Hello Jim,
I am a retired MSgt. I was diagnosed with Degenerative Disc Disease (DDD) while on active duty. I had disc decompression surgery on my lower back in the fall of 2005 shortly after I retired. The VA has acknowledged my Disability but when they made a percentage decision (20%) it did not change my total allowance which is currently 60%.
Since my surgery in 2005 I have been diagnosed with the same issue in my entire spine and am currently receiving shots there and in my neck due to the spread of the disease. This has been confirmed by civilian doctors after an MRI was performed late in 2012. I wanted to go to the VA for medical treatment but their process and procedures take so long that I wasn't receiving timely treatment. What is the best way to address this issue with the VA and engage in an increase request for my DDD.
I do not want to go through the long process again just to have them tell me I don't have an issue. I currently take pain meds prescribed from the VA, so they obviously know that I have pain and issues with my spine.
Thanks for the help.
Reply:
Degenerative joint disease is a common problem. VA usually views it as one of the hazards of aging. You're one of the very few who have it documented in service so that you may be rated for the condition.
Unfortunately, there is nothing to do to seek a raise in the benefit but following the lengthy and convoluted process. There are no shortcuts, no tricks that will make it easier.
VA is a process oriented system. The only thing important to VA is that the process is followed to the letter. The ultimate outcome isn't important to VA so long as all the t's are crossed and i's are dotted.
I suggest that any veteran who believes that they deserve a raise in a benefit first do their own assessment. This involves going to The Schedule For Rating Disabilities here http://www.benefits.va.gov/warms/bookc.asp
The veteran should study the schedule to match his symptoms and physical issues as closely as possible to what he finds in the schedule.
Once you find the rating that you believe most closely identifies your particular issue, you may determine the potential of a higher rating. Keep in mind that if a veteran wants a jump from a 20% rating to a 60% rating, the veteran will have to prove that he's eligible. Asking for the raise isn't enough.
If the vet determines he's eligible, then he can go to the Combined Ratings Table http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_25.DOC
The veteran can then use the potential rating to learn if it will actually make a difference if he were to get a higher rating. All too often, the CRT (or "VA math") will nullify any actual increase.
Should you file for an increase? Probably, if you believe it's appropriate. Even if an increase doesn't make a difference this year, it may make the difference 10 years from now.
You tell me, "I do not want to go through the long process again just to have them tell me I don't have an issue." I hear similar things from a lot of vets.
But really...how much trouble is it? In your case, you may spend 2 hours researching your claim. Then you write a letter to VA asking for an increase. You'll have to go to a C & P exam and that day is probably shot. Then you wait, and wait, and wait. If you prevail, you're done. If there is a denial, you spend a couple of hours to find an attorney to represent you for the appeal.
I'd guess that over the 2 year period that it will take to process your claim, you may invest 10 hours or less of your time. Although the system is really annoying to deal with, the rewards of the benefits that you've earned are great.
I don't understand it when veterans tell me that they don't have time or patience to deal with VA. The process isn't really difficult even though it takes far too long.
We veterans have conquered many serious challenges during our honorable military service service but dealing with VA is beyond our capability? I don't accept that, not at all. Dealing with VA is mostly drudge work and isn't terribly complex. If you deserve an increase, go for it.
Read http://www.vawatchdog.org/how-to-increase-an-existing-benefit--.html for more.
05/16/2013 UPDATE: Comments from a senior RVSR/Rater
Hi Jim,
Some comments on the Veteran with the degenerative disc disease (DDD). DDD and DJD (degenerative joint disease) are 2 separate processes. If the Veteran received a 20 percent evaluation, that means his range of motion, with or without pain, fell into the 20 percent range. It does not matter how much pain there is, unless the C&P examiner finds that upon repetitive motion there is additional loss of range of motion that falls into the range of a higher evaluation, the Veteran will not get a higher evaluation. The Veteran can also get a higher evaluation if he has “incapacitating episodes” which are defined as period of bed rest prescribed by a physician (which rarely occurs with the level of medical technology today).
A person can have lumbar disc disease and never get cervical disc disease. Therefore, a spread of the disc disease from the lumbar to the cervical spine (neck) does not mean the cervical spine disease will automatically be granted service connection. The Veteran has to prove a secondary relationship between the lumbar and cervical spine disabilities. If the Veteran’s private physician indicates in his notes or in a DBQ that the cervical spine is related to the lumbar spine with a credible rationale, the Veteran should be granted service connection for the cervical spine. If a DBQ is completed, a VA examination is not required. Even if an exam is conducted and the VA examiner disagrees with that opinion, so long as the Veteran’s physician provides a credible rationale, the VA has to accept that opinion which is most favorable to the Veteran. This is the “reasonable doubt” regulation under 38 CFR 3.102. (I know everyone does not follow this rule but they should be).
DJD is somewhat different. DJD is also synonymous with arthritis and osteoarthritis (but not rheumatoid arthritis). There are two types of DJD for VA purposes: traumatic DJD and systemic DJD. Traumatic DJD occurs when the Veteran suffered an injury to a joint that over the years progresses to DJD. In this case, if the Veteran also develops DJD in other joints, there would be no entitlement to service connection for those joints unless a medical provider establishes one.
Systemic DJD occurs when the Veteran gets a diagnosis of DJD in service (or within one year after release from active duty) when there is no record or evidence of trauma to the joint. In this case, if the Veteran develops DJD in any other joint in the future, that joint is automatically subject to service connection. The diagnostic code for traumatic DJD is 5010 and the diagnostic code for systemic DJD is 5003.
If the Veteran is granted service connection for the cervical spine in addition to the lumbar spine, he gets a separate evaluation (percent of compensation) for each. Also, there are times when a Veteran gets pain radiating into his legs as a result of DDD or DJD. If the Veteran has a diagnosis of radiculopathy, he should be entitled to a separate evaluation for that also under a neurological diagnostic code (usually 8520 or 8521).