C&P Exam Results-Help Determining Rating

[Reeldirtydawg]

Newbie here!!!!!  Thanks to fellow Veterans I finally filed a disability claim 15 years after I retired from USMC with 20 years of active duty service.  Of course initial claim was denied(Jan 2015), not enough evidence to service connect.  Thanks again to fellow veterans and this forum did some homework and filed an appeal Dec 2015.  Opted into RAMP on July 2018, C&P exam a few weeks ago, still gathering evidence in Vets.gov

Did not post all of the C&P Exam just what seemed to be relevant; can someone with experience let me know their thoughts?

Back (Thoracolumbar Spine) Conditions
Disability Benefits Questionnaire

Does the Veteran now have or has he/she ever been diagnosed with a thoracolumbar spine (back) condition?
[X] Yes [ ] No
Thoracolumbar Common Diagnoses:
[ ] Ankylosing spondylitis
[ ] Lumbosacral strain
[X] Degenerative arthritis of the spine
[X] Intervertebral disc syndrome
[ ] Sacroiliac injury
[ ] Sacroiliac weakness
[ ] Segmental instability
[ ] Spinal fusion
[ ] Spinal stenosis
[ ] Spondylolisthesis
[ ] Vertebral dislocation
[ ] Vertebral fracture

Diagnosis #1: DDD
ICD code: M51.36
Date of diagnosis: 2005
Diagnosis #2: IVDS
ICD code: M51
Date of diagnosis: 2005
Diagnosis #3: Disc Herniation
ICD code: M51.2
Date of diagnosis: 9/12/2016

2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's thoracolumbar spine (back) condition (brief summary):
The veteran has years of chronic back pain and left leg radicular symptoms. The veterans initial back injury occured while
repelling and loosing control of the rope and landing quite hard, also injuring his shoulder and ribs in this fall. The veteran has reported
chronic back pain since that time. The veterans DDD has progressed and lead to bulging discs and radiculopathy. The veteran is currently experiencing a
flare-up, he reports that for the last month his back has been flared-up and the pain is severe. The veteran today has antalgic short strided gait,
if he takes a longer stride his left leg sciatica in unbearable. The veteran is clearly in significant pain due to his current flare-up.

3. Range of motion (ROM) and functional limitation
--------------------------------------------------
a. Initial range of motion
[ ] All normal
[X] Abnormal or outside of normal range
[ ] Unable to test (please explain)
[ ] Not indicated (please explain)
Forward Flexion (0 to 90): 0 to 20 degrees
Extension (0 to 30): 0 to 5 degrees

Right Lateral Flexion (0 to 30): 0 to 10 degrees
Left Lateral Flexion (0 to 30): 0 to 10 degrees
Right Lateral Rotation (0 to 30): 0 to 10 degrees
Left Lateral Rotation (0 to 30): 0 to 10 degrees

Observed repetitive use
Is the Veteran able to perform repetitive use testing with at least three repetitions?

[ ] Yes [X] No
If no, please provide reason:
current flare-up prevents further ROM testing.

If the examination is not being conducted immediately
after repetitive
use over time:
[X] The examination is medically consistent with the
Veteran's statements describing functional loss with repetitive use over time.

Does the Veteran have radicular pain or any other signs or symptoms due to radiculopathy?
[X] Yes [ ] No
a. Indicate symptoms' location and severity (check all that
apply):
Constant pain (may be excruciating at times)
Right lower extremity: [X] None [ ] Mild [ ] Moderate
[ ] Severe
Left lower extremity: [ ] None [ ] Mild [X] Moderate

Intermittent pain (usually dull)
Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe
Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe

Paresthesias and/or dysesthesias
Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe
Left lower extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe

Numbness
Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe
Left lower extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ]
a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service
injury, event or illness.
c. Rationale: The veterans STR's show complaints of back pain throughout service, including his retirement physical in which he reported
history of chronic recurrent back pain. The veterans back condition has progressed, his radiculopathy is the progression of the DDD and chronic pain.
The post service records clearly chow no other injuries, and they all show he's has chronic back pain since the military. The current symptoms are
reflective of the flare-up he was having during this appointment.

