This misdiagnosis can affect a later disability claim for spinal stenosis, although it can be countered by evidence showing the diagnosis was, in fact, made in error. Rheumatoid arthritis is a disease that causes destruction of the joints in the body. VA physicians will measure your range of motion in six places, using a goniometer. A. found that the VA processed the majority of the 62,500 spinal injury claims decided in the first half of 2018. The VA disability rating system for spinal stenosis is the same general formula as for other similar spinal conditions, including: If the VA determines your spinal stenosis is service-connected, you will receive a disability rating between 0% and 100%. You can get disability benefits for your illness or condition if you have a disability rating of 10% or more and you have one of these presumptive diseases: Because the rating formula is almost entirely based on ROM measurements, its important to make sure that a doctor performs ROM testing as accurately as possible. Both of these must be true: You have a health condition that's caused by exposure to Agent Orange, and You served in a location that exposed you to Agent Orange Keep reading for the full eligibility requirements. Service-connected disabilities vary widely in severity and type: Some examples are the loss of a limb, migraines, and hypertension. Do you have a low back (lumbar) injury related to your military service? If your spine is locked in an unfavorable position, you may qualify for a relatively high disability rating as high as 100%. Basically, the VA understands that the Veteran would not have developed sleep apnea if they didnt get PTSD while in service. Table II - Ratings for Multiple Losses of Extremities With Dictator's Rating Code and 38 CFR Citation Note. Muscle spasms are involuntary contractions or extensions of muscles. For example, if your VA disability rating for spinal stenosis is based on total ROM but ignores a flexion ROM that would result in a higher VA disability rating, it can be challenged by pointing out the mistake and asking for a review at the same level or by a higher-level authority. Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. As the foramen close in, it can lead to those nerves becoming pinched. These are periods of acute pain severe enough for a doctor to proscribe bed rest. Cookies help us deliver the best experience on our website. A posterior spinal fusion of a segment of adjoining vertebra, prior to clinical onset only of Spondylolysis or Spondylolisthesis Posterior spinal fusion means a surgical procedure involving immobilization of the posterior elements of two or more vertebrae by the use of bone grafting, in the absence of immobilization of the lateral elements, of . If your back is not frozen, VA doctors will base their assessment on how much range of motion you have left, which they will measure with a goniometer. Function: Postural support of body; extension and lateral movements of spine. Spinal stenosis is a disorder that affects your back. Because c-spine stenosis is a degenerative illness, a person's condition will continue to deteriorate . We use cookies to ensure that we give you the best experience on our website. All but 10% of lumbar IVDS is at the L4-L5 or L5-S1 level. Use our VA disability calculator to estimate your. Disability Evaluation Under Social Security 1.00 Musculoskeletal Disorders - Adult Section 1.01 Category of Impairments, Musculoskeletal . The spine is considered as a minor joint. VA Disability Rating for Spinal Stenosis Depends on Range of Motion Spinal stenosis can arise from both degenerative conditions (such as arthritis, bulging discs, and herniated discs) and physical injury, such as bone fragments, dislocated vertebrae, or swollen tissues. Spinal stenosis is a form of degenerative disc disease. In many cases, symptoms resolve themselves with rest, physical therapy, exercise, and anti-inflammatories. When this evidence is presented to the VA, it may be possible to obtain VA disability benefits. Its never too late to apply for VA benefits. During the months after surgery, veterans are entitled to a 100% disability rating so they can recover from the procedure. The VA will use a series of diagnostic codes for areas of the spine. The VA not only makes, Both degenerative arthritis and traumatic arthritis, regardless of the joint affected, are rated under diagnostic code 5003. If your MRIs dont show a significant stenosis, but you are experiencing severe back pain that still inhibits your ability to work, and you have. If a doctor doesnt use a goniometer to measure your ROM, the VA will not consider the results. IVDS commonly includes back pain and sciatica (pain along the course of the sciatic nerve into the buttock and the leg) in the case of lumbar disc disease, and neck plus arm or hand pain in the case of cervical disc disease. Va rating of 60%. Traumatic arthritis occurs after an injury, excessive movement, or other physical trauma. With this in mind, its important to know which spinal conditions are not rated under the general rating formula. Spinal stenosis is a medical condition in which the passages through which your nerves travel through your spine become narrow or partially blocked. The disability rating is the highest rating produced by the rating tables. Have you been affected by Camp Lejeune water contamination? If two or more major OR minor groups are affected a 20% rating will be assigned if the arthritis is occasionally incapacitating. Disability benefits are paid for service-connected disabilities. Oftentimes, spinal conditions will cause other conditions, and