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Andyman73
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Posts posted by Andyman73
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I had my second visit with the MH doc, and we didn't talk about anything except how he wanted to progress and such. Which is okay, but didn't move me any closer to help or an official DX. On the bright side, tho, we didn't get off track and talk about my life before the Marines, either. I was all prepared to give non-commital answers about my childhood and such. Maybe next time.
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Buck,
I mentioned the red ears to the doc, and he said it most likely is a response to elevated stress, like getting flushed in the face, and such. He said we'll be looking into that. Also mentioned night sweats, and he said it could be many reasons. I said I've told my PCP about them several times, and he wasn't overly concerned. But MH doc, said we'll be checking that out as well.
Yep, words like that hurt, even from little kids nearest and dearest to our hearts.
Buck,...ebennies is easy, when you're on the main page, after logging in, scroll over manage, I think the first drop down option has a side bar that shows apply or check up on in process claims. It takes an hour or more for your first claim, since you will have to manually enter all the pertinent info, like dates and branch of service and so on. That stuff then will always be there for future claims.
As you go thruogh it there will be a section that gives you the choices of what you claiming...such as back or foot, or MH, or AO and so on. And if you are filling for secondary, it also goes through that.
Hope that helps you.
Semper Fi.
Andy
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msattler,
Sometimes Ebennies is way behind the times. I recently had a claim finalized and was awarded a nice bump, but nothing showed in Ebennies until I had already received my award letter and retro $.
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Ok, guys, thanks. Here's the quick run down. Back in March I had an MRI done in conjunction with a C&P for my back. I was awarded an increase from 10-40% for back pain/strain. The MRI showed degenerative disc disease, and narrowing of the neural foramina(tubes the nerves run through) at several different locations with L5-S1 being worst with a moderate to severe narrowing, bilaterally.
Next I had an EMG done on both legs in conjunction with a C&P for foot conditions. The doc who performed the EMG was same who ordered back MRI a few months earlier. She gave her opinion that what ever nerve related problems in my feet are, in her opinion, related to the back, specifically the L5-S1. This is a part of the C&P exam findings for my feet claim, which I was awarded 30% for pes cavus (claw foot) w/plantar fasciitis.
I want to use both sets of findings as evidence for a sciatica(radiculopathy)claim, I do have 1 or 2 STRs where I complained about pins and needles, numbness and burning sensations in both legs and feet.
Also, I would like to use the Pes Cavus DX as causative source for ankle pain. I am currently 10% for L ankle, and want to file a secondary for R ankle. I know that my feet have caused me lots of aggravation over the years, and now have VA provided medical evidence. And same foot DX as source of aggravation for claim for increase for my bilateral knee condition as well. When I last made claims for these I didn't have the Pes Cavus DX, and now I do.
And last but not least, would I be in my right mind to file for secondary for shoulders and neck due to long term pain and suffering from my lower extremities. Which have caused me to depend on my shoulders and arms for pulling me up versus pushing up with my legs.
What say you all?
Semper Fi.
Andy
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Buck,
I plan to reopen several claims from earlier this year. They all can be tied in with the VA's own evidence.
And the one doc inferred that some of my foot issues are caused by my back. And she had ordered the MRI that she then used to opine in such a way that got my back increased from 10 to 40%. So...I am willing to bet on her opinion again.
I ordered my C-file back in May. So...lots of hurry up and wait.
Semper Fi.
Andy.
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Buck,
Believe it or not, I do have an appointment with MH doc tomorrow. I had a claim for increase for my SCD hearing due to a change in my tinnitus which is also SC'd. I never even thought to mention the red ears.
It seems to me that it's always apparent to others in social settings. I can feel it when it happens. They start to burn and feel hot to the touch. It feels like a second degree sunburn. I will ask the MH doc tomorrow.
As for stress...you may recall some of my earlier posts in other threads. I think the doc wants to go over my alcohol abuse during my service years. Don't know when he will go into the suicidal thoughts, very anxious about that.
I will let you how that went. I did see his preliminary notes through myhealthevet and his first impression is major depression reoccurring. I am hoping he will move towards ptsd. I enjoy OSA, and have such fun trying to sleep with my CPAP. I know that sleep apnea and ptsd are linked.
Semper Fi.
