Just Received Rating

[jessie0054]

Hello everyone.

Just received the decision and rate on my sons claims, Not happy about it and some of the wording i don't understand.

Frist of all for the Spinal Condition [ DDD]

Rated at 20 % from Feb, 10th 2006 effective date

Rated at 100 % from March 2, 2006 to July 1, 2006

Rated at 10 % from July 1, 2006

Reasons for decision:

The available private treatment reports show that you report a long history od low back pain since highschool. Treated with Chiropractic Manipulation in the past. You denied loss of bowel or bladder function, and you also denied pain, numbness, tingling or weakness of the LEFT LOWER EXTREMITY.

IT WAS HIS RIGHT SIDE LOWER EXTREMITY AND LOW BACK where he was having numbness pain and weakness!!!

You underwent fusion stabilization surgery on March 2nd 2006 Good alignment was demonstrated after surgery.. Follow up report six weeks after surgery you reported only mild discomfort in the low back.

HELLO, He was still on large doses of pain killers!!!!

DR.XXXX provided the opinion that you would be able to be gainfully employed with limitation on Heavy Lifting by the end of June 2006.

Don't believe i every saw this statement in any of DRXXXX reports.

Anyway my son is a Deisel Mechanic [ all lifting is heavy]

In August 2006 VA Treatment reports show POSTURAL MALALIGNMENT and LACK OF LUMBAR STABILITY.

At the VA [C&P] examination of October 4th, 2006 You reported only intermittent low back pain. Which you treat with Non Steroidal Anti-inflammatory medications as needed.

XX No mention of the list of medications he takes daily such as ALLEVE 2 tables 3 times a day, Flexeril 20 miligrams 3 times a day, Gabapentin 300 miligram 3 capsules 3 times a day. Not to mention that he had just broken his wrist in 4 places the day before and had not yet has surgery to repair and was again on large doses of Narcotic Pain Medications.

At the C&P the DR. Did not do a ROM and wrote " ROM is deferred as he is post op and do not risk flare at this time, He says he was to avoid tristing, Bending or stooping.

All the ROM given in the Decsion were done in exams done before surgery.

XXX He not only is to avoid twisting, bending or stooping he simply can not do this with 2 steel plates and 8 screws.

XX There is no mention in the decision about how his DDD affects his daily living .

The DR doing the C&P wrote " Lumbar Spine More Likely than not prevents him from working his Mechanic Job.

It prevents him from Sports, Effects are moderate to usual daily activities od chores and exerise."

Any sugestions ??

Jessie

[Berta]

Jessie- you presented very good arguments here for each point of the claim that was not satisfactory.

"DR.XXXX provided the opinion that you would be able to be gainfully employed with limitation on Heavy Lifting by the end of June 2006."

It sure would help to get the actual report this doctor made.It does conflict with the other doctor's statement.

I think I would attach a TDIU form to the NOD if I were your son and then-since he is getting some retro it might pay to get an IMO as to whether he can actually work again-

even if the TDIU award is not granted at least an IMO could potentially get him a higher rating.

Those meds too- they need to be considered by the VA.

Was his wrist fracture in any way at all due to his SC disability?

What I mean is:

"In August 2006 VA Treatment reports show POSTURAL MALALIGNMENT and LACK OF LUMBAR STABILITY." Did his lumbar instability cause him to fall and he tried to break the fall by putting too much pressure on his wrist? If so he could claim the wrist as secondary condition.

The 100%- is this a convalescence rating?

Did they consider the August 6 report at all in the decision?

[john999]

My VA doctor wrote two opinions that my secondary conditions were service connected and due to my DMII. She did not hesitate to write the opinions and was trying her best to help me. That is a big change in philosophy at the VAMC.

[jessie0054]

Dear John999, Berta, Rickb54 and Fla Viking:

Just a quick note to say thank you for your replies.

I want to make replies to each of you as i have time. !!! I have printed your replies off and will get back to you as i do more reading on the decision and know i'm going to have to ask lots of questions and i need to get this right!!!!

Last evening i suddenly have a house full again as another of our sons marriage just broke up and he and his 2 children came here for help. The children are 3 and 8 years old. So needless to say i am going to have very little time until we can get things worked out for school and sitter for when daddy is working and i am not availably.

Thanks, Jessie

[Guest jangrin]

Jesse,

one of the things that concerns me about your sons treatment is how radical the surgery was. It is NOT a simple spinal fusion. This was an immobilization of the lumbar spine by attaching plates and screws. Does your son have a copy of the surgical report saying how big (long the plates were)? 10% seems way low for lumbar spine with this type of radical surgery

Also, long term irritation in an area causes degenerative changes throughout the spine. Does the report state anything about the areas immediately above or below the surgical area.