these conditions qualify a Veteran for another rating. Errors are frequently made when rating conditions. When rheumatoid arthritis affects the spine, it typically occurs in the cervical spine (the neck) rather than the thoracolumbar spine (the low back). Depending on what joint is affected, there will be an identifying diagnostic code assigned to the condition. Spinal stenosis can cause a variety of symptoms depending on the location of the spinal stenosis and the compressed nerve. The exact VA disability percentage for spinal stenosis that has caused a frozen spine depends on the position where the spine is frozen. San Jose, CA: 2880 Zanker Road, Ste. SSA will consider disability claims for degenerative disc disease that are supported by medical evidence such as: Physical examination for type and location of pain, range of motion, nerve function, sensation, and muscle strength, with a full review of the entirety of symptoms Diagnostic imaging tests (such as MRI, CT scans, and x-rays) Veterans looking to receive VA disability for spinal stenosis often develop the disability due to an injury to the spine. Service-connected disabilities are disabilities that manifested during your service, regardless of when your diagnosis occurred, or was diagnosed prior to your service and was worsened by your service. Muscle guarding occurs when muscles react to prevent pain or discomfort. ). This means that a 10% VA disability rating for spinal stenosis plus 60% VA disability rating for peripheral nerve disability in an arm will produce an overall VA disability rating of 60%. Both degenerative arthritis and traumatic arthritis, regardless of the joint affected, are rated under diagnostic code 5003. They may also be used to keep track of what [products, video, links, etc.] The ratings range from 10% to 60%. Copyright 2023 Hill & Ponton, P.A.. All Rights Reserved. Ratings will fall between 0% and 100% disability. Your VA doctor may conclude that your spinal stenosis is service-connected because of this pre-existing whiplash and disk herniation. Our monthly newsletter features about important and up-to-date veterans' law news, keeping you informed about the changes that matter. You may not notice at the onset, but the pain will evolve slowly over time. These cookies are essential so that you can move around the website and use its features. For example, if your spinal stenosis is caused by a bulging disc, herniated disc, or other degenerative disc condition, you may get a better rating for intervertebral disc syndrome (IVDS). yet assertive representation for our clients. . Failure to address the symptoms will lead to a lifestyle filled with numbness, pain, and muscle weakness. This website adheres to the W3Cs AA Accessibility guidelines. Provide a current diagnosis of spinal stenosis, Present evidence of an in-service event, injury, or illness, Obtain a medical opinion linking the in-service occurrence to their diagnosed spinal stenosis. Theres no presumptive benefit the burden is on the veteran to demonstrate a service connection to the stenosis. When symptoms are present, they usually start gradually and worsen over time. If your MRIs dont show a significant stenosis, but you are experiencing severe back pain that still inhibits your ability to work, and you have intervertebral disc syndrome, you may be able to get a higher rating due to incapacitating episodes. If the spine is frozen in a favorable position, the disability rating may be capped at 40%. If there is decreased range of motion of the cervical or thoracolumbar spine, the condition would be rated according to the general rating formula for the spine that is based off of range of motion measurements. Spinal discs act as cushions between your vertebrae. It will also help if someone else in your division remembers what happened. Degenerative arthritis is the chronic breakdown of the cartilage surrounding the joints. They will have you move, twist, or turn as far as you can without reaching your limit or experiencing significant pain and note the degrees of movement you can manage. IVDS is rated under diagnostic code 5243, and the rating criteria relies on the number of incapacitating episodes and how much bed rest the veteran's physician prescribed within the last year. For example, fractured and/or dislocated vertebrae can lead to pain and weakness in the arms, hips, shoulders, etc. If your case of spinal stenosis does not result in limits on your ROM, you may receive a low VA disability rating even though your condition interferes with your quality of life and earning capacity. These secondary conditions would be rated separately from the underlying spinal condition. In such cases, the VA is able to consider certain, Once the VA has acknowledged that your disability is related to servicei.e. VA disability rating rules treat all forms of spinal stenosis the same way, with the cause being irrelevant to the actual VA disability rating for spinal stenosis. Thus, if the flexion ROM measurement produces a 40% VA disability percentage and the total ROM measurement produces a 30% VA disability percentage, the VA disability percentage for spinal stenosis would be 40%. Contacting us does not create an attorney-client relationship. If you are suffering from the effects of Spinal stenosis you may qualify for disability benefits. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_3" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_4" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_5" ).setAttribute( "value", ( new Date() ).getTime() ); Were you stationed at Camp Lejeune before 1987? 