Chronic Back & Neck Pain

Hello everyone.

I am expecting my IPEB paperwork back here in the next week. I submitted it around OCT 4TH 2008.

I was in a car accident in OCT 2006. I got rear ended while waiting at a red light. I've been troubled with chronic back and neck pain eversince and also reoccuring migraines about 5-6 times a month.

I did physical rehab, i've seen neurologist, and i've done acupuncture, and the medical system has been trying their best to help get me back in the program, but despite all the hard work I am still having chronic pain and headaches. My MRI's and X-rays came back not showing anything wrong with my spine or anything, so not exactly sure what the problem is, my doctor said maybe its soft tissue damage or something, but not sure.

Currently I take Morphine every morning and night to help with the pain, which it does. Also I do stretching exercises and lift low ammounts of weight to try to keep my body strong. My job is network administration I do a lot of sitting at a desk which is very uncomfortable and painful as well. The only time I really feel good is when I am at home and I am fully laid back relaxing and have taken my pain medications.

Well, anyways, I am not sure what type of rating I will get if I get one at all. Just wondering though, what do you guys think? I am expecting something back this upcomming week. Last week when I called they said the status was "Informal Board Ready".

Any comments or suggestions would be greatly appreciated.

Seph123

PS: I have also been diagnosed with High blood pressure (most likely because of the constant pain) and have been taking high blood pressure medicine for about 6 months now as well. High blood pressure isent unfitting is it? Also, currently I am in my MOS but at the unit i am stationed at I don't deploy so i am able to somewhat work. but if I was doing what my mos really is supposed to do, installing networks in the desert, there is no way I could do it in my current condition. Does that play a factor in my disability?

PS2: Thank you everyone for all of your posts on this board. I think I've read everyones stories atleast twice. but I couldn't find anyone with a story too simular to mine, so I finally decided to post. Thanks again.
 
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seph123,

In regards to your health issue; I suggest having your spine checked by a licensed Chiropractor. It is common for whiplash injuries to improve under competent Chiropractic care. I have other posts you may check out here(pebforum) on this issue, that I have already addressed. Please let me know if you have any questions.

Chiropractically,
dcudoc
 
thank you so much for your response, i was waiting for someone to say something.

So you think that my injury is not permenant in nature and that I can hopefully be better one day? With all that I have been through in the last 2 years with this injury it really feels like I will be disabled for the rest of my life....

I think I deserve TDRL and if I do get better in 5 years after that I can be removed but If i dont get better then I goto PDRL. Thats the only thing that sounds fair to me........

I am constantly suffering with back, neck pain & migraines ugh....... horrible..........the morphine makes me so sleepy too.......
 
i know w/you are going through w/the chronic pain. i injured my back in 2006. i believe the motor vehicle accident that i had started it, and then i think it became worse (herniation l5-s1) from continuing to work. 4 surgeries later i'm much worse. deffinately continue to get treatment. i never saw a chiro., but wish i did. pretty much after 6 months w/most med. conditions it goes from acute to chronic. the big thing w/me was dealing w/the fact that i would always be in some kind of pain. now i'm @ the point where i've come to grips w/it and it's just a matter of working w/my PCM to contol my pain mgmt. as best they can. good luck!
 
Welcome seph123,

I have been trying to post to you for days, but things keep coming up that I have had to tend too-just as I would get ready to type:rolleyes:.
Please don't think that we're not reading-we're all here for you, ready to listen and too help.

Medically, I agree with dcudoc. You've probably seen our posts and we both agree with hands on treatment and the most conservative treatments first. A good, licensed chiropractor should take xrays and do a good evaluation before treatment. They have many modalities of treatment to help. Heating pads,, tens units, ultra sound, and of course align the spine. It could be the treatment that helps you. I'm sorry to hear that acupuncture didn't work. My doctor of Oriental Medicine uses all the above techniques and uses the needles to open meridians. It has worked for me. I am not healed, but I am off all medications! I keep them in my drawer, but its not a daily routine like it was before. More like "just in crisis"... I also have improved moblility. Everyone is different and not one treatment will work for everyone...and sometimes its a combination that works. Its up to you to figure out the magic mix. I do seriously want to caution you on something...you mentioned that you use Morphine and its what makes you feel better. I understand that, and I understand how terrible the pain can be...Being in the medical field, I have seen the serious addictions that occur when narcotics/opiates and other meds are prescribed for chronic pain. I was terrified when I was told by my doctor, "do yourself a favor and take the morphine". Its still unopened. Morphine is a highly addictive drug. The last thing any of us need is to top off our injuries with an addiction. So please, if you do need it....I understand-but be very cautious. The added stress of the MEB and everything else doesn't help the pressure you feel; your shoulders and upper back are probably terribly tight and that just adds to your migranes.

