Any injuries or disabilities that are the result of military service are eligible for compensation by the Department of Veterans Affairs (VA). Their testimony can mean the difference between an approval or a denial of your case. The general rating formula for spinal stenosis and the other spinal conditions listed above is as follows: General Rating Formula Spinal Stenosis and Select Spinal Conditions. 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. After recovery, the VA will re-evaluate their condition. If you believe you may have been wrongly denied benefits, you may benefit from the services of a VA disability lawyer. Because c-spine stenosis is a degenerative illness, a person's condition will continue to deteriorate . Depending on what joint is affected, there will be an identifying diagnostic code assigned to the condition. The diagnostic code for rheumatoid arthritis is 5002. Registration is FREE of charge! The attorneys at Berry Law Firm are dedicated to helping injured Veterans. You can file a disability claim for any secondary symptoms or conditions caused by your service-connected degenerative disc disease. You can talk these problems over with your physician, as well. Table II - Ratings for Multiple Losses of Extremities With Dictator's Rating Code and 38 CFR Citation Note. Some joints are referred to as major joints, while others are referred to as minor joints. As you can see, ROM measurements play a significant role in rating spinal conditions. Acute, Subacute, or Chronic Diseases Prosthetic Implants and Resurfacing 1 Also entitled to special monthly compensation. VA/DoD CLINICAL PRACTICE GUIDELINE FOR DIAGNOSIS AND TREATMENT OF LOW BACK PAIN Department of Veterans Affairs Department of Defense . What is the diagnostic code for traumatic arthritis? It is rated under another diagnostic group. Lack of cartilage causes pain and limitation of motion. Degenerative arthritis of the spine, sometimes referred to as facet joint osteoarthritis, causes a breakdown of the cartilage between the facet joints in the back of the spine. Please call for an appointment before visiting: Mail Processing Center: P.O. That is, they get it wrong more than half the time. Disability Evaluation Under Social Security 1.00 Musculoskeletal Disorders - Adult Section 1.01 Category of Impairments, Musculoskeletal . How to Appeal a Denied Veterans Disability Claim Copyright 2023 Hill & Ponton, P.A.. All Rights Reserved. Incomplete but severe paralysis of the sciatic nerve could then result in a 60 percent disability rating according to the social security administration. If these conservative options dont get results, your doctor may recommend injecting a corticosteroid into your spine, which can give you relief for a few days or weeks. The technical storage or access that is used exclusively for anonymous statistical purposes. These complications of stenosis are called. have the greatest impact on the veterans ability to work. Our doctors know how service-connected disabilities work, so they know what to look for in your file. There are two types of arthritis that are rated under the same rating system; degenerative arthritis, and traumatic arthritis. If you believe you may have been wrongly denied benefits, you may benefit from the services of a VA disability lawyer. Spinal stenosis can cause a variety of symptoms depending on the location of the spinal stenosis and the compressed nerve. These secondary conditions would be rated separately from the underlying spinal condition. These cookies allow the website to remember choices you make to give you better functionality and preferences such as text size, fonts and other customizable website elements. Neck muscle injuries. Also, the VA requires that all ROM measurements be taken with a goniometer. Under 38 CFR 4.73, injuries to neck muscles are compensated differently depending on the severity of the impairment and the muscles affected. Other causes include tumors and lesions, enlargement of facet joints, thickened ligaments, injuries that cause displacement of vertebrae, vertebral fractures, and rheumatoid arthritis, which can cause bone spurs. 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. yet assertive representation for our clients. For example, if the spine is frozen tilted to one side or leaning forward, that would constitute an unfavorable position. This can severely affect your movement and eventually takes a toll on your ability to move. For example, a cervical spine with forward flexion of 15 produces a VA disability percentage of 30% and a lumbar spine with a total ROM of 120 produces a VA disability percentage of 20%, for an overall VA disability rating of 40%. As evidenced by the rating schedules below, the only back condition eligible for a 100 percent schedular rating is unfavorable ankylosis (immobility) of the entire spine. A very common impairment caused by this nerve compression is sciatica. It may also cause bladder and bowel issues. Incomplete but severe paralysis of the sciatic nerve may lead to a 60 percent disability rating. means your spine is locked in a position that is something other than vertical. Appellant represented by: Disabled American Veterans. Spinal stenosis will cause pain in different areas of the body including the neck, lower and middle back, your buttocks and legs. Service-connected disabilities vary widely in severity and type: Some examples are the loss of a limb, migraines, and hypertension. