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Anyone Have Rating For Leg Pain Secondary To Back?


vet201060

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I am fighting to get my sciatica rated and they keep calling it hip strain. I have heard of Vets getting rated for leg pain and trying to see if anyone else has been down this road too.

Thanks guys!

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I was fortunate that I was rated for bi lateral Radiculopathy from my two c&P's if there is a positive outcome from the examinations and the conditions. My first rated my left and my second, a request for increase, service connected my right. However the left was low balled as my private treatment records indicate moderate nerve damage. Oh one note, this was connected without the VA conducting an EMG on my legs

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  • Content Curator/HadIt.com Elder

Same here. Was SC for cervical and lumbar degeneration. Won SC for peripheral nerves in all extremities. The EMG's were no fun at all, but taking them prone vs standing produces less rfindings.

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I just dont understand why I never get a C&P exam for these claim that I reopen. They just dismiss it even if they can see they are being treated by the VA at the VAMC. What is their job when you file for a claim. Do they have any responsibility to look at your medical records to see if there is a reason for a claim? I guess they expect us to have a lawyer to spell it out for them since they know we are not good at representing ourselves.

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  • Content Curator/HadIt.com Elder

Sometimes the raters probably have to have what they deem as a minimum level of evidence to warrant a C&P. I know it sounds stupid, and it is. I have had plenty of denials without even getting a C&P. I actually had one of my claims go all the way up to the BVA where I testified. The board was surprised I was not given an exam at all. They referred it out and I got the exam, then got SC.

I actually had one claim get approved without a separate C&P exam. In that case, there was sufficient medical evidence in my records to justify it. I actually had a really damn good doc who documented the visit to the n'th degree. If you have a DBQ that is filled out thoroughly, there is a chance that they could potentially use that in place of a C&P. This is just an assumption of mine. I have not had any C&P's since the DBQ's came out, so that is why I am stating that this is an assumption.

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I will see if my Dr can fill one out for each condition and upload it and see what happens. Is it against the rules to use a VA CBOC Community based out patient clinic I believe that is what they are called? Same Dr that treats me now.

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I will see if my Dr can fill one out for each condition and upload it and see what happens. Is it against the rules to use a VA CBOC Community based out patient clinic I believe that is what they are called? Same Dr that treats me now.

Is it against the rules to use a VA CBOC Community based out patient clinic I believe that is what they are called? Same Dr that treats me now.

No if your doctor will fill it out for you most VA doctor won't. You could ask your doctor to run some xray ,mri, or an EMG on lower extremities

I just ask for an increase for radiculopathy on legs and at the c&p exam last month the only thing they did was straight leg raise but I have not

got the decision. Get some evidence even if you have to go to a private doctor. You need somebody to state its radiculopathy and not a hip

strain. Get some test done like emg. jmho

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My initial claim was for my lower back only. I had the radiating leg pain at the time, but was not aware that I was able to claim it (I was new/ignorant and had poor assistance). That claim was successful, but got a low-ball 20% rating. About a year later, I filed for an increase plus added the legs as secondary. Filed the new claim FDC (fully developed claim) and in only six weeks, I received the increase on my back (40%) plus both legs were connected (right leg moderate 20% and left leg mild 10%). I had one c&p exam and it was very simple. Mostly just questions about the pain. The c&p examiners during both of my claims commented on my MRI. Both stated that the MRI showed my back was so bad, they didn't really need to do any other tests. Apparently the MRI made all the difference in my case.

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Is it against the rules to use a VA CBOC Community based out patient clinic I believe that is what they are called? Same Dr that treats me now.

No if your doctor will fill it out for you most VA doctor won't. You could ask your doctor to run some xray ,mri, or an EMG on lower extremities

I just ask for an increase for radiculopathy on legs and at the c&p exam last month the only thing they did was straight leg raise but I have not

got the decision. Get some evidence even if you have to go to a private doctor. You need somebody to state its radiculopathy and not a hip

strain. Get some test done like emg. jmho

My local Veteran Service rep at the *County* level, said that if they refuse to fill out the DBQ then come in and they will file a complaint with the local / regional offices. Used to be a policy that said they had to fill this stuff out, but it seems that went away in 2012 when the DBQ was put into place. Now, it seems they have to fill out the DBQ, but are not required to provide a statement on the nexus - which is what most of us need anyways!

