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Pn Lower Extremity.


Conecuh

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What percentage is possable for PN of lower extremities? Can you only get 10% per leg, foot.

Does percentage only rely on medical evidence?

Thanks for your help.

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The level of disability assigned to ANY CLAIMED ISSUE will be based upon the medical evidence provided in support of the claim. Normally PN is based upon the results of an EMG and the specific nerve affected.

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hi conecuh. i am assuming you are talking about peripheral neuropathy as due to diabetes mellitus. here is how i rate it, and i am fairly typical. if the vet indicates subjective pain, numbness and tingling, 0 percent. if va examiner finds that there is some objective impairment of sensation to touch or pinprick, 10 percent. higher evaluations need emg data to back them up, as ricky pointed out. however, i will make an exception if there is persistent diabetic ulceration or complete loss of all protective sensation (objectively documented). there are more liberal raters out there, so pursue the claim, you may luck out.

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Guest terrysturgis

My lower body PN is now rated at 40% bilaterial. Initially I was rated at 20% bliaterial. The C&P consisted of sensory touch and range of motion. I never had an EMG.

The decision states:

The neuropathy is a common complication of diabetes, and is considered part of your initial claim for service connection for diabetes.

The evaluation of peripherial neuropathy of both lower extremities is increased to 40 percent disabling effective xxx xx, 200x, which is the date of the VA examination that showed the condition had worsened. Vibratory sense was absent at the ankles and monofilament sensorium was absent over much of the feet. The examination showed that in addition to loss of sensations which had been shown ealier, strenght in your quadriceps flexors and flexors in your feet was reduced to 4/5, a medical finding that indicates strength against light resistance only, not full strength. The examiner stated that the neuropathy now involved several nerve tracts and described the severity of the neuropathy as moderate to severe. These findings meet the requirements for the increased evaluation from the date of examination.

A higher evaluation of 60 percent is not warranted unless there is evidence of incomplete paralysis below the knee which is severe with marked muscular atrophy. There is no marked muscular atrophy, so the 60 percent evaluation is not assigned.

My upper body is 10 percent bilaterial.

I must have found one of the more liberial raters and the C&P examiner did a good exam. Long story short, the PN hurts like h___ and has ruined my life but it's OK I have my wife of 39 years to open the pickle jar. Take care. Terry Sturgis

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  • HadIt.com Elder

The thing about PN is that it can lead to amputation due to unnoticed injuries to the foot that become infected. I knew a fellow postal worker who lost his foot due to PN and gangreen setting in all due to DMII and lack of care.

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hi conecuh. i am assuming you are talking about peripheral neuropathy as due to diabetes mellitus. here is how i rate it, and i am fairly typical. if the vet indicates subjective pain, numbness and tingling, 0 percent. if va examiner finds that there is some objective impairment of sensation to touch or pinprick, 10 percent. higher evaluations need emg data to back them up, as ricky pointed out. however, i will make an exception if there is persistent diabetic ulceration or complete loss of all protective sensation (objectively documented). there are more liberal raters out there, so pursue the claim, you may luck out.

Treatment; Electromyography (EMG).

Diagnosis; Sever Diffuse Sensorimotor Peripheral Neuropathy.

I was bit 27 times by fire ants and did not know it. Droped the fire off my cig in my flip-flop, did not know it.

I am sure my SSD award was for "service connected condistion" of Diabetes 2 with PN lower extremity. Lumbago is in my medical records but was hardly mentioned in SSD applacation. By the way folks, Diabetes 2 with PN is one of the few "Listed" reasons you can be awarded SSD.

My complaint is that while the EMG showed both lower extremities, I was only awarded one. 10%. So instead of having my "40% for one condition" I only have 30%.

I worked construction. Can't get down on my knees, crawl, climb etc etc. Can't feel my feet. I stumble because of that.

But I understand the rater does not take that into consideration.

Hopefully I will get a rater with good common sence. "Complete loss of all protective sensation" describes my situation.

Entropent, are you allowed to speak english to the rater? Grin! I mean, just tell him in your own words in a cover letter?

John999, I am happy to just have feet! I know I must sound like I am whinning. I feel bad posting,as I know so many are in much worse shap than me.

But the truth is, I can't work because of this. And that miff's me a little bit. Did I mention the PTSD? Grin!

Thanks, Thanks, Thanks to all.

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"entropent, are you allowed to speak english to the rater? Grin! I mean, just tell him in your own words in a cover letter?"

absolutely the best way to communicate with the rater. you don't need a 4138. send a letter to whom it may concern. specifically state that you have had these incidents with fire ants and cigarettes, and if your wounds have difficulty healing, state that, too. state that you can't feel your feet, and that you stumble. be brief, to the point, and be real. (and type it, easier to read that way.) the rater doesn't know how this affects your life until you tell him. he may not quote your statement back to you in his reasoning, but he will have to read it, and in so doing, he will understand what you are living with. if you add in emg abnormalities in both lower extremities, i am pretty optimistic about your claim.

