I Need Hadiit Elder Assistance As Usuall.and Anyone Else Kind Enough To Help

[jecsb4]

I have several feet and ankle problems which are SC and I am concerned about a recent rating that I received, I do not understand the new rating…it seems like it is good news but I want to make sure l think it involves the bilateral factor yet they don’t tell me that in their decision.

Here is what my brief history is: I have a 4 year claim (NOD, etc) 0 % then 30% then 80% combined for various things. I had three separate 30% rating and only one which is the topic of this thread which is 30% for bilateral pes planus. I had 6 - 10%’s SC for (things of which 2 – 10% were for bilateral hammertoes post bunion surgery.

Well I was submitting new and material evidence that was not considered in my initial ‘award’ of 30% rating for pes planus and as I mentioned I also had had 10% each foot for hammertoes post bunionectomy.

Just after my decision was decided (which I didn’t know) …even after calling the 1-800 number and seeing my POA and looking at the magic PC my claim was still pending, when I went to get my mail….bingo the decision was there! THE 1-800 nor thr POA knew!!!

Well my rating for pes planus was changed from 30% to 50%!! That is the max for this condition. I guess I should be happy, but what has my concern is the fact that they changed my left hammer toes post bunionectomy 10% and right (Bilateral right?) to ZERO %!! They say it is more appropriately rated as part of the pes planus at ZERO percent!

Strange how can you change a bilateral 10 % left and right 10% TO zero???

I MEAN I GET 30 TO 50 PES PLANUS AND OVERALL 80 TO 90 SO THEY SAY EVEN BY LOOSING THE 2 OF MY 6 10%!!!!! I don't think it would change or increase my rating as I am now at the max....I just don't understand why they gavrs be zeros fro the lfoet and rifht foot hammner toes. It;s like they say its no big deal!!

Should I just move on?

[Ricky]

For them to apply a bilateral rating for hammer toes and a bilateral rating for PES PLANUS would be pyramiding.

The max rating you could have received for bilateral hammertoe would have been 22 percent. The max for bilateral pes planus is 50 percent. Therefore, they did what they were supposed to do and award the disability that would be most advantageous to the veteran which is pes planus at the 50 percent rate.

[carlie]

jecsb4,

Old Ricky ain't clowning around on this one and I agree

with his response post below.

jmho,

carlie

[jecsb4]

Thanks Guy's,

So I guess this is where the bilateral factot comes inot pplany and the 50% gets and extra 10% which then gives me a overall jump from 80% to 87% rounded to 90%?

I don't know why I can't see to accept good new...yes I do, I part of one of my querks I am dealing with.

Thanks so much.

[rentalguy1]

I don't think pes planus and hammertoes would be pyramiding. They are anotomically close, but not the same. They are two completely seperate conditions; one for the musculoskelatal condition of the foot, and one for the musculoskelatal condition of the toes. Since these two anotomical regions have seperate and distinct purposes, they are not the same. I would do some digging on this one...

§4.14 Avoidance of pyramiding.

The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation and the evaluation of the same manifestation under different diagnoses are to be avoided.

If a vet has spinal stenosis at L4-5, and DDD at L4-5, that would be two conditions causing the same disability. I think these would constitute two seperate disabilities, not the same disability.

Pes planus is a condition where the arch or instep of the foot collapses and comes in contact with the ground. If a fusion has to be done to resolve pain, loss of ankle range of motion can occur. Flatfoot can lead to other orthopedic problems in the knees, hips, and back.

Hammertoe is a contracture, or bending of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. Hammertoe can lead to other foot problems.

I would appeal this one.

Edited August 26, 2008 by rentalguy1

[jecsb4]

I don't think pes planus and hammertoes would be pyramiding. They are anotomically close, but not the same. I would do some digging on this one...

RENTALGUY1,

I don't think so either, what got me was they changed my two bilateral hammer toes to 0, then pes planus from 30 to 50 and they did not day in the decision that they addded the 10% value of pes planus to the 50% which would be 55% which givees me 90. Wither way I would get the 90, I just got confused when i saw the 0% and they did't explain the bilateral factor.

[carlie]

You might find in the Rating Decision that they combined the two.

jmho,

carlie