PEB Rating Question DDD with Radiculopathy

G

green594

PEB Forum Regular Member
PEB Forum Veteran
I am being re-evlauated by the VA for Lumbar DDD with radiculopathy. My previous rating was 10% for DDD but due to a moderate injury the situation has become much worse. My question is with regards to the PEB, if the DDD is unfitting do they also consider the Radiculopathy or is it considered secondary to the primary injury and not counted? The assumption is that the VA will give me two ratings one for DDD and the other for the Radiculopathy. Any assistance is appreciated.
Thanks
 
Note 1 to the General Rating Formula for Diseases and Injuries of the Spine states,

"Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code." 38 C.F.R. §4.71a​
​
They should rate radiculopathy separately. ​
 
I am in the Army and in the IDES process. I am awaiting a decision from the IPEB. It lists my unfitting conditions as Lumbar DDD with Radiculopathy. Should this have been listed as 1. Lumbar DDD and 2. Radiculpathy? Thanks for the insight. If it should be listed seperately, how do I get it changed?
 
Yes, they are separate conditions (one musuloskeletal, the other neurological). Best time to have addressed it originally was at the MEB level. However, since you are past that point, you may have to address it to the formal board.
 
Should I be seeing doctors while I'm still on active duty to have conditions evaluated, or will the VA do an exam regardless of what my active duty record says?
 
Jessica D. said:
Should I be seeing doctors while I'm still on active duty to have conditions evaluated, or will the VA do an exam regardless of what my active duty record says?
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Absolutely, you should definitely be seeking care. That will help insure that you get a service connection. And, yes, the VA does an exam as well regardless of what your records show.
 
It is very common for the MEB to list the DDD, but not the Radiculopathy on the NARSUM. I had to appeal my NARSUM and have them listed as two separate conditions that failed to meet retention standards. If you don't get this done, you will only get a rating from the service for DDD and not the Radiculopathy. This makes a huge difference. Most DDD cases I have seen are rated at 20% and this will get you severance pay. The Radiculopathy in my case added 10% which resulted in medical retirement. The benefits of being medically retired can't be overstated. Just the Tricare insurance alone far exceeds what you will get from severance.

Just my .02

Joe
 
ranger2992 said:
It is very common for the MEB to list the DDD, but not the Radiculopathy on the NARSUM. I had to appeal my NARSUM and have them listed as two separate conditions that failed to meet retention standards. If you don't get this done, you will only get a rating from the service for DDD and not the Radiculopathy. This makes a huge difference. Most DDD cases I have seen are rated at 20% and this will get you severance pay. The Radiculopathy in my case added 10% which resulted in medical retirement. The benefits of being medically retired can't be overstated. Just the Tricare insurance alone far exceeds what you will get from severance.

Just my .02

Joe
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Joe and Jason,

Thanks for the information. I have been referred for Lumbar DDD with Radiculopathy to the IPEB. I am still awaiting a decision, however, looks like I will be requesting a Formal to address these issues.

I was also listed for Cervical DDD but it was listed as Medically Acceptable. I am also experiencing shooting pain and weakness down my left arm.

Thanks.
 
I have been having issues with my back off and on since 2009 (noted on LOD). I have avoided going to medical for this until 04/2011 it tends to get better on its own. This time it has not I had an x-ray done last Friday and it noted the following information. What does this mean? Is this something a MEB will review?I ask because I was set for a MEB last year and was able to get my L3 down graded to L2 in an effort to deploy.I am going to provide the MRI findings for the Foot here also. Maybe someone will be able to assist me. I am sure I will be facing a MEB again question is when and do i have any case for a medical retirement I am a reserve soldier and would need a 30% rating. My unit does not know about the back I see private MDs.

