How Does Va Rate

[Guest rickb54]

Vike 17, Berta, Allen

Do any of you (or anyone else) know if the va actually rates spinal stenosis or spondylitis seperately from degenerative disc disease.

I was informed by a PVA service officer that stenosis warrants a seperate rating..

I have been rated for DDD with siatic nerve damage with foot drop since 1999. Althought my MRI's, CT's and melygram show spinal stenosis, spondylitis and arthritis I was not rated for these problems. According to this service officer the foot drop warrants a 30% rating as well as the K award. I know these all have seperate codes, but title 38 does not really indicate what are the high or low rates for the problems.... Am I missing something?

what say you...

[Vike17]

Rick,

I think the SO is wrong in this instance. The VA can't rate the two seperately because it involves the same bodily etiology since both were in the lumbar spine. Now if you had DDD in the lumbar spine and spinal stenosis in the cervical spine, then they would be rated seperately. Also, according to the rating schedule (new criteria), it specifically lists spinal stenosis as a condition and should be rated under the general rating formula for the spine. The only condition that could be rated under either the general rating formula or based on incapacitating episodes is IVDS. I'm willing to bet the VA didn't mention spinal stenosis because the IVDS resulted in the higher evaluation. Does this make sense? The only thing I would do if it resulted in a an additional benefit would be to claim your foot drop as secondary to your IVDS. I think we discussed this a while back in another thread. If memory serves me correctly, you are rated under the old criteria and the VA 'lumped' the two together.

Does this make sense?

Vike 17

Edited November 2, 2006 by Vike17

[Guest rickb54]

Vike,

I agree with you but I wanted another opinion. I think that this PVA guy might be remembering the old criteria and confusing it with the new. As we talked about before, I am rated under the old criteria, at 60% this includes the footdrop, and sicatic nerve damage. If I were to request a seperate rating for the footdrop under the new criteria that would mean the va would have to re-rate my back and sicatic nerve condition seperately as well. I have studied the rating criteria in the past and I still don't see how I could get a better rating overall. We all know it is better to have one 60% rating than to have three 20% ratings. I just wish them damn service officers know what they are talking about befor they open their mouth.

The other quetion that comes to mind... this same guy stated that my drop foot should be rated at 30% and that I should still get a K award. It was my understanding that the K award was granted because the dropfoot was part and parcel of the back injury. This service officer states that can not be the case. He swears I got screwed out of 30%( I just don't see how). What is your take on this? ever heard of a seperated rating for drop foot that still allows the K award?

[Vike17]

Rick,

This SO doesn't know his stuff very well. There isn't a 30% rating for drop foot due to the sciatic nerve. It goes from 10, 20, 40, 60, & 80. However, for drop foot due to the External popliteal nerve (common peroneal) there is a 30% rating. You did say it was the sciatic nerve, right? Here are the ratings for both;

Sciatic nerve.

8520 Paralysis of:

Complete; the foot dangles and drops, no active movement possible of muscles below the knee,

flexion of knee weakened or (very rarely) lost ..........80%

Incomplete:

Severe, with marked muscular atrophy ...................60%

Moderately severe ..................................................40%

Moderate ..............................................................20%

Mild ......................................................................10%

External popliteal nerve (common peroneal).

8521 Paralysis of:

Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension

(dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened;

anesthesia covers entire dorsum of foot and toes ........40%

Incomplete:

Severe ...................................................................30%

Moderate .................................................................20%

Mild ........................................................................10%

I thought from our other discussion from the previous thread a while back you were already receiving SMC "K" for your drop foot? Did I miss something? Depending on how bad your foot drop is, you could be rated up to 60%-80%. A rating like that might in turn qualify you for a higher SMC other than "K" or "S," depending on what the break down of all of your other disabilities are.