Andy
- TALON II FE and Buck52
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Mark,
How long ago did you do this? Earlier this year I filed for increase for my SC L ankle. It was denied. No surprise, right? I never even considered a secondary for my R ankle because of the denied increase.
But now I have the 30% bilateral pes cavus with plantar fasciitis SCD. I would like to reopen the ankle claim and adding the R ankle as secondary.
Your thoughts are welcomed with an open mind.
Semper Fi
Andy
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Ok, I have a question. Can I use C&P exam findings/results as medical evidence to support a claim for increase or secondary contention? My issue is this, I just received 30% for pes cavus w/plantar fasciitis, bilateral. The evidence and opinions would support a claim for increase for my knees and ankles, since both are aggravated by my feet. This is a new award, however the L ankle and bilateral knee SCDs date back to 1998. Since this time my R ankle has become affected by the non-stop limping.
Also I had an EMG done, to both lower extremities to determine what effect on my feet, was from nerve impingement. Doc who did the EMG, had ordered an MRI of my back this past late winter. In the MRI report is noted L5-S1 moderate to severe narrowing of the neural foramina, bilateral, w/bulging disc that may impinge upon the nerve root, therein. She opined that the non-physical issues with my feet may be due to the back issue. Can these then be used as medical evidence for claims of increase for the known SCDs and for secondary for R ankle. Also, for shoulders and cervical/neck, since I over use my upper body to compensate for the back, knees, feet etc.?
As I understand it, secondary contentions are either caused by or aggravated by SCDs. And they do not need to be in STRs, correct?
Thoughts and opinions, please, all.
Thanks,
Semper Fi.
Andy
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Buck,
You not greedy, just trying to get what is owed to you....all of it.
I have no clue as to how you feel, I'm not combat nuthin...just a Jarhead airdale mech type, I each. I feel some of those things you described, too. Especially the night sweats. I mentioned it to my PCP several times, over the years, and he gives me nothing. I ask if it's related to my HBP, he says no. My ears get bright red and burning, he says not related to HBP. I noted that my ears do that when ever I get near a stressful location, home, work, social functions...I've been asked a thousand times...why are your ears red? I don't know...why are they???
When my daughter was about 4, we were talking about friends, (don't remember why) and she laughed and said "silly Daddy, you don't have any friends" Good thing she was only 4, I knew she didn't know the cutting strength of those words. I've never told anyone that.
You have friends here, don't forget that.
File the claim, protect what's yours, for you and your family.
Semper Fi.
Andy
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My Dad is one of the "lucky" ones, who was enjoying the concurrent receipt penalty. He was losing a big chunk of his 60% VA comp, to cover for his 68%, high 3, E-7 w/24yrs, Army retirement check. This started in late '94, about 2 years after he retired, it took that long to get his VA award. It went on for many years, until he was made whole, after the law was changed/fixed/corrected. Because he was under 70% VA, his restoration, I believe, was 10% of the penalty amount per year, for 10 yrs, added back, until his penalty was cleared. He never complained, but praised God when the law was fixed.
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Berta,
You are always the best!
Your husband sure hit the wife lottery when he first met you.
I'm sure you are aware, but if not, did you know that the USPS has a "dead letter" office? Maybe the VA can send your husband's mail there? Just a thought.
I'm with Julie1975, I would so love to watch Bill O'Reilly open up a can of "whoop ass" on the VA!
As for your misdirected payment....it sure will be very interesting to learn who got you and your husband's hard fought, and muchly deserved compensation.
As always,
Andy
Semper Fi.
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They may try to steer you towards the part of your life before service, to see if that can become a reason to either deny or lowball you. I only have just begun my MH process, tomorrow I have my 2nd appt with the doc. I don't have a claim in, yet, but do expect to by this fall.
Semper Fi.
Andy
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Berta,
I'm going to go out on a limb here, but, maybe, what if....your husband replies with smoke signals? Or maybe one of those massive Swiss Alp horns? Or Morse code via telegraph?
Have you ever considered contacting a Barbara Walter's type journalist for a nice expose of what the VA has been putting you through?
Semper Fi.
