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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I went to a civilian pys therapy place to get my ROM done because I wanted to see the "difference" between civilian and military. I paid cash for the visit.

The civilian ROM took my forward flexion, then reduced it by 30 to account for Sacral ROM...so it then gave TRUE lumbar flexion.

They did my flexion, extension,right and left.

This document was straight from the pys ther book-it says Guides to the evaluation of permanent impairment, fig 83. Lumbar Range of Motion.

The military PT said they've never seen it (the reduction for the sacral ROM) and dismissed it.

The military PT measured me-but it wasn't with the goiniometer. And the numbers were way different.

I took in the paperwork from the VA website saying how to do ROM according to VA/Dod, but they didn't even look at the paperwork. (:

Good luck to you and make sure they use the right equipment.
 
It would be a hugh leap in faith to expect either the military or the VA to comprehend this technique.

FDM
www.coworkforce.com/dwc/Medical/AMA_Range_Of_Motion_Worksheets/Figure%2083.pdf -
 
Okay here we go, I got a copy of the results finally.

The paperwork says

Objective:
AOX 3
Moderate distress
Motor 4++/5 throughout
Neg bilat SLR
ROM:- Neck Flex and Ext 10-15 deg, Lat flex 15 deg, Rotation 15 deg bilat.
Lumbosacral:- flex 20 deg, ext 10 deg, lat flex 15 deg bilat, rotation 20 deg bilat

and then below all that stuff they have the results of my MRI's on my cervical, thoracic, and lumbar spine.... which are all unremarkable.... (no visable damages)

The results are being sent up to the med board and hopefully they won't request anymore additional information. Hopefully they can give me a rating and get me on my feet back out of here.
 
I had my ROM on the 30th of December 2008. When I bent down they told me to go until I couldn't go anymore irregardless of pain, and then they would press down on my back to see if they could get me to go down anymore. After reading the threads in this blog, I don't think they conducted this correctly. Please advise.....
 
w/all the hardware in my back, i would not trust it, nor would i feel safe. i wouldn't be comfortable w/that (litterally:)). even all the times i went to phys. therapy, they would do manual stretches on me they and stop @ the point where i was maxed out. maybe someone w/experience will jump in, but it just doesn't make sense to me.
 
Diver,
You are correct, they did not conduct the range of motion IAW the guidance given. There isn't any part of the ROM that has them doing a "partner assisted" version....the point isn't to assess how far THEY can get you to go. I would discuss with you PEBLO at least and make sure you bring this up with the MEB doctor who is responsible for the NARSUM.
 
If they will not correct this/address this, you want to strongly consider asking for an Independent Medical Advisor and address this with them and submit an appeal to the MEB based on the erroneous procedures used to evaluate your ROM.
 
From the results of my ROM that I posted. If they determine that either my back or neck stops me from staying in the military I will rate a disability percent correct? and then when I file for VA I will rate the disability percent no matter what? even if i can still work or not?? 40% for 30 degrees or less forward flexion in thoracic spine and 30% for 15 degrees or less forward flexion in cervical spine? total of 70%? do they total them together or do they just pick the higher one??

When I do VA claim do I have to get the ROM's redone? Or are the ones I just got from the doctor good? How often will I have to do a ROM test?

Also does anyone know what any of the other stuff that the doctor wrote means by my ROM test?
 
1. AOX 3:
do not know without a little research.

2. Moderate distress:
do not know the context the provider is referring to. (i.e. emotional, physical, mental or overall)

3. Motor 4++/5 throughout:
assuming 5 being the best and 0 being the worst, this is near perfect motorsensory testing.

4. Neg. bilat SLR:
negative findings for bilateral (both left and right legs) Straight Leg Raiser(SLR). This would test is to identify any buldging/herniated discs. A positive SLR either right or left or bilateral would be reproduced Low Back Pain upon testing.

5. Neck Flex and Ext 10-15 deg:
flexion is bending head down and extention is bending head back. The test should document seperately Flex...degrees and then Ext...degrees.

6. Lat flex 15 deg:
Lateral flexion-this is bending left ear towards left shoulder and then right ear towards your right shoulder. Again, the documentation should specify what the right lateral flexion is and then what the left lateral flexion is, like number 5 above.

7. Lumbosacral flex. 20 deg:
this is bending forward

8. Lumbosacral ext. 10 deg:
this is leaning backward

9. lat flex. 15 deg bilateral:
bilateral is combination left and right. However, again, this should be measured right lat. flex ... degrees and then left lat. flex...degress. This is not clear whether it is 15 degrees right lat. flex. and then 15 degrees left lat. flex.

10. rot 20 deg bilat:
rotation of lumbosacral is simply twisting left and then twisting right. Again, there is a discrepency in the way this is documented. It should state specifically right lumbosacral rotation...degrees then left lumbosacral rotation...degrees.

Chiropractically,
dcudoc
 
seph123,

My guess is that you will likely have another examination (a Compensation and Pension-C&P) in connection to your VA claims. This is not necessarily a bad thing although you should become educated on the VA claims process. This site library has a good collection of VA related information. In addition, there are a number of forum members who have some experience with the VA, either as a claimant or rating officer. It is critically important for you to file for any condition in your medical history that may be service related, not only just those identified in your MEB/PEB. Keep your questions coming and folks here will help.

fdm
 
dcudoc:
Thank you for the very well described explanation, very much appreciated! Do you think that because the doctor didn't give results for left and right that I am going to have to have it redone with another doctor or something? Or would they just assume that left and right is the same degrees?

fdmckeever:
Also thank you for your reply. Yes that makes sense that they would want to examine me with their own doctors and everything. I just thought that I had read somewhere that I could file the claim and not get examined and rate so much just through my medical record book. The only reason I ask is that if I am in a remote location where there is no VA examiners, it would be a real pain in the butt for me to have to fly to America just to get examined real quick?


