Physical Evaluation Board Forum

I was discharged medically from the Marine Corps in 1986. I have dealt with back pain, among other pains, since. The initial lower back problem was spondylothesis in the L4 - L5 segment. That has now become a lot worse with severe narrowing of the nerve passage and degeneration of the disk to the point of bone on bone in both the L4-L5 and L5-S1 segments. The nerve on the right side is impinged and my right hip feels like there is a little knife in it when I walk. The doc characterizes the injury as "severe". I am scheduled for injections and the doc has told me to do PT. I will be honest; the whole process scares the hell out of me. I don't trust them with knives and needles around my back and most of the stories I have heard are horror stories.

Any input on results of PT versus surgery? What about just living with it? Any statistics on how fast and far it degenerates? I see myself in a wheelchair in 10, but I don't know. What about the VA--I am currently 10% rated for my spine (80% total with all injuries combined), but as I said above, the condition is a lot worse then when I was discharged. If I ask for a higher rating from the VA, will they deny if I don't take what they consider "proactive" steps to fix the problem?

Hello and so sorry to hear of your back problem. Many of us in this forum have back issues and so I'm sure you will get a lot of different responses-probably like from doctors..one says this and the other says that.

I know what you mean about the knife in your back-I like how you put that-I haven't described it that way, but I may start.

I have L-1 thru S-1 DDD and tears, and narrowing. I have pain everyday. This has been going on for 1 1/2 yrs for me. I tried all the injections-and they didn't work for me. I think its less invasive than surgery. But too many steroids can cause cartilage breakdown.

I believe that some PT would be good-conservative, maybe 10's unit or something like that. Dead Bug and Bridging work particularly well for me.

I have turned to Acupuncture and Oriental medicine and I've had the best relief ever. I pay out of my own pocket, but I feel relief. I know I have a long way to go. My Dr. of Oriental medicine believes there is a place for both Eastern/Western methods-he even practices in one of our local hospitals....Anyway, I haven't finished 10 treatments yet, and I know I'll need more-but he's fixing the underlying problem that medications won't touch-neurontin, morphine, vicadin, etc..

What he told me today and showed me on the model was my lower back...he said he didn't care if people had surgery in the thoracic area-but he said no, no, no to surgery around the L5/S1...he said its too dangerous. So, I am giving him my energy and time and we'll see what happens...But for today, I am heading to the hot springs to go soak.

I wish you the best. Trust yourself-you know your body. Educate yourself in all the modalities of treatment. You can heal. ( :

The other guys know more about the ratings.

Take care,

Chinook

i tore mine up about 5 years ago and just tried to keep it a secret so i wouldnt lose my clearance to fly. it would hurt like hell for a few days but it would gradually subside and be fine in about a month. I would bend over awkwardly and aggravate it about every six months later and have to go thru the same process all over again. I did alot of PT and i think it helped it from getting worse until the disc finally blew apart.

The last time it went out on me i couldnt walk, sit up or anything. i actually had to have my roommate at the time dress me and carry me to the hospital. The disc completely filled the cavity where the nerve resides and they could see pieces of it floating in my spinal cavity.

They gave me a total of 5 different sets of steroid injections and tried a nerve block on me and none of them worked. i had a microdisectomy and it reduced the pain in my lower extremities a good bit but now i am in constant back pain and it actually caused the disc above it to pop back out.

I think any good doctor will start out as conservative as possible and no one will rush you to surgery unless everything else has failed and you can't live with the pain anymore. The spine health forums is an amazing place to read about people who has had every type of procedure done and they are very good about answering any questions you may have.

hey crawl23451,

I was just re-reading all the spine posts again and saw your post. I totally agree with least invasive. I was wondering-are you going through an MEB? You said you have pain everyday-how is your quality of life? I hope you don't mind me asking-and of course, you don't have to answer , but I was just wondering how people with spine issues are doing. For me, everyday I have pain, but some days are worse than others. They say my MEB will be finished in 3-4 weeks and I'm a little worried about the results. Seems there are a lot of 20% out there. I of course want that min 30%. I wouldn't be getting out if I could move around. Thing is, I couldn't do any job with consistancy right now. Not knowing from min to min how I'm going to feel. Hope this makes since....I'm not whining-just sharing. I'm good. I'll be great. I'm working through this but I know its going to take time.