One doctor said your son cannot work doing heavy lefting, the other said that he didn't want to do the ROM exam becasue he (your son) risked having post surgical complications. Does your son or could your son find a written job discription for being a deisle mechanic? At the least if he cannot do that kind of work, which I personally doubt he can -he could qualify to get re-habilitation with pay for new job training if they turn him down for TDIU on the appeal.

Hqave your son request pre and post surgical medical records if you can it would be interesting to see what the doctors wrote on their reports.

Jesse these are just off the top of my head to add to info from the other posts

Jangrin :D

[Hoppy]

Jesse,

The fact that he was taking narcotics priot to an exam would be reason to have a new exam when he was not under tthe influence of a drug. This is especially true if there is relevence to his statements. They may claim that they went more by the doctors expectations of the surgery rather than you sons statements.

If the doctor made his predictions prior to the surgery you need to get a post surgical statement from the doctor. That is the way they do it under labor law. Basically they are saying that he can return to work with limitations. Vocational Rehabilitation is the alternative if they will not allow him to continue in his usuall line of work. Find out exactally what effect the meds will have on his ability to work with a medical opinion addressing this issue.

[jessie0054]

Berta: Thank You very much for your reply:

I will try to answer quickly while the littles one are watching tv. And the phone will quit ringing.

Jessie- you presented very good arguments here for each point of the claim that was not satisfactory.

"DR.XXXX provided the opinion that you would be able to be gainfully employed with limitation on Heavy Lifting by the end of June 2006."

On the last visit to DR. XXXX on April 24. 2006 wrote in his report,

Is 6 weeks following poster lumbar interbody fusion with internal stabilization from L4 to S1.

Plan: it would be appropriate to send him to physical medicine and rehabilitation for a program of therapy and i have instructed him in some leg lift exercises. He inquired about doing some work that does not require any heavy lifting at this time: I think that would be appropriate.

The patient is discharged to physical Medicine and rehabilitation to begin a program of mild exercises and i think he should be able to be gainfully employed in another 2 months.

XXXX Problem here!! Dr. XXXX discharged patient to Physical Medicine and rehab.

This surgery was done by a Neurosurgery-Spine Specialist outside the VA that the VA had sent him to for the surgery. When he had a followup appointment with his PCP at the VA he had not received the final report . And we hasn't seen the report either. The PCP said for us to call back for another appointment in 6 months.

During this 6 months he checked himself into the VA for Drug Rehab to get off the pain killers he had developed an addiction to. While in Drug he was requried to sit for 45 mins to an hour. He couldn't do this because of the back pain. So he went to see his PCP and ask him to have him seen in the PT to see it they might offer him some help with the pain. That was in August 2006 when the PT diagnosed him with Postural Malignment and lack of lumbar Stability. They put him in a back brace taht wrapped around and gave him exerices to do at home and somesorta little back roll thingy to use in a chair or while driving. He was to wear this brace 70% of the time.

He had the back brace on the day of the C&P exam but it was not mentioned. The DR. doing the C&P didn't ask about his pain level, Took down the list of medications he takes, But made the commit that he still has intermited pain at the incision site better with walking, slightly better with meds. Listed the meds he takes.

XXX The statement my son made about the walking wasn't for the incisional pain it was he walks to help releve the Back pain.

It sure would help to get the actual report this doctor made.It does conflict with the other doctor's statement.

Yes, There is a conflict in the statements

I think I would attach a TDIU form to the NOD if I were your son and then-since he is getting some retro it might pay to get an IMO as to whether he can actually work again-

even if the TDIU award is not granted at least an IMO could potentially get him a higher rating.

Those meds too- they need to be considered by the VA.

Was his wrist fracture in any way at all due to his SC disability?

XXX No, His wrist facture wasn't at all due to the SC Disability. He was tripped by someone.

What I mean is:

"In August 2006 VA Treatment reports show POSTURAL MALALIGNMENT and LACK OF LUMBAR STABILITY." Did his lumbar instability cause him to fall and he tried to break the fall by putting too much pressure on his wrist? If so he could claim the wrist as secondary condition.

The 100%- is this a convalescence rating?

Did they consider the August 6 report at all in the decision?

No, It wasn't consider because it said he was prescribed Physical Therapy. He hasn't yet had PT done at the VA for this, Shortly after his discharge fron the VA Drug Rehap. he left here and went to stay with my brother in another State. That is when he broke his wrist. He came back here to have his C&P and to have surgery on his wrist. The Va here didn't have an Ortho Dr on staft here so he returned to my brother's in SC and had the Surgery there . He then had to stay there for aftercare . He has decided to remain there and is trying to get all his treatment set up there at the VA. So he has yet to get the PT.

Although the DR doing the C&P did link his back condition to his military service the report is filled with statements he said my son said that he didn't, I was there!!

Any suggestions??

Jessie