Spinal fusion - do I file a new claim or request a re-evaluation of degenerative arthritis. s

[Grilla79]

Disabilities include degenerative arthritis, lumbar spine 10% and sciatica, right lower extremity 10%, both with November 2011 effective dates.  Back pain and function got progressively worse over the years, developed extreme pain and left foot drop in December 2019, had lumbar discectomy with spinal fusion L5-S1 in April 2020.  I also have documented sciatica in the left lower extremity now.  X-rays and other diagnostics taken before my retirement Nov 2011 showed all sorts of misaligned vertebrae and narrowed disk spaces.  I had been planning on requesting a re-evaluation last winter but COVID pandemic put a hold on that.  Should I file for a re-evaluation of the degenerative arthritis or file a new claim for the issues pre and post lumbar fusion.  When I do searches I usually see fusions with their own category.  I have x-rays and such while i was on active duty that show misalignment of disks and irregular disk spaces and plenty of medical notes for back pain the last 3 years of active duty.  I was basically on activity restrictions the last 3 years of my service.  Hadn't completed a fitness test in 4 years before retirement,  Also wondering if a decision on a new issue would nullify one or both of the existing back condition ratings.  My current total rating is 91.1 % and I'd hate to come out of all this with a lower rating

 

appreciate any advice, ty

[broncovet]

Excellent question!  My advice?  Do both.  Let the decision makers sort it out!  

1.  Apply for a new condition.

2.  Apply for increase. 

     Reason:  Trying to figure out "what" a VA decision maker is thinking is a crap shoot.  Dont roll the dice.  By asking for both, you should preserve your effective date "whichever way" the VA decision maker decides.  By the way, VA has thousands of decision makers, and they all have different ideas!  

[Grilla79]

Well Ok then.  Never thought of that and it was right in front of me.  since the VA separated two back/spine issues - lumbar arthritis and Right sided sciatica, i will ask for re-eval on those and do new claims for spinal fusion/ankylosis and left -sided sciatica since that happened and was documented by more civilian doctors when the L5-S1 disc blew in December.  thank you.  

 

Don

[Ken Dillon]

Hay Brother I feel your pain, I just went currently back in July this year had fusion of L4 to S1 

and I  had C@P exam in Sept still in a holding pattern waiting for decision. I have degenerative disc disease rated at 20 percent, and 10 percent each leg, plus 0 for surgery scar. As for the fusion part I can not bend at waist anymore, not that I had a lot of movement before surgery. Currently I do have a lot more pain in rt leg from surgery and foot drop, but on the up side my back pain is more manageable. I hope this help you.

Ken

[broncovet]

And, yes, its possible to get Both an increase in disability percentage (if your SC condition got worse) AND also get a new rating on a new disorder, that may or may not be secondary to your current SC condition.  

When you apply (for both) dont burn down bridges you have not crossed yet!  Apply for them both "direct" (sometimes called primary) AND secondary.  Again, let the decision maker figure it out, they will want to anyway.  

[Carl the Engineer]

Grilla,

This is too late, but maybe members reading this will learn something.  When you got rated 10% lumbar, it was from the x-ray showing arthritis.  When you got the 10%, the VA basically low-balled you, which they did to me and every other Veteran.  You, as I did probably complain of lower back pain with in service medical records to support and the VA shot an x-ray and said yep, here's your 10%, and you like me said hey that's great and went on our way.  Mine was in 2009.  Then after being on this site for a year, I figure out the money is in Range Of Motion.  So, in 2011, I asked for an increase in my lower back pain, and since 10% is all you can get for an x-ray, the VA did a ROM test, and I got 20%, which is what you and I would have had from the start if we knew about ROM testing, that and that the VA low-balls new claims.  With fused disks, I would think your ROM is very limited.

I would claim a increase for both.  And I would claim anything new as secondary to your original claims.

You have nothing to loose,

Hamslice

 

[ShuMan]

Does the pain your back cause mental anguish? If it does you could be looking at a secondary claim (if your not already service connected for mental health).