BACK X-RAY:
FINDINGS: Five non-rib-bearing lumbar vertebrae identified. There is no fracture or spondylolisthesis. Mild endplate spurs of the lower thoracic spine and lower lumbar spine seen. Intervertebral disc spaces are maintained. Mild degenerative facet disease ate the L3-L4 to L5-S1 levels identified. Mild degenerative changes of S1 Joints seen.
IMPRESION: Degenerative changes of spine and pelvis seen without acute fracture or spondyloisthesis of lumbar spine.
I was seen at sick call in april of 2011 for the back and do not have any info on the x-ray they did. I was given meds and sent on my way I cant imagin the x-ray the military did was clear. It only been 11 months now my civilian MD gives me this info. I need to see how to get a complete copy of my medical records from the military to include any x-ray and MRI films not sure how to do that yet.

LEFT FOOT MRI:
TECHNIQUE: The following sequences were performed on a 1.5 Tesla GE Echospeed magnet: Axial T1, axial T2, sagittal T1 and STIR, Coronal T2 and STIR.
FINDINGS: The peroneal tendons are intact. There is marrow edema of the cuboid consistent with bone contusion or stress fracture. There is patchy marrow edema seen of the undersurface of the talus at the ligament of the sinus tarsi consistent with stress change. There is non-visualization of the spring ligament with pes panus deformity consistent with a prior tear. The posterior tebaalis tendon is medially bowed, however otherwise is intact. There anterior tabialis tendon is intact. There is an inferior calcaneal spur.
2.0cm proximal to the insertion, there is some abnormal signal in the Achilles tendon over a sistance of 1.0cm consisten with strain with retrocalcaneal bursitis. There is a small inferior calcaneal spur. The platar facia is intact there is subtle marrow edema of the inferior calcaneus at a heel spur consistent with bone contusion. The posterior talofibular ligament is intake. The calcaneofibular ligament is edematous. The talar dome appears normal. The tibiofiburlar ligaments are intact. There are cysts of the lateral calcaneus at the lateral subtalar joint.
IMPREAION:
1. Old tear of the spring ligament with pes planus. (I never had any issue with my feet not sure how or when the tear happened)
2. Bowed posterior tabialis tendo.
3. Traumatic marrow edema of the cuboid

4. Strain Achilles tendon with retrocalcanel bursitis

5. Bone contusion of the inferior calcaneus.

6. Stress change of the midbody of the talus.
I was placedin in a walking cam for 8 weeks after this MRI. That or a regular cast was the choice.
 
Are any of these conditions in the line of duty (and do you have a LOD showing this)?
 
Jason said:
Are any of these conditions in the line of duty (and do you have a LOD showing this)?
Click to expand...

yes I have an LOD this is the info noted on it.
nature and extent of injury: joint pain localized in the hip (LT), overuse syndome, Back Strain Sacroilliac Reagion, Foot Pain
injury is likely to resurlt in a claim against the gov for future medical care
injury was inccurred in line of duty.

I think the foot is a given becasue the go v did all the care and MRI on it the person who prepaired the LOD noted it was for both feet because her noted foot and did not note LT or RT. not sure is he is correct because most all of the care for my feet was on the left foot.
 
green594 said:
I am being re-evlauated by the VA for Lumbar DDD with radiculopathy. My previous rating was 10% for DDD but due to a moderate injury the situation has become much worse. My question is with regards to the PEB, if the DDD is unfitting do they also consider the Radiculopathy or is it considered secondary to the primary injury and not counted? The assumption is that the VA will give me two ratings one for DDD and the other for the Radiculopathy. Any assistance is appreciated.
Thanks
Click to expand...

Green,
I have a very similar situation as yourself and received 20% severance pay from the NAVY for back issues and medicallly seperated.

I filed with the VA around 9 months later and 6 months after that received a 20% disability rating from them under 10% for DDD and 10% for DDD with radiculopathy (20%).

One thing I can say about anything additional that is giving you pain. You should not leave the service before being treated for all of them sufficiently as your VA Rating will depend on this.

I can tell you that I also hurt my wrist in the NAVY and was treated once. I got out and the VA found my wrist non-service connected due to lack of treatment and/or non-major issue. I was told by the VA expert at his office today that I cannot get service connection for the wrist unless I find new information from when I was AD that they did not consider...I have none. So, my now hurting wrist is my problem.
 
