Concerns- Referred for Back Pain

areed6

PEB Forum Regular Member
Registered Member
Hey all, just referred to the MEB for back pain. Tried to stave off the inevitable for years, but here we are. I'm an active duty officer with 10 years in.

Episodes of severe back pain with symptoms in my legs are well documented back to 2014, I'd say about a dozen of them. I was rarely (once) profiled, though I did do rounds of physical therapy, different medications, etc.

Last year I had an episode and it just never went away. Did about six months of treatment with little relief until my doctor recommended an MEB. Being up for the MAJ board, I said no and went on another ~9 months trying to rehab it. I did experience a 4 month period of relief through a chiropractor and a new medication, but that fell off very quickly and the mental side effects are a tough trade off. So for the last 2 months I've been back in seeing the doctors, trying to figure it out, and pretty much came to terms with the fact that I'm not going to recover from this.

No idea what the behavioral health records say, but I've been seeing them for some not so great stuff for the last ~8 months, though the first time I sought help was two years ago.

Anyhow, my question is regarding expectations for the exam/unfitting condition. My ROM with my lumbar spine is really dependent on the day; there are days I can't move, and there are days I can. Current medication is still having some positive effect. The real issue that I believe warrants rating is the spine guarding. I started doing that years ago, and walk with what I consider to be an unnatural gait. That specific point is only reflected a few times in my record, and other encounters note a normal gait. It has gotten progressively worse over time. Just looking for thoughts on this.

For my legs, I don't really know how they determine severe/moderate/mild. I would love to cut my right leg off given the pain that it causes me. My left leg is more of a 'buzzing' or just numb. MRI shows stenosis in the lumbar spine pressing on the nerves. I'm worried because most of this stuff is not documented in a profile. The only two I ever had just said low back pain. Even the one now just says low back pain. The symptoms are there, documented to differing degrees by different doctors over the years. It's just worrying not knowing how this exam will go and what evidence will be given what weight.

My last question- the doctor did not adjust my profile to a P3 when he referred me to IDES. He didn't adjust it all despite my complaints of progressing symptoms.

Hope you're all doing alright. Thanks!
 

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CuriousCat

New Member
Registered Member
Sir

I dont have answers for most of your questions but I am in the same boat as you are. In regards to the profile not documenting the issues, keep in mind that if the profiles are coming from a PCM, most PCMs are not MDs and are educated as GPs. They cant, with any authority, be specific because they dont have the in depth knowledge. From my understanding of the medical field from working in it for half my career, issues such as these will necessitate the people looking into the actual medical treatment records and then just referring to time spent on profile for issues related to the injury.

This page isnt a guarantee of what the decision will be, but it has helped me understand what they look at as far as severity and it explains what is ratable and not:

Hope this helps even a little.
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
I only had one profile in my records when I had my C&P exam, and I dont believe the VA gives much weight when you have a well documented treatment record for lumbar and cervical issues. I had two EMGs done to support my Radiculopathy claim. At the end of the day during the exam you need to stop bending over, sideways when you feel the pain. The examiner went over my records before he even asked me to do any movement, I am not saying to pretend any pain..but you know when it hurts the most, even when you have a good day. I received 40% lumbar, 30% cervical, 20% for each a.rm and each leg. The exam lasted 15 minutes with the majority of the time being told that my back issues are well enough documented that this exam was just "checking the block". Again. I had one four week profile in my records after having fusion on my C5-C7.
 

areed6

PEB Forum Regular Member
Registered Member
Sir

I dont have answers for most of your questions but I am in the same boat as you are. In regards to the profile not documenting the issues, keep in mind that if the profiles are coming from a PCM, most PCMs are not MDs and are educated as GPs. They cant, with any authority, be specific because they dont have the in depth knowledge. From my understanding of the medical field from working in it for half my career, issues such as these will necessitate the people looking into the actual medical treatment records and then just referring to time spent on profile for issues related to the injury.

This page isnt a guarantee of what the decision will be, but it has helped me understand what they look at as far as severity and it explains what is ratable and not:

Hope this helps even a little.

Thank you for the input. I hope that everything works out favorably for you.

