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bamboocrazy wrote:

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About the range of motion, I can almost touch my toes but it is very painful in my lower back. My MRI states degenerative disc disease. So, during my CP next month i'll be told to bend forward, I will do so, then the doctor says non-compensable rating? When does pain on movement become a factor in the ratings from the VA?

With regard to pain and range of motion, you should tell the doctor at what point pain begins and also at what point the pain is such that you don't desire to move further. I think it is important to be realistic in something like this. For example I have cervical disc disease and my neck hurts to some degree just about all the time whether I move it or not. Does that mean that I can't or won't move my neck? Of course not. At the same time there is a point at which the pain is such that I choose to not move it beyond that point under normal circumstances. This is the type information that must be conveyed to the doctor during the examination.

A compensable evaluation is warranted when there is painful motion even when there is a full range of motion demonstrated. What must be determined then is at what point in the range of motion does this pain become severe enough that it effectively precludes any useful activity of the joint beyond that point. In other words, at what point does this painful motion provide for an additional functional impairment.

Let's use the shoulder as an example. Let's say that you have a full or almost full range of motion of the shoulder, but there is pain associated with this range of motion almost from the get go. With other objective findings such as x-ray evidence of degenerative arthritis this painful motion alone would warrant at least the minimum compensable evaluation for the shoulder.

Now let's suppose that even though you can raise your arm above your head, at about halfway between your waist and shoulder level the pain increases to the point that you can't effectively lift anything of any significance from this point on up. As long as the objective findings support this complaint of pain you would be entitled to an evaluation based on range of motion to midway between the waist and shoulder despite the fact that you can raise your arm higher. Unless your arm serves no other purpose than to be raised, you have a functional impairment due to painful motion beginning at the level between the waist and shoulder due to the painful motion.

But again, note that I referred to other objective findings. If you tell the doc that you suffer pain with any movement that is so bad that you effectively cannot use the arm for much, the doc will likely then note how much muscle atrophy is present. Each muscle has a different function and the docs know these muscles and what they do. For example, the muscle that raises your arm is not the same muscle that lowers your arm, etc. So if this fictional person tells the doc that he cannot use his arm due to pain, one expects to see significant atrophy in those muscles, not to mention things like an absence of calluses on the hands, that sort of thing.

Cruiser