnostic code for traumatic DJD is 5010 and the diagnostic code for systemic DJD is 5003.

If the Veteran is granted service connection for the cervical spine in addition to the lumbar spine, he gets a separate evaluation (percent of compensation) for each. Also, there are times when a Veteran gets pain radiating into his legs as a result of DDD or DJD. If the Veteran has a diagnosis of radiculopathy, he should be entitled to a separate evaluation for that also under a neurological diagnostic code (usually 8520 or 8521).

My questions are as follows:

I am currently service connected at 10 percent under Diagnostic Code 5003 for degenerative arthritis (spondylosis) of the Thoracic and Lumbar spines. Recently I was diagnosed with Cervical Spondylosis and Hip osteoarthritis. From reading the above article can I assume that I do not need a Nextus or IMO to ask for service connection for my diagnosed degenerative arthritis of my cervical spine and hips? I would just provide the VA with the current diagnoses and ask for increase for service connected degenerative arthritis?

All this dealing with the VA is confusing, painstaking and time consuming and I am still not sure I really understand everything or understand how to approach the VA to obtain earned benefits.

Will appreciate everyone’s thoughts and advice. Dick Hill