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals. Our firm was founded in 1986 in Orlando, Florida. All rights reserved. Pain, numbness, tingling, muscle weakness, and loss of motor control are some of the symptoms of the condition. Forever Grateful, [K.S.]. One common cause of foraminal stenosis and radiculopathy is a bulging or herniated disc. By using our website, you agree to the use of certain cookies. Stenosis can occur in the cervical or c-spine (neck) and lumbar (lower back) areas of the spine. It can cause muscle weakness and pain or cramping extending from the buttocks down through the leg. For example, 5241 spinal fusion VA rating and 5238 spinal stenosis VA rating are calculated entirely on the range of motion (ROM) of your back even though spinal fusion and spinal stenosis are very different conditions. 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 rating will largely depend on whether you have lost range of motion as a result of stenosis. Another way to connect your disability to your service is to show that you had been diagnosed with spinal stenosis prior to your service, and the condition worsened during your service. These mistakes cost veterans at least $5.9 million in payments over the period studied. Call 512-454-4000 for help today. The rating assigned under the rating criteria for degenerative arthritis depends on how many joint groups are affected and whether there is painful motion. These exams are called comprehensive preventive health evaluations (CPHE) or wellness checks.. If spinal stenosis is suspected, your doctor may order X-rays, magnetic resonance imaging (MRI), and/or CT or CT myelogram. Secondary service connection occurs when a service-connected disability causes another disability. Finally, the general VA disability ratings table for spinal injuries and diseases allows ratings based on muscle guarding, muscle spasm, or tenderness in your back. A, Oftentimes, spinal conditions will cause other conditions, and these conditions qualify a Veteran for another rating. During the months after surgery, veterans are entitled to a 100% disability rating so they can recover from the procedure. Yes No Does applicant expect to be out of work for at least 12 months? The VA will use a series of diagnostic codes for areas of the spine. Confidential or time-sensitive information should not be sent through this form. This condition causes small bones in your spine to fuse in place to one another, sometimes resulting in significant range-of-motion loss. 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. Lumbar spinal stenosis resulting in compromise of the cauda equina 1.17 Reconstructive surgery or surgical arthrodesis of a major weight-bearing joint 1.18 Abnormality of a major joint(s) in any extremity . The rating assigned under the rating criteria for degenerative arthritis depends on how many, Rheumatoid arthritis is a disease that causes destruction of the joints in the body. Since that time, we have provided compassionate You may not notice at the onset, but the pain will evolve slowly over time. Cookies help us deliver the best experience on our website. Williamsburg, VA 23185. You should consult an attorney for advice regarding your individual situation. By using this information, you understand that there is no attorney-client relationship created by you reading or using the information contained on this website or in this newsletter, article, or blog. I had been fighting for my benefits since 1980 by myself and I managed to get 50% rating. We use your disability rating to determine how much disability compensation you'll receive each month, as well as your eligibility for other VA benefits. In a February 2007 rating decision, the RO granted service connection for spinal stenosis and degenerative disc disease of the lumbar spine. AVVO 10/10 Superb Rating, BBB A+ Rated. The VA awards disability ratings for incapacitating episodes as follows: You may be asked to take a compensation & pension exam (C&P exam). It will also help if someone else in your division remembers what happened. A post-service diagnosis of spinal stenosis can sometimes be used to show that the condition was misdiagnosed during your time in the service. NOTE: Entitlement of a spinal condition includes spinal stenosis. This opinion will be most favorable when it comes to establishing service connection. For some veterans, the objective criteria in the disability rating schedule may not accurately reflect their true level of disability. Not necessarily, but its worth looking at your C-File to see if you had spinal stenosis during your service and it was incorrectly diagnosed. These exams are called comprehensive preventive health evaluations (CPHE) or wellness checks., The VA routinely mishandles spinal injury claims. To qualify