What to Expect at a VA C&P Exam for Sciatica: The Insider’s Guide

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In this Insider’s Guide, Brian Reese reveals and explains everything you can expect during a VA C&P exam for sciatica.

After you’ve filed a VA claim for sciatica (also called “paralysis of the sciatic nerve”), you’ll likely be scheduled for a Compensation and Pension (C&P) exam by a private company contracted by the VA.

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

Sciatica is a very common in military veterans; in fact, paralysis of the sciatica nerve is the #3 most common VA disability claim.

Pro Tip: VA disability ratings for sciatica range from 10% to 80% with breaks at 20%, 40%, and 60%, depending on the severity of symptoms. With complete paralysis, characterized by a total inability to move the muscles below the knee, resulting in the foot dangling and dropping, and potentially accompanied by weakened or lost knee flexion, a disability rating of 80% is assigned. Incomplete paralysis, especially when accompanied by marked muscular atrophy, is rated at 60%. If the condition is moderately severe, it receives a 40% rating. Moderate paralysis, where the impact is less substantial but still significant, is rated at 20%. Mild cases of sciatica are given a 10% disability rating.

What to Expect at a C&P Exam for Sciatica

A C&P exam for sciatica is designed to assess whether (#1) you have some form of sciatic nerve condition diagnosed, (#2) if there is a “nexus” for service connection (meaning your sciatica was caused or made worse by your military service or another service connected disability for secondary service connection), and (#3) 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 sciatica:

• Review of Medical History: The C&P examiner will begin by reviewing your medical records related to any spinal and nerve problems, particularly focusing on those relevant to sciatic nerve issues. This includes past diagnoses, treatments, and evaluations. The examiner will have access to the medical records and documents you’ve already submitted to the VA so you don’t need to bring additional records to the exam unless you believe they will aid in recalling important details.

• History and Onset: The discussion will include your military service history and any previous incidents or conditions that might have contributed to your sciatica. Several risk factors increase the likelihood of veterans developing sciatica. Combat-related injuries, especially those affecting the spine or lower extremities, can lead to spinal disc herniation or nerve compression. Prolonged physical exertion and traumatic incidents during active duty contribute to this risk. Additionally, post-traumatic stress disorder (PTSD) can indirectly exacerbate sciatica through muscle tension and stress-related changes in pain perception. Repetitive motions, prolonged sitting or standing, and inadequate access to timely medical care during military service further heighten the risk of sciatica development in veterans.

• Discussion of Symptoms: You will be asked about the specific symptoms of your sciatica, such as when they began, their frequency, and their severity. Common symptoms of sciatica include pain that travels along the path of the sciatic nerve, from the lower back through the buttock and down one leg. This pain can range from a dull ache to a sharp, burning sensation and may worsen with movement or prolonged sitting. Numbness, tingling, and weakness in the leg or foot are common accompanying symptoms. Additionally, discomfort in the lower back, buttock, or hip region may be present. Severe cases can result in difficulty walking or standing due to intense pain or muscle weakness. Overall, sciatica’s primary symptoms include pain, numbness, tingling, and weakness, impacting daily activities and mobility.

• Negative Impacts on Work, Life, and Social Functioning: The examiner will need to understand how your sciatica affects your ability to work, perform daily activities, and engage socially. Pain and mobility issues can severely impact job performance, restrict personal activities, and decrease social interaction, leading to broader effects on mental health and quality of life.

• Physical Examination: The physical exam will focus on your back and legs. The examiner will assess muscle strength, reflexes, and sensation. They will also look for signs of pain or discomfort, and test your ability to sit, stand, walk, and bend. The range of motion might be measured with a goniometer to obtain precise data about any limitations.

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

List of Questions You Might Get Asked at a Sciatica C&P Exam

Here’s a detailed list of questions from 13 sections of the DBQ for Sciatica that veterans can expect to be asked during their C&P exam:

SECTION I – DIAGNOSIS:

• What is the diagnosis related to sciatica?
• What is the appropriate ICD code and dates of diagnosis?

SECTION II – MEDICAL HISTORY:

• Describe the history, onset, and course of the veteran’s sciatica.

SECTION III – SYMPTOMS:

• Does the veteran have any symptoms attributable to sciatica?
• If yes, describe the location and severity of: Constant pain, intermittent pain, paresthesias and/or dysesthesias, and numbness.

SECTION IV – MUSCLE STRENGTH TESTING:

• Test muscle strength for areas such as leg muscles, ankle, and foot on both the affected and unaffected sides. Each muscle group’s strength is rated on a scale from 0/5, indicating no muscle movement, to 5/5, which represents normal strength.

