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TexasVeteran

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Has anyone ever heard of any of these three codes being given separate ratings? I realize these are all rated by the range of motion, with the only exception being IDS, which can be rated by how many times you are placed on bed rest (incapacitating episodes). I'm getting a lot of conflicting information about this, as some people seem to think there are special circumstances which the VA will separate at least some of these out. But, no one can explain what those circumstances would be.

1. thoracolumbar strain (5237)    http://www.militarydisabilitymadeeasy.com/thespine.html
2. intervertebral disc syndrome (5243)
3. ankylosing spondylitis (5243)
4. degenerative arthritis (5003) http://www.militarydisabilitymadeeasy.com/diseasesofthemusculoskeletalsystem.html#a
    ^^ This is in my spine but obviously not enough to be coded 5242, degenerative arthritis of the spine

Edited by TexasVeteran
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I have never heard of the codes being rated separately. The VA combined the codes for my service connected back condition. I’m serviced connected for Lumbosacral Strain with Arthritis and Intervertebral Disc Syndrome.

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On 6/17/2020 at 9:03 PM, TexasVeteran said:

2. intervertebral disc syndrome (5243)

I am not sure how many are aware of the below stated items. I can't do physical labor and I have never been in bed for more that a day or two. Mine is rated as - 5295-5292 Degenerative Disc Disease and Spondylosis, Lumbar Spine (Previously Rated as Lumbosacral Strain).

https://cck-law.com/blog/intervertebral-disc-syndrome-ivds-and-va-disability/

It can be difficult for veterans to satisfy this rating criteria because modern medical practices no longer call for bed rest to treat IVDS. In fact, physicians have often held that such long durations of bedrest can actually do more harm for disabilities of the spine than they can help. 

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On 6/17/2020 at 9:03 PM, TexasVeteran said:

Has anyone ever heard of any of these three codes being given separate ratings? I realize these are all rated by the range of motion, with the only exception being IDS, which can be rated by how many times you are placed on bed rest (incapacitating episodes). I'm getting a lot of conflicting information about this, as some people seem to think there are special circumstances which the VA will separate at least some of these out. But, no one can explain what those circumstances would be.

1. thoracolumbar strain (5237)    http://www.militarydisabilitymadeeasy.com/thespine.html
2. intervertebral disc syndrome (5243)
3. ankylosing spondylitis (5243)
4. degenerative arthritis (5003) http://www.militarydisabilitymadeeasy.com/diseasesofthemusculoskeletalsystem.html#a
    ^^ This is in my spine but obviously not enough to be coded 5242, degenerative arthritis of the spine

This was the subject of a radio show a couple of weeks ago. IVDS is a rating they seem to be getting away from as Bed Rest is out dated. For Traumatic Arthritis the range of motion is measured and you are rated accordingly. If you have spine related issues then these are to be rated separately.  

 

At this time the VA is tinkering with the spine ratings

Take C5 for example. You had an injury to C5. You have fusion. That is based on ROM. You have nerve issues in the arm. Those issues may be rated separately based on the results of Nerve Conduction tests.

There are a lot of secondary conditions associated with the spine, especially Traumatic Arthritis. These conditions are degenerative and get worse over time.

 

 

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The VA has a responsibility to maximize your ratings.  "If" by combining these, they get a lower percentage than by rating them seperately, you can/should appeal.  Remember, however, the law is clear.  We can not be paid for the same symptom TWICE (pyramiding).  For example, if you have "back pain" you can not get paid for back pain for IDS AND AGAIN for arthritis.   To prevent pyramiding, you can seperate out the symptoms (maybe?) and check the rating schedule and see if seperate ratings, would be more than a combined rating.  

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If not rated yet,

Have a doc take a picture of your cervical spine.  If arthritic, secondary it to your lumbar.

I am 20% lumbar, 20% cervical, as they can be rated separately.  Both mine are Range of Motion.

Work on secondary's, they are a lot easier than initial (primary) claims.

Hamslice

 

Edited by Hamslice
cause I can
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