It's stressful not really knowing how things will go. I'm used to pulling out a regulation and coming away fairly certain of the way ahead. Who can say how an exam will go on any given day, or how the unnamed rating authorities will read the records? I didn't even know you could read through your own record until a few weeks ago. I do know what reality is, and I do believe that an examiner could read my records and come to the same conclusions I have, but it's still just full of uncertainty.
 

areed6

PEB Forum Regular Member
Registered Member
I only had one profile in my records when I had my C&P exam, and I dont believe the VA gives much weight when you have a well documented treatment record for lumbar and cervical issues. I had two EMGs done to support my Radiculopathy claim. At the end of the day during the exam you need to stop bending over, sideways when you feel the pain. The examiner went over my records before he even asked me to do any movement, I am not saying to pretend any pain..but you know when it hurts the most, even when you have a good day. I received 40% lumbar, 30% cervical, 20% for each a.rm and each leg. The exam lasted 15 minutes with the majority of the time being told that my back issues are well enough documented that this exam was just "checking the block". Again. I had one four week profile in my records after having fusion on my C5-C7.

Thanks for sharing your experience. I'm curious about the EMGs. Mine reflected some mild abnormality in one leg but not the other. For four years I've been describing the symptoms in my legs the same way every time. You EMG technician stated that the test results don't rule out radiculopothy, just that they couldn't see it at that time. This is the sort of thing that is frustrating and creates a ton of anxiety about the process going forward. I understand that some people probably lie and claim to have pain that is not there, but I feel like one EMG study can't be conclusive one way or the other.
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
While it is true that it is not necessarily conclusive it will support your claim as well as carpal tunnel syndrome as a seperate claim. The examiner will do several tests on your lower back..stretching them a certain way to see if you have any pain to determine which nerve is affected. As for me, my sciatica nerve is the cause for my Radiculopathy and one more I can not recall at this time. A current MRI will also help, the xrays taking at the CP exam are not helpful in determining Radiculopathy, at least thata what my examiner told me. All in all , the QTC examiners were very polite, did not question my claims and really just went down the DBQ checklist..which was pleasant during the PTSD evaluation. I did not have to get into details and he made clear that he just has to validate the current diagnosis.
 

CuriousCat

New Member
Registered Member
I have records that go back almost 10 years regarding my low back. And 15 years for my neck. What concerns me is how they interpret the records rather than how things are documented. I had a doctor tell me 2 days after I got my MRI that my back didnt show anything different than what everyone at my age should have. But the radiologist that wrote the report said that I had two herniations in my low back and one that was pressing on the nerve. Everything with this process is subjective. From talking with people I work with as well as people who have gone through the process is just to be completely honest, at this point there is no pretending there isnt a problem. I have spent so long pretending it wasnt an issue that it is challenging not to dismiss things.
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
Your records will speak for.you, before I had five different neurosurgeons give me five different opinions, from recommending surgery to continue getting shots, I knew my pain amd what I was going through and felt comfortable with my last surgeon to do surgery. As far as CP exams go..the examiner had read my records and I am sure that he had made up his mind even before I walked in on how severe my issues are. Male no mistake that the evaluation weighs heavily in the rating decision,but your records either support your claim or they do not. I was anxious and scared as hell that I would have a "good" day on my appointment and the examiner be an ass about my claim. I can't speak for others experience, but my examiner had most of the DBQ already filled out before we started just by going over my records and talking to me.
 

hopelesswife83

New Member
Registered Member
I only had one profile in my records when I had my C&P exam, and I dont believe the VA gives much weight when you have a well documented treatment record for lumbar and cervical issues. I had two EMGs done to support my Radiculopathy claim. At the end of the day during the exam you need to stop bending over, sideways when you feel the pain. The examiner went over my records before he even asked me to do any movement, I am not saying to pretend any pain..but you know when it hurts the most, even when you have a good day. I received 40% lumbar, 30% cervical, 20% for each a.rm and each leg. The exam lasted 15 minutes with the majority of the time being told that my back issues are well enough documented that this exam was just "checking the block". Again. I had one four week profile in my records after having fusion on my C5-C7.
hi! My husband have Radiculopathy and is going to have an EMG test, he refused surgery. were you Medboarded for this issue?
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
I was not med boarded, I was already over 20 yrs and my PCP gave me the option to either drop my retirement packet or get med boarded. I wanted to leave on my terms and told him I drop my packet..received my VA rating during my terminal leave and qualified for CDRP.
 

