C&P Exam for Radiculopathy: Here’s What to Expect and How to Prepare

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Today, Brian Reese the VA Claims Insider explains everything you need to know to prepare for a C&P exam for Radiculopathy.

If you’ve filed a VA disability claim for Radiculopathy, there’s a high probability you’ll be scheduled for a Compensation and Pension (C&P) exam by a private company contracted by the VA.

We’ll cover what to expect and how to prepare along with the questions you can expect during the exam.

First things first: Radiculopathy and Sciatica are very common among military veterans.

In fact, paralysis of the sciatic nerve is the #3 most common VA disability claim.

Pro Tip: VA disability ratings for Radiculopathy generally range from 0% to 70%, depending upon the severity of your symptoms and how those symptoms negatively impact your work, life, and social functioning. However, VA ratings for Sciatica range from 10% to 80%. The highest possible schedular rating for Radiculopathy with complete paralysis is 90%.

What to Expect at a C&P Exam for Radiculopathy

A C&P exam for Radiculopathy is designed to assess whether (#1) you have some form of Radiculopathy diagnosed, and if so, (#2) the severity of your symptoms in terms of frequency, severity, and duration along with any negative impacts to your work, life, and social functioning.

Here’s what you can expect during a VA C&P exam for Radiculopathy:

• Review of Medical History: The C&P examiner should start by reviewing your medical records, including any previous diagnoses, medical history, treatments, and evaluations related to spinal and nerve issues, including Radiculopathy. The examiner has access to the medical records and documents you submitted to the VA, so you don’t need to bring records with you to the exam. However, it’s certainly acceptable to do so if you think it will help you remember important things.

• History and Onset: The examiner should ask about your military service history and any prior diagnoses of Radiculopathy. For example, here’s some risk factors for veterans: Prior combat or training injuries, physical demands of your military service, environmental exposures, age and lifestyle factors, obesity, and co-existing health conditions of the neck, back, and spine including degenerative disc disease, spinal stenosis and osteoarthritis.

• Discussion of Symptoms: The examiner should ask you about your symptoms of Radiculopathy, including when you first noticed them and how often you experience them. Remember, your final VA rating for Radiculopathy depends upon the Frequency (how often), Severity (how bad), and Duration (how long) of symptoms and how those symptoms negatively affect your work, life, and social functioning. The most common symptom of Radiculopathy in veterans is pain, which can vary from sharp to burning and may radiate along the nerve pathways. Veterans may also experience numbness or a “pins and needles” sensation in the affected area, indicating compression on the nerves. Weakness in muscles served by the compressed nerve is also common, which can impact your daily activities. Additionally, muscle spasms may occur, further contributing to discomfort. Changes in reflexes and coordination may also be noticeable, with reflexes becoming exaggerated or diminished and coordination becoming compromised. Note that Radiculopathy symptoms can vary depending on the location and severity of the nerve compression.

• Negative Impacts on Work, Life, and Social Functioning: Radiculopathy can significantly impact your work, life, and social functioning due to the debilitating symptoms it presents. Chronic pain is the most common symptom, and it can lead to all sorts of issues. For example, at work, you may struggle with tasks that require physical exertion or prolonged periods of sitting or standing, leading to decreased productivity and potential absenteeism. Daily life can also be impacted by things such as: Difficulty lifting objects and mobility issues, including trouble walking, sitting, and standing. Socially, Radiculopathy can limit your participation in recreational activities, sports, or social gatherings because of pain, weakness, or mobility issues. Additionally, chronic pain and physical limitations can lead to feelings of frustration, isolation, and even depression, affecting relationships and overall well-being.

• Physical Examination: The C&P examiner will conduct a physical exam of the neck, back, and spine to check for signs and symptoms of Radiculopathy. The examiner will also check for signs of pain, discomfort, difficult sitting, standing, and walking, as well as limitation of range of motion. To ensure accurate measurements, the limitation of range of motion should be measured with a goniometer.

• Completion of VA Disability Benefits Questionnaire (DBQ) for Back (Thoracolumbar Spine) Conditions: The examiner will document their findings on the DBQ for Back Conditions Including Radiculopathy, which is then submitted to the VA Rater for further processing. Eventually, the VA Rater will either approve, deny, or defer your claim for Radiculopathy.

Questions You Might Get Asked at a Radiculopathy C&P Exam

Here’s a list of 25 questions the examiner is required to document on the VA DBQ for Radiculopathy during and after your exam:

• 1. Does the veteran have a diagnoses associated with the claimed condition(s), including Radiculopathy?

• 2. Describe the history (including onset and course) of the Veteran’s thoracolumbar spine condition (brief summary).

• 3. Does the Veteran report flare-ups of the thoracolumbar spine? If yes, document the Veteran’s description of the flare-ups he/she experiences, including the frequency, duration, characteristics, precipitating and alleviating factors, severity, and/or extent of functional impairment he/she experiences during a flare-up of symptoms.

• 4. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this questionnaire, including but not limited to after repeated use over time? If yes, document the Veteran’s description of functional loss or functional impairment in his/her own words.

• 5. Document range of motion and functional limitations as follows: For any joint condition, examiners should address pain on both passive and active motion, and on both weight-bearing and non-weight-bearing. If testing cannot be performed or is medically contraindicated (such as it may cause the Veteran severe pain or the risk of further injury), an explanation must be given below. Please note any characteristics of pain observed on examination (such as facial expression or wincing on pressure or manipulation).

• 6. What are the initial range of motion measurements?

• 7. If range of motion is outside of “normal” range but is normal for the Veteran (for reasons other than a back condition, such as age, body habitus, neurologic disease), please describe.