20 percent disability rating: $327.99 per month. If you experienced a back injury during active duty, or an injury that later contributed to back pain, you may be eligible for disability benefits. Chicago, IL: 332 S. Michigan Avenue, Floors 8 and 9, Chicago, IL 60604 Do You Qualify for Long Term Disability Benefits? WITNESS AT HEARING ON APPEAL. This disruption can cause strange sensations and loss of muscle control in the affected areas. Do You Have Long-Term Disability Insurance Coverage? However, military doctors and corpsmen may be reluctant to order an x-ray or MRI if they think a diagnosis can be made without one. Because the rating formula is almost entirely based on ROM measurements, its important to make sure that a doctor performs ROM testing as accurately as possible. THE ISSUE. The amount of base compensation veterans receive . AVVO 10/10 Superb Rating, BBB A+ Rated. If severe enough, anxiety and depression arising from a service-related condition may also qualify for an additional disability rating. Lumbar spinal stenosis results in low back pain, as well as weakness, numbness, pain and abnormal sensations in the buttocks, thighs, legs, calves, and feet. The Board notes that by rating decision dated December 2005 the veteran's service-connected degenerative disc disease of the lumbar spine with spinal stenosis and radiculopathy was evaluated as 60 percent disabling, effective August 23, 1999. In addition to the ROM measurements, the general rating criteria for spinal involves whether the cervical and/or thoracolumbar spine is frozen in a favorable vs. unfavorable position. Causes can include herniated or bulging spinal discs. Also, the VA requires that all ROM measurements be taken with a goniometer. At these exams, you can expect your doctor to ask you questions about your background and medical history, evaluate your symptoms and range of motion. Most of the time, spinal stenosis occurs in the lower back and the neck. Although this type of arthritis is most common in the small joints of the hands and feet, it can occur in any joint. These types of lawyers have experience dealing with the laws and rules that govern the VA and may have ideas and suggestions for increasing or challenging your VA disability rating. In that case, a lumbar spine and cervical spine frozen in an unfavorable position is given a VA disability rating of 100%. The technical storage or access that is used exclusively for statistical purposes. The information you obtain on this website is not, nor is it intended to be, legal advice. The diagnostic code for rheumatoid arthritis is 5002. When your medical disability occurred during your service, it is almost always presumed to be service-connected. Camp Lejeune Lawsuit. The SSA has a specific disability listing for lumbar stenosis. Examples of secondary conditions that may arise as complications of stenosis include radiculopathy, neurogenic bladder, and knee and hip problems caused by walking difficulties due to stenosis. For example, fractured and/or dislocated vertebrae can lead to pain and weakness in the arms, hips, shoulders, etc. Spinal stenosis simply refers to the narrowing of the spinal canal which results in pain, weakness, and numbness when nerves are compressed. The rating assigned under the rating criteria for degenerative arthritis depends on how many joint groups are affected and whether there is painful motion. The VA has a separate rating system for these conditions. For a cervical spine that is frozen in a favorable position, the disability rating may be capped at 30%. Specifically, VA rates spinal stenosis according to its General Rating Formula for Diseases and Injuries of the Spine, outlined below: 100% - unfavorable ankylosis of the entire spine Favorable position means your spine is locked but more or less vertical, so you can still sit at a desk chair, for example. We are sorry that this post was not as useful for you! The cervical spine (neck) and the thoracolumbar spine (low back) are rated according to the following criteria: Flexion 45 degrees, OR combined ROM 340 degrees, Flexion 90 degrees, OR combined ROM 240 degrees, Flexion between 30 and 45 degrees, OR combined ROM between 175 and 340 degrees, Flexion between 60 and 90 degrees, OR combined ROM between 125 and 240 degrees, Flexion between 15 and 35 degrees, OR combined ROM 170 degrees, Flexion between 30 and 65 degrees, OR combined ROM 120 degrees, Flexion 15 degrees, OR entire cervical spine is frozen in a favorable position, Entire cervical spine is frozen in an unfavorable position, Flexion 30 degrees, OR entire thoracolumbar spine is frozen in a favorable position, Entire thoracolumbar spine is frozen in an unfavorable position, Entire spine is frozen in an unfavorable position. If the condition is not severe enough to meet the above criteria, then the VA rating for back pain / arthritis will be based on specific symptoms. Los Angeles, CA: 10880 Wilshire Blvd., Ste 1101, Los Angeles, CA 90025 These are periods of acute pain severe enough for a doctor to proscribe bed rest. To qualify for disability because of spinal stenosis, you must meet several requirements: The stenosis must be in your lumbar region. Phone: (757) 220-4529. Diagnostic Code 5238 Cervical Spine Stenosis The spinal canal narrowing for one reason or another Diagnostic Code 5242 Degenerative Arthritis of the Spine Pain from the degeneration of the cervical vertebrae This rating criterion is primarily based on a range of motion measurements. To qualify for the total unemployability disability benefit, you must meet two distinct criteria: Note that theres a significant difference in monthly disability benefits between