Just had exam for increase in benefits for ruptured disc

[TugnTow]

Hello all,

 

I am new to the forum and this is my first post so I hope that its in the correct forum and makes sense. I'll give my background. I did 5 years in the USGC all aboard seagoing buoy tenders. I was a Boatswains Mate 2nd Class when I got out. I hurt my back while on the ship moving anchor chain around for the buoys we serviced. When I got out I was given 10% VA compensation for Degenerative Disc Disease but I had already had an MRI which showed a tear in the L4-L5 disc and a small herniation in the L5-S1. In 2011 I recieved an added 10% for sciatic nerve damage right lower extremity. My condition has since gotten a lot worse so I decided to re-file for an increase. The following is what I claimed

Disabilities Claimed: degenerative disc disease lumbar spine with herniated nucleus pulposis (Increase), sciatic nerve damage right lower extremity (Increase), L4-L5 Right paracentral annular tear small central disc protrusion slightly effacing ventral thecal sac mild bilateral facet disease. (New), L5-S1 Large paracentral disc protrusion effacing the ventral thecal sac severly compressing S1 Root. Moderate left severe right recess stenosis. Bilateral radiculpathy right greater than left. Mild Bilateral Facet Disease. (New)                   

Under the section "Pending Disabilities" in ebenifits it says

Degenerative Disc Disease Lumbar Spine With Herniated Nucleus Pulposis	01/03/2018	INC	View Pending Claim
Sciatic Nerve Damage Right Lower Extremity	01/03/2018	INC	View Pending Claim
L4-l5 Right Paracentral Annular Tear Small Central Disc Protrusion Slightly Effacing Ventral Thecal Sac Mild Bilateral Facet Disease.	01/03/2018	NEW	View Pending Claim
L5-s1 Large Paracentral Disc Protrusion Effacing The Ventral Thecal Sac Severly Compressing S1 Root. Moderate Left Severe Right Recess Stenosis. Bilateral Radiculpathy Right Greater Than Left. Mild Bilateral Facet Disease.	01/03/2018	NEW	View Pending Claim

 

I submitted all sorts of documentation (MRI's, Nerve Studies, several years worth of documentation showing my treatment from my primary care doctor, letters from my wife, DBQ's, and letters from my surgeon who recommended a lumbar microdiscectomy. Since filing the claim in October I went forward with the surgery to try and relieve some of the pain I was having and because I was told I may cause irreversable nerve damage and loss of feeling in my legs. I went for my VA exam this past Thursday in Hinesville, Ga. and the Dr. asked questions and measureed the scar on my back from the surgery and did all of the range of motion measurements. I wasn't able to see what any of the measurements came out to be which is disappointing because I wanted to compare those to what I know is part of the VA requirements.

Some of my questions are:

1 is it possible to get an increase in sciatic nerve and degenerative disc disease based on the info provided

2 are tears in the disc rated seperately than ruptured discs (I have one disc that is ruptured, one that is torn)

3 is Bilateral Facet Disease rated seperately than Degenerative Disc Disease

4 are Radiculpathy and Stenosis rated separately

5 does the increase if any change if it affects both sides of the body (Bilateral) as opposed to just one leg

6 is the scar that he measured ratable.

7 about how long after the VA exam can you expect a decision? I submitted it through the ebenifits website as a fully developed claim

8 In your opinion or experience what is the highest rating that you can get for the conditions I listed.

 

I hope this post was laid out in a way that is understandable and appropriate for the forum. I'm not sure how all of this works yet. Thank you in advance for any help or advice.

 

 

[broncovet]

Once service connected, you will be rated on symptoms, but you can not "pyramid" symptoms.  

So, if there is overlap of symptoms on sciatic nerve vs DDD, then you only get paid for the worst of them.  

For example, if you are compensated for "back pain", then you wont get the same for DDD and sciatic nerve.  

You can also be compensated for loss of range of motion, but again, pyramiding prevents you getting paid for one symptom twice.  

Lots of Vets want to be compensated for multiple disorders, even when there is only "one" set of symptoms.  That wont fly.  

Yes, bilateral symptoms are compensated higher than unilateral.  

Scars are rated by the size of them, and whether or not they are painful.  I think facial scars are rated higher than a scar "which doesnt show" with your clothes on.  