SECTION V – REFLEX EXAM:

• Assess and rate the reflexes for areas such as the knee and ankle.

SECTION VI – SENSORY EXAM:

• Indicate sensation for areas like the leg and foot.

SECTION VII – TROPHIC CHANGES:

• Does the veteran have trophic changes such as loss of hair or smooth, shiny skin attributable to sciatica?

SECTION VIII – GAIT:

• Is the veteran’s gait normal?
• If not, describe the abnormal gait and its etiology.

SECTION IX – SPECIAL TESTS FOR SCIATIC NERVE:

• Were special tests indicated and performed for sciatic nerve evaluation? (e.g., Straight Leg Raise test, Slump test).

SECTION X – NERVES AFFECTED:

• Indicate if the sciatic nerve is affected and the severity of the condition.

SECTION XI – ASSISTIVE DEVICES:

• Does the veteran use any assistive devices for locomotion?
• Specify the devices and their frequency of use.

SECTION XII – FUNCTIONAL IMPACT:

• Does sciatica impact the veteran’s ability to work or perform daily activities? If yes, explain.

SECTION XIII – REMARKS:

• Provide any additional comments or observations that might help in assessing the veteran’s condition.

Examples of Work, Life, and Functional Impacts of Sciatica

Work Impacts

• Decreased Productivity: Sciatica can lead to sharp pain and discomfort in the lower back and legs, which can reduce productivity and work performance.

• Increased Absenteeism: The painful symptoms of sciatica may necessitate regular medical visits and sick leave, especially when the pain is acute, thus increasing absenteeism.

• Limited Employment Opportunities: Veterans with severe sciatica might find their ability to perform certain jobs—especially those requiring prolonged periods of sitting, standing, or physical labor—greatly restricted.

Life Impacts

• Social Withdrawal: Constant pain and discomfort due to sciatica may cause veterans to avoid social activities and hobbies, negatively affecting their social life and personal interests.

• Emotional Health: The ongoing nature of sciatica and its impact on everyday activities can lead to emotional distress, such as depression and anxiety.

• Sleep Disturbances: Sciatic pain can intensify at night, disrupting sleep patterns and leading to poor sleep quality and chronic fatigue, which impacts overall health and wellbeing.

Functional Impacts

• Reduced Mobility: Sciatica can limit mobility and make it difficult to perform movements that require flexibility or balance, such as walking or bending.

• Impaired Sensation: Sciatica may cause numbness or a tingling sensation in the legs, reducing the ability to sense touch or temperature, complicating tasks like walking or driving.

• Weakness: Muscle weakness associated with sciatica can create difficulties in activities that require strength, like climbing stairs or lifting objects, and may increase the risk of falls and injuries.

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

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

• Gather Records and Documents: Assemble all relevant medical records, including diagnostic tests and reports, treatment history, medication lists, and any correspondence related to your sciatica. These documents will provide crucial evidence to support your claim during the examination. Review them thoroughly and bring hard copies to the C&P exam for reference.

• Create a Symptoms Diary: Maintain a detailed log of your symptoms, recording the frequency, severity, and duration of pain episodes and flare-ups. Note any factors that worsen or alleviate your symptoms, such as activities or positions. This diary will be vital in demonstrating the impact of sciatica on your work, life, and social activities during the exam.

• List Functional Impacts: Catalog specific ways sciatica affects your daily functioning. For instance, sciatica can lead to pain and weakness in the legs, affecting mobility and increasing the risk of falls. It may also cause numbness and tingling, which can hinder tasks requiring precise leg movements, heighten the risk of injury, and complicate driving. Issues with prolonged sitting or standing may worsen discomfort, and balance problems may affect movement. Daily activities, work performance, social interactions, and mental health can all be impacted. Sleep disturbances are also common with sciatica.

• Review the DBQ for Peripheral Nerve Conditions: Familiarize yourself with the DBQ for nerve conditions before your exam, focusing on sections relevant to sciatica. Be prepared to describe the onset, progression, and current state of your condition, as well as any treatments you have tried and their effectiveness. The examiner will document their findings on the DBQ for Sciatica, which is then submitted to the VA Rater for further processing. Eventually, the VA Rater will either approve, deny, or defer your claim for neuropathy.

DBQ for Sciatica [Download]

It’s possible for the examiner to use the DBQ for the Back and Spine depending on the part(s) of the body most impacted by your nerve issues.

Most likely; however, the examiner will complete the electronic version of the VA DBQ for Peripheral Nerve Conditions at your exam.

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

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