Thanks again for everyones replys and making this thread an active one, this is such a big part of my life right here and every reply or piece of feedback is a great contribution. I also hope that some of the stuff convered here can help other people out that are getting screwed on range of motions or something like that. I mean considering the fact that your range of motion plays A VERY BIG PART in your disability rating....... I got 20 degrees forward flexion, from what I read, that translates into 40% disability, which should mean that I get to go TDRL and keep my ID card and everything - thats absolutely great! I hope that is the case..... Still waiting for my informal med board to come back. They are soooo slow, im afraid they gonna ask for more information - make me do those roms again, and intentionally screw me somehow.....

Seph123
 
seph123,

I found this information from the Veteran helping Veteran site relating to residing overseas and VA exams.

www.veteranhelpingveteran.com

Veterans who live in foreign countries other than the Philippines file their claims with the Washington Regional Office (WRO) at 1120 Vermont Avenue N.W. Washington D.C., DC 20421. If the WRO feels your claim is valid they will order an exam. It is the responsibly of claimants residing overseas to meet the exam date and travel to the location designated at their own expense. The Philippines is the only VA regional Office overseas and handles disability claims for veterans residing in the Philippines only. If the WRO feels your claim is valid they will order an exam. On rare occasions at the request of veterans outside the RP the PRO will attempt to conduct Compensation and Pension examinations. However, it becomes complicated because the ordering of the exam must come to PRO from the WRO and coordinating a response from that office has historically been difficult. The normal procedure is for WRO to arrange for the exam through the US Embassy in the country where the veteran is residing. The results of the exam are returned to the WRO and adjudication of the claim takes place back there. If for some reason the exam is decided to be coordinated through the PRO the only reimbursement you would receive is for your travel expense within the Philippines.
 
seph123,

Regarding the question of having a re-exam vs. assuming the adjudicators will decide what you hope: Since you expect to get 40% disability rating with the cervical flexion of 20 degrees or less and your satisfied with that, I would let it ride and then if the decision comes back not in your agreement, you can use the argument of not properly documenting the left and right degrees. However, I know there are members that are wiser than I am on the best approach of sending in these claims and would welcome additional opinions. This is just mine. Also, the issue of not being near a VA medical center to do an exam could be a factor to go with what you already have documented and wait on the decision before requesting a re-exam.

Chiropractically,
dcudoc
 
Thank you both for your replies again.

I have no idea what I really am gonna get, I am still waiting for the IPEB to come back after we sent the additional information that they requested back out. I just know that they asked for the Thoraciclumbar spine ROM which after the test was done I could see rated a 40%. The doctor also did a neck ROM test, and it rates a 30% but I don't think that the military is willing to give me that too - the doctor just did it because he wanted to, he wasnt supposed to do both or atleast they didnt ask him too. When I get out though and goto VA if they re-do my ROM measurements and if they are the same measurements that they are now, then I should get 40 for back and 30 for neck right? 70% total correct? If I can get 30% more for my sinusitus or my anxiety I can get the 100% VA disability right? I saw that there is a huge jump in benefits from 90% to 100% for VA. 90% is like $1800 and 100% is like $2800!! I wonder why such the big jump? Thats weird huh? Well im impatiently waiting for something back from the IPEB - my anxiety is going crazy!
 
seph123,

I hope you get the best outcome possible.

As for the combined percentage calculations, no.

"In a nutshell, the PEB uses the same system as the VA in calculating percentages. The idea is that you start with a "whole person" at 100%. When you subtract one conditions percentage, the remaining person (as expressed by the percentage) is what you apply the next disability percentage to. Remember, the ratings are calculated highest to lowest. So, for example, 50% and 40% equals 70% (100%-50% = 50%. Then 40% of 50% is 20%. The final step is 50% + 20% = 70%)."

http://www.pebforum.com/site-technical-issues/396-peb-calculator.html#post804 (In the post, it tells you to go to the calculator link, but that has been taken down....the link embedded in the post works though).

40% plus 30% equals 60% (add another 30% and you get 70% total).
 
After more than a month of waiting, I'm finally starting to see some movement! I'm waiting on my NARSUM to be blessed off by the DCCS, and my PEBLO just faxed me an updated Profile (added left leg radiculpathy, no standing more than 20 minutes and no weights over 20 pounds). She also needed a new LES. I almost feel like jumping up and down, cuz things are happening!! Maybe just little stuff, but one way or another, its a step closer to the end of a VERY long road! :D
 
Congratulations on getting your PEB, just saw your other post as well as this one. Good luck on getting everything you want out of your PEB. Hopefully everything will go in your favor, and smoothly. Keep us updated. I wish I would of tracked my dates better with when I started my MEB and everything. I might have to start lookin at my paperwork to figure that stuff out so that I can add it here for timeline purposes for people.

Do you have your timeline that you can share?
 
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