RIVER RAT

Thank you. Do you know what is mean't by weightbearing line over or medial to great toe? Is there a diagram on this?

I was granted 0% SC for Bi-lateral flat feet on appeal but never actually had a VA comp and Pen exam. I had my MSR, VA progress notes and a couple independent medical opinions. Oh and I had my pediatrician review her records on me and she wrote a nice letter saying I never had flat feet nor had she treated me for flat feet and she was my doc from birth until I joined the service. My entrance physical states that my feet were normal. I appealed the 0% rating because I have pain, swelling, over pronation, Posterior tibial tendon dysfunction and plantar faciitis. I have used all kinds of orthotics, heel wedges, and heel cups. Should I be worried at all about losing my 0%.

I WAS RATED 10%SC FOR RIGHT SHOULDER IMPINGEMENT AND TRAPEZIUS STRAIN TOGETHER. I THINK OF THESE AS TWO DIFFERENT ISSUES ONE AFFECTS MY SHOULDER AND ONE AFFECTS MY NECK. THE EXAMINER DID RANGE OF MOTION TESTING AFTER TALKING WITH ME ABOUT MY TRAPEZIUS STRAIN BUT HE SAID IT WASN'T PART OF WHAT HE WAS TASKED TO DO. SHOULD THESE BE RATED TOGETHER OR SEPERATLEY?

Well I got my rating 10% Service Connected for Trapezius strain and right shoulder impingement(minor). Should this be combined like this? They never considered the affects on my range of motion of my neck due to the trapezius strain only considered the painful motion of my shoulder/arm? The examiner wrote his opinion and findings and my lack of forward flexion and his estimate of loss of range of motion during flareups seems to match up with a 20% rating but this wasn't looked at? The rater wrote the word minor in the description of service connection but the examiner wrote that my conditions have a significant and moderate impact on my daily activities. I think that I should have gotten atleast 20% for the trapezius strain and 10% for my shoulder impingement. but cannot figure out the 10% for both? Should I do a notice of disagreement, ask for a reconsideration? I have stated since my service time that my flare ups directly affect my neck. The Department of Veterans Affairs General Rating Formula for Diseases and Injuries of the Spine states; Forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees warrants a 20% rating. “Although the Veteran is not claiming spinal pathology in and of itself,as he reported,Alteration neck movement is due to his trapezius strain, range of motion of the cervical spine was measured.There is no evidence of direct spinal or paraspinal tenderness in the cervical spine.No evidence of cervical spine ankylosis., Curvatures arenormal. Range of motion of the cervical spine in degrees: Forward flexion0 to 30, extension 0 to40, right andleft lateral flexion 0 to 40,right and leftlateral rotation 0 to 60. There was no pain noted in the spineitself. However, with neck movements, there was increased pain notedin the upper right trapezius muscle, especiallywith movement that would stretch this muscle, left lateral flexion and right and left rotation maneuvers. Following three repetitions of range of motion of the cervical spine, there wereno changes in the above-notedmeasurements and no increase in trapezius pain or other pain noted.” “DELUCA VERSUS BROWNCERVICAL SPINE: “There is no direct suspicion for cervical spine pathhology. There wereno changes notedin cervical spinemotion following three repetitions. The Veteran does report, however, some limitation of ability to turn his neck during flare-ups of the trapezius strain. Based on thehistory and today's examination1 it would be feasible to expect that the Veteran could lose an additional 5-10 degrees of right and left lateralflexion and right andleft lateral rotation of the cervical spine during flare-ups of the right trapezius strainwhen these occurdue to pain and spasm.”

Does this mean they actually made a decision? "Your file is currently pending processing of a recent rating decision. If the appeal is granted, the award will be processed here and you will be notified of the decision. If the appeal is denied, you will be furnished a Supplemental Statement of the Case informing you of the reasons and bases for our decision. We will allow you 30 days to respond. Any response received from you will be considered. If the decision remains unchanged or no response is received, your records will be returned to BVA for appellate consideration."

If Im awarded my appeal and receive 30% sc will I get back pay for my dependents?

I recently had a comp and pen exam and for trapezius strain. The examiner performed the range of motion for the cervical spine becasue my flare ups affect my neck movement. How will a rater look at this? What diagnostic codes would they use?