Andy
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traveler,
Congrats on your successful claim. What did your award letter say? It should have some info giving you an idea on what's coming. For example, I had a claim that just finalized, letter said claim received in May, (18th, I believe) and award date of June. So I received 1 month retro, which was pending in my bank account on the same day I got the letter in the mail. I have read on here that some Vets, who are retirees, have had some issues with either their comp or retro, or both. Something to do with DFAS having to do an audit on you, in reference to your pension and compensation. I'm not too sure of the particulars, but some of the vastly more experienced Hadit members can and will share some words on that, with you. Hope it won't take too long to get your retro.
Semper Fi.
Andy
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S&B,
You're not sitting well with this because it sounds like a brush off. And it is. As you are learning, and most if not all of us here, have learned, that as a system, the VA does not care for Veterans. Some of the VA's employees do, but this branch of Gov't does not. Otherwise we wouldn't be here, and all these scandals wouldn't have happened, and new ones coming out every day.
Perhaps you may need to consult with a lawyer, such as Chris Attig(a member on here) to see what can be done to help your father.
Semper Fi.
Andy
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Buck,
It's me, again. I say...file the claim. It's the least you can do, for you and your family. I have only just begun my own MH journey, mostly due to the fact that I always believed I wasn't worth it(still do), and that there wasn't VA help available for Vets like me. Don't let another day go by without it. You deserve it, you and your wife have earned this. You by serving, her by loving and caring for you.
Semper Fi
Andy
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My Ebenefits has apparently been hacked. I tried to log in and was told my user name or password did not match so I checked my email and had one stating my log in information had been changed. I changed it back through email verification only to have it changed again 25 minutes later by an unknown party. I called support nd was told there was a problem with my account and they had to disable it and for me to re-register but the man was not authorized to tell me what the problem was. I went through that entire process and got it all set up correctly but it would not allow me into the personal information section. I called back to make sure all of that was correct and was told it was. Now as of today my direct deposit was sent to a bank account at American Express which I have never had under an account that has been closed, under someone else's name and in a completely different state than the one I live in.
Also, a dependent benefits claim was started under my file and they will not tell me who started it. Funny thing,,,, I have no dependents.. I was just told by my service rep that it will take 30 days or more for them to issue the payment to the correct account. So I guess the VA wants me to go without paying my bills or eating for a month.
Hmmm...maybe you want to file a stolen identity type of report. Maybe IRS as well. Don't know....but I would so be looking into legal protection of your ID. What did they say when you told them you have no dependants?
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Talon,
I feel bad for you, being in a location where you get farmed out for VA service. Dang, just one more thing to hinder your travels down the yellow brick road!
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I would be willing to go through with the shots if and when they service connect me...which will be in the near future, once I file that claim. I received a shot in my foot to alieveate pain from plantar fasciitis caused bone spurs...and said shot led to nerve damage. I have a lump in my foot in the general area where the shot came out of the needle tip. The C&P examiner was able to feel it, too.
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Talon,
Well, for starters, I know both of my big toes hurt all the time, mostly it's a burning sensation. But this morning on my drive in to work, I noticed my L big toe went numb, no tingling or pins and needles, just numb, like it wasn't there.
I started wearing inserts/insoles while on AD, that I purchased myself. But as for orthotics...it would have been since '99, from the VA. And I received 1 or more injections into the L arch to help relieve symptoms from bone spurs caused by the plantar fasciitis. Which then caused nerve damage within a week or so, of the injection.
Not sure about the hammer toes.
The doc who did the EMG, and ordered the ASO for my L ankle, surmised that the issue is being caused by the back...I do believe I need to file a claim for that separately, but not quite sure what to list the claim as. I think she was telling me, in her "not saying it out loud" kind of way, that I need to claim radiculapathy for that. Especially since she is the same who ordered the MRI that shows the S1-L5 moderate to severe narrowing of the neural foramina-bilaterally.
Thanks again, Talon, for your opinions on this. I wait anxiously for others to chime in and add their 2 cents worth...cuz those pennies do add up over time!
Andy
Semper Fi!
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Well, I tried to copy and paste from my downloaded VA notes from myhealthevet...no luck, such is my poor computer useage skills. But any way, I can certainly type the VA award letter...here goes...
acquired pes cavus with plantar fasciitis/ 30%.
We have assigned a 30% evaluation for your acquired pes cavus with plantar fasciitis based on - marked tenderness under metatarsal heads - Shortened plantar fascia Additional symptom(s) include - Definite tenderness under metatarsal heads.
