Va rating of 60%

Discussion in 'Physical Evaluation Board System Overview' started by hunting8171, Dec 27, 2008.

  1. hunting8171

    hunting8171 PEB Forum Veteran

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    Ok guys this is my first post

    I was injured in Iraq on Nov 19 ,2007, I filed my claims when I got home from Iraq, the V/A called me yesterday and told me that I got a 60% rating for. The only problem is that I have had spinal fusion on my lower back on oct 8 2008, I was faxing the DAV all my information as I would get it from the doctors. They only gave me 10% for it, the spinal fusion will put me out of the National Guard + I’m also a federal technician I will be medically retried from there too. I have never had a C&P exam on my lower back at all. I went to physical therapy they checked my ROM I have 25 to the front 25 left and 30 right 0 back. If you look at 38 CFR 4.71a I should be around 40-60% just on my back, I turned in a good LOD and all my paperwork what happened? The unit is not helping me at all on this. I called them and told them about this rating they said guess you need to have a MEB then. Just need litte info on this process. Think I need to re-open my claim some of the paper work must have not been turned in
    30 PTSD
    10 left and right knee
    10 lower back
    10 for right ear tinnitus
     
  2. robs42

    robs42 Moderator

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    welcome,

    i had the fusion in 07 and i'm still waiting on the results of my MEB.
    just keep appealing your rating no matter what. whatever you come out of the MEB w/you will get the higher of the 2.
    are you using a rep. for the VA stuff?

    along w/this type of injury comes sleep issues, depression/anxiety/PTSD. are you having any of these issues? if so that's a cause for a higher rating. also w/your claim when you do have any kind of phys. exam, tell them if you are having any kind of residual issue, like hips, upper back pain, any type of stuff that you didn't have before the injury.

    as far of the lack of support from your unit, that all too common. i found that out 1'st hand. like i said earlier, it's been 2 yrs. since my injury and my MEB was initiated in 2007. most of the time it's lack of education on their part and sometimes they just don't care, because it doesn't affect them. your doing the right thing by being proactive w/your case. you will not find a more informative site on the web then here and most of the people here are going through the same thing or have already been through it.

    if there is anything i can do to guide you in the right direction, i would be glad to. good luck!
     
  3. fdmckeever

    fdmckeever PEB Forum Veteran

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    hunting,

    Welcome to the forum. There is good news and bad news with your VA award. The good news is that you are in the system and the VA has acknowledged service connection for 4 conditions. The bad news is that your actual rating will be based on the combined VA table per link below, which will actually put you at 50%. If you have evidence, such a ROM tests from the military, then you can file a Notice of Disagrement (NOD)with the VA and present this evidence and ask for a higher rating for your back. The process to file will be explained in the official package you receive from the VA. It is important that you follow the timelines for filing a NOD. If you are using a Veterans Service Organization (VSO) to handle you claim then they can do this for you. If you have any problems getting this accomplished then change VSO's, or revoke their power of attorney and do it yourself. Although the MEB and the VA are two separate actions the MEB can establish the service connections and provide medical documentation, such a ROM measurements. When I filed my NOD in Aug of 07 it took a year and 3 additional C&P exams to prevail. But it was worth the time and effort. It will take a lot of patience but you can win. Somewhere along the line you should request you C-file from the Va regional office that is handling your claim. This will show you all the documentation the VA has on your claim, and if something is missing you can present it as new evidence. I think the VA process is complicated by design to wear you down but as Robs says, stay strong.

    FDM


    www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_25.DOC
     
  4. hunting8171

    hunting8171 PEB Forum Veteran

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    Sleep issues I have severe RLS that they gave me 0% but its service connected. I should have my letter today. I will try to post it today. Thanks for the info
     
  5. hunting8171

    hunting8171 PEB Forum Veteran

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    Listed below is a copy of my MRI that I had done. I have had a spinal fusion L5/S1 on OCT 8 2008 my file went to the rating board they only gave me 10%. I just need to regroup and fight this. I will be calling my DAV rep on Tuesday.



    Lumbar T12 –L1 minimal 1-2 mm central disc bulges are seen without significant spinal canal or neural foramina stenosis.
    L2-3 through L3-L4 mild 2mm posterior annular disc bulges are seen without significant spinal canal or neural foramina stenosis
    L4-L5 mild 3mm posterior annular bulge is seen without significant spinal canal or neural foramina stenosis
    L5-S1 central disc extrusion is seen extending approximately 6mm posterior and 4 inferior to the endplates. Combined with posterior osteophyte /disc complex, ligamentum flavum hypertrophy, and articular facet hypertrophy, this results in mild spinal canal narrowing and mild bilateral neural foraminal narrowing flattening of the anterior thecal sac is seen.

    Cervical
    C2-through C4-C5 no significant disc heriation or spinal canal stenosis is identified.
    C5-C6 small 2-3mm central disc protrusion is seen without mild spinal canal stenosis to 9mm. the disc protrusion contracts and mildly flattens the anterior spinal cord. Effacements of the subarachnoid apace is noted.
    C6-7 through C7-T1 no significant disc herniation or spinal canal stenosis identified.

