Spinal fusions

Jason Perry

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buckeyejh,

Welcome! It is hard to give a likely rating without more information. Remember, each condition must be separately unfitting to be compensable by the DoD. Also, your MEB does not rate, it only documents disqualifying conditions for retention and recommends whether a PEB is necessary. As to whether you will get a higher rating after surgery, it again depends on your degree of functional limitation at the time. If you do not have limitations due to that condition after treatment, you may be fit for that conditions. On the other hand, if you suffer from significant limitations on range of motion, you may be assigned a high rating for this. So, much will depend on your condition when you are boarded (assuming a PEB comes to pass).

You are relatively close to retirement and it is to your benefit to reach 20 years. Your administrative process/situation should not drive the train for your medical treatment, but the surgery and recovery may put you much closer to your 20 years.

I have seen the gamut of findings for conditions such as yours, from separation to retirement. You should read the Guide to PEB Forum link, look at all migraine threads in Ratings and Conditions forums, read the Fitness vs Unfitness thread and then post any questions you have. I wish I could tell you more now, it would really take much more information and after you read up on these topics, your questions will probably be more focused.

I hope you have some relief from the pain and success through this process.
 

buckeyejh

PEB Forum Regular Member
Thank you Jason. I am so glad to be here.

I just received an email from the Doc:

"Basically, you have multiple medical issues that, while important, are not something requiring a medical board. Your neck pain with associated radiculopathy, for which it has been recommended you undergo ACDF, is significant and will be boarded, as it limits your duties and will likely have long term disabilities associated, regardless of surgical outcomes. The other stuff I hear about, like cubital tunnel syndrome, trigeminal neuralgia, reflux, etc do not require an MEB. I understand that the trigeminal neuralgia is painful, but it is not a boardable condition. I am more than happy to fix you up with the aforementioned Neuro visit for evaluation by a military neurologist for second opinion/any duty restrictions, but the board I will begin at this time will focus on your neck injury/pain and subsequent treatments. With these most recent neuro/neurosurgery notes, I have enough info to start this, but do need to see your for in-house physical exam."

OK, so it looks like he is saying the spinal fusion/herniated disc the only reason I am going through the MEB? And he would get this from:

AFI36-3212 2 FEBRUARY 2006

3.18. Ratable Physical Defects and Conditions. Disability evaluation boards assign a disability percentage
rating of zero or more to each ratable defect or condition using the VASRD and DoD Instruction
1332.39 as guides. The boards will rate only those conditions which make a member unfit for continued
active duty.

So they will NOT take into account my other neurological conditions? I cannot believe my TN or Migraines are not a ratable condition as my TN is just as painful as my herniated disc requiring fusion. Here is what [FONT=TimesNewRoman,Bold]AFI48-123V2 5 JUNE 2006 says:[/FONT]

[FONT=TimesNewRoman,Bold][FONT=TimesNewRoman,Bold]AFI48-123V2 5 JUNE 2006[/FONT][/FONT]

[FONT=TimesNewRoman,Bold]Attachment 2
MEDICAL STANDARDS FOR CONTINUED MILITARY SERVICE (RETENTION)
A2.1. Conditions listed in this attachment require Medical Evaluation Board (MEB) processing for active
duty members, worldwide duty evaluation for ARC members when appropriate (see [FONT=TimesNewRoman,Bold]Chapter 5
), and are
not all-inclusive. These standards and other diseases or defects not specifically listed can be cause for
rejection based upon the medical judgment of the examining physician or reviewing authority.

[FONT=TimesNewRoman,Bold]A2.12. Neurologic Disorders.


A2.12.8. Migraine. Manifested by frequent disabling attacks, which last for several consecutive days, and are unrelieved by treatment.

A2.12.14. Peripheral nerve conditions such as:

A2.12.14.1. Neuralgia, when symptoms are severe, persistent, and do not respond to treatment.

A2.12.14.2. Neuritis or paralysis due to peripheral nerve injury, when manifested by more than moderate, permanent functional impairment.

A2.12.16. Other neurological conditions. Any other neurological condition, regardless of etiology, when after adequate treatment, there remain residuals, such as persistent severe headaches, weakness or paralysis of important muscle groups, deformity, incoordination, pain or sensory disturbance, disturbance of consciousness, speech, or mental defects, or personality changes of such a degree as to definitely interfere with the performance of duty.

[FONT=TimesNewRoman,Bold]A2.15. Spine, Scapulae, Ribs, and Sacroiliac Joints.


A2.15.4. Herniation of nucleus pulposus, when symptoms and associated objective findings are of

such a degree as to require repeated hospitalization or frequent absences from duty.

Doesn't that mean they should include my TN and Migraines along with the Herniation of nucleus pulposus?



