Wrong Titled Diagnosis?

BrokenC23

PEB Forum Regular Member
PEB Forum Veteran
In my board paperwork that went to the IPEB, the VA doctor listed my lumbar condition as Lumbar Degenerative Disc Disease instead of 5243 Intervertebral disc syndrome. Is this something that the VA will transcribe once it gets to them?
 

erock

PEB Forum Regular Member
Very good point here BrokenC23: I would like to see if any of the experts on here have any experience dealing with this particular issue. Looking up intervertebral disc syndrome only a few sites pop up w/ information. But from what I gather from those sites are that this particular condition involves a herniated disc/s causing exacerbations in the spinal area and delibadating pain< excuse my spelling.

Also from the VASRD stand point, it seems that "intervertebral disc syndrome" is the only back condition that can be rated either by ROM or Incapacitating episodes. Can someone chime in on this and address it more clearly?

The VARSD is very hard to interpretate in regards to this condition. It seems like a general condition that a lot of people w/ back issues can fall under, but what if someone was diagnosed with lumbago, and it's clear they have herniated discs on an MRI, giving them this pain and let's say they've had incapacitating episodes with prescribed bed rest, would that mean since they were diagnosed with lumbago that they would not be rated by the incapacitating episodes standard? and would just have to rely on ROM?

Thanks ahead of time.
 

Jason Perry

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Very good point here BrokenC23: I would like to see if any of the experts on here have any experience dealing with this particular issue. Looking up intervertebral disc syndrome only a few sites pop up w/ information. But from what I gather from those sites are that this particular condition involves a herniated disc/s causing exacerbations in the spinal area and delibadating pain< excuse my spelling.
Because the disability is what is rated and not the diagnosis, I tend to think that any back condition that caused incapacitating episodes should be rated under ratings for Intervertebral disc syndrome so long as that results in a higher rating than based on limitation of ROM under the general spine schedule (remember, the VA has an obligation to rate a member under any applicable theory and grant the highest award).

Also from the VASRD stand point, it seems that "intervertebral disc syndrome" is the only back condition that can be rated either by ROM or Incapacitating episodes. Can someone chime in on this and address it more clearly?
Well, I tend to think this is a correct literal read of the regulations. However, I would point out that "flares" are to be rated as part of considering ROM under Deluca (and many cases citing to Deluca). So, even though it is somewhat of a word game, I would argue that if you have infrequent incapacitating episodes, you may be better rated by assessing the limitation of ROM during these flares. The difficulty, of course, is getting an accurate measurement. You are unlikely to just have a incapacitating episode at the same time you have an appointment to be measured. But, I think this is the correct way to deal with this issue.

The VARSD is very hard to interpretate in regards to this condition. It seems like a general condition that a lot of people w/ back issues can fall under, but what if someone was diagnosed with lumbago, and it's clear they have herniated discs on an MRI, giving them this pain and let's say they've had incapacitating episodes with prescribed bed rest, would that mean since they were diagnosed with lumbago that they would not be rated by the incapacitating episodes standard? and would just have to rely on ROM?
No, they should be rated on whatever yields the higher result.
 

BrokenC23

PEB Forum Regular Member
PEB Forum Veteran
In research...Link: http://biotech.law.lsu.edu/blaw/dodd/corres/pdf2/i133239p.pdf

DODI 1332.3

E2.A1.1.19. 5293. Intervertebral Disc Syndrome. /// is what they use to rate, per AFI 36-3212, Chapter 1, Para. 1.7.

Tomorrow, I will be going and getting ALL medical records to see what they exactly said. If anything, I'll request an EMG to see if the disk is herniated, thus supporting my IDS claim and they can't say anything about it.
 
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