Mailroom: Defunct Cervical Spine Disability Claim

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130910 Mailroom Cervical Spine Disability

Here is a letter from a disabled veteran who was probably totally screwed on his cervical spine disability claim.

Most of us oversimplify the severity of a back injury. I know I sure did until my hands started going numb. The trick is to get it diagnosed properly right away and to modify your life so that you don’t make it worse.

For this veteran, VA incorrectly awarded a 10% rating based on one of two things.

Either they were deficient in training and knowledge in how they failed to address the secondary issues below, which is likely negligence.

Or, VA participants engaged in a fraud because they collectively knew they needed to address it but did not diagnose properly to save money.

Anyone familiar with the scam that is VA benefits should know that VA has a mystery policy that almost always results in a “deny first” kind of outcome. I’ll explain how this impacted this poor veteran below.

Keep in mind as you read this, VA has a duty to assist regarding the development of a complete claim which generally includes the conditions/symptoms you state during the exam that are realistic.

Here’s the drill: I include this for all newcomers. Each week, I take an email from a veteran that would have broad appeal to many veterans. Questions are usually about the GI Bill, VA Voc Rehab, or Disability Compensation.

I then analyze the veterans benefits issue for a bit and post my input here in our weekly segment: Mailroom.

Basically, I take out all of the veteran’s identifying information from the best email and post it here with my answer.

If you have a burning question about your veterans benefits, sent me an email by selecting the contact tab at the top of this page. If I think your situation will be helpful for other veterans, I will re-post it here.

* If you do not want me to write about your veterans benefits situation, please feel free to let me know within the email. I have no problem keeping a lid on the situation, too.

 

Letter from the Disabled Veteran:

Well here’s the situation, I retired in Jan 2008. I had a final exam before retiring. One of the things I mention to the doctor is that my left arm continually goes numb with my fingers tingling along with spasms and the like.

Well, several months later, the document that the VA sent me explaining what they rated and what was not. I was rated with a cervical spine in which I received 10 percent. However, the VA did not rate the pain, numbness in my left arm because they said there is no rating for those symptoms. Well, I began to have chronic pain not only in my arm but in my neck as well. I knew something was wrong so 2011 I began to go to a neurologist.

Long story, an MRI revealed that I had severe cervical disease. The problem was so bad that all cervical discs have buckled. There is no surgery that will correct the problem.

The doctor annotated that it is multilevel degenerative disc disease with posterior disc bulging and spondylosis. He explained that my neck has neuroforaminal stenosis at multiple levels.

Well my question, based on the information that I did have some type of cervical condition and had the symptoms even before I retired, am I entitled to a VA rating for degenerative disease and can I get back pay for when it was not discovered in 2008?

 

Letter from Benjamin Krause (me):

You are asking two different questions. “First, am I entitled to service connection for my current condition? Second, can that service connection go back to 2008?”

My answer is “maybe” to both. Let me explain based on my own experience.

Background on Dynamic Upright MRI

I literally have a similar condition that was only diagnosed by a civilian doctor doing a Dynamic MRI. This kind of MRI is done while sitting.

It is a procedure that insurance companies and VA do not want people to do. First, it can be expensive – $6,000. Second, and most important, it will more effectively pick up problems with the spine that go unnoticed while laying down for a typical MRI.

Ever notice that lying down takes a lot of pressure off the back and removes pain? It would stand to reason that a person cannot work from this kind of position, and for that reason, such imaging would not properly diagnose problems while standing or sitting.

Gravity plus flexing positions equals an accurate reading of how your spine is impacted during a regular day. VA and insurance companies do not want accuracy if it means they will need to pay more.

Now that I’ve explained a little about diagnosis and VA’s tricks regarding the back, let’s talk about service connection.

Service Connection Cervical Spine Conditions

To the first question: yes, any condition that happened while in military service or is the result of military service will generally be service connected.

