Nerve Conduction Study / EMG Required for Radiculopathy

saceo

PEB Forum Regular Member
Registered Member
Jason,

In your experience with the formal MEB boards (specifically Air Force), was a positive nerve conduction study or EMG required to successfully add Radiculopathy as a Category 1 condition?

Thank you in advance!
 
The Army wanted to see it in my personal case. They actually did not want to accept the VA results from treatment and conducted their own study during the MEB process. As far as the C&P exam went, they used the "pin prick" method to rate me.

It was not included as a separate cat 1 condition for me, but combined with my cervicalagia rating. The VA did give me a rating for an additional never group based on the C&P and that was rated at 20%
 
I had a diagnosis of peripheral neuropathy upper and lower from a neurologist, lower was verified by a punch hole biopsy. The board turned the lower into sciatica, the MEB doctor writing my NARSUM said that the only reason my upper was not unfitting is because I didn't not have an EMG or other definitive test.
 
I'm curious on this. My PCM is still writing my NARSUM and I've had plenty of EMGs/nerve conduction studies in the past and have one next month again. Does anyone else have an autoimmune disease that is causing the nerve damage? I only ask this cause I was diagnosed with parsonage Turner syndrome and just curious on how it's going to be rated. I've seen someone a couple years ago on here get rated 70% for one arm but I have bilateral and reoccurring.
 
No, not needed....but it is helpful.
 
Thank you all for your responses! One follow-up question is whether the board takes MRI results into consideration (i.e., disc herniation and protrusion on the spinal cord)?

I requested a nerve study/ EMG from my PCM yesterday and he told me that it would be redundant based on the MRI already confirming the compression/irritation of the spinal cord.

Thanks again!
 
One follow-up question is whether the board takes MRI results into consideration (i.e., disc herniation and protrusion on the spinal cord)?
The board is required to consider all relevant evidence. So, yes. (The bigger question is what are you trying to show by the EMG).

I requested a nerve study/ EMG from my PCM yesterday and he told me that it would be redundant based on the MRI already confirming the compression/irritation of the spinal cord.

It is not unusual for there to be a "disconnect" between what evidence is needed for a medical determination and what evidence is needed for the legal/administrative disability evaluation system process. (And, there can be overlap, too).

What I mean is that if you have a spine condition, and the doctors suspect or believe you have radiculopathy and or related nerve dysfunction, medically, there is little need for additional exams, like the EMG. Why perform a test when the medical evidence needed for the diagnosis and the treatment will not change based on the results (and, taking into account that there are "false negatives"). Medically, the test is not needed. However, the picture changes when viewed through the legal/administrative lens. The EMG, if positive, can point to the need to evaluate and/or compensate for the nerve dysfunction separately.

So, going back to one of your earlier questions, no, the test is not strictly speaking "required." Other evidence, even opinion evidence from physicians may suffice in lieu of the EMG. However, an MRI is unlikely to show the nerve dysfunction (especially in a peripheral nerve/limb) and an EMG may well be the best evidence to show that the separate disability exists.

Doctors (maybe rightly so) get frustrated when non-doctors give medical advice/opinions. However, the same frustration is often felt by attorneys when non-attorneys (in this case, the doctor) is looking at the issues only from a medical point of view and are essentially giving legal advice/opinions. The disciplines and body of knowledge are different.

Hope this helped and made sense. Best of luck!
 
I'm headed to the FPEB next week to try and get my radiculopathy rated separately. My conditions went up separately, but were combined during the IPEB rating process. I've since had another EMG with abnormal results. I'm extremely stressed and nervous about next week. All I can do is hope for the best.
 
I just started the MEB process and this so stressful....I think it is set up this way because they want us to become frustrated and accepted what is handed to us. Our medical records is evidence enough for them to make a decision. But we have to show proof of severity and other documentation in reference to some claimed illnesses. What should happen is Doctors needs to be fired or suspended....for example I am a migraine sufferer and is medicated heavily when I go to the doctors, no profile for my migraines was ever issued though I was hospitalized and visit (s) (ed) the ER on numerous occasions. MEB refuses to review this as valid because of no profile. Has anyone gone through this?
 
I had a positive nerve conduction study then MRI which led to my dX of Multiple Sclerosis. The doctor informed me a nerve conduction study is helpful in all neurological diseases.
 
I had a positive nerve conduction study then MRI which led to my dX of Multiple Sclerosis. The doctor informed me a nerve conduction study is helpful in all neurological diseases.

If you don't mind me asking, what showed up on the MRI that ended with the diagnosis of MS?
 
If you don't mind me asking, what showed up on the MRI that ended with the diagnosis of MS?

The MRI showed 3 demyelinating lesions. 2 on my brain and one on the spine. The lesions were active (meaning I was going through a relapse at the time) and were consistent with that of MS. Lesions on the spine are worse and affect the mobility of your limbs. Mainly your walking and balance. I think because mine were active at the time it was easier to dX.
 