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  • HadIt.com Elder

If you have PN in both legs then the VA should consider the bilateral factor as well.

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  • HadIt.com Elder

Twenty-seven fire ant bits? I had 31 on one foot & my wife had to ask me what were all these red spots. I know how it feels, or maybe how it doesn't feel.

Don

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Twenty-seven fire ant bits? I had 31 on one foot & my wife had to ask me what were all these red spots. I know how it feels, or maybe how it doesn't feel.

Don

OK, you win on count, but these were Alabama fire ants! They had hate in their eyes.

I was a weldor and am said to say I know the smell of Hair, paper, cloth or skin burning. I was on my riding mower, up next to my leyland cypres trees when I knocked the fire off my cig. On a nice day, in my own yard, now why would I smell skin burning!

Did not know until I found the large blister taking a shower. Well, I was taking the shower. B)

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Conecuh,

I am sc DMII and after annual exam last October, filed for PN. My PCP wrote that sensory foot exam was abnormal, and previous C&P exam mentioned mild PN in great toe of both feet. Had a C&P 2/07 . Results were sc for PN rt lower extremity @ 30% and same for lower extremity, all based on the C&P exam. Besides lack of feeling during the exam, I also was not able to feel the tuning fork vibrate when put against my ankle bone.

The rating decision refers to the early diabetic neuropathy bilateral feet that was included with the basic evaluation of DMII but that these conditions had progressed to seperate diability that was compensable.

Ed

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Conecuh,

I am sc DMII and after annual exam last October, filed for PN. My PCP wrote that sensory foot exam was abnormal, and previous C&P exam mentioned mild PN in great toe of both feet. Had a C&P 2/07 . Results were sc for PN rt lower extremity @ 30% and same for lower extremity, all based on the C&P exam. Besides lack of feeling during the exam, I also was not able to feel the tuning fork vibrate when put against my ankle bone.

The rating decision refers to the early diabetic neuropathy bilateral feet that was included with the basic evaluation of DMII but that these conditions had progressed to seperate diability that was compensable.

Ed

Thanks Ed

Remember, I am new.

You are saying the rater kinda gives you a "standard" 20% 10% 10% for DM2 with PN both lower extremity.

But it can be raised to 30% per R or L lower extremity? Or is that 30% for both lower extremities?

I had the needles, Tuning fork, EMG. All bad. I was able to stand on toes & hills. I cant do that as well now. Only been 4 or 5 months.

I think I was under rated. Bet yall never heard that one before! B)

Have a appointment tomorrow. C&P Exam 11th. I have to learn fast!

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Guest terrysturgis

Conecuh, You should also look up the VA's DMII training letter that has posted on this site several times. Contains information as to what the examiner is supposed to be looking for. The first time I saw it was posted by Berta.

I'll make it your assingment today as you know that your learning process will lead to success. Seriously, the more you know about the process the better your chances of getting the big award.

How long did it take you to get SSD. I've been waiting 18 months? Did you use an attorney?

Take care. Terry Sturgis

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  • HadIt.com Elder

They will also ask you to try and point your toes up or down. If you can't tell them if your toes are pointing up or down your PN is worse than 10%. At my VARO unless you have very severe PN you get 10%. It is different everywhere.

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Conecuh, You should also look up the VA's DMII training letter that has posted on this site several times. Contains information as to what the examiner is supposed to be looking for. The first time I saw it was posted by Berta.

I'll make it your assingment today as you know that your learning process will lead to success. Seriously, the more you know about the process the better your chances of getting the big award.

How long did it take you to get SSD. I've been waiting 18 months? Did you use an attorney?

Take care. Terry Sturgis

"How long did it take you to get SSD."

I had a fool as my attorney, me!

I "edumacated" myself on their process. DM2 with PN is one of 10 or 12 listed reasons you can be awarded. Age is considred, 55 is ok, 57 is better. Type of work and length of time doing that type of work. I think 35 years was mentioned, I had 36. Educatuion level is considered. I have none.Grin!

I set about to make this as easy as possable for the SSD rater to find in my favor. In that, I filed on line. The paper work was then already done. (Already in the computer). Next was the collection of medical evidence. When they sent me the forms to file out for them to send to doctors etc., I went to the doctors and got copy of my medical records and sent then in along with the release of information forms they had sent me. They did not have to wait for records to come in from doctors.

I presented that evidence in a well organized understandable way by date. I was well documented as to my statements. The rater did not have to deschiper my information.

I had a possative attitude and gave due respect. When I turned in my application, I joked that I wanted to set the new world record at getting my SS award.

