Help with the diagnosis....Quick

My husband has degenerative disc disease at L4-L5 and L5-S1 and they wanted at the local MEB board to change his diagnosis to Lumbago? Isn't that very broad definition? He has arthritis in those places, two prolapse discs and because of how he has been limping has not arthritis of right hip and knee
 
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"They" did the same to my husband. Changed it from degenerative disc disease after 2 herniated disc surgeries to "chronic pain status post surgeries". I believe it is in the favor of the Military, I don't see us getting over 30% for chronic pain. After 2 years of waiting for a P3 profile, my husband was too "tired" and afraid to fight it. Either way, we are stationed overseas, we are not yet rated combined like in the pilot programs, so we get screwed anyway. If you guys are up for it, I would try to get the profile amended.
Good luck!
Ursula
 
Lumbago is defined as basic back pain...DDD is VA compensable. I would NOT let them change the diagnosis to Lumbago. I personally would request either a diagnosis of OA or DDD for the back.

One question I do have is was your husband on jump status? Impact fractures and DDD that where not diagnosed before might pop up now. My spine specialist looked at my MRIs and said I had impact fractures and stress fractures that never healed. And he worked on astronauts, Bush 41, NASCAR racers and others. I find the military is using residents, not doctors, to make evaluations. And they tend to minimize issues.
 
Any disability of the back would be rated under the General Schedule for Rating Spine Conditions or under Intervertebral Disc Syndrome criteria for ratings for Incapacitating Episodes. So, as long as they are not saying he no longer has a back disability, it should not matter to the outcome as far as rating.
 
That is what I feared, but we were told that the MEB doc was a orthopedic specialist and even though the PCM said DDD he would keep it at lumbago. We have MRI and X-rays that backs us up, and we do have Neurosurgeon and pain specialist on our side. It's daunting...the packaged was sent off, so we would have to just stick with the diagnosis now. My husband didn't fight it.
 
Hi,

I am sorry for your pains too, we are also overseas. It' complicates many things I feel...
 
Jason said:
Any disability of the back would be rated under the General Schedule for Rating Spine Conditions or under Intervertebral Disc Syndrome criteria for ratings for Incapacitating Episodes. So, as long as they are not saying he no longer has a back disability, it should not matter to the outcome as far as rating.
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My concern is that the Physical therapist mentioned that my husband was having pains when he shouldn't...that he was guarded. Then his PCM who we have trusted diagnose my husband with DDD and he goes in after and changes it?! My husband thinks that it might be to help him out, but I don't see how a doctor he never met is more helpful then a PCM who has taken good care of him for a few years.

Its all just very frustrating, as I am just the spouse..
 
What outcome does your husband want? Not sure what was changed...if it was just one note, the more important thing is what is in the MEB Narrative summary. That document should be accurate, if it is not, then that is a problem. But, guarding would only be an issue if the ROM was such that the guarding results in a higher rating. Here is the relevant portion of the rating criteria:


Forward flexion of the thoracolumbar spine greater than 30 degrees but not
greater than 60 degrees; or, forward flexion of the cervical spine greater
than 15 degrees but not greater than 30 degrees; or, the combined range of
motion of the thoracolumbar spine not greater than 120 degrees; or, the
combined range of motion of the cervical spine not greater than 170 degrees;
or, muscle spasm or guarding severe enough to result in an abnormal gait
or abnormal spinal contour such as scoliosis, reversed lordosis, or
abnormal kyphosis 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not
greater than 85 degrees; or, forward flexion of the cervical spine greater than
30 degrees but not greater than 40 degrees; or, combined range of motion of
the thoracolumbar spine greater than 120 degrees but not greater than 235
degrees; or, combined range of motion of the cervical spine greater than
170 degrees but not greater than 335 degrees; or, muscle spasm, guarding,
or localized tenderness not resulting in abnormal gait or abnormal spinal
contour; or, vertebral body fracture with loss of 50 percent or more of the
height 10
If the ROM results in a higher rating, then this won't matter. If it does, then it should be rebutted.
 
They changed the whole diagnosis. Plus they mentioned that he might be scared of pain...more than he actually felt pain. It's really upsetting because I live with him and this pain limits more than just movement at work...It hurts us at home too. His range of motion is less than 30 degrees.
 
Jason said:
What outcome does your husband want? Not sure what was changed...if it was just one note, the more important thing is what is in the MEB Narrative summary. That document should be accurate, if it is not, then that is a problem. But, guarding would only be an issue if the ROM was such that the guarding results in a higher rating. Here is the relevant portion of the rating criteria:


Forward flexion of the thoracolumbar spine greater than 30 degrees but not
greater than 60 degrees; or, forward flexion of the cervical spine greater
than 15 degrees but not greater than 30 degrees; or, the combined range of
motion of the thoracolumbar spine not greater than 120 degrees; or, the
combined range of motion of the cervical spine not greater than 170 degrees;
or, muscle spasm or guarding severe enough to result in an abnormal gait
or abnormal spinal contour such as scoliosis, reversed lordosis, or
abnormal kyphosis 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not
greater than 85 degrees; or, forward flexion of the cervical spine greater than
30 degrees but not greater than 40 degrees; or, combined range of motion of
the thoracolumbar spine greater than 120 degrees but not greater than 235
degrees; or, combined range of motion of the cervical spine greater than
170 degrees but not greater than 335 degrees; or, muscle spasm, guarding,
or localized tenderness not resulting in abnormal gait or abnormal spinal
contour; or, vertebral body fracture with loss of 50 percent or more of the
height 10
If the ROM results in a higher rating, then this won't matter. If it does, then it should be rebutted.
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I see now, yes was not able to move much, and got a high "reading" so will the guarding then matter? The ROM we have seen with the rating would make me thing 40% disability which means that they might try and claim he is crying wolf? But he is in a lot of pain, and it's sad to see how a man who has been fine till he had a back problem is getting so much hassle. The commanders letter was good, it noted that he was great up until his back issue and that he recommends that the military not overlook his excellent service of almost 17 years and gives him medical retirement....I know nothing is "for sure" in this process. So we are doing a lot of praying!
 
I had a case earlier this year where the PEB tired to reduce my client's rating for his back based on his "guarding." I pointed out that the Deluca case (which states that pain has to be taken into account in measuring degree of limitation of motion) was a case where the VA claimed that because of guarding Mr. Deluca's ROM was accurately measured (low). After I pointed this out, they gave my client the full rating we asked for.

Not sure if this is what is going on in your husband's case. Just that guarding is not a reason to lower a rating.
 
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