Im not going to venture a guess on your rating...since you have not indicated if you have the Caluza elements in place for service connection for the new conditions.  

Remember, VA benefits are designed to replace income lost due to the disabilities.  We dont know if you are working, or if you are able to work, and/or how much "time off" does your disabilites cause.  

Has a doctor placed you "on restrictions" from your back?  Does he limit lifting to 5 pounds?  50 pounds?  Do you have full range of motion?  Pain?  How severe is the pain?  Do you have pain while seated?  Pain while sleeping?  How much work have you lost do to your back issues?  Do they affect other things, such as your arms or legs?  Your neck?  

How much did your condition worsen since your C and P exam where you were rated?  

I would not venture even a guess at this point.  

[Carl the Engineer]

And, keep in mind when talking VA speak (VA math), that the Thoracic and Lumbar are rated together as one, and the Cervical is rated seperately.  So you can get 2 seperate ratings for your spine.  I get 20% for Lumbar/Thoracic and 20% for Cervical.

Now with all DDD and DJD service connected conditions, for permanent (or Static) conditions, ROM (Range of Motion) is where you will get your bigger ratings from. From what I have been reading, doctors are not prescribing bed rest, etc. anymore, and surguries are temporary ratings (I think).

Also, read your doctor exams and lab (x-ray) reports regards any arthritis.  At your exams (not C&P, but your medical exams) ask the doc about arthritis and hopefully he opines in his notes about it.  Claiming arthritis secondary to your DDD, while it will not get you an increase because of piramiding, it once service connected, you will be able to claim joints that get arthritis close by secondary to your now service connected joint, etc.  Arthitis spreads.

X-rays are 10% and ROM will get you 20-40%.

You have to really messed up to get 60% for your back, and the doc would have to prescribe six weeks bed rest. Not sure they do that anymore.

"at 60% if there are incapacitating episodes of at least six weeks total duration during the past 12 months"

ROM is where it's at,

Hamslice

 

[TugnTow]

Sorry I am so late getting back to you on my original question. Some of the things I learned while going in for physical therapy was that one, my ROM for my back was as follows.

Forward Flexion 19 deg

Back Extension 0 deg

Left Lateral 13 deg

Right Lateral 15 deg

Twist from waist 5 deg left and right

My Legs were mesured for flexibility while lying flat on my back with my thigh at 90 deg to my back and those measurements were as follows.

Left leg was 75 deg from straight and the right was 70 deg due to tight hamstrings. I basically looked like I was sitting in a chair lying flat on my back if that makes any sense. 

I also have documentation of required bed rest from my doctor for 2-4 weeks that was submitted with my DBQ's with restrictions of lifting to 10-15lbs. I don't know about the scar. It won't be visible while wearing clothes but it does hurt and is sensitive to touch. I have radicular pain that is documented as bilateral as well as the facet arthropathy which is basically arthritis of the spine. All of the measurements that I gave were taken with a goniometer by a physical therapist after the VA Dr. Visit. The VA Dr. measured with the goniometer as well but he didn't give me my measurments though I'm sure they were really close to or worse than the ones I gave above due to them being taken after the VA appointment.

My ebenefits page shows that the initial review is complete and they aren't waitin on anything else so I assume they are just reviewing all of the documentation. A couple of weeks ago they showed that they were requesting info from the VA for files on my previous dealings with them.

Not sure if this will help from what you initially commented. 

 

Thanks for the info

[kanewnut]

6 hours ago, TugnTow said:

I don't know about the scar. It won't be visible while wearing clothes but it does hurt and is sensitive to touch

I have a neck scare from a fusion. It doesn't bother me at all. They rated it at 0%. If your's is painful it should be rated above 0%. 

[TugnTow]

I got my claim dicision back and they moved me from 20% to 60%. 40% for Degenerative Disc Disease with herniated disc and lumbar microdiscectomy, 20% Right Leg Radiculpathy with nerve Damage, and 10% Left Leg radiculpathy. I'm happy with the decision. Honestly its more than I was expecting. 

 

[Berta]

That's great! You did well!

If this  ever gets worse and prevents  you from working,by all means apply for TDIU and SSDI benefits.