Lumber Secondary Condition to thorasic.

[USMCVMO]

Hello fellow Vets!   I am currently at 70% rating total.  Last updated in 2020. 

T10-T12 – Disc herniation – 20%

Lower left radiculopathy – 20%

Right lower extremity – 20%

Depressive disorder (secondary to back pain) – 30%

I have some questions.  I continue to get worse back pain and its becoming increasing more difficult to sit for any period of time to do my day job. I also have developed lumbar disc problems now.   I had once read that spinal issues can be connected. 

1.  Would it be worthwhile to submit a claim for the lumbar as secondary?   Any advice on how to be successful?
2.  Any advice on if my current rated conditions could be increased to 100.  What would the VA look for to make such a increase for those conditions. 

Edited June 17, 2022 by USMCVMO
typo

[GBArmy]

I'm not a doctor, neither are you. In order to win a secondary condition to an already s-c disability. you of course need a current diagnosis of the new disability. Also, you would need a nexus or connection made by a doctor that "X" is caused by your s-c disability. If you can get your current doctor to provide a dbq for the new condition, great. Most importantly, you need that medical diagnosis that it is connected. If you can't get your doctor to provide, you're going to have to get an outside med opinion. Cost to you any ware from free to $1000 or more. But you NEED the nexus. Think of it as an investment.  As for your current conditions being increased, pull up the diagnostic codes and dbq's for radiculopathy, etc. and do a honest self eval as to what your current symptoms are compared to the requirements for increased levels. if they are worse, you need to get a current diagnosis of the worsen conditions, think new dbq if you go outside for the diagnosis. No nexus would be required as it is already s-c. Do this for all your existing disabilities and be especially attentive to MH depression symptoms, as it may be your best option.

[Vync]

@USMCVMO

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 Would it be worthwhile to submit a claim for the lumbar as secondary?   Any advice on how to be successful?

I might be wrong because I have not checked the rating criteria yet, but I believe the VA may still consider the thoracic/lumbar/sacral regions as a single segment (which is ridiculous). The cervical is a separate segment and can be SC separate from lumbar. Because thoracic/lumbar/sacral are considered a single segment -and- you are currently SC for the segment, if any vertebrae within the segment become worse, consider checking the rating criteria and determine if it might be worth requesting an increase. If you have medical records from the preceding 12 months showing this, the VA can backdate the increase. You can also consider filing for side effects of meds used to treat your SC conditions. For example, NSAIDs are not good for the stomach or heard, MH meds can tank out libido, etc... 

 

Quote

 Any advice on if my current rated conditions could be increased to 100.  What would the VA look for to make such a increase for those conditions. 

Same deal I just described. Check the rating criteria and then your medical records. See if anything meets requirements for a higher rating %.

 

To add to @GBArmy 's response, sometimes you can be fortunate enough to get your treating doc to handle the nexus. I had a non-VA neurosurgeon who was treating me write a nexus for the mere cost of  my private insurance co-pay. Just keep in mind that many non-VA docs may be hesitant to do this for various reasons, with the most likely reason being they are just too busy.
  However, the VA has become more picky over the years and seems to shun non-VA nexus' by making them jump through extra hoops like stating they have reviewed your medical records.

 

I linked a couple of my blog posts which might be able to help. Please keep in mind these are a couple of years old, so you might need to double-check the referenced laws/regs/ratings because they may have changed. Should be a good start for you.

 

 

[Richard1954]

I have been rated 60%  for lower DDD ( L3-L4, L4-L5,L5-S1) , since 1999, and the VA then awarded me TDIU,  because civil serviced forced me into a medical retirement, from a GS position.   I have a lot of problems with my lower back, sciatica problems (both sides now) and drop foot.  I have considered trying to get a new rating from the VA for this condition, but when I read the requirements for a 60% rating, ( prescribed bed rest), I am reluctant to file. 

Also in 1999, sciatica was rated along with the dropfoot as part and parcal of  the back injury, we didn't get sepaate ratings. I have no doubt that I could get separate  ratings for my back, dropfoot and sciatica but a single 60% rating is better than 3 or 4 20% ratings when it comes to benefits, also my 60% rating in addition  to my 100% rating gave me a half step up in A&A. and I am not going to take a chance on messing with that.

Vync is correct the VA screwed up when they rewrote the rules and now the court says that the  thoracic/lumbar/sacral have to be rated as one. I don't understand that either, but it has something to do with the wording in the new ratings. ( I say new ratings, but they actually go back a few years now). Even if the segements are rated as one, its possible you could still get an increased rating.

You may benefit from a increase rating, I simply can't say. I agree that you need to read the requirements of the ratings, consider how you condition might be ratred  and if you think you could benefit take a stab at a new claim.  You were rated in 2000, so you will be rated under the same guidelines.

 

 

Edited June 17, 2022 by Richard1954

[Vync]

@Richard1954And the way the spine ratings are designed, they completely fail to take into account the impact that even a single damaged vertebral segment can have, let alone multiple. I believe the IVDS factors may still be based on doctor-prescribed bedrest without any regard to self-care options.

[Richard1954]

On 6/17/2022 at 9:43 AM, Vync said:

I believe the IVDS factors may still be based on doctor-prescribed bedrest

100% correct

[USMCVMO]

8 hours ago, Richard1954 said:

100% correct

This one is a little challenging for me.   I am fortunate enough to have a home based job that requires just a laptop and phone.   I often work from my inclined bed when I get my flare ups or blow my back out which happens every couple of months. If I go to the doctor they just give me more pills and tell me to take it easy which I am already doing.   I don't get much benefit from MDs.   I go to the chiropractor at least once a week , sometimes twice and it helps free me up. Does the VA value a chiropractors bedrest note?