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[quote name="Vync" post="346482" timestamp="1409019655"isn't that some crap. I mentioned that if they wanted to rate my nerve damage to performs and EMG and or x ray with dye VA did neither.

Same here. Was SC for cervical and lumbar degeneration. Won SC for peripheral nerves in all extremities. The EMG's were no fun at all, but taking them prone vs standing produces less rfindings.

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I find that on the EMG to get and accurate reading or fair assessment of the radiculapathy pain and numbness both must be performed in the sitting, prone, and standing position, but what do I know I just read a lot. Nerve conduction speeds differ quite a bit in different postures.

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  • Content Curator/HadIt.com Elder

There is also another test that tests for touch sensation, but most insurance does not cover it because they claim it is subjective. Can't remember the name.

The problem with an EMG is that it tests only the main nerve highways, but only to a degree.

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  • Content Curator/HadIt.com Elder

My local Veteran Service rep at the *County* level, said that if they refuse to fill out the DBQ then come in and they will file a complaint with the local / regional offices. Used to be a policy that said they had to fill this stuff out, but it seems that went away in 2012 when the DBQ was put into place. Now, it seems they have to fill out the DBQ, but are not required to provide a statement on the nexus - which is what most of us need anyways!

You are right!

The DBQ pretty much is only pertinent to the rating percentage, not SC! Gee VA, thanks a lot!

The DAV rep at the Montgomery RO told me that every single fieldn of the DBQ must be filled out. He even went so far as to tell me he would not pass one on to the raters unless this was done. My claims were decided on evidence in the records, so I never turned one in.

It is like a conspiracy to keep SC-ruling language solely in the hands of the C&P examiners, who are often part of the problem.

Nexus Yes/No should be the first question on all DBQ's, if SC hasn't been established yet.

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You are quite lucky in that respect. The MRI's I had are listed in the evidence but never mentioned in the c&p or the decision. If they would acknowledge the body of evidence the outcome would have been significantly different. Ah that's what the appeals process is for and why lawyers are needed.

My initial claim was for my lower back only. I had the radiating leg pain at the time, but was not aware that I was able to claim it (I was new/ignorant and had poor assistance). That claim was successful, but got a low-ball 20% rating. About a year later, I filed for an increase plus added the legs as secondary. Filed the new claim FDC (fully developed claim) and in only six weeks, I received the increase on my back (40%) plus both legs were connected (right leg moderate 20% and left leg mild 10%). I had one c&p exam and it was very simple. Mostly just questions about the pain. The c&p examiners during both of my claims commented on my MRI. Both stated that the MRI showed my back was so bad, they didn't really need to do any other tests. Apparently the MRI made all the difference in my case.

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You are quite lucky in that respect. The MRI's I had are listed in the evidence but never mentioned in the c&p or the decision. If they would acknowledge the body of evidence the outcome would have been significantly different. Ah that's what the appeals process is for and why lawyers are needed.

Congratulations on winning your increase! Unfortunately, too many times it takes several trips to point out what they should have seen in the first place.

The VA is allowed to vaguely mention a list of evidence. I have seen some raters go the extra mile and state something like "your MRI on {insert date here} showed {insert details here}", but I have also seen raters be very nonspecific and state stuff like "you had MRI's. you had pain blocks, etc...". I think that's where you can tell the quality of the person reviewing your evidence and whether or not it was actually reviewed in full.

In some cases it is like finding the needle in the haystack. I prefer to find it for them and then say, look, here it is!

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I'm not done yet Vync. Although I must admit a couple of times I've looked into throwing the towel on a permanent basis. Still do, however, I keep the demons at bay. They'll get it right even if I have to do it by all means necessary. In the end I won't ever get back what I lost and $ isn't going to mend the deep wounds or anything like that, I am going after the principle of the matter, going after my own definition of justice if there is such a thing. I just can't keep ignoring the pain, and the anguish. In any case, way off point here. The ratings for leg and nerve pain were automatically done for my left, low balled of course, the first go around and I had to nudge for the second to get the right. At NOD time I pretty much laid it out for the VA, primary injury to include all the secondaries such as muscle and nerve and other rate able and affected body parts. The VA tried to say in so many words the IVDS of L1 doesn't cause osteoarthritis of the spine and hips and I agree. Falling from a moving vehicle and landing on your back and hip however, does. Voila. Traumatic injury, connect the dots VA. It's ok. My points will be made LIMA CHARLIE soon enough.

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