Higher eval of 50% not warrented for acquired claw foot unless the evidence shows bilateral involvement with marked contraction of plantar fascia with dropped forefoot, all toes hammer toes, very painful callosities, market varus deformity.
The examiner opined that this condition at least as likely as not incurred in or caused by claimed in-service injury, event, or illness. The examiner's rationale was upon review of STRs and after performing physical exam; current symptoms are consistent with symptoms suffered during active service in 1998. His pes cavus foot type will have likely residuals of heel/arch pain and plantar metatarsal pain consistent with current symptoms.
That's all from the VA letter.
Ok, here is what I could get from myhealthevet...
CONFIDENTIAL Page 5 of 16
Disability Benefits Questionnaire
ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this document:
[ ] Review of available records (without in-person or video telehealth
examination) using the Acceptable Clinical Evidence (ACE) process because the
existing medical evidence provided sufficient information on which to prepare
the DBQ and such an examination will likely provide no additional relevant
evidence.
[ ] Review of available records in conjunction with a telephone interview
with the Veteran (without in-person or telehealth examination) using the ACE
process because the existing medical evidence supplemented with a telephone
interview provided sufficient information on which to prepare the DBQ and such
an examination would likely provide no additional relevant evidence.
[ ] Examination via approved video telehealth
[X] In-person examination
a. Evidence Review
Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed?
[X] Yes [ ] No
Was the Veteran's VA claims file (hard copy paper C-file) reviewed?
[ ] Yes [X] No
If no, check all records reviewed:
[X] Military service treatment records
[ ] Military service personnel records
[ ] Military enlistment examination
[ ] Military separation examination
[ ] Military post-deployment questionnaire
[ ] Department of Defense Form 214 Separation Documents
[X] Veterans Health Administration medical records (VA treatment
records)
[ ] Civilian medical records
[ ] Interviews with collateral witnesses (family and others who have
known the Veteran before and after military service)
[ ] Other:
[ ] No records were reviewed
b. Was pertinent information from collateral sources reviewed?
[ ] Yes [X] No
1. Diagnosis
------------
a. List the claimed condition(s) that pertain to this DBQ:
Bilateral plantar fasciitis
b. Select diagnoses associated with the claimed condition(s):
[X] Acquired pes cavus (claw foot)
ICD Code: 736.71
Side affected: Both
Date of diagnosis: Right Not specified
Date of diagnosis: Left Not Specified
[X] Plantar fasciitis
ICD Code: 726.73
Side affected: Both
Date of diagnosis: Right Not Specified
Date of diagnosis: Left Not Specified
c. Comments (if any):
No response provided
d. Was an opinion requested about this condition (internal VA only)?
[X] Yes [ ] No [ ] N/A
2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's
foot
condition (brief summary):
41 yo male veteran seen today for C&P examination for bilateral foot
conditions.
Veteran relates pain in his feet dating back to 1997-1998 during his active
mititary service. He was diagnosed with plantar fasciitis and dispensed
custom molded orthotics.
He relates that it is difficult to find shoes that provide comfort for his
feet.
Steroid injection therapy was attempted in 2007 at the VAMC Lebanon, PA for
heel pain with temporary results. He was then followed by a non-VA
Podiatrist and kept using custom molded orthotics.
He was recently dispensed new custom molded orthotics at Lebanon VAMC with
no benefits. An EMG was ordered due to a "lazy foot" complaint;
however the
EMG results were normal.
He is awaiting a left ankle ASO for stability.
Currently symptoms include pain in both arches upon weightbearing; worse by
the end of the day; along with pain in the left great toe joint when
standing or walking.
b. Does the Veteran report pain of the foot being evaluated on this DBQ?
[X] Yes [ ] No
If yes, document the Veteran's description of pain in his or her
own
words:
Constant pain in both arches when standing or walking.
"Shooting" pain
in the left great toe radiating back toward the ankle when walking.
c. Does the Veteran report that flare-ups impact the function of the foot?
[X] Yes [ ] No
If yes, document the Veteran's description of flare-ups in his or
her
own words:
Pain in the feet limit the amount of time that he is able to stand or
walk.
d. Does the Veteran report having any functional loss or functional impairment
of the foot being evaluated on this DBQ (regardless of repetitive use)?