Try to keep a positive attitude about healing. I believe that anyone can heal. I really mean it. The power of the mind is amazing and limitless! Think positive affirmations, think about how you felt before the injury and that you want to be better than that! Don't get bitter, get better! Don't let pain and injury win-take your life back.

As far as your ratings go, I'm sure someone else with more expertise will chime in with that....its tough to guess which code is used and for what. How things are documented are very important.

I've got to go again, but you take care and let us know what the IPEB comes back with.
 
seph123 said:
Hello everyone.

I've been troubled with chronic back and neck pain eversince and also reoccuring migraines about 5-6 times a month.

...despite all the hard work I am still having chronic pain and headaches.

Currently I take Morphine every morning and night to help with the pain, which it does. Also I do stretching exercises and lift low ammounts of weight to try to keep my body strong.

My job is network administration I do a lot of sitting at a desk which is very uncomfortable and painful as well. The only time I really feel good is when I am at home and I am fully laid back relaxing and have taken my pain medications.

PS: I have also been diagnosed with High blood pressure (most likely because of the constant pain) and have been taking high blood pressure medicine for about 6 months now as well....
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Seph,

Welcome! I have a few comments.

First, you need to make sure that your migraines are well documented. I don't know what is in your MEB Report, but very often Servicemember's migraines are not well documented in the MEB.

Second, generally speaking, there are two bases for ratings for back conditions. The most common basis is for limitations due to Range of Motion. However, very often, Incapacitating Episodes (which it sounds like you have) is a basis for a higher rating. Again, this is very often not well documented.

It would take looking at what is in your MEB to know how well they did document your condition. Remember, at the PEB you can submit more evidence. If you have not documented your conditions to this point, you must begin to do so now to insure a proper rating. You are not necessarily at the end of the process, but rather you should continue to prepare your case.

High Blood Pressure is very rarely an unfitting condition. Like everything, the basis is interference with reasonable duty performance expected of someone of your grade, rank, rating, or office.

Best of luck and please let us know any questions.
 
Thank you for your reply Jason.

I am realizing with every post I read all hard the system can be for some people.

Some people are getting exactly what they want, and some arent getting what they want at all.

I think this board does help atleast educate us to make more informed decisions.

Seph123
 
Happy Holidays All,

Just got a reply from the IPEB today, they need additional info for my case.

They need ROM for my thoraculumbar spine (spelling?). I heared a lot of people having problems with them doing it wrong so I took a look at the army's procedure hopefully its not to different from the navy's procedure.....

Whenever I am bending down, am I supposed to stop bending when I feel pain? How much pain? This is going to be difficult..... I think if I tell him it hurts at the slightest bend he will think I am not trying hard enough, what do you all think??? I've never met this doctor before, he's a complete stranger, which makes me a little uncomfortable.

Seph123
 
Pain impacts the ability to move through a normal range of motion. I would state when you start to feel the pain, though you may be able to continue the repetition. If the doctor is evaluating you correctly, s/he will note when you first feel pain. Under a case called Deluca v. Brown, the doctor should attempt to quantify how your pain impacts your range of motion. This is easiest (and most advantageous) if they count your ROM as being limited at the point of pain. However, if your pain is minimal and starts early in your ROM, but increases, there may be a logical basis for quantifying it at a later point than when you feel, say, minimal discomfort.

They are also supposed to quantify the effect of pain on multiple repetitions. I see this error from time to time, the examiner states there is pain on repetition, but does not quantify it and just states what the ROM is. This is a mistake, because Deluca requires them to, if possible, state how the pain impacts your ROM, and note it as a subtraction from your degrees of movement. I think that since the PEBs are not used to following the strict requirements of VA law, they think they are complying by noting the pain. However, for the law, as announced in the Deluca case, to make any sense, that pain has to result in an change to the functional limitation as expressed in degrees.

