hand shoulder and arm Neuritis of all radicular groups

[Force Lima]

Hello all. 

My question is.  Would Neuritis of all radicular groups of the shoulder, arm and hand all be under one rating?

Thank you.

[Berta]

I am sorry no one answered yet-

Neuritis is under Diagnostic code 8305-

but this statement has to be taken into account:

"4.123   Neuritis, cranial or peripheral.

Neuritis, cranial or peripheral, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete, paralysis. See nerve involved for diagnostic code number and rating. The maximum rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis."

Under Diseases of the Cranial Nerves:

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=eb8a0bacddaf91ae72fee1d0e3a44e53&mc=true&n=sp38.1.4.b&r=SUBPART&ty=HTML#se38.1.4_1124a

But we need more info- do you receive now a VA rating for "the radicular groups"you mentioned?

 

[Force Lima]

Hello and Thank you Ma'am

Yes i am rated neuropathy of the left shoulder, with C5- T1 radiculopathy 30%
 

I was asking because the statement of the case the DRO acknowledges that it is the full upper extremity but the rating still only shows L.shoulder.  I was wondering if it would all (L.hand, L. Arm and L.Shoulder) be under one rating or separate ratings for L. arm and L. Shoulder?

Current SC's are 

Syringomyelia Minimum 30% 

everything here is listed as residual of the Syringomyelia

neuropathy of the left shoulder, with C5- T1 radiculopathy 30%

degenerative joint disease, cervical spine, residual of decompression surgery 20%

migraine headaches 30%

depressive disorder 70%

L5-S1 disc bulge and protrusion 20%

sciatic neuralgia, right lower extremity 10%

sciatic neuralgia, left lower extremity 10%

residual scar, status post decompression surgery 10%

scars, posterior trunk, status post spinal stimuli implant 0%

Total 90% but I just received TDIU P&T back dated to 2009

I asked this question before i knew i recieved TDIU, but I am still interested in any information offered.

Thank you 

 

 

Edited September 25, 2019 by Force Lima

[Berta]

I know we have others here with more expertise on radiculopathy claims, than I have, but this might help you:

.https://www.bva.va.gov/

At the right hand of this site ( Board of Veterans Appeals) you can click on decisions, and by putting the key words into the search area, you might find something to help. The most rcent decisions are the best ones to read, as sometimes, regulations change i the older decisions.

14 hours ago, Force Lima said:

Total 90% but I just received TDIU P&T back dated to 2009

I asked this question before i k

Did this rating trigger the TDIU ?

"depressive disorder 70%" or was this a secondary rating to the Syringomyelia?

"

"Total 90% but I just received TDIU P&T back dated to 2009"

Yesterday I tried to find BVA decision on Neuritis at the BVA, plenty there but I really didnt know what I was looking for.

This is a BVA search feature you could use for Syringomyelia- I only picked bact to 2015 and there seems to be many denials, but still I am sure there are awards that might include some rating info-

https://www.index.va.gov/search/va/bva_search.jsp?QT=Syringomyelia&EW=&AT=&ET=&RPP=10&DB=2019&DB=2018&DB=2017&DB=2016&DB=2015

It does seem that many or all of the other conditions are related to this disability.

But I am always concerned about SMC-if not the 200% plus 60% criteria, there is always potential for the SMC Housebound award.

Have you applied for SSDI?

Hopefully others here with more expertise than me will chime in......

 

[Berta]

Do you have Chairi malformation?

Do your ratings seem to coincide with this BVA case? And are the diagnostic codes the same?

https://www.va.gov/vetapp16/files4/1628705.txt

"Syringomyelia is rated according to 38 C.F.R. § 4.124a, diagnostic code 8024 and a minimum 30 percent rating is warranted. 38 C.F.R. § 4.124a (2015). The diseases and residuals listed in 38 C.F.R. § 4.124a may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc. are to be especially considered and should be rated by referring to the appropriate bodily system of the rating schedule. Id. The Note to diagnostic code 8024 states: It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses. Although not binding on the Board because it is an administrative guide, the M21-1 provides further guidance on rating a similar disorder to syringomyelia, as the rating criteria are identical to those listed for multiple sclerosis under diagnostic code 8018. 38 C.F.R. § 4.124a. The M21-1 directs that, in rating cases of multiple sclerosis, the residuals are each rated separately under their appropriate diagnostic codes and then a combined rating is determined for the entire disability. If the combined rating is less than 30 percent, a 30 percent rating is assigned. See M21-1.III.iv.4.G.5.b-c. The Veteran's disability rating for syringomyelia is currently comprised of a 30 percent rating for the general disability under diagnostic code 8024 as stated; a 30 percent rating for limitation of motion of the cervical spine under 38 C.F.R. § 4.71a, diagnostic code 5290; a 30 percent rating for right upper extremity radiculitis under 38 C.F.R. § 4.124a, diagnostic code 8513; a 30 percent for dysthymic disorder under 38 C.F.R. § 4.130, diagnostic code 9433; and 10 for scars under 38 C.F.R. § 4.118, diagnostic code 7804. The Veteran currently has a combined rating of 80 percent for his service-connected disabilities."