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[/FONT][/FONT][/FONT]
 

pakeboy

PEB Forum Regular Member
I have a C&P for my neck on 9 July...they are going to do a ROM test.
Since my surgery on 10 Feb 2008, my cervical condition is healing. My chronic pain is always an “8” on a pain scale of 1-10. It is debilitating most of the time, but I have to keep working to pay the bills. The company I work for gives us 40 hours a year for sick leave. I take it all plus my vacation time. I have “pins and needles” in both ring & little fingers on both hands and my neck feels like the flu. The numbness starts from my neck to my shoulders and down my arms. Mostly on the right side. I also have frequent headaches. I walk, sit and stand with my head down to alleviate the pain and turn it ever so gently when needed. Otherwise my whole body turns to look. In the morning when I wakeup, it takes 30 minutes to move and function enough to get ready for the day. I take 6-8 Extra-strength Tylenol gel caps a day and Medical MD Sleep-aide at night to sleep. My Neurosurgeon will not prescribe me “pain medicine” and I refuse to go to the local Pain Clinic again at this point. My C-4 & C-5 are deteriorated and I'll require surgery in my near future when I can’t take these symptoms anymore. Tahat's about it in a nutshell. I'll post again after my C&P. Peace...
 

drakkon84

PEB Forum Regular Member
I had a cervical fusion c-4/c-5 with plating and bone graph from hip done back in october of '06. I have complained about chronic pain since then. The numbness and tingling is gone in my left arm, but i still have problems with muscle spasms in my back and just overall stiff in the neck. My pain is normally around a 5 and am on neurotin and muscle relaxers for life i was told. Two years later they send me to Japan and i get here see one of the navy med officers about getting my meds refilled and BAM IPEB. I have exhausted my LIMDU time and still have complications wearing fighting gear and get migraines thou not dehabilitating after pt sessions. So she put me on no duty but i requested running as it does not bother me much and i hate being stationary. At this point i know I need out as my condition is getting worst and I am now getting massive lower back pain. I have limited rom in my neck of course and now I get my pysical come friday and my paperwork gets sent up the 18th of september. Everything is pretty well documented, but I have been worried now since I have technically done my job for the past 2 years just fine and re-enlisted. But I was on a reserve base and pt was lax and now I am feeling the pain worst than ever here as pt is much more physical. So i guess i just sit and wait.....
 

Jason Perry

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drakkon84,

Welcome aboard (I always feel better about saying that to Navy personnel)!

It sounds like you are in agreement with an "unfit finding." One thing I wanted to say is that with both back and neck issues, you have some opportunities with ratings, but also some issues. You can get rated for both back and neck with a separate rating. This can greatly increase your chances of reaching 30%. However, what I sometimes see is that if you don't have the conditions addressed separately, the military will sometimes say, "it is only you neck" or "it is only your back," and not find both unfitting. This may in fact be the case (that only one is unfitting) but if both conditions keep you from reasonable duty performance, then it is important that your limitations are attributed to each condition. The typical badly rated case is where you have one condition that has existed and your chain of command and doctors are aware of it and document it. But then another condition comes up. When you can't perform in some way, they may have a tendency to attribute it to the first condition, when in fact you may be suffering from the second condition. The result is that sometimes you will see the chain of command write in their assessment that "Member's neck condition prevents them from doing (x,y, or z)." They may not realize that without also documenting your back's limitations, they are not giving the PEB the info necessary to correctly rate you.

Best of luck and please let us know any questions.
 

drakkon84

PEB Forum Regular Member
Thanks for the head up on that you are correct in assuming they are only shooting for the fusion on my PEB. They are figuring on the back being attributed to that condition. I did go in for my physical exam from the medical officer. She did annotate in my med board about my chronic lower back pain, my shoulder pain, and my migraines however she said it as secondary to my fusion. Is it good enough to have it in there or do I need to try and get it more documented somewhere else?
 

drakkon84

PEB Forum Regular Member
Quick question I had a ROM done by my Neurosurgeon she rated me at 30 forward flexion in cervical and 45 forward flexion in in thoracolumbar spine. She put me down for three conditions to be rated as my fusion and my upper and lower back pain. My question is due to this could they rate me on both ROMs.From what I read in the VASRD they would rate it separately at 20% a piece for neck and then for back? meaning 36% disability? i am also assuming to get that they would have to claim both as being unfitting to get it?
 

drakkon84

PEB Forum Regular Member
I am pretty sure they do but it would equal out to 36% and then get bumped to 40% cause that would go up I beleive.
 

Jason Perry

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Right, the ratings are in ten percent increments, but when combined, can end up with a number not in ten percent increment. However, you are also correct, that number would be rounded to the nearest 10%.
 

drakkon84

PEB Forum Regular Member
I cannot help but question this now that i look closely. There are three parts to the back why does the vasrd only look at two. Like my med dictation states 5 extention 30 flexion in neck and 5 extension and 45 flexion of the lumbosacral which does not seem to even be rated in the vasrd. Am I just missing it somewhere?
 

Nyjohnny

PEB Forum Regular Member
Registered Member
Does having a spinal fusion automatically initiate a MEB or PEB? Or will i still have a chance to stay in the navy if all goes well and I fully recover with no limitations?
 

Warrior644

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Does having a spinal fusion automatically initiate a MEB or PEB? Or will i still have a chance to stay in the navy if all goes well and I fully recover with no limitations?
From an U.S. Army perspective while on active duty via my own personal experiences upon having spinal fusion surgery, the answer is no.

In retrospect, my referral and acceptance into the DoD IDES while on military active duty occurred nearly 14 months post spinal fusion surgery due to continuing medical complications and the exhaustion of further medical treatment. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

Nyjohnny

PEB Forum Regular Member
Registered Member
From an U.S. Army perspective while on active duty via my own personal experiences upon having spinal fusion surgery, the answer is no.

In retrospect, my referral and acceptance into the DoD IDES while on military active duty occurred nearly 14 months post spinal fusion surgery due to continuing medical complications and the exhaustion of further medical treatment. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes![/QUOT
I have been found fit for full duty and am awaiting orders. I'm just concerned I won't pass a sea duty screening
 
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