I think you are correct to be concerned with the accuracy of the exam and also to be aware of the effect if the doctor describes your effort as less than your best effort. I think so long as you explain what is happening, it will help with a more accurate examination/evaluation.

Please let us know any questions.
 
Jason, Thank you so much for your reply. I will post the results using what you described here. I'll input feedback on wether they told me to stop when the pain was strong enough or if they told me to keep going against my pain.

Happy New Years everyone! See you all in the next year with my next post.
 
Well, I did my ROM test today with a doctor i've never met before. He didn't use any measurement tools or anything. He instructed me to just go as far as I can. I did all the motions and then he said thats it. Your PEBLO will have the results in the system in a couple of days. When I asked him about the tool that is supposed to be used he said thats for "NEW DOCTORS and that the place that I was getting my test done had their own method of measuring".

Do you believe that? What kind of bullcrap is that? When I asked for a copy of the results he said that I could get a copy from the PEBLO in a couple of days when it hits the system.

That really dosen't sound right at all. This is supposed to be accurately done and now I kinda feel like i'm being cheated. Then again - I don't know what the results are *in his head atleast*.

Seph123
 
they should use a ginometer. from what i've heard it's the most accurate. when i get a new ROM, i want it used. the ortho. doc. that did my NARSUM never even did a range of motion, nor di i have one prior and there was a range of motion listed on mine:mad:.
 
I see an appeal position. Read the NARSUM carefully, mine clearly states a goinameter or whatever they are called was used. (and it was) and both doctors that did mine were both retired COL's and definetly old school docs and they both used the meter thingy.

AND, don't forget to ask for your INDEPENDENT MEDICAL REVIEW!!!!!!!

It is your right, use it.



Stu
 
You are right. Definately is. Doctor told me he would put it in the system and that I could know the results in a couple days, its been almost a week and nothing yet. I am very skeptical of his eye measurements. I talked to PEBLO about it and he told me that no one has the correct tool so thats how they do it.... by eye. I really don't mind as long as it's in my favor.
 
Seph,

This is really amazing that they don't have a goiniometer. I just googled a medical equipment site and they cost $5.95. It is a very simple plastic protractor device. Here's the link, see item 6160. I'd buy one a donate it to the docs. This device is used in every physical rehab facility also. The apathy at some medical facilities is beyond belief.

www.fmcmedicalrehab.com

FDM
 
I have seen 9 ortho doc for my ankle problems and not a one has used a goiniometer, they just look and guess. I have had 3 PT use a goiniometer and surprise, surprise the military PT measured my ankle with better ROM than either of the civilian PT. My primary civilian PT even made sure she used the exact same goiniometer every time she measured my ankle.
 
I don't know why these doctors are seemingly against helping us. Like you said Jim1960 that the military always gives better range of motions which equals them paying you less. I'm going to call tomorrow and find out what this guys eye measurement disposition is on my ROM for my back & neck. It shouldn't be against my favor..... I mean he hardly took the test seriously..... when he told me to lean back, I was getting ready to lean back and he said " is that all you can do? okay good" but i dident even get a chance to lean back yet! He didnet push me at all to go any further then I did, he said just go as far as you can..... ahhhhhh I want to know the results, can't believe how long it takes to get into the system, unbelivable! I just don't want to have to fight this stuff..... it really does make me miserable. On top of everything I just got a new PCM that I am going to see tomorrow. So hes going to be going through everything all over again, turning and bending ughh......
 
I just got my range of motion done and was read at 68% for forward flexion of my lumbar spine. I believe this qualifies me for 10% rating. Go figure if I would have had 60% I would have had 20% rating. Does this make sense according to the VASRD Schedule of ratings chart?

Thank you!
 
OQnavy,

how did they do your ROM. did they use a ?gynometer? or just do it by sight?

i would try and talk to your PCM about the results and bring up the other things that jason mentioned in the other thread. worst case scenario you can get one done @ the VA when this stuff is over. and you can bring up the issues w/the ROM when you appeal for an increas in rating. good luck!
 
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