From Application to award letter was 7 weeks.

Medical evidence

Time worked

Age

Attitude

I have to go study. A mind is a terrible thing to ....uh? B)

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They will also ask you to try and point your toes up or down. If you can't tell them if your toes are pointing up or down your PN is worse than 10%. At my VARO unless you have very severe PN you get 10%. It is different everywhere.

John999

My medical records from a specialist indicate; Treatment; Electromyography (EMG).

Diagnosis; Sever Diffuse Sensorimotor Peripheral Neuropathy.

One doctor had me stand on my toes, hills. I can do that, but only for 5 sec. So I guess he put down that I was ok on that.

All my medical records were from outside of the VA at time of rating.

I have heard of them giving 10% without even having an EMG.

I go to the doctor today. What is a good approach to let the doctor know (or tell the doctor) I think I am underrated by VA for my service connected disability? I think this doctor would help me.

Thanks for your reply, it was very helpful.

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Conecuh,

My original rate was 10% DMII controlled by diet, then raised to 20% when meds were added to control.

Then, after C&P exam, each lower extremity was rated seperatly at 30% due to PN.

As was told to me in the past, keep on top of your DMII. It is in your best interest.

Good luck with the C&P.

Ed

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"How long did it take you to get SSD."

I had a fool as my attorney, me!

I "edumacated" myself on their process. DM2 with PN is one of 10 or 12 listed reasons you can be awarded. Age is considred, 55 is ok, 57 is better. Type of work and length of time doing that type of work. I think 35 years was mentioned, I had 36. Educatuion level is considered. I have none.Grin!

I set about to make this as easy as possable for the SSD rater to find in my favor. In that, I filed on line. The paper work was then already done. (Already in the computer). Next was the collection of medical evidence. When they sent me the forms to file out for them to send to doctors etc., I went to the doctors and got copy of my medical records and sent then in along with the release of information forms they had sent me. They did not have to wait for records to come in from doctors.

I presented that evidence in a well organized understandable way by date. I was well documented as to my statements. The rater did not have to deschiper my information.

I had a possative attitude and gave due respect. When I turned in my application, I joked that I wanted to set the new world record at getting my SS award.

From Application to award letter was 7 weeks.

Medical evidence

Time worked

Age

Attitude

I have to go study. A mind is a terrible thing to ....uh? B)

Conechu:

So the SSA will accept the records from the individual applying? I thought that they would only accept directly from Docs or actual agencies. Maybe it depends on where you are from. I will send mine in anyway. I am in South Carolina.

jmack

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In the process, there will be ample opportunity for you to make statements about how your condition affects you. They may ask you for a contact person and ask them for a written statement. There is a lot of paper work.

That's why you need to organize it well. Go get your records from doctors. Organize them by date of event. When that doctor refers you to another doctor, put that in there too. (The referral). Next put the records of doctor referred too in by date etc etc.

I do genealogy. When you put Events down by date, it tells a story. If you don't, they seem unrelated.

Empathy is not one of my attributes. But try to think of this from their side. If you present a good clear case with documented evidence, you have a good chance.

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What percentage is possable for PN of lower extremities? Can you only get 10% per leg, foot.

Does percentage only rely on medical evidence?

Thanks for your help.

Update on Doctors visit.

My blood pressure was high. He had already put me on medication for HBP and explained it was preventative. I do not have a claim filed for HBP. I understand you need to have 3 readings of HBP on records. He upped my HBP medication. Being medicated by VA for HBP and having the dosage increased, would that be sufficient evidence to file for HBP? Would that not also be evidence/ indication of "worsening condition"? Would that then be considered "new material evidence?

About my complaint of them only rating me for one leg with PN. I ask the doctor to look in the computer and they do now have me rated at 10% for both lower extremities. So I have my 40% for one condition. He said the other leg had been added in at a later date. Evidence of worsening condition?

I had emailed the VA explaining the apparent error in not having the other lower extremity included. They did not reply. My compensation has not increased. But it is on my record, a copy of which I acquired. referred to as; Paralysis of Sciatic Nerve 10% - Service Connected

Thanks to this Forum and Vike17 I found this; Sciatic nerve.

8520 Paralysis of:

Complete; the foot dangles and drops, no active movement possible of muscles below the knee,

flexion of knee weakened or (very rarely) lost ..........80%

Incomplete:

Severe, with marked muscular atrophy ...................60%

Moderately severe ..................................................40%

Moderate ..............................................................20%

Mild ......................................................................10%

Well folks, it is not MILD! I can't work because of it. It is either Moderate or Moderately severe . But even if just moderate would give me 60% one condition, 70% total.

I know my Paralysis of Sciatic Nerve is worse than 10%. But how can I prove that with evidence?

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