SC % For Pain in Body Parts

[glashutte]

Hi everyone, 

I see a lot of posts where people post things like:  0% lower back pain, 10% shoulder pain, etc. 

Is there an actual diagnosis for pain or are they referring to arthritis? I was seen and diagnosed for chronic pain during service but was never diagnosed as arthritis or any specific condition. 

Should I even claim these? It was just mysterious random pains treated with Ibuprofen. 

[kanewnut]

4 hours ago, glashutte said:

In regards to submitting claims, if one was only diagnosed with 'pain' to joint such as shoulder and lower back, should it be plainly submitted as Pain? (now knowing this new information)

That should be okay unless you have a doctor that is telling you that it is a specific thing.

You can look at the below listings and look up what most matches your conditions. 

1. CFR › Title 38 › Chapter I › Part 4 › Subpart B › Section 4.71a

38 CFR 4.71a - Schedule of ratings - musculoskeletal system.

I originally got a 0% rating for low back pain. This was after my SMR's stated it was chronic pain. 

They later changed it to lumbosacral strain and upped it to 10%. Keeping fighting with them until they get it right.

[glashutte]

17 hours ago, kanewnut said:

That should be okay unless you have a doctor that is telling you that it is a specific thing.

You can look at the below listings and look up what most matches your conditions. 

1. CFR › Title 38 › Chapter I › Part 4 › Subpart B › Section 4.71a

38 CFR 4.71a - Schedule of ratings - musculoskeletal system.

I originally got a 0% rating for low back pain. This was after my SMR's stated it was chronic pain. 

They later changed it to lumbosacral strain and upped it to 10%. Keeping fighting with them until they get it right.

Great advice, thank you. 

The military has done, in my opinion, way too many x rays on me already so I don't want to undergo more x rays to try to specify the diagnosis. 

In your case, did they take further x rays to change your diagnosis from chronic pain to lumbosacral strain?

[Vync]

On 4/1/2018 at 9:07 PM, glashutte said:

Hi everyone, 

I see a lot of posts where people post things like:  0% lower back pain, 10% shoulder pain, etc. 

Is there an actual diagnosis for pain or are they referring to arthritis? I was seen and diagnosed for chronic pain during service but was never diagnosed as arthritis or any specific condition. 

Should I even claim these? It was just mysterious random pains treated with Ibuprofen. 

Prior to reading Berta's post, I would have just advised you to look at the musculoskeletal ratings table §4.71a   Schedule of ratings—musculoskeletal system and you could look up the criteria for your back, shoulder, etc...

Now, I don't know what to think except that it looks very promising. However, I have no idea how pain would now be rated.

 

 

[kanewnut]

6 hours ago, glashutte said:

In your case, did they take further x rays to change your diagnosis from chronic pain to lumbosacral strain?

I believe they took x-rays at the first C&P exam. This was in 2000. At my last C&P exam in 2016 she said I had something and no more x-rays would be needed. I can't remember what she called it. She was a contractor, not a VA employee. 

My diagnosis never went from chronic pain to lumbosacral strain. It was listed as low back pain and then they listed it as lumbosacral strain.

[Berta]

NVLSP and Its Private Law Firm Partner Persuade the Federal Circuit to Overturn 19-Year Precedent, VA Can Now Award Disability Benefits For Pain Related to Military Service

FOR IMMEDIATE RELEASE – April 4, 2018

WASHINGTON – In a sweeping legal victory for veterans, the U.S. Court of Appeals for the Federal Circuit overturned a 19-year lower court precedent which prohibited the Department of Veterans Affairs (VA) from awarding disability benefits to a veteran for disabling pain if it was not linked to a medical diagnosis.

“What this ruling means is that if a physician cannot diagnose the cause of the pain the veteran is experiencing, but the pain is related to an event, injury, or disease that occurred during the veteran’s military service, the veteran should now win disability benefits,” said Bart Stichman, executive director and co-founder of the National Veterans Legal Services Program (NVLSP) and one of the attorneys who represented the veteran in the case.

The Federal Circuit’s decision in Saunders v. Wilkie overturned the 1999 precedential decision issued by the Court of Appeals for Veterans Claims that said VA had no authority to award benefits for pain alone, if the pain was untethered to a medical diagnosis explaining its cause. 

NVLSP partnered with pro-bono counsel, Orrick, Herrington & Sutcliffe, LLP, on the case. They won the case on behalf of Gulf war veteran Melba Saunders, who served in the Army from November 1987 until October 1994.

Saunders did not experience knee problems before serving in the Army. During her service, however, she sought treatment for knee pain and was diagnosed with patellofemoral pain syndrome. Her exit examination reflected normal lower extremities but noted she had a history of swollen knee and hip joints and bone spurs on her feet.