hopelesswife83

New Member
Registered Member
I was not med boarded, I was already over 20 yrs and my PCP gave me the option to either drop my retirement packet or get med boarded. I wanted to leave on my terms and told him I drop my packet..received my VA rating during my terminal leave and qualified for CDRP.
Thanks for your quick reply. At least you were given that option. My husband has an appt next week.
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
No worries, I am sure your husband will be fine. I would have gotten recommended for a med board if I had not put in my retirement packet. The rating for lumbar and cervical is completely based on his range of motion..just keep in mind that they do not rate pain..only his ability to bend different ways. The diagnosis from his PCP and a Neuro surgeon hold alot of weight. found my CP exam to really just validate what was in my records.
 

CopterGuy

PEB Forum Regular Member
Registered Member
Hey all, just referred to the MEB for back pain. Tried to stave off the inevitable for years, but here we are. I'm an active duty officer with 10 years in.

Episodes of severe back pain with symptoms in my legs are well documented back to 2014, I'd say about a dozen of them. I was rarely (once) profiled, though I did do rounds of physical therapy, different medications, etc.

Last year I had an episode and it just never went away. Did about six months of treatment with little relief until my doctor recommended an MEB. Being up for the MAJ board, I said no and went on another ~9 months trying to rehab it. I did experience a 4 month period of relief through a chiropractor and a new medication, but that fell off very quickly and the mental side effects are a tough trade off. So for the last 2 months I've been back in seeing the doctors, trying to figure it out, and pretty much came to terms with the fact that I'm not going to recover from this.

No idea what the behavioral health records say, but I've been seeing them for some not so great stuff for the last ~8 months, though the first time I sought help was two years ago.

Anyhow, my question is regarding expectations for the exam/unfitting condition. My ROM with my lumbar spine is really dependent on the day; there are days I can't move, and there are days I can. Current medication is still having some positive effect. The real issue that I believe warrants rating is the spine guarding. I started doing that years ago, and walk with what I consider to be an unnatural gait. That specific point is only reflected a few times in my record, and other encounters note a normal gait. It has gotten progressively worse over time. Just looking for thoughts on this.

For my legs, I don't really know how they determine severe/moderate/mild. I would love to cut my right leg off given the pain that it causes me. My left leg is more of a 'buzzing' or just numb. MRI shows stenosis in the lumbar spine pressing on the nerves. I'm worried because most of this stuff is not documented in a profile. The only two I ever had just said low back pain. Even the one now just says low back pain. The symptoms are there, documented to differing degrees by different doctors over the years. It's just worrying not knowing how this exam will go and what evidence will be given what weight.

My last question- the doctor did not adjust my profile to a P3 when he referred me to IDES. He didn't adjust it all despite my complaints of progressing symptoms.

Hope you're all doing alright. Thanks!
I am in the same boat, my man. 2011, Afghanistan, on a planned three-day convoy providing bounding overwatch (I am not an Infantry type) that ended up taking 11 days in total, the MATV I was driving barrel-rolled down a hill after the ground gave out underneath us. Coming to rest, I had to be shaken awake and at the time was the only "issue" I had from it. But, as the adrenaline wore off, the next day I was in excruciating back pain. To where laying on my side was the only way to not be in as much pain. From that moment, my back pain has never subsided and at times when I sneeze or cough, both of my legs give out. Now, if I am standing still, I can catch myself should I be near a wall or counter. However, if I am mid-stride and this happens, I buckle like a house of cards. Fun. This is also the point - after smashing the left side of my head against the bulletproof glass - that I began having left side migraines, only on my left side. Get back from that deployment, and we have a robust medical evaluation where it is determined I have a neurological issue happening and an MRI was ordered. We are now into mid-fall 2012. MRI comes back, the disc between L4/5 is torn completely in half, and is impacting the nerve bundle on the left side. From there, I was told that I needed a minimum of six months uninterrupted physical therapy mon-wed-fri for 1.5hrs each time. From the rank of Sgt through CWO2, that was unattainable. Especially during workups for a MEU. Fast fwd to Jan, 2020 and have been PCSd to a location that is not under direct Naval care other than a PCM. I am seen out in town by a civilian spine specialist and an orthopedic surgeon who after multiple xrays, MRIs and doc visits - as well as my patient history - determine that a spinal fusion is the way to go. Hell ya, let's do it. May 2020, the fusion is conducted. Everything is great until Aug/Sept of 2020. The pain is starting to come back, a different pain. Worse. Carrying my backpack in/out of work everyday is miserable, but hey, gotta eat right? Running, forget it. The bouncing makes the pain nearly unbearable and is residual for nearly a month depending on how far I attempted to run. So there goes PFTs and CFTs, yes at this point it is confirmed I am a Marine. I cannot carry weight in my arms outstretched, its misery reaching down to grab my 9mo old lol, which I have to do a lot. Dang kids. On top of all that, my issue with my legs buckling has come back, but now with left leg sensation loss, which as been confirmed with a Neurologist.

