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Any help would be appreciated!

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garion

Question

I requested an increase for Peripheral Neuritis and Arthritis. Below is the results.  The C&P examiner also found I had Sciatic Neuritis and Posterior Tibial Nerve damage. 

Will the VA rate me separately or together for all four issues?  Or are they rated separately?

Thanks!

 

3. Veteran's current claimed and diagnosed Right and Left Lower

Extremity Peripheral Neuritis due to cold exposure is at least as likely as not(50

percent or greater probability) a continuation and/or progression of the

Veteran's already service connected Right and Left Lower Extremity,

Peripheral Neuritis from Cold Injury.

4. Veteran's current claimed Osteoarthritis of Right Foot/Right

Lower Extremity is at least as likely as not(50 percent or greater

probability)proximately due to or the result of the Veteran's

already service connected Peripheral Neuritis from cold Injury, Left and Right

Lower Extremity condition(s)/disability.

Rationale:

Veteran's current clinical radiologic findings- Right Foot, positive

for objective Right Calcaneal Spurring.

The C&P doctor also wrote this...

11. Nerves Affected: Severity evaluation for lower extremity nerves

a. Sciatic nerve

Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis

If Incomplete paralysis is checked, indicate severity:

[ ] Mild

[X] Moderate

[ ] Moderately Severe

[ ] Severe, with marked muscular atrophy

Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis

If Incomplete paralysis is checked, indicate severity:

[ ] Mild

[X] Moderate

[ ] Moderately Severe

[ ] Severe, with marked muscular atrophy

f. Posterior tibial nerve

Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis

If Incomplete paralysis is checked, indicate severity:

[ ] Mild [X] Moderate [ ] Severe

Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis

If Incomplete paralysis is checked, indicate severity:

[ ] Mild [X] Moderate [ ] Severe

 

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Ok.   You have to have a diagnosis to get service connected.  However, VA compensates for symptoms, not diagnosis.  I think you may get compensation for both to the extent the symptoms do not overlap.  For example, if you have pain in the same joint for both arthritis and Peripheral neuritis, you will get "painful knee" in one of these but not both. 

Same for range of motion.  If you have reduced ROM from arthritis, you wont get reduced ROM from peripheral neuritis in the same joint. 

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sciatic nerve includes the following;

Sciatic

sciatic nerve (DCs 8520, 8620, and 8720)

external popliteal nerve (common peroneal) (DCs 8521, 8621, and 8721)

musculocutaneous nerve (superficial peroneal) (DCs 8522, 8622, and 8722)

anterior tibial nerve (deep peroneal) (DCs 8523, 8623, 8723)

internal popliteal nerve (tibial) (DCs 8524, 8624, and 8724), and

posterior tibial nerve (DCs 8525, 8625, and 8725).

 

The tibial nerve is a part of the sciatic nerve, so you will be rated only on the sciatic.  The sciatic nerve is the largest nerve coming from the lumbar spine, it branches into the listed nerves mostly from about the knee down to the ankle/foot.

Sciatic nerves are in the leg, so they are peripheral nerves, (the peripherals are arms and legs).

Depending on the location of arthritis will depend on how that is rated.  The Spine is typically rated as IVDS or DDD instead of arthritis because you get higher ratings in the spine.  Need further info for arthritis to figure that out. 

 

 

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sciatic nerve includes the following;

Sciatic

sciatic nerve (DCs 8520, 8620, and 8720)

external popliteal nerve (common peroneal) (DCs 8521, 8621, and 8721)

musculocutaneous nerve (superficial peroneal) (DCs 8522, 8622, and 8722)

anterior tibial nerve (deep peroneal) (DCs 8523, 8623, 8723)

internal popliteal nerve (tibial) (DCs 8524, 8624, and 8724), and

posterior tibial nerve (DCs 8525, 8625, and 8725).

 

The tibial nerve is a part of the sciatic nerve, so you will be rated only on the sciatic.  The sciatic nerve is the largest nerve coming from the lumbar spine, it branches into the listed nerves mostly from about the knee down to the ankle/foot.

Sciatic nerves are in the leg, so they are peripheral nerves, (the peripherals are arms and legs).

Depending on the location of arthritis will depend on how that is rated.  The Spine is typically rated as IVDS or DDD instead of arthritis because you get higher ratings in the spine.  Need further info for arthritis to figure that out. 

 

 

The nerve damage is in my ankles and feet from cold weather injury.  I am already 10% service connection for each foot for peripheral neuritis (increase) due to cold weather injury and requested an increase.    I also was being examined for arthritis (new claim) in both feet in which the VA decided to examine and rate themselves.  I guess my injury usually lead to arthritis so the VA decided to do the C&P exam on that as well.  The sciatic nerve and posterior tibial nerve damage do to my cold weather injury is something new the doctor found during my C&P exam.  She stated in her notes that the arthritis, sciatic and posterior tibial nerve damage is caused by my service connected peripheral neuritis.  I have been service connected for peripheral neuritis for over 20 years now. 

The VA did say it would be a 2 hour exam and they was checking everything with my feet. 

I was thinking all my pain was coming from the cold weather injury but the doctor found other thing like the arthritis which freaked me out.  You can't do anything without your feet...          

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http://blog.militarydisabilitymadeeasy.com/2014/05/rating-arthritis-for-military-disability_12.html

good info on arthritis here

The posterior tibial is a branch from the sciatic.  If they rate it as sciatic you might get a higher rating, but if they question it they might want to check that it actually affects the whole sciatic nerve, that could shoot that down.  With an EMG, they can detect if the sciatic nerve is affected, where it starts and how much of the nerve is affected.  That part where they stick needles into your muscle tissue is a pain, but it gives them exact and scientific fact to base the rating on.

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http://blog.militarydisabilitymadeeasy.com/2014/05/rating-arthritis-for-military-disability_12.html

good info on arthritis here

The posterior tibial is a branch from the sciatic.  If they rate it as sciatic you might get a higher rating, but if they question it they might want to check that it actually affects the whole sciatic nerve, that could shoot that down.  With an EMG, they can detect if the sciatic nerve is affected, where it starts and how much of the nerve is affected.  That part where they stick needles into your muscle tissue is a pain, but it gives them exact and scientific fact to base the rating on.

Thanks pwrslm!  I already did that test a long time ago.  That's how I got my first rating.  The problem I am having is which one will they rate me on?  It's documented by my C&P and pervious doctors that I have sciatic nerve damage and posterior nerve damage.  Each have it's own rating and code. 

Here are the ratings.

Code 8520: Paralysis of the sciatic nerve. Complete paralysis: If the foot drops (it cannot be lifted by the muscles in the legs), all the muscles in the leg below the knee do not work at all, and the knee has serious trouble bending (bending the knee doesn’t have to be impossible to rate as complete paralysis of the sciatic nerve, it just has to be limited), it is rated 80%. Incomplete, severe paralysis is rated 60%. Incomplete, moderately severe paralysis is rated 40%. Incomplete, moderate paralysis is rated 20%. Incomplete, mild paralysis is rated 10%.

Code 8525: Paralysis of the posterior tibial nerve. Complete paralysis: If the toes cannot curl or separate, all the muscles on the bottom of the foot cannot move at all, the foot has trouble turning inward (but it can do it), and the foot has trouble pointing (but it can do it), it is rated 30%. Incomplete, severe paralysis is rated 20%. Incomplete, moderate paralysis is rated 10%. Incomplete, mild paralysis is rated 10%.

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Glad you made it thru the exam bud, and I myself have had a few conditions granted that I did not submit for, yet Examiner noted conditions thru treatment or MRIs. Sounds like a good thing to me.

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