OverqualifiedNavy said:
Green,
I have a very similar situation as yourself and received 20% severance pay from the NAVY for back issues and medicallly seperated.

I filed with the VA around 9 months later and 6 months after that received a 20% disability rating from them under 10% for DDD and 10% for DDD with radiculopathy (20%).

One thing I can say about anything additional that is giving you pain. You should not leave the service before being treated for all of them sufficiently as your VA Rating will depend on this.

I can tell you that I also hurt my wrist in the NAVY and was treated once. I got out and the VA found my wrist non-service connected due to lack of treatment and/or non-major issue. I was told by the VA expert at his office today that I cannot get service connection for the wrist unless I find new information from when I was AD that they did not consider...I have none. So, my now hurting wrist is my problem.
Click to expand...


I was on active duty for BCT and AIT at the time the LOD was issued in 2009. I have always been a reserve soldier. I have stopped going to MTF I now see civilian doctors MTF is to much red tape. The military did not note any actual issue with my back just gave me pain meds. I guess I need to get a copy of the X-ray report from last year to see what came back on that. I can’t imagine the issues noted on the one I had last week were not there 11 months ago when the MTF took X-rays.
 
tarain said:
I was on active duty for BCT and AIT at the time the LOD was issued in 2009. I have always been a reserve soldier. I have stopped going to MTF I now see civilian doctors MTF is to much red tape. The military did not note any actual issue with my back just gave me pain meds. I guess I need to get a copy of the X-ray report from last year to see what came back on that. I can’t imagine the issues noted on the one I had last week were not there 11 months ago when the MTF took X-rays.
Click to expand...

PAPER TRAIL hopping all the way!:D
 
ranger2992 said:
It is very common for the MEB to list the DDD, but not the Radiculopathy on the NARSUM. I had to appeal my NARSUM and have them listed as two separate conditions that failed to meet retention standards. If you don't get this done, you will only get a rating from the service for DDD and not the Radiculopathy. This makes a huge difference. Most DDD cases I have seen are rated at 20% and this will get you severance pay. The Radiculopathy in my case added 10% which resulted in medical retirement. The benefits of being medically retired can't be overstated. Just the Tricare insurance alone far exceeds what you will get from severance.

Just my .02

Joe
Click to expand...
How do I make sure that both conditions are being considered? I had cauda equina syndrome, so I certainly do not want my nerve damage overlooked! I'd be one angry sailor! And, in medical retirement, does that work like normal retirement? Like, do you get an ID card, exchange privileges, etc.? Or is it just medical benefits?
 
Jessica D. said:
How do I make sure that both conditions are being considered? I had cauda equina syndrome, so I certainly do not want my nerve damage overlooked! I'd be one angry sailor! And, in medical retirement, does that work like normal retirement? Like, do you get an ID card, exchange privileges, etc.? Or is it just medical benefits?
Click to expand...

I am not familiar with cauda equina, but it should be the same for any condition. Make sure the VA docs document it. Once it's in writing, you can check it against your services medical standards for service. If the condition does not meet retention standards, then you make sure your NARSUM has it listed that way. If it's not listed, appeal it.

Although the system is lenthly, cumbersome, and hard to understand, it is also set up to let you flash a stop sign during the process and make sure everything is going by the rules. Remember, they are all human beings too. They make mistakes just like we do. I think there are very few out there that set out to hurt service members. They just make mistakes during their daily grind.

This is why there is a MEB Counsel, VFW, Purple Heart, the VA, and many other organizations. They will look at your stuff and advise you to whether or not your board is good. Make sure you yourself completely understand this process. Don't rely on experts to set you straight. You need to be able to set them straight.

The last thing I will say is don't get impatient! Going through this process I saw a lot of people that were very focused on the end game of being out of the military. These people were and are very suseptable to letting things slip. They want out in the fasted means possible, and will buy the old statement of "the VA will take care of it when you're out". You have to keep your eyes wide open and be able to flash that stop sign if you want this to meet your needs. Saying stop may add some time to your board, but it's well worth it if it equates to you getting your full benefits.

Joe
 
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