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aoneinsun

lumbosacral
Recently separated - dealing with disc bulge issues & VA next

Question

Hi,

I’ve been recently separated as a USAF Captain from active duty due to reduction in force, and I am new to this realm. (I was not medically separated.) I’d sure appreciate some advice.

 

Background

While on active duty, I suffered a bulging disc and had a lot of left hip discomfort after some long runs at the unit’s physical training sessions. They called it piriformis syndrome and gave me physical therapy sessions at the base clinic, muscle relaxers, & some pain killers. I’ve long had an issue with my low back which have been well documented throughout my career, and have paid for a chiropractic care out of my own pocket (Tricare does not cover chiropractor) for 10 years to keep my back in decent shape. I was identified as having a mild curve (scoliosis) before joining the service in fact.

I suspected something more was wrong since I felt more discomfort in the back (in addition to the left hip), and so I asked for an MRI of my back. That is when they found a 5mm disc bulge at L4-L5, pushing into the nerve root there.

The base physical therapy sessions (and some off base message work) did help my left hip muscles loosen, but I was still having left hip pain and back pain. So I did just go through round two of physical therapy off base (about 14 PT sessions). I couldn’t straighten either leg during their straight leg exam. I’m slightly better afterwards but still having about the same issue with what I believe is a bulging disc that is the main culprit for the pain in the hip. I’ve never had any shooting pain down the leg thank goodness. But recently I’ve also had some feeling of pin pricks sticking me in the toes of my left foot while driving, which I think is a bit of sciatica. I’ve also recently had mild twitching episodes/muscle spams, which happen intermittently on my left side.

Since I limp and favor my right side, it has been taking all my weight. Recently, I have noticed my right knee has been hurting, and my right ankle too, with my right ankle hurting to lift up too far (angling the right ankle up to the right to far results in an interesting pop sound, which hurts).

My 6 months of Tricare benefits post-separation are over, and I’m meeting with the VA doctor for an initial exam in early December. I am wondering how this will unfold. Here are a few of my questions:

  • While standing I have very limited ability to step forward with my left foot (if keeping my left leg straight). I also cannot quite lift my right leg up fully (if keeping the right leg fully straight). I believe this is because of the bulging disc, and sciatic pain that results (felt in the left hip which prevents me from stepping forward very much without going into pain). If I have this issue with BOTH left and right legs, would bilateral factor come into play, or are they likely to say that is all because of the bulging disc (which is what I really think)? I researched and found that limited motion of the hip seems like the most applicable rating along with some radiculopathy (sciatica). Is that the most applicable for rating purposes?

  • They had done an MRI of my left hip, and the MRI came back normal. But I think something may be going on with the hip such as trochanteric bursitis (though I’m no Doctor), since the remaining pain is along the outside of the left hip, and not just the buttock. There is also constant ache deep in the left hip,

  • Should I ask the VA Doctor for examination of the left hip in particular?

  • I assume they will give me a cane to help take the pressure off my right side. I have full range of motion of the right knee, but it has a wired feeling (as though it has been twisted), and it hurts to flex while bearing weight, and it hurts with certain motions. Would this be ratable as secondary to (caused by) the back issue which has forced me to put all this extra weight on the right knee over 8 months? Since I still have full range of motion, is the pain with motion all that must be evident for the knee to be rated more than 0%? Or is pain AND limited motion required for the knee to be rated above 0%?

  • As to the right ankle, I cannot lift my toes up much (dorsiflexion). I think this falls under code 5271: If the ankle is not frozen, but limited in motion.  If I lift the ankle up too much it pops, and that hurts. It aches in general. Apparently, the ankle is considered a major joint. If it only has pain and nothing else in this major joint, would that result in a rating higher than 0%? Or is BOTH pain and limited motion required for the ankle to be rated above 0%?

  • I cannot bend down to touch my toes. In fact I cannot bend over much at all without feeling pain in the left hip. I think that will fall under 5237: Lumbosacral or cervical strain. (I certainly cannot bend over more than 30 degrees, which is certainly ratable.) Is 5237 the most applicable for rating purposes? 

  • For any of the tests the VA will ask me to do, must I go into pain to ascertain the maximum range that I can flex to? I intend to stop flexing before pain and let the VA examiner know of the pain.

With these various issues, should I consult an attorney up front? Are there good attorneys or really, really knowledgeable people about this unfolding process to really get good advice? Who would you recommend?

I appreciate any advice and thoughts for pointing me in the right direction for the best help.

