More importantly, when both the lumbar spine and cervical spine are affected by spinal stenosis, the two may be separately rated unless both are frozen in an unfavorable position. The rating will largely depend on whether you have lost range of motion as a result of stenosis. The only problem is that I have had spinal fusion on my lower back on oct 8 2008, I was faxing the DAV all my information as I would get it from the doctors. This data may be used to help optimize our websites and make them easier for you to navigate. These cookies are essential so that you can move around the website and use its features. Theres no presumptive benefit the burden is on the veteran to demonstrate a service connection to the stenosis. have the greatest impact on the veterans ability to work. The spine is considered as a minor joint. THE ISSUE. However, you may get a 100% VA disability rating for up to one year after serious back surgery, such as a spinal fusion. If two or more major OR minor groups are affected a 20% rating will be assigned if the arthritis is occasionally incapacitating. To find out more, view our Privacy Policy. Lack of cartilage causes pain and limitation of motion. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals. If you are concerned that your VA disability percentage for spinal stenosis fails to account for the extent of your disability, you may wish to speak to a VA benefits lawyer. Does Spinal Stenosis Qualify for Disability Benefits? 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. Pain, numbness, tingling, muscle weakness, and loss of motor control are some of the symptoms of the 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. Getting Veterans (VA) Disability for Spinal Injuries, Radiculopathy VA Disability Ratings and Benefits, VA Disability Ratings for Neck Pain Explained. Also, the VA requires that all ROM measurements be taken with a goniometer. You can file a disability claim for any secondary symptoms or conditions caused by your service-connected degenerative disc disease. 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. As discussed above, nerve pain in the leg may be diagnosed as a leg injury rather than spinal stenosis. Its never too late to apply for VA benefits. Have you been affected by Camp Lejeune water contamination? The VA can reject a claim that your condition was made worse during your service if it believes that the worsening was a natural progression of the condition. In a February 2007 rating decision, the RO granted service connection for spinal stenosis and degenerative disc disease of the lumbar spine. The VA routinely mishandles spinal injury claims. Acute, Subacute, or Chronic Diseases Prosthetic Implants and Resurfacing 1 Also entitled to special monthly compensation. Because there are technically, As mentioned above, many different joints are rated under the rating criteria for degenerative arthritis. Many people only think about their medical issues when applying for Social Security disability. Copyright 2023 Woods and Woods, LLC | PO Box 1287 Evansville, IN 47706. Thank you so much Woods & Woods. When you visit web sites, they may store or retrieve data in your web browser. However, it can also be caused by herniated discs, thickened ligaments in your spine, tumors, and spinal injuries. Spinal stenosis is a degenerative disc disease that occurs when there is pressure placed on the nerves in your spine. An increase at this point for a spine disability requires additional loss of range of motion, ankylosis, or . The diagnostic code for traumatic arthritis is 5010. The information you obtain on this website is not, nor is it intended to be, legal advice. This occurs when the soft tissue discs between segments of the spine become displaced and are squeezed into the spinal nerve canal or into the ventral nerve roots. Philadelphia, PA: 1 International Plaza, Suite 550, Philadelphia, PA, 19113 Keep in mind that arthritis will only be rated under diagnostic code 5003 when the condition does not result in severe enough limitation of motion to be rated under the general rating formula for the spine. The disability rating is the highest rating produced by the rating tables. Muscle guarding occurs when muscles react to prevent pain or discomfort. To qualify for disability because of spinal stenosis, you must meet several requirements: The stenosis must be in your lumbar region. Houston, TX: 2925 Richmond Ave, 12th Floor, Houston, TX 77098 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. We use cookies to ensure that we give you the best experience on our website. Because there are technically two diagnostic codes associated with one condition, you would see the condition listed on rating decisions as 5242-5003. To continue receiving VA disability benefits, you should be compliant with these exams. Ratings will fall between 0% and 100% disability. Entire thoracolumbar spine is frozen in an unfavorable position. These mistakes cost veterans at least $5.9 million in payments over the period studied. One common cause of foraminal stenosis and radiculopathy is a bulging or herniated disc. It can cause muscle weakness and pain or cramping extending from the buttocks down through the leg. However, generally speaking, symptoms may include the following: Most often, spinal stenosis is caused by overuse or general wear-and-tear changes in the spine related to osteoarthritis. Depending on what joint is affected, there will be an identifying diagnostic code assigned to the condition. VA Disability Claims List: What Conditions Can Veterans Claim? 