Combined on original decision, separated on SOC, now a new claim needed?

[Rivet62]

I had an original rating of 10% for DDD of my entire spine. Now on my SOC they have combined the DDD lumber and DDD thoracic as 10%, and now I just received a letter from the RO that they are asking me to file a brand new claim for cervical. It seems they want to question SC for cervical. Well the lumbar is most definitely SC, and the thoracic they SC'd because the back is the back (I carried too much weight in the service).

Why are they asking me to file a new claim for cervical? Is it to deny me SC for cervical? 

BTW, before the SOC I was at 84% actual, and now by magic I'm 82% actual. 

Edited January 29, 2022 by Rivet62

[Rivet62]

2 hours ago, Hamslice said:

So, yes, they are probably looking at rating you seperately for the c-spine, which is great.

Ok. It may not be an uphill battle. All they can do is deny it.

[ArNG11]

4 minutes ago, Rivet62 said:

I hope so. It appears they service connected it before, but for things to be correct I have to file a claim I guess.

Not sure, you have to wait unfortunately, until they make a decision.  Also you mentioned that this was service connected before???? Did you loose it? Did you actually have a rating? Was there an error? Can you clarify this a bit?

[Rivet62]

10 hours ago, ArNG11 said:

Not sure, you have to wait unfortunately, until they make a decision.  Also you mentioned that this was service connected before???? Did you loose it? Did you actually have a rating? Was there an error? Can you clarify this a bit?

Yeah in the original decision they simply called it DDD.

This is their words in the original decision:

"Service connection for degenerative disc disease (claimed scoliosis, compressed nerve C3-4, C5-6, L2, L4-5) is granted with an evaluation of 10 percent effective August 19, 2016"

Now in the SOC that's gone and it now reads:

"We have assigned a 10 percent evaluation for your thoracolumbar spine based on: 38 CFR Section 4.59 allows consideration of functional loss due to painful motion to be rated to at least the minimum compensable rating for a particular joint. Since you demonstrate painful motion of the thoracolumbar spine, the minimal compensable rating is assigned.

Additional symptom(s) include:

• Range of motion within normal limits
• X-ray evidence of arthritis"

See? Once again I'm up against the range of motion criteria of 2018. I have to respond to this somehow. Based on what my recent physical therapy observes it should be at 20% Sc'd. I don't know how to respond to this part of things.  Supplemental claim?

About the C-spine, the RO letter says file a claim. A new claim?  Hold on... I need to find the letter to state exactly what that says.

It says 

"Please submit a separate claim application for claimed cervical spine condition. VA regulations require all claims to be submitted on a standardized form.

bla bla bla... In order for us to begin processing your claim for compensation, you must complete, sign, and return VA Form 21-526EZ..."

The RO was in error to combine it all in the first place. Now it says I should file VA Form 21-526EZ for C spine. I think I'll just go ahead and file the claim without further evidence, since they granted it before.

 

Edited January 30, 2022 by Rivet62
Added quotes from VA letter for C-Spine claim submission

[ArNG11]

Something don't jive.  With those segments mentioned what I wrote about the ratings applies. Thoracic and Lumbar is one segment, c spine is an independently ratable section on its own.   Then there is nerve ratings and muscles ratings. Which all would need EMG and nerve studies.  Take it slow and steady and make sure you go over the decision thoroughly.

[Rivet62]

9 minutes ago, ArNG11 said:

Something don't jive.  With those segments mentioned what I wrote about the ratings applies. Thoracic and Lumbar is one segment, c spine is an independently ratable section on its own.   Then there is nerve ratings and muscles ratings. Which all would need EMG and nerve studies.  Take it slow and steady and make sure you go over the decision thoroughly.

I edited my comment to include VA's request for a C-spine claim submission.

[broncovet]

"If" anyone could ever answer "WHY" VA does anything, they would be prepared for the next most important question troubling mankind:  "Why do women behave as they do?"  

Of course, this is impossible to figure out, because, if we ever did figure it out, all the rules would be immediately changed.  (source: My spouse)

In either case, we need to follow the Knoxism:  "Play the hand you are dealt".  (Rather than worry about the hand you dont have. )

Thus, you have some combination of these 2 choices:

1.  Comply with VA's request.  

2.  Throw the "challenge flag"..(challenge to the last referee call).  This means filing a CUE.  

Logic suggests that, if the military service caused injury on "some parts" of your back, then the same causal effects would likely apply to other portions of the back.  Dont expect VA to "do logic", however.  The VA avoids common sense and logic like the bubonic plague.  

Edited January 30, 2022 by broncovet