 

Edited February 13, 2019 by Reeldirtydawg

[Berta]

It certainly seems that they will Service  Connect  and rate you for this.

I have no idea ( others will help) on what rating you could expect.

I hope you realize that it will take a 50% or higher rating for you to be eligible for CRDP:

https://www.dfas.mil/retiredmilitary/disability/crdp.htm

Also I just got email from NCOA:

 

"Dear  ,

Rep. Gus Bilirakis (Fla.) introduced the "Retired Pay Restoration Act" (H.R. 303), which would expand the eligibility of retirees with less than 50 percent disability rating to receive service-connected disability from VA and their full retirement pay for retirees eligible for Concurrent Retirement and Disability Payments (CRDP). Currently, only CRDP disability disabled retirees with a rating of 50 percent or more are eligible for concurrent receipt.

Rep. Sanford Bishop (Ga.) has also introduced comprehensive concurrent receipt reform (HR 333) that includes disabled retirees with CRDP less than 50 percent and CRDP (Chapter 61) medically retired (less than 20 years of service). Rep. Sanford's bill is similar to the Senate bill and would have the same impact.

Support HR. 303 & HR 333 - Concurrent Receipt Reform!

 

NCOA and Miitary.com , on line, as well as us here try to keep retirees informed of 

any possible changes to  CRDP. 

 

Edited February 14, 2019 by Berta

[doc25]

On 2/12/2019 at 4:09 PM, Reeldirtydawg said:

Newbie here!!!!!  Thanks to fellow Veterans I finally filed a disability claim 15 years after I retired from USMC with 20 years of active duty service.  Of course initial claim was denied(Jan 2015), not enough evidence to service connect.  Thanks again to fellow veterans and this forum did some homework and filed an appeal Dec 2015.  Opted into RAMP on July 2018, C&P exam a few weeks ago, still gathering evidence in Vets.gov

Did not post all of the C&P Exam just what seemed to be relevant; can someone with experience let me know their thoughts?

Back (Thoracolumbar Spine) Conditions
Disability Benefits Questionnaire

Does the Veteran now have or has he/she ever been diagnosed with a thoracolumbar spine (back) condition?
[X] Yes [ ] No
Thoracolumbar Common Diagnoses:
[ ] Ankylosing spondylitis
[ ] Lumbosacral strain
[X] Degenerative arthritis of the spine
[X] Intervertebral disc syndrome
[ ] Sacroiliac injury
[ ] Sacroiliac weakness
[ ] Segmental instability
[ ] Spinal fusion
[ ] Spinal stenosis
[ ] Spondylolisthesis
[ ] Vertebral dislocation
[ ] Vertebral fracture

Diagnosis #1: DDD
ICD code: M51.36
Date of diagnosis: 2005
Diagnosis #2: IVDS
ICD code: M51
Date of diagnosis: 2005
Diagnosis #3: Disc Herniation
ICD code: M51.2
Date of diagnosis: 9/12/2016

2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's thoracolumbar spine (back) condition (brief summary):
The veteran has years of chronic back pain and left leg radicular symptoms. The veterans initial back injury occured while
repelling and loosing control of the rope and landing quite hard, also injuring his shoulder and ribs in this fall. The veteran has reported
chronic back pain since that time. The veterans DDD has progressed and lead to bulging discs and radiculopathy. The veteran is currently experiencing a
flare-up, he reports that for the last month his back has been flared-up and the pain is severe. The veteran today has antalgic short strided gait,
if he takes a longer stride his left leg sciatica in unbearable. The veteran is clearly in significant pain due to his current flare-up.