What exams would he use and what codes would be used to rate rotator cuff strain and impingement syndrome of the right shoulder?

I was sent for a comp and pen exam as part of an BVA remand. The judge had stated that all of the evidence on record was in my favor but wanted a more current diagonosis and and the relationship to the service. I'm still awaiting a decision but, I have a copy of the exam report, here is some of what is in the report. What exams did he use and what codes would be used to rate trapezius strain and a rotator cuff strain and impingement syndrome of the right shoulder? Any thoughts on possile sc % if any? Some exam results are; right shoulder condition-Range of motion right shoulder in degrees. flexion 0 to 135, abduction 0 to 134, internal and external rotation 0-90. There was evidence of pain during movement of the right shoulder. The was some clicking with internal and external rotation associated with pain. The motion was primarily noted during motion in the rotator cuff deltoid area but also extended to the superior trapezius areas as well. Additional loss of range of motion during flares is not likely. For comparison the range of motion of the left shoulder is all normal. Right shoulder pain with abduction and adduction between 45 and 90 degrees. This condition has moderate affects on the Veterans activitieshe Veterans chronic right shoulder rotator cuff strain with impingement syndrome is as least likely as not caused by or a result of the Veterans military service. right scapular and trapezius area indicates tenderness to palpitation over the superior and mid right trapezius muscle area over the rhomboid area. Although the veteran is not claiming spinal pathology in and of itself. alteration in neck movement due to his trapezius strain, range of motion of the cervical spine was measured. Range of motion of the cervical spine are as follows; forward flexion 0 to 30 , extension 0 to 40, right and left lateral flexion 0 t 40, right and left rotation 0 to 60. with neck movements there was there was increased pain noted in the upper right trapezius muscle, especially movement that would stretch that muscle. Based on examinatiob it would be feasible for the veteran to lose an addition 5 to 10 degrees of right and left lateral flexion and right and left lateral rotation of the cervical spine during flare ups of the right trapezius strain when these occur due to pain and spasm. This condition has had significant affects on the veterans activities.The veterans right trapezius strain is as least likely as not caused by or a result of the Veterans military service.

My case got remanded for another comp and Pen exam. I'm being examined for Right Trapezius strain and Right Shoulder. They need to see first if I have acurrent disabilty and whether they think its is service connected. Has anyone had an exam for Trapizius strain, I'm not sure what to expect never had an exam for this. I know this sounds crazy but I'm hoping to have it flare up so they can see it at its worst.

I got rated a 0% SC for Bi-lateral Pes Planus. Because they noted a 2008 document that I stated no foot pain, but that is not acurate, It statesI have heel pain and shin splints. They did not mention the two surgeons that specialize in foot surgeries and treated me after that date. I pasted what I found required for the 10% rating. "evaluation of 10 percent is granted whenever the weight-bearing line is over or medial to the greater to with inward bowing of the tendon achills, and pain deformation and pain on maninpulation and use of the feet." My question is three other doctors describe my feet as severe flat feet or marked pes planus, marked pronation. I have plantar faciitis heel pain and posterior tibial tendon dysfunction. Does having the pain on use and manipulation qualify for the 10% or do you also need the inward bowing of the acilles? I'm thinking I need to file a notice of disagreement. But, this has been such a long process and getting the 0% SC took over four years and its really hard to keeping pointing out what evidence people are not reading. The Judge read everything and grated the SC but then the rating doesnt even mention some of the evidence the judge noted as the basis for my SC. Should I file for Posterior tibial tendon dysfunction and plantar faciatis or will those all be part of the Pes Planus

I just won an appeal in a case very similar for bilateral pes -planus. My entrance physical the doctor noted feet as normal and near the end of my enlistment a physical therapist noted my feet and prescribed a heel lift and orthotics. I had an comp and pen exam for right knee and was denied because the examiner noted congenital flat feet possibly being the cause of the right knee. That being said I got three independent medical opinions that supported my claim that flat feet were related to my service. I was also very fortunate to find my pediatrician in her 70's that still had my files and wrote a letter that I didn't have flat feet and she would be best to know because she treated me from birth to just before my enterig the service. I made copies of my service medical records and private medical records highlighted and tabbed the areas and pages relating to my feet and knee and entrance exam notes. I made appointments with orthopedic surgeons and asked them for an exam of my feet and to review my records and give their opinion if my current foot and knee issues began and were caused by my service. I also worte them a letter describing my military service, my occupation, where I had been stationed. What I did Long hours of standing guard on hard surfaces, ruck marches, losts of running, etc. I tried to make it as easy for the doctor to review as I could they are very busy people and while they seemed put off a bit they did an excellent job and I was only charged for the exam visit. I know everycase is different, but if you know your right, Never quit! Good luck!

