Spine ROS rating question

Gangly

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Registered Member
Good evening. I am waiting on my physical to be done but I am looking over the rating of the spine and I don’t understand. Is this the bend over and touch your toes test? If so, what happens if all of your inflection is in your hips and almost none of it in your Thoracolumbar spine?

From looking at the pictures given, it looks like they are rating just the Thoracolumbar spine inflection. Meaning not the “bend over and touch your toes” test.

Could I please get feedback from those of you who have back injuries?
 

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Warrior644

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Good evening. I am waiting on my physical to be done but I am looking over the rating of the spine and I don’t understand. Is this the bend over and touch your toes test? If so, what happens if all of your inflection is in your hips and almost none of it in your Thoracolumbar spine?

From looking at the pictures given, it looks like they are rating just the Thoracolumbar spine inflection. Meaning not the “bend over and touch your toes” test.

Could I please get feedback from those of you who have back injuries?
Welcome to the PEB Forum! :)

In retrospect while on military active duty in the U.S. Army, I had an ALIF L4/5 (lumbar spinal fusion), a pain level of an 8 out of 10 consistently, and use a walking cane due to having stability issues.

Indeed, at the DoVA C&P examination for your lumbar spine condition, the medical examiner should perform accurate measurements in accordance with 38 CFR VASRD §4.46. It states...

"Accurate measurement of the length of stumps, excursion of joints, dimensions and location of scars with respect to landmarks, should be insisted on. The use of a goniometer in the measurement of limitation of motion is indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be accurately measured and reported. [41 FR 11294, Mar. 18, 1976]"

That said, often times the DoVA C&P examination's medical physician may not employ the use of a goniometer when taking range of motion (ROM) measurements. It seems that they will employ the "eye-balling" method to approximate ROM measurements which is a widely used DoVA strategy accepted by the DoVA D-RAS during VA rating(s) adjudication. So be very aware of the "eye-balling" method when the DoVA C&P examination medical physician ask you to remove your shoes while sitting, remove your socks while sitting, pickup an object from the floor while standing or sitting, ask you to reach for an object while sitting, ask you to get dressed while watching how you put on your shoes and socks, etc.

To any extent, the aforementioned tactics were all used during my DoVA C&P examination for a lumbar spine condition since the medical examiner didn't use a goniometer in the measurement of limitation of motion. Fortunately, I couldn't perform most of the tactics and asked several times for assistance with removing my shoes and socks while sitting then putting them back on while sitting at the conclusion of the examination. If you can't perform a certain ROM function then make sure to inform the medical examiner immediately; don't force yourself to do anything which causes pain.

In response to your specific inquiry from my own experiences while in the DoD IDES process, you shall receive a DoVA proposed rating satisfying the applicable criteria for the forward flexion of the thoracolumbar spine; probably a 40% rating due to the forward flexion of the thoracolumbar spine being measured at 30 degrees or less. As annotated in accordance with 38 CFR VASRD §4.71a Schedule of ratings—musculoskeletal system "The Spine" under the "General Rating Formula for Diseases and Injuries of the Spine" it shows ROM measurements in degrees for the forward flexion of the thoracolumbar spine, or the combined range of motion of the thoracolumbar spine measurements in degrees.

As such, both calculation measurements (e.g.., forward flexion ROM and combined ROM) were used by the DoVA D-RAS to adjudicate a DoVA proposed 20% rating for my lumbar spine condition originally. But, I was involved in a motor vehicle accident with a SUV as a pedestrian and became even more disabled. As a direct result of the motor vehicle accident examination report, the medical physician used a goniometer when performing the ROM measurements on my lumbar spine and my forward flexion of the thoracolumbar spine was 30 degrees or less. So, via the submission of a VARR request by the IDES PEB, the DoVA D-RAS revised the my PEB-referred "unfit for duty" lumbar spine condition to a DoVA proposed 40% rating which became my DoD (Army) proposed 40% rating also. I hope this helps. Take care!

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

Best Wishes!
 

Gangly

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Registered Member
Warrior,

Thank you for the warm welcome. Although, I wish I hadn’t the need to discover this forum. Which I’m sure everyone here felt the same when they were in my position. Now I feel like I am left to simply try and protect myself and families wellbeing.

That is increbily disheartening that they eyeball test. I know in my case my flexion in my back is horrible, but my flexion in my hips compensate for 99%. And since I have stupididly long arms I can still accomplish most simple tasks with only mild struggles.

Has anyone called the examiner out for not following proper procedure?

Also, should I get a lawyer now before this process really starts rolling or wait until the results of the physical, informal board, etc.

Thank you.
 

mjf114

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PEB Forum Veteran
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Like Warrior644 said, I was "eyeballed" during my ROM test and was given a 20% rating when I cant even touch my knees. SAF even called out the VA and did their own SAF requested VAR pretty much saying, they were not buying that. I was measured at a rehab clinic and the VA came back with 40%. The ole "Kentucky Windage" doesn't work and isn't fair to anybody. Good luck.
 

Warrior644

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Warrior,

Thank you for the warm welcome. Although, I wish I hadn’t the need to discover this forum. Which I’m sure everyone here felt the same when they were in my position. Now I feel like I am left to simply try and protect myself and families wellbeing.

That is increbily disheartening that they eyeball test. I know in my case my flexion in my back is horrible, but my flexion in my hips compensate for 99%. And since I have stupididly long arms I can still accomplish most simple tasks with only mild struggles.

Has anyone called the examiner out for not following proper procedure?

Also, should I get a lawyer now before this process really starts rolling or wait until the results of the physical, informal board, etc.

Thank you.
Indeed, you are quite welcome!

In retrospect, for my lumbar spine condition via the DoVA C&P examiner, I filed a complaint within the MEB appeal. But, the MEB stated that I needed to coordinate with the MSC for any potential rescheduling of another DoVA C&P examination; it never happened.

Moreover, I also filed a formal complaint to the Patient Advocate at the VA Outpatient Clinic on the C&P examiner who performed my PTSD examination. The end result was that the C&P examiner was eventually "reassigned" due to having numerous complaints filed about annotating erroneous statements on the mental health DBQs for DoD IDES participants.

As far as hiring a civilian attorney at this point, it's definitely a personal decision for sure since you will have to pay all legal fees. Remember that your branch of military service shall provide IDES legal services free of charge to the military service member officially referred and accepted into the DoD IDES process. Take care!

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

Best Wishes!
 

Gangly

PEB Forum Regular Member
Registered Member
You guys are awesome! I can already tell it would have been an honor to serve with everyone in this board.

I was at the Naval Hospital today for my monthly mental health appointment and stopped into to speak with and meet the PEBLOs and also got a chance to talk with the JAG Lawyer for the IDES process in the Pensacola, Fl region. It was very imformative day, and while I am concerned about the future it is really good have the knowledge of how to proceed from this point. I am hoping that I am found fit for duty, but if I am not I have avenues that I will hopefully help take care of me and my family.

Once again thank you guys and without a doubt you will see my gangliness on this forum and learning as much as I can from those of you who have had good and bad experiences. Because, I, like Loki, believe that experience is experience.
 
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