lumbosacral C&P exam for SI joint/SI crest pain

[Andyman73]

On the 14th I had a C&P exam for SI joint/crest pain.  The examiner used the low back dbq for the exam. Question, if so, then what ever findings would just be lumped in with the low back rating, right? That was the idea the examiner was trying to convey to me, that the max is 40%, which I already have.

If so, then, would the SI crest pain, which is a pretty nasty burning sensation, be secondary to the low back?  I know it gets a separate rating, since I had already looked it up on the rating chart.

That exam was so...bogus, for lack of more polite way to say it. I wrote a pretty lengthy new topic post for that, first thing this morning, but as soon as I hit submit, it disappeared and wanted me to log in again!!!

That examiner, a PA, spent more time focusing on my lower back, to which I have been SC since 11/98, than the SI joint area.  After I saw the exam notes on myhealthyvet, I fired off a complaint  via IRIS, about how this PA was downplaying what my local VAMC doctors had already DXd and been treating me for.  Told them(IRIS) that I feel quite put upon, to have an under trained, under educated med tech, examine me and report findings that barely even match what my VA Dr had DXd! Told them I felt that this was just a ploy to set me up for an easy denial.  At no point did I use any foul language or personally attack the examiner.

GRRRRR!!!

§4.66   Sacroiliac joint.

The common cause of disability in this region is arthritis, to be identified in the usual manner. The lumbosacral and sacroiliac joints should be considered as one anatomical segment for rating purposes. X-ray changes from arthritis in this location are decrease or obliteration of the joint space, with the appearance of increased bone density of the sacrum and ilium and sharpening of the margins of the joint. Disability is manifest from erector spinae spasm (not accounted for by other pathology), tenderness on deep palpation and percussion over these joints, loss of normal quickness of motion and resiliency, and postural defects often accompanied by limitation of flexion and extension of the hip. Traumatism is a rare cause of disability in this connection, except when superimposed upon congenital defect or upon an existent arthritis; to permit assumption of pure traumatic origin, objective evidence of damage to the joint, and history of trauma sufficiently severe to injure this extremely strong and practically immovable joint is required. There should be careful consideration of lumbosacral sprain, and the various symptoms of pain and paralysis attributable to disease affecting the lumbar vertebrae and the intervertebral disc.

Where it says limited ROM of hip, does this mean a separate rating, for loss of hip ROM, apart from low back strain? Strangely enough, I have a congenital defect of "transitional anatomy" in the form of a partial L6 fused to the sacrum at S1. And my fall down the stairs contributed the "Traumatism". 

Any ideas or comments?

Edited December 22, 2016 by Andyman73
Added info

[Andyman73]

Bump

[Buck52]

Andyman

I'm not sure I can be of any help..but we never know how the rater will rate? we can use the CFR's to our advantage( if the raters reads them?)

  The rater's have medical manuals to go by to help them and a lot of raters miss- interprets them , thus how we get DENIALS 

This is unfortunate for veterans such as yourself and other vets...My only advice is wait and see what the examiner wrote about it?

sometimes  we tend to read into the bad things  before we get a decision.

 so maybe just wait and find out.....and NOD if you feel you got a bad rating decision.

[flores97]

Andyman73,  I noticed that you mentioned you were able to see the notes from the exam? Did the examiner mark the at least as likely box,  or were you not able to view the entire portion of the exam. It really p's me off that so many Compensation exams are done by unqualified medical personnel rather than the specialists they should be using,  I hope the results turn out well for you! 

[Andyman73]

Buck,

It's not that I wanted help, just wanted folks to give their 2 cents worth, tell me I'm dumb, or tell me I have a mouse's chance in a catnip factory.

I suppose it's real easy for the raters to misinterpret the manual and read the exam notes upside down and backwards, especially after the exam was performed by a lower level med tech.

Flores,

The examiner did NOT state whether or not anything for my SI joint issue. As for the bunion, she did state less likely as not caused by, and ignored the aggravated bye, part of what makes up secondary SCDs.  I know the VA does not recognize bunions as primary SC based on medical science, which shows that bunions are actually not caused by foot wear, but genetic code.  Studies show equal rate of occurance between shoe wearing and non-shoe wearing peoples, world round.  My VA Podiatrist told me that this is the VA's official position on bunions.  So, very clearly, by omission, bunions would be SC secondary via aggravated by SCDs.

 

 

[Andyman73]

On 12/21/2016 at 1:49 PM, Andyman73 said:

postural defects often accompanied by limitation of flexion and extension of the hip.

What about this, tho? Do I claim this as secondary to my low back and SI joint issue?  I had a C&P exam a year ago for that, and the ROM was noted as moderately reduced with pain throughout my sacroiliac crest bilaterally.  According to the 38 CFR 4.66, it states as I quoted reduced ROM of the hips is also often a part of it.

Edited December 23, 2016 by Andyman73

[Andyman73]

On 12/21/2016 at 1:49 PM, Andyman73 said:

postural defects often accompanied by limitation of flexion and extension of the hip.

What about this, tho? Do I claim this as secondary to my low back and SI joint issue?  I had a C&P exam a year ago for that, and the ROM was noted as moderately reduced with pain throughout my sacroiliac crest bilaterally.  According to the 38 CFR 4.66, it states as I quoted reduced ROM of the hips is also a part of it.