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. Our monthly newsletter features about important and up-to-date veterans' law news, keeping you informed about the changes that matter. For example: Suppose you were diagnosed with whiplash as a result of a Humvee accident while you were in the service. However, Veterans can also receive disability compensation on a secondary basis. For a Veteran to get a disability service connected, they must: If a Veteran can prove all three elements listed above, they should be given a disability rating by the department of Veterans affairs. Entire cervical spine is frozen in an unfavorable position. However, the VA still rates degenerative arthritis of the spine under the criteria listed for diagnostic code 5003. These cookies dont collect information that identifies you. 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. Some examples of cervical conditions that are rated under this code include the following: Diagnostic Code 5237 Cervical Strain A torn tendon or muscle in the neck. 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. A, Oftentimes, spinal conditions will cause other conditions, and these conditions qualify a Veteran for another rating. This disruption can cause strange sensations and loss of muscle control in the affected areas. They may also be used to keep track of what [products, video, links, etc.] Under the IVDS schedule, a VA disability rating can be obtained based on the number and frequency of incapacitated episodes in which bed rest is ordered by a physician. These cookies allow the website to remember choices you make to give you better functionality and personal features. There are two types of arthritis that are rated under the same rating system; degenerative arthritis, and traumatic arthritis. 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 . REPRESENTATION. The rating will largely depend on whether you have lost range of motion as a result of stenosis. This metric is used in calculating your VA disability rating. Yes, you can. For example, if you receive a VA disability rating based on a general spinal injury but could have received a higher VA disability rating for IVDS, you can submit additional evidence showing that your spinal stenosis is caused by a bulging, herniated, or degenerated disc and request a re-calculation. If the entire spine is frozen in an unfavorable position, the disability rating may be as high as 100%. With regard to the medical opinion, doctors must state that your condition is at least as likely as not due to your time in service. Its possible for rheumatoid arthritis to be rated under diagnostic code 5003 like degenerative and traumatic arthritis. Stenosis can occur in the spinal column itself, or it can occur within the intervertebral foramen, which are the passages through which your nerve roots branch out laterally through the spine. What is the diagnostic code for traumatic arthritis? To qualify for disability because of lumbar spinal stenosis under listing 1.16, you must show that you suffer from ALL of the following: Non-radiating pain in one or both legs, or non-radiating loss of feeling in one or both legs, or neurogenic claudication (pain or cramping caused by nerve compression) However, the VA still rates degenerative arthritis of the spine under the criteria listed for diagnostic code 5003. Typically, this would be established by medical records from your time in the military showing that your condition worsened. 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 Rather, they are added using VA math. This field is for validation purposes and should be left unchanged. This opinion will be most favorable when it comes to establishing service connection. Incomplete but severe paralysis of the sciatic nerve could then result in a 60 percent disability rating according to the social security administration. 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). 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 only occur in extraordinary cases in which the VA ratings formula does not account for the effects or consequences of your disability. All information these cookies collect is aggregated and therefore anonymous. Do You Qualify for Long Term Disability Benefits? 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. In most cases, foraminal stenosis is caused by gradual degeneration of the spine that happens as you age. Additional medical appliances may be required. The VA has a separate rating system for these conditions. They fought hard for me and got me more than I ever could dream of. The rating systems used for arthritis of the spine is the second most common rating system for spine conditions. Some of the most common disabilities Veterans have are the result of injuries to their back, especially those related to the spine. 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. In all other cases, the ROM measurements of the lumbar spine are rated separately from the ROM measurements of the cervical spine. Table II - Ratings for Multiple Losses of Extremities With Dictator's Rating Code and 38 CFR Citation Note. This information is not a substitute for legal advice. Your spinal stenosis may cause or contribute to other medical conditions, as well. 5239 - VA disability rating for Spondylolisthesis or segmental instability: A condition that causes a vertebra to slide forward over the bone below it. I had been fighting for my benefits since 1980 by myself and I managed to get 50% rating. If you were denied disability benefits by the VA or were given a low disability rating, Berry Law can help you appeal.
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