Feet/ankle Issues

[RichL]

I am service connected for Left and Right Achilles tendinitis at 10% for each foot. I have been seen by a VA Podiatry doctor who had orthotics made for both of my feet. I have also been on various pain medications for my foot pain.

I recently had a general C&P exam. During this exam the examiner stated in the report that I was diagnosed with Bilateral Achilles tendinitis that has significant effects on my occupation.

In the Musculoskeletal Exam section of the report, the examiner states that in the Other Significant Physical Findings section that my right ankle active range of motion for each type of joint:

Dorsiflexion: 0-10 degrees

Plantarflexion: 0-45 degrees

Is there pain on motion: Yes

Motion and degree at which painful motion begins and ends: Pain with Dorsiflexion from 5 to 10 degrees. Negative Deluca

For the left ankle active range of motion for each type of joint:

Dorsiflexion: 0-0 degrees

Plantarflexion: 0-45 degrees

Is there pain on motion: Yes

Motion and degree at which painful motion begins and ends: Pain with Dorsiflexion from -5 to 0 degrees. Negative Deluca

What does this mean, and is it possible based on this exam to receive and increase for my Achilles tendinitis? Or should I make a new claim for foot injuries other (5284), or ankle limited motion (5271), or some other claim?

[sixthscents]

OK so I understand 0 degree dorsiflexion of left foot? It looks to me like they just rated you for painful motion and thats it.

Edited September 28, 2007 by sixthscents

[sixthscents]

OK a couple section apply:

The Ankle

------------------------------------------------------------------------

Rating

------------------------------------------------------------------------

5270 Ankle, ankylosis of:

In plantar flexion at more than 40[deg], or in dorsiflexion at 40

more than 10[deg] or with abduction, adduction, inversion or

eversion deformity...........................................

In plantar flexion, between 30[deg] and 40[deg], or in 30

dorsiflexion, between 0[deg] and 10[deg].....................

In plantar flexion, less than 30[deg]......................... 20

5271 Ankle, limited motion of:

Marked........................................................ 20

Moderate...................................................... 10

and:

The Foot and Leg

------------------------------------------------------------------------

Rating

------------------------------------------------------------------------

5310 Group X. Function: Movements of forefoot and toes;

propulsion thrust in walking. Intrinsic muscles of the foot:

Plantar: (1) Flexor digitorum brevis; (2) abductor hallucis;

(3) abductor digiti minimi; (4) quadratus plantae; (5)

lumbricales; (6) flexor hallucis brevis; (7) adductor hallucis;

(8) flexor digiti minimi brevis; (9) dorsal and plantar

interossei. Other important plantar structures: Plantar

aponeurosis, long plantar and calcaneonavicular ligament,

tendons of posterior tibial, peroneus longus, and long flexors

of great and little toes.......................................

Severe...................................................... 30

Moderately Severe........................................... 20

Moderate.................................................... 10

Slight...................................................... 0

Dorsal: (1) Extensor hallucis brevis; (2) extensor digitorum

brevis. Other important dorsal structures: cruciate, crural,

deltoid, and other ligaments; tendons of long extensors of toes

and peronei muscles............................................

Severe...................................................... 20

Moderately Severe........................................... 10

Moderate.................................................... 10

Slight...................................................... 0

Looks to me that they disreguarded the flexion and just rated you as moderate limitation of motion. Personally if the numbers are correct I'd file a NOD simply based on 5270.

Edited September 28, 2007 by sixthscents

[sixthscents]

Further you state "orthotics made for both feet"... what type of orthotic... is it an AFO? Because that opens up the whole "loss of use" issue.

Edited September 28, 2007 by sixthscents

[RichL]

OK so I understand 0 degree dorsiflexion of left foot? It looks to me like they just rated you for painful motion and thats it.

So, does that mean that I should file for a new SC rating for painful motion of the left foot?

[RichL]

Further you state "orthotics made for both feet"... what type of orthotic... is it an AFO? Because that opens up the whole "loss of use" issue.

I had custom molded orthotics made for my feet at the VA. I do not know what an AFO is? Please explain....