Looking for Accurate Information - Joint Pain / Radiculopathy

[KMac1181]

Hello,

Please forgive me if this is not the correct location; I'm admittedly a bit lost in navigating the forums.  I discovered this site during hours of Googling and Reddit perusing, but still have not found what I'm looking for.

The first item I have a question about is how the VA *actually* rates shoulder pain, when there is no LOM.  Based on what I've read, the VA will grant the veteran the minimum compensation for a specific joint, but how do you determine the DC or minimum rating?  If it's painful to laterally raise your arms both in front of you and out to the side, but you have essentially full ROM still, how will the VA actually rate that?  Is the minimum per side for shoulders 10% or 20%?  The internet is full of conflicting information, and the VA's documentation doesn't specify this exact question (or I'm just an idiot).

The second question I have is IRT a DBQ for lumbar radiculopathy.  In this case, the VA's Rating Schedule is ambiguous; terms like "mild", "moderate", and "severe" are on the DBQ, but the schedule of ratings does nothing to expound on what symptoms classify each descriptor.  Will the VA rate radiculopathy based on the boxes that are checked in the DBQ?  If the Veteran's Peripheral Nerves Conditions DBQ has all symptoms checked as "Moderate" and "Incomplete Paralysis", will the VA actually award a 20% rating for each side?

Finally, on the same Peripheral Nerves Conditions DBQ, does the VA assign ratings for each nerve group that is affected?  If both the Sciatic nerve and Femoral Nerve are marked as having "Moderate incomplete paralysis", will each nerve receive it's own rating, or are they bunched together as mental health conditions?

Please forgive the lack of brevity.  I'm currently going through a MEDBOARD with 21 years of active service, and I want to have the most accurate information moving forward in the event I need to appeal.  These specific outcomes will likely be the determining factor in whether I receive a 90% overall rating vs. a 100% rating, so I'm really stressing it.  I'm hoping one of them is actually 20% per side.

Any and all insight on the above questions is *greatly* appreciated.  Thank you for your time,

Shaun

[broncovet]

Welcome to hadit.  Generally, "before" I suggest someone "try to figure out what their rating would be", they get things IN THE RIGHT ORDER.  That is, first is the question of Service connection or no.  Its a terrible idea to skip this part.  I did, and it was a bad idea.  

To determine if a condition is SC, check to see if all 3 Caluza elements are met:  Current diagnosis, in service event and nexus.  

NOW, you can begin trying to figure out a possible percentage, but your percentage wont matter if you are not service connected.  You have to start over.  

Lets say you did your homework and you have your Caluza elements, and maybe already awarded SC, and are either seeking an increase or you are pretty sure you will be sc.  

"Shoulder pain" is "probably not" a diagnosis.  Its probably a symptom of one or more shoulder injuries.  I have no idea which diagnosis yours is, but you may be able to look it up on your medical records.  

To determine the rating criteria, we would need to know the diganosis.  

[KMac1181]

48 minutes ago, broncovet said:

Welcome to hadit.  Generally, "before" I suggest someone "try to figure out what their rating would be", they get things IN THE RIGHT ORDER.  That is, first is the question of Service connection or no.  Its a terrible idea to skip this part.  I did, and it was a bad idea.  

To determine if a condition is SC, check to see if all 3 Caluza elements are met:  Current diagnosis, in service event and nexus.  

NOW, you can begin trying to figure out a possible percentage, but your percentage wont matter if you are not service connected.  You have to start over.  

Lets say you did your homework and you have your Caluza elements, and maybe already awarded SC, and are either seeking an increase or you are pretty sure you will be sc.  

"Shoulder pain" is "probably not" a diagnosis.  Its probably a symptom of one or more shoulder injuries.  I have no idea which diagnosis yours is, but you may be able to look it up on your medical records.  

To determine the rating criteria, we would need to know the diganosis.  

Hi Broncovet,

 

Thank you for the reply.  As far as service connection goes, everything I'm in the process of claiming is in my medial record.  In fact, when I filled out the 21-526EZ form and submitted it to my MSC, I copied/pasted everything directly from my record into the form, so there was no room for ambiguity, at least, in theory.

With that said, these are all initial claims; I have no VA rating whatsoever, in the process of waiting for my MEDBOARD results to come back, hopefully in the next 2 months or so.

For the radiculopathy, I know it stems from having pinched nerves in my lower back.  I have several issues that are diagnosed in my lower back (DDD, spinal stenosis, others).  XRays and MRIs confirm this, and the Doc who did my C&P exam also noted in the DBQ that evidence is in my record.  He then marked the boxes as I explained in the OP, as "Moderate" and "Incomplete Paralysis" for both Sciatic nerve and Femoral nerve.  I just don't know if the VA actually goes by their own black-and-white rating schedule, that a 'moderate' radiculopathy is good for 20% per side.

For my shoulders, it was the same Doc, and on that DBQ he checked two boxes on there that I had been diagnosed with "shoulder strain" as well as "rotator cuff tendonitis", in both shoulders for each issue.  I don't recall ever receiving official diagnoses for either of those, but that's what's on the DBQ.  My medical record does have instances of me bringing up shoulder pain over several years.  And then again, I'm trying to determine what the minimum rating would be for 'painful joints' as it pertains to shoulders.  Some say it's 10%, others say it's 20%.

Again, thank you for the reply, and for any further insight!

Shaun

 

[Rattler]

Have you been MEB / PEB? If you are still awaiting discharge some of that will play into your ratings. I have some of the same shoulder issues ou have but only on one side. (left)

An orthopedic surgeon diagnosed it as shoulder impingement.  When the VA rated me at 20% for that.

[KMac1181]

13 minutes ago, Rattler said:

Have you been MEB / PEB? If you are still awaiting discharge some of that will play into your ratings. I have some of the same shoulder issues ou have but only on one side. (left)

An orthopedic surgeon diagnosed it as shoulder impingement.  When the VA rated me at 20% for that.

Hey Rattler,

Thank you for the reply and information.  Yes, I am currently going through the MEDBOARD process.  All of my C&P exams are complete, and my PEBLO gave me copies of each of them about a week ago. 

Shaun

[broncovet]

Once service connected, if you get SC, then your ratings will normally be based on symptoms.  Specifically, the rating system is designed to compensate you for functional loss.  Since I dont know what/if you have as a functional loss, I cant begin to guess a rating.  

Example:  Let say you are diagnosed with, and service connected for DDD.  

Here are some of the ratings related to skeletal disorders:

https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFRd3005f7d828ea7b/section-4.71a

[KMac1181]

2 hours ago, broncovet said:

Once service connected, if you get SC, then your ratings will normally be based on symptoms.  Specifically, the rating system is designed to compensate you for functional loss.  Since I dont know what/if you have as a functional loss, I cant begin to guess a rating.  

Example:  Let say you are diagnosed with, and service connected for DDD.  

Here are some of the ratings related to skeletal disorders:

https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFRd3005f7d828ea7b/section-4.71a

Hey Broncovet,

Yep, I'm somewhat familiar with the VA'a rating schedule.  I did read over them, which is actually what ultimately brought me here.  

Just wondering if the VA actually uses its own documentation.  Since the radiculopathy rating schedule shows percentages for arbitrary symptoms "Mild/Moderate/Severe."

^^^ Those aren't very concise.  So on a DBQ, if the C&P doc checks boxes for "Moderate", does the VA give it a "moderate" rating?  Or are the boxes on DBQ's irrelevant?

And I haven't been able to figure out if each impacted nerve group gets its own rating.  

 

Shaun