[ ] Yes [X] No
3. Flatfoot (pes planus)
------------------------
No response provided
4. Morton's neuroma (Morton's disease) and metatarsalgia
--------------------------------------------------------
a. Does the Veteran have Morton's neuroma?
[ ] Yes [X] No
b. Does the Veteran have metatarsalgia?
[X] Yes [ ] No
If yes, indicate side affected:
[ ] Right [ ] Left [X] Both
c. Comments: Pain upon palpation of the plantar metatarsal head areas of both
feet due to plantarflexed metatarsals.
5. Hammer toe
-------------
No response provided
6. Hallux valgus
----------------
No response provided
7. Hallux rigidus
-----------------
a. Does the Veteran have symptoms due to hallux rigidus?
[X] Yes [ ] No
If yes, indicate severity (check all that apply):
[X] Mild or moderate symptoms
Side affected: [ ] Right [X] Left [ ] Both
b. Comments: No comments provided
8. Acquired pes cavus (clawfoot)
--------------------------------
a. Effect on toes due to pes cavus (check all that apply):
[X] None
b. Pain and tenderness due to pes cavus (check all that apply):
[X] Definite tenderness under metatarsal heads
[X] Right [ ] Left [ ] Both
[X] Marked tenderness under metatarsal heads
[ ] Right [X] Left [ ] Both
c. Effect on plantar fascia due to pes cavus (check all that apply):
[X] Shortened plantar fascia
[ ] Right [ ] Left [X] Both
d. Dorsiflexion and varus deformity due to pes cavus (check all that apply):
[X] None
[ ] Right [ ] Left [X] Both
e. Comments: No comments provided
9. Malunion or nonunion of tarsal or metatarsal bones
-----------------------------------------------------
No response provided
10. Foot injuries and other conditions
--------------------------------------
a. Does the Veteran have any foot injuries or other foot conditions not
already
described?
[ ] Yes [X] No
b. Indicate severity and side affected:
No response provided
c. Does the foot condition chronically compromise weight bearing?
No response provided
d. Does the foot condition require arch supports, custom orthotic inserts or
shoe modifications?
No response provided
e. Comments: No comments provided
11. Surgical procedures
-----------------------
a. Has the Veteran had foot surgery (arthroscopic or open)?
[ ] Yes [X] No
b. Does the Veteran have any residual signs or symptoms due to arthroscopic or
other foot surgery?
No response provided
12. Pain
--------
RIGHT FOOT:
Is there pain on physical exam?
[X] Yes [ ] No
If yes, (there is pain on physical exam), does the pain contribute to
functional loss?
[X] Yes [ ] No
(Further description of limitations requested in Section XIII below.)
LEFT FOOT:
Is there pain on physical exam?
[X] Yes [ ] No
If yes, (there is pain on physical exam), does the pain contribute to
functional loss?
[X] Yes [ ] No
(Further description of limitations requested in Section XIII below.)
13. Functional loss and limitation of motion
--------------------------------------------
a. Contributing factors of disability (check all that apply and indicate side
affected):
[X] Pain on movement
Side affected: [ ] Right [ ] Left [X] Both
[X] Pain on weight-bearing
Side affected: [ ] Right [ ] Left [X] Both
[X] Disturbance of locomotion
Side affected: [ ] Right [ ] Left [X] Both
Contributing factors of disability associated with limitation of motion:
b. Is there pain, weakness, fatigability, or incoordination that significantly
limits functional ability during flare-ups or when the foot is used
repeatedly over a period of time?
RIGHT FOOT: [X] Yes [ ] No
If yes, (there is a functional loss due to pain, during flare-ups
and/or when the joint is used repeatedly over a period of time) please
describe the functional loss:
Limitation on amount of time walking or standing when heel pain is
increased.
LEFT FOOT: [X] Yes [ ] No
If yes, (there is a functional loss due to pain, during flare-ups
and/or when the joint is used repeatedly over a period of time) please
describe the functional loss:
Limitation on amount of time walking or standing when heel pain is
increased.
c. Is there any other functional loss during flare-ups or when the foot is
used
repeatedly over a period of time?