BVA granted me bi-lateral Pes-planus and right knee anterior knee pain syndrome. How will the Boston RO decide my rating, Will I need to go in for another exam or will they just review of evidence in my file? How long have other folks been waiting on average from BVA grant to rating?

Finally someone reviewed my file and actually read my evidence, I have won my BVA appeal for service connection for Bi-lateral Pes planus and right knee. Now I wait to see what percentage they decide to rate me. I overcame the one examiners "congenital" statement with evidence from three of my own doctors along with my entrance physical stating that I did not have flat feet before the mIlitary.

Yes the comp and Pen examiner mentioned that I had very marked congenital pes planus and that was used to dent my right ankle sprain and right knee claim back in 1999 and 2002.

Thank you.

They mentioned the pediatiricans statement like and quoted it almost verbatim, but they used it against my claim stating that her statement "does not show any metion of treatment or complaint of this condition" Then they said this does not show that this condition was incurred or aggravated by military service. But the point I was trying to make was that I didn't have Pes Planus before the service. My pediatrician I thought would be the best person to state this since she treated me my whole life before the service. I even wrote a statement outling my logic for them but, it didnt seem to help. I also had my current Provider look at all of my claims folder and she wrote that she thought that more likely than not that the Pes Planus was incurred or aggravated by military service How best do I use the Wagner decision? I havent got an IMO for the Knee and Ankle secondary to the Feet. But I do have have an IMO in support of my right knee being service related from an orthopedic surgeon. But, That has not been mentioned yet and I have submitted it at least on two occassions. I have a copy of my claims folder and it in there. I am service connected for lower lumbar strain right side at 10%.

Not sure how to file a CUE. Howmuch time would something like add to the process?

I had filed a claim for a sparined right ankle in 1990 shortly after my discahrge from active duty. I had 2 exams and for this the last one in 2002, I was denied service connection both times. This was even though the 2002 examiner diagnosed me with a right ankle spain. He had also said "examination reveals very marked (congenital) Pes Planus bilaterally and certainly that could be a cause of his discomfort." This was also used to deny my right knee claim. I went to get a IMO and had that faxed in to the VA, in the mean time I moved away and tried to have my claim follow me but, the denial became final. I see they said "Service connection is not granted for a congenital disabilty and your SMRs do not show aggrivation by service" Here I am years later I have found that the doctors office where I got my IMO had missed spelled my name and the evidence in support of my claim went into someone elses file. I have had foot issues since my time in the service and the VA podiatrist supplies my custom orthotics. I looked over my SMR to see if Pes planus was ever noted and it was. I had been prescribed orthotics and a heel lift as part of a work up on my right knee. So with this information I submitted a claim for Pes Planus, which the VA turned into me re-opening and renaming my Right Ankle sprain claim(HOW DOES THAT WORK).I thought I was in good shape, I had my documentation SMR, have current diagnosis and treatment (moderate ecessive pronation of STJ in stance and gait, Mild abducted gait, mild genu varum), documentation of Pes Planus in my comp and Pen files along with their X-ray evidence, a letter from my pediatrician that stated she cared for me from birth until a month before my joining the service and she said that she never treated or diagnosed my with Pes Planus( = not congenital). My entry physical state feet as Normal. I was on this site and noticed a refernce to Wagner v. Principi, §3.304, and Authority: 38 U.S.C. 1111. "(b) Presumption of soundness. The veteran will be considered to have been in sound condition when examined, accepted and enrolled for service except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in examination reports are to be considered as noted. " My question is should this apply to my case where it goes back to 1999 and 2002? If it does apply Do I need to bring this to their attention? I feel like me knee claim is also being held because of the"congenital" notation the examiner made in 2002. Should my Pes planus been lumped into my Ankle claim or should it be its own claim? Sorry so long but this has been an exhausting and confusing process with no end in sight.