    My LOD states on line one
    Review of the evidence provided for the line of duty investigation pertaing to SSG ***** with a diagnosis of : DDD DEGENERATIVE DISC CHANGES DUE TO TRAUMA has been determined in the line of duty,


    All this only 10%
     
  6. longbchdirtbag

    longbchdirtbag PEB Forum Veteran

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    I could see an appeals officer overturning it, but look at your rating decision and see what it says for your VA examination portion. Did you have one of those DOD/VA joint physicals? They had to have a VA exam to rate it or enough evidence of record to make a decision. The only way they wouldn't is if you no-showed for a exam, which doesn't seem to be the case. If the PT results were not of record they wouldn't have considered them. Look at the rating decision and than use your PT results to justify you have a higher level of functional impairment which if found to be so you would meet the 40 percent which I can guarantee will be a future examination attached to see if it gets better. If that evidence isn't strong enough to the VA they will set up an examination.

    Note: If your PT evidence was not of record it will be a re-opened claim.

    An FYI: with the new evidence of the spinal fusion you should be able to get a one to three month 100 percent for convalescence as long as you were out of active duty when you had it.

    Without what the VA said the findings were its hard to speculate. It should be the middle paragraph for that issue. If you want (your choice) summarize it and I can give a better idea.
     
  7. hunting8171

    hunting8171 PEB Forum Veteran

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    ok i have this paper work in front of me but its very hard to understand. some of the claims state srvice connection for depression with post traumatic stress disorder and insomnia is granted with an evaluation of 30% what does this mean?

    the V/A also told me that i had Asthma and they give me meds but my claim was denied

    Lumbar spine condition 10% apr 29, 2008, siad that it could go up to 20% if my thoracolumbar spine greater than 30 deg but not greater then 60% deg or the combined range of motion of the thoraclolumbar spine is not greater than 120 deg, i have been going to PT , have 25 to the front and 25 left 30 right, the V/A rated my claim with the PT notes,
    Lumbar spine condition 100% oct 2008
    Lumbar spine fusion with degenerative changes 10% apr 29, 2008
    Depression with post traumatic stress disorder and insomnia 30% apr, 2008
    Cervical stenosis with degenerative disc disease 10% apr 2008
    Retro patellar pain syndrome 10% apr 29, 2008
    Tinnitus 10% apr 29 2008
    Restless leg syndrome left 0% apr 29, 2008
    Restless leg syndrome right 0% apr 29, 2008

    For a total of 60 %
     
  8. robs42

    robs42 Moderator

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    did you apply for combat related special compensation (CRSC)?
     
  9. hunting8171

    hunting8171 PEB Forum Veteran

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    didnt know anything about that?
     
  10. longbchdirtbag

    longbchdirtbag PEB Forum Veteran

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    Ok, you are looking at the main letter that tells you what you got. There should be a thick looking legal document that was with that letter. It should have each of your claims with a number by them from 1 to however many you claimed. This is the rating decision. It has a big Veterans Affairs seal on it, your name, social, and since the DAV is your power of attorney, the DAV. Look at that and find the middle paragraph of the rating decision for your back and if you would list it. I can than tell you why you got a 10 percent. When you are looking at the rating decision look at the section that lists your lumbar or thoracolumbar spined and than look for forward flexion, left and right rotation, etc for your thoracolumbar spine. Tell me those or you might understand on your own why they gave you a ten and find ways how to strengthen your argument. Whatever they used for ROM they may say represents the overall disability picture better and thats why they gave a 10 percent.

    As for your asthma, did you have it before service or in service? Since you were in the NG if the VA hospital dxd (diagnosed) it outside of service thats probably why they denied it. We as Iraq/Afghanistan vets are entilted to five years of free healthcare, but the conditions they find during this time may or may not be service connected. If it was dxd after service you have to prove its related to your service. They could say it wasn't caused by your service. I am not sure if its a presumptive disability or not as I can't easily access a good way to view the rating schedule and 38 CFR part 3 like at work, but I'd ask your DAV service officer if it is.

    Side note: CRSC is when you apply to get both VA and retirement pay for disabilities you occurred in combat or from an instrumentality of war. You can't receive both your disability pay and your VA pay normally, but if the military finds disabilites you are service connected for occurred in combat you are eligible to get some of both as calculated by the VA and the military. Here is a link: http://www.moaa.org/serv/serv_paybe.../serv_paybenefits_compensation_crsc/index.htm

    It looks like they gave you a temporary 100 percent rating for your back? That's good for sure. As for the restless leg syndrome I doubt you will be higher than a zero, but it seems like you were rated pretty well besides your back problem. If you get me that info I can help explain it and than you can go about strengthening your case.
     
  11. hunting8171

    hunting8171 PEB Forum Veteran

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    4. Service connection for lumbar spine fuaion with degenerative changes has been granted.