for a 100% rating for stenosis, you would have to have severe ankylosis across your entire spine, locking your spine in an unfavorable condition, unless you have one or more severe secondary conditions. In some cases, the VA may help veterans get surgery to treat spinal stenosis. Contacting us does not create an attorney-client relationship. In extreme cases, spinal stenosis can cause incontinence or constipation if the compressed nerve controls the muscles surrounding the bladder or bowel, respectively. The same veteran with a 100% disability rating would receive $3,106.04. See Entitlement Considerations, Section B of this . In fact, occasionally, the back pain associated with spinal stenosis may be dwarfed by the nerve pain experienced in the legs, feet, arms, and hands. which may qualify you for a higher rating. If the spine is frozen in a favorable position, the disability rating may be capped at 40%. I served during peace timein theArmy. . Trouble walking, and loss of bowel or bladder control may also result. Ratings will fall between 0% and 100% disability. A favorable position means the ROM measurement for flexion or extension is 0 degrees. Its never too late to apply for VA benefits. Spine Condition Ratings. Causes can include herniated or bulging spinal discs. The exact VA disability percentage for spinal stenosis that has caused a frozen spine depends on the position where the spine is frozen. Disability benefits are paid for service-connected disabilities. Specifically, VA rates spinal stenosis according to its General Rating Formula for Diseases and Injuries of the Spine, outlined below: If you were denied VA disability benefits for spinal stenosis, Chisholm Chisholm & Kilpatrick LTD may be able to help you through the appeals process. This information is made available for educational purposes only and to provide general information and a general understanding of the law. Some of the most common disabilities Veterans have are the result of injuries to their back, especially those related to the spine. A VA lawyer can run through all the scenarios with you for obtaining a fair VA disability rating that reflects the ways spinal stenosis affects you. Flexion measures 30 degrees or less, OR entire thoracolumbar spine is frozen in a favorable position. 203, San Jose, CA 95134 When these lateral nerve roots become compressed, it can disrupt the signals passing from your brain and spinal column out through the nerve roots to your arms, legs, and other parts of your body a condition called foraminal stenosis, which can cause radiculopathy. If severe enough, anxiety and depression arising from a service-related condition may also qualify for an additional disability rating. So, spinal disabilities focus on the lack of mobility or range of motion. 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. Conversely, when the lumbar spine (the lower section of the back) is affected, symptoms may cause pain and nerve sensations in the back, legs, and feet. These cookies may be set through our website by our advertising partners. Yes No To qualify for disability because of spinal stenosis, you must meet several requirements: The stenosis must be in your lumbar region. 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. The RO assigned an initial 10 percent rating for the disability, effective June 13, 1994. 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. For example, the specific code for degenerative arthritis of the spine is 5242. The following percentages are available under the rating criteria for rheumatoid arthritis: Its possible for rheumatoid arthritis to be rated under diagnostic code 5003 like degenerative and traumatic arthritis. The most straightforward pathway to fulfilling this criterion is a diagnosis of spinal stenosis in your military records. Congenital spinal stenosis is present at birth as a normal variant in the population or due to congenital conditions. Additional medical appliances may be required. Do you have a low back (lumbar) injury related to your military service? 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. You may be eligible for VA disability benefits if you meet both of these requirements. Both upper (cervical) and . These measurements are taken while bending the neck and back forward and backward, tilting the neck and back from size to side, and rotating the neck and back to each side. Background In 2017, 4.5 million veterans with medical conditions or injuries that occurred or worsened during active-duty service received disability compensation from the Department of Veterans Affairs (VA). 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: Although this type of arthritis is most common in the small joints of the hands and feet, it can occur in any joint. