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ptsd results of cp exam of back they found nerve pain will the rate it to or do i need to put in another claim
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Question
gass278th
My question is I only claimed back injury but will they rate my nerve pain as well because it was found on cp exam or do i need to file another claim for both legs. I have been out of work I have a feeling I am only gona get 20%. I really hope not but who is to say. Id like to get some opinions. please
Veteran hasnt worked since 12/2015 because of service connected injury of being thrown out of humvee.
40 degrees forward flexion
extension, right and left lateral flexion= 15
rotation = 30 degrees
severity analog pain 4-7, and moderate 8-10
quality: aching throbbing burning dull grinding popping sharp and soreness.
diagnosed with degenerative joint and disk disease and ivds.
veteran experiences flareups and has functional loss regardless of rep use.
flareups results of daily activities sitting for short periods and standing for short periods of times.
the examination is medically consistent with additional loss during flareups.
localized tenderness in abnormal gait
guarding resulting in abnormal gait
additional contributing factors of disability include: ankylosis adhesions weakened movement due to muscle or peripheral nerve injury instability of station disturbance of locomotion interference with sitting and standing.
hip ankle knee and great toe extension 4/5
deep tendon flexes knee and ankle are 1+ = hypoactive
veteran has radicular pain and symptons due to radiculopathy
constant pain= moderate
left and right lower extremity moderate
paresthesias= mild
numbness= moderate
veteran has no other signs of radiculopathy
nerve roots involved l4 l5 s1 s2 s3 both
right and left= moderate
ivds= no bedrest
does veterans back affect ability to work= yes
veteran report flareups occur daily and secondary to daily living
claim type supplemental
the veterans assertion of increased pain and loss of function are credible
however the probable etiology of the current additional intensity of pain and disability are more than might be normally expected with the current diagnosis therefore the significant increasse of pain from the anticipated level may suggest that it may be more than likely than not attributable to non anatomic cause. The current chief complaints of increased pain and loss of function are more likely than not the result of confounding factors. Confounding factors = ptsd,depression,anxiety.
Note: Evaluating the possible impact of these multiple complex confounding factors effecting the veterans perception of musclo skeletal pain are beyond the technical expertise scope of practice of the general medical provider.
Rationale: It is more likely than not the service connected injury resulted in a progressive disability of the veterans back.
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