    Review of your service treatment records showed no diagnosis for lumbar spine condition. However there is a line of duty determination which shows a diagnosis of degenerative disc changes due to trauma.

    A review of your private treatment records reported that back pain with MRI showing bulging discs, anterior lumbar interbody fusion, hernicorpectomy and implantation of reconstructive fusion on October 8, 2008 mild degenerative changes with mild spinal canal narrowing and low back pain with treatment requiring steroid injections.
    Your VA treatment records reported back apin with diagnostic tests showing degenerative changes in the lumber and thoracic spine.

    Service connection for lumbar spine fusion with degenerative changes has been granted with 10 percent evaluation. An evaluation of 10 percent has been assigned for painful motion of a major joint. A higher evaluation of 20 percent is not warranted unless there is forward flexion of the thoracolumbar spine greater than 30degress but not greater than 60 degrees or the combined range of motion of the thoracolumbar spine is not greater than 120 degress. A temporary 100 percent evaluation has been assigned due to surgical convalescence of a service connected disability. This evaluation will remain for three months, when an examination will be ordered to reassess your condition.

    The effective date is April 29, 2008 day after discharge, as we received your original claim within one year of separation from military service. The effective date for your temporary total evaluation is October 8, 2008 date of when your procedure took place.

    5. Service connection for cervical stenosis with degenerative disc disease has been granted.
    Review of your service treatment records showed no treatment for cervical spine.
    Review of private treatment records reported back pain with MRI showing bulging discs in the C-spine, and mild spinal canal stenosis amd mild flattening of the anterior spinal cord.

    Your VA treatment records reported back apin with mild spinal canal stenosis and minimal degenerative disc disease.
    Service connection for cervical stenosis with degenerative disc disease has been granted with a evaluation of 10 percent for painful motion of a major joint. A higher evaluation of 20 percent is assigned if there is forward flexion of the cervical spine greater than 15 degress but not greater than 30 degress, or the combined range of motion of the cervical spine is not greater than 170 degress.
     
  12. hunting8171

    hunting8171 PEB Forum Veteran

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    The only ROM testing is that of my personal physical therapist had done, the VA or military doctor never tested it. Or did I have a C& P exam, so they don’t really know how much I can or cant move.
     
  13. longbchdirtbag

    longbchdirtbag PEB Forum Veteran

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    Wow. Well, I well say you have a pretty solid case since they didn't even mention ROM in the rating. Do what you need to do with that bad boy and show that PT evidence and my guess is that you will be set up with a C and P exam. You should be good after that. Or if you are lucky a Decision Review Officer will look at the evidence and give you a 40 since it is recent. Cool thing is you get a fat backpayment for that temporary 100 percent for your lumbar spine and will get more if your appeal is granted. In my ratings I always put ROM and if I have to rate off the records I note what normal is and what I saw. Basically they looked at your VA records, saw painful motion, and gave you a 10 and got it out the door. I don't want to tell you to appeal since I believe its a conflict of interest for me giving personal advice vice publicly available advice, but do what you need to do. If thats all that was in your rating its honestly supported pretty weak, giving you a strong case for an increased rating.

    I'd do your neck to if you can find anything in your treatment records showing ROM of the neck limited at 30 or below. Hope this helped and good luck!

    Make sure you tell your DAV officer what you told us! Have your PT records available to submit and any other evidence that supports you. They are there to help you but have a ton of clients so the easier you make it for them the BETTER!!!!! I think you will fare well with your case!!

    Note: The rater felt they could rate it on the available evidence, and you can argue the point that you either need an exam or they need to give you the higher rating based on recent testing. Could go either way. That is why there wasn't an examination.
     
  14. hunting8171

    hunting8171 PEB Forum Veteran

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    I have all my record in a 3 ring binder ready to go, I will call the VA rep tomorrow,

    Thanks for the help

    I will post information tomorrow when I hear something

    Again thanks for the help
     
  15. Bogey43

    Bogey43 New Member

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    I had my L-5 to S-1 fused two years ago. I have an Grade 4 annular tear in my L-2 to L-3 Vertebrae, bulging L-1 to L2 disk ,fractured T-12 and T-2. Head aches and lots of neck pain. I get 40% for all of this. I average 4 hours of sleep a night if I'm lucky. This is all service connected. I am using the American Legion to help with my appeal. Each regional VA office will have a American Legion rep that will help with each claim. It is their job to keep your records moving and help you each step of the way. They are athorized to look at your medical records and fall under the privicy act. They do very good work. I suggest that if your using the American Legion to represent you, find the number to the rep at the VA regional office near you. Also, if any one gets scheduled for a C & P eval, "make sure you make the appointment", "Do not reshedule" they will stop your claim and you will have to appeal to get it going again. It happen to my wife and 2 good friends I have served with. I hope this information helps.
     
  16. Bogey43

    Bogey43 New Member

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    Little extra note to my post. Due to my back conditon, I was medically retired from the Air National Gurard and my technician job. The service conditions are from active duty.
     

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