tdiu Va: Mri Lumbar Spine=small Osteophytes

[3 years to retire]

Hello

I went to my VA dr. who sent me in for a MRI for my lower back. ("56y/o man with chronic low back pain he has a mass in left sacroiliac region..)

The MRI report :

Small osteophytes are present anterior to the spine at all levels from L1 through L5. No other bone or disc admormality noted. There is no evidence of foraminal or spinal stenosis.

Impression: Small osteophytes anterior to the lumbar spine as described above>

So what I have found in research is that the osteophytes are bone spurs:

bone spurs usually occur as the result of a disease or condition - most commonly osteoarthritis

bone spurs form in places where they might rub against other bones or push against nerves causing pain and disability.

My questions are:

since the report stated that there was no evidence of foraminal or spinal stenosis, can someone explain to me what that means?

Also, there was no mention of arthritis in this report. Which is what I feel is the cause of the bone spurs. I have both knees with arthritis (va connected) now.

Also, how should I proceed, can this lead up to unemployability (100%) since I am ready to retire in 9 months, it would be very helpful to be raised to 100%. I am currently at 40%, on both of my knees?

Thanks...

[Berta]

You will need medical evidence that either can associate these conditions as secondary to your 40 % SC disability, or a nexus to these additional problems that is in your SMRs, showing inservice

documentation of these problems.

If the above two scenarios aren't feasible-to use in a claim-the evidence of the back condition- not in SMRs-and/or no connection to your knees, then you will need a strong medical statement with full medical rationale from a doctor with the expertise to opine on service connection of the spinal problems.

You would need a C & P exam but then again that exam might well not be able to establish the nexus to your service.

"Also, how should I proceed, can this lead up to unemployability (100%) since I am ready to retire in 9 months, it would be very helpful to be raised to 100%"

The only way I foresee this possibly leading to 100% is that medical evidence establishes this as service connected with an inservice nexus and that it is rated properly-but that is only part of this---

Even then 100% criteria can be found with a search here at hadit and there are numerous areas of consideration involving 100%-

the fact that a vet is unemployed or might become unemployed-and should be service connected as unemployable depends on the SC disabilities and their affect on the vets ability to be employed-which also is solely determined by medical evidence showing the vet is unemployable to due service connected disabilities.

All of these regs are found within 38 CFR 4.16 et al

Edited March 11, 2007 by Berta

[Vike17]

3 years,

As Berta said, you'll need to either have medical evidence that your service-connected knees have somehow caused your lower back problems, or there will need to be some sort of medical evidence in your SMR's showing your back warrants service-connection on a direct basis. If you think your back condition was caused by your knees (Abnormal gait), you'll need a IMO to connect the two. I would talk to my doctor about that. Also if some sort of back problems were noted in your SMR's, but you haven't been seen since your discharge, you'll also need a IMO to connect the two to each other.

The lower back is rated on range of motion (how far you can bend over), or if you have IVDS, it is rated on incapacitating episodes. For IVDS, the VA will assign the rating that results in the higheest percentage over all.

As far as spinal stenosis, this is a condition that normally shows up in the later stages of Degenerative Disc Disease or in the elderly. It's a sign of Digerenative Disc Disease in it's later stages.

From a post of yours in Sept. 2005, you stated you applied for IU. What happened to that, were you denied because you're working? I ask this because you made a reference to that again. IU will only be granted if you can not obtain and maintain a gainful occupation due to service-connected disabilities. Just the mere fact the you are getting ready to retire because of legth of time on the job, does not warrant IU. Now, if you are forced to retire due to a service-connected disability, then that's an entirely different situation. Furthermore, as I think someone pointed out to you some time ago, you'll need to think about the two retirement option you have as far as receiving VA disability and retirement from OWCP.