nicolste,
I can relate to your pain, I've just gotten my PEB rating and yes I got the 20% I was told by my PEBLO that may be the max for that injury. the only treatments left from the Army doctors at WRAMC was spinal fusion, which may sound cool but with 6-12 months of rehab and only a 50% chance of success I'll take my chances with civilian medicine.
can anyone confirm that 20% is max? should I go to my formal board?

lokiano,

For ratings based on range of motion or for incapacitating episodes, that is not the case at all. 20% will often times be awarded for spasms that cause antalgic/abnormal gait, but I see a great many errors made in rating back injuries.

What basis did they give for the 20% rating?

__________________
Jason

Physical Evaluation Board Forum Administrator
New Members- Read OVERVIEW OF MEB/PEB PROCESS

to quote: "cannot carry a fighting load 2 miles, rated for forward flexion 50 degrees and IAW VASRD 4.10, 4.40, 4.65 and 4.59-rating includes considerations of functional loss due to factors such as pain due to repeated use and painful motion

according to my doc at WRAMC I have two disc tears and a herniated/bulging disc and there's no hope without some form of invasive surgery with only a 50% chance of success

I'm not sure what to do at this point and the clock is ticking as I have until the 25th of November to respond. My thinking is that 0% is the same as 20% so I have nothing to lose-is this really the case? I'm also not sure about working with a JAG assigned rep to walk me through this, should I request the formal hearing.

FYI this process once a MEB was requested (started late Aug 08) and rating received the 18th of November. The overall problem is 3 years in the making

any advice appreciated

Right, from a DoD compensation point of view, 0%, 10% or 20% yields the same amount of severance pay.

As far as the details of whether the 20% is an appropriate rating, it would take a thorough review of your medical documentation and the MEB narrative summary to know whether there is a likely basis for a higher rating. My experience is that there are often errors made in the rating decision, but it is hard to know if the facts of your case support a higher rating.

Do you have acute pain that causes you to have to lay down at times? This would suggest a rating under Incapacitating Episodes may be appropriate.

__________________
Jason

Physical Evaluation Board Forum Administrator
New Members- Read OVERVIEW OF MEB/PEB PROCESS

welcome,
do your reasearch, prior to considering surgery. i'm 4 surgeries deep right now. would i do it again? NO! the only one who has every took an active interest in my treatment is my civilian PCM. alot of these docs. just wanna cut. to me surgery is a 50-50 crap shoot. you did come to the right place. chinook is a good source of info. from the holistic/non-surgical approach. and jason is just a fountain of knowledge.if you want or have to have the surgery, feel free to contact me. good luck!

__________________
"you are your only advocate". stay strong!!!

out,
tucci


"Do not yield. Do not flinch. Stand up. Stand up with our President and fight. We're Americans. We're Americans, and we'll never surrender. They will."
John McCain

thanks for responding robs42 and Jason

my injury in the last 6 months has caused my back to go out at times, where my Primary Care Physician (our local PA) can not even see me because I've already been referred to WRAMC, in most cases I'm given quarters until the pain subsides(yes I'm totally laid out in bed for that time) as for the course of treatment since I've elected not to take on the surgeries they've offered I'm on a steady diet of Vicodin (500mg 3-4 times a day, more when the back goes out) I've tried radio frequency de-nervation, epidural injections and accupuncture all w/o notable success.
when all of this came down to the MEB I copied my medical records(2 copies) contacted AMVETS
I've also had to go to our local clinic on post which has documented my back going out-BTW it should be mentioned that my MOS is 11C-I was told by my PEBLO that was how I got 20% as well being infantry
if I do go to a formal board what kind of attorney do I need-are there lawyers out there that handle/specialize military MEB/PEB's, I'm not sure I would do myself any good representing myself-I also realize that I'm not going to get a second chance at this and that I will have to live with the decision once it's done, because they don't re-open cases once a decision has been made.
rob were all the surgeries done by military doctors/facilities? I've heard about