Thoracic and Lumbar Spine

[gs106]

Are thoracic and lumbar spine disabilities always rated as thoracolumbar or can they be rated separately? How can I find out which DC was used when I was rated for arthritis of the thoracic spine?

[brokensoldier244th]

Im pretty sure they are rated as one unit. Your rating decision letter should tell you what code they are under. 

 

[rootbeer22]

gs106

The lower and upper spine are rated as two distinct areas. This is how I'm rated and it makes sense based upon the effects on the body. I was in a Tank Accident and later a tank main gun explosion and both areas where hurt significantly. Unfortunately, the tank hatch broke and hit me on he back and top of my head. If I did not have my CVC Helmet on at the time,It would have killed me. Also nerve damage plays a role as well with the ratings.  Of course, one of the most significant considerations is the ROM or Range of Motion and for dating purposes this is a critical element of any back rating. I've noticed that the addition or deletion of a few simple words on the CP exam makes a huge difference. The key is to accurately understand where painful motion starts and stops. During the examination, you need to ensure that the doctor understands how this lack of motion is affecting your pain. You 're not rated for pain, but are rated on the restrictions on your body motion and how that would affect your ability to work.

 

Godspeed Rootbeer22

 

[Vync]

Upper spine segment = cervical (i.e. neck)

Lower spine segment = thoracic/lumbar (i.e. back)

Personally, I think it is pretty stupid having two segments when anatomically there are more...

[63Charlie]

Just another brill technique the VA uses to keep ratings(comp. payments) lower. 

Think if they had lumped all three spinal segments into one rating.

 

[Vync]

12 hours ago, 63Charlie said:

Just another brill technique the VA uses to keep ratings(comp. payments) lower. 

Think if they had lumped all three spinal segments into one rating.

Definitely

[gs106]

Thanks for all the replies.  I just found a CAVC  decision that is bad news for me. The thoracic and lumbar spine are considered the same for rating purposes but not for disability purposes.  This is an excerpt from that decision

:

ANALYSIS

 Mr. Dietrich argues that the Board erred in treating his DISH as a disability separate from his thoracic scoliosis. He contends that under 38 C.F.R. § 4.71a (2014), the rating schedule for diseases of the spine, the Board is required to treat thoracic and lumbar disorders as one disability. For support, Mr. Dietrich cites a proposed VA rule change noting that because "the thoracic and lumbar segments ordinarily move as a unit, it is clinically difficult to separate the range of movement of one from that of the other." Schedule for Rating Disabilities; The Spine, 67 Fed. Reg. 56,509-12 (proposed Sept. 4, 2002). He further argues that the Board did not support its decision with an adequate statement of reasons or bases. The Board's rating determinations are findings of fact that the Court reviews under the "clearly erroneous" standard of review set forth in 38 U.S.C. § 7261(a)(4). A finding is clearly erroneous when, after reviewing all the evidence, the Court "'is left with the definite and firm conviction that a mistake has been committed.'" Gilbert v. Derwinski, 1 Vet.App. 49, 52, 54 (1990) (quoting United States v. U.S. Gypsum Co., 333 U.S. 364, 395 (1948)). Further, the Board's decision must include a written statement of the reasons or bases for its findings and conclusions of fact and law that adequately enables an appellant to understand the basis for the Board's decision and facilitates review by this Court. See 38 U.S.C. § 7104(d)(1); Allday v. Brown, 7 Vet.App. 517, 527 (1995); Gilbert v. Derwinski, 1 Vet.App. 49, 56-57 (1990). Mr. Dietrich's argument conflates the issue of service connection with the issue of rating a service-connected disability. As this Court has previously explained, "for rating purposes, § 4.71a combines the thoracic and lumbar spines and provides criteria for rating disabilities of the 'thoracolumbar spine.'" Cullen v. Shinseki, 24 Vet.App. 74, 82 n.8 (2010) (emphasis added). Accordingly, the rating criteria and proposed rule change cited by Mr. Dietrich would be relevant where a Board decision treated thoracic and lumbar sections of the spine separately for rating 2 purposes. Here, however, the issue involves two separate conditions–one that is service-connected, and one that is not. This situation raises the issue of service connection, and not the rating of a service-connected disability. See D'Amico v. West, 209 F.3d 1322, 1326 (Fed. Cir. 2000) ("A claim for veteran's disability benefits has five elements: (1) veteran status; (2) existence of a disability; (3) service connection of the disability; (4) degree of disability, and (5) effective date of the disability."); Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997) (explaining that "the logically up-stream element of service-connectedness" is separate and distinct from "the logically down-stream element of compensation level"). Because VA is not required to treat all disabilities of the spine as a singular disorder for purposes of service connection or consider distinguishable symptoms of a non-service-connected disability in rating a service-connected disorder, the Court rejects Mr. Dietrich's argument that the Board erred in failing to consider his symptoms of DISH. Notably, the Board adequately explained that symptoms attributable to DISH did not support an increased rating for thoracic scoliosis because DISH is "not related to service," and Mr. Dietrich does not argue that the Board erred in denying service connection for DISH. R. at 15.