Vike 17

Edited March 11, 2007 by Vike17

[Guest jangrin]

You said,

So what I have found in research is that the osteophytes are bone spurs:

bone spurs usually occur as the result of a disease or condition - most commonly osteoarthritis

bone spurs form in places where they might rub against other bones or push against nerves causing pain and disability.

My questions are:

since the report stated that there was no evidence of foraminal or spinal stenosis, can someone explain to me what that means?

Also, there was no mention of arthritis in this report. Which is what I feel is the cause of the bone spurs. I have both knees with arthritis (va connected) now.

Also, how should I proceed, can this lead up to unemployability (100%) since I am ready to retire in 9 months, it would be very helpful to be raised to 100%. I am currently at 40%, on both of my knees?

Thanks...

Edited March 11, 2007 by jangrin

[3 years to retire]

From a post of yours in Sept. 2005, you stated you applied for IU. What happened to that, were you denied because you're working? I ask this because you made a reference to that again. IU will only be granted if you can not obtain and maintain a gainful occupation due to service-connected disabilities. Just the mere fact the you are getting ready to retire because of legth of time on the job, does not warrant IU. Now, if you are forced to retire due to a service-connected disability, then that's an entirely different situation. Furthermore, as I think someone pointed out to you some time ago, you'll need to think about the two retirement option you have as far as receiving VA disability and retirement from OWCP.

Vike 17

[sixthscents]

OK, Vike and all the rest have pretty much laid this out, but I'd like to reinforce a few points:

The MRI showing "Small osteophytes are present anterior to the spine at all levels from L1 through L5", is actually really common, but since no disc space narrowing was noted, the osteophytes are not interfearing yet with the spinal canal, or impinging on any nerves that were obsrved.

So, how can you develop your claim from this point. Well, a diagnosis of degenerative disk disease would be a good starting point. For you claim to be workable you have to have a diagnosis... so far you have shown evidence, but no formal diagnosis of anything in relation to your back... did I miss something?

OK so 1.. go to an Orthopedic doc and get a diagnosis based on this MRI, or a get your VA doc to make one.

Something that caught my eye..

56y/o man with chronic low back pain he has a mass in left sacroiliac region.

Mass? - could you give some more information on that please... I did not see anyhting in the MRI to explain that.

OK, now 2... service connection - you will have to link your back diagnosis to an exsisting service connected injury - i.e. Vikes comment about gait... basically if you have an injury in a major joint of the leg, which causes weight to be thrown on a higher joint, and that joint then has problems, it can be seen to be service-connected as well but you will need an opinion staing that it is at least as likely as not that your back problems were caused by you irregular gait... (by the way this applies from the ankle to the lumbar spine... no higher)... or you will have to show some sort of injury which occured during service that could have caused your yet undiagnosed back problem.

and 3... you will need something which proves the extent or impact of the injury... to whit, a range of motion test showing how it affect you, or under IVDS (intra Vertebrate Disk Syndrome) the number of days in the last 12 months you were uncapacitated CFR 38 4.71 ... (a) I think? for defintion if incapacitated. I doubt you'll get far under IVDS if you were working and are working... but its worthy of mention

Personally at this point I would suggest a referral to Ortho, and work your claim from there since... unless I missed something... there has been no diagnosis of injury...

While IU is nice... well, I'm NOT going to comment what I think there... just get a referral and get a diagnosis, thats the place to start.

[3 years to retire]

Thanks for all of the comments.

I notified my Insurance and requested a list of Orth. doctors located in my area that I can make contact with.

Once I get an appointment, I plan on taking the MRI report from the VA and explaining to the Dr. that I need an opinion on what cause the bone spurs and if in his/her opinion is it connected to my left knee injury. If I get a postive report then I will move on to the next step of filing a claim and requesting the Va to review my claim with supportive evdence.

If I do not care for the report I plan on choosing another dr and doing the same as the first.

As for the mass in left sacroiliac region, I will also ask both the VA doctor and any private dr. I see, to check futher.

Thanks again.