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13 answers to this question

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Welcome to Hadit, and thank you for your service.  You said you have an appointment with a VA doc in December...is this for a VA claim?  Do you have a complete copy of your STR(service treatment record)? What about your tricare time period, do you have a complete copy of those treatment records?  These are most crucial to your VA claims process, and if you don't, then you must request them ASAP.

If you do have them, then you can file claims and submit COPIES, not originals, of your STRs pertaining to each claim.

If you don't have one, go on to VA.gov and sign up for you eBenefits account, which is one of if not, the easiest and quickest way to file a claim, which are posted as received the second you hit the submit button.  That is what establishes your claim date.

For you, I'm not sure, but I think that since you are well within your 1 year after service window, your immedieate claims will be back dated to your EAS.  Otherwise the date is set by when you submit your claim.  VA does not pay for partial months, and the comp check that hits your account on the first is for the month just ended.

I will use myself as an example for you, as to initial claims...I went through transition assistance program, in the Marines, called TAPS, about 6 months before my EAS.  During that week long program we met with a VA rep. who reviewed our STRs for viable cliams, and if we wanted, initiated that process then.  For me, he picked out a few issues that he thought would be easy successes and I went for them.

I had a flurry of appointments at various VAMCs around the area, 2 were nearly 100 miles away.  I was bumped to the next immidiately available appointment due to still being on AD status.  Strangely enough I received a denial for vocational rehab right away, even tho I was still on AD.  And the reason was no service connection.  I didn't know better to follow up on that, back then(fall of 1998) and appeal the dicision.

By my EAS date, I was just waiting for their rating decisions, which took until May of 1999.  I was awarded 3 10% ratings and it was dated to the month of my EAS, which was November.  I had to fight for 2 years for another that should have been a gimme, since it happened on my 5th day of boot camp, and had the most entries in my STR.

Let me tell you this up front, when you are in those exams, everything from you must reflect your worst day, and range of motion must reflect the moment the pain begins, not how far you can go beyond the pain.  The VA is not in your corner, they do not care for or about you.  Many of us here have learned the hard way about that.  The examiners will be watching you get up from your chair in the waiting room, walk to their exam room, and so on.  If you have any pain, it must be evident to them, use what ever device you have, and are supposed to be wearing, braces, cane, orthotic inserts in your shoes, and so on.

The examiner will look for anything to discredit you and so forth.  Yes, it's true most of us here have that experience.  They will mark no when you said yes, they will ignore sections of exams all together.

Also, once you hit the 30% comp rate you then can and will put in a claim for any dependants, spouse, kids, dependant parents that are living with you(or kids you support via child support) While the amount isn't much, it's worth every penny.

There are others here that my knowledge can't even be seen compared to theirs, and they will chime in.  You made the best decision for your future, by coming to Hadit.

Again, welcome, and thank you for your service, sir.

Semper Fi.

Andyman

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Hi,

Great insight and yes, I'm about to order my military record.

Also, I was reading if you have a combined disability rating of 50% or greater, you should be eligible to receive Concurrent Retirement Disability Pay (CRDP). If you receive CRDP, you will receive your full military retirement pay along with your full VA disability compensation.

I'm wondering if one must do 20 "good years" to be able to get CRDP? Thus, if I was medically retired from the Reserves below 20 years would I not be able to claim CRDP? I heard it was open to Reservists now with 20 "good years"... But what I don't know is if it can extend to people with less than 20 years (and I don't think so).

Anyone know for sure?

 

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http://www.dfas.mil/retiredmilitary/disability/payment.html

http://www.military.com/benefits/military-pay/special-pay/comparing-crsc-and-crdp.html

These links should explain CRDP and Andyman is right, and gave excellent advise..if you file the claim within one year of your discharge, VA will compensate you back to your discharge date.

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Also, since you apply within a year of your discharge, you get a "presumption" that any malady you have that you did not have prior to service is service connected.  See 38 CFR 3.07  

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Thank you Berta!

Broncovet, I forgot about that part!

I hope aoneinsun jumps on that ball and at least gets all those claims filed to preserve that 1 yr window! 

aoneinsun, make sure you do that, blast them with all your contentions to protect your 1 year window! 

Good luck and God bless!

Semper Fi.

Andyman

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Broncovet means the Chronic Presumptives, which must,by medical evidence, be disabling at least  at 10% during the presumptive period:

https://www.law.cornell.edu/cfr/text/38/3.307

This contains the link to 38 CFR 3.309 that lists those specific disabilities.

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