The MRI showed 3 demyelinating lesions. 2 on my brain and one on the spine. The lesions were active (meaning I was going through a relapse at the time) and were consistent with that of MS. Lesions on the spine are worse and affect the mobility of your limbs. Mainly your walking and balance. I think because mine were active at the time it was easier to dX.

Oh my gosh, I'm so sorry to hear that. Was your MRI with contrast? I've had several spine MRIs without contrast and one brain MRI without contrast and they've all come back with several issues, but none mentioned lesions. I've wondered if contrast was required to detect something like that. I hope you're feeling good and good luck with your IDES process. I'm headed to DC on Tues for my formal appeal. I really can't wait until this is all over, this whole process has been ;ess than ideal.
 
Oh my gosh, I'm so sorry to hear that. Was your MRI with contrast? I've had several spine MRIs without contrast and one brain MRI without contrast and they've all come back with several issues, but none mentioned lesions. I've wondered if contrast was required to detect something like that. I hope you're feeling good and good luck with your IDES process. I'm headed to DC on Tues for my formal appeal. I really can't wait until this is all over, this whole process has been ;ess than ideal.

Thanks and no worries. I'm grateful it was discovered fairly early. The MRI is always done with contrast when it comes to MS. Not sure why but it takes forever. 2-3 hours each time. My IDES process is moving at a decent pace. I just agreed to my NARSUM and it's been sent up to IPEB. I'm just ready to put the military behind me. I hope everything is going quickly with your process as well.
 
Thanks and no worries. I'm grateful it was discovered fairly early. The MRI is always done with contrast when it comes to MS. Not sure why but it takes forever. 2-3 hours each time. My IDES process is moving at a decent pace. I just agreed to my NARSUM and it's been sent up to IPEB. I'm just ready to put the military behind me. I hope everything is going quickly with your process as well.

I wish my MRIs had been done with contrast. The brain MRI was not done with contrast either and it was done to rule out MS prior to my first surgery. I've had Cervical, Thoracic and Lumbar MRIs that have been consistent with some of my pain and nerve issues. But I kind of wish they had done them with contrast. Not that I'm hoping for a diagnosis of MS, just that some of my symptoms are consistent with MS and it makes me nervous not to know. But some of the symptoms are also consistent with radiculopathy and myelopathy too. I'm also looking to put this all past me and thank you.
 
The board is required to consider all relevant evidence. So, yes. (The bigger question is what are you trying to show by the EMG).



It is not unusual for there to be a "disconnect" between what evidence is needed for a medical determination and what evidence is needed for the legal/administrative disability evaluation system process. (And, there can be overlap, too).

What I mean is that if you have a spine condition, and the doctors suspect or believe you have radiculopathy and or related nerve dysfunction, medically, there is little need for additional exams, like the EMG. Why perform a test when the medical evidence needed for the diagnosis and the treatment will not change based on the results (and, taking into account that there are "false negatives"). Medically, the test is not needed. However, the picture changes when viewed through the legal/administrative lens. The EMG, if positive, can point to the need to evaluate and/or compensate for the nerve dysfunction separately.

So, going back to one of your earlier questions, no, the test is not strictly speaking "required." Other evidence, even opinion evidence from physicians may suffice in lieu of the EMG. However, an MRI is unlikely to show the nerve dysfunction (especially in a peripheral nerve/limb) and an EMG may well be the best evidence to show that the separate disability exists.

Doctors (maybe rightly so) get frustrated when non-doctors give medical advice/opinions. However, the same frustration is often felt by attorneys when non-attorneys (in this case, the doctor) is looking at the issues only from a medical point of view and are essentially giving legal advice/opinions. The disciplines and body of knowledge are different.

Hope this helped and made sense. Best of luck!
VERY NICELY PUT!!!!!!!
 
I had an EMG done after I was out with the V.A. and I'm trying to figure out how I get this added to my ROM which I was discharged for with 20%.
 
I had an EMG done after I was out with the V.A. and I'm trying to figure out how I get this added to my ROM which I was discharged for with 20%.
EMG will not help with Range of Motion. The EMG just shows what nerve involvement you have for your disability. The ROM is just that- what your ROM is.
 
I have had emg study that goes along with mri findings. Any sort of pointers in a convincing rebutte letter to seperate radiculopathy from "lumbago" diagnosis? I know what I want to say, I just don't know how to say it, if that ,makes sense
 
EMG will not help with Range of Motion. The EMG just shows what nerve involvement you have for your disability. The ROM is just that- what your ROM is.
The V.A added it as a secondary condition to the ROM and listed it as service connected. I contacted the BCMR reading room where all of the dockets are posted and the POC responded to my email and is sending me the decision which I haven't seen yet.
 
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