Back is Getting Worse Need to Request New Rating

[AntiqueLT]

I have been researching this for a while and I keep ending up here at HadIt reading old threads.  So, now that I am ready to ask questions I have com to you.  I appreciate the knowledge I have acquired here already.  Thank you all.

My situation is that I was service connected rated 20% for Degenerative Disc Disease (DDD L2-3 and L5-S1) limited mobility as well as 10% each for a shoulder, both knees and PTSD back in 2011.  50% total rating.  This was done through the Army/VA program when they told me I couldn't play with them anymore.

Fast forward to last year and I began to have numbness and tingling in my legs from standing for more that 20 minutes at a time.  Over the course of the year it shortened to 10 minutes and I was experiencing warm and cold flush sensations in my thighs.  In November I had bad sciatic pain and a steroid pack resolved it.  Then in January this year it went precipitously downhill.  I started having numbness start from my groin to just below my knees after 5 or so minutes.  I was down to 5 - 10 minutes of stand or walk time and I started getting wobbly and falling down if I pushed it.  I had to stop working in April because I was stumbling and scared that I was going to fall off the ladder I climbed repeatedly throughout the day.

So I have had MRIs and an EMG and fought with doctors and it appears that all the VA is willing to do is give me a shot in the back and leave me crippled.  The diagnosis is lumbar radiculopathy.  The MRIs show two herniated discs (L4-5 and L5-S1 and a bulging disc above at L3-4) as well as stenosis and multiple moderate and severe nerve impingements at these levels.  The EMG shows "electro-diagnostic evidence of L5-S1 radiculopathy.

Given that I apparently need to grab a Snickers while the VA medical side struggles to do medicine, I figure I need to file a claim on the worsening back and the neurological deficits that it is creating.  My problem is this:  I'm not sure how I should make the new claim and what it should be for, exactly.  I contacted the American Legion rep for my county and he basically said he just files paperwork.

I have looked at 4.71a and I get the rating for the spine itself.  I'll need to get them to do a measurement for flexion to see if I meet the criteria for that to change.  When I go looking for the neurological stuff I get lost.  Same goes for the stenosis and arthritis.  I can't seem to figure out how they get rated and what I would present from my file to establish the criteria.  I have to think the numbness and loss of strength from standing / walking leading to falls have some place in this.  If someone can give me some help and guidance I would be eternally grateful.

Then there is the whole how do you write it up so that the paper shuffler who has a couple minutes to go-nogo the packet sees what they need to see.  But that is a separate matter for when I have the what figured out, I suppose.

Thank you all again for any help you can provide.

[brokensoldier244th]

10 hours ago, vetquest said:

Brokensoldier and Vync are correct on this.  Even though you do not have paralysis per se it is rated under 8520 for neuropathy too.  You will also receive a bilateral factor for each leg if they rate both. 

As I have learned...stay off of ladders.  If your work requires ladders it might be time to start looking for TDIU.  No, you do not qualify for it right now but if they rate you as moderate bilateral you should have the necessary rating.  If you file now you will lock in a date.  The fact that you cannot stand for long periods of time is also a hint.  See if your neurologist will state in a letter you can no longer work due to your service connected condition.  Also see if you cannot get a neurological DBQ and then have your neurologist fill it out.  I believe this is the correct one.  If it is not then someone will be along to correct me.

https://www.vba.va.gov/pubs/forms/VBA-21-0960C-10-ARE.pdf

Yeah, I roll my ankles a lot, too, when I walk. I now buy athletic shoes with a pronounced stabilization on both sides, and have orthotics in them to help defray some of it. I still occasionally trip on stairs because I don't lift my foot up high enough, and last year I fell down some stairs after a job interview because my ankle rolled and I ended up breaking my wrist and getting surgery, and have a nice scar through part of an eyebrow.

[AntiqueLT]

On 8/21/2018 at 2:48 PM, vetquest said:

See if your neurologist will state in a letter you can no longer work due to your service connected condition.  Also see if you cannot get a neurological DBQ and then have your neurologist fill it out.  I believe this is the correct one.  If it is not then someone will be along to correct me.

https://www.vba.va.gov/pubs/forms/VBA-21-0960C-10-ARE.pdf

Unfortunately, I don't have a neurologist.  I have an idiot that I hope to never see again that told me to f off and die.  "Find a job where you don't have to walk or stand."  and "Don't let anyone operate on you."  I fought for a second opinion and got a civilian neuro who told me there is nothing he can do except give me drugs to deal with it, I need to see a neuro surgeon.  The VA refused to send me to a neuro surgeon and sent me to an ortho whose assistant told me that while civilian medical would do a surgery because of profit motives, the VA would not.  

Typing that will now leave me too pissed off to do much for a while. 

[vetquest]

I can believe that the doctor might be right to say let nobody operate on you.  Otherwise he sounds like a neurologist I saw for a C&P that all but said I was malingering.  Maybe at a C&P they will get a contract neurologist to look at you.  You can apply for TDIU and they are supposed to do a C&P.  If you are not working TDIU is the last best course that I know of.  I would also request the medical exam the civilian neuro performed on you using the blue button.  It might be interesting.

[brokensoldier244th]

My doc didnt want to operate either, reason being my nerve damage and disc damage is low enough in my back that if they were to operate they might nick or damage something further down in the caudal area and cause more problems. Hence, im on pain killers and conservative maintenance and stretching/core exercises for life. 

[Vync]

13 hours ago, brokensoldier244th said:

My doc didnt want to operate either, reason being my nerve damage and disc damage is low enough in my back that if they were to operate they might nick or damage something further down in the caudal area and cause more problems. Hence, im on pain killers and conservative maintenance and stretching/core exercises for life. 

Same boat here

[Navy04]

The VA sucks when it comes to Diagnosing, Treating or Rating Back issues. The VA back Docs wanted to install a Pain Pump, kind of Stupid considering I am Allergic to pain medicine. So I went to Civilian side and have had 2 Back surgeries in the last 10 months, those did not work either my friend. Now I am worse then ever. The last surgery damaged 2 nerves in my left leg, so numbness was made worse then before. The VA has a way of screwing Vets by using multiple Diagnosed back or nerve conditions along with lower %s, even if they Grant the Vet the Service Connection. I dont think people or Docs in General realize how much a Human uses their Back for Daily Living. Sorry to hear of your issues bud. Good luck and God Bless