Important Topics - Please Review This Thread.

[Tbird]

when you make a post that may be a possible trigger for folks dealing with depression, ptsd, mst, etc,

can you add the words Possible Trigger to the post topic

thanks

[Tbird]

this poll was requested by rsg and he was kind enough to provide the following links for further information

http://www.atsdr.cdc.gov/HAC/pha/treasure/tre_toc.html

http://www.scorecard.org/env-releases/land...1170090087#maps

http://www.scorecard.org/env-releases/land...id=CA1170090087

http://www.sfweekly.com/2006-05-24/news/toxic-acres/

http://www.envirostor.dtsc.ca.gov/public/p...bal_id=38370044

http://www.sfweekly.com/2007-02-21/news/dig-this/

[rentalguy1]

Since there are so many claims for spinal conditions, I'm making an attempt to put everything in one thread. Tbird...could possibly pin this so it can be easily found?

Here are the rating codes/criteria found in 38 CFR 4.71(a):

The Spine

Rating

General Rating Formula for Diseases and Injuries of the Spine

(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating

Intervertebral Disc Syndrome Based on Incapacitating Episodes):

With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease

Unfavorable ankylosis of the entire spine 100

Unfavorable ankylosis of the entire thoracolumbar spine 50

Unfavorable ankylosis of the entire cervical spine; or, forward flexion

of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of

the entire thoracolumbar spine 40

Forward flexion of the cervical spine 15 degrees or less; or, favorable

ankylosis of the entire cervical spine 30

Forward flexion of the thoracolumbar spine greater than 30 degrees but not

greater than 60 degrees; or, forward flexion of the cervical spine greater

than 15 degrees but not greater than 30 degrees; or, the combined range of

motion of the thoracolumbar spine not greater than 120 degrees; or, the

combined range of motion of the cervical spine not greater than 170 degrees;

or, muscle spasm or guarding severe enough to result in an abnormal gait

or abnormal spinal contour such as scoliosis, reversed lordosis, or

abnormal kyphosis 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not

greater than 85 degrees; or, forward flexion of the cervical spine greater than

30 degrees but not greater than 40 degrees; or, combined range of motion of

the thoracolumbar spine greater than 120 degrees but not greater than 235

degrees; or, combined range of motion of the cervical spine greater than

170 degrees but not greater than 335 degrees; or, muscle spasm, guarding,

or localized tenderness not resulting in abnormal gait or abnormal spinal

contour; or, vertebral body fracture with loss of 50 percent or more of the

height 10

Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.

Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.

Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner

[rentalguy1]

Here is the "interim criteria" that was used from about 2001-2003. If I can find the old criteria, I will post it as well.

From 67 FR 54349:

THE SPINE

Rating

* * * * *

5293 Intervertebral disc syndrome:

Evaluate intervertebral disc syndrome

(preoperatively or postoperatively)

either on the total

duration of incapacitating episodes

over the past 12 months

or by combining under

[rentalguy1]

The 2002 VA Training Letter on IVDS:

Ronald J. Henke, Director

Compensation and Pension Service

Enclosure

Training Letter for Intervertebral Disc Syndrome

1. What is Intervertebral Disc Syndrome (IVDS)?

Definition: IVDS is a group of signs and symptoms resulting from displacement of an intervertebral disc or disc fragments at any level of the spine. There are usually pain and other signs and symptoms at or near the site of the disc, and there may be pain referred to more remote areas, plus neurologic abnormalities due to irritation or pressure on adjacent nerves or nerve roots.

Other names: IVDS may also be referred to as slipped, herniated, ruptured, prolapsed, bulging, or protruded disc, degenerative disc disease (DDD), sciatica, discogenic pain syndrome, herniated nucleus pulposus, pinched nerve, etc. There may be some differences, but these terms are not well-defined and are often used interchangeably.

Components: IVDS commonly includes back pain and sciatica (pain along the course of the sciatic nerve) in the case of lumbar disc disease, and neck plus arm or hand pain in the case of cervical disc disease. It may also include scoliosis, paravertebral muscle spasm, limitation of motion of the spine, tenderness over the spine, limitation of straight leg raising, and neurologic findings corresponding to the level of the disc. If the disc compresses the cauda equina (the collection of nerve roots extending from the lower end of the spinal cord), bowel or bladder sphincter functions or sexual function may also be affected.

Frequency of location:

[rentalguy1]

From the C&P Service Clinician's Guide:

<H2 style="MARGIN: 12pt 0in 3pt">11.1 What are the basic elements of a musculoskeletal examination for disability evaluation purposes?</H2>

a. Initial examination: Follow the specific worksheet(s) for the area(s) to be examined. This chapter supplements the following examination worksheets: BONES (FRACTURES AND BONE DISEASE); FIBROMYALGIA; RESIDUALS OF AMPUTATIONS; JOINTS (SHOULDER, ELBOW, WRIST, HIP, KNEE AND ANKLE); HAND, THUMB AND FINGERS; FEET; SPINE (CERVICAL, THORACIC AND LUMBAR); AND MUSCLES.

b. Review/follow-up examination: Only an interval history covering the period since the last examination is needed. In addition, no diagnostic studies are needed on a review examination if the diagnosis has been previously well established. Otherwise, follow the specific worksheet for the area to be examined.

<H2 style="MARGIN: 12pt 0in 3pt">[url=http://]11.2 What are the important factors in range-of-motion testing?</H2>

a. Accurate assessment of joint range-of-motion (ROM) is extremely important. See worksheets for standardized descriptions of