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Lawyers 6940 O St, Suite 400 Lincoln, NE 68510. As discussed above, nerve pain in the leg may be diagnosed as a leg injury rather than spinal stenosis. Although this type of arthritis is most common in the small joints of the hands and feet, it can occur in any joint. If your spine is locked, but its in a favorable condition, your disability rating may be as low as 30% or 40%. With this in mind, its important to know which spinal conditions are not rated under the general rating formula. Prosthetic replacement of knee joint: For 1 year following implantation of prosthesis 100 Flexion measures 15 degrees or less, OR entire cervical spine is frozen in a favorable position. For instance, which pages you go to most. Furthermore, as to case summaries, reports of past results, individual lawyer biographies, news posts and other information pertaining to past and present cases, these descriptions are meant only to provide information to the public about the activities and experience of our law firm. for L3 -L4 L4-L5 L5- S1 in the past they are rating as post operative residuals of . These cookies dont collect information that identifies you. . While we still have our home base in Florida, Please complete this form to send us your message. Our monthly newsletter features about important and up-to-date veterans' law news, keeping you informed about the changes that matter. To continue receiving VA disability benefits, you should be compliant with these exams. Traumatic arthritis causes symptoms similar to other types of arthritis such as pain, inflammation, and build-up of fluid around the affected joint. Please register to post comments. If your spine is not frozen, the VA disability rating for spinal stenosis will depend on the ROM measurements using a goniometer. Its possible for rheumatoid arthritis to be rated under diagnostic code 5003 like degenerative and traumatic arthritis. That is, they get it wrong more than half the time. These cookies allow the website to remember choices you make to give you better functionality and personal features. Spinal stenosis is a medical condition in which the passages through which your nerves travel through your spine become narrow or partially blocked. The spine is considered as a minor joint. In order to ensure that youre getting the most out of your disability claim, you need to understand how the VA rates your condition. A single veteran with no dependents and a total disability rating of 40% would receive $627.61 per month, as of 2020. For example, if spinal stenosis causes nerve pain or other issues in the peripheral nerves of the arms, hands, legs, or feet, you may be able to obtain a higher VA disability rating through an independently ratable peripheral nerve disability. Experienced Social Security Disability Lawyer. we represent clients nationwide. However, the VA still rates degenerative arthritis of the spine under the criteria listed for diagnostic code 5003. Canes range from $25 to $100 and walkers can be more than $200. Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae. The VA disability rating for spinal stenosis will be based on both individual ROM measurements and the total ROM measurement. If a doctor doesnt use a goniometer to measure your ROM, 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. Updated: August 3, 2020. This can lead to a misdiagnosis of spinal stenosis. The VA assigns rating percentages based on the frequency of incapacitating episodes. Many people only think about their medical issues when applying for Social Security disability. Examples of a few disability ratings for spinal stenosis are: 20%: A 20% disability rating for spinal stenosis means you have more than 30 degrees forward flexion of the thoracolumbar spine, but not greater than 60 . While these codes may seem important, the rating formula is the same whether you suffer from spinal stenosis, intervertebral disc syndrome, vertebral dislocation or fracture or another condition. Cincinnati, OH: 300 E Business Way, Suite 200, Summit Woods Corporate Center, Cincinnati, OH, 45241 A TDIU is an award of increased compensation. If you were denied disability benefits by the VA or were given a low disability rating, Berry Law can help you appeal. When spinal stenosis causes additional disabilities, those problems may qualify as secondary service-connected disabilities. Less frequently, stenosis can occur in the upper back (thoracic). Spinal stenosis Mental health disorders, such as depression and anxiety And more. Vertebral fractures and dislocations (diagnostic code 5235). It is the problems that may be CAUSED by Spinal Stenosis that are rateable. WITNESS AT HEARING ON APPEAL. For example, if your spinal stenosis is caused by a bulging disc, dislocated vertebrae, or bone fragments, you may be able to identify an accidental fall, vehicle collision, or any other physical injury incurred during your military service that worsened your condition. When these lateral nerve roots become compressed, it can disrupt the signals passing from your brain and spinal column out through the nerve roots to your arms, legs, and other parts of your body a condition called, Your spinal stenosis may be accompanied by other back conditions, including, Lumbosacral or cervical strain (diagnostic code 5237) used to refer to neck or, Spondylolisthesis/segmental instability (, Ankylosing spondylitis (diagnostic code 5240) a painful type of spinal arthritis.