Guess what rating increase lumbar cervical spine

[V I man]

I am rating 40% for 20 cervical with findings of degenerative arthritis and narrowing disk spaces C2-C3 through C5-C6, 10% low back condition residuals of back injury, 10% idiopathic urticaria exam 07July 2016.File

Appeal Pending - Substantive Appeal

VA has received your Form 9 and will begin completing final actions regarding your appeal before it is sent to the Board of Veterans’ Appeals. 13 may 2016 would appreciate any suggestion if possible  regarding rating increase. SC since Nov 1992 unemployable due SC Sept 2006. Examination In-person exam Was the Veteran's VA claims file (hard copy paper e-file reviewed? yes Spinal fusion Z98.1 2006 Other specify right Lower Extremity sensory neuroapathy g62.9 1/6/2015 .Medical History Onset of the Veteran's condition was in 1990. veteran was working as a rigger aboard ship moving heavy equipment. The following morning he had sharp pains in his back, no feeling in feet and was unable to get out of bed the overall condition of his back ha continued to deteriorate. Veterans currently has neck pain, shoulder pain radiating down left arm numbness of ring finger, electrical shock sensation of left forearm, numbness of buttocks and feet sharp pain in lower back, and loss of balance. the Veteran's treatments include l5-s1 decompression in 2006 IMPLANT NEURO TEN unit in 2013 and Posterior Laminecotomy in T9 MRI Lumbar Spine 8/22/2012 MRI Cervical Spine  10/8/2012 Does the veteran report flare-up of the Thoarocolumbarr Spine? Yes IF yes document the Vetran's description of the flare-up in his or her own word. pain so bad that he cannot walk or stand,gets in and out of bed trying to get comfortable. Oftentimes unable to tie shoe laces or pull up pants Does the Veteran report having any functional loss or functional impairment of the Thoarocolumbar Spine (back) ( regardless of repetitive use? Yes. If yes document the Vetran's description of functional impairment in his or her own words. Sometimes he cannot lift bend over, carry go up or down steps. Initial ROM measurement Abnormal or outside normal range Forward Flexion (0-90) 30 degrees Extension (0-30) 5 degrees Right Lateral Flexion (0-30) 20 degrees Left Lateral Flexion (0-30) 20 degrees Right Lateral Rotation (0-30) 10 degrees Left Lateral rotation (0-30) degrees 10 If abnormal does the range of motion itself contribute to a functional loss? Yes If yes, please explain. He cannot lift bend over carry go up down steps; cannot turn to look behind Description of Pain Pain noted  on examination and, causes functional If noted on examination which ROM exhibited pain Extension,right Lateral Flexion, Left Lateral Flexion I  sthe objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue of the Thoarocolumbar Spine (back)? Yes If yes describe including location severity and relationship to condition. Location Par spinal lumbar Severity Moderate/Servere Relationship(s) Spasm, guarding, and tenderness due to scarring and fibrosis from previous surgical procedures Is there evidence of pain with weight bearing? Yes Is the Veteran able to perform repetitive-use testing with at least three repetitious? No Is the veteran being examined immediately after repetitive use over time? NO The examination is medically consistent with the Veteran's statements describing functional loss with repetitive use over time. Does pain weakness fatigability, or incoordination significantly limit functional ability with repeated use over a period of time? Unable to say without mere speculation Does the Veteran have guarding or muscle spasm of the Thoarocolumbar Spine? Yes Resulting in abnormal spine contour Provide description and/or etiology of muscle spasm Par-spinal muscle spasm due to scarring, fibrosis, and pain which are residual of surgery, lminectomty and fusion. Less movement than normal Weakened movement Disturbance of locomotion Interference with sitting Inference with standing Straight Leg Raising Test Right leg Positive Left leg Positive Radiculopathy Constant right lower extremity Moderate Left lower extremity Moderate Intermittent negative none both legs Parrasthesins and/or   dynesthesia Right lower extremity Mild Left lower extremity Mild Numbness Right lower extremity Mild Left lower extremity Mild Does the veteran have any other signs or symptoms of radiculopathy? No Other nerves involved Sural,peroneal Right Moderate Left Not affected Does the veteran have IVDS No Assistive Devices Cane constant Motorized cart OTHER PERTAIN PHYSICAL FINDINGS CONDITION SCARS YES LUMBAR Length 12.5 cm width 0.5 cm DIAGNOSTIC TESTING Have imaging studies of the Thoracolumbar Spine? Yes If yes is arthritis documented? No Does the Veteran have thoracic vertebral fracture with loss of 50 percent or more of height No Are there any other significant diagnostics test finding or results? Yes EMG 5/23/2016 radiculopathy and mild sensory neuropathy for median and ulnar nerves, left arm EMG 1/5/2015 Parispinal neural sensory neuropathy right sural and peroneal nerve Does the Veteran's Thoracolumbar Spine conditions impact his or her ability to work? Yes If yes describe the impact of each of the Veteran's Thoracolumbar Spine conditions providing one or more examples. He cannot work because he cannot lift bend over carry or go up or down steps. He is unable to sit or stand for more than a few minutes at a time. REMARK A progression and correction of the veteran's service connected diagnosis to Right Lower Extremity sensory neuropathy and Spinal Fusion Please provide a rational to support your opinion. To be more accurate of the veteran's back condition. The vertan has developed upper and lower extermity radiculopathy and these, are progressive extension of his thoracolumbar disease. Third Class Petty Office  Thank ever so much for update information pertaining to this complex requesting rating increase..