C&p Exam On Left Foot Sc

[yoggie2]

I hap a C&P on my L-foot I was afraid to add after being screwed by my RO last ones I had that was more likely than not. But this one is also SC broke it in 1990 and again and again then had to have surgery and cast again went on for close to years. I still have many problems with it that has never changed even after 2 C&Ps I never attended the only one that was on record was at my MEB board that stated I still have problems with my foot but my back was my main concern that was 1994NOV.

Edited November 5, 2008 by yoggie2

[yoggie2]

Anyone have an idea here on this?

[rentalguy1]

I still think that they will rate you under code 5284 (Foot Injuries, other). The examiner shut the door on all the other dx codes by stating that it wasn't an exam for them (page 1). On page 2 where he discusses the impacts on your daily life, the majority of them are either severe or prevents. That should tell the rater to rate you at the severe level, which is 30% under this code. Since we all know that many raters could stick their thumb up their rears without written instructions, it wouldn't be shocking to see it come back with a moderately severe rating which is 20%. The nexus should not be a problem as the original injury and treatments show up in your SMR's (I think you told me this). I also think the scar will be rated under code 7803 (Scars, superficial, unstable), which is a 10% rating. Hope this helps some.

[jbasser]

Rich, I think they will apply a 30 percent ratingto the foot and add the 10 percent for the scar.

I also think they rate your back at 60, then the foot at 30 and scar at 10.

[hotcoffee2]

wow. if your foot was broken and subject to several surgeries, it is not surprising that your back is bad. the c and p for the foot is deficient in several areas. there is no range of motion test (yes i see the pain note, but it is necessary to obtain this data to determine rating) ROM is the degree of impairment of dorsiflection, flexion, inversion, eversion. There is no evidence that x-rays have been evaluated. both past and current. do you have arthritis/deformities. pain is not expressed numerically. where is the pain in relation to the foot anatomy? i.e. toes, metatarsals, ankle joints etc. what is the assessment of your gait?

maybe you posted before. sorry i gotta fly out the door at moment.

what injury did you sustain? break of what foot ______? was there a soft tissue injury? what is the name of the surgeries they performed? this should be in diagnostic form in your clinical notes and in the informed consent you signed.

do you need prosthetic shoes? brace?

is your back aggravated by your gait?

just some thoughts...

[rentalguy1]

ROM doesn't matter in this case due to the rating criteria in the dx code. All of the other questions you had are answered in the C&P that he posted in his original post.

[hotcoffee2]

original post? i said i did not go through his priors to see how this interplayed. it is a shitty c & p from a purely medical standpoint. as a neophyte to the VA game, that's were i'm coming from. if it doesn't look right from a medical standpoint then i try to comment on it.

i also tried to hussle up the rating:

10. DC 5284 is a more general diagnostic code under which a variety of foot injuries may be rated. Trauma to the foot may involve the forefoot and toes, the talus and midfoot, and the os calcis and heel cord. See generally 2 Disorders of the Foot 1449-1542 (Melvin H. Jahss ed., 1982). Some of these injuries may affect range of motion. Fractures and dislocations, for example, may limit motion in the subtalar, midtarsal, and metatarsophalangeal joints. See Jesse C. DeLee, Fractures and dislocations of the foot, in 2 Surgery of the Foot 592 (Roger A. Mann ed., 5th ed. 1986). These joints are important to the biomechanics of the foot. See generally Roger A. Mann, Biomechanics of the foot and ankle, in 2 Surgery of the Foot 12-18. Other injuries may not affect range of motion, however. Thus, the nature of the particular injury determines whether limitation of motion is involved under DC 5284.

...if this was a personal post for people who have knowledge of what has gone down thus far, then i would not have commented. not knowing what the guy broke is obviously a drawback in commenting. however repeated breaks>casting>pt et al. effects rom, pain, gait, etc. Mr. yoggie was asking for feedback....and feedback is what i solemnly sp? offered.

ROM doesn't matter in this case due to the rating criteria in the dx code. All of the other questions you had are answered in the C&P that he posted in his original post.