Vike 17

[Guest rickb54]

Vike,

Thanks for your input. Your memory serves you well I did state that I do in fact draw a K award for drop foot and have since Sept 1998. You may also remember that under the rules prior to 1999, I never received a seperate rating for the drop foot because and I quote from my rating;

" Entitlement to a seperate evaluation for left foot drop is not warranted becaue a 60% evaluation has been assigned for the veteran's back conditon based on pronounced interverebral disc syndrom with peristent symtoms compatible with sciatic neuropathy, characteristic pain demonstrable muscle spasm, absent ankle jerk, or other neurological findings appropriate to site of diseased disc and little intermittent relief. The left foot drop is considered part and pacrel of the service-connected back strain with degenerative disc disease. Entlement to specially monthly compensation (K award)is warranted in this case because criteria regarding loss of use of left foot have been met."

My medical records(1999) state the drop foot is mild to moderate which might have warranted a 20% award.

Is it your opinion that I should have been rated for drop foot seperate from the back disability regardless of which rating schedule(old or new) was followed?

My ratings are:

60% Back

60% Asthma

30% COPD (pending DeNovo request for 60% and EED)

10% tinnitis

10% torn r medicus knee

10% arthritis r knee

10% allergic rhinitis

10% hemorridds

0% hearing (even though I wear hearing aids)

0% epiddmittis

Thanks for the information I am always listening and learning.

10:11 PM I just realized there are two seperate rating scales one for siatic nerve damage, and one for fot drop.. makes me wonder again about the rating I received.

Edited November 3, 2006 by rickb54

[Vike17]

Rick,

I don't think, according to the old criteria, you were rated wrong back in 1999. It appears the rating specialist at the time did take into account your drop foot when he/she assinged your rating. Without any neurological manifestations it appears a rating of 40% was appropriate, but since you had mild too moderate foot drop, you were assigned the higher 60% evaluation. According to them IVDS training letter from 2002 it states;

"IVDS that is disabling primarily because of chronic orthopedic manifestations (e.g., painful muscle spasm or limitation of motion), chronic neurologic manifestations (e.g., footdrop, muscle weakness or atrophy, or sensory loss), or a combination of both, is evaluated by assigning separate evaluations for the orthopedic and neurologic manifestations, using diagnostic code 5293 hyphenated with the appropriate orthopedic (musculoskeletal) or neurologic code."

Furthermore, it states;

"The former evaluation criteria for IVDS (DC 5293) included a 60-percent evaluation for persistent sciatic neuropathy or other neurologic findings, with little intermittent relief; a 40-percent evaluation for severe recurring attacks; a 20-percent evaluation for moderate recurring attacks; a 10-percent evaluation for a mild condition; and a zero-percent evaluation for the postoperative, cured condition....These required a subjective determination as to whether the condition is "mild," "moderate," or "severe" and raised questions as to when a 60-percent evaluation was warranted on the basis of neurologic manifestations. There was also uncertainty about whether IVDS with neurologic manifestations could be evaluated higher or lower than 60 percent. This subjectivity has been removed...Alternative criteria allow evaluation under the method most beneficial to the veteran, and the revised criteria can all be applied to either the pre-operative or post-operative state."

Regardless if your IVDS in 1999 was hyphenated with the DC for foot drop or not, the rating did take the neurological findings into account.

I guess it all depends on whether you want to file a claim for the foot drop under the new criteia. Would the additional precentage be of any advantage to you in the overall disability rating you receive from VA i.e. a higher SMC?

Vike 17

[Guest rickb54]

Vike,

I come to the same conclusion as before. Even if I were rated seperately for drop foot I suspect not more than 20% would be awarded. I do not expect a higher SMC award either. Far more important, I think if I requested a seperate award for the drop foot, the VA would be compelled to re-rate my total back injury, under both the old and new schedules. There is no way to be sure what the out come of such would be. But if I were rated seperately for each little item that still would mean smaller awards (example 20%-20% 20%) and as I stated before one 60% rating is better than three 20% ratings. I only wish that service officers knew what they were talking about before they try to convince someone to reopen a claim. Based on everything I have read, and based on what u say, I am convinced that this PVA service officer has his head in a place that the sun doesn't shine. I reallly didn't need this crap!

Thanks again for your input.