I do not know enough about your records to definitively say “yes” or “no” for you. But, it sounds like you need to be re-evaluated to ensure you receive a proper diagnosis if you believe you did not receive a fair adjudication.

The numbness you are talking about is similar to what I experience. If I pick up boxes while moving my hands will go numb. Similarly, if I drive for longer than two hours, my feet will also go numb.

Since you have the MRI showing the impact of the back condition, it sounds like VA just lowballed you at 10%.

Generally, conditions within the cervical spine are rated from 0% to 50% depending on the specific diagnosis. My best guess would be that your symptoms could be considered “severe” based on what you wrote. If that is true, the rating could be classified between 30% to 60% depending on the specific issue.

That does not include ratings for hand numbness due to the cervical spine issue that is probably putting pressure on your nerves. Depending on specifics, that could also be 20% bilateral (each hand).

[Check out VA Rating Scale Here – Hit Cntl + F to search for “cervical” quickly]

Numbness in the hands and feet due to a back condition for me resulted in a 50% combined rating. However, I was also awarded 10% at first, too. I had to fight over 10 years to get close to an accurate compensation picture.

Rumor has it VA does specifically avoid awarding for conditions related to the cervical spine. If true, my guess is that cervical spine conditions can become quite expensive if the condition is serious enough. For that reason, they limit awarding this finding even if the records states otherwise.

Earlier Effective Date

Regarding the earlier effective date to 2008, it could be possible if VA knew or should have known of the claim but failed to adjudicate it. It could also be possible if you filed a Notice of Disagreement that is either ongoing since then or was not adjudicated by VA.

Beyond this, I would suggest speaking with either an attorney or a veteran service organization. Personally, I prefer lawyers because of their level of experience and training.

Plus, if they screw up, you can always sue them for malpractice. I’m not sure if that is possible for veteran organizations that make mistakes.

Summary

In summary, I think you should speak with someone about your file. We have a free guide here that can help you research your VA disability claim and get a copy of your file.

This is important because you need to know why you were only awarded a 10%.

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3 Comments

  1. Mr. Krause,

    Thank you for maintaining a communication open to veterans, which allows them a venue to ask questions before making decisions (like accepting a 10% rating for a severe back condition). In other words, you help them look before they leap. For that you are commended. I too am a veteran. Now rated at 100% (raw rating at 270+). After almost 5 years of dealing with the VA (for myself and others) I researched the mistakes that were being made by the VA. I found ways to correct them. Without spending billions more or leaving veterans hanging for years waiting for benefits they earned and deserve. I started a Petition on change.org to effect these changes. We now have the attention of the House Committee on Veterans Affairs. I only ask that you take a moment to read through the Petition and if so inclined, sign it and forward it. Any suggestions you may have will be warmly welcomed.

    Very respectfully,
    YN1 Lauren Price, USN (Ret.)

    https://www.change.org/petitions/the-veterans-administration-overhaul-the-claims-processing-create-mandatory-claims-deadlines?utm_campaign=share_button_mobile&utm_medium=facebook&utm_source=share_petition

  2. Hi Lauren, thank you for your concern and efforts. Maybe you would like to sign and spread the word about this petition that has over 27,000 signatures already instead of starting a new one.Just go about half way down the page to sign. There is also info on tweeting and Face-booking about it. https://millionvetbacklog.com/

    Thank you for your service. 🙂

  3. I too have the same conditions that both of you stated. It is my experience that even though you might not have debuted their findings and rating, you can file a new one to get the higher rating. I believe that you have 1 year to contest the rating. It took me many times of refiling but they finally came through. You can also file for 100% “Unemployability” That was finally the last resort I had to take. I was at 90% and then filed the last time. If you are near a VA Hospital or large clinic, see if there is a VA Representative there and ask them to file your rebuttal to the 10% rating. I tried the Veterans organizations but had much better luck with the VA Rep at the hospital. Keep trying. Ciao, Shannon, CPO, USN Retired, DAV

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