a 40% disability rating and a 100% disability rating. To receive VA disability for spinal stenosis, like all other disabilities, a Veteran must first establish service connection for the injury. Spinal stenosis caused by IVDS qualifies for a separate IVDS disability rating and you are entitled to the higher of the two ratings. Spinal stenosis of the cervical and thoracic regions may contribute to neurologic injury, such as development of a central spinal cord syndrome following spinal trauma. Flexion measures 30 degrees or less, OR entire thoracolumbar spine is frozen in a favorable position. Markedly severe residual weakness, pain or limitation of motion following implantation of prosthesis 70 Moderately severe residuals of weakness, pain or limitation of motion 50 Minimum rating 30 5055 Knee replacement (prosthesis). I had been fighting for my benefits since 1980 by myself and I managed to get 50% rating. If you have multiple disability ratings, we use them to calculate . . Copyright 2023 Chisholm Chisholm & Kilpatrick LTD. All Rights Reserved. If your service-related stenosis causes a secondary condition, that condition would be rated separately by the VA. If two or more major OR minor groups are affected a 20% rating will be assigned if the arthritis is occasionally incapacitating. Additional medical appliances may be required. When spinal stenosis causes additional disabilities, those problems may qualify as secondary service-connected disabilities. 30 percent disability rating: $508.05 per month. Confidential or time-sensitive information should not be sent through this form. VA/DoD CLINICAL PRACTICE GUIDELINE FOR DIAGNOSIS AND TREATMENT OF LOW BACK PAIN Department of Veterans Affairs Department of Defense . for L3 -L4 L4-L5 L5- S1 in the past they are rating as post operative residuals of . By using our website, you agree to the use of certain cookies. I was medically retired from active duty Army in January of 2016 with a rating of 80% for a variety of things. Flexion 45 degrees, OR combined ROM 340 degrees, Flexion 90 degrees, OR combined ROM 240 degrees, Flexion between 30 and 45 degrees, OR combined ROM between 175 and 340 degrees, Flexion between 60 and 90 degrees, OR combined ROM between 150 and 240 degrees, Flexion between 15 and 35 degrees, OR combined ROM 170%, Flexion between 30 and 60 degrees OR combined ROM of 120%. If your spine is frozen due to spinal stenosis, meaning that you have no Range Of Motion, you may qualify for a relatively high VA disability rating. In severe cases, it can lead to myelopathy, paralysis, bladder and bowel incontinence or retention, headaches, and other debilitating symptoms. To facilitate this process, the VA has created a ratings table. The RO assigned an initial 10 percent rating for the disability, effective June 13, 1994. That is, they get it wrong more than half the time. This will effectively increase your VA disability rating. Philadelphia, PA: 1 International Plaza, Suite 550, Philadelphia, PA, 19113 We advocate for the disabled. If spinal stenosis is suspected, your doctor may order X-rays, magnetic resonance imaging (MRI), and/or CT or CT myelogram. Fax: (757) 220-9451. These mistakes cost veterans at least $5.9 million in payments over the period studied. When spinal stenosis manifests in the form of back pain and a frozen spine, obtaining a fair VA disability rating for spinal stenosis is primarily a matter of obtaining accurate ROM measurements of the cervical spine and lumbar spine. The VA rating for degenerative disc disease typically is 20%, despite how much pain the condition may cause. Deland, FL: 1607 South State Road 15A Suite 12 Deland, FL 32720, Satellite Offices What is the diagnostic code for traumatic arthritis? Spine Condition Ratings. 100% VA disability rating for spinal cancer. For instance, which pages you go to most. You may be owed compensation. Brooklyn, NY: 300 Cadman Plaza West, One Pierrepont Plaza, 12th Floor, Brooklyn, NY, 11201 you may be able to get a higher rating due to incapacitating episodes. Under the VAs rules, you can challenge a VA disability rating by asserting that the VA misapplied its schedule. Symptoms vary depending on the location of the stenosis and which nerves are affected. The most straightforward pathway to fulfilling this criterion is a diagnosis of spinal stenosis in your military records. I served during peace timein theArmy. you have shown that there is was an incident in service and that you have a current disability, When the VA awards service-connection for a condition/disease, it has to determine how much to award for the condition/disease. You may also be able to show your spinal stenosis is service-related via a secondary service connection. You can talk these problems over with your physician, as well. Thank you so much Woods & Woods. As mentioned above, spinal stenosis is typically diagnosed with x-rays or MRIs that show a narrowing of the spinal canal. However, the VA still rates degenerative arthritis of the spine under the criteria listed for diagnostic code 5003. Your spinal stenosis may cause or contribute to other medical conditions, as well. To establish service connection, veterans must generally do the following: Evidence to support your VA disability claim may include military personnel and medical records, lay testimony, and medical opinions. However, the VA disability rating for spinal stenosis is calculated exactly the same as other spinal diseases and injuries. Your spinal stenosis may force you to stop working before normal retirement age because you can't do certain things.
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