Chronic Pain

[Ken Dillon]

I have the following disability's 40% ivds, 20% RT foot drop, 20% Rt lower radiculopathy, 10 % lower radiculopathy and a few other for total of 80%. Ever since I had my last surgery for lumbar fusion I have nothing but chronic pain in my back, legs and hips. Does the above percentages cover the pain, of is Chronic Pain something different to put in for.  I have tried drug therapy, acupuncture, physical therapy, and chiropractor. Still no relief, this has been going on for two years no since surgery.  Thanks for all inputs. Ken

[Chuck Haven]

Chronic pain is subjective for sure - tough to diagnose and treat.

I would consider seeing a doctor for fibromyalgia.  If you served in Southwest Asia this disability is presumptive.  Max rating is 40% under diagnostic code 5025.  Requires a rheumatologist diagnosis.  Do your homework on the disease and symptoms before seeing the doctor.  Then you can have a productive discussion.... 

[Vync]

On 8/5/2022 at 10:11 PM, Dustoff 11 said:

If I recall correctly constant severe chronic pain can be used to request an increase in the vet's service connected condition. They ruled that VA raters could not ignore the issue of chronic pain in claim decisions.

Correct! The Saunders v. Wilkie (2018) decision by the US Court of Appeals forced the VA to recognize chronic pain.

https://cck-law.com/blog/chronic-pain-va-disability-benefits/#:~:text=VA can now award service,cause functional impairment or loss.

Prior to the decision, the VA required the traditional Caluza elements. This changed things especially in cases where chronic pain does not have a specific diagnosis. They still require it to be connected to an event or symptom while on active duty, plus it must cause functional impairment or loss.

Here's the VA's "interpretation" of it:

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000090796/Saunders-v.-Wilkie,-Apr-3,-2018,-886-F.-3d-1356-(Fed.-Cir.-2018)

 

On a side note, I submitted a number of musculoskeletal claims related to numerous injuries in the service when I got out in the 90s. All the VA did was perform ROM evaluation and testing, note that pain appeared to be present, and did x-rays which came back normal (because they don't show soft tissue issues). Of course, they denied all of them. Although this ruling was from 2018, it stinks that is cannot be used to retroactively apply to the denials from the 90s.

[pacmanx1]

43 minutes ago, Chuck Haven said:

Chronic pain is subjective for sure - tough to diagnose and treat.

I would consider seeing a doctor for fibromyalgia.  If you served in Southwest Asia this disability is presumptive.  Max rating is 40% under diagnostic code 5025.  Requires a rheumatologist diagnosis.  Do your homework on the disease and symptoms before seeing the doctor.  Then you can have a productive discussion.... 

Fibromyalgia is a catch all disorder that can be caused by different situations not just serving in the Gulf War (Southwest Asia arena). I never served in the Southwest Asia arena, and I am service connected for fibromyalgia. Fibromyalgia can be caused by injuries to the spine or emotional problems. Fibromyalgia can also be secondary to a service-connected spine injury.  You would just need a diagnosis and a medical opinion that your fibromyalgia is as least likely as not caused by or results of your already service-connected disorder with a good medical rationale. Treatment and diagnosis normally come from being monitored (treated) by a Rheumatologist and or a Neurologist over a few months.

Fibromyalgia: Possible Causes and Risk Factors (webmd.com)

[deedub75]

People suffering from chronic pain usually suffer from depression due to the chronic pain. I've seen a lot of veterans successfully apply for depression secondary to chronic pain caused by service connected disabilities. 

Have you tried pregabalin. I have the same back issues and radiculopathy and it seems to work for me. 

[El Train]

5 hours ago, pacmanx1 said:

Fibromyalgia is a catch all disorder that can be caused by different situations not just serving in the Gulf War (Southwest Asia arena). I never served in the Southwest Asia arena, and I am service connected for fibromyalgia. Fibromyalgia can be caused by injuries to the spine or emotional problems. Fibromyalgia can also be secondary to a service-connected spine injury.  You would just need a diagnosis and a medical opinion that your fibromyalgia is as least likely as not caused by or results of your already service-connected disorder with a good medical rationale. Treatment and diagnosis normally come from being monitored (treated) by a Rheumatologist and or a Neurologist over a few months.

Fibromyalgia: Possible Causes and Risk Factors (webmd.com)

Indeed.  I had an accident in service which resulted in neck and spine pain since it happened.  They denied my spine/neck claims but approved Fibro at 40% (GW presumptive).  Pretty sure they just exchanged one for the other.  Doubt I would've got got 20% for neck and spine claim.  I didn't save treatment records for it after I got out.  Put in a claim 25 years after I got out.  So it was denied based on lack of treatment records when I got out and age.  Could I fight it and win? Yes.  I have Nexus letters (from an MD who has trained C&P examiners in the past) for the neck/spine & Fibro.  I'll leave well enough alone since I'm 100% P&T with SMC-S.  I do get Chiro & massage for the spine issues.  

 

[john999]

VA so under treats pain!  They claim it is subjective so hard to rate.  PTSD is subjective but they manage to treat and rate that.  Early on the VA just dropped a boat load of dope on those suffering pain. Now they don't want to prescribe at all for a bunch of reasons.  It is true that narcotics just be constantly adjusted but that is the job of the VA doctors.  Now if you complain that your pain meds no longer work the VA sees that as an opportunity to just cut your current dose.  They offer almost nothing in return.  This is malpractice IMO.  They are forcing vets to look elsewhere for pain relief such as medical pot or street drugs.  They then come down on you and refuse to prescribe for you.  The VA mixes politics with medicine and politics always wins.  They are deathly afraid of the DEA and would rather see a patient die or commit suicide than stick their necks out one inch.