I am now into my second LIMDU, with orders - lets say - to leave the country by this summer. My PCM has already told me she will not allow that, and will medically deny me. I had an hour long conversation with our LIMDU Coordinator here - very knowledgeable - as well as a lengthy conversation with a good friend who told me about this amazing forum. Either way, if she denies the orders or I go on that 3rd LIMDU, it appears my time is up and that terrifies me. Not because I am a brainwashed Marine and I wont know what to do or how to act as a Civilian, but rather this process I am about to step into can either set me up for life, or really screw me.

Timeline of Injury
July 31, 2011: Vehicle rollercoaster ride
March/April 2012: Initial Diagnosis and MRI, showing disc torn completely in half between L4/5
May 2012- Dec 2019: Little to no help from Navy medicine, or my inability to make appointments (blame my lack of trust towards Naval medicine, or being unable to look my Cmdr in the and request so much time off to go "fix myself"). Leading to a deteriorating chronic back pain, and migraines multiple times a month, some debilitating. Meanwhile I deployed to Afgh again and did a MEU pump.
Feb 2020: Seen by civilian spine specialists
March 2020: After numerous MRIs/XRays, L4/5 fusion is recommended
May 2020: L4/5 Fusion performed
Aug/Sept 2020: Pain returns with gusto, legs giving out returns now painful when occurs, new symptom of left leg sensation loss begins
Nov 2020: Neurologist confirms left leg nerve issue. Prescribed migraine medicine which works wonders.
Dec 2020 - Present: Neurologist orders an MRA study, scheduled for next week. PCM recommends denying orders on medical grounds, waiting for official orders to be issued.
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
I would recommend to see a specialist If you have not seen a Neurosurgeon yet, just ask for the referal. When you do youe CP exam, bend only as far as you can on your WORST day, dont think it be in your interest to tough it out, or that they look at your ROM in your records..that is determined during your exam. Have your PCP or the Neurosurgeon put in your re words that you suffer from Radiculopathy, there has to be a diagnosis of your nerve damage due to your lumbar spine in your records..most Neuros also do a EMG which will be in your favor. Lastly, I would ask your BH counselor to send you to BAMC for a six weeks outpatient PTSD treatment, it is a great program..if your mental health is PTSD related, besides the treatment benefits..it certainly will weigh heavy on your VA mental health rating.
 

lesco431

PEB Forum Regular Member
Registered Member
Hello Gentlemen, could y’all speak on the following question;
In regards to the back; I realize that ROM coincides with a rating. In addition to ROM, is there a rating for pain as well: for example, could you get a 20% for ROM, and 10% for pain, giving a total of 30%?
 

ArcticWarrior907

Well-Known Member
PEB Forum Veteran
Registered Member
I do not believe that you would get a secondary rating for chronic rheumatoid pain to your primary rated disability. Even if you do, a 20% rating and a 10% rating in VA math does not add up to 30%. Remember that rated conditions are compounded..a 20% and 10% rating equals to 25%, with additional conditions it does play a significant role when it comes to rounding up or down for your total rating.
 
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