8011 - Poliomyelitis, anterior

DBQ: Link to Index of DBQ/Exams by Disability for DC 8011 

Acronyms: POLIO, PM

Definition

Poliomyelitis is defined as inflammation of the gray matter of the spinal cord. The condition also referred to as infantile paralysis, acute anterior poliomyelitis, or Heine-Medin disease, causes destruction of the motor cells in the spinal cord and brainstem.

Etiology

The condition is caused by a poliovirus. It is highly contagious, and is spread through direct contact.

Signs & Symptoms

The virus may be in the body usually from 7 to 14 days before signs and symptoms appear abruptly. Manifestations of the condition may include: fever; sore throat; severe headache; vomiting; deep muscle pain; urinary retention; muscle spasms; and stiffness of the neck and back. Paralysis may or may not occur. If the respiratory muscles are involved, there may be difficulty in swallowing, inability to cough, and pooling of tracheobronchial secretions.

Tests

Diagnostic measures may include analysis of cerebrospinal fluid (CSF), and throat or stool cultures.

Treatment

Treatment is symptomatic, and may include bed rest, analgesics, and antipyretics. Antibiotics are used if there is a urinary tract infection. Physical therapy may be needed. If the respiratory function is impaired, artificial respiration is used. Orthopedic surgery may eventually be needed to correct deformities.

Residuals

Progressive paralysis may rarely occur years after the initial acute attack. Residuals may include varying degrees of paralysis, atrophy of muscles, and deformities. Physical therapy may be long-term. There may be a need for corrective orthopedic appliances.

Special Considerations

  • This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a) [chronic disease].

  • May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC)

Notes

  • It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

  • Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

  • With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a