RIGHT FOOT: [ ] Yes [X] No
LEFT FOOT: [ ] Yes [X] No
14. Other pertinent physical findings, complications, conditions, signs,
symptoms and scars
------------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings, complications,
conditions, signs or symptoms related to any conditions listed in the
Diagnosis section above?
[X] Yes [ ] No
If yes, describe (brief summary):
EMG performed 13JUL15 on left lower extremity reveals WNL results.
Normal shoe wear pattern noted to bilateral shoes.
Gait analysis is propulsive gait without limp or drop foot.
b. Does the Veteran have any scars (surgical or otherwise) related to any
conditions or to the treatment of any conditions listed in the Diagnosis
section above?
[ ] Yes [X] No
c. Comments: No comments provided
15. Assistive devices
---------------------
a. Does the Veteran use any assistive device as a normal mode of locomotion,
although occasional locomotion by other methods may be possible?
[ ] Yes [X] No
b. If the Veteran uses any assistive devices, specify the condition and
identify the assistive device used for each condition:
No response provided
16. Remaining effective function of the extremities
---------------------------------------------------
Due to the Veteran's foot condition, is there functional impairment of an
extremity such that no effective function remains other than that which would
be equally well served by an amputation with prosthesis? (Functions of the
upper extremity include grasping, manipulation, etc., while functions for the
lower extremity include balance and propulsion, etc.)
[ ] Yes, functioning is so diminished that amputation with prosthesis would
equally serve the Veteran.
[X] No
17. Diagnostic testing
----------------------
a. Have imaging studies of the foot been performed and are the results
available?
[X] Yes [ ] No
If yes, is degenerative or traumatic arthritis documented?
[X] Yes [ ] No
If yes, indicate foot: [ ] Right [ ] Left [X] Both
b. Are there any other significant diagnostic test findings or results?
[ ] Yes [X] No
c. If any test results are other than normal, indicate relationship of
abnormal
findings to diagnosed condition:
No response provided
18. Functional impact
---------------------
Regardless of the Veteran's current employment status, do the
condition(s)
listed in the Diagnosis section impact his or her ability to perform any type
of occupational task (such as standing, walking, lifting, sitting, etc.)?
[X] Yes [ ] No
If yes, describe the functional impact of each condition, providing one or
more examples:
Consideration should be made for limited weightbearing activities due to
heel pain.
19. Remarks, if any:
--------------------
No remarks provided
****************************************************************************
Medical Opinion
Disability Benefits Questionnaire
Indicate method used to obtain medical information to complete this
document:
[ ] Review of available records (without in-person or video telehealth
examination) using the Acceptable Clinical Evidence (ACE) process
because
the existing medical evidence provided sufficient information on which
to
prepare the DBQ and such an examination will likely provide no
additional
relevant evidence.
[ ] Review of available records in conjunction with a telephone interview
with the Veteran (without in-person or telehealth examination) using the
ACE process because the existing medical evidence supplemented with a
telephone interview provided sufficient information on which to prepare
the DBQ and such an examination would likely provide no additional
relevant evidence.
[ ] Examination via approved video telehealth
[X] In-person examination
Evidence review
---------------
Was the Veteran's VA claims file reviewed? No
If no, check all records reviewed:
[X] Military service treatment records
[X] Veterans Health Administration medical records (VA treatment
records)
MEDICAL OPINION SUMMARY
-----------------------
RESTATEMENT OF REQUESTED OPINION:
a. Opinion from general remarks:
DBQ MUSC Foot Conditions including Flatfoot (pes planus)
____________________________________________________________________________
_________
The following contentions need to be examined:
any bilateral foot condition to include plantar faciitis
Active duty service dates:
Branch: Marine Corps
EOD: 11/16/1992
RAD: 11/15/1998
DBQ MUSC Foot Conditions including Flatfoot (pes planus):
Please review the Veteran's electronic folder in VBMS and state that it
was
reviewed in your report.
MEDICAL OPINION REQUEST
TYPE OF MEDICAL OPINION REQUESTED: Direct service connection
OPINION: Direct service connection
Does the Veteran have a diagnosis of (a)any bilateral foot condition to
include plantar faciitis that is at least as likely as not (50 percent or
greater probability) incurred in or caused by (the) complaints of any
bilateral foot condition noted on page 137 of strs dated July of 1998 during
service?
Rationale must be provided in the appropriate section.