3. Range of motion (ROM) and functional limitation
--------------------------------------------------
a. Initial range of motion
[ ] All normal
[X] Abnormal or outside of normal range
[ ] Unable to test (please explain)
[ ] Not indicated (please explain)
Forward Flexion (0 to 90): 0 to 20 degrees
Extension (0 to 30): 0 to 5 degrees

Right Lateral Flexion (0 to 30): 0 to 10 degrees
Left Lateral Flexion (0 to 30): 0 to 10 degrees
Right Lateral Rotation (0 to 30): 0 to 10 degrees
Left Lateral Rotation (0 to 30): 0 to 10 degrees

Observed repetitive use
Is the Veteran able to perform repetitive use testing with at least three repetitions?

[ ] Yes [X] No
If no, please provide reason:
current flare-up prevents further ROM testing.

If the examination is not being conducted immediately
after repetitive
use over time:
[X] The examination is medically consistent with the
Veteran's statements describing functional loss with repetitive use over time.

Does the Veteran have radicular pain or any other signs or symptoms due to radiculopathy?
[X] Yes [ ] No
a. Indicate symptoms' location and severity (check all that
apply):
Constant pain (may be excruciating at times)
Right lower extremity: [X] None [ ] Mild [ ] Moderate
[ ] Severe
Left lower extremity: [ ] None [ ] Mild [X] Moderate

Intermittent pain (usually dull)
Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe
Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe

Paresthesias and/or dysesthesias
Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe
Left lower extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe

Numbness
Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe
Left lower extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ]
a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service
injury, event or illness.
c. Rationale: The veterans STR's show complaints of back pain throughout service, including his retirement physical in which he reported
history of chronic recurrent back pain. The veterans back condition has progressed, his radiculopathy is the progression of the DDD and chronic pain.
The post service records clearly chow no other injuries, and they all show he's has chronic back pain since the military. The current symptoms are
reflective of the flare-up he was having during this appointment.

 

Congrats! You received a favorable nexus.

ROM and pain during your exam stands out to me.

I believe you are eligible to receive a combined rating higher than 20%...which the rater might low-ball you with.

ROM is rated like this 

General Rating Formula

There is one general rating formula for any condition of the spine that is used in the majority of cases. We’ll discuss this general formula first, and then address exceptions.

The general formula is based primarily on range of motion (ROM). The images below show a normal ROM for the cervical and thoracolumbar spines.

Below is a chart of the general rating formula. A few points to know:

– If the spine is frozen and cannot move at all, it is considered favorableif it is frozen at 0° for flexion or extension. If it is frozen at any other place in flexion or extension, then it is considered unfavorable.
– To get the combined ROM, add all the measurements together: left rotation, right rotation, flexion, extension, right lateral flexion, and left lateral flexion. The normal combined measurements for the cervical spine is 340°, and the thoracolumbar spine is 240°.
– All measurements are rounded to the nearest 5 (8° rounds up to 10°, 7° rounds down to 5°, etc.)

Rating	Cervical Spine	Thoracolumbar Spine
100%	Entire spine frozen in an unfavorable position.
50%		Entire thoracolumbar spine frozen in an unfavorable position.
40%	Entire cervical spine frozen in an unfavorableposition.	Flexion measures 30° or less.  -OR-  Entire thoracolumbar spine frozen in a favorable position.
30%	Flexion measures 15° or less. -OR- Entire cervical spine is frozen in a favorableposition.
20%	Flexion measures more than 15° but not more than 30°. -OR- Combined ROM is 170° or less.	Flexion measures more than 30° but not more than 60°. -OR- Combined ROM is 120° or less.
10%	Flexion measures more than 30° but less than 45°. -OR- Combined ROM is between 175° and 340°.	Flexion measures more than 60° but less than 90°. -OR- Combined ROM is between 125° and 240°.
0%	Flexion measure 45° or more. -OR- Combined ROM measures 340° or more.	Flexion measures 90° or more. -OR- Combined ROM measures 240° or more.

 

Pain is rated seperately. But, I think it is capped at 10%.I'll post the rating for pain soon.

 

 

[Reeldirtydawg]

Thank you Doc25 and Berta...I have three other things I was also evaluated for and they all seemed favorable so hoping that they would put me at 50%.  Trying to understand the back rating was just confusing to me and still is, will just have to wait and see what they come back with.