---------------------------------------------------------

This next BVA decisions holds a grant for Special Adaptive housing:

"Review of a VA Form 26-4555 (Veteran's Application in 
Acquiring Specially Adapted Housing or Special Home 
Adaptation Grant), received by VA in April 2001 shows that 
the Veteran claimed to be unable to walk without the use of 
adaptive equipment due to his service-connection cervical 
disc disease and syringomyelia.  As part of a March 2002 
letter supplied by the Veteran's then accredited 
representative (Disabled American Veterans), the contention 
is raised that the Veteran was entitled to specially adapted 
housing due to the Veteran's syringomyelia, which destroys 
the center of the spinal cord. " 

It seems the veteran did not request SMC Housebound but only the Special Adaptive Housing-which was granted and is a great benefit.

https://www.va.gov/vetapp09/files2/0916019.txt

 

[Force Lima]

Wow thank you, for all this information.

I have days of reading ahead of me it seems.  

Yes i have been on SSDI since 2008

I do have chiari also Yes my spinal cord was damaged from the c5 to t8. (which reduced in size but the damage is already done) its still present but i cannot monitor it with mri's because  about 10 years ago VA pain clinic put in a spinal stimulator so i have not been able to monitor the syrinx with mri's, Kick my self in the butt for not doing my due diligence cause if i had i would not have accepted the implant.

the tdiu was granted for  syringomyelia as a whole. Everything is listed as secondary to syringomyelia, 

the wording in the award letter states

Medical evidence shows you have severe complications stemming from your service connected syringomyelia with chiari malformation, including but not limited to a left upper extremity neurological condition , headaches and depression. these conditions, when isolated from your nonservice-connected conditions and age, are sufficient severity as to preclude you from obtaining or maintaining substantially gainful employment.The effective date of this grant is December 7, 2009 the date service connection was established for your complications of syringomyelia with chiari malformation, which is also the date you first met the disability percentage for this benefit. (38CFR 3.400) This follows as your TDIU claim is considered part and parcel of your appeal for increased evaluation for your complications of syringomyelia with chiari malformation. 

 

I am now headed to bury myself in BVA decision.

Thank you so much for all your help Ms Berta,

I am truely grateful. 

[Berta]

Thank YOU! for being willing to go through those links-much of what I have learned about claims is by reading BVA decisions- whether awards or denials.

This claim under a Chiari malfomation syringomyelia is on remand for some stuff but the veteran was rated for a shunt:

A 30 percent rating for a disfiguring scar of the neck associated with Chiari malformation with syringomyelia and residuals of a posterior fossa decompression and syringo subarachnoid shunt of the spinal cord is granted since May 17, 2010.

https://www.va.gov/vetapp18/files6/18112273.txt

 

A rating in excess of 10 percent for two stable, but painful, scars associated with Chiari malformation with syringomyelia and residuals of a posterior fossa decompression and syringo subarachnoid shunt of the spinal cord is denied since May 17, 2010.

A 60 percent rating for right upper extremity radiculitis associated with Chiari malformation with syringomyelia and residuals of a posterior fossa decompression and syringo subarachnoid shunt of the spinal cord is granted since May 17, 2010.

A rating in excess of 30 percent under 38 C.F.R. § 4.124a, Diagnostic Code 8024, for Chiari malformation with syringomyelia and residuals of a posterior fossa decompression and syringo subarachnoid shunt of the spinal cord since May 17, 2010, is denied.

https://www.va.gov/vetapp18/files6/18112273.txt

 

4.  The criteria for a rating of 60 percent, since May 17, 2010, for right upper extremity radiculitis have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.321, 3.326(a), 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.124a, Diagnostic Code 8513 (2017); M21 1.III.iv.4.N.5.b

This claim under a Chiari malfomation syringomyelia is on remand for some stuff but the veteran was rated for a shunt:

A 30 percent rating for a disfiguring scar of the neck associated with Chiari malformation with syringomyelia and residuals of a posterior fossa decompression and syringo subarachnoid shunt of the spinal cord is granted since May 17, 2010.

https://www.va.gov/vetapp18/files6/18112273

It is a confusing read- but nevertheless- the shunt- would that be similar to your status post spinal stimuli implant 0%. Obviously I sure do not have MD after my name.

I have been reading BVA decisions since they first came on line, and their awards as well as their denials contain a wealth of info. That has helped me to succeed in many claims.

I had a BVA decision that was rendered Moot long ago because I had won that claim at the RO level and never knew I should have withdrawn the appeal.

But the BVA made a statement in that decision, that completely supported a re- open of my claim in 2003.

My RO cannot read and ignored the BVA statement-but that's OK - I won it anyhow.   After a Royal battle with the RO.

Our Motto Knowledge is Power here is SO TRUE.

It can be a pain in the butt to sit for hours seeking info at  the BVA, the BVA or CAVC etc etc but that pain goes away fast when it helps us to get a proper award. The BVA and the CAVC can read . They are lawyers and LOVE evidence.

 

 

 

 

 

 

Edited September 25, 2019 by Berta