• 8. If abnormal, does the range of motion itself contribute to a functional loss?

• 9. Is the Veteran able to perform repetitive use testing with at least three repetitions?

• 10. Is there additional loss of function or range of motion after three repetitions?

• 11. Is there evidence of pain? Note: When pain is associated with movement, the examiner must give a statement on whether pain could significantly limit functional ability during flare-ups and/or after repeated use over time in terms of additional loss of range of motion. In the exam report, the examiner is requested to provide an estimate of decreased range of motion (in degrees) that reflect frequency, duration, and during flare-ups – even if not directly observed during a flare-up and/or after repeated use over time.

• 12. Does the Veteran have any of the following? Pain, Fatigability, Weakness, Lack of Endurance, or Incoordination. If yes, check all that apply.

• 13. Does the Veteran have localized tenderness, guarding or muscle spasm of the thoracolumbar spine?

• 14. Does the Veteran have any of the following? Interference with standing, interference with sitting, disturbance of locomotion, instability of station, atrophy of disuse, deformity, swelling, weakened movement, or less movement than normal?

• 15. Are there findings of Radiculopathy? Note: For purposes of the exam, the diagnoses of IVDS and Radiculopathy can be made by a history of characteristic radiating pain and/or sensory changes in the legs, and objective clinical findings, which may include the asymmetrical loss or decrease of reflexes, decreased strength and/or abnormal sensation. Electromyography (EMG) studies are rarely required to diagnose radiculopathy in the appropriate clinical setting.

• 16. Does the Veteran have radicular pain or any other signs or symptoms due to radiculopathy?

• 17. Indicate the Veteran’s Radiculopathy symptoms including the location and severity based on a scale of none, mild, moderate, or severe: Constant pain (may be excruciating at times), intermittent pain (usually dull), intermittent pain (usually dull), and numbness.  

• 18. Does the Veteran have any other signs or symptoms of radiculopathy?

• 19. Indicate nerve roots involved (if any).

• 20. For any abnormal or positive identified neurological findings identified, explain the likely cause of those identified symptoms.

• 21. Is there ankylosis of the spine? If yes, indicate severity.

• 22. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the diagnosis section?

• 23. Have imaging studies been performed in conjunction with this examination or were any available for review prior to the exam?

• 24. Regardless of the Veteran’s current employment status, do the conditions listed in the diagnosis section impact his/her ability to perform any type of occupational task (such as standing, walking, lifting, sitting etc.)? If yes, describe the functional impact of each condition, providing one or more examples.

• 25. Does the examiner have any remarks to add that haven’t already been explained?

Examples of Work, Life, and Functional Impacts of Radiculopathy

Work Impacts

• Decreased Productivity: Pain and discomfort can distract and prevent individuals from focusing on tasks, leading to decreased productivity and performance.

• Increased Absenteeism: The need for medical appointments, procedures, and days when the pain is too severe can lead to increased absenteeism from work.

• Limited Job Opportunities: Chronic Radiculopathy might limit the types of jobs individuals can perform, especially if their job involves physical labor or sitting for long periods, which could exacerbate their condition.

Life Impacts

• Social Withdrawal: Chronic pain and discomfort can lead to social withdrawal, as individuals may feel less inclined or able to participate in social activities or hobbies they once enjoyed.

• Emotional Health: Chronic pain can have a significant impact on emotional health, leading to conditions such as depression, anxiety, and stress due to ongoing discomfort and its limitations on daily life.

• Sleep Disturbances: The discomfort and pain caused by Radiculopathy can lead to difficulty falling asleep or staying asleep, resulting in poor sleep quality and fatigue.

Functional Impacts

• Reduced Mobility: Depending on the nerve affected, individuals may experience reduced mobility or difficulty performing certain movements, which can affect daily tasks such as walking, bending, or lifting.

• Impaired Sensation: Numbness or tingling in affected areas can lead to a decreased ability to feel or sense touch, which can impair fine motor skills or the ability to perform tasks requiring precise hand movements.

• Weakness: Muscle weakness along the affected nerve path can lead to difficulties in performing tasks that require strength, such as carrying groceries, climbing stairs, or even maintaining balance.

How to Prepare for Your VA C&P Exam for Radiculopathy

Here are some tips to help you prepare for your Radiculopathy C&P exam:

• Gather Records and Documents: Collect all relevant medical records, including diagnosis testing and reports, treatment history, medications list, and any correspondence related to your Radiculopathy. This documentation will provide essential evidence to support your claim during the examination. Review the documents in detail and feel free to bring hard copies with you to the C&P exam for reference.

• Create a Symptoms Diary: Keep a detailed log of your symptoms, noting the frequency, severity, and duration of episodes and flare-ups. Document any factors that exacerbate or alleviate your symptoms of pain, weakness, numbness, etc. This diary will help you explain the impact of Radiculopathy on your work, life, and social functioning during the C&P exam.

• List Functional Impacts: Make a list of specific ways in which Radiculopathy affects your ability to perform daily tasks and activities. For example, do you have difficulty standing, walking, lifting, or sitting? Has your Radiculopathy impacted your ability to work? If yes, explain how. Providing concrete examples at your exam will help strengthen your case for service connection and ensure a more accurate VA rating.

• Review the DBQ for Radiculopathy: It’s a good idea to review the Radiculopathy  VA DBQ before your exam. Radiculopathy is specially mentioned in Section 7. Be prepared to describe the onset and progression of your symptoms over time, as well as any treatments you have pursued and their effectiveness (if any).

DBQ for Radiculopathy [Download]

The VA DBQ for Back Conditions including Radiculopathy will be completed electronically by the C&P examiner at your exam.

We’ve made a copy available for review and download below:

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