Please direct any questions regarding this request to:
Please Review The Veteran's VBMS File state that the VBMS file has been
reviewed and Advise.
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE
CONNECTION ]
a. The condition claimed was at least as likely as not (50% or greater
probability) incurred in or caused by the claimed in-service injury, event
or
illness.
c. Rationale: Upon review of medical records and after perfomring a physical
examination; the current symptoms are consistent with the symptoms suffered
during active service in 1998. His Pes cavus foot type will have likely
sequelae of heel/arch pain and plantar metatarsal pain consistent with
current symptoms.
*************************************************************************
/es/ NEIL D BISER DPM
PODIATRIST
Signed: 07/17/2015 09:53
Date/Time:
13 Jul 2015 @ 1301
Note Title:
CONSULTATION REPORT
Location:
KEENAN,BARBARA F
Co-signed By:
KEENAN,BARBARA F
Date/Time Signed:
13 Jul 2015 @ 1532
Note
LOCAL TITLE: CONSULTATION REPORT
STANDARD TITLE: CONSULT
DATE OF NOTE: JUL 13, 2015@13:01 ENTRY DATE: JUL 13, 2015@13:01:47
AUTHOR: KEENAN,BARBARA F EXP COSIGNER:
URGENCY: STATUS: COMPLETED
Chief complaint: Back pain, numbness and tingling left foot
Veteran self-identified by stating full name, last 4 SSN, and DOB.
History: 41-year-old male Veteran complains of 5 years intermittent numbness
and tingling in the left foot in the area of the arch particularly during
episodes of back pain. Also complains of burning in the right great toe and ball
of the right foot, and fatigue on the dorsum of the right foot also for five
years. No persistent lower extremity weakness, however, when the left foot
develops numbness on the dorsum of the foot with prolonged walking the left
ankle feels weak in dorsiflexion. Describes it as "lazy foot."
Sometimes feels
he is catching his left foot when he walks. No bowel or bladder issues.
PMH and medications: Reviewed in computerized record. No history of diabetes.
No anticoagulants.
Physical examination:
Well-developed, well-nourished, no atrophy or fasciculations in the lower
extremities.
Strength 5/5 for all major muscle groups in the lower extremities.
Sensation intact in the lower extremities.
Reflexes 2/4 symmetric knees and ankles.
Babinski negative, no ankle clonus.
MRI of the lumbar spine 3/17/2015 is reported to show mild disc degeneration and
mild circumferential disc bulge at L5-S1; minor facet changes at that level;
moderate to severe stenosis of the right and left neural foramina and possible
compromise of either L5 nerve root.
Full report and images are available in the record.
Informed consent was obtained in iMed; EMG/NCS of the bilateral lower
extremities was performed.
Veteran tolerated the procedure well.
FINDINGS: This is a NORMAL STUDY with NO electrodiagnostic evidence of peroneal
nerve entrapment on either side, tarsal tunnel syndrome on either side, lumbar
radiculopathy on either side, or generalized peripheral neuropathy. (The left
and right lateral plantar ortho sensory nerves showed reduced amplitude on both
sides; this is of doubtful clinical significance as the latencies are normal.)
For full results see report in Vista imaging when scanning is completed.
Results were discussed with the patient.
He is being referred to Physical Therapy for a left ASO.
He was also advised to follow up with referring provider in Podiatry and with
his Primary Care provider for further care.
The patient expressed understanding of the information and agreement with the
recommendation. No further follow-up is scheduled in the EMG Clinic. Please
follow the patient.
/es/ BARBARA F KEENAN, M.D.
PHYSIATRIST
Signed: 07/13/2015 15:32
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Yeah,
I just started using myhealthevet, this past week. I went to VAMC for appt, and while there, I spoke with the myhealthevet rep and got premium access. I looked at some stuff, but not too indepth. Will be doing that much more thoroughly, tho.
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Buck,
I was thinking the same thing, since the examiner opined that most of his findings were bilateral, and not limited to just one foot. I will be checking the award letter and going onto myhealthevet this evening. On Monday I have an appt at my VAMC, so I will be hitting the records office and get print outs of my most recent visits to include the c&p exam.
Andy
Members Opinion Needed!
in PTSD Post Traumatic Stress Disorder Claims
Posted
Buck,
Just trial and error, not too hard.
Andy