News Room

NVLSP COURT VICTORY FOR VETERANS: VA CAN NOW AWARD BENEFITS FOR DISABLING PAIN

Released 4/4/18 | Tags: Class Actions

NVLSP and Its Private Law Firm Partner Persuade the Federal Circuit to Overturn 19-Year Precedent, VA Can Now Award Disability Benefits For Pain Related to Military Service

FOR IMMEDIATE RELEASE – April 4, 2018

WASHINGTON – In a sweeping legal victory for veterans, the U.S. Court of Appeals for the Federal Circuit overturned a 19-year lower court precedent which prohibited the Department of Veterans Affairs (VA) from awarding disability benefits to a veteran for disabling pain if it was not linked to a medical diagnosis.

“What this ruling means is that if a physician cannot diagnose the cause of the pain the veteran is experiencing, but the pain is related to an event, injury, or disease that occurred during the veteran’s military service, the veteran should now win disability benefits,” said Bart Stichman, executive director and co-founder of the National Veterans Legal Services Program (NVLSP) and one of the attorneys who represented the veteran in the case.

The Federal Circuit’s decision in Saunders v. Wilkie overturned the 1999 precedential decision issued by the Court of Appeals for Veterans Claims that said VA had no authority to award benefits for pain alone, if the pain was untethered to a medical diagnosis explaining its cause. 

NVLSP partnered with pro-bono counsel, Orrick, Herrington & Sutcliffe, LLP, on the case. They won the case on behalf of Gulf war veteran Melba Saunders, who served in the Army from November 1987 until October 1994.

Saunders did not experience knee problems before serving in the Army. During her service, however, she sought treatment for knee pain and was diagnosed with patellofemoral pain syndrome. Her exit examination reflected normal lower extremities but noted she had a history of swollen knee and hip joints and bone spurs on her feet.

After leaving the military, she suffered with pain from bilateral knee disorders. In 1994, Saunders filed a VA claim for disability compensation for knee pain, hip pain, and a bilateral foot condition. The VA Regional Office denied it. She filed a reopened VA claim for bilateral knee pain in 2008 and was denied again. She appealed to the Board of Veterans’ Appeals which remanded the case to the Regional Office for additional evidence.

A 2011 VA exam found that Saunders had functional limitations on walking, that she was unable to stand for more than a few minutes, and that sometimes she required use of a cane or brace. The VA physician diagnosed Saunders with bilateral knee pain and concluded that Saunders’ knee condition was at least as likely as not caused by her military service.  Nonetheless, the Board of Veterans’ Appeals denied the claim, explaining that VA is not authorized to pay disability compensation for “pain” alone, without a medical diagnosis for the pain.  The Board cited in support the 1999 Veterans Court decision in Sanchez-Benitez v. West, which held that “pain alone is not a disability for the purpose of VA disability compensation.”

With NVLSP’s help, Ms. Saunders appealed this Board decision to the Court of Appeals for Veterans Claims in 2015.  Relying on its 1999 precedent in Sanchez-Benitez v. West, the Veterans Court affirmed the Board’s denial of her 2008 bilateral knee claim. Ms. Saunders then appealed this 2016 decision of the Veterans Court to the Federal Circuit. 

The Federal Circuit’s decision in Saunders v. Wilkie should affect thousands of disabled veterans suffering from pain related to their military service.  Over the last 19 years, the Court of Veterans Appeals cited the precedent invalidated by the Federal Circuit in over 100 individual appeals filed by veterans in the Veterans Court.  Moreover, the Board of Veterans’ Appeals cited the Veterans Court’s now-invalidated precedent in more than 11,000 individual Board decisions.

“The Federal Circuit’s ruling is a significant victory for disabled veterans, like our client Melba Saunders, who have served their country in wartime and are now unable to work to their full capacity as a result,” said Mel Bostwick, a partner at Orrick, Herrington & Sutcliffe, LLP who argued the case before the court.

“Congress recognized that the nation owes these veterans for their sacrifices, and the court today vindicated the common-sense notion that this debt does not depend on whether a veteran’s disabling pain can be labeled with a specific medical diagnosis. We are pleased with the court’s straightforward application of the law that corrects a decades-long error by the Veterans Administration,” said Bostwick.

About NVLSP
The National Veterans Legal Services Program (NVLSP) is an independent, nonprofit veterans service organization that has served active duty military personnel and veterans since 1980. NVLSP strives to ensure that our nation honors its commitment to its 22 million veterans and active duty personnel by ensuring they have the federal benefits they have earned through their service to our country. NVSLP offers training for attorneys and other advocates; connects veterans and active duty personnel with pro bono legal help when seeking disability benefits; publishes the nation's definitive guide on veteran benefits; and represents and litigates for veterans and their families before the VA, military discharge review agencies and federal courts. For more information go to www.nvlsp.org.

Media contact: Ami Neiberger-Miller, 703.887.4877, ami@steppingstoneLLC.com

Director of Communications: Pamela Goldsmith, 202.702.2655, Pamela@nvlsp.org

Source: http://www.nvlsp.org/news-room/press-releases/court-victory-for-veteransva-can-now-award-disability-benefits-for-pain-rel

[kanewnut]

On 4/3/2018 at 1:42 PM, saxman said:

remember pain is not a condition. you must know what's causing the pain.

That can be a problem when the doctors just shrug their shoulders when you ask then what is wrong with you.