DOD Rating Question

Hello All,

Has anyone been rated for Cervical Degenerative Disc Disease other than IVDS and Cervical Spinal Stenosis? I was wondering if the DOD will combine these two or rate them separately,

Thanks

 

[bjenk]

I am a little confused with your profile. Is it other than or with IVDS? Does your profile include cervical DDD with radiculopathy or headaches, or other secondary disabilities? It sounds like you will be rated for cervical DDD based on limited range of motion. If you are having constant pain, weakness and numbness in the arms and hands, please report everything you think that may be linked to cervical DDD. Tell your medical team and chain of command how your disabilities limit your military duties and physical fitness training.

 

[thanks4urhelp]

I got individual ratings for DDD and cervical strain and both were based on ROM. But if both conditions are localized to your cervical spine, that will likely only get a rating based on ROM.

 

[chaplaincharlie]

ROM applies to joints, nerves are rated separately by nerve group. VA does all ratings. DoD only decides fit or unfit.

 

[mos63b]

Gentlemen, I appreciate the response; I was given different opinions on how the DOD will rate. I was trying to understand if both medical issues are related to the cervical area. Will they provide one rating for my problems or two separate ratings? Cervical DDD other than IDVS and Cervical Stenosis.

 

[thanks4urhelp]

Gentlemen, I appreciate the response; I was given different opinions on how the DOD will rate. I was trying to understand if both medical issues are related to the cervical area. Will they provide one rating for my problems or two separate ratings? Cervical DDD other than IDVS and Cervical Stenosis.

Here's what I found:

Under Diagnostic Code 5238, spinal stenosis is evaluated using the General Rating Formula for Diseases and Injuries of the Spine. See 38 C.F.R. § 4.71a, Diagnostic Code 5238 (2010). The schedule for rating spine disabilities was changed, effective September 26, 2003, to provide for the evaluation of all spine disabilities under a new General Rating Formula for Diseases and Injuries of the Spine, unless the disability is rated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes (renumbered as Diagnostic Code 5243).

Source is hyperlinked on the text above. Keep in mind this seems to be a case interpretation and decision which could be outdated, though law firms soliciting their services seem to agree that stenosis is still based on ROM.

I think that the two issues would end up being lumped into the same rating as they seem to be rated under the same criteria. Not sure if you're familiar with the concept of pyramiding, but it's essentially a way to stop people from claiming issues that have multiple origins from stacking percentages on top of eachother for higher benefit. Like if I had a wrist strain, but I also had arthritis in that wrist. I would likely only get the one rating.

Now here's the difference: you can claim nerve issues like radiculopathy and that would be a separate rating.

I'm just a dude going through this process as well, so believe me when I say I'm not a professional this is just my interpretation. I could have been an asshole and just linked the Hill & Ponton site that states it's ROM based but that's a shit answer, it's always better to see it from the VA. Hope the perspective helps somewhat.

 

[mos63b]

ROM applies to joints, nerves are rated separately by nerve group. VA does all ratings. DoD only decides fit or unfit.

Thanks

Here's what I found:

Under Diagnostic Code 5238, spinal stenosis is evaluated using the General Rating Formula for Diseases and Injuries of the Spine. See 38 C.F.R. § 4.71a, Diagnostic Code 5238 (2010). The schedule for rating spine disabilities was changed, effective September 26, 2003, to provide for the evaluation of all spine disabilities under a new General Rating Formula for Diseases and Injuries of the Spine, unless the disability is rated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes (renumbered as Diagnostic Code 5243).

Source is hyperlinked on the text above. Keep in mind this seems to be a case interpretation and decision which could be outdated, though law firms soliciting their services seem to agree that stenosis is still based on ROM.

I think that the two issues would end up being lumped into the same rating as they seem to be rated under the same criteria. Not sure if you're familiar with the concept of pyramiding, but it's essentially a way to stop people from claiming issues that have multiple origins from stacking percentages on top of eachother for higher benefit. Like if I had a wrist strain, but I also had arthritis in that wrist. I would likely only get the one rating.

Now here's the difference: you can claim nerve issues like radiculopathy and that would be a separate rating.

I'm just a dude going through this process as well, so believe me when I say I'm not a professional this is just my interpretation. I could have been an asshole and just linked the Hill & Ponton site that states it's ROM based but that's a shit answer, it's always better to see it from the VA. Hope the perspective helps somewhat.

thank4urhelp: Someone told me the very same thing. However, I figure someone may have some better insight. I appreciate the assistance. I believe you are right. What is sad is they are saying my radiculopathy is fitting. It makes no sense. It seems they are always trying to screw us. Thanks

 

[thanks4urhelp]

Thanks

thank4urhelp: Someone told me the very same thing. However, I figure someone may have some better insight. I appreciate the assistance. I believe you are right. What is sad is they are saying my radiculopathy is fitting. It makes no sense. It seems they are always trying to screw us. Thanks

The burden of proof for a condition to be unfitting is pretty damn high. You have to imagine that that issue could be emphasized enough to be seen as a sole reason to get you out. Leg numbness and pain short of significant paralysis would be hard to justify under those terms.

Many individuals who board out get 90% or above, and only one condition is considered unfitting. It's strange because an unfitting condition could be 30 or 40%, and that SM could have conditions that are rated at 50% or 60% and the branch could say nope they could live with that in service just fine.

I don't make the rules but I sure can laugh at them, they're a little crooked sometimes.

 

[chaplaincharlie]

The burden of proof for a condition to be unfitting is pretty damn high.

Each branch of the service has published guidelines as to what makes a member unfit. The standards vary by service and by rate/MOS/AFSC. The guidance for each service is found on